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Rodríguez-Vázquez A, Laredo C, Renú A, Rudilosso S, Llull L, Amaro S, Obach V, Vera V, Páez A, Oleaga L, Urra X, Chamorro Á. Optimizing the Definition of Ischemic Core in CT Perfusion: Influence of Infarct Growth and Tissue-Specific Thresholds. AJNR Am J Neuroradiol 2022; 43:1265-1270. [PMID: 35981763 PMCID: PMC9451632 DOI: 10.3174/ajnr.a7601] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 06/20/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND PURPOSE CTP allows estimating ischemic core in patients with acute stroke. However, these estimations have limited accuracy compared with MR imaging. We studied the effect of applying WM- and GM-specific thresholds and analyzed the infarct growth from baseline imaging to reperfusion. MATERIALS AND METHODS This was a single-center cohort of consecutive patients (n = 113) with witnessed strokes due to proximal carotid territory occlusions with baseline CT perfusion, complete reperfusion, and follow-up DWI. We segmented GM and WM, coregistered CTP with DWI, and compared the accuracy of the different predictions for each voxel on DWI through receiver operating characteristic analysis. We assessed the yield of different relative CBF thresholds to predict the final infarct volume and an estimated infarct growth-corrected volume (subtracting the infarct growth from baseline imaging to complete reperfusion) for a single relative CBF threshold and GM- and WM-specific thresholds. RESULTS The fixed threshold underestimated lesions in GM and overestimated them in WM. Double GM- and WM-specific thresholds of relative CBF were superior to fixed thresholds in predicting infarcted voxels. The closest estimations of the infarct on DWI were based on a relative CBF of 25% for a single threshold, 35% for GM, and 20% for WM, and they decreased when correcting for infarct growth: 20% for a single threshold, 25% for GM, and 15% for WM. The combination of 25% for GM and 15% for WM yielded the best prediction. CONCLUSIONS GM- and WM-specific thresholds result in different estimations of ischemic core in CTP and increase the global accuracy. More restrictive thresholds better estimate the actual extent of the infarcted tissue.
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Affiliation(s)
- A Rodríguez-Vázquez
- From the Comprehensive Stroke Center (A.R.-V., C.L., A.R., S.R., L.L., S.A., V.O., V.V., X.U., A.C.), Functional Unit of Cerebrovascular Diseases
| | - C Laredo
- From the Comprehensive Stroke Center (A.R.-V., C.L., A.R., S.R., L.L., S.A., V.O., V.V., X.U., A.C.), Functional Unit of Cerebrovascular Diseases
| | - A Renú
- From the Comprehensive Stroke Center (A.R.-V., C.L., A.R., S.R., L.L., S.A., V.O., V.V., X.U., A.C.), Functional Unit of Cerebrovascular Diseases
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (A.R., S.R., L.L., S.A., V.O., X.U., A.C.), Barcelona, Spain
- University of Barcelona (A.R., L.L., S.A., V.O., X.U., A.C.), Barcelona, Spain
| | - S Rudilosso
- From the Comprehensive Stroke Center (A.R.-V., C.L., A.R., S.R., L.L., S.A., V.O., V.V., X.U., A.C.), Functional Unit of Cerebrovascular Diseases
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (A.R., S.R., L.L., S.A., V.O., X.U., A.C.), Barcelona, Spain
| | - L Llull
- From the Comprehensive Stroke Center (A.R.-V., C.L., A.R., S.R., L.L., S.A., V.O., V.V., X.U., A.C.), Functional Unit of Cerebrovascular Diseases
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (A.R., S.R., L.L., S.A., V.O., X.U., A.C.), Barcelona, Spain
- University of Barcelona (A.R., L.L., S.A., V.O., X.U., A.C.), Barcelona, Spain
| | - S Amaro
- From the Comprehensive Stroke Center (A.R.-V., C.L., A.R., S.R., L.L., S.A., V.O., V.V., X.U., A.C.), Functional Unit of Cerebrovascular Diseases
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (A.R., S.R., L.L., S.A., V.O., X.U., A.C.), Barcelona, Spain
- University of Barcelona (A.R., L.L., S.A., V.O., X.U., A.C.), Barcelona, Spain
| | - V Obach
- From the Comprehensive Stroke Center (A.R.-V., C.L., A.R., S.R., L.L., S.A., V.O., V.V., X.U., A.C.), Functional Unit of Cerebrovascular Diseases
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (A.R., S.R., L.L., S.A., V.O., X.U., A.C.), Barcelona, Spain
- University of Barcelona (A.R., L.L., S.A., V.O., X.U., A.C.), Barcelona, Spain
| | - V Vera
- From the Comprehensive Stroke Center (A.R.-V., C.L., A.R., S.R., L.L., S.A., V.O., V.V., X.U., A.C.), Functional Unit of Cerebrovascular Diseases
| | - A Páez
- Radiology Department (A.P., L.O.), Hospital Clínic, Barcelona, Spain
| | - L Oleaga
- Radiology Department (A.P., L.O.), Hospital Clínic, Barcelona, Spain
| | - X Urra
- From the Comprehensive Stroke Center (A.R.-V., C.L., A.R., S.R., L.L., S.A., V.O., V.V., X.U., A.C.), Functional Unit of Cerebrovascular Diseases
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (A.R., S.R., L.L., S.A., V.O., X.U., A.C.), Barcelona, Spain
- University of Barcelona (A.R., L.L., S.A., V.O., X.U., A.C.), Barcelona, Spain
| | - Á Chamorro
- From the Comprehensive Stroke Center (A.R.-V., C.L., A.R., S.R., L.L., S.A., V.O., V.V., X.U., A.C.), Functional Unit of Cerebrovascular Diseases
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (A.R., S.R., L.L., S.A., V.O., X.U., A.C.), Barcelona, Spain
- University of Barcelona (A.R., L.L., S.A., V.O., X.U., A.C.), Barcelona, Spain
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Vera V, Ashcroft J, Bennett J, Davies R. 231 Diagnostic Outcomes in Suspected Appendicitis Before and During the COVID-19 Pandemic. Br J Surg 2022. [PMCID: PMC9383475 DOI: 10.1093/bjs/znac039.146] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Introduction Routine operative treatment of appendicitis was temporarily interrupted during the COVID-19 pandemic. Non-operative management in suspected appendicitis makes a definitive diagnosis difficult. This study investigated diagnostic outcomes of suspected appendicitis patients before and during COVID-19. Method A retrospective review of patients aged 16–45 undergoing treatment for suspected appendicitis pre-COVID-19 (1st January 2019–1st January 2020) and during the COVID-19 pandemic (1st March 2020 to 31st June 2020) was performed. Patients were followed up for one year (31st June 2021) to explore diagnostic outcomes. Results At one year follow up, 206 patients were identified in the pre-COVID-19 cohort with 100% (n = 206) undergoing an appendicectomy. On histopathological examination 77.2% (n = 159) had appendicitis; 10.7% (n = 22) another pathology; 2.9% (n = 6) neuroendocrine tumour. There were 62 patients in the COVID-19 cohort in which 79% (n = 49) underwent appendicectomy (56% (n = 35) immediate appendicectomy; 23% (n = 13) interval appendicectomy). On histopathological examination 61% (n = 38) had appendicitis; 13% (n = 8) another pathology; 5% (n = 3) neuroendocrine tumour. Of the remaining 13/62 patients, one had undergone a CT scan and colonoscopy for gastrointestinal symptoms demonstrating signs of chronic caecal inflammation treated conservatively. One underwent a CT scan alone for gastrointestinal symptoms finding no pathology. The remaining 11/62 patients had no further reported symptoms or diagnostics. Conclusions This study demonstrates that the risk of appendiceal malignancy and chronic inflammation is important in non-operative management of suspected appendicitis and establishing consistent follow up pathways is essential.
