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Weis-Torres SMDS, França ADO, Granato C, Passarini A, Motta-Castro ARC. Seroprevalence of hepatitis E virus infection among volunteer blood donors in Central Brazil. Braz J Infect Dis 2022; 26:102350. [PMID: 35487275 PMCID: PMC9387457 DOI: 10.1016/j.bjid.2022.102350] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/15/2022] [Accepted: 03/28/2022] [Indexed: 11/09/2022] Open
Abstract
A cross-sectional study was carried out in the Hematology and Hemotherapy Institute of the state of Mato Grosso do Sul (Hemosul) to evaluate the seroprevalence and risk factors of Hepatitis E Virus (HEV) exposure among volunteer blood donors in Central Brazil. Two-hundred fifty samples from the biorepository were tested for anti-HEV IgG and IgM using the Wantai HEV ELISA test. The seroprevalence of HEV exposure was 6.4% (95% CI: 3.9–10.2). Being born in another state of Brazil, mainly in the Southeast and South regions, was associated with a higher risk of HEV exposure (p < 0.001).
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Cristelli MP, Viana LA, Fortaleza CM, Granato C, Nakamura MR, Santos DWCL, Foresto RD, Tedesco-Silva H, Medina-Pestana J. Lower seroprevalence for SARS-CoV-2-specific antibodies among kidney transplant recipients compared to the general population in the city of Sao Paulo, Brazil. Transpl Infect Dis 2021; 23:e13706. [PMID: 34322975 PMCID: PMC8420153 DOI: 10.1111/tid.13706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 05/27/2021] [Revised: 07/07/2021] [Accepted: 07/22/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Kidney transplant recipients have higher COVID-19 associated mortality compared to the general population. However, as only symptomatic patients seek medical attention, the current level of exposure, the main sources of acquisition, and the behavior of humoral immunity over time are poorly understood. METHODS This cross-sectional prospective single-center study recruited kidney transplant recipients of any age living in Sao Paulo. A sample size of 401 patients was calculated considering the 17.2% seroprevalence in the municipality population from a published survey, a 95% confidence interval and an absolute error of 2%. RESULTS Of the 2636 eligible patients, 416 were included. The seroprevalence for IgG anti-SARS-CoV-2 was 8.2%. Seroconversion rate decreased with increasing age, from 15.7% (18-35 years) to 8.3% (36-60 years) and 4.2% (>60 years, p = 0.042). Seropositivity among previously confirmed COVID-19 patients was 68.4%, followed by 9.4% in those with flu-like symptoms and only 4.6% among asymptomatic patients (p < 0.0001). Seroprevalence was significantly higher among patients reporting household contact (p = 0.018). Twenty-seven from the 34 IgG+ patients had a second test after 59 (IQR 50-63) days, and, in 33%, the IgG index became below the positivity threshold. CONCLUSIONS In this cohort of kidney transplant recipients, the seroprevalence for IgG anti-SARS-CoV-2 was lower than that of the general population, decreased with ageing, and was associated with household contacts. In a considerable proportion of the patients, there was a significant decay in the IgG levels in a short period of time. Therefore, preventive strategies, such as prioritization for vaccination, should be urgently considered.
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Affiliation(s)
- Marina P Cristelli
- Transplant Division, Hospital do Rim, Universidade Federal de São Paulo (UNIFESP), São Paulo, Sao Paulo, Brazil
| | - Laila A Viana
- Transplant Division, Hospital do Rim, Universidade Federal de São Paulo (UNIFESP), São Paulo, Sao Paulo, Brazil
| | - Carlos M Fortaleza
- Infectious Diseases Division, Universidade Estadual Paulista (UNESP), Botucatu, Sao Paulo, Brazil
| | - Celso Granato
- Infectious Diseases Division, Universidade Federal de São Paulo (UNIFESP), São Paulo, Sao Paulo, Brazil
| | - Monica R Nakamura
- Transplant Division, Hospital do Rim, Universidade Federal de São Paulo (UNIFESP), São Paulo, Sao Paulo, Brazil
| | - Daniel W C L Santos
- Transplant Division, Hospital do Rim, Universidade Federal de São Paulo (UNIFESP), São Paulo, Sao Paulo, Brazil
| | - Renato Demarchi Foresto
- Transplant Division, Hospital do Rim, Universidade Federal de São Paulo (UNIFESP), São Paulo, Sao Paulo, Brazil
| | - Helio Tedesco-Silva
- Transplant Division, Hospital do Rim, Universidade Federal de São Paulo (UNIFESP), São Paulo, Sao Paulo, Brazil
| | - Jose Medina-Pestana
- Transplant Division, Hospital do Rim, Universidade Federal de São Paulo (UNIFESP), São Paulo, Sao Paulo, Brazil
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Rocha L, Pires T, Reichhuber S, Donner H, Granato C. DESEMPENHO DIAGNÓSTICO DOS ENSAIOS ELECSYS HIV DUO E ANTI‐HCV II NO NOVO COBAS E 801 COMPARADO ÀS ALTERNATIVAS DISPONÍVEIS COMERCIALMENTE. Braz J Infect Dis 2021. [DOI: 10.1016/j.bjid.2020.101228] [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: 10/22/2022] Open
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4
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Servato M, La Mura L, Lopez Sainz A, Granato C, Teixido G, Galian L, Gutierrez L, Gonzalez Alujas M, Casas G, Valente F, Rodriguez Palomares J, Evangelista A. Are aortic root and ascending aorta echocardiographic diameters by adult vs paediatric guidelines recommendations interchangeable? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Both aortic root size and ascending aorta are clinical parameters with significant therapeutic implications which can be easily assessed by transthoracic echocardiography (TTE). However, measurement values may vary according to cardiac cycle and the edge convention used.
