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Soler M, Lu E, Masch R, Alfaro K, Anderson JR, Cremer M. Affordable cancer technologies: Lessons learned from the design and implementation of two randomized clinical trials to develop innovative treatments for cervical precancer. Contemp Clin Trials Commun 2023; 36:101224. [PMID: 38028323 PMCID: PMC10663751 DOI: 10.1016/j.conctc.2023.101224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/24/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Montserrat Soler
- Obstetrics and Gynecology Institute, Cleveland Clinic, Cleveland, OH, USA
- Basic Health International, San Salvador, El Salvador and Pittsburgh, PA, USA
| | | | - Rachel Masch
- Basic Health International, San Salvador, El Salvador and Pittsburgh, PA, USA
| | - Karla Alfaro
- Basic Health International, San Salvador, El Salvador and Pittsburgh, PA, USA
| | - Jean R. Anderson
- Jhpiego, Baltimore, MD, USA
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Miriam Cremer
- Obstetrics and Gynecology Institute, Cleveland Clinic, Cleveland, OH, USA
- Basic Health International, San Salvador, El Salvador and Pittsburgh, PA, USA
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2
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Bendixen T, Lightner AD, Apicella C, Atkinson Q, Bolyanatz A, Cohen E, Handley C, Henrich J, Klocová EK, Lesorogol C, Mathew S, McNamara RA, Moya C, Norenzayan A, Placek C, Soler M, Vardy T, Weigel J, Willard AK, Xygalatas D, Lang M, Purzycki BG. Gods are watching and so what? Moralistic supernatural punishment across 15 cultures. Evol Hum Sci 2023; 5:e18. [PMID: 37587943 PMCID: PMC10426076 DOI: 10.1017/ehs.2023.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/28/2023] [Accepted: 05/01/2023] [Indexed: 08/18/2023] Open
Abstract
Psychological and cultural evolutionary accounts of human sociality propose that beliefs in punitive and monitoring gods that care about moral norms facilitate cooperation. While there is some evidence to suggest that belief in supernatural punishment and monitoring generally induce cooperative behaviour, the effect of a deity's explicitly postulated moral concerns on cooperation remains unclear. Here, we report a pre-registered set of analyses to assess whether perceiving a locally relevant deity as moralistic predicts cooperative play in two permutations of two economic games using data from up to 15 diverse field sites. Across games, results suggest that gods' moral concerns do not play a direct, cross-culturally reliable role in motivating cooperative behaviour. The study contributes substantially to the current literature by testing a central hypothesis in the evolutionary and cognitive science of religion with a large and culturally diverse dataset using behavioural and ethnographically rich methods.
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Affiliation(s)
| | | | - Coren Apicella
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Quentin Atkinson
- Department of Psychology, University of Auckland, Auckland, New Zealand
- Max Planck Institute for the Science of Human History, Jena, Germany
| | | | - Emma Cohen
- Wadham College, University of Oxford, Oxford, UK
| | | | - Joseph Henrich
- Department of Human Evolutionary Biology, Harvard University, Cambridge, Massachusetts, USA
| | | | | | | | - Rita A. McNamara
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
| | - Cristina Moya
- Department of Anthropology, University of California Davis, Davis, California, USA
| | - Ara Norenzayan
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Caitlyn Placek
- Department of Anthropology, Ball State University, Muncie, Indiana, USA
| | - Montserrat Soler
- Ob/Gyn and Women's Health Institute Cleveland Clinic, Cleveland, Ohio, USA
| | - Tom Vardy
- Department of International Development, London School of Economics, London, UK
| | - Jonathan Weigel
- Haas School of Business, University of California Berkeley, Berkeley, California, USA
| | | | - Dimitris Xygalatas
- Department of Anthropology, University of Connecticut, Storrs, Connecticut, USA
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Martin Lang
- LEVYNA, Masaryk University, Brno, Czech Republic
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3
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Garcia JR, Compte A, Bassa P, Soler M, Buxeda M, Riera E. Testicular metastasis of prostate origin diagnosed by PET/MR with 18F-Choline. Rev Esp Med Nucl Imagen Mol 2023; 42:51-52. [PMID: 35637149 DOI: 10.1016/j.remnie.2022.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/25/2021] [Accepted: 06/27/2021] [Indexed: 02/01/2023]
Affiliation(s)
- J R Garcia
- CETIR VIladomat, ASCIRES grupo biomédico, Barcelona, Spain.
| | - A Compte
- CETIR VIladomat, ASCIRES grupo biomédico, Barcelona, Spain
| | - P Bassa
- CETIR VIladomat, ASCIRES grupo biomédico, Barcelona, Spain
| | - M Soler
- CETIR VIladomat, ASCIRES grupo biomédico, Barcelona, Spain
| | - M Buxeda
- CETIR VIladomat, ASCIRES grupo biomédico, Barcelona, Spain
| | - E Riera
- CETIR VIladomat, ASCIRES grupo biomédico, Barcelona, Spain
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4
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Soler M, Alfaro K, Masch RJ, Conzuelo Rodriguez G, Qu X, Wu S, Sun J, Hernández Jovel DM, Bonilla J, Puentes LO, Murillo R, Alonzo TA, Felix JC, Castle P, Cremer M. Safety and Acceptability of Three Ablation Treatments for High-Grade Cervical Precancer: Early Data From a Randomized Noninferiority Clinical Trial. JCO Glob Oncol 2022; 8:e2200112. [PMID: 36525620 PMCID: PMC10166394 DOI: 10.1200/go.22.00112] [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: 12/23/2022] Open
Abstract
PURPOSE This ongoing trial is comparing the efficacy and safety of three ablation treatments for cervical intraepithelial neoplasia grade 2 or higher. Here, we present early data regarding pain, side effects, and acceptability of CO2 gas-based cryotherapy (CO2), nongas cryotherapy, and thermal ablation (TA). Efficacy results are expected to become available in late 2023. MATERIALS AND METHODS This noninferiority randomized trial is taking place in El Salvador, China, and Colombia. Patients are 1,152 eligible women with biopsy-confirmed cervical intraepithelial neoplasia grade 2 or higher who will receive one of three ablation treatments. Pain is measured before, during, and after treatment with a visual analog scale (1-10). Side effects and acceptability are assessed at 6 weeks. RESULTS To date, 1,024 of 1,152 (89%) women were randomly assigned to treatment. The median pain level was higher during TA (4, IQR = 4) than CO2 (2, IQR = 4) or nongas cryotherapy (2, IQR = 4) (P < .01, range: 0-10). The most common post-treatment symptom was watery discharge, reported by 97.9% of women, and it lasted longer in the CO2 group than the other two treatments (in days, median [IQR]: CO2 = 20[20], nongas cryotherapy = 15[10], TA = 18[15], P < .01). Bleeding was reported more frequently in women treated with TA (27.6%) than CO2 (17.5) or nongas cryotherapy (18.7%) (P < .01). The majority of patients reported being very satisfied with the treatment they received at 6 weeks (91%) and again at 12 months post-treatment (97%). CONCLUSION Despite differences in pain and side effects across ablation treatments, all were safe and highly acceptable to patients. In addition to efficacy, considerations such as cost and portability may be more significant in choosing a treatment method.
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Affiliation(s)
- Montserrat Soler
- Ob/Gyn and Women's Health Institute, Cleveland Clinic, Cleveland, OH.,Basic Health International, Pittsburgh, PA; San Salvador, El Salvador
| | - Karla Alfaro
- Basic Health International, Pittsburgh, PA; San Salvador, El Salvador
| | - Rachel J Masch
- Basic Health International, Pittsburgh, PA; San Salvador, El Salvador
| | | | - Xinfeng Qu
- Basic Health International, Pittsburgh, PA; San Salvador, El Salvador
| | - Suhui Wu
- Department of Obstetrics and Gynecology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Jingfen Sun
- Department of Obstetrics and Gynecology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
| | | | - Jairo Bonilla
- Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Luis Orlando Puentes
- Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Raúl Murillo
- Centro Javeriano de Oncología, Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Todd A Alonzo
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Juan C Felix
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI
| | - Philip Castle
- Divisions of Cancer Prevention and Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Miriam Cremer
- Ob/Gyn and Women's Health Institute, Cleveland Clinic, Cleveland, OH.,Basic Health International, Pittsburgh, PA; San Salvador, El Salvador
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5
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Adsul P, Chambers D, Brandt HM, Fernandez ME, Ramanadhan S, Torres E, Leeman J, Baquero B, Fleischer L, Escoffery C, Emmons K, Soler M, Oh A, Korn AR, Wheeler S, Shelton RC. Grounding implementation science in health equity for cancer prevention and control. Implement Sci Commun 2022; 3:56. [PMID: 35659151 PMCID: PMC9164317 DOI: 10.1186/s43058-022-00311-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 05/20/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The past decade of research has seen theoretical and methodological advances in both implementation science and health equity research, opening a window of opportunity for facilitating and accelerating cross-disciplinary exchanges across these fields that have largely operated in siloes. In 2019 and 2020, the National Cancer Institute's Consortium for Cancer Implementation Science convened an action group focused on 'health equity and context' to identify opportunities to advance implementation science. In this paper, we present a narrative review and synthesis of the relevant literature at the intersection of health equity and implementation science, highlight identified opportunities (i.e., public goods) by the action group for advancing implementation science in cancer prevention and control, and integrate the two by providing key recommendations for future directions. DISCUSSION In the review and synthesis of the literature, we highlight recent advances in implementation science, relevant to promoting health equity (e.g., theories/models/frameworks, adaptations, implementation strategies, study designs, implementation determinants, and outcomes). We acknowledge the contributions from the broader field of health equity research and discuss opportunities for integration and synergy with implementation science, which include (1) articulating an explicit focus on health equity for conducting and reviewing implementation science; (2) promoting an explicit focus on health equity in the theories, models, and frameworks guiding implementation science; and (3) identifying methods for understanding and documenting influences on the context of implementation that incorporate a focus on equity. To advance the science of implementation with a focus on health equity, we reflect on the essential groundwork needed to promote bi-directional learning between the fields of implementation science and health equity research and recommend (1) building capacity among researchers and research institutions for health equity-focused and community-engaged implementation science; (2) incorporating health equity considerations across all key implementation focus areas (e.g., adaptations, implementation strategies, study design, determinants, and outcomes); and (3) continuing a focus on transdisciplinary opportunities in health equity research and implementation science. We believe that these recommendations can help advance implementation science by incorporating an explicit focus on health equity in the context of cancer prevention and control and beyond.