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Affiliation(s)
- V. Vera
- Addenbrookes Hospital, Cambridge, United Kingdom
| | - J. Ashcroft
- Addenbrookes Hospital, Cambridge, United Kingdom
| | - J. Bennett
- Addenbrookes Hospital, Cambridge, United Kingdom
| | - R.J. Davies
- Addenbrookes Hospital, Cambridge, United Kingdom
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Rudilosso S, Ríos J, Rodríguez A, Gomis M, Vera V, Gómez-Choco M, Renú A, Matos N, Llull L, Purroy F, Amaro S, Terceño M, Obach V, Serena J, Martí-Fàbregas J, Cardona P, Molina C, Rodríguez-Campello A, Cánovas D, Krupinski J, Ustrell X, Torres F, Román LS, Salvat-Plana M, Jiménez-Fàbrega FX, Palomeras E, Catena E, Colom C, Cocho D, Baiges J, Aragones JM, Diaz G, Costa X, Almendros MC, Rybyeba M, Barceló M, Carrión D, Lòpez MN, Sanjurjo E, de la Ossa NP, Urra X, Chamorro Á. Effectiveness of Thrombectomy in Stroke According to Baseline Prognostic Factors: Inverse Probability of Treatment Weighting Analysis of a Population-Based Registry. J Stroke 2021; 23:401-410. [PMID: 34649384 PMCID: PMC8521260 DOI: 10.5853/jos.2021.00962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 05/10/2021] [Indexed: 11/28/2022] Open
Abstract
Background and Purpose In real-world practice, the benefit of mechanical thrombectomy (MT) is uncertain in stroke patients with very favorable or poor prognostic profiles at baseline. We studied the effectiveness of MT versus medical treatment stratifying by different baseline prognostic factors. Methods Retrospective analysis of 2,588 patients with an ischemic stroke due to large vessel occlusion nested in the population-based registry of stroke code activations in Catalonia from January 2017 to June 2019. The effect of MT on good functional outcome (modified Rankin Score ≤2) and survival at 3 months was studied using inverse probability of treatment weighting (IPTW) analysis in three pre-defined baseline prognostic groups: poor (if pre-stroke disability, age >85 years, National Institutes of Health Stroke Scale [NIHSS] >25, time from onset >6 hours, Alberta Stroke Program Early CT Score <6, proximal vertebrobasilar occlusion, supratherapeutic international normalized ratio >3), good (if NIHSS <6 or distal occlusion, in the absence of poor prognostic factors), or reference (not meeting other groups’ criteria).
Results Patients receiving MT (n=1,996, 77%) were younger, had less pre-stroke disability, and received systemic thrombolysis less frequently. These differences were balanced after the IPTW stratified by prognosis. MT was associated with good functional outcome in the reference (odds ratio [OR], 2.9; 95% confidence interval [CI], 2.0 to 4.4), and especially in the poor baseline prognostic stratum (OR, 3.9; 95% CI, 2.6 to 5.9), but not in the good prognostic stratum. MT was associated with survival only in the poor prognostic stratum (OR, 2.6; 95% CI, 2.0 to 3.3).
Conclusions Despite their worse overall outcomes, the impact of thrombectomy over medical management was more substantial in patients with poorer baseline prognostic factors than patients with good prognostic factors.
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Affiliation(s)
- Salvatore Rudilosso
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.,Clinical and Experimental Neuroscience: Cerebrovascular Diseases, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - José Ríos
- Medical Statistics Core Facility, August Pi i Sunyer Biomedical Research Institute (IDIBAPS) and Hospital Clinic, Barcelona, Spain.,Biostatistics Unit, Faculty of Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Alejandro Rodríguez
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Meritxell Gomis
- Stroke Unit, Department of Neuroscience, Germans Trias Hospital, Badalona, Spain
| | - Víctor Vera
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain
| | | | - Arturo Renú
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.,Clinical and Experimental Neuroscience: Cerebrovascular Diseases, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Núria Matos
- Department of Neurology, Althaia Foundation Hospital, Manresa, Spain
| | - Laura Llull
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.,Clinical and Experimental Neuroscience: Cerebrovascular Diseases, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Francisco Purroy
- Stroke Unit, Department of Neurology, University Hospital Arnau of Vilanova, Lleida, Spain
| | - Sergio Amaro
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.,Clinical and Experimental Neuroscience: Cerebrovascular Diseases, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Mikel Terceño
- Stroke Unit, Department of Neurology, Josep Trueta University Hospital, Girona, Spain
| | - Víctor Obach
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Joaquim Serena
- Stroke Unit, Department of Neurology, Josep Trueta University Hospital, Girona, Spain
| | - Joan Martí-Fàbregas
- Stroke Unit, Department of Neurology, Santa Creu i Sant Pau, Barcelona, Spain
| | - Pedro Cardona
- Stroke Unit, Department of Neurology, Bellvitge University Hospital, Barcelona, Spain
| | - Carlos Molina
- Stroke Unit, Department of Neurology, Vall d'Hebron University Hospital, Barcelona, Spain
| | | | - David Cánovas
- Department of Neurology, Parc Taulí Hospital, Sabadell, Spain
| | - Jerzy Krupinski
- Department of Neurology, Mutua de Terrassa University Hospital, Terrassa, Spain
| | - Xavier Ustrell
- Stroke Unit, Department of Neurology, Joan XXIII University Hospital, Terragona, Spain
| | - Ferran Torres
- Medical Statistics Core Facility, August Pi i Sunyer Biomedical Research Institute (IDIBAPS) and Hospital Clinic, Barcelona, Spain.,Biostatistics Unit, Faculty of Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Luis San Román
- Department of Radiology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - Mercè Salvat-Plana
- Department of Health, Pla Director Malaltia Vascular Cerebral (Catalan Stroke Program), Barcelona, Spain
| | | | | | - Esther Catena
- Department of Neurology, Consorci Sanitari Garraf Hospital, Sant Pere de Ribes, Spain
| | - Carla Colom
- Department of Emergency, Hospital of Igualada, Igualada, Spain
| | - Dolores Cocho
- Department of Emergency, Hospital of Granollers, Granollers, Spain
| | - Juanjo Baiges
- Department of Emergency, Verge de la Cinta Hospital, Tortosa, Spain
| | | | - Gloria Diaz
- Department of Emergency, Hospital of Campdevànol, Campdevànol, Spain
| | - Xavier Costa
- Department of Emergency, Hospital of Figueres, Figueres, Spain
| | | | - Maria Rybyeba
- Department of Emergency, Hospital of Olot, Olot, Spain
| | - Miquel Barceló
- Department of Emergency, Cerdanya Hospital, Puigcerdá, Spain
| | - Dolors Carrión
- Department of Emergency, Hospital of Móra d'Ebre, Móra d'Ebre, Spain
| | | | | | - Natalia Pérez de la Ossa
- Stroke Unit, Department of Neuroscience, Germans Trias Hospital, Badalona, Spain.,Department of Health, Pla Director Malaltia Vascular Cerebral (Catalan Stroke Program), Barcelona, Spain
| | - Xabier Urra
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.,Clinical and Experimental Neuroscience: Cerebrovascular Diseases, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Ángel Chamorro
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain.,Clinical and Experimental Neuroscience: Cerebrovascular Diseases, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.,University of Barcelona, Barcelona, Spain
| | -
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clínic of Barcelona, Barcelona, Spain
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Abdalkader M, Shaikh SP, Siegler JE, Cervantes-Arslanian AM, Tiu C, Radu RA, Tiu VE, Jillella DV, Mansour OY, Vera V, Chamorro Á, Blasco J, López A, Farooqui M, Thau L, Smith A, Gutierrez SO, Nguyen TN, Jovin TG. Cerebral Venous Sinus Thrombosis in COVID-19 Patients: A Multicenter Study and Review of Literature. J Stroke Cerebrovasc Dis 2021; 30:105733. [PMID: 33743411 PMCID: PMC7931726 DOI: 10.1016/j.jstrokecerebrovasdis.2021.105733] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/23/2021] [Accepted: 02/28/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND COVID-19 infection has been known to predispose patients to both arterial and venous thromboembolic events such as deep venous thrombosis, pulmonary embolism, myocardial infarction, and stroke. A few reports from the literature suggest that Cerebral Venous Sinus Thrombosis (CVSTs) may be a direct complication of COVID-19. OBJECTIVE To review the clinical and radiological presentation of COVID-19 positive patients diagnosed with CVST. METHODS This was a multicenter, cross-sectional, retrospective study of patients diagnosed with CVST and COVID-19 reviewed from March 1, 2020 to November 8, 2020. We evaluated their clinical presentations, risk factors, clinical management, and outcome. We reviewed all published cases of CVST in patients with COVID-19 infection from January 1, 2020 to November 13, 2020. RESULTS There were 8 patients diagnosed with CVST and COVID-19 during the study period at 7 out of 31 participating centers. Patients in our case series were mostly female (7/8, 87.5%). Most patients presented with non-specific symptoms such as headache (50%), fever (50%), and gastrointestinal symptoms (75%). Several patients presented with focal neurologic deficits (2/8, 25%) or decreased consciousness (2/8, 25%). D-dimer and inflammatory biomarkers were significantly elevated relative to reference ranges in patients with available laboratory data. The superior sagittal and transverse sinuses were the most common sites for acute CVST formation (6/8, 75%). Median time to onset of focal neurologic deficit from initial COVID-19 diagnosis was 3 days (interquartile range 0.75-3 days). Median time from onset of COVID-19 symptoms to CVST radiologic diagnosis was 11 days (interquartile range 6-16.75 days). Mortality was low in this cohort (1/8 or 12.5%). CONCLUSIONS Clinicians should consider the risk of acute CVST in patients positive for COVID-19, especially if neurological symptoms develop.