Purpose
This study aimed to compare the aortic diameter values measured using the lastest recommendations of two different guidelines, adults and children, to determine the influence of these methods on echocardiographic measurements.
Methods
Two hundred and fifty adult patients (56% male, 63±15 years of age) and 67 children (65% male, 10.04±4.5 years of age) in whom TTE was clinically indicated were included. Aortic diameters were measured twice at 2 levels (sinuses of Valsalva and ascending aorta): leading edge to leading edge during diastole, (L-L in D) following the 2015 American Society of Echocardiography (ASE) adults guidelines and inner edge to inner edge during systole (I-I in S) following the 2010 ASE paediatric guidelines.
Results
Mean aortic diameters obtained by L-L in D and I-I in S are shown in Table 1. Correlation coefficient was 0.990 (CI95% 0.988–0.992) for sinuses of Valsalva measurements and 0.991 (CI95% 0.989–0.993) for ascending aorta in adult patients and 0.983 (CI95% 0.975–0.973) and 0.970 (CI95% 0.956–0.952) in childrens respectively. When both populations were analysed together, concordance correlation coefficients were 0.991 (CI95% 0.989–0.993) and 0.970 (CI95% 0.991–0.994), respectively. Bland- Altman analysis for each level measured (A: aortic root; B: ascending aorta) in the total cohort of 317 patients is shown in Figure 1. Mean aortic diameters and differences in the whole group are shown in Table 1.
Conclusions
Measurement of aortic root and ascending aorta showed a significantly larger diameters by L-L in D than by I-I in S. However, these differences had subclinical significance and management implications. These similar diameter values may be used indifferently but systematically during follow-up. Systolic diameter expansion has a similar value to that of anterior aortic wall thickness; however, it is more vulnerable to changes in haemodynamic conditions.
Figure 1
Funding Acknowledgement
Type of funding source: Public Institution(s). Main funding source(s): Vall d'Hebron Research Institute
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Affiliation(s)
- M.L Servato
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - L La Mura
- University Hospital Vall d'Hebron, Barcelona, Spain
| | | | - C Granato
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - G Teixido
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - L Galian
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - L Gutierrez
- University Hospital Vall d'Hebron, Barcelona, Spain
| | | | - G Casas
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - F Valente
- University Hospital Vall d'Hebron, Barcelona, Spain
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5
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Candido DS, Claro IM, de Jesus JG, Souza WM, Moreira FRR, Dellicour S, Mellan TA, du Plessis L, Pereira RHM, Sales FCS, Manuli ER, Thézé J, Almeida L, Menezes MT, Voloch CM, Fumagalli MJ, Coletti TM, da Silva CAM, Ramundo MS, Amorim MR, Hoeltgebaum HH, Mishra S, Gill MS, Carvalho LM, Buss LF, Prete CA, Ashworth J, Nakaya HI, Peixoto PS, Brady OJ, Nicholls SM, Tanuri A, Rossi ÁD, Braga CKV, Gerber AL, de C Guimarães AP, Gaburo N, Alencar CS, Ferreira ACS, Lima CX, Levi JE, Granato C, Ferreira GM, Francisco RS, Granja F, Garcia MT, Moretti ML, Perroud MW, Castiñeiras TMPP, Lazari CS, Hill SC, de Souza Santos AA, Simeoni CL, Forato J, Sposito AC, Schreiber AZ, Santos MNN, de Sá CZ, Souza RP, Resende-Moreira LC, Teixeira MM, Hubner J, Leme PAF, Moreira RG, Nogueira ML, Ferguson NM, Costa SF, Proenca-Modena JL, Vasconcelos ATR, Bhatt S, Lemey P, Wu CH, Rambaut A, Loman NJ, Aguiar RS, Pybus OG, Sabino EC, Faria NR. Evolution and epidemic spread of SARS-CoV-2 in Brazil. Science 2020; 369:1255-1260. [PMID: 32703910 PMCID: PMC7402630 DOI: 10.1126/science.abd2161] [Citation(s) in RCA: 335] [Impact Index Per Article: 83.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 07/16/2020] [Indexed: 12/16/2022]
Abstract
Brazil currently has one of the fastest-growing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemics in the world. Because of limited available data, assessments of the impact of nonpharmaceutical interventions (NPIs) on this virus spread remain challenging. Using a mobility-driven transmission model, we show that NPIs reduced the reproduction number from >3 to 1 to 1.6 in São Paulo and Rio de Janeiro. Sequencing of 427 new genomes and analysis of a geographically representative genomic dataset identified >100 international virus introductions in Brazil. We estimate that most (76%) of the Brazilian strains fell in three clades that were introduced from Europe between 22 February and 11 March 2020. During the early epidemic phase, we found that SARS-CoV-2 spread mostly locally and within state borders. After this period, despite sharp decreases in air travel, we estimated multiple exportations from large urban centers that coincided with a 25% increase in average traveled distances in national flights. This study sheds new light on the epidemic transmission and evolutionary trajectories of SARS-CoV-2 lineages in Brazil and provides evidence that current interventions remain insufficient to keep virus transmission under control in this country.
