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Colunga-Pedraza IJ, Galarza-Delgado DA, Azpiri-Lopez JR, Rodriguez-Romero AB, Guajardo-Jauregui N, Cardenas-de la Garza JA, Lugo-Perez S, Meza-Garza A, Loya-Acosta J, Garza-Acosta AC. Nail involvement in psoriatic arthritis patients is an independent risk factor for carotid plaque. Ann Rheum Dis 2021; 80:1629-1631. [PMID: 34167948 DOI: 10.1136/annrheumdis-2021-220782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 06/15/2021] [Indexed: 11/03/2022]
Affiliation(s)
| | | | | | | | | | | | - Salvador Lugo-Perez
- Cardiology, Dr Jose Eleuterio Gonzalez University Hospital, Monterrey, Nuevo Leon, Mexico
| | - Alejandro Meza-Garza
- Cardiology, Dr Jose Eleuterio Gonzalez University Hospital, Monterrey, Nuevo Leon, Mexico
| | - Julieta Loya-Acosta
- Rheumatology, Dr Jose Eleuterio Gonzalez University Hospital, Monterrey, Nuevo Leon, Mexico
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Reyes Mondragón AL, Cantú-Rodríguez OG, Garza-Acosta AC, Gutiérrez-Aguirre CH, Colunga Pedraza PR, Del Carmen Tarín-Arzaga L, Jaime-Pérez JC, Hawing Zárate JA, González-Cantú GA, Villalobos-Gutiérrez LE, Jiménez-Castillo RA, Vera-Pineda R, Gómez-Almaguer D. Performance of serum procalcitonin as a biochemical predictor of death in hematology patients with febrile neutropenia. Blood Cells Mol Dis 2021; 90:102586. [PMID: 34126299 DOI: 10.1016/j.bcmd.2021.102586] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/28/2021] [Accepted: 05/28/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Historically, the measurement of serum procalcitonin (PCT) levels in patients with leukopenia has been rejected without sufficient prospective evidence to justify this argument. On the other hand, the accumulated use of broad spectrum antibiotics in these patients and their consequences make the use of PCT attractive in an effort to reduce its use. PATIENTS AND METHODS We conducted a prospective study between 2016 and 2018, recruiting newly diagnosed FN patients, evaluating them with PCT levels during the first 24 h. After this we evaluate them with overall survival throughout the follow-up. RESULTS A total of 81 episodes of FN in 72 patients were included. We report a mortality of 27.2% in our cohort. The mean serum PCT in these patients was 4.01 ng/mL compared to 0.42 ng/mL in the survivors group (p < 0.01). Using ROC curves, we determined a cut-off point to predict septic shock/death at 0.46 ng/mL. Patients with a procalcitonin >0.46 ng/mL had an increased risk of death, with a HR of 4.43, (p = 0.048). CONCLUSION In conclusion, in our trial a single PCT on admission at a cut-off value of 0.46 ng/mL was able to predict the occurrence of septic shock and death in FN patients.
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Affiliation(s)
- Alan Ledif Reyes Mondragón
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Hematology Service, Monterrey, N.L., Mexico
| | - Olga Graciela Cantú-Rodríguez
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Hematology Service, Monterrey, N.L., Mexico.
| | - Andrea Cecilia Garza-Acosta
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Hematology Service, Monterrey, N.L., Mexico
| | - César Homero Gutiérrez-Aguirre
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Hematology Service, Monterrey, N.L., Mexico
| | - Perla Rocío Colunga Pedraza
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Hematology Service, Monterrey, N.L., Mexico
| | - Luz Del Carmen Tarín-Arzaga
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Hematology Service, Monterrey, N.L., Mexico
| | - José Carlos Jaime-Pérez
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Hematology Service, Monterrey, N.L., Mexico
| | - José Angel Hawing Zárate
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Hematology Service, Monterrey, N.L., Mexico
| | - Graciela Alejandra González-Cantú
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Hematology Service, Monterrey, N.L., Mexico
| | | | - Raúl Alberto Jiménez-Castillo
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Internal Medicine Department, Monterrey, N.L., Mexico
| | - Raymundo Vera-Pineda
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Internal Medicine Department, Monterrey, N.L., Mexico
| | - David Gómez-Almaguer
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González", Hematology Service, Monterrey, N.L., Mexico
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Cantú-Rodríguez OG, Vázquez-Mellado A, González-Treviño JL, Martínez-Garza DM, Gómez-De León A, Hawing-Zarate JA, Jaime-Pérez JC, Gutierrez-Aguirre CH, Garza-Acosta AC, Mancías-Guerra C, González-Llano O, González-Cantú GA, Herrera-Rojas MA, Sada-Ovalle I, Gómez-Almaguer D. Cyclosporine A for the Prevention of Ocular Graft versus Host Disease in Allogeneic Hematopoietic Stem Cell Transplant Recipients Is Safe and Feasible. Acta Haematol 2019; 143:425-431. [PMID: 31505491 DOI: 10.1159/000502405] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/27/2019] [Indexed: 01/16/2023]
Abstract
PURPOSE To evaluate the safety and efficacy of ocular cyclosporine in the prevention of the development of ocular graft versus host disease (oGVHD) in patients undergoing allogeneic hematopoietic stem cell transplantation (AHSCT) in comparison with historic data. DESIGN We developed a longitudinal, observational, prospective nonrandomized study. We evaluated the feasibility of prophylactic use of topical cyclosporine A (CsA) to prevent or decrease the incidence of oGVHD and compared this with historic data. METHODS Patients undergoing AHSCT were treated with prophylactic topical CsA for 12 months after engraftment, followed by serial ophthalmic evaluations, including the Schirmer test. RESULTS Twenty patients were included. No serious adverse effects were reported. Poor adherence was documented in 15% of patients. In spite of observing extra-ocular GVHD (acute and chronic GVHD incidence of 50 and 45%, respectively), only 1 in 20 patients developed oGVHD over the 20-month follow-up for the entire cohort. No statistically significant difference was observed in the incidence of oGVHD when compared to a historical cohort. CONCLUSIONS Topical CsA as a prophylactic measure for oGVHD, administered over a period of 1 year after grafting, is safe and feasible and may decrease the incidence of ophthalmic manifestations of GVHD. These findings must be confirmed in a randomized trial.
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Affiliation(s)
- Olga Graciela Cantú-Rodríguez
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González" Hematology Service, Monterrey, Mexico,
| | - Alberto Vázquez-Mellado
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González" Hematology Service, Monterrey, Mexico
| | | | - David Mauricio Martínez-Garza
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González" Hematology Service, Monterrey, Mexico
| | - Andrés Gómez-De León
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González" Hematology Service, Monterrey, Mexico
| | - José Angel Hawing-Zarate
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González" Hematology Service, Monterrey, Mexico
| | - José Carlos Jaime-Pérez
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González" Hematology Service, Monterrey, Mexico
| | - César Homero Gutierrez-Aguirre
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González" Hematology Service, Monterrey, Mexico
| | - Andrea Cecilia Garza-Acosta
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González" Hematology Service, Monterrey, Mexico
| | - Consuelo Mancías-Guerra
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González" Hematology Service, Monterrey, Mexico
| | - Oscar González-Llano
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González" Hematology Service, Monterrey, Mexico
| | | | - Miguel Angel Herrera-Rojas
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González" Hematology Service, Monterrey, Mexico
| | - Isabel Sada-Ovalle
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González" Hematology Service, Monterrey, Mexico
| | - David Gómez-Almaguer
- Universidad Autónoma de Nuevo León, Hospital Universitario "Dr. José Eleuterio González" Hematology Service, Monterrey, Mexico
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