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Affiliation(s)
- Mohamad Abdalkader
- Department of Radiology, Boston Medical Center, Boston, Massachusetts, USA.
| | - Shamsh P Shaikh
- Department of Neurology, Boston Medical Center, Boston, Massachusetts, USA
| | - James E Siegler
- Department of Neurosurgery, Boston Medical Center, Boston, Massachusetts, USA
| | - Anna M Cervantes-Arslanian
- Department of Neurology, Boston Medical Center, Boston, Massachusetts, USA; Department of Neurology, Cooper University Hospital, Camden, New Jersey, USA
| | - Cristina Tiu
- Department of Neurology, Elias University Emergency Hospital, Bucharest, Romania
| | | | - Vlad Eugen Tiu
- Department of Neurology, Elias University Emergency Hospital, Bucharest, Romania
| | - Dinesh V Jillella
- Department of Neurology, Emory University Hospital, Atlanta, Georgia, USA
| | - Ossama Yassin Mansour
- Department of Neurology, Alexandria University School of Medicine, Alexandria, Egypt
| | - Víctor Vera
- Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Ángel Chamorro
- Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Jordi Blasco
- Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Antonio López
- Department of Radiology, Hospital Clínic de Barcelona, Barcelona, Spain
| | | | - Lauren Thau
- Department of Neurosurgery, Boston Medical Center, Boston, Massachusetts, USA
| | - Ainsley Smith
- Department of Neurosurgery, Boston Medical Center, Boston, Massachusetts, USA
| | | | - Thanh N Nguyen
- Department of Radiology, Boston Medical Center, Boston, Massachusetts, USA; Department of Neurology, Boston Medical Center, Boston, Massachusetts, USA; Department of Neurology, Cooper University Hospital, Camden, New Jersey, USA
| | - Tudor G Jovin
- Department of Neurosurgery, Boston Medical Center, Boston, Massachusetts, USA
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Rudilosso S, Olivera M, Esteller D, Laredo C, Amaro S, Llull L, Renú A, Obach V, Vera V, Rodríguez A, Blasco J, López-Rueda A, Urra X, Chamorro Á. Susceptibility Vessel Sign in Deep Perforating Arteries in Patients with Recent Small Subcortical Infarcts. J Stroke Cerebrovasc Dis 2020; 30:105415. [PMID: 33142246 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105415] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/05/2020] [Accepted: 10/15/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Recent small subcortical infarcts (RSSI) are considered an acute manifestation of cerebral small vessel disease. Paramagnetic signals in perforating arteries supplying RSSI may be detected on T2*-relaxation derived sequences on MRI and is defined as susceptibility vessel sign (SVS). We aimed to study the prevalence of SVS in patients with RSSI, and explore whether its identification is related to cerebral small vessel disease markers. MATERIALS AND METHODS We selected patients with RSSI identified on MRI during admission from a single-center stroke registry. The main demographic and clinical features, including vascular risk factors, were collected. Radiological features of RSSI and cerebral small vessel disease [white matter hyperintensities in deep and periventricular regions, enlarged perivascular spaces, lacunae, microbleeds, and brain atrophy] were described using validated qualitative scores. The presence of SVS was assessed on T2*gradient-echo or other susceptibility-weighted imaging. We compared the clinical and radiological features of patients with or without SVS in uni- and multivariate models. RESULTS Out of 210 patients with an RSSI on an MRI, 35 (17%) showed SVS. The proportion of SVS+ patients was similar in different susceptibility imaging modalities (p=.64). Risk factor profiles and clinical course were similar in SVS+ and SVS- patients. SVS+ patients had a higher grade of deep white matter hyperintensities and brain atrophy, more lacunae (p=.001, p=.034, p=.022, respectively), and a similar degree of the rest of radiological variables, compared to SVS- patients. In the multivariate analysis, the grade of deep white matter hyperintensities was the only independent factor associated with SVS [OR 3.1 (95% CI, 1.5-6.4)]. CONCLUSIONS SVS in patients with RSSI is uncommon and related to a higher grade of deep white matter hyperintensities. Pathophysiological mechanisms underlying the deposition of hemosiderin in the path of occluded perforating arteries are uncertain and might include endothelial dysfunction or embolic mechanisms.
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Affiliation(s)
- Salvatore Rudilosso
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.
| | - Marta Olivera
- Department of Neurology, Hospital Clínic of Barcelona, Spain
| | - Diana Esteller
- Department of Neurology, Hospital Clínic of Barcelona, Spain
| | - Carlos Laredo
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Sergio Amaro
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Laura Llull
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Arturo Renú
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Víctor Obach
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Víctor Vera
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain
| | - Alejandro Rodríguez
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain
| | - Jordi Blasco
- Department of Radiology, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Antonio López-Rueda
- Department of Radiology, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Xabier Urra
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain.
| | - Ángel Chamorro
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona, Villarroel 170, 08036 Barcelona, Spain; August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
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6
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Rudilosso S, Laredo C, Vera V, Vargas M, Renú A, Llull L, Obach V, Amaro S, Urra X, Torres F, Jiménez-Fàbrega FX, Chamorro Á. Acute Stroke Care Is at Risk in the Era of COVID-19: Experience at a Comprehensive Stroke Center in Barcelona. Stroke 2020; 51:1991-1995. [PMID: 32438895 PMCID: PMC7258755 DOI: 10.1161/strokeaha.120.030329] [Citation(s) in RCA: 180] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND PURPOSE The purpose of the study is to analyze how the coronavirus disease 2019 (COVID-19) pandemic affected acute stroke care in a Comprehensive Stroke Center. METHODS On February 28, 2020, contingency plans were implemented at Hospital Clinic of Barcelona to contain the COVID-19 pandemic. Among them, the decision to refrain from reallocating the Stroke Team and Stroke Unit to the care of patients with COVID-19. From March 1 to March 31, 2020, we measured the number of emergency calls to the Emergency Medical System in Catalonia (7.5 million inhabitants), and the Stroke Codes dispatched to Hospital Clinic of Barcelona. We recorded all stroke admissions, and the adequacy of acute care measures, including the number of thrombectomies, workflow metrics, angiographic results, and clinical outcomes. Data were compared with March 2019 using parametric or nonparametric methods as appropriate. RESULTS At Hospital Clinic of Barcelona, 1232 patients with COVID-19 were admitted in March 2020, demanding 60% of the hospital bed capacity. Relative to March 2019, the Emergency Medical System had a 330% mean increment in the number of calls (158 005 versus 679 569), but fewer Stroke Code activations (517 versus 426). Stroke admissions (108 versus 83) and the number of thrombectomies (21 versus 16) declined at Hospital Clinic of Barcelona, particularly after lockdown of the population. Younger age was found in stroke admissions during the pandemic (median [interquartile range] 69 [64-73] versus 75 [73-80] years, P=0.009). In-hospital, there were no differences in workflow metrics, angiographic results, complications, or outcomes at discharge. CONCLUSIONS The COVID-19 pandemic reduced by a quarter the stroke admissions and thrombectomies performed at a Comprehensive Stroke Center but did not affect the quality of care metrics. During the lockdown, there was an overload of emergency calls but fewer Stroke Code activations, particularly in elderly patients. Hospital contingency plans, patient transport systems, and population-targeted alerts must act concertedly to better protect the chain of stroke care in times of pandemic.
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Affiliation(s)
- Salvatore Rudilosso
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain (S.R., C.L., V.V., M.V., A.R., L.L., V.O., S.A., X.U., Á.C.)
| | - Carlos Laredo
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain (S.R., C.L., V.V., M.V., A.R., L.L., V.O., S.A., X.U., Á.C.)
| | - Víctor Vera
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain (S.R., C.L., V.V., M.V., A.R., L.L., V.O., S.A., X.U., Á.C.)
| | - Martha Vargas
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain (S.R., C.L., V.V., M.V., A.R., L.L., V.O., S.A., X.U., Á.C.)
| | - Arturo Renú
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain (S.R., C.L., V.V., M.V., A.R., L.L., V.O., S.A., X.U., Á.C.)
| | - Laura Llull
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain (S.R., C.L., V.V., M.V., A.R., L.L., V.O., S.A., X.U., Á.C.)
| | - Víctor Obach
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain (S.R., C.L., V.V., M.V., A.R., L.L., V.O., S.A., X.U., Á.C.)
| | - Sergio Amaro
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain (S.R., C.L., V.V., M.V., A.R., L.L., V.O., S.A., X.U., Á.C.)
| | - Xabier Urra
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain (S.R., C.L., V.V., M.V., A.R., L.L., V.O., S.A., X.U., Á.C.)
| | - Ferrán Torres
- Biostatistics Unit, Autonomous University of Barcelona, Spain (F.T.)
| | | | - Ángel Chamorro
- Comprehensive Stroke Center, Department of Neuroscience, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Spain (S.R., C.L., V.V., M.V., A.R., L.L., V.O., S.A., X.U., Á.C.)