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Affiliation(s)
- Darlan S Candido
- Department of Zoology, University of Oxford, Oxford, UK
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Ingra M Claro
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Jaqueline G de Jesus
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - William M Souza
- Centro de Pesquisa em Virologia, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, Brazil
| | - Filipe R R Moreira
- Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Simon Dellicour
- Spatial Epidemiology Lab, Université Libre de Bruxelles, Brussels, Belgium
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - Thomas A Mellan
- MRC Centre for Global Infectious Disease Analysis, J-IDEA, Imperial College London, London, UK
| | | | | | - Flavia C S Sales
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Erika R Manuli
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Julien Thézé
- Université Clermont Auvergne, INRAE, VetAgro Sup, UMR EPIA, Saint-Genès-Champanelle, France
| | - Luiz Almeida
- Laboratório de Bioinformática, Laboratório Nacional de Computação Científica, Petrópolis, Brazil
| | - Mariane T Menezes
- Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carolina M Voloch
- Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcilio J Fumagalli
- Centro de Pesquisa em Virologia, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, Brazil
| | - Thaís M Coletti
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Camila A M da Silva
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Mariana S Ramundo
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Mariene R Amorim
- Departamento de Genética, Evolução, Microbiologia e Imunologia, Instituto de Biologia, Universidade Estadual de Campinas, Campinas, Brazil
| | | | - Swapnil Mishra
- MRC Centre for Global Infectious Disease Analysis, J-IDEA, Imperial College London, London, UK
| | - Mandev S Gill
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - Luiz M Carvalho
- Escola de Matemática Aplicada (EMAp), Fundação Getúlio Vargas, Rio de Janeiro, Brazil
| | - Lewis F Buss
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Carlos A Prete
- Department of Electronic Systems Engineering, University of São Paulo, São Paulo, Brazil
| | | | - Helder I Nakaya
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Pedro S Peixoto
- Departamento de Matemática Aplicada, Instituto de Matemática e Estatística, Universidade de São Paulo, São Paulo, Brazil
| | - Oliver J Brady
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
- Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Samuel M Nicholls
- Institute for Microbiology and Infection, University of Birmingham, Birmingham, UK
| | - Amilcar Tanuri
- Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Átila D Rossi
- Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Alexandra L Gerber
- Laboratório de Bioinformática, Laboratório Nacional de Computação Científica, Petrópolis, Brazil
| | - Ana Paula de C Guimarães
- Laboratório de Bioinformática, Laboratório Nacional de Computação Científica, Petrópolis, Brazil
| | | | - Cecila Salete Alencar
- LIM 03 Laboratório de Medicina Laboratorial, Hospital das Clínicas Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Cristiano X Lima
- Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Simile Instituto de Imunologia Aplicada Ltda, Belo Horizonte, Brazil
| | | | | | - Giulia M Ferreira
- Laboratório de Virologia, Instituto de Ciências Biomédicas, Universidade Federal de Uberlândia, Uberlândia, Brazil
| | - Ronaldo S Francisco
- Laboratório de Bioinformática, Laboratório Nacional de Computação Científica, Petrópolis, Brazil
| | - Fabiana Granja
- Departamento de Genética, Evolução, Microbiologia e Imunologia, Instituto de Biologia, Universidade Estadual de Campinas, Campinas, Brazil
- Centro de Estudos da Biodiversidade, Universidade Federal de Roraima, Boa Vista, Brazil
| | - Marcia T Garcia
- Divisão de Doenças Infecciosas, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, Brazil
| | - Maria Luiza Moretti
- Divisão de Doenças Infecciosas, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, Brazil
| | - Mauricio W Perroud
- Hospital Estadual Sumaré, Universidade Estadual de Campinas, Campinas, Brazil
| | - Terezinha M P P Castiñeiras
- Departamento de Doenças Infecciosas e Parasitárias, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carolina S Lazari
- Divisão de Laboratório Central do Hospital das Clínicas, da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Sarah C Hill
- Department of Zoology, University of Oxford, Oxford, UK
- Department of Pathobiology and Population Sciences, Royal Veterinary College, Hatfield, UK
| | | | - Camila L Simeoni
- Departamento de Genética, Evolução, Microbiologia e Imunologia, Instituto de Biologia, Universidade Estadual de Campinas, Campinas, Brazil
| | - Julia Forato
- Departamento de Genética, Evolução, Microbiologia e Imunologia, Instituto de Biologia, Universidade Estadual de Campinas, Campinas, Brazil
| | - Andrei C Sposito
- Departamento de Clínica Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, Brazil
| | - Angelica Z Schreiber
- Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, Brazil
| | - Magnun N N Santos
- Departamento de Patologia Clínica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, Brazil
| | - Camila Zolini de Sá
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Renan P Souza
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Luciana C Resende-Moreira
- Departamento de Botânica, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Mauro M Teixeira
- Departamento de Bioquímica e Imunologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Josy Hubner
- Departamento de Biologia Celular, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Patricia A F Leme
- Centro de Saúde da Comunidade, Universidade Estadual de Campinas, Campinas, Brazil
| | - Rennan G Moreira
- Centro de Laboratórios Multiusuários, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maurício L Nogueira
- Laboratório de Pesquisas em Virologia, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, São Paulo, Brazil
| | - Neil M Ferguson
- MRC Centre for Global Infectious Disease Analysis, J-IDEA, Imperial College London, London, UK
| | - Silvia F Costa
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - José Luiz Proenca-Modena
- Departamento de Genética, Evolução, Microbiologia e Imunologia, Instituto de Biologia, Universidade Estadual de Campinas, Campinas, Brazil
| | - Ana Tereza R Vasconcelos
- Laboratório de Bioinformática, Laboratório Nacional de Computação Científica, Petrópolis, Brazil
| | - Samir Bhatt
- MRC Centre for Global Infectious Disease Analysis, J-IDEA, Imperial College London, London, UK
| | - Philippe Lemey
- Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Leuven, Belgium
| | - Chieh-Hsi Wu
- Mathematical Sciences, University of Southampton, Southampton, UK
| | - Andrew Rambaut
- Institute of Evolutionary Biology, University of Edinburgh, Edinburgh, UK
| | - Nick J Loman
- Institute for Microbiology and Infection, University of Birmingham, Birmingham, UK
| | - Renato S Aguiar
- Departamento de Genética, Ecologia e Evolução, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Ester C Sabino
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
- Departamento de Moléstias Infecciosas e Parasitárias, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Nuno Rodrigues Faria
- Department of Zoology, University of Oxford, Oxford, UK.