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Affiliation(s)
- Prajakta Adsul
- Internal Medicine, School of Medicine, University of New Mexico, Albuquerque, NM USA
| | - David Chambers
- Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD USA
| | - Heather M. Brandt
- HPV Cancer Prevention Program, St. Jude Children’s Research Hospital, Memphis, TN USA
| | - Maria E. Fernandez
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, USA
| | | | - Essie Torres
- East Carolina University, 2309 Carol Belk Bldg, Greenville, NC 27858 USA
| | | | - Barbara Baquero
- University of Washington, 3980 15th Ave. NE, Seattle, WA 98195 USA
| | | | - Cam Escoffery
- Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322 USA
| | - Karen Emmons
- Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115 USA
| | - Montserrat Soler
- Ob/Gyn and Women’s Health Institute, Cleveland Clinic, Cleveland, OH USA
| | - April Oh
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, USA
| | - Ariella R. Korn
- Cancer Prevention Fellowship Program, Implementation Science, Office of the Director, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, USA
| | - Stephanie Wheeler
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, CB #7411, Chapel Hill, NC 27599 USA
| | - Rachel C. Shelton
- Department of Sociomedical Sciences, Columbia University, Mailman School of Public Health, 722 W 168th Street, New York, NY 10032 USA
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6
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Vacher C, Romo L, Dereure M, Soler M, Picot MC, Purper-Ouakil D. Efficacy of cognitive behavioral therapy on aggressive behavior in children with attention deficit hyperactivity disorder and emotion dysregulation: study protocol of a randomized controlled trial. Trials 2022; 23:124. [PMID: 35130934 PMCID: PMC8819925 DOI: 10.1186/s13063-022-05996-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is frequently associated with emotional dysregulation (ED). ED is characterized by excessive and inappropriate emotional reactions compared to social norms, uncontrolled and rapid shifts in emotion, and attention focused on emotional stimuli. Few studies have evaluated non-pharmacological interventions to improve ED in children with ADHD. The current randomized controlled trial assesses the efficacy of a cognitive behavioral therapy (CBT) intervention compared with a theater-based intervention (TBI) in children with ADHD and ED. METHODS Sixty-eight 7- to 13-year-old children with ADHD and ED will be recruited and randomly assigned to the CBT or TBI group. CBT aims to reduce ED by teaching anger management strategies. TBI seeks to reduce ED by improving emotion understanding and expression through mimics and movement. In both groups, children participate in 15 1-h sessions, and parents participate in 8 sessions of a parent management program. The primary outcome measure is the change in the "Aggression" sub-score of the Child Behavior Checklist (CBCL). Secondary outcome measures include overall impairment (Children's Global Assessment Scale, Strengths and Difficulties Questionnaire), personality profile (Hierarchical Personality Inventory for Children), executive function (Behavioral Rating Inventory of Executive Function), quality of life (Kidscreen-27), parental stress (Parenting Stress Index, 4th edition), parental depression (Beck Depression Inventory-II), and impact of child disorders on the quality of the family life (Parental Quality of Life and Developmental Disorder). DISCUSSION Children with ADHD and ED are at risk of functional impairment and poor outcomes and have specific therapeutic needs. This randomized controlled trial wants to assess non-pharmacological treatment options for this population. TRIAL REGISTRATION Clinicaltrials.gov. NCT03176108 . Registered on June 5, 2017.
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Affiliation(s)
- C Vacher
- Centre Hospitalo-Universitaire de Montpellier, Service Médecine Psychologique de l'Enfant et de l'Adolescent, Montpellier, Hérault, France. .,CLIPSYD EA-4430, UFR Sciences Psychologiques et Sciences de l'Education, Université de Nanterre, Nanterre, Hauts de Seine, France. .,INSERM U 1018, CESP, Psychiatrie du développement - Evaluer et traiter les troubles émotionnels et du neurodéveloppement (ETE-ND), Montpellier, France.
| | - L Romo
- CLIPSYD EA-4430, UFR Sciences Psychologiques et Sciences de l'Education, Université de Nanterre, Nanterre, Hauts de Seine, France.,Service de Pathologies professionnelles et de l'environnement, Assistance Publique des Hôpitaux de Paris, Hôpital Universitaire Raymond Poincaré, Garches, France
| | - M Dereure
- Unité de Recherche Clinique et Epidémiologie, Département de l'Information Médicale, Centre Hospitalo-Universitaire de Montpellier, Montpellier, Hérault, France
| | - M Soler
- Unité de Recherche Clinique et Epidémiologie, Département de l'Information Médicale, Centre Hospitalo-Universitaire de Montpellier, Montpellier, Hérault, France
| | - M C Picot
- Unité de Recherche Clinique et Epidémiologie, Département de l'Information Médicale, Centre Hospitalo-Universitaire de Montpellier, Montpellier, Hérault, France.,Centre d'Investigation Clinique, Hôpital Saint Eloi, Centre Hospitalo-Universitaire de Montpellier, Montpellier, Hérault, France
| | - D Purper-Ouakil
- Centre Hospitalo-Universitaire de Montpellier, Service Médecine Psychologique de l'Enfant et de l'Adolescent, Montpellier, Hérault, France.,INSERM U 1018, CESP, Psychiatrie du développement - Evaluer et traiter les troubles émotionnels et du neurodéveloppement (ETE-ND), Montpellier, France
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7
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Soler M, Masch R, Saidu R, Cremer M. Thermal Ablation Treatment for Cervical Precancer (Cervical Intraepithelial Neoplasia Grade 2 or Higher [CIN2+]). Methods Mol Biol 2022; 2394:867-882. [PMID: 35094363 DOI: 10.1007/978-1-0716-1811-0_46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Cervical cancer is a leading cause of mortality for women in low- and middle-income countries (LMICs). Invasive disease can be prevented through the treatment of high-grade cervical precancer lesions. Types of treatment for cervical precancer include excisional procedures that surgically remove the affected tissue and ablation treatments which utilize extreme temperatures to destroy precancerous cells. Excision is the first-line treatment in higher income countries, but requires specialized training and equipment that make it unsuitable for low-income settings. The most common treatment globally is cryotherapy, which utilizes cryogenic gas to freeze the area. However, the need for gas presents significant procurement and logistical challenges. The World Health Organization (WHO) has recently endorsed the use of thermal ablation, a method that utilizes heat to destroy precancerous tissue. This review describes three existing thermal ablation devices and protocols for their use, including step-by-step instruction guides to perform a successful treatment with each device and observations specific to each machine.
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Affiliation(s)
- Montserrat Soler
- Ob/Gyn and Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA.
- Basic Health International, Pittsburgh, PA, USA.
| | | | - Rakiya Saidu
- Department of Obstetrics and Gynaecology, University of Cape Town, Cape Town, South Africa
| | - Miriam Cremer
- Ob/Gyn and Women's Health Institute, Cleveland Clinic, Cleveland, OH, USA
- Basic Health International, Pittsburgh, PA, USA
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8
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Marcos Garces V, Gabaldon-Perez A, Merenciano-Gonzalez H, Soler M, Lorenzo-Hernandez M, Nunez-Marin G, Bonanad C, De La Espriella R, Chorro FJ, Bodi V, Santas E. Clinical applicability of echocardiographic strict negative criteria for suspected infective endocarditis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Infective endocarditis (IE) is an uncommon but potentially lethal disease that requires a timely diagnosis. Echocardiography has a pivotal role in EI diagnosis, but this may lead to an overuse of this technology in clinical daily practice, and it is unclear which patients can benefit from a follow-up study if the initial transthoracic echocardiogram (TTE) shows no signs of IE. The strict negative criteria (good ultrasound quality and no high-risk features such as significant valvular regurgitations or stenosis, pericardial effusion or intracardiac devices) have been recently proposed to avoid unnecessary follow-up echocardiograms.
Purpose
The objective of this study is to review the contemporary, real-world use of echocardiography in patients with suspected IE and analyze the potential applicability of the strict negative criteria.
Methods
We retrieved all the echocardiograms that were performed in our center for suspected or confirmed IE between January 2014 and December 2018. We defined different groups according to the strict negative criteria and reviewed the electronic clinical history to check if a definitive diagnosis of IE was established or not.
Results
We included a total of 905 TTEs. 451 (49.8%) of them fulfilled the strict negativity criteria (Group 1). In this group, IE was seldom diagnosed (n=4, 0.9%). In 338 (37.4%) patients no signs of IE were evident but they didn't fulfill the strict negative criteria (Group 2). A follow-up echocardiogram and definitive diagnosis of IE were more frequent (n=48, 14.2% and n=20, 5.9%). Finally, in 116 (12.8%) patients the initial TEE showed typical or suggestive signs of IE, in whom the diagnosis was confirmed in 48 (41.4%). The independent predictors of follow-up echocardiography were the previous history of valvular heart disease (HR 2.38 [1.39–3.89], p=0.001) or cancer (HR 0.47 [0.27–0.84], p=0.01), positive blood cultures for Enterococcus (HR 5.01 [2.34–10.73], p<0.001), methicillin-sensitive Staphylococcus aureus (HR 2.8 [1.27–6.17], p=0.011) or Streptococcus (HR 2.36 [1.12–5], p=0.024), and the presence of typical or suggestive signs of infective endocarditis on initial TTE (HR 13.77 [8.6–22.05], p<0.001). A definitive diagnosis of IE was confirmed in a minority of the study population (n=72, 8%). Only one readmission for underdiagnosis of IE during index hospitalization was noted on Group 2.
Conclusions
In a real-life, observational setting only a minority of patients in whom IE was suspected had a definite diagnosis. An initial TTE for suspected IE fulfilling the strict negative criteria predicts both a low probability of requesting a follow-up study and of a definitive diagnosis of IE. Further research should be performed to rationalize echocardiogram requests for suspected IE.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- V Marcos Garces
- University Hospital Clinic of Valencia, Department of Cardiology, Valencia, Spain
| | - A Gabaldon-Perez
- University Hospital Clinic of Valencia, Department of Cardiology, Valencia, Spain
| | | | - M Soler
- University Hospital Clinic of Valencia, Department of Cardiology, Valencia, Spain
| | - M Lorenzo-Hernandez
- University Hospital Clinic of Valencia, Department of Cardiology, Valencia, Spain
| | - G Nunez-Marin
- University Hospital Clinic of Valencia, Department of Cardiology, Valencia, Spain
| | - C Bonanad
- University Hospital Clinic of Valencia, Department of Cardiology, Valencia, Spain
| | - R De La Espriella
- University Hospital Clinic of Valencia, Department of Cardiology, Valencia, Spain
| | - F J Chorro
- University Hospital Clinic of Valencia, Department of Cardiology, Valencia, Spain
| | - V Bodi
- University Hospital Clinic of Valencia, Department of Cardiology, Valencia, Spain
| | - E Santas
- University Hospital Clinic of Valencia, Department of Cardiology, Valencia, Spain
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9
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Santas Olmeda E, Palau P, De La Espriella R, Minana G, Soler M, Lorenzo M, Nunez G, Chorro FJ, Nunez J. Sex-related differences in mortality following an admission for acute heart failure across left ventricular ejection fraction spectrum. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Prognosis in heart failure (HF) may differ between women and men. However, data is conflicting and sex-related differences in prognosis may be determined by left ventricular ejection fraction (LVEF) status. We sought to evaluate the prognostic differences between women and men with HF following an admission for acute HF (AHF).
Methods
We included 4,812 patients consecutively admitted for AHF in a multicenter registry from 3 hospitals in Valencia (Spain). Study endpoints were all-cause, cardiovascular (CV), and HF-related mortality at 6-months follow-up. Multivariable Cox regression models were fitted to investigate sex-related differences across LVEF status.
Results
2,243 (46.6%) patients were women and 2,569 (53.4%) were men. 2,608 (54.2%) patients had HF with preserved ejection fraction. At 6-months follow-up, 645 patients died (13.4%), being 544 (11.3%) and 416 (8.6%) CV and HF-related deaths, respectively. LVEF was not independently associated to mortality risk (HR=1.02; 95% CI 0.99–1.05; p=0.135). After multivariate adjustment, we found no sex-related differences in all-cause mortality (p-value for interaction=0.168). However, a significant interaction between sex and the risk of CV and HF mortality was found across LVEF status (p-value for interaction= 0.030 and 0.007; respectively). Compared to men, women had a significant lower risk of CV-mortality and HF-mortality at LVEF<25% and <42%, respectively. On the contrary, women showed a higher risk of HF-mortality at the upper extreme of LVEF (>75%) (Figure, panel A and B).
Conclusions
Following an admission for AHF, no sex-related differences were found in the risk of all-cause mortality. However, compared to men, women showed a lower risk of CV and HF-mortality at the lower extreme of LVEF. On the contrary, they showed a higher risk of HF-death at the upper extreme.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- E Santas Olmeda
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - P Palau
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - R De La Espriella
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - G Minana
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - M Soler
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - M Lorenzo
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - G Nunez
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - F J Chorro
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - J Nunez
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
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10
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Abstract
Cervical cancer is a disease of inequality. The majority of cervical cancer cases can be prevented through vaccination against the human papillomavirus (HPV) (primary prevention) and screening and early treatment of precancerous lesions caused by HPV infections (secondary prevention), and it can be controlled if treated in early stages (tertiary prevention). However, significant gaps in access to care have shifted the burden of disease to resource-poor countries in Africa, Asia and Latin America. The recent World Health Organization’s Call to Action to eliminate cervical cancer is a unique opportunity to galvanize change and remove barriers to prevention and care.
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Affiliation(s)
- Karla Alfaro
- Basic Health International, San Salvador, El Salvador.
| | - Mauricio Maza
- Basic Health International, San Salvador, El Salvador
| | - Miriam Cremer
- Basic Health International, Pittsburgh, PA, USA
- Ob/Gyn and Women's Health Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
| | | | - Montserrat Soler
- Basic Health International, Pittsburgh, PA, USA
- Ob/Gyn and Women's Health Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
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11
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Garcia JR, Compte A, Bassa P, Soler M, Buxeda M, Riera E. Testicular metastasis of prostate origin diagnosed by PET/MR with 18F-Choline. Rev Esp Med Nucl Imagen Mol 2021; 42:S2253-654X(21)00143-8. [PMID: 34446385 DOI: 10.1016/j.remn.2021.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/25/2021] [Accepted: 06/27/2021] [Indexed: 11/24/2022]
Affiliation(s)
- J R Garcia
- CETIR VIladomat, ASCIRES grupo biomédico, Barcelona, España.
| | - A Compte
- CETIR VIladomat, ASCIRES grupo biomédico, Barcelona, España
| | - P Bassa
- CETIR VIladomat, ASCIRES grupo biomédico, Barcelona, España
| | - M Soler
- CETIR VIladomat, ASCIRES grupo biomédico, Barcelona, España
| | - M Buxeda
- CETIR VIladomat, ASCIRES grupo biomédico, Barcelona, España
| | - E Riera
- CETIR VIladomat, ASCIRES grupo biomédico, Barcelona, España
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12
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Alfaro K, Maza M, Felix JC, Gage JC, Castle PE, Alonzo TA, Chacón A, González E, Soler M, Conzuelo-Rodriguez G, Masch R, Cremer M. Outcomes for Step-Wise Implementation of a Human Papillomavirus Testing-Based Cervical Screen-and-Treat Program in El Salvador. JCO Glob Oncol 2021; 6:1519-1530. [PMID: 33064628 PMCID: PMC7605377 DOI: 10.1200/go.20.00206] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
PURPOSE The Cervical Cancer Prevention in El Salvador (CAPE) project is a public-sector intervention introducing lower-cost human papillomavirus (HPV) testing in all four departments of the Paracentral region that screened a total of 28,015 women. After demonstrating success of an HPV screen-and-treat (S&T) algorithm over colposcopy management in the first two phases, the third phase scaled up the S&T strategy. We present results from phase III and evaluate S&T components across the entire project. METHODS During phase III, 17,965 women age 30-59 years underwent HPV testing. HPV-positive women were asked to return and, if eligible, received gas-based cryotherapy. We compare loss to follow-up and time intervals between S&T steps across the three phases. RESULTS There were no differences in HPV positivity across phases (phase I, 11.9%; phase II, 11.4%; phase III, 12.3%; P = .173). Although most HPV-positive women completed indicated follow-up procedures within 6 months in phases I (93.3%, 111 of 119) and II (92.3%, 429 of 465), this proportion declined to 74.9% (1,659 of 2,214; P < .001) in phase III. Mean days between testing and delivery of results to patients increased over program phases (phase I, 23.2 days; phase II, 46.7 days; phase III, 99.8 days; P < .001). CONCLUSION A public-sector implementation of an HPV-based S&T algorithm was successfully scaled up in El Salvador, albeit with losses in efficiency. After CAPE, the Ministry of Health changed its screening guidelines and procured additional tests to expand the program.
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Affiliation(s)
- Karla Alfaro
- Basic Health International, San Salvador, El Salvador and New York, NY
| | - Mauricio Maza
- Basic Health International, San Salvador, El Salvador and New York, NY
| | - Juan C Felix
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI
| | - Julia C Gage
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD
| | - Philip E Castle
- Division of Cancer Prevention and Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH/DHHS, Rockville, MD
| | - Todd A Alonzo
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Andrea Chacón
- Unidad de Cáncer, Ministerio de Salud República de El Salvador, San Salvador, El Salvador
| | - Enrique González
- Unidad de Cáncer, Ministerio de Salud República de El Salvador, San Salvador, El Salvador
| | - Montserrat Soler
- Ob/Gyn & Women's Health Institute, Cleveland Clinic, Cleveland, OH
| | | | - Rachel Masch
- Basic Health International, San Salvador, El Salvador and New York, NY
| | - Miriam Cremer
- Basic Health International, San Salvador, El Salvador and New York, NY.,Ob/Gyn & Women's Health Institute, Cleveland Clinic, Cleveland, OH
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13
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Piñeiro-Juncal N, Díaz-Almela E, Leiva-Dueñas C, Deulofeu O, Frigola J, Soler M, Martinez-Cortizas A, Giralt S, Garcia-Orellana J, Mateo MÁ. Processes driving seagrass soils composition along the western Mediterranean: The case of the southeast Iberian Peninsula. Sci Total Environ 2021; 768:144352. [PMID: 33454472 DOI: 10.1016/j.scitotenv.2020.144352] [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: 06/17/2020] [Revised: 11/05/2020] [Accepted: 12/02/2020] [Indexed: 06/12/2023]
Abstract
Seagrasses are distributed all along the coast of the Mediterranean Sea being Posidonia oceanica and Cymodocea nodosa the most common species. They promote sedimentation, leading to the formation of well-structured soils. Over the last decade, a growing attention has been paid to their role as CO2 sinks in the form of organic carbon (Corg) and to their use as environmental archives. However, most of the knowledge about pedogenetic processes in these soils refer to the rhizosphere. This study aims to understand seagrass soils biogeochemistry in the rhizosphere and below, which in turn can help to understand their long term formation processes. Fifteen cores were strategically sampled along a 350 km stretch of the Southeast Iberian coast, and analyzed for elemental composition (XRF core-scanning), magnetic susceptibility, Corg content and gran size distribution. The cores were dated by 210Pb and 14C-AMS techniques to estimate soil accretion. Principal component analysis was used to explore the main geochemical processes linked to soil formation. The results showed that terrestrial runoff plays a key role in meadow soil composition. Furthermore, Corg accumulation did not follow any general depth trend in our soil records, suggesting that temporal variation in Corg inputs is an important factor in determining carbon depth distribution within the soil. We obtained evidence that the establishment of well-developed, stable C. nodosa meadows in the Mediterranean Sea may be promoted by adverse environmental conditions to P. oceanica settlement. Metal's behavior within the meadow deposit and their interaction with organic matter and carbonates is unclear. The results presented in this paper highlight the importance of the influence of land-based inputs in the characteristics of seagrass meadow deposits, highly determining their Corg content, as well as the need for further studies on metal behavior, to understand their full potential as environmental records.
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Affiliation(s)
- Nerea Piñeiro-Juncal
- EcoPast (GI-1553), Facultade de Bioloxía, Universidade de Santiago de Compostela, Campus Sur s/n, Santiago de Compostela 15782, Spain; Group of Aquatic Macrophytes Ecology, Centre d'Estudis Avançats de Blanes (CEAB-CSIC), 17300 Blanes, Girona, Spain.
| | - Elena Díaz-Almela
- Group of Aquatic Macrophytes Ecology, Centre d'Estudis Avançats de Blanes (CEAB-CSIC), 17300 Blanes, Girona, Spain
| | - Carmen Leiva-Dueñas
- Group of Aquatic Macrophytes Ecology, Centre d'Estudis Avançats de Blanes (CEAB-CSIC), 17300 Blanes, Girona, Spain
| | - Ona Deulofeu
- Group of Aquatic Macrophytes Ecology, Centre d'Estudis Avançats de Blanes (CEAB-CSIC), 17300 Blanes, Girona, Spain
| | - Jaime Frigola
- GRC Geociències Marines, Departament de Dinàmica de la Terra i de l'Oceà, Facultat de Ciències de la Terra, Universitat de Barcelona, Carrer Martí i Franquès s/n, 08028 Barcelona, Spain
| | - Montserrat Soler
- Group of Aquatic Macrophytes Ecology, Centre d'Estudis Avançats de Blanes (CEAB-CSIC), 17300 Blanes, Girona, Spain
| | - Antonio Martinez-Cortizas
- EcoPast (GI-1553), Facultade de Bioloxía, Universidade de Santiago de Compostela, Campus Sur s/n, Santiago de Compostela 15782, Spain
| | - Santiago Giralt
- Geosciences Barcelona (Geo3BCN-CSIC), Lluís Solé i Sabarís s/n, 08028 Barcelona, Spain
| | - Jordi Garcia-Orellana
- Institut de Ciència i Tecnologia Ambientals, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Barcelona, Spain; Departament de Física, Universitat Autònoma de Barcelona, 08193 Cerdanyola del Vallès, Barcelona, Spain
| | - Miguel Ángel Mateo
- Group of Aquatic Macrophytes Ecology, Centre d'Estudis Avançats de Blanes (CEAB-CSIC), 17300 Blanes, Girona, Spain; Centre for Marine Ecosystems Research, Edith Cowan University, Joondalup, WA, Australia
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14
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Garcia J, Compte A, Galan C, Cozar M, Buxeda M, Mourelo S, Piñeiro T, Soler M, Valls E, Bassa P, Santabarbara J. 18F-choline PET/MR in the initial staging of prostate cancer. Impact on the therapeutic approach. Rev Esp Med Nucl Imagen Mol 2021. [DOI: 10.1016/j.remnie.2020.10.010] [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: 12/27/2022]
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15
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Gabaldon-Perez A, Marcos-Garces V, Santas E, Lorenzo-Hernandez M, Soler M, Nunez-Marin G, Merenciano-Gonzalez H, Bonanad C, Bodi V, Chorro F. Echocardiographic strict negative criteria for suspected infective endocarditis. Can we avoid unnecessary echocardiograms? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Infective endocarditis (IE) is an uncommon but potentially lethal disease that require a timely diagnosis. Transthoracic echocardiography (TTE) has a pivotal role in diagnosis and follow-up and should be requested if there is a clinical suspicion of IE. However, it is unclear which patients can benefit from a follow-up echocardiogram if the initial TTE shows no signs of IE. The strict negative criteria (SNC) have been recently proposed to avoid unnecessary follow-up echocardiograms.
Purpose
The objective of this study is to review the contemporary, real-world use of echocardiography in patients with suspected IE and analyze the possible effect that incorporating the SNC would have in our clinical practice.
Methods
We searched the echocardiography database for the words “endoc” and “veget” to find the tests that were performed for suspected or confirmed IE between January 2014 and December 2018. We extracted and manually reviewed all the echocardiographic data and applied the SNC to patients with an initial negative TTE. We reviewed the electronic clinical history to check if a final diagnosis of IE was established or not.
Results
We included a total of 957 echocardiograms in our registry. 493 (51.5%) did not meet the SNC. The main reasons for exclusion were the occurrence of more than mild valvular regurgitation (n=293, 30.6%), the presence of typical or suggestive signs of IE (n=128, 13.3%), the evidence of more than mild valvular stenosis or sclerosis (n=105, 10.9%) and a suboptimal ultrasound quality (n=90, 9.4%). Globally, a follow-up echocardiogram was performed in 143 (14.9%) patients. Only in 25 (5.4%) of patients which fulfilled the SNC a follow-up echocardiogram was requested, compared to 60 (16%) patients which neither fulfilled the SNC nor showed echocardiographic signs of IE and 68 (53.5%) patients in which the SNC weren't met but showed echocardiographic signs of IE (p<0.001). After performing a binary logistic regression model, the only independent predictor of follow-up echocardiography in patients who didn't met the SNC was the presence of typical or suggestive signs of infective endocarditis on initial TTE (HR 2.84 [2.17–3.71], p<0.001).
Conclusions
1. In a real-life, observational setting an initial TTE for suspected IE that fulfilled the defined SNC predicts a low probability of requesting a follow-up echocardiography (5.4%), even though these criteria were neither reported by the echocardiographist nor probably known by the clinician in charge of the patient.
2. The number of echocardiograms avoided by applying these criteria in this context is low.
3. A follow-up echocardiogram was requested more frequently if the SNC weren't met, especially when typical or suggestive signs of IE were described in the initial TTE (53.5% vs 16%). This factor seems to be the only independent echocardiographic variable that predicts the probability of requesting a follow-up echocardiogram in this subgroup of patients.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Gabaldon-Perez
- University Hospital Clinic of Valencia, Cardiology Department, Valencia, Spain
| | - V Marcos-Garces
- University Hospital Clinic of Valencia, Cardiology Department, Valencia, Spain
| | - E Santas
- University Hospital Clinic of Valencia, Cardiology Department, Valencia, Spain
| | - M Lorenzo-Hernandez
- University Hospital Clinic of Valencia, Cardiology Department, Valencia, Spain
| | - M Soler
- University Hospital Clinic of Valencia, Cardiology Department, Valencia, Spain
| | - G Nunez-Marin
- University Hospital Clinic of Valencia, Cardiology Department, Valencia, Spain
| | | | - C Bonanad
- University Hospital Clinic of Valencia, Cardiology Department, Valencia, Spain
| | - V Bodi
- University Hospital Clinic of Valencia, Cardiology Department, Valencia, Spain
| | - F.J Chorro
- University Hospital Clinic of Valencia, Cardiology Department, Valencia, Spain
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16
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Ortiz S, García J, Riera E, Soler M, Compte Montañez A, Valls E. Diagnostic value of 68Ga-DOTATOC PET in the localization of primary tumor in patients with liver metastases of neuroendocrine origin but unknown primary. About a case. Rev Esp Med Nucl Imagen Mol 2020. [DOI: 10.1016/j.remnie.2020.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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17
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Garcia J, Cozar M, Soler M, Bassa P, Riera E, Buxeda M, Valls E, Ferrer J. Standardization of acquisition protocols using PET/CT with 18F-Choline in prostate cancer. Rev Esp Med Nucl Imagen Mol 2020. [DOI: 10.1016/j.remnie.2020.03.008] [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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18
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Maza M, Meléndez M, Herrera A, Hernández X, Rodríguez B, Soler M, Alfaro K, Masch R, Conzuelo-Rodríguez G, Obedin-Maliver J, Cremer M. Cervical Cancer Screening with Human Papillomavirus Self-Sampling Among Transgender Men in El Salvador. LGBT Health 2020; 7:174-181. [PMID: 32407149 DOI: 10.1089/lgbt.2019.0202] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Purpose: Sexual and gender minority persons in low-income countries have very limited access to routine health services. This study evaluated the feasibility of using a self-sampled human papillomavirus (HPV) test to increase access to screening for cervical cancer among transgender men in El Salvador. Methods: We partnered with a local advocacy organization for recruitment. A total of 24 transgender men (men assigned female at birth) ages 19-55 were enrolled and provided consent. Questionnaires assessed sociodemographics, health and sexual histories, and knowledge about HPV and cervical cancer. Screening was performed with a self-sampled HPV test. Participants with a positive test were offered colposcopy and cryotherapy treatment, if appropriate. Those with a negative test were advised to return in 5 years for rescreening. Results: Out of 24 consenting participants, 23 (95.83%) agreed to conduct HPV self-sampling, and 22/23 (95.65%) expressed willingness to self-sample in the future. Among self-sampled individuals, 3/23 (13%) tested positive and accepted colposcopy and biopsy. Analyses of biopsied tissue revealed one case of cervical intraepithelial neoplasia grade 1. Conclusion: HPV self-sampling and subsequent procedures were accepted by the majority of participants. This screening method may be a viable alternative to cytology among transgender men in El Salvador.
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Affiliation(s)
- Mauricio Maza
- Basic Health International, Pittsburgh, Pennsylvania, USA; New York, New York, USA; and San Salvador, El Salvador
| | - Mario Meléndez
- Basic Health International, Pittsburgh, Pennsylvania, USA; New York, New York, USA; and San Salvador, El Salvador
| | - Alejandra Herrera
- Basic Health International, Pittsburgh, Pennsylvania, USA; New York, New York, USA; and San Salvador, El Salvador
| | - Xavier Hernández
- Asociación Generación Hombres Trans El Salvador, San Salvador, El Salvador
| | - Bryan Rodríguez
- Asociación Generación Hombres Trans El Salvador, San Salvador, El Salvador
| | - Montserrat Soler
- Basic Health International, Pittsburgh, Pennsylvania, USA; New York, New York, USA; and San Salvador, El Salvador.,Ob/Gyn and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Karla Alfaro
- Basic Health International, Pittsburgh, Pennsylvania, USA; New York, New York, USA; and San Salvador, El Salvador
| | - Rachel Masch
- Basic Health International, Pittsburgh, Pennsylvania, USA; New York, New York, USA; and San Salvador, El Salvador
| | - Gabriel Conzuelo-Rodríguez
- Basic Health International, Pittsburgh, Pennsylvania, USA; New York, New York, USA; and San Salvador, El Salvador
| | - Juno Obedin-Maliver
- Department of Obstetrics and Gynecology, Standford School of Medicine, Palo Alto, California, USA
| | - Miriam Cremer
- Basic Health International, Pittsburgh, Pennsylvania, USA; New York, New York, USA; and San Salvador, El Salvador.,Ob/Gyn and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio, USA
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19
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Garcia JR, Cozar M, Soler M, Bassa P, Riera E, Buxeda M, Valls E, Ferrer J. Standardization of acquisition protocols using PET/CT with 18F-Choline in prostate cancer. Rev Esp Med Nucl Imagen Mol 2020; 39:204-211. [PMID: 32192907 DOI: 10.1016/j.remn.2020.01.007] [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: 10/05/2019] [Revised: 12/29/2019] [Accepted: 01/07/2020] [Indexed: 11/16/2022]
Abstract
AIM To standardize acquisition protocols for 18F-Choline PET/CT to prevent from urine interference, to determine the best time point for the whole-body study, and to assess whether "dual point" acquisition allows for differentiating malignant vs. benign lesions. METHODS One hundred consecutive patients with prostate cancer were prospectively studied. Immediately after 18F-Choline injection, a pelvis study was acquired, and a whole-body was subsequently obtained 1 and 2 hours p.i. Mean SUVmax was obtained in regions and for every sequential imaging. Mean analysis (χ2) and SUV percentage change (2/1 hours; 1 hours/0 min) were obtained. Metabolic pattern dynamics were assessed: accumulative vs. clearance. Patient follow-up after therapy and directed classification whenever ethically possible were performed. RESULTS Fifty-three prostate foci, without disturbing urinary activity was ever found on early images. Accumulative pattern in 42, with percentage increase was: 0 min/1 hour: +16.7% (χ20.94); 1/2 hours: +10,0% (χ2 0.83). Clearance pattern in 11, with percentage decrease: 0 min/1 hour: -21.4% (χ20.91): -7.7% (χ20.85), corresponding in 7 to initial staging and in 4 post-radiotherapy biochemical recurrence. Every infradiaphragmatic uptake (n: 24) showed accumulative pattern, with percentage increase of +9.1% (χ20.97), all of them depicted on early imaging. As for 12 supradiaphragmantic uptake, 8 of them showed clearance pattern with percentage decrease: -13.0% (χ20.95). Accumulative pattern showed in 4 of them with percentage increase +13.0% (χ2 0.96), thus being assessed as invasive/malignant. Every bone uptake (n: 18) showed accumulative pattern, with percentage increase: +17.1% (χ20.95), all of them depicted on 1 hour imaging. CONCLUSIONS As for prostate assessment is concerned, dual point at 0 min/1 hour proved to be the best procedure. As for supradiaphragmatic lymph-nodes detection, dual point with 1/2 hours performed best. As for infradiaphragmatic and bone involvement, as well as for inconclusive findings, the 2 hour imaging increased our diagnostic confidence.
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Affiliation(s)
- J R Garcia
- Unidad PET CETIR ASCIRES Grupo biomédico, Esplugues de Llobregat, Barcelona, España.
| | - M Cozar
- Unidad PET CETIR ASCIRES Grupo biomédico, Esplugues de Llobregat, Barcelona, España
| | - M Soler
- Unidad PET CETIR ASCIRES Grupo biomédico, Esplugues de Llobregat, Barcelona, España
| | - P Bassa
- Unidad PET CETIR ASCIRES Grupo biomédico, Esplugues de Llobregat, Barcelona, España
| | - E Riera
- Unidad PET CETIR ASCIRES Grupo biomédico, Esplugues de Llobregat, Barcelona, España
| | - M Buxeda
- Unidad PET CETIR ASCIRES Grupo biomédico, Esplugues de Llobregat, Barcelona, España
| | - E Valls
- Unidad PET CETIR ASCIRES Grupo biomédico, Esplugues de Llobregat, Barcelona, España
| | - J Ferrer
- Unidad PET CETIR ASCIRES Grupo biomédico, Esplugues de Llobregat, Barcelona, España
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20
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García JR, Compte A, Buxeda M, Mourelo S, Soler M, Blanch A, Valls E, Riera E. Value of 18F-Choline PET/MRI hybrid technique on the therapeutic approach for patients with prostate cancer treated with prostatectomy and rising prostate specific antigen levels below 1 ng/ml. Rev Esp Med Nucl Imagen Mol 2020; 39:197-203. [PMID: 32165153 DOI: 10.1016/j.remn.2020.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 01/12/2020] [Accepted: 01/20/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To assess the detection rate of 18F-Choline PET/MRI and subsequent changes in therapy approach for patients with prostate cancer treated by prostatectomy and with rising levels of PSA <1 ng/ml. METHODS Prospective study with our first 36 patients with prostatectomy for prostate cancer and rising levels of PSA, who were referred for an 18F-Choline PET/MRI study. A dual-phase study was acquired after intravenous administration of 185±10% MBq of 18F-Choline: 1) early imaging (immediately after tracer administration) of prostate area (emission PET/Multiparametric MRI). 2) whole-body imaging 1 h after tracer injection (emission PET/MRI: T1, T2, STIR, diffusion). The therapy approach for patients was decided upon the Oncology Committee consensus based on 18F-Choline PET/MRI findings. RESULTS Twenty out of 36 patients (55.6%) were positive for the 18F-Choline PET/MRI study: 8 (22.2%) within the prostatectomy bed, 7 (19.4%) with infradiaphragmatic lymph nodes, 4 (11.1%) with local recurrence and infradiaphragmatic lymph nodes, and 1 (2.8%) with bone metastasis. Sixteen out of the 36 patients (44.4%) were negative for the 18F-Choline PET/MRI study. 18F-Choline PET/MRI findings had an impact on the therapy approach to follow: 15 patients (41.6%) showed oligometastatic disease which was treated by imaging-guided radiotherapy, 5 (13.9%) with multiple metastatic disease were treated by androgen deprivation therapy, 16 (44.4%) negative were under active surveillance. CONCLUSION Hybrid 18F-Choline PET/MRI procedure showed a high detection rate for recurrence in prostate cancer patients treated with prostatectomy and rising PSA levels <1 ng/ml, and 18F-Choline PET/MRI findings resulted in a better tailored therapy approach delivered to our patients.
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Affiliation(s)
| | - A Compte
- CETIR, ASCIRES, Barcelona, España
| | - M Buxeda
- CETIR, ASCIRES, Barcelona, España
| | | | - M Soler
- CETIR, ASCIRES, Barcelona, España
| | - A Blanch
- CETIR, ASCIRES, Barcelona, España
| | - E Valls
- CETIR, ASCIRES, Barcelona, España
| | - E Riera
- CETIR, ASCIRES, Barcelona, España
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21
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Lang M, Purzycki BG, Apicella CL, Atkinson QD, Bolyanatz A, Cohen E, Handley C, Kundtová Klocová E, Lesorogol C, Mathew S, McNamara RA, Moya C, Placek CD, Soler M, Vardy T, Weigel JL, Willard AK, Xygalatas D, Norenzayan A, Henrich J. Moralizing gods, impartiality and religious parochialism across 15 societies. Proc Biol Sci 2020; 286:20190202. [PMID: 30836871 DOI: 10.1098/rspb.2019.0202] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The emergence of large-scale cooperation during the Holocene remains a central problem in the evolutionary literature. One hypothesis points to culturally evolved beliefs in punishing, interventionist gods that facilitate the extension of cooperative behaviour toward geographically distant co-religionists. Furthermore, another hypothesis points to such mechanisms being constrained to the religious ingroup, possibly at the expense of religious outgroups. To test these hypotheses, we administered two behavioural experiments and a set of interviews to a sample of 2228 participants from 15 diverse populations. These populations included foragers, pastoralists, horticulturalists, and wage labourers, practicing Buddhism, Christianity, and Hinduism, but also forms of animism and ancestor worship. Using the Random Allocation Game (RAG) and the Dictator Game (DG) in which individuals allocated money between themselves, local and geographically distant co-religionists, and religious outgroups, we found that higher ratings of gods as monitoring and punishing predicted decreased local favouritism (RAGs) and increased resource-sharing with distant co-religionists (DGs). The effects of punishing and monitoring gods on outgroup allocations revealed between-site variability, suggesting that in the absence of intergroup hostility, moralizing gods may be implicated in cooperative behaviour toward outgroups. These results provide support for the hypothesis that beliefs in monitoring and punitive gods help expand the circle of sustainable social interaction, and open questions about the treatment of religious outgroups.
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Affiliation(s)
- Martin Lang
- 1 Department of Human Evolutionary Biology, Harvard University , Cambridge, MA 02138 , USA.,2 LEVYNA: Laboratory for the Experimental Research of Religion, Masaryk University , Brno 602 00 , Czech Republic
| | - Benjamin G Purzycki
- 3 Department of Human Behavior, Ecology and Culture, Max Planck Institute for Evolutionary Anthropology , Leipzig 04103 , Germany
| | - Coren L Apicella
- 4 Department of Psychology, University of Pennsylvania , Philadelphia, PA 6241 , USA
| | - Quentin D Atkinson
- 5 Department of Psychology, University of Auckland , Auckland , New Zealand.,6 Department of Linguistic and Cultural Evolution, Max Planck Institute for the Science of Human History , Jena 07745 , Germany
| | - Alexander Bolyanatz
- 7 Social Science Sub-Division, College of DuPage , Glen Ellyn, IL 60137 , USA
| | - Emma Cohen
- 8 School of Anthropology and Museum Ethnography, University of Oxford , Oxford OX2 6PE , UK.,9 Wadham College, University of Oxford , Oxford OX2 6PE , UK
| | - Carla Handley
- 10 Institute of Human Origins, Arizona State University , Tempe, AZ 4101 , USA
| | - Eva Kundtová Klocová
- 2 LEVYNA: Laboratory for the Experimental Research of Religion, Masaryk University , Brno 602 00 , Czech Republic
| | - Carolyn Lesorogol
- 11 Department of Anthropology, Washington University in St. Louis , St. Louis, MO 63130 , USA
| | - Sarah Mathew
- 10 Institute of Human Origins, Arizona State University , Tempe, AZ 4101 , USA
| | - Rita A McNamara
- 12 School of Psychology, Victoria University of Wellington , Wellington 6140 , New Zealand
| | - Cristina Moya
- 13 Department of Anthropology, University of California-Davis , Davis, CA 95616 , USA
| | - Caitlyn D Placek
- 14 Department of Anthropology, Ball State University , Muncie, IN 47306 , USA
| | - Montserrat Soler
- 15 Department of Anthropology, Montclair State University , Montclair, NJ 07043 , USA
| | - Thomas Vardy
- 5 Department of Psychology, University of Auckland , Auckland , New Zealand
| | - Jonathan L Weigel
- 16 Department of Economics and Government, Harvard University , Cambridge, MA 02138 , USA
| | - Aiyana K Willard
- 17 Centre for Culture and Evolution, Brunel University London , Middlesex UB8 3PH , UK
| | - Dimitris Xygalatas
- 18 Department of Anthropology, University of Connecticut , Storrs, CT 06269 , USA
| | - Ara Norenzayan
- 19 Department of Psychology, University of British Columbia , Vancouver, BC, Canada V6T 1Z4
| | - Joseph Henrich
- 1 Department of Human Evolutionary Biology, Harvard University , Cambridge, MA 02138 , USA
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Garcia J, Alvarez-Moro F, Soler M, Mourelo S, Bassa P, Riera E. Better discrimination of the nature of two synchronous pulmonary nodules with different morpho-metabolic features on the 18F-FDG PET/CT. Rev Esp Med Nucl Imagen Mol 2020. [DOI: 10.1016/j.remnie.2019.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Campos NG, Alfaro K, Maza M, Sy S, Melendez M, Masch R, Soler M, Conzuelo-Rodriguez G, Gage JC, Alonzo TA, Castle PE, Felix JC, Cremer M, Kim JJ. The cost-effectiveness of human papillomavirus self-collection among cervical cancer screening non-attenders in El Salvador. Prev Med 2020; 131:105931. [PMID: 31765712 DOI: 10.1016/j.ypmed.2019.105931] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 11/19/2019] [Accepted: 11/21/2019] [Indexed: 01/17/2023]
Abstract
Cervical cancer screening with human papillomavirus (HPV) DNA testing has been incorporated into El Salvador's national guidelines. The feasibility of home-based HPV self-collection among women who do not attend screening at the clinic (i.e., non-attenders) has been demonstrated, but cost-effectiveness has not been evaluated. Using cost and compliance data from El Salvador, we informed a mathematical microsimulation model of HPV infection and cervical carcinogenesis to conduct a cost-effectiveness analysis from the societal perspective. We estimated the reduction in cervical cancer risk, lifetime cost per woman (2017 US$), life expectancy, and incremental cost-effectiveness ratio (ICER, 2017 US$ per year of life saved [YLS]) of a program with home-based self-collection of HPV (facilitated by health promoters) for the 18% of women reluctant to screen at the clinic. The model was calibrated to epidemiologic data from El Salvador. We evaluated health and economic outcomes of the self-collection intervention for women aged 30 to 59 years, alone and in concert with clinic-based HPV provider-collection. Home-based self-collection of HPV was projected to reduce population cervical cancer risk by 14% and cost $1210 per YLS compared to no screening. An integrated program reaching 99% coverage with both provider- and home-based self-collection of HPV reduced cancer risk by 74% (compared to no screening), and cost $1210 per YLS compared to provider-collection alone. Self-collection facilitated by health promoters is a cost-effective strategy for increasing screening uptake in El Salvador.
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Affiliation(s)
- Nicole G Campos
- Center for Health Decision Science, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, 718 Huntington Avenue, Boston, MA, USA.
| | - Karla Alfaro
- Basic Health International, Colonia San Francisco, Avenido Las Camelias 14, San Salvador, El Salvador; Basic Health International, 25 Broadway, 9th Floor, New York, NY 10004, USA
| | - Mauricio Maza
- Basic Health International, Colonia San Francisco, Avenido Las Camelias 14, San Salvador, El Salvador; Basic Health International, 25 Broadway, 9th Floor, New York, NY 10004, USA
| | - Stephen Sy
- Center for Health Decision Science, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, 718 Huntington Avenue, Boston, MA, USA
| | - Mario Melendez
- Basic Health International, Colonia San Francisco, Avenido Las Camelias 14, San Salvador, El Salvador; Basic Health International, 25 Broadway, 9th Floor, New York, NY 10004, USA
| | - Rachel Masch
- Basic Health International, Colonia San Francisco, Avenido Las Camelias 14, San Salvador, El Salvador; Basic Health International, 25 Broadway, 9th Floor, New York, NY 10004, USA
| | - Montserrat Soler
- Obstetrics, Gynecology & Women's Health Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
| | | | - Julia C Gage
- Department of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, USA
| | - Todd A Alonzo
- University of Southern California, 222 East Huntington Drive, Suite 100, Monrovia, CA 91016, USA
| | | | - Juan C Felix
- Department of Pathology, Medical College of Wisconsin, 9200 W Wisconsin Avenue, Milwaukee, WI, USA
| | - Miriam Cremer
- Basic Health International, Colonia San Francisco, Avenido Las Camelias 14, San Salvador, El Salvador; Basic Health International, 25 Broadway, 9th Floor, New York, NY 10004, USA; Obstetrics, Gynecology & Women's Health Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
| | - Jane J Kim
- Center for Health Decision Science, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, 718 Huntington Avenue, Boston, MA, USA
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Garcia JR, Alvarez-Moro FJ, Soler M, Mourelo S, Bassa P, Riera E. Better discrimination of the nature of the synchronous pulmonary nodules with different morpho-metabolic characteristics by 18F-FDG PET/CT. Rev Esp Med Nucl Imagen Mol 2020; 39:110-111. [PMID: 31918977 DOI: 10.1016/j.remn.2019.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/31/2019] [Accepted: 11/06/2019] [Indexed: 10/25/2022]
Affiliation(s)
- J R Garcia
- ASCIRES CETIR Esplugues, Esplugues de Llobregat, Barcelona, España.
| | - F J Alvarez-Moro
- ASCIRES CETIR Esplugues, Esplugues de Llobregat, Barcelona, España
| | - M Soler
- ASCIRES CETIR Esplugues, Esplugues de Llobregat, Barcelona, España
| | - S Mourelo
- ASCIRES CETIR Esplugues, Esplugues de Llobregat, Barcelona, España
| | - P Bassa
- ASCIRES CETIR Esplugues, Esplugues de Llobregat, Barcelona, España
| | - E Riera
- ASCIRES CETIR Esplugues, Esplugues de Llobregat, Barcelona, España
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25
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Rojo D, Vázquez JM, Sánchez C, Arencibia A, García MI, Soler M, Kilroy D, Ramírez G. Sectional anatomic and tomographic study of the feline abdominal cavity for obtaining a three-dimensional vascular model. Iran J Vet Res 2020; 21:279-286. [PMID: 33584840 PMCID: PMC7871740] [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] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 09/16/2020] [Accepted: 09/26/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Unlike dogs, feline abdominal studies are rare. Note that anatomical estudies in felines are scarce and almost unique using feline cadaver by means of sectional anatomy and computed tomography (CT) or magnetic resonance imaging (MRI). Aims: In this study, a non-pathological vascularization model of feline abdomen was conducted on three adult cats was using anatomical and diagnostic imaging techniques. METHODS A live pet cat and two cat cadavers were used in this study. Cat cadavers were injected with colored latex to show well-differentiated vascular structures and serial sections of cat abdomen were then provided. Computed tomography was performed by injecting an iodinated contrast medium through the cephalic vein of a live cat immediately before scanning. The CT images showed the arterial and venous vascular formations hyper-attenuated with two tomographic windows. The correlation between anatomical sections and their CTs was studied to identify vascular and and visceral structures. RESULTS Hyper-attenuated vascular structures with the contrast medium were identified and marked along their path in the series of Dicom images with the Amira program. In this approach, sequentially and semiautomatically, vascular volumetric reconstruction was obtained without visceral formations. With the OsiriX program, volumetric reconstruction was automatic and maintained the fidelity of all visceral and vascular formations. CONCLUSION We conclude that these improved prototypes could be used in veterinary clinics as normal vascular models and as a basis for obtaining future 3D models of vascular anomalies such as portosystemic shunts.
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Affiliation(s)
- D. Rojo
- Department of Anatomy and Comparative Pathological Anatomy, Veterinary Faculty, Campus of Espinardo, University of Murcia, 30100, Murcia, Spain
| | - J. M. Vázquez
- Department of Anatomy and Comparative Pathological Anatomy, Veterinary Faculty, Campus of Espinardo, University of Murcia, 30100, Murcia, Spain
| | - C. Sánchez
- Department of Anatomy and Comparative Pathological Anatomy, Veterinary Faculty, Campus of Espinardo, University of Murcia, 30100, Murcia, Spain
| | - A. Arencibia
- Department of Morphology, Veterinary Faculty, University of Las Palmas de Gran Canaria, Trasmontaña, Arucas, 35413 Las Palmas, Spain
| | - M. I. García
- Support Research Service, University of Murcia, 30100, Murcia, Spain
| | - M. Soler
- Department of Animal Medicine and Surgery, Veterinary Faculty, Campus of Espinardo, University of Murcia, 30100, Murcia, Spain
| | - D. Kilroy
- Division of Veterinary Science Centre, University College Dublin, School of Veterinary Medicine, Belfield, Dublin 4, Ireland
| | - G. Ramírez
- Department of Anatomy and Comparative Pathological Anatomy, Veterinary Faculty, Campus of Espinardo, University of Murcia, 30100, Murcia, Spain
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Garcia J, Bassa P, Soler M, Jaramillo A, Ortiz S, Riera E. Benign differentiation of treated neuroblastoma as a cause of false positive by 123I-MIBG SPECT/CT. Usefulness of 18F-FDG PET/CT. Rev Esp Med Nucl Imagen Mol 2019. [DOI: 10.1016/j.remnie.2019.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Santas Olmeda E, De La Espriella R, Minana G, Valero E, Palau P, Amiguet M, Gonzalez J, Soler M, Sanchis J, Chorro FJ, Nunez J. P3543Rehospitalization burden in heart failure with mid-range ejection fraction and morbidity burden. Is it a distinct phenotype? Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Heart failure with mid-range ejection fraction (HFmrEF) has been recognized as a distinct HF phenotype, but wether patients on this category fare worse, similarly, or better than those with HF with reduced EF (HFrEF) or preserved EF (HFpEF) in terms of rehospitalization risk over time remains unclear. We therefore sought to characterize the mordibity burden of HFmrEF patients by evaluating the risk of recurrent hospitalizations following an admission for acute HF.
Methods
We prospectively included 2,961 consecutive patients discharged for acute HF in our institution from 2004 to 2017. Patients were categorized according to their ejection fraction (EF) obtained by an echocardiography during the index admission: HFmrEF (EF 41–49%), HFrEF (EF≤40%) and HFpEF (EF≥50%). Negative binomial regression method was used to evaluate the association between EF status and recurrent all-cause and HF-related admissions. Risk estimates were expressed as incidence ratio ratios (IRR).
Results
Mean age of the cohort was 73.9±11.1 years, 49% were women, and 46.0% had suffered from previous HF admissions. 472 patients (15.9%) had HFmrEF, 956 (32.3%) had HFrEF, and 1,533 (51.8%) had HFpEF. At a median (interquartile range) follow-up of 2.4 (4.4) years, 1,821 (61.5%) patients died and 6,035 all-cause readmissions were registered in 2,026 patients (68.4%), being 2,163 of them HF-related. Rates of all-cause readmission per 100 patients-years of follow-up were 43.4, 47.1 and 50.1 per HFrEF, HFmrEF and HFpEF categories, respectively. After multivariable adjustment, and compared to patients with HFrEF, HFmrEF status was not associated with a higher risk of all-cause or HF-related recurrent admissions (IRR=1.06; 95% confidence interval (CI), 0.93–1.20; p=0.89), and IRR=1.07; 95% CI, 0.91–1.26; p=0.389, respectively), whereas HFpEF status was associated with a non-significant increase in the risk of all-cause recurrent admissions but a similar risk of HF-related readmissions (IRR=1.10; 95% confidence interval (CI), 0.99–1.22; p=0.06, and IRR=1.01; 95% CI, 0.88–1.16; p=0.900, respectively)
Conclusion
Following an admission for acute HF, patients with HFmrEF have a similar all-cause and HF-related rehospitalization burden when compared to patients with HFrEF, by means of recurrent events analysis.
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Affiliation(s)
- E Santas Olmeda
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - R De La Espriella
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - G Minana
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - E Valero
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - P Palau
- Hospital General de Castellόn. Universitat Jaume I, Castellon, Spain
| | - M Amiguet
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - J Gonzalez
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - M Soler
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - J Sanchis
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - F J Chorro
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
| | - J Nunez
- Hospital Clinic Universitari. Universitat de València, Valencia, Spain
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Garcia J, Soler M, Álvarez-Moro F, Mourelo S, Ortiz S, Riera. E. 18F-FDG PET/CT in the diagnosis of the abscopal effect. A case report. Rev Esp Med Nucl Imagen Mol 2019. [DOI: 10.1016/j.remnie.2019.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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García J, Soler M, Álvarez-Moro F, Mourelo S, Ortiz S, Riera E. La PET/TC con 18F-FDG en el diagnóstico del efecto abscopal. A propósito de un caso. Rev Esp Med Nucl Imagen Mol 2019; 38:330-331. [DOI: 10.1016/j.remn.2018.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 12/07/2018] [Accepted: 12/11/2018] [Indexed: 11/26/2022]
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Cremer M, Alfaro K, Garai J, Salinas M, Maza M, Zevallos A, Taxa L, Diaz AC, Castle P, Alonzo TA, Masch R, Soler M, Conzuelo-Rodriguez G, Gage JC, Felix JC. Evaluation of two alternative ablation treatments for cervical pre-cancer against standard gas-based cryotherapy: a randomized non-inferiority study. Int J Gynecol Cancer 2019; 29:ijgc-2018-000148. [PMID: 31055452 PMCID: PMC9884482 DOI: 10.1136/ijgc-2018-000148] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 03/20/2019] [Accepted: 04/08/2019] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION Gas-based cryotherapy is the conventional ablative treatment for cervical pre-cancer in low-income settings, but the use of gas poses significant challenges. We compared the depth of necrosis induced by gas-based cryotherapy with two gas-free alternatives: cryotherapy using CryoPen,and thermoablation. METHODS We conducted a five-arm randomized non-inferiority trial: double-freeze carbon dioxide (CO2) cryotherapy (referent), single-freeze CO2 cryotherapy, double-freeze CryoPen, single-freeze CryoPen, and thermoablation. Subjects were 130 women scheduled for hysterectomy for indications other than cervical pathology, and thus with healthy cervical tissue available for histological evaluation of depth of necrosis post-surgery. The null hypothesis was rejected (ie, conclude non-inferiority) if the upper bound of the 90% confidence interval (90% CI) for the difference in mean depth of necrosis (referent minus each experimental method) was <1.14 mm. Patient pain during treatment was reported on a scale of 0 (no pain) to 10 (worst pain). RESULTS A total of 133 patients were enrolled in the study. The slides from three women were deemed unreadable. One patient was excluded because her hysterectomy was postponed for reasons unrelated to the study, and two patients were excluded because treatment application did not follow the established protocol. For the remaining 127 women, mean depth of necrosis for double-freeze CO2 (referent) was 6.0±1.6 mm. Differences between this and other methods were: single-freeze CO2 = 0.4 mm (90% CI -0.4 to 1.2 mm), double-freeze CryoPen= 0.7 mm (90% CI 0.04 to 1.4 mm), single-freeze CryoPen= 0.5 mm (90% CI -0.2 to 1.2 mm), and thermoablation = 2.6 mm (90% CI 2.0 to 3.1 mm). Mean pain levels were 2.2±1.0 (double-freeze CO2 cryotherapy), 1.8±0.8 (single-freeze CO2 cryotherapy), 2.5±1.4 (double-freeze CryoPen), 2.6±1.4 (single-freeze CryoPen), and 4.1±2.3 (thermoablation). DISCUSSION Compared with the referent, non-inferiority could not be concluded for other methods. Mean pain scores were low for all treatments. Depth of necrosis is a surrogate for treatment efficacy, but a randomized clinical trial is necessary to establish true cure rates.
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Affiliation(s)
- Miriam Cremer
- OB/GYN and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio, USA
- Basic Health International, San Salvador, El Salvador
- Basic Health International, New York City, New York, USA
| | - Karla Alfaro
- Basic Health International, San Salvador, El Salvador
| | - Jillian Garai
- Basic Health International, New York City, New York, USA
| | - Manuel Salinas
- Instituto Salvadoreño del Seguro Social, San Salvador, El Salvador
| | - Mauricio Maza
- Basic Health International, San Salvador, El Salvador
| | | | - Luis Taxa
- Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Ana C Diaz
- Instituto Salvadoreño del Seguro Social, San Salvador, El Salvador
| | - Philip Castle
- Yeshiva University Albert Einstein College of Medicine, Bronx, New York, USA
| | - Todd A Alonzo
- University of Southern California, Los Angeles, California, USA
| | - Rachel Masch
- Basic Health International, New York City, New York, USA
| | - Montserrat Soler
- OB/GYN and Women's Health Institute, Cleveland Clinic, Cleveland, Ohio, USA
- Basic Health International, New York City, New York, USA
| | | | - Julia C Gage
- National Cancer Institute, Bethesda, Maryland, USA
| | - Juan C Felix
- Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Garcia JR, Bassa P, Soler M, Jaramillo A, Ortiz S, Riera E. Benign differentiation of treated neuroblastoma as a cause of false positive by 123I-MIBG SPECT/CT. Usefulness of 18F-FDG PET/CT. Rev Esp Med Nucl Imagen Mol 2019; 38:389-390. [PMID: 31000447 DOI: 10.1016/j.remn.2019.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 03/07/2019] [Accepted: 03/08/2019] [Indexed: 12/01/2022]
Affiliation(s)
- J R Garcia
- ASCIRES CETIR Esplugues, Esplugues de Llobregat, Barcelona, España.
| | - P Bassa
- ASCIRES CETIR Esplugues, Esplugues de Llobregat, Barcelona, España
| | - M Soler
- ASCIRES CETIR Esplugues, Esplugues de Llobregat, Barcelona, España
| | - A Jaramillo
- ASCIRES CETIR Esplugues, Esplugues de Llobregat, Barcelona, España
| | - S Ortiz
- ASCIRES CETIR Esplugues, Esplugues de Llobregat, Barcelona, España
| | - E Riera
- ASCIRES CETIR Esplugues, Esplugues de Llobregat, Barcelona, España
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García J, Baquero M, Soler M, Bassa P, Moreno C, Riera E. Diagnóstico de linfoma de Burkitt mediante PET cerebral con 11C-metionina en paciente VIH positivo con lesiones encefálicas indeterminadas. Rev Esp Med Nucl Imagen Mol 2019; 38:57-58. [DOI: 10.1016/j.remn.2018.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 01/26/2018] [Accepted: 01/29/2018] [Indexed: 11/16/2022]
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García J, Baquero M, Soler M, Bassa P, Moreno C, Riera E. Burkitt lymphoma diagnosed on 11C-Methionine cerebral PET in an HIV-positive patient with undetermined brain injury. Rev Esp Med Nucl Imagen Mol 2019. [DOI: 10.1016/j.remnie.2018.04.001] [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: 10/16/2022]
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Garcia J, Castañeda A, Morales A, Bassa P, Soler M, Riera E. Staging and follow-up of a Ewing sarcoma patient using 18F-FDG PET/CT. Rev Esp Med Nucl Imagen Mol 2018. [DOI: 10.1016/j.remnie.2017.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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35
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Maza M, Melendez M, Masch R, Alfaro K, Chacon A, Gonzalez E, Soler M, Conzuelo-Rodriguez G, Gage JC, Alonzo TA, Castle PE, Felix JC, Cremer M. Acceptability of self-sampling and human papillomavirus testing among non-attenders of cervical cancer screening programs in El Salvador. Prev Med 2018; 114:149-155. [PMID: 29958860 DOI: 10.1016/j.ypmed.2018.06.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/21/2018] [Accepted: 06/25/2018] [Indexed: 10/28/2022]
Abstract
In a cross-sectional study carried out in El Salvador between February 2016 and July 2017, self-sampling and human papillomavirus (HPV) testing was found to be highly acceptable among 2019 women who had not attended a cervical cancer screening in at least 3 years. Within this population, HPV positivity rates differed according to age, marital status, number of children, and lifetime sexual partners. The proportion of women who tested HPV positive or who were diagnosed with cervical intraepithelial neoplasia grade 2 (CIN2) or more severe diagnoses (CIN2+) was similar to the general population of the area. Among the reasons for failing to participate in previous screening programs, non-attending women described logistic concerns, but also erroneous beliefs regarding HPV and cervical cancer, misconceptions regarding the screening procedure, discomfort with male providers, and confidentiality fears. The aim of this study was to identify opportunities and challenges that emerged from the use of self-sampling and HPV testing as part of a public cervical cancer control effort in a low-resource setting.
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Affiliation(s)
- M Maza
- Basic Health International, Colonia San Francisco, Avenida Las Camelias 14, San Salvador, El Salvador; Basic Health International, 25 Broadway, 9th Floor, New York, NY 10004, United States of America.
| | - M Melendez
- Basic Health International, Colonia San Francisco, Avenida Las Camelias 14, San Salvador, El Salvador; Basic Health International, 25 Broadway, 9th Floor, New York, NY 10004, United States of America.
| | - R Masch
- Basic Health International, Colonia San Francisco, Avenida Las Camelias 14, San Salvador, El Salvador; Basic Health International, 25 Broadway, 9th Floor, New York, NY 10004, United States of America.
| | - K Alfaro
- Basic Health International, Colonia San Francisco, Avenida Las Camelias 14, San Salvador, El Salvador; Basic Health International, 25 Broadway, 9th Floor, New York, NY 10004, United States of America.
| | - A Chacon
- Ministry of Health, San Salvador, El Salvador, Calle Arce 827, San Salvador, El Salvador
| | - E Gonzalez
- Ministry of Health, San Salvador, El Salvador, Calle Arce 827, San Salvador, El Salvador
| | - M Soler
- Basic Health International, Colonia San Francisco, Avenida Las Camelias 14, San Salvador, El Salvador; Basic Health International, 25 Broadway, 9th Floor, New York, NY 10004, United States of America.
| | - G Conzuelo-Rodriguez
- Basic Health International, Colonia San Francisco, Avenida Las Camelias 14, San Salvador, El Salvador; Basic Health International, 25 Broadway, 9th Floor, New York, NY 10004, United States of America.
| | - J C Gage
- National Cancer Institute, 9000 Rockville Pike, Bethesda, MD 20892, United States of America.
| | - T A Alonzo
- University of Southern California, 222 East Huntington Drive, Suite 100, Monrovia, CA 91016, United States of America.
| | - P E Castle
- Albert Einstein College of Medicine, 300 Morris Park Avenue, Bronx, NY 10461, United States of America
| | - J C Felix
- Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, United States of America.
| | - M Cremer
- Basic Health International, Colonia San Francisco, Avenida Las Camelias 14, San Salvador, El Salvador; Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States of America; Basic Health International, 25 Broadway, 9th Floor, New York, NY 10004, United States of America.
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Garcia J, Bassa P, Soler M, Moro FA, Blanch T, Riera E. Local recurrence on PET/CT with 11C-choline following brachytherapy for prostate cancer: A characteristic tracer uptake pattern. Rev Esp Med Nucl Imagen Mol 2018. [DOI: 10.1016/j.remnie.2018.01.002] [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: 10/17/2022]
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Garcia J, Bassa P, Soler M, Moro FA, Blanch T, Riera E. Patrón característico de recidiva local tras braquiterapia prostática mediante PET/TC con 11C-colina. Rev Esp Med Nucl Imagen Mol 2018; 37:323-324. [DOI: 10.1016/j.remn.2017.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 12/21/2017] [Accepted: 12/21/2017] [Indexed: 10/18/2022]
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Martinez M, Pallares F, Soler M, Agut A. Relationship between ultrasonographic and histopathological measurements of small intestinal wall layers in fresh cat cadavers. Vet J 2018; 237:1-8. [DOI: 10.1016/j.tvjl.2018.05.001] [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] [Received: 06/18/2017] [Revised: 04/26/2018] [Accepted: 05/01/2018] [Indexed: 12/31/2022]
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Siroux V, Ballardini N, Soler M, Lupinek C, Boudier A, Pin I, Just J, Nadif R, Anto JM, Melen E, Valenta R, Wickman M, Bousquet J. The asthma-rhinitis multimorbidity is associated with IgE polysensitization in adolescents and adults. Allergy 2018; 73:1447-1458. [PMID: 29331026 DOI: 10.1111/all.13410] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND Children with multimorbid asthma and rhinitis show IgE polysensitization to several allergen sources. This association remains poorly studied in adolescents and adults using defined allergen molecules. We investigated IgE sensitization patterns towards a broad panel of aeroallergen components in adults and adolescents with a focus on individuals with asthma and rhinitis multimorbidity. METHODS IgE reactivity to 64 micro-arrayed aeroallergen molecules was determined with the MeDALL-chip in samples from the French EGEA study (n = 840, age = 40.7 ± 17.1) and the Swedish population-based birth cohort BAMSE (n = 786, age = 16 ± 0.26). The age- and sex-adjusted associations between the number of IgE-reactive allergen molecules (≥0.3 ISU) and the asthma-rhinitis phenotypes were assessed using a negative binomial model. RESULTS Groups representing 4 phenotypes were identified: no asthma-no rhinitis (A-R-; 30% in EGEA and 54% in BAMSE), asthma alone (A+R-; 11% and 8%), rhinitis alone (A-R+; 15% and 24%) and asthma-rhinitis (A+R+; 44% and 14%). The numbers of IgE-reactive aeroallergen molecules significantly differed between phenotypes (median in A-R-, A+R-, A-R+ and A+R+: 0, 1, 2 and 7 in EGEA and 0, 0, 3 and 5 in BAMSE). As compared to A-R- subjects, the adjusted ratio of the mean number of IgE-reactive molecules was higher in A+R+ than in A+R- or A-R+ (10.0, 5.4 and 5.0 in EGEA and 7.2, 0.7 and 4.8 in BAMSE). CONCLUSION The A+R+ phenotype combined the sensitization pattern of both the A-R+ and A+R- phenotypes. This multimorbid polysensitized phenotype seems to be generalizable to various ages and allergenic environments and may be associated with specific mechanisms.
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Affiliation(s)
- V. Siroux
- Inserm, CNRS, IAB; University Grenoble Alpes; Grenoble France
| | - N. Ballardini
- Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
- Sachs’ Children and Youth Hospital; Södersjukhuset; Stockholm Sweden
- St John's Institute of Dermatology; King's College London; London UK
| | - M. Soler
- Inserm, CNRS, IAB; University Grenoble Alpes; Grenoble France
| | - C. Lupinek
- Division of Immunopathology; Department of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
| | - A. Boudier
- Inserm, CNRS, IAB; University Grenoble Alpes; Grenoble France
| | - I. Pin
- Inserm, CNRS, IAB; University Grenoble Alpes; Grenoble France
- Department of Pediatrics; CHU Grenoble Alpes; Grenoble France
| | - J. Just
- Allergology Department; Children Hospital Armand Trousseau; Paris France
- Inserm, UMR-S 1136 INSERM; UPMC; Paris France
| | - R. Nadif
- Inserm, U1168; VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches; Villejuif France
- UMR-S 1168; Univ Versailles St-Quentin-en-Yvelines; Montigny le Bretonneux France
| | - J. M. Anto
- ISGLoBAL; Centre for Research in Environmental Epidemiology (CREAL); Barcelona Spain
| | - E. Melen
- Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
- Sachs’ Children and Youth Hospital; Södersjukhuset; Stockholm Sweden
| | - R. Valenta
- Division of Immunopathology; Department of Pathophysiology and Allergy Research; Center for Pathophysiology, Infectiology and Immunology; Medical University of Vienna; Vienna Austria
- NRC Institute of Immunology FMBA of Russia; Moscow Russia
| | - M. Wickman
- Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
- Sachs’ Children and Youth Hospital; Södersjukhuset; Stockholm Sweden
- Centre for Clinical Research Sörmland; Uppsala University; Eskilstuna Sweden
| | - J. Bousquet
- Inserm, U1168; VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches; Villejuif France
- UMR-S 1168; Univ Versailles St-Quentin-en-Yvelines; Montigny le Bretonneux France
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Algara M, López-Guerra J, Flaquer A, Beato I, Martínez F, Rodríguez J, Sanz X, Salinas J, Soler M, Frías A, Juan G, Manso A. EP-1301: Incidental or intentional node irradiation in breast cancer. preliminary results of OPTIMAL trial. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31611-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Algara M, Rodríguez E, Flaquer A, Beato I, Martínez F, Rodríguez J, Sanz J, Salinas J, Soler M, Frias A, Juan G, Manso A, Calin A, Diaz I, Gonzalez E, Lozano A, Carrasco F, Garcia I, Manterola A, Guimon E. OPTimizing Irradiation through Molecular Assessment of Lymph Node: Preliminary results of OPTIMAL Trial comparing incidental versus intentional irradiation in early breast cancer. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30396-4] [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: 10/17/2022]
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Soler A, López M, Martínez D, Benedicto A, Navarro A, Monroy J, Albert M, Domingo C, Soler M. EP-1620: Muscle-Invasive Bladder Cancer Bladder-Preservation by Combined-Modality Therapy: Long-Term Outcomes. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31929-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Maza M, Melendez M, Cremer M, Masch R, Alonzo T, Castle P, Alfaro K, Soler M, Conzuelo G, Gage J. High Acceptability of Human Papillomavirus Self-Sampling Among Nonattenders of a Public Cervical Cancer Screening Program in El Salvador. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.50000] [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: 11/20/2022] Open
Abstract
Abstract 29 Purpose In high-income countries, human papillomavirus (HPV) self-sampling has been demonstrated to increase adherence to cervical cancer prevention initiatives in underscreened women. El Salvador recently completed the Cervical Cancer Prevention in El Salvador (CAPE) program using a high-risk HPV test as the screening method. Although successful, 12% of targeted women did not attend their screening appointments. HPV self-sampling may offer the opportunity to reach these nonattending women. In the current study, we evaluated HPV self-sampling as a way to increase screening among CAPE nonattenders and to report factors that impact self-sampling acceptability in a low- to middle-income country. Methods Nonattending and underscreened women age 30 to 59 years from the Paracentral region of El Salvador were invited to participate (N = 2,019). Women were visited at home and offered self-sampling with an HPV test. Women who provided consent also received a series of questionnaires to collect demographic and test acceptability data. After tests were analyzed, women were provided with results during another home visit. HPV-positive women were asked to make an appointment at a local clinic to undergo colposcopy, biopsy, and, if eligible, cryotherapy treatment. Women with contraindications for cryotherapy were referred to appropriate treatment or follow-up. Results Of 1,989 eligible women, 94% accepted the HPV self-sampled test. Of these, 11.8% (n = 221) tested positive. All but 13 women attended the colposcopy appointment, and 190 women received cryotherapy. Biopsy results revealed low-grade precancer in 6.3% of women, whereas 12.6% received diagnoses of high-grade precancer. Reasons for not attending the original CAPE appointment included logistic concerns, but also discomfort with male providers, confidentiality fears, and misconceptions regarding HPV, cervical cancer, and the screening procedure. Conclusion HPV self-sampling was shown to be overwhelmingly acceptable to nonattending and underscreened rural women in El Salvador. This method may be a feasible alternative that circumvents barriers to cervical cancer screening in low- to middle-income countries. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors
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Affiliation(s)
| | | | | | | | | | | | - K. Alfaro
- Basic Health International, New York, NY
| | | | | | - Julia Gage
- Basic Health International, New York, NY
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Meléndez M, Herrera A, Hernández X, Rodríguez B, Soler M, Alfaro K, Masch R, Cremer M, Maza M. Cervical Cancer Screening in Transgender Men in El Salvador: A Pilot Study. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.40000] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract 27 Purpose Transgender persons are particularly vulnerable to a lack of adequate health care, particularly with regard to sexual and reproductive health. In El Salvador, where cervical cancer is a leading cause of cancer death, transgender men are at high risk of developing this disease. Whereas the Papanicolaou test is the most widely used screening method for cervical cancer, there are reports of high numbers of unsatisfactory results among transgender men compared with nontransgender persons. Human papillomavirus (HPV) testing may be a more viable screening option in this population. In this pilot study, we assessed the feasibility of cervical cancer screening among transgender men using a self-sampling HPV test as an alternative to the Papanicolaou test. Methods Participants were transgender men of the Organización Generación Hombres Trans El Salvador (Trans Men Generation Organization of El Salvador) between age 19 and 55 years. After obtaining informed consent, a questionnaire was administered to 24 participants to collect sociodemographic, lifestyle, and sexual behavior data, and to assess knowledge about cervical cancer prevention. Participants then performed a vaginal, self-sampling HPV test. Participants who received a positive HPV result were offered a colposcopy evaluation. Results Almost all participants—23 of 24—agreed to conduct vaginal self-sampling. Of these, three (13%) of 23 participants tested positive, with the remainder obtaining a negative result. Colposcopies and biopsies were accepted by all three participants who tested positive. One participant was diagnosed with CIN3, whereas two2 were diagnosed with CIN1. Conclusion There is limited information on cervical cancer prevention among transgender men, particularly in low and middle-income countries. Use of HPV self-sampling tests is a viable method that can significantly improve participation in and acceptance of screening in this vulnerable population. HPV testing may reduce the number of unsatisfactory results generated when using Papanicolaou tests as a screening method. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST No COIs from the authors.
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Soler M, González-Bártulos M, Figueras E, Massaguer A, Feliu L, Planas M, Ribas X, Costas M. Delivering aminopyridine ligands into cancer cells through conjugation to the cell-penetrating peptide BP16. Org Biomol Chem 2018; 14:4061-70. [PMID: 27055538 DOI: 10.1039/c6ob00470a] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Peptide conjugates incorporating the N-based ligands (Me2)PyTACN or (S,S')-BPBP at the N- or the C-terminus of the cell-penetrating peptide were synthesized (PyTACN-BP16 (), BP16-PyTACN (), BPBP-BP16 (), and BP16-BPBP ()). Metal binding peptides bearing at the N-terminus the ligand, an additional Lys and a β-Ala were also prepared (PyTACN-βAK-BP16 () and BPBP-βAK-BP16 ()). Moreover, taking into account the clathrin-dependent endocytic mechanism of , the enzymatic cleavable tetrapeptide Gly-Phe-Leu-Gly was incorporated between the ligand and the N- or C-terminus of (BPBP-GFLG-BP16 () and BP16-GLFG-BPBP ()). Analysis of the cytotoxicity of all the peptide conjugates showed that: (i) the position of the ligand influenced the IC50 values, (ii) the incorporation of the βAla-Lys dipeptide rendered non active sequences, (iii) peptide conjugates derived from the (S,S')-BPBP ligand were more active than those bearing (Me2)PyTACN, and (iv) the introduction of the cleavable tetrapeptide significantly enhanced the activity of the BPBP conjugates (IC50 of 4.3 to 11.7 μM ( and ) compared to 26.0 to >50 μM (, and )). The most active peptide was BPBP-GFLG-BP16 () (IC50 of 4.3 to 5.0 μM). This high activity was attributed to its high internalization in MCF-7 cells, as shown by flow cytometry, and to the subsequent release of the ligand by the intracellular cleavage of the enzyme-labile spacer, as observed in cathepsin B enzymatic assays. Therefore, these results pave the way for the design of novel peptide conjugates to be used in pro-oxidant anticancer therapies.
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Affiliation(s)
- M Soler
- QBIS-CAT Research Group, Institut de Química Computacional i Catàlisi (IQCC) and Departament de Química, Universitat de Girona, Campus Montilivi, E-17071 Girona, Catalonia, Spain. and LIPPSO, Departament de Química, Universitat de Girona, Campus Montilivi, E-17071 Girona, Catalonia, Spain.
| | - M González-Bártulos
- QBIS-CAT Research Group, Institut de Química Computacional i Catàlisi (IQCC) and Departament de Química, Universitat de Girona, Campus Montilivi, E-17071 Girona, Catalonia, Spain. and Departament de Biologia, Universitat de Girona, Campus Montilivi, E-17071 Girona, Catalonia, Spain.
| | - E Figueras
- LIPPSO, Departament de Química, Universitat de Girona, Campus Montilivi, E-17071 Girona, Catalonia, Spain.
| | - A Massaguer
- Departament de Biologia, Universitat de Girona, Campus Montilivi, E-17071 Girona, Catalonia, Spain.
| | - L Feliu
- LIPPSO, Departament de Química, Universitat de Girona, Campus Montilivi, E-17071 Girona, Catalonia, Spain.
| | - M Planas
- LIPPSO, Departament de Química, Universitat de Girona, Campus Montilivi, E-17071 Girona, Catalonia, Spain.
| | - X Ribas
- QBIS-CAT Research Group, Institut de Química Computacional i Catàlisi (IQCC) and Departament de Química, Universitat de Girona, Campus Montilivi, E-17071 Girona, Catalonia, Spain.
| | - M Costas
- QBIS-CAT Research Group, Institut de Química Computacional i Catàlisi (IQCC) and Departament de Química, Universitat de Girona, Campus Montilivi, E-17071 Girona, Catalonia, Spain.
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Soler M, Úbeda X. Evaluation of fire severity via analysis of photosynthetic pigments: Oak, eucalyptus and cork oak leaves in a Mediterranean forest. J Environ Manage 2018; 206:65-68. [PMID: 29059572 DOI: 10.1016/j.jenvman.2017.10.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 10/05/2017] [Accepted: 10/07/2017] [Indexed: 06/07/2023]
Abstract
Few studies to date have examined the effect of the high temperatures attained during wildfire events on the pigments present in forest foliage. Here, we seek to analyse the main photosynthetic pigments in the leaves of the oak, cork oak and eucalyptus following a wildfire. We also subject leaves of these last two species to a range of contact temperatures (100-500 °C) in the laboratory using a muffle furnace. The samples were left in the muffle for two hours at 100, 150, 200, 250, 300, 350, 400 and 500 °C, in line with other soil study models (Úbeda et al., 2009; Düdaite et al., 2013). At temperatures above 250 °C, chromatography fails to detect any pigments. A minimal increase in temperature degrades chlorophyll, the process being more rapid in eucalyptus than in cork oak, while it increases pheophytin concentrations.
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Affiliation(s)
- M Soler
- Centre d'Estudis Avançats Blanes (CEAB-CSIC), Carrer Acces a la Cala de Sant Francesc, 14, 17300 Blanes, Spain
| | - X Úbeda
- GRAM, Department of Geography, University of Barcelona, Montalegre 6, 08001 Barcelona, Spain.
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Garcia J, Riera E, Bassa P, Mourelo S, Soler M. 18 F-FDG PET/CT in follow-up evaluation in paediatric patients with Langerhans histiocytosis. Rev Esp Med Nucl Imagen Mol 2017. [DOI: 10.1016/j.remnie.2017.06.002] [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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Garcia J, Soler M, Bassa P, Minoves M, Riera E. Assessment of soft tissue involvement in pressure ulcers and osteomyelitis diagnosis by 18 F-FDG PET/CT. Rev Esp Med Nucl Imagen Mol 2017. [DOI: 10.1016/j.remnie.2017.06.001] [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: 11/27/2022]
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Garcia J, Corbella C, Baquero M, Bassa P, Soler M. Extracranial metastasis of multiforme glioblastoma detected by 11 C-methionine brain PET/CT. Rev Esp Med Nucl Imagen Mol 2017. [DOI: 10.1016/j.remnie.2016.10.001] [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: 10/19/2022]
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Garcia J, Corbella C, Baquero M, Bassa P, Soler M. Detección de metástasis extracraneal de glioblastoma multiforme mediante PET/TC cerebral con 11 C-metionina. Rev Esp Med Nucl Imagen Mol 2017; 36:271-272. [DOI: 10.1016/j.remn.2016.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 08/04/2016] [Accepted: 08/05/2016] [Indexed: 11/29/2022]
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