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Kaplan V, Morales C, Bobadilla F, Fernández J, Segovia L, Vera V, Sanhueza I. Epidemiologic and Histopathologic Characterization of Cutaneous Metastases in Patients Who Visited 2 Hospitals in Santiago de Chile Between 2005 and 2017. Actas Dermo-Sifiliográficas (English Edition) 2019. [DOI: 10.1016/j.adengl.2019.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Kaplan V, Morales C, Bobadilla F, Fernández J, Segovia L, Vera V, Sanhueza I. Epidemiologic and Histopathologic Characterization of Cutaneous Metastases in Patients Who Visited 2 Hospitals in Santiago de Chile Between 2005 and 2017. Actas Dermosifiliogr (Engl Ed) 2018; 110:220-226. [PMID: 30577946 DOI: 10.1016/j.ad.2018.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/12/2018] [Accepted: 07/15/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Cutaneous metastases (CMs) account for 2% of skin tumors and their incidence varies between 0.7% and 9% in patients with cancer. The objective of this study was to describe and analyze the demographic, clinical, and histopathologic characteristics of CM in patients who visited 2 hospitals in the Santiago de Chile metropolitan region. MATERIAL AND METHOD We performed a retrospective, descriptive, analytical, observational, cross-sectional study. We reviewed the pathology reports, patient records, pathology slides, and dates of death for diagnosed cases of CM from the anatomic pathology departments of 2 hospitals in the Santiago de Chile metropolitan region between 2015 and 2017. RESULTS Ninety-six patients with CM were included in the study; 60.42% were women and 39.58% were men. The mean (SD) age was 67.95 (13.74) years, with a range of 28 to 96 years. The most common primary tumor was melanoma in 27.08% of cases (n=26), followed by breast cancer (18.75%, n=18), and adenocarcinoma (15.63%, n=15). The median time between diagnosis of the tumor and cutaneous metastasis was 9 months. Patients with CM of melanoma had a higher survival rate than patients with metastasis of other primary tumors (P<.05). A histopathologic study of 91 slides showed that diffuse infiltration of the tissue with tumor cells was the most common pattern and vascular invasion was rare. CONCLUSIONS The results are similar to those found worldwide. CM is a rare manifestation of internal tumors. It presents mainly at an advanced age and is equally prevalent in both sexes.
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Affiliation(s)
- V Kaplan
- Departamento de Dermatología y Venereología, Universidad de Chile, Santiago, Chile.
| | - C Morales
- Servicio de Anatomía Patológica, Hospital Clínico de la Universidad de Chile, Santiago, Chile
| | - F Bobadilla
- Servicio de Dermatología y Venereología, Hospital Barros Luco Trudeau, Santiago, Chile
| | - J Fernández
- Servicio de Dermatología y Venereología, Hospital San José, Santiago, Chile
| | - L Segovia
- Servicio de Anatomía Patológica, Hospital Barros Luco Trudeau, Santiago, Chile
| | - V Vera
- Departamento de Nutrición, Universidad de Chile, Santiago, Chile
| | - I Sanhueza
- Facultad de Medicina, Universidad de Chile, Santiago, Chile
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Hernando B, Aliaga I, Fernandez C, Garcia E, Gomez A, Vera V. Caries in Mount Classification: clinical and radiological concordance. J Clin Exp Dent 2017. [DOI: 10.4317/medoral.176438700] [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: 11/05/2022] Open
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Hervás I, Bello P, Falgas M, Del Olmo MI, Torres I, Olivas C, Vera V, Oliván P, Yepes AM. 177Lu-DOTATATE treatment in neuroendocrine tumours. A preliminary study. Rev Esp Med Nucl Imagen Mol 2016; 36:91-98. [PMID: 27889527 DOI: 10.1016/j.remn.2016.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 09/29/2016] [Accepted: 10/03/2016] [Indexed: 02/07/2023]
Abstract
Therapy with radiolabelled somatostatin analogue peptides is a promising new therapy to treat neuroendocrine tumours. The aim of this preliminary study is to present our experience with 177Lu-DOTATATE therapy, and evaluate tolerability and short-term efficacy in patients with tumours expressing somatostatin receptors. A total of 7 patients with metastatic neuroendocrine tumours were treated, each with 4 doses of 177Lu-DOTATATE. The treatment response was evaluated in the form of biochemical response (tumour markers), imaging methods (somatostatin receptor scintigraphy, computed tomography, and magnetic resonance), and functional and quality of life responses using the Karnofsky performance status scale. Treatment toxicity was also evaluated. The results obtained were as follows: Biochemical response: 60% of patients showed tumour marker levels returning to normal, while they decreased significantly in the remaining 40%. Imaging response: 85.7% had a partial response, while 14.3% showed stable disease. All (100%) patients showed a significant improvement in quality of life, with increased Karnofsky scale scores. No patient had acute or chronic toxicity, and subacute transient haematological toxicity was observed in 42.8% of patients. Despite being a preliminary study, it was found that treatment with 177Lu-DOTATATE is a safe treatment with few side effects, and an objective response was achieved in most patients.
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Affiliation(s)
- I Hervás
- Servicio de Medicina Nuclear, Hospital Universitario La Fe, Valencia, España.
| | - P Bello
- Servicio de Medicina Nuclear, Hospital Universitario La Fe, Valencia, España
| | - M Falgas
- Servicio de Medicina Nuclear, Hospital Universitario La Fe, Valencia, España
| | - M I Del Olmo
- Servicio de Endocrinología, Hospital Universitario La Fe, Valencia, España
| | - I Torres
- Servicio de Medicina Nuclear, Hospital Universitario La Fe, Valencia, España
| | - C Olivas
- Servicio de Medicina Nuclear, Hospital Universitario La Fe, Valencia, España
| | - V Vera
- Servicio de Medicina Nuclear, Hospital Universitario La Fe, Valencia, España
| | - P Oliván
- Servicio de Medicina Nuclear, Hospital Universitario La Fe, Valencia, España
| | - A M Yepes
- Servicio de Medicina Nuclear, Hospital Universitario La Fe, Valencia, España
