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Jiménez M, Ivanovic-Zuvic D, Loureiro C, Carvajal CA, Cavada G, Schneider P, Gallardo E, García C, Gonzalez G, Contreras O, Collins MT, Florenzano P. Clinical and molecular characterization of Chilean patients with X-linked hypophosphatemia. Osteoporos Int 2021; 32:1825-1836. [PMID: 33666701 DOI: 10.1007/s00198-021-05875-w] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 02/02/2021] [Indexed: 11/30/2022]
Abstract
UNLABELLED We report the most comprehensive clinical and molecular characterization of XLH patients performed in Chile. We show high prevalence of musculoskeletal burden and pain, associated with significantly impaired physical capacity and quality of life, with many relevant complications presenting more frequently than previously reported in cohorts from developed countries. INTRODUCTION Our current understanding of the clinical presentation and natural history of X-linked hypophosphatemia (XLH) comes mainly from cohorts from developed countries, with limited data on the clinical and genetic abnormalities of XLH patients in South America. OBJECTIVE To describe the clinical, biochemical, and molecular presentation of patients with XLH in Chile. METHODS Patients with XLH referred by endocrinologist throughout Chile were included. Demographic data and clinical presentation were obtained from a clinical interview. Surveys were applied for quality of life (QoL), pain, and functionality. FGF23 was measured by ELISA, and genetic testing was performed. Imaging studies were conducted to assess skeletal and renal involvement. RESULTS We included 26 patients, aged 2-64 years, from 17 unrelated Chilean families. All pediatric patients but only 40% of adults were receiving conventional therapy, while 65% of all patients had elevated alkaline phosphatase. All patients had mutations in PHEX, including 5 novel variants. Radiographic skeletal events (RSE) and enthesopathies in adults were frequent (34% and 85%, respectively). The duration of treatment was associated with fewer RSE (p < 0.05). Most adults reported pain and impaired QoL, and 50% had impaired physical capacity. The number of enthesopathies was associated with worse pain and stiffness scores (p < 0.05). CONCLUSION Chilean patients with XLH have a high prevalence of musculoskeletal burden associated with pain and impaired physical capacity and QoL, especially in adults who were generally undertreated. These data identify a significant unmet need, inform our understanding of the current status of patients, and can guide care for XLH patients in similarly socioeconomically defined countries.
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Affiliation(s)
- M Jiménez
- Endocrinology Department, School of Medicine, Pontificia Universidad Católica de Chile, Av. Diagonal Paraguay 362, Cuarto Piso, Santiago, Chile
| | - D Ivanovic-Zuvic
- Internal Medicine Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - C Loureiro
- Department of Pediatric Endocrinology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - C A Carvajal
- Endocrinology Department, School of Medicine, Pontificia Universidad Católica de Chile, Av. Diagonal Paraguay 362, Cuarto Piso, Santiago, Chile
- Center for Translational Research in Endocrinology, CETREN-UC, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - G Cavada
- Biostatistics division, School of Public Health, Universidad de Chile, Santiago, Chile
- School of Medicine, Universidad Finnis Terrae, Santiago, Chile
| | - P Schneider
- Department of Pediatric Endocrinology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - E Gallardo
- Radiology Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - C García
- Radiology Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - G Gonzalez
- Endocrinology Department, School of Medicine, Pontificia Universidad Católica de Chile, Av. Diagonal Paraguay 362, Cuarto Piso, Santiago, Chile
- Center for Translational Research in Endocrinology, CETREN-UC, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - O Contreras
- Radiology Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - M T Collins
- Skeletal Disorders and Mineral Homeostasis Section, National Institutes of Dental and Craniofacial Research, National Institutes of Health (NIH), Bethesda, MD, USA
| | - P Florenzano
- Endocrinology Department, School of Medicine, Pontificia Universidad Católica de Chile, Av. Diagonal Paraguay 362, Cuarto Piso, Santiago, Chile.
- Center for Translational Research in Endocrinology, CETREN-UC, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
- Skeletal Disorders and Mineral Homeostasis Section, National Institutes of Dental and Craniofacial Research, National Institutes of Health (NIH), Bethesda, MD, USA.
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Abstract
INTRODUCTION Dental and oral health researchers compose a small share of the research workforce, and within this group female researchers form a much smaller share than male researchers. Additionally, a majority of full-time faculty appointments at dental schools are held by men, with women making up only 39% of full-time appointments. These factors suggest that there could be disparities between men and women in obtaining research funding. OBJECTIVE The focus of our study was to determine whether there are gender differences in award funding obtained from the National Institute of Dental and Craniofacial Research or the National Institutes of Health (NIH). METHODS NIH administrative data were analyzed by focusing on Research Project Grants (RPGs), the primary and most commonly used mechanism to support investigator-initiated research projects. Analyses involved 1 or 2 of the following variables: number of unique applicants or awardees, fiscal years 2007 to 2016, average age of unique applicants, awardee's degrees, awardee's age at first R01, and award rates. RESULTS About two-thirds of RPG applicants and awardees were men. Although there were significantly more male applicants and awardees, there was no significant difference in award rate by gender, and there was no significant award rate variation through time or by degrees. The average ages of RPG applicants were similar for genders for all degrees, except that male dentists and PhD-dentists applying to the National Institute of Dental and Craniofacial Research were older and male MDs and PhD-dentists from dental schools applying to the NIH were older. CONCLUSIONS This study demonstrated that men in the dental/oral health workforce submit more applications and receive more NIH awards than do women; however, there was no difference in award rates between women and men and no difference in ages by gender at which the first R01 awards are received. KNOWLEDGE TRANSFER STATEMENT Analyses of the implications of this study by the academic dentistry and oral health community could lead to establishing opportunities to expand the representation of women in dental and oral health research. Increasing the number of applications submitted by women may help achieve an equitable balance of grantees in the workforce.
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Affiliation(s)
- M.N. Garcia
- Applied Dental Medicine, School of Dental Medicine, Southern Illinois University, Alton, IL, USA
| | - J.P. Tiano
- Office of Science Policy and Analysis, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - O. Contreras
- Office of Policy, Research, and Diversity, American Dental Education Association, Washington, DC, USA
| | - C.F. Hildebolt
- Applied Dental Medicine, School of Dental Medicine, Southern Illinois University, Alton, IL, USA
| | - J. Horsford
- Office of Science Policy and Analysis, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - D. Stewart
- Office of Policy, Research, and Diversity, American Dental Education Association, Washington, DC, USA
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González G, Baudrand R, Sepúlveda MF, Vucetich N, Guarda FJ, Villanueva P, Contreras O, Villa A, Salech F, Toro L, Michea L, Florenzano P. Tumor-induced osteomalacia: experience from a South American academic center. Osteoporos Int 2017; 28:2187-2193. [PMID: 28341900 DOI: 10.1007/s00198-017-4007-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 03/10/2017] [Indexed: 12/19/2022]
Abstract
UNLABELLED The majority of tumor-induced osteomalacia cases have been reported in the Northern Hemisphere and Asia. In this first series of South American patients, we show that the clinical presentation and sensitivity of plasmatic fibroblast growth factor 23 and somatostatin analog-based imaging are similar to those described in other populations. INTRODUCTION Describe the experience of clinical presentation, diagnostic study, and treatment of patients with tumor-induced osteomalacia (TIO) in a South American academic center in comparison to literature. METHODS Analysis of the records of patients diagnosed with TIO. The clinical presentation, diagnostic studies, and treatment were analyzed. Fibroblast growth factor 23 (FGF23) was measured by ELISA. RESULTS Six patients were diagnosed with TIO during the studied period. The patients' median age was 53 years (range 22-64). All patients presented with weakness and pain in the extremities. Four experienced fractures during their evolution. The median time to diagnosis was 4.5 years (1-20). Biochemical studies showed hypophosphatemia, median of 1.4 mg/dL (1.2-1.6), with low maximum rates of tubular reabsorption of phosphate adjusted for glomerular filtration rate. FGF23 was elevated in 4/6 patients and inappropriately normal in the other two. In three patients, the location of the tumor was clinically evident and confirmed with anatomical imaging. In the remaining patients, two tumors were located with 68Ga DOTATATE-PET/CT and one with OctreoScan. The causal tumors were located in the lower extremities in five patients and invading the frontal sinus in one patient. In all patients, tumors were successfully removed. Within 14 days, there was normalization of phosphate and FGF23 levels and resolution of clinical symptoms in all patients. In all cases, the histopathology was compatible with a phosphaturic mesenchymal tumor. CONCLUSIONS The clinical presentation, delay time to diagnosis, FGF23 diagnostic sensitivity and histopathology in this first series of South American patients is similar to those described in other populations. The success of localization by somatostatin analog-based imaging, suggests this may the optimal imaging modality.
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Affiliation(s)
- G González
- Departamento de Endocrinología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Cuarto piso, Santiago, Chile
| | - R Baudrand
- Departamento de Endocrinología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Cuarto piso, Santiago, Chile
| | - M F Sepúlveda
- Departamento de Endocrinología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Cuarto piso, Santiago, Chile
| | - N Vucetich
- Departamento de Endocrinología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Cuarto piso, Santiago, Chile
| | - F J Guarda
- Departamento de Endocrinología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Cuarto piso, Santiago, Chile
| | - P Villanueva
- Departamento de Neurocirugía, Escuela de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - O Contreras
- Departamento de Radiología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - A Villa
- Departamento de Traumatología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Chile
| | - F Salech
- Instituto de Ciencias Biomédicas, Hospital Clinico Universidad de Chile, Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Centro de Investigacion Clinica Avanzada, Hospital Clinico Universidad de Chile, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - L Toro
- Instituto de Ciencias Biomédicas, Hospital Clinico Universidad de Chile, Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Centro de Investigacion Clinica Avanzada, Hospital Clinico Universidad de Chile, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - L Michea
- Instituto de Ciencias Biomédicas, Hospital Clinico Universidad de Chile, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - P Florenzano
- Departamento de Endocrinología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Cuarto piso, Santiago, Chile.
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Martínez J, Aznar S, Contreras O. El recreo escolar como oportunidad de espacio y tiempo saludable / The recess school space and time as an opportunity healthy.pp. 419-432. rimcafd 2015. [DOI: 10.15366/rimcafd2015.59.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Juarez A, Rivera A, Contreras O, Tellez S, Duran M, Islas L. Neurocisticercosis en el embarazo. Clínica e Investigación en Ginecología y Obstetricia 2013. [DOI: 10.1016/j.gine.2010.02.001] [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: 11/30/2022]
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Soto G, Tiznado H, Contreras O, Pérez-Tijerina E, Cruz-Reyes J, Del Valle M, Portillo A. Preparation of a Ag/SiO2 nanocomposite using a fluidized bed microwave plasma reactor, and its hydrodesulphurization and Escherichia coli bactericidal activities. POWDER TECHNOL 2011. [DOI: 10.1016/j.powtec.2011.07.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [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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Palma P, Riccetto C, Muller V, Fraga R, Contreras O, Sarsotti C, Paladini M, Cianci A, Barthos P. POS-01.15: Nazca: a monoprosthesis for the simultaneous correction of cystocele and urinary stress incontinence - a multicentric trial. Urology 2007. [DOI: 10.1016/j.urology.2007.06.903] [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: 11/24/2022]
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Palma P, Riccetto C, Müller V, Paladini M, Adile B, Cianci A, Contreras O, Barthos P. 871 MONOPROSTHESIS FOR SIMULTANEOUS CORRECTION OF STRESS URINARY INCONTINENCE AND CYSTOCELE: A MULTICENTRIC PROSPECTIVE STUDY. ACTA ACUST UNITED AC 2007. [DOI: 10.1016/s1569-9056(07)60866-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Dadgar A, Strittmatter A, Bläsing J, Poschenrieder M, Contreras O, Veit P, Riemann T, Bertram F, Reiher A, Krtschil A, Diez A, Hempel T, Finger T, Kasic A, Schubert M, Bimberg D, Ponce FA, Christen J, Krost A. Metalorganic chemical vapor phase epitaxy of gallium-nitride on silicon. ACTA ACUST UNITED AC 2003. [DOI: 10.1002/pssc.200303122] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Srinivasan S, Cai J, Contreras O, Ponce F, Look D, Molnar R. Luminescence Properties of Charged Dislocations in Semi‐Insulating GaN : Zn. ACTA ACUST UNITED AC 2002. [DOI: 10.1002/pssc.200390100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- S. Srinivasan
- Department of Physics and Astronomy, Arizona State University, P.O.Box 871504, Tempe, Arizona 85287, USA
| | - J. Cai
- Department of Physics and Astronomy, Arizona State University, P.O.Box 871504, Tempe, Arizona 85287, USA
| | - O. Contreras
- Department of Physics and Astronomy, Arizona State University, P.O.Box 871504, Tempe, Arizona 85287, USA
| | - F.A. Ponce
- Department of Physics and Astronomy, Arizona State University, P.O.Box 871504, Tempe, Arizona 85287, USA
| | - D.C. Look
- Semiconductor Research Center, Wright State University, Dayton, Ohio 45435, USA
| | - R.J. Molnar
- Massachusetts Institute of Technology, Lincoln Laboratory , Lexington, Massachusetts 02420, USA
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Dadgar A, Poschenrieder M, Contreras O, Christen J, Fehse K, Bl�sing J, Diez A, Schulze F, Riemann T, Ponce F, Krost A. Bright, Crack-Free InGaN/GaN Light Emitters on Si(111). ACTA ACUST UNITED AC 2002. [DOI: 10.1002/1521-396x(200208)192:2<308::aid-pssa308>3.0.co;2-m] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Fava M, Contreras O, Loyola S, López F. [Colorectal neoplasms. Treatment of obstruction with autoexpanding metal stents]. Rev Med Chil 1999; 127:1207-12. [PMID: 10835737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
BACKGROUND Expandable metal stents can be used as a palliative or pre surgical method to decompress obstructing colonic carcinomas. AIM To assess the effectiveness of these stents in the treatment of obstructive colonic carcinoma. PATIENTS AND METHODS Expandable metal stents were placed in nine patients with the diagnosis of colorectal carcinoma and with clinical and radiographic signs of intestinal obstruction. Stents were placed under fluoroscopic guidance in nine patients and with endoscopic help in 2. The indications were palliative treatment in 7 and pre surgical decompression in 2 patients. RESULTS Stent placement was successful in all patients. One patient presented a self limited rectal bleeding after the procedure. Obstruction was relieved in less than 24 hours after the procedure. CONCLUSION Expandable metal stent placement is an effective means of relieving intestinal obstruction caused by colorectal carcinoma.
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Affiliation(s)
- M Fava
- Departamento de Radiología, Pontificia Universidad Católica de Chile, Santiago-Chile
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Orellana P, Jalil R, Valdés F, Fava M, Olea E, Fernández MS, Valdés G, Contreras O, Fontbote C. [Renal scintigraphy with captopril in the evaluation of renovascular hypertension]. Rev Med Chil 1993; 121:762-7. [PMID: 8296080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The administration of an angiotensin-converting enzyme (ACE) inhibitor transitorily reduces the GFR in a kidney with renal artery stenosis, effect that can be ascertained with scintigraphic studies using ACE inhibitors. We evaluated the clinical usefulness of captopril renography (CR) in the diagnosis of renovascular hypertension (RVH) in 51 hypertensive patients in which this diagnosis was suspected. All subjects underwent angiography and RVH was diagnosed when renal artery stenosis exceeded 60%, there was lateralization of renal vein renin or there was a concordant clinical outcome. Renography was performed 15 minutes after Lasix administration, using Tc-99m DTPA, before and 60 minutes after the oral administration of 50 mg of captopril. The scintigraphic criteria for a positive test were a decreased split renal function, a delayed peak uptake, a decreased excretion of DTPA and a prolonged transit time. In three of 28 patients in whom angiography discarded RVH, CR was positive. In the 23 patients with confirmed RVH, CR was positive in 10 of 12 with unilateral stenosis, in 3 of 8 with bilateral stenosis and 1 of 3 with stenosis in a transplanted kidney. The overall sensitivity and specificity of the test for RVH was 60.9% and 89.2% respectively. There were no changes in blood pressure or adverse effects after captopril administration. We conclude that CR in RVH is useful to select patients for further studies (angiography) and to perform a functional interpretation of angiographic alterations.
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Affiliation(s)
- P Orellana
- Hospital Clínico, Facultad de Medicina, Pontifficia Universidad Católica, Santiago de Chile
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Abstract
Some defects related to untreated palatal or residual clefts represent major deformities. A review of 177 cases, untreated or operated on according to Schwekkendiek's (1958) chronology, was carried out. The advantage of simultaneous operative techniques is discussed, specifically pharyngoplasties, vestibular flap rotation, and osteoplastic closure. When all other surgical possibilities have failed, some flaps have been used to restore mucosal continuity. A multidisciplinary evaluation of each individual case is emphasized.
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Affiliation(s)
- O Contreras
- Craniomaxillo Facial Unit, Hospital Barros Luco Trudeau, Chilean Medical School, Santiago de Chile
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