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- MRC Centre for Global Infectious Disease Analysis, J-IDEA, Imperial College London, London, UK
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Ruiz Munoz A, Guala A, Rodriguez-Palomares JF, Lopez-Sainz A, Granato C, Valente F, Gutierrez L, Galian L, La Mura L, Gonzalez-Alujas T, Servato L, Sao-Aviles A, Ferreira I, Evangelista A, Teixido-Tura G. P372 Aortic stiffness in Loeys-Dietz syndrome: a comparison with Marfan syndrome patients and healthy volunteers. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
ISCIII PI14/0106 and PI17/00381, La Marató de TV3 (20151330), Eur FP7/People 267128 and CIBERCV
BACKGROUND
Genetic syndromic aortic diseases are rare, with Marfan syndrome (MFS) being the most common. However, less is known of Loeys-Dietz syndrome (LDS) which has much lower prevalence and presumed worse prognosis. Increased aortic stiffness in MFS has been previously described but no studies have evaluated aortic biomechanics in LDS. Pulse wave velocity (PWV) is the gold standard measure for arterial stiffness and can be quantified by 4D flow MRI. We aim to evaluate regional aortic PWV by 4D flow MRI in LDS compared to MFS and healthy volunteers.
METHODS
Sixteen LDS patients with a pathogenic mutation, 76 MFS and 49 healthy volunteers were prospectively and consecutively included. No patient had previous aortic dissection or surgery. All underwent a 4D flow MRI study in a 1.5 T clinical scanner. Ascending (AAo) and descending (DAo) aorta PWV were computed using wavelet analysis of the systolic upslope for transit time calculation (Figure). Statistical comparison was made with non-parametric analysis to account for the non-normality of data and multivariate analysis was evaluated separately for AAo and DAo PWV.
RESULTS
Ascending and descending aortic PWV revealed stiffer aortas in LDS patients than in healthy volunteers, even after adjustment for diameter of sinus of Valsalva (SoV) and sex. Conversely, no differences in aortic stiffness were found between LDS and MFS patients (Table).
CONCLUSIONS
Abnormally high regional aortic stiffness was observed in LDS patients when compared with controls. The severity of increased regional aortic stiffness was found similar to the one affecting MFS patients.
Table Controls (N = 49) LDS (N = 16) MFS (N = 76) LDS vs. HV LDS vs. MFN Parameter Unadjusted p-value Adjusted p-value Unadjusted p-value Adjusted p-value Age [years] 39 ± 12 39 ± 16 36 ± 12 0.903 0.599 Men 32 (65%) 6 (37%) 34 (45%) 0.079 0.782 Weight [kg] 72 ± 11 69 ± 13 74 ± 16 0.288 0.194 Height [cm] 172 ± 8 172 ±12 181 ± 11 0.834 0.008 Systolic BP [mmHg] 126 ± 18 125 ± 14 127 ± 17 0.957 0.523 Diastolic BP [mmHg] 70 ± 11 77 ± 6 75 ± 12 0.011 0.318 SoV diameter [mm] 30.6 ± 3.9 35.4 ± 4.6 38.1 ± 5.9 0.001 0.060 AAo diameter [mm] 27.7 ± 3.8 29,0 ± 5.0 29.7 ± 5.4 0.458 0.579 DAo diameter [mm] 20.0 ± 2.0 21.3 ± 3.6 22.9 ± 3.8 0.546 0.124 AAo PWV [m/s] 5.2 ± 1.9 7.6 ± 2.4 7.3 ± 2.8 0.001 0.050* 0.534 NS DAo PWV [m/s] 7.1 ± 2.2 9.4 ± 2.6 10.7 ± 4.6 0.003 0.025** 0.493 NS
Abstract P372 Figure
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Affiliation(s)
- A Ruiz Munoz
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - A Guala
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | | | - A Lopez-Sainz
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - C Granato
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - F Valente
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - L Gutierrez
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - L Galian
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - L La Mura
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | | | - L Servato
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - A Sao-Aviles
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - I Ferreira
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - A Evangelista
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - G Teixido-Tura
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
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7
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Ruiz Munoz A, Guala A, Teixido-Tura G, Dux-Santoy L, Sao-Aviles A, Lopez-Sainz A, Granato C, Servato L, Casas G, Gonzalez-Alujas T, La Mura L, Galian L, Ferreira I, Evangelista A, Rodriguez-Palomares JF. P1600 Aortic dilatation in patients with chronic descending aorta dissection is related to maximum false-lumen systolic flow deceleration rate as evaluated by 4D-flow MRI. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.1018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Due to improved surgical strategies a growing number of patients survive acute aortic dissection. Patent false lumen (FL) is common in chronic dissection and it has been associated with poor prognosis, which is mainly driven by FL expansion. Several variables indirectly related to flow characteristics have been associated with progressive aortic dilation. We aimed to evaluate whether the maximum systolic flow deceleration rate (MSDR) in the FL, quantified by 4D-flow MR, is related to FL dilation in chronic type B aortic dissection.