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Taniguchi Y, Takahashi Y, Toba T, Yamada S, Yokoi K, Kobayashi S, Okajima S, Shimane A, Kawai H, Yasaka Y, Smanio P, Oliveira MA, Machado L, Cestari P, Medeiros E, Fukuzawa S, Okino S, Ikeda A, Maekawa J, Ichikawa S, Kuroiwa N, Yamanaka K, Igarashi A, Inagaki M, Patel K, Mahan M, Ananthasubramaniam K, Mouden M, Yokota S, Ottervanger J, Knollema S, Timmer J, Jager P, Padron K, Peix A, Cabrera L, Pena Bofill V, Valera D, Rodriguez Nande L, Carrillo Hernandez R, Mena Esnard E, Fernandez Columbie Y, Bertella E, Baggiano A, Mushtaq S, Segurini C, Loguercio M, Conte E, Beltrama V, Petulla' M, Andreini D, Pontone G, Guzic Salobir B, Dolenc Novak M, Jug B, Kacjan B, Novak Z, Vrtovec M, Mushtaq S, Pontone G, Bertella E, Conte E, Segurini C, Volpato V, Baggiano A, Formenti A, Pepi M, Andreini D, Ajanovic R, Husic-Selimovic A, Zujovic-Ajanovic A, Mlynarski R, Mlynarska A, Golba K, Sosnowski M, Ameta D, Goyal M, Kumar D, Chandra S, Sethi R, Puri A, Dwivedi SK, Narain VS, Saran RK, Nekolla S, Rischpler C, Nicolosi S, Langwieser N, Dirschinger R, Laugwitz K, Schwaiger M, Goral JL, Napoli J, Forcada P, Zucchiatti N, Damico A, Damico A, Olivieri D, Lavorato M, Dubesarsky E, Montana O, Salgado C, Jimenez-Heffernan A, Ramos-Font C, Lopez-Martin J, Sanchez De Mora E, Lopez-Aguilar R, Manovel A, Martinez A, Rivera F, Soriano E, Maroz-Vadalazhskaya N, Trisvetova E, Vrublevskaya O, Abazid R, Kattea M, Saqqah H, Sayed S, Smettei O, Winther S, Svensson M, Birn H, Jorgensen H, Botker H, Ivarsen P, Bottcher M, Maaniitty T, Stenstrom I, Saraste A, Pikkarainen E, Uusitalo V, Ukkonen H, Kajander S, Bax J, Knuuti J, Choi T, Park H, Lee C, Lee J, Seo Y, Cho Y, Hwang E, Cho D, Sanchez Enrique C, Ferrera C, Olmos C, Jimenez - Ballve A, Perez - Castejon MJ, Fernandez C, Vivas D, Vilacosta I, Nagamachi S, Onizuka H, Nishii R, Mizutani Y, Kitamura K, Lo Presti M, Polizzi V, Pino P, Luzi G, Bellavia D, Fiorilli R, Madeo A, Malouf J, Buffa V, Musumeci F, Rosales S, Puente A, Zafrir N, Shochat T, Mats A, Solodky A, Kornowski R, Lorber A, Boemio A, Pellegrino T, Paolillo S, Piscopo V, Carotenuto R, Russo B, Pellegrino S, De Matteis G, Perrone-Filardi P, Cuocolo A, Piscopo V, Pellegrino T, Boemio A, Carotenuto R, Russo B, Pellegrino S, De Matteis G, Petretta M, Cuocolo A, Amirov N, Ibatullin M, Sadykov A A, Saifullina G, Ruano R, Diego Dominguez M, Rodriguez Gabella T, Diego Nieto A, Diaz Gonzalez L, Garcia-Talavera J, Sanchez Fernandez P, Leen A, Al Younis I, Zandbergen-Harlaar S, Verberne H, Gimelli A, Veltman C, Wolterbeek R, Bax J, Scholte A, Mooney D, Rosenblatt J, Dunn T, Vasaiwala S, Okuda K, Nakajima K, Nystrom K, Edenbrandt L, Matsuo S, Wakabayashi H, Hashimoto M, Kinuya S, Iric-Cupic V, Milanov S, Davidovic G, Zdravkovic V, Ashikaga K, Yoneyama K, Akashi Y, Shugushev Z, Maximkin D, Chepurnoy A, Volkova O, Baranovich V, Faibushevich A, El Tahlawi M, Elmurr A, Alzubaidi S, Sakrana A, Gouda M, El Tahlawi R, Sellem A, Melki S, Elajmi W, Hammami H, Okano M, Kato T, Kimura M, Funasako M, Nakane E, Miyamoto S, Izumi T, Haruna T, Inoko M, Massardo T, Swett E, Fernandez R, Vera V, Zhindon J, Fernandez R, Swett E, Vera V, Zhindon J, Alay R, Massardo T, Ohshima S, Nishio M, Kojima A, Tamai S, Kobayashi T, Murohara T, Burrell S, Van Rosendael A, Van Den Hoogen I, De Graaf M, Roelofs J, Kroft L, Bax J, Scholte A, Rjabceva I, Krumina G, Kalvelis A, Chanakhchyan F, Vakhromeeva M, Kankiya E, Koppes J, Knol R, Wondergem M, Van Der Ploeg T, Van Der Zant F, Lazarenko SV, Bruin VS, Pan XB, Declerck JM, Van Der Zant FM, Knol RJJ, Juarez-Orozco LE, Alexanderson E, Slart R, Tio R, Dierckx R, Zeebregts C, Boersma H, Hillege H, Martinez-Aguilar M, Jordan-Rios A, Christensen TE, Ahtarovski KA, Bang LE, Holmvang L, Soeholm H, Ghotbi AA, Andersson H, Ihlemann N, Kjaer A, Hasbak P, Gulya M, Lishmanov YB, Zavadovskii K, Lebedev D, Stahle M, Hellberg S, Liljenback H, Virta J, Metsala O, Yla-Herttuala S, Saukko P, Knuuti J, Saraste A, Roivainen A, Thackeray J, Wang Y, Bankstahl J, Wollert K, Bengel F, Saushkina Y, Evtushenko V, Minin S, Efimova I, Evtushenko A, Smishlyaev K, Lishmanov Y, Maslov L, Okuda K, Nakajima K, Kirihara Y, Sugino S, Matsuo S, Taki J, Hashimoto M, Kinuya S, Ahmadian A, Berman J, Govender P, Ruberg F, Miller E, Piriou N, Pallardy A, Valette F, Cahouch Z, Mathieu C, Warin-Fresse K, Gueffet J, Serfaty J, Trochu J, Kraeber-Bodere F, Van Dijk J, Mouden M, Ottervanger J, Van Dalen J, Jager P, Zafrir N, Ofrk H, Vaturi M, Shochat T, Hassid Y, Belzer D, Sagie A, Kornowski R, Kaminek M, Metelkova I, Budikova M, Koranda P, Henzlova L, Sovova E, Kincl V, Drozdova A, Jordan M, Shahid F, Teoh Y, Thamen R, Hara N, Onoguchi M, Hojyo O, Kawaguchi Y, Murai M, Udaka F, Matsuzawa Y, Bulugahapitiya DS, Avison M, Martin J, Liu YH, Wu J, Liu C, Sinusas A, Daou D, Sabbah R, Bouladhour H, Coaguila C, Aguade-Bruix S, Pizzi M, Romero-Farina G, Candell-Riera J, Castell-Conesa J, Patchett N, Sverdlov A, Miller E, Daou D, Sabbah R, Bouladhour H, Coaguila C, Smettei O, Abazid R, Boulaamayl El Fatemi S, Sallam L, Snipelisky D, Park J, Ray J, Shapiro B, Kostkiewicz M, Szot W, Holcman K, Lesniak-Sobelga A, Podolec P, Clerc O, Possner M, Liga R, Vontobel J, Mikulicic F, Graeni C, Benz D, Herzog B, Gaemperli O, Kaufmann P. Poster Session 1: Sunday 3 May 2015, 08:30-18:00 * Room: Poster Area. Eur Heart J Cardiovasc Imaging 2015. [DOI: 10.1093/ehjci/jev051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Moran JM, Rodriguez-Velasco FJ, Roncero-Martin R, Vera V, Pedrera-Zamorano JD. Cytotoxic effects of curcumin in osteosarcoma cells. Int J Nanomedicine 2014; 9:5273-5. [PMID: 25484580 PMCID: PMC4238894 DOI: 10.2147/ijn.s75005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- J M Moran
- Metabolic Bone Diseases Research Group, University of Extremadura, Cáceres, Spain
| | | | - R Roncero-Martin
- Metabolic Bone Diseases Research Group, University of Extremadura, Cáceres, Spain
| | - V Vera
- Metabolic Bone Diseases Research Group, University of Extremadura, Cáceres, Spain
| | - J D Pedrera-Zamorano
- Metabolic Bone Diseases Research Group, University of Extremadura, Cáceres, Spain
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Vera G, Tam J, Vera V, Pinto E. Pruebas ecotoxicológicas con cadmio y cromo usando postlarvas del pejerrey Odontesthes (Austromenidia) regia regia Hildebrand. Rev peru biol 2014. [DOI: 10.15381/rpb.v8i2.6715] [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: 12/01/2022] Open
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Parra M, Villouta S, Vera V, Belmar J, Zúñiga C, Zunza H. Synthesis and Mesomorphic Properties of Azo Compounds Derived from Phenyl-and Thienyl-1,3,4-Thiadiazole. ACTA ACUST UNITED AC 2014. [DOI: 10.1515/znb-1997-1215] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The synthesis and mesomorphic behaviour of new series of liquid crystals containing 1,3,4- thiadiazole and thiophene rings with azo central bond are reported (series 5a and 5b). All compounds of series 5a exhibit enantiotropic nematic mesophase and the higher homologues (n = 9 - 10) also show a monotropic smectic C phase. Series 5b show dimorphism SC - N (for n = 5 - 7 the SC is monotropic). These series are compared with the Schiff’s bases analogues, the imine bond gives rise to similar liquid crystals phase but larger mesomorphic range.
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Affiliation(s)
- M. Parra
- Concepción, Departamento de Química Orgánica, Facultad de Ciencias Químicas, Universidad de Concepción, Casilla 3-C, Concepción-Chile
| | - Sh. Villouta
- Concepción, Departamento de Química Orgánica, Facultad de Ciencias Químicas, Universidad de Concepción, Casilla 3-C, Concepción-Chile
| | - V. Vera
- Concepción, Departamento de Química Orgánica, Facultad de Ciencias Químicas, Universidad de Concepción, Casilla 3-C, Concepción-Chile
| | - J. Belmar
- Concepción, Departamento de Química Orgánica, Facultad de Ciencias Químicas, Universidad de Concepción, Casilla 3-C, Concepción-Chile
| | - C. Zúñiga
- Concepción, Departamento de Química Orgánica, Facultad de Ciencias Químicas, Universidad de Concepción, Casilla 3-C, Concepción-Chile
| | - H. Zunza
- Concepción, Departamento de Química Orgánica, Facultad de Ciencias Químicas, Universidad de Concepción, Casilla 3-C, Concepción-Chile
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Aliaga I, Garcia-Barbero AE, Vera V, Campo L, Hernando B, Montalvo N, De Paz JF. Using Case Based Reasoning System to predict composite restorations failure. J Clin Exp Dent 2014. [DOI: 10.4317/jced.17643787] [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: 11/05/2022] Open
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Hernando Dumaraog B, De Paz JF, Corchado JM, Garcia E, Aliaga I, Campo L, Vera V. Application of Bioinformatics in the Mount/Hume classificacition of caries and his relationship with Orthopantomography. J Clin Exp Dent 2014. [DOI: 10.4317/jced.17643816] [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: 11/05/2022] Open
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Jaime C. J, Mancipe LF, Ramírez G, Vera V. Cultivos Celulares como Alternativa para el Aislamiento y la Producción de Biológicos Contra el Virus de Influenza. nova 2011. [DOI: 10.22490/24629448.491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
<p>El virus de influenza ha sido reconocido como un importante patógeno en poblaciones humanas y animales, ya que es el principal causante de enfermedades respiratorias. Muchas vacunas y aislamientos de virus de influenza humana y animal son realizadas actualmente en huevos embrionados, siendo este el método usado tradicionalmente por décadas. Sin embargo, se han encontrado inconvenientes en la elaboración de vacunas ya que el proceso de fabricación es de capacidad limitada (se requiere aproximadamente un huevo para generar una dosis vacunal) y alta demanda tiempo, disminuyendo su habilidad para generar biológicos rápidamente en el caso de una pandemia. El empleo de líneas celulares continuas para la producción de vacunas virales nace como alternativa que ofrece diversas ventajas: (i) oportunidad de emplear células completamente caracterizadas y estandarizadas, (ii) producción y planeación permanente de vacunas y (iii) los biológicos pueden ser producidos de forma más rápida.</p><p>El objetivo de esta revisión es analizar las diferentes alternativas empleadas en el cultivo y/o aislamiento de virus de influenza, enfatizando en el uso de cultivos celulares como sustrato para el aislamiento y la producción de biológicos destinados a la salud humana y animal.</p>
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Dimova I, Hlushchuk R, Makanya A, Djonov V, Theurl M, Schgoer W, Albrecht K, Beer A, Patsch JR, Schratzberger P, Mahata S, Kirchmair R, Didie M, Christalla P, Rau T, Eschenhagen T, Schumacher U, Lin Q, Zenke M, Zimmmermann W, Hoch M, Fischer P, Stapel B, Missol-Kolka E, Erschow S, Scherr M, Drexler H, Hilfiker-Kleiner D, Diebold I, Petry A, Kennel P, Djordjevic T, Hess J, Goerlach A, Castellano J, Aledo R, Sendra J, Costales P, Badimon L, Llorente-Cortes V, Dworatzek E, Mahmoodzadeh S, Regitz-Zagrosek V, Posa A, Varga C, Berko A, Veszelka M, Szablics P, Vari B, Pavo I, Laszlo F, Brandenburger M, Wenzel J, Bogdan R, Richardt D, Reppel M, Hescheler J, Terlau H, Dendorfer A, Heijman J, Rudy Y, Westra R, Volders P, Rasmusson R, Bondarenko V, Ertas Gokhan MD, Ural Ertan MD, Karaoz Erdal PHD, Aksoy Ayca PHD, Kilic Teoman MD, Kozdag Guliz MD, Vural Ahmet MD, Ural Dilek MD, Poulet C, Christ T, Wettwer E, Ravens U, Van Der Pouw Kraan C, Schirmer S, Fledderus J, Moerland P, Leyen T, Piek J, Van Royen N, Horrevoets A, Fleissner F, Jazbutyte V, Fiedler J, Galuppo P, Mayr M, Ertl G, Bauersachs J, Thum T, Protze S, Bussek A, Ravens U, Li F, Hoo R, Lam K, Xu A, Westenbrink B, Maass A, Sillje H, Van Veldhuisen D, Van Gilst W, De Boer R, Biesmans L, Bito V, Driessen R, Holemans P, Subramanian P, Lenaerts I, Huysmans C, Sipido K, Mourouzis I, Pantos C, Galanopoulos G, Gavra M, Perimenis P, Spanou D, Cokkinos D, Karshovska E, Berezin A, Panasenko T, Euler G, Partsch S, Harjung C, Heger J, Bogdanova A, Mihov D, Mocharla P, Yakushev S, Megens R, Vogel J, Gassmann M, Tavakoli R, Johansen D, Sanden E, Xi C, Sundset R, Ytrehus K, Bliksoen M, Rutkovskiy A, Akhtar S, Mariero L, Vaage I, Stenslokken K, Pisarenko O, Shulzhenko V, Studneva I, Serebryakova L, Tskitishvili O, Pelogeykina Y, Timoshin A, Heyll K, Vanin A, Ziberna L, Lunder M, Drevensek G, Passamonti S, Gorza L, Ravara B, Scapin C, Vitadello M, Zigrino F, Jansen Y, Gerosa G, Gwathmey J, Del Monte F, Vilahur G, Juan-Babot O, Onate B, Casani L, Badimon L, Lemoine S, Calmettes G, Weber C, Jaspard-Vinassa B, Duplaa C, Couffinhal T, Diolez P, Dos Santos P, Fusco A, Santulli G, Cipolletta E, Sorriento D, Cervero P, Schober A, Trimarco B, Feliciello A, Iaccarino G, Loganathan S, Barnucz E, Korkmaz S, Hirschberg K, Karck M, Szabo G, Kozichova K, Zafeiriou M, Hlavackova M, Neckar J, Kolar F, Novakova O, Novak F, Kusmic C, Matteucci M, Pelosi G, Vesentini N, Barsanti C, Noack C, Trivella M, Abraham N, L'abbate A, Muntean D, Mirica S, Duicu O, Raducan A, Hancu M, Fira-Mladinescu O, Ordodi V, Renger A, Voelkl J, Haubner B, Neely G, Moriell C, Seidl S, Pachinger O, Penninger J, Metzler B, Dietz R, Zelarayan L, Bergmann M, Meln I, Malashicheva A, Anisimov S, Kalinina N, Sysoeva V, Zaritskey A, Barbuti A, Scavone A, Mazzocchi N, Crespi A, Capilupo D, Difrancesco D, Qian L, Shim W, Gu Y, Mohammed S, Wong P, Noack C, Renger A, Zafiriou M, Dietz R, Schaeffer H, Bergmann M, Zelarayan L, Kovacs P, Simon J, Christ T, Wettwer E, Varro A, Ravens U, Athias P, Wolf J, Bouchot O, Vandroux D, Mathe A, De Carvalho A, Laurent G, Rainer P, Huber M, Edelmann F, Stojakovic T, Trantina-Yates A, Trauner M, Pieske B, Von Lewinski D, De Jong A, Maass A, Oberdorf-Maass S, Van Gelder I, Lin Y, Li J, Wang F, He Y, Li X, Xu H, Yang X, Coppini R, Ferrantini C, Ferrara C, Rossi A, Mugelli A, Poggesi C, Cerbai E, Rozmaritsa N, Voigt N, Christ T, Wettwer E, Dobrev D, Ravens U, Kienitz MC, Zoidl G, Bender K, Pott L, Kohajda Z, Kristof A, Kovacs P, Virag L, Varro A, Jost N, Voigt N, Trafford A, Ravens U, Dobrev D, Prnjavorac B, Mujaric E, Jukic J, Abduzaimovic K, Brack K, Patel V, Coote J, Ng G, Wilders R, Van Ginneken A, Verkerk A, Brack K, Coote J, Ng G, Xaplanteris P, Vlachopoulos C, Baou K, Vassiliadou C, Dima I, Ioakeimidis N, Stefanadis C, Ruifrok W, Qian C, Sillje H, Van Goor H, Van Veldhuisen D, Van Gilst W, De Boer R, Schmidt K, Kaiser F, Erdmann J, De Wit C, Barnett O, Kyyak Y, Cesana F, Boffi L, Mauri T, Alloni M, Betelli M, Nava S, Giannattasio C, Mancia G, Vilskersts R, Kuka J, Svalbe B, Liepinsh E, Dambrova M, Zakrzewicz A, Maroski J, Vorderwuelbecke B, Fiedorowicz K, Da Silva-Azevedo L, Pries A, Gryglewska B, Necki M, Zelawski M, Grodzicki T, Scoditti E, Massaro M, Carluccio M, Distante A, Storelli C, De Caterina R, Kocgirli O, Valcaccia S, Dao V, Suvorava T, Kumpf S, Floeren M, Oppermann M, Kojda G, Leo C, Ziogas J, Favaloro J, Woodman O, Goettsch W, Marton A, Goettsch C, Morawietz H, Khalifa E, Ashour Z, Dao V, Floeren M, Kumpf S, Suvorava T, Kojda G, Rupprecht V, Scalera F, Martens-Lobenhoffer J, Bode-Boeger S, Li W, Kwan Y, Leung G, Patella F, Mercatanti A, Pitto L, Rainaldi G, Tsimafeyeu I, Tishova Y, Wynn N, Kalinchenko S, Clemente Lorenzo M, Grande M, Barriocanal F, Aparicio M, Martin A, Hernandez J, Lopez Novoa J, Martin Luengo C, Kurlianskaya A, Denisevich T, Leo C, Ziogas J, Favaloro J, Woodman O, Barth N, Loot A, Fleming I, Wang Y, Gabrielsen A, Ripa R, Jorgensen E, Kastrup J, Arderiu G, Pena E, Badimon L, Kobus K, Czyszek J, Kozlowska-Wiechowska A, Milkiewicz P, Milkiewicz M, Madonna R, Montebello E, Geng Y, De Caterina R, Chin-Dusting J, Michell D, Skilton M, Dixon J, Dart A, Moore X, Hlushchuk R, Ehrbar M, Reichmuth P, Heinimann N, Djonov V, Hewing B, Stangl V, Stangl K, Laule M, Baumann G, Ludwig A, Widmer-Teske R, Mueller A, Stieger P, Tillmanns H, Braun-Dullaeus R, Sedding D, Troidl K, Eller L, Benli I, Apfelbeck H, Schierling W, Troidl C, Schaper W, Schmitz-Rixen T, Hinkel R, Trenkwalder T, Pfosser A, Globisch F, Stachel G, Lebherz C, Bock-Marquette I, Kupatt C, Seyler C, Duthil-Straub E, Zitron E, Scholz E, Thomas D, Gierten J, Karle C, Fink R, Padro T, Lugano R, Garcia-Arguinzonis M, Badimon L, Schuchardt M, Pruefer J, Toelle M, Pruefer N, Jankowski V, Jankowski J, Zidek W, Van Der Giet M, Pena E, Arderiu G, Badimon L, Fransen P, Van Hove C, Michiels C, Van Langen J, Bult H, Quarck R, Wynants M, Alfaro-Moreno E, Rosario Sepulveda M, Wuytack F, Van Raemdonck D, Meyns B, Delcroix M, Christofi F, Wijetunge S, Sever P, Hughes A, Ohanian J, Forman S, Ohanian V, Wijetunge S, Hughes A, Gibbons C, Ohanian J, Ohanian V, Costales P, Aledo R, Vernia S, Das A, Shah V, Casado M, Badimon L, Llorente-Cortes V, Fransen P, Van Hove C, Van Langen J, Bult H, Bielenberg W, Daniel J, Tillmanns H, Sedding D, Daniel JM, Hersemeyer K, Schmidt-Woell T, Kaetzel D, Tillmans H, Sedding D, Kanse S, Tuncay E, Kandilci H, Zeydanli E, Sozmen N, Akman D, Yildirim S, Turan B, Nagy N, Acsai K, Farkas A, Papp J, Varro A, Toth A, Viero C, Mason S, Williams A, Marston S, Stuckey D, Dyer E, Song W, El Kadri M, Hart G, Hussain M, Faltinova A, Gaburjakova J, Urbanikova L, Hajduk M, Tomaskova B, Antalik M, Zahradnikova A, Steinwascher P, Jaquet K, Muegge A, Ferrantini C, Coppini R, Wang G, Zhang M, Cerbai E, Tesi C, Poggesi C, Ter Keurs H, Kettlewell S, Smith G, Workman A, Acsai K, Lenaerts I, Holemans P, Sokolow S, Schurmans S, Herchuelz A, Sipido K, Antoons G, Wehrens X, Li N, Respress JR, De Almeida A, Van Oort R, Bussek A, Lohmann H, Christ T, Wettwer E, Ravens U, Saes M, Muegge A, Jaquet K, Messer A, Copeland O, Leung M, Marston S, Matthes F, Steinbrecher J, Salinas-Riester G, Opitz L, Hasenfuss G, Lehnart S, Caracciolo G, Eleid M, Carerj S, Chandrasekaran K, Khandheria B, Sengupta P, Riaz I, Tyng L, Dou Y, Seymour A, Dyer C, Griffin S, Haswell S, Greenman J, Yasushige S, Amorim P, Nguyen T, Schwarzer M, Mohr F, Doenst T, Popin Sanja S, Lalosevic D, Capo I, Momcilov Popin T, Astvatsatryan A, Senan M, Astvatsatryan A, Senan M, Shafieian G, Goncalves N, Falcao-Pires I, Henriques-Coelho T, Moreira-Goncalves D, Leite-Moreira A, Bronze Carvalho L, Azevedo J, Andrade M, Arroja I, Relvas M, Morais G, Seabra M, Aleixo A, Winter J, Brack K, Ng G, Zabunova M, Mintale I, Lurina D, Narbute I, Zakke I, Erglis A, Astvatsatryan A, Senan M, Marcinkevics Z, Kusnere S, Abolins A, Aivars J, Rubins U, Nassar Y, Monsef D, Hamed G, Abdelshafy S, Chen L, Wu Y, Wang J, Cheng C, Sternak M, Khomich T, Jakubowski A, Szafarz M, Szczepanski W, Mateuszuk L, Szymura-Oleksiak J, Chlopicki S, Sulicka J, Strach M, Kierzkowska I, Surdacki A, Mikolajczyk T, Balwierz W, Guzik T, Grodzicki T, Dmitriev V, Oschepkova E, Polovitkina O, Titov V, Rogoza A, Shakur R, Metcalfe S, Bradley J, Demyanets S, Kaun C, Kastl S, Pfaffenberger S, Huk I, Maurer G, Huber K, Wojta J, Eriksson O, Aberg M, Siegbahn A, Prnjavorac B, Niccoli G, Sgueglia G, Conte M, Giubilato S, Cosentino N, Ferrante G, Crea F, Dmitriev V, Oschepkova E, Polovitkina O, Titov V, Ilisei D, Leon M, Mitu F, Kyriakakis E, Philippova M, Cavallari M, Bochkov V, Biedermann B, De Libero G, Erne P, Resink T, Titov V, Bakogiannis C, Antoniades C, Tousoulis D, Demosthenous M, Psarros C, Sfyras N, Channon K, Stefanadis C, Del Turco S, Navarra T, Basta G, De Caterina R, Carnicelli V, Frascarelli S, Zucchi R, Kostareva A, Malashicheva A, Sjoberg G, Gudkova A, Semernin E, Shlyakhto E, Sejersen T, Cucu N, Anton M, Stambuli D, Botezatu A, Arsene C, Lupeanu E, Anton G, Beer A, Theurl M, Schgoer W, Albrecht K, Patsch J, Huber E, Schratzberger P, Kirchmair R, Lande C, Cecchettini A, Tedeschi L, Trivella M, Citti L, Chen B, Ma Y, Yang Y, Ma X, Liu F, Hasanzad M, Rejali L, Fathi M, Minassian A, Mohammad Hassani R, Najafi A, Sarzaeem M, Sezavar S, Akhmedov A, Klingenberg R, Yonekawa K, Lohmann C, Gay S, Maier W, Neithard M, Luescher T, Xie X, Ma Y, Yang Y, Fu Z, Li X, Ma X, Liu F, Chen B, Kevorkov A, Verduci L, Mercatanti A, Cremisi F, Pitto L, Wonnerth A, Katsaros K, Zorn G, Kaun C, Weiss T, Huber K, Maurer G, Wojta J, De Rosa R, Galasso G, Piscione F, Santulli G, Iaccarino G, Piccolo R, Luciano R, Chiariello M, Szymanski M, Schoemaker R, Van Veldhuisen D, Van Gilst W, Hillege H, Rizzo S, Basso C, Thiene G, Valente M, Rickelt S, Franke W, Bartoloni G, Bianca S, Giurato E, Barone C, Ettore G, Bianca I, Eftekhari P, Wallukat G, Bekel A, Heinrich F, Fu M, Briedert M, Briand J, Roegel J, Rizzo S, Pilichou K, Basso C, Thiene G, Korkmaz S, Radovits T, Pali S, Hirschberg K, Zoellner S, Loganathan S, Karck M, Szabo G, Bartoloni G, Pucci A, Pantaleo J, Martino S, Pelosi G, Matteucci M, Kusmic C, Vesentini N, Piccolomini F, Viglione F, Trivella M, L'abbate A, Slavikova J, Chottova Dvorakova M, Kummer W, Campanile A, Spinelli L, Santulli G, Ciccarelli M, De Gennaro S, Assante Di Panzillo E, Trimarco B, Iaccarino G, Akbarzadeh Najar R, Ghaderian S, Tabatabaei Panah A, Vakili H, Rezaei Farimani A, Rezaie G, Beigi Harchegani A, Falcao-Pires I, Hamdani N, Gavina C, Van Der Velden J, Niessen H, Stienen G, Leite-Moreira A, Paulus W, Goncalves N, Falcao-Pires I, Moura C, Lamego I, Eloy C, Niessen H, Areias J, Leite-Moreira A, Bonda T, Dziemidowicz M, Hirnle T, Dmitruk I, Kaminski K, Musial W, Winnicka M, Villar A, Merino D, Ares M, Pilar F, Valdizan E, Hurle M, Nistal J, Vera V, Toelle M, Van Der Giet M, Zidek W, Jankowski J, Astvatsatryan A, Senan M, Karuppasamy P, Chaubey S, Dew T, Sherwood R, Desai J, John L, Marber M, Kunst G, Cipolletta E, Santulli G, Attanasio A, Del Giudice C, Campiglia P, Illario M, Iaccarino G, Berezin A, Koretskaya E, Bishop E, Fearon I, Heger J, Warga B, Abdallah Y, Meyering B, Schlueter K, Piper H, Euler G, Lavorgna A, Cecchetti S, Rio T, Coluzzi G, Carrozza C, Conti E, Crea F, Andreotti F, Berezin A, Glavatskiy A, Uz O, Kardesoglu E, Yiginer O, Bas S, Ipcioglu O, Ozmen N, Aparci M, Cingozbay B, Ivanes F, Hillaert M, Susen S, Mouquet F, Doevendans P, Jude B, Montalescot G, Van Belle E, Leon M, Ilisei D, Mitu F, Castellani C, Angelini A, De Boer O, Van Der Loos C, Gerosa G, Thiene G, Van Der Wal A, Dumitriu I, Baruah P, Kaski J, Maytham O, D Smith J, Rose M, Cappelletti A, Pessina A, Mazzavillani M, Calori G, Margonato A, De Rosa R, Galasso G, Piscione F, Cassese S, Piccolo R, Luciano R, D'anna C, Chiariello M, Niccoli G, Ferrante G, Leo A, Giubilato S, Silenzi A, Baca' M, Biasucci L, Crea F, Baller D, Gleichmann U, Holzinger J, Bitter T, Horstkotte D, Bakogiannis C, Antoniades C, Antonopoulos A, Tousoulis D, Miliou A, Triantafyllou C, Channon K, Stefanadis C, Masson W, Siniawski D, Sorroche P, Casanas L, Scordo W, Krauss J, Cagide A, Schuchardt M, Toelle M, Huang T, Wiedon A, Van Der Giet M, Chin-Dusting J, Lee S, Walker K, Dart A, O'dea K, Skilton M, Perez Berbel P, Arrarte Esteban V, Garcia Valentin M, Sola Villalpando M, Lopez Vaquero C, Caballero L, Quintanilla Tello M, Sogorb Garri F, Duerr G, Elhafi N, Bostani T, Swieny L, Kolobara E, Welz A, Roell W, Dewald O, Kaludercic N, Takimoto E, Nagayama T, Chen K, Shih J, Kass D, Di Lisa F, Paolocci N, Vinet L, Pezet M, Briec F, Previlon M, Rouet-Benzineb P, Hivonnait A, Charpentier F, Mercadier J, Villar A, Cobo M, Llano M, Montalvo C, Exposito V, Nistal J, Hurle M, Ruifrok W, Meems L. Saturday, 17 July 2010. Cardiovasc Res 2010. [DOI: 10.1093/cvr/cvq174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Valdebenito I, Fletcher C, Vera V, Fernández J. Factores fisicoquímicos que regulan la motilidad espermática en peces: aspectos básicos y aplicados. Una revisión. ACTA ACUST UNITED AC 2009. [DOI: 10.4067/s0301-732x2009000200002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [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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Rodriguez E, Vera V, Perez-Puigbo A, Capriles-Hulett A, Ferro S, Manrique J, Abate J. Equivalence of a single saline nebulised dose of formoterol powder vs three doses of nebulised Albuterol every twenty minutes in acute asthma in children: a suitable cost effective approach for developing nations. Allergol Immunopathol (Madr) 2008. [DOI: 10.1016/s0301-0546(08)72549-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Rodriguez E, Vera V, Perez-Puigbo A, Capriles-Hulett A, Ferro S, Manrique J, Abate J. Equivalence of a single saline nebulised dose of formoterol powder vs three doses of nebulised Albuterol every twenty minutes in acute asthma in children: a suitable cost effective approach for developing nations. Allergol Immunopathol (Madr) 2008; 36:196-200. [PMID: 18928685 DOI: 10.1157/13127042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND An increase in asthma prevalence is reported from developed as well as developing nations, with rising costs from acute asthma and great expenditures to health care systems. Venezuela's Ministry of Health ambulatory facilities care for 80 % or more of a mostly urban and impoverished population of 26 million inhabitants, registering close to a million acute asthma visits per year; a nebulised fixed fenoterol-ipratropium bromide combination (Bero-dual, Boehringer-Ingelheim) in repeated dosing is the standard treatment. OBJECTIVES to simplify acute asthma care and management in a cost effective manner employing Formoterol Fumarate powder, a long acting beta agonist with immediate bronchodilator effects. METHODOLOGY Fifty acute asthmatic children (5-12 years old) were randomly assigned (25 patients in each group) to receive either a nebulised single dose (US $1.35) of two 12 microg Formoterol Fumarate capsules (Foradil 12 microg/cap, Novartis Pharma AG, Basel, Switzerland) diluted in 2.5 ml of sterile saline solution; or 3 doses of Albuterol (US $ 6.73) every twenty minutes for one hour (Glaxo Smith Kline Albuterol ampoules, 2.5 mg/2.5 ml, at a dose of 0.15 mg/kg/dose, maximum dose 2.5 mg). Symptoms score, oxygen saturation and lung function testing were recorded before and one hour after commencing treatments. RESULTS Both groups improved significantly on all parameters, except for FEV(1) in the Albuterol group. CONCLUSIONS Single dose nebulised Formoterol Fumarate (dry powder) in sterile saline solution, as depicted in this trial, is equivalent to three doses of Albuterol every twenty minutes for one hour in acute asthma in children, simplifying acute care management and at one fifth of medication costs. A pursuit of simpler and more cost effective approaches is found wanting in developing nations with depressed economies and unique cultural and socio-medical contexts; also, in countries where pharmaco-economics orients quality of health policies, novel approaches like this are worth exploring.
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Affiliation(s)
- E Rodriguez
- Hospital Pediátrico "Elías Toro". Caracas. Venezuela
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Corzo JL, Garcia-Martin FJ, Vera V, Mayorga C, Torres MJ, Gonzalez L, Cornejo-García JA, Jurado A, Blanca M. Toxic epidermal necrolysis induced by lamotrigine in a child: Rapid recovery after high dose intravenous immunoglobin treatment. J Allergy Clin Immunol 2002. [DOI: 10.1016/s0091-6749(02)81580-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Molina M, Ortega N, Valiente B, Vera V. [Spontaneous pneumothorax and active pulmonary tuberculosis]. An Med Interna 2001; 18:149-51. [PMID: 11594182] [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] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
We report three HIV-negative patients with spontaneous pneumothorax as clinical manifestation of active tuberculosis acute chest pain and dyspnea was the cause of admission. Chest roentgen grams showed lung collapse and parenchymal cavitation in two of therm and hydropneumothorax in the other. Outcome was favorable with antituberculous drug therapy and placement of chest tube. Although spontaneous pneumothorax is frequent in fibrosis pulmonary tuberculosis, it seldom complicated active tuberculosis in spite of increase of its incidence.
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Affiliation(s)
- M Molina
- Servicio de Medicina Interna, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia
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Molina M, Ortega G, Vera V, Pérez Luján R. [Cardiac tamponade and myelodysplastic syndrome]. An Med Interna 1999; 16:323-4. [PMID: 10422309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Molina M, Ortega G, Pérez Luján R, Vera V. [Pancreatitis, thrombophlebitis and empyema complicating typhoid fever]. An Med Interna 1998; 15:112-3. [PMID: 9542212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Molina M, Ortega G, Serrano C, Vera V. [Spontaneous pneumomediastinum and cavitary pulmonary tuberculosis]. Enferm Infecc Microbiol Clin 1997; 15:230-1. [PMID: 9312292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Molina M, Ortega G, Vera V, Serrano C. [Pericardial calcification and fever]. Rev Clin Esp 1996; 196:861-2. [PMID: 9132866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- M Molina
- Servicio de Medicina Interna, Hospital Virgen de la Arrixaca, El Palmar, Murcia
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Molina M, Ortega G, Vera V, Pérez Luján R. [Tuberculosis of the palate]. Enferm Infecc Microbiol Clin 1996; 14:630-1. [PMID: 9053014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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