Methods
Twenty-nine patients with a patent FL after aortic dissection and a prior follow-up of at least 3 years underwent contrast-enhanced 4D-flow MR. Marfan patients were excluded. Time-resolved FL flow acceleration was calculated in a 5 cm-long volume of the descending aorta around the level of the pulmonary bifurcation. MSDR was determined as the maximum minus the minimum acceleration in systole over the corresponding time interval (Figure 1a). Aortic growth rate (GR) was measured as the difference between final and initial maximum FL diameters obtained by angio-CT divided by follow-up duration. Population was divided into tertiles based on GR.
Results
Demographic and clinical variables were similar among GR tertiles (Table). MSDR was lower in patients with a GR <1mm/year (group 1) compared to both the other two patient groups (p = 0.009 and 0.003 for groups 2 and 3, respectively) (Figure 1c). MSDR showed a marked positive linear correlation with GR (R = 0.481, p = 0.008) (Figure 1b).
Conclusions
The MSDR in the FL of chronic type B aortic dissection is linearly related to FL growth rate and discriminated between tertiles of aortic dilation. Prospective longitudinal studies are need to unveil possible prognostic value of this parameter.
Table Group 1 (n = 9) Group 2 (n = 10) Group 3 (n = 10) p-value Age (years) 63.44 ±13.54 62.50 ± 13.60 64.56 ± 6.67 0.902 BSA (m2) 2.00 ± 0.18 1.77 ± 0.20 1.94 ± 0.12 0.213 Men 6 (86%) 4 (57%) 4 (100%) 0.210 Hypertension 4 (66%) 5 (71%) 4 (100%) 0.438 Atheroclerosis 1 (17%) 1 (14%) 0 (0%) 0.699 Initial Diameter (mm) 45.00 ± 7.69 36.00 ± 4.20 37.00 ± 6.48 0.078 Final Diameter (mm) 49.50 ± 6.74 44.86 ± 5.70 59.25 ± 9.84 0.049 Follow-up (year) 11.83 ± 8.79 7.82 ± 3.34 8.08 ± 4.05 0.921 GR (mm/year) 0.27 ± 0.29 1.18 ± 0.26 2.64 ± 0.97 <0.001 MSDR (cm/s3) 1212.18 ± 467.61 2410.54 ± 1034.30 2558.16 ± 1098.06 0.005
Abstract P1600 Figure 1
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Affiliation(s)
- A Ruiz Munoz
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - A Guala
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - G Teixido-Tura
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - L Dux-Santoy
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - A Sao-Aviles
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - A Lopez-Sainz
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - C Granato
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - L Servato
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - G Casas
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | | | - L La Mura
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - L Galian
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - I Ferreira
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
| | - A Evangelista
- University Hospital Vall d"Hebron, Cardiology, Barcelona, Spain
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8
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La Mura L, Teixido-Tura G, Guala A, Ruiz-Munoz A, Lopez Sainz A, Valente F, Pisaniello M, Strada S, Granato C, Galian Gay L, Gonzalez-Alujas T, Servato ML, Ferreira I, Rodriguez-Palomares JF, Evangelista A. P1601 Relationship between aortic distensibility and aortic regurgitation assessed by CMR in bicuspid valve patients. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.1019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Spanish Ministry of Economy and Competitiveness RTC-2016-5152-1, ISCIII PI17/00381, La Marató de TV3 (20151330), Eur FP7/People 267128 and CIBERCV
BACKGROUND
The severity of aortic regurgitation can be evaluated with cardiac magnetic resonance (CMR) through calculation of regurgitant fraction (RF) in phase contrast sequences acquired at the aortic root (as close as possible to the aortic valve). However, the impact of aortic distensibility in this evaluation remains unkown.
PURPOSE
The aim of the study was to evaluate the relation between aortic distensibility and RF valve in bicuspid aortic valve patients.
METHODS
We enrolled bicuspid aortic valve patients without significant aortic stenosis (maximum velocity <2.5 m/s) and connective tissue disease. All patients underwent a CMR study with phase contrast sequences for evaluation of regurgitant fraction at the level of the aortic valve. Aortic regurgitation was considered as mild, moderate or severe depending on RF value (mild <15%; moderate 15-30%; severe >30%). Furthermore we used cine-sequences of aortic root, ascending and proximal descending aorta to estimate aortic diameters and distensibilities, using Art Fun software. Distensibility was calculated as (change in aortic area between systole and diastole/diastolic area)/brachial pulse pressure.
RESULTS
A total of 98 bicuspid aortic valve patients were included (30% female, 49.7 ± 14.5 years). 75 (76,5%) AR was mild, 17 (17,4%) moderate and 6 (6,1%) severe. RF valvewas significantly correlated with aortic root diameter (r= 0.430 y p < 0.001 )and aortic distensibility at the level of the ascending (r = 0.273 p =0.016) and descending aorta (r = 0.502 and p< 0.001). Aortic distensibility was positively correlated with RFvalve even after adjustment for aortic diameter ( p = 0.002 and p <0.001 respectively) . (Table) (IMG)
CONCLUSIONS
In our study, aortic regurgitation in bicuspid valve patients, evaluated by CMR using RF valve, is related to aortic distensibility. Thus, aortic distensibility should be included in the evaluation of aortic regurgitation by CMR as additional parameter. However, longitudinal studies are needed to evaluate the impact of including aortic distensibility in the evaluation of AR severity by CMR.
AR SEVERITY MILD MODERATE SEVERE Descending aorta distensibility(mean ± std. deviation) 2693,68 ± 997,5 3285,8 ±1952,7 5042,99 ±2873,44 Correlation between AR severity (by RFvalve) and descending aorta distensibility
Abstract P1601 Figure.
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Affiliation(s)
- L La Mura
- University Hospital Vall d"Hebron, Barcelona, Spain
| | | | - A Guala
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - A Ruiz-Munoz
- University Hospital Vall d"Hebron, Barcelona, Spain
| | | | - F Valente
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - M Pisaniello
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - S Strada
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - C Granato
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - L Galian Gay
- University Hospital Vall d"Hebron, Barcelona, Spain
| | | | - M L Servato
- University Hospital Vall d"Hebron, Barcelona, Spain
| | - I Ferreira
- University Hospital Vall d"Hebron, Barcelona, Spain
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9
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Guala A, Teixido-Tura G, Dux-Santoy L, Granato C, Ruiz-Muñoz A, Valente F, Galian-Gay L, Gutiérrez L, González-Alujas T, Johnson KM, Wieben O, Sao Avilés A, Evangelista A, Rodriguez-Palomares J. Decreased rotational flow and circumferential wall shear stress as early markers of descending aorta dilation in Marfan syndrome: a 4D flow CMR study. J Cardiovasc Magn Reson 2019; 21:63. [PMID: 31607265 PMCID: PMC6791020 DOI: 10.1186/s12968-019-0572-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 08/28/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Diseases of the descending aorta have emerged as a clinical issue in Marfan syndrome following improvements in proximal aorta surgical treatment and the consequent increase in life expectancy. Although a role for hemodynamic alterations in the etiology of descending aorta disease in Marfan patients has been suggested, whether flow characteristics may be useful as early markers remains to be determined. METHODS Seventy-five Marfan patients and 48 healthy subjects were prospectively enrolled. In- and through-plane vortexes were computed by 4D flow cardiovascular magnetic resonance (CMR) in the thoracic aorta through the quantification of in-plane rotational flow and systolic flow reversal ratio, respectively. Regional pulse wave velocity and axial and circumferential wall shear stress maps were also computed. RESULTS In-plane rotational flow and circumferential wall shear stress were reduced in Marfan patients in the distal ascending aorta and in proximal descending aorta, even in the 20 patients free of aortic dilation. Multivariate analysis showed reduced in-plane rotational flow to be independently related to descending aorta pulse wave velocity. Conversely, systolic flow reversal ratio and axial wall shear stress were altered in unselected Marfan patients but not in the subgroup without dilation. In multivariate regression analysis proximal descending aorta axial (p = 0.014) and circumferential (p = 0.034) wall shear stress were independently related to local diameter. CONCLUSIONS Reduced rotational flow is present in the aorta of Marfan patients even in the absence of dilation, is related to aortic stiffness and drives abnormal circumferential wall shear stress. Axial and circumferential wall shear stress are independently related to proximal descending aorta dilation beyond clinical factors. In-plane rotational flow and circumferential wall shear stress may be considered as an early marker of descending aorta dilation in Marfan patients.
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Affiliation(s)
- A. Guala
- Hospital Universitari Vall d’Hebron, Department of Cardiology. CIBER-CV. Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - G. Teixido-Tura
- Hospital Universitari Vall d’Hebron, Department of Cardiology. CIBER-CV. Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - L. Dux-Santoy
- Hospital Universitari Vall d’Hebron, Department of Cardiology. CIBER-CV. Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - C. Granato
- Hospital Universitari Vall d’Hebron, Department of Cardiology. CIBER-CV. Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - A. Ruiz-Muñoz
- Hospital Universitari Vall d’Hebron, Department of Cardiology. CIBER-CV. Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - F. Valente
- Hospital Universitari Vall d’Hebron, Department of Cardiology. CIBER-CV. Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - L. Galian-Gay
- Hospital Universitari Vall d’Hebron, Department of Cardiology. CIBER-CV. Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - L. Gutiérrez
- Hospital Universitari Vall d’Hebron, Department of Cardiology. CIBER-CV. Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - T. González-Alujas
- Hospital Universitari Vall d’Hebron, Department of Cardiology. CIBER-CV. Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - K. M. Johnson
- Departments of Medical Physics & Radiology, University of Wisconsin – Madison, Madison, WI USA
| | - O. Wieben
- Departments of Medical Physics & Radiology, University of Wisconsin – Madison, Madison, WI USA
| | - A. Sao Avilés
- Hospital Universitari Vall d’Hebron, Department of Cardiology. CIBER-CV. Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - A. Evangelista
- Hospital Universitari Vall d’Hebron, Department of Cardiology. CIBER-CV. Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d’Hebron 119-129, 08035 Barcelona, Spain
| | - J. Rodriguez-Palomares
- Hospital Universitari Vall d’Hebron, Department of Cardiology. CIBER-CV. Vall d’Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Paseo Vall d’Hebron 119-129, 08035 Barcelona, Spain
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10
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Guala A, Izagirre N, Ruiz Munoz A, Dux-Santoy L, Madrenas L, Gandara M, Granato C, Valente F, Gutierrez L, Galian L, Servato L, La Mura L, Evangelista A, Rodriguez-Palomares JF, Teixido Tura G. P4131Abnormal flow pattern in the main pulmonary artery of Marfan patients is related to local dilation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Marfan syndrome (MFS) is a hereditary connective tissue disorder caused by mutation in the FBN1 gene. Main pulmonary artery (MPA) dilation is very prevalent in MFS patients. Indeed, the old Ghent nosology considered main pulmonary artery (MPA) dilation as diagnostic criterion of MFS patients. Although clinical complications related to pulmonary dilation in MFS are rare, this may potentially lead to MPA dissection or be a marker of vascular disease in MFS. Studies regarding potential causes of MPA dilation in MFS patients are very scarce.
Purpose
Through 4D flow CMR, we aimed to assess whether flow abnormalities exist in the MPA of MFS patients and their relation to local diameter.
Methods
Fifty-five consecutive Marfan syndrome adults (MFS) and 22 healthy volunteers (HV) were prospectively enrolled. All subjects underwent non-contrast-enhanced 4D flow-MRI, obtaining 4D flow field and a 3D angiography. The MPA was segmented from the 3D angiography, and the segmentation was used to mask 4D velocity data. Four, equidistant analysis planes were placed in the MPA between the pulmonary valve and the pulmonary artery bifurcation. Common descriptors of large arteries hemodynamics were computed at each plane: maximum velocity, systolic flow reversal ratio (a descriptor of the amount of systolic backward flow) and circumferentially-averaged axial and circumferential wall shear stress (WSS). Pulmonary artery diameters were measured on axial images. MPA dilation was defined as a diameter larger than 27 mm in women and 29 mm in men. Systolic (SBP) and diastolic (DBP) systemic blood pressure were measured at the brachial artery with a calibrated cuff immediately after the scan.
Results
Compared with HV, MFS patients presented similar age, BSA, SBP and maximum blood velocity, but had larger MPA diameter (27.8 vs 25.1 mm, p<0.001) and higher DBP (75.5 vs 66.8 mmHg, p=0.003). According to the used threshold, 45% (27) of MFS patients had MPA dilation. Compared with HV, Marfan patients presented an increased systolic flow reversal ratio in the proximal part of the MPA (Figure 1). In MFS patients axial WSS was reduced in central sections of the MPA, while the circumferential component was not difference with respect to HV. All these flow abnormalities were also present in the subset of 28 MFS patients without pulmonary artery dilation. In multivariable analysis, MPA diameter was independently related to age (B=0.056; p=0.032), sex (B=−2.3; p=0.02) and axial (B=6.4; p=0.039) and circumferential (B=33.9; p<0.001) WSS.
Figure 1
Conclusions
Dilation of the main pulmonary artery is prevalent in Marfan syndrome patients. Abnormal increase in systolic vortexes and reduction in axial WSS were present in dilated and non-dilated MPA in MFS patients. Axial and circumferential WSS were independently related to MPA diameter. The eventual predictive role of abnormal pulmonary flow pattern in pulmonary artery dilation in MFS patients remain to be established
Acknowledgement/Funding
Instituto de Salud Carlos III (PI14/0106), La Maratό de TV3 (20151330), CIBERCV and FP7/People (267128)
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Affiliation(s)
- A Guala
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - N Izagirre
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - A Ruiz Munoz
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - L Dux-Santoy
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - L Madrenas
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - M Gandara
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - C Granato
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - F Valente
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - L Gutierrez
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - L Galian
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - L Servato
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - L La Mura
- University Hospital Vall d'Hebron, Barcelona, Spain
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11
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Ruiz Munoz A, Guala A, Dux-Santoy L, Teixido-Tura G, Sao-Aviles A, Granato C, Lopez-Sainz A, Servato ML, La Mura L, Galian L, Casas G, Gonzalez-Alujas T, Ferreira I, Evangelista A, Rodriguez-Palomares JF. P1827Maximum systolic flow deceleration rate in the false lumen by 4D-flow MRI is associated with aortic dilatation in patients with chronic descending aorta dissection. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Patent false lumen (FL) in aortic dissection has been associated with poor prognosis mainly due to aortic expansion. Although morphologic variables have been related to aortic dilatation as expression of high pressure in the FL, they do not reflect flow characteristics. We propose the maximum systolic flow deceleration rate (MSDR) in the FL, quantified by 4Dflow, assuming that flow should be strongly decelerated during systole under high pressure.
Methods
Twenty-nine patients with a patent FL after aortic dissection (no Marfan syndrome) and with a follow-up of at least 3 years underwent a contrast-enhanced 4D-flow MR. FL acceleration was calculated during the cardiac cycle in a sub-volume of the descending aorta (5 cm around the level of the pulmonary bifurcation). MSDR was determined as the maximum minus the minimum acceleration in systole over the corresponding time interval (Figure 1a). Aortic growth rate (GR) was defined as the difference between final and initial aortic diameters obtained by angio-CT over the period of follow-up. Population was divided into tertiles based on GR.
Results
Demographic, clinical variables or basal aortic diameter did not show differences among GR groups (Table 1). MSDR was statistically different in patients with a GR <1mm/year (group 1) compared to fast-dilating patients (groups 2, 3) (Figure 1c). MSDR showed a positive linear correlation with GR resulting in a Pearson's correlation of 0.481 (p=0.008) (Figure 1b).
Table 1. Demographic and other variables Tertile 1 Tertile 2 Tertile 3 p-value Age (year) 63.4 (±13.5) 62.5 (±13.6) 64.6 (±6.7) 0.902 BSA (m2) 2.0 (±0.2) 1.8 (±0.2) 1.9 (±0.1) 0.213 Men 6 (86%) 4 (57%) 4 (100%) 0.210 Hypertension 4 (66%) 5 (71%) 4 (100%) 0.438 Atherosclerosis 1 (17%) 1 (14%) 0 (0%) 0.699 Initial diameter 45.0 (±7.69) 36.0 (±4.2) 37.0 (±6.5) 0.078 Final diameter 49.5 (±6.74) 44.9 (±5.7) 59.2 (±9.8) 0.049* Follow-up (year) 11.8 (±8.79) 7.9 (±3.3) 8.1 (±4.0) 0.921 Aortic GR (mm/year) 0.3 (±0.3) 1.2 (±0.3) 2.6 (±1.0) 0.001* MSDR (cm/s3) 1212 (±468) 2411 (±1034) 2558 (±1098) 0.005* Values are mean (±SD) or n (%).
Conclusion
MSDR of flow in the FL derived from 4D-flow RM is related to GR of dissected descending aorta. It is useful to discriminate mild vs. significant aorta enlargement and identify patients who may benefit from earlier therapy.
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Affiliation(s)
- A Ruiz Munoz
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - A Guala
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - L Dux-Santoy
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - G Teixido-Tura
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - A Sao-Aviles
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - C Granato
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - A Lopez-Sainz
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - M L Servato
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - L La Mura
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - L Galian
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - G Casas
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | | | - I Ferreira
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - A Evangelista
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
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12
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Guala A, Teixido Tura G, Rodriguez-Palomares JF, Ruiz Munoz A, Granato C, Galian L, Valente F, Servato L, Villalva N, Gutierrez L, Lopez Sainz A, Gonzalez-Alujas T, Sanchez V, Forteza A, Evangelista A. P1821Proximal aorta longitudinal but not circumferential strain predicts aortic events and aortic root dilation rate in marfan syndrome patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The most common cardiovascular complications in Marfan syndrome (MFS) are aortic root dilation and type A aortic dissections. Elective aortic root surgery is indicated when maximum aortic diameter is larger than a defined threshold or in the case of fast-progressing dilation. However, maximum aortic diameter is limited for the prediction of aortic events. Indeed, a large international registry of acute aortic syndromes reported that as much as 40% of aortic dissections happen with maximum aortic diameter lower than 50 mm. Consequently, there is a need for new, non-invasive biomarkers to improve the prediction of aortic complications.
Purpose
The aim of the present study was to assess if proximal aorta circumferential and longitudinal strain and ascending aorta distensibility were associated with progressive aortic dilation and incidence of aortic events in Marfan syndrome patients.
Methods
Eighty seven Marfan syndrome patients free from previous cardiac/aortic surgery or dissection, were prospectively included in a multicenter follow-up. Patients were diagnosed by original Ghent criteria. Proximal aorta longitudinal and circumferential strain and distensibility were computed from baseline cine CMR images by means of feature-tracking. The predictive capacity of each stiffness biomarkers was separately tested with multivariable linear regression analysis (aortic growth) and with Cox logistic regression analysis (aortic events), both corrected for clinical and demographic variables, including baseline maximum aortic diameter.
Results
During a follow-up of 81.6±17 months, mean diameter growth-rate was 0.65±0.67 mm/year and z-score growth rate was 0.07±0.13 / year. Elective aortic root replacement was performed in 11 patients while two patients presented type A aortic dissection.Baseline proximal aorta longitudinal strain was independently related to diameter growth-rate (p=0.001), z-score growth-rate (p=0.018) and aortic events (p=0.018). Conversely, neither circumferential strain nor distensibility were independent predictors of diameter growth-rate (p=0.385 and p=0.381, respectively), z-score growth-rate (p=0.515 and p=0.484, respectively) and aortic events (p=0.064 and p=0.205, respectively).
Conclusions
Proximal aorta longitudinal strain predicts aortic root dilation and major aortic events in Marfan syndrome patients beyond aortic root diameter and clinical and demographic characteristics.
Acknowledgement/Funding
ISCIII PI14/0106, La Maratό de TV3 (20151330) and CIBERCV. Guala A. FP7/People n° 267128
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Affiliation(s)
- A Guala
- University Hospital Vall d'Hebron, Barcelona, Spain
| | | | | | - A Ruiz Munoz
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - C Granato
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - L Galian
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - F Valente
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - L Servato
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - N Villalva
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - L Gutierrez
- University Hospital Vall d'Hebron, Barcelona, Spain
| | | | | | - V Sanchez
- University Hospital 12 de Octubre, Madrid, Spain
| | - A Forteza
- University Hospital Puerta de Hierro Majadahonda, Madrid, Spain
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13
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Mila L, Teixido Tura G, Granato C, Limeres J, Servato L, Lopez-Sainz A, Gutierrez L, Galian L, Gonzalez-Alujas T, Rodriguez-Palomares J, Evangelista A. 6126Peripheral aneurysms in Marfan patients are common and are related to age and advanced aortic disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Peripheral aneurysms are not included in the diagnostic criteria for Marfan syndrome (MFS); however, their real prevalence in MFS is unknown. Furthermore, they are commonly seen in other genetic entities such as Loeys-Dietz syndrome.
We aimed to investigate the prevalence of peripheral aneurysm in Marfan syndrome.
Methods
Patients with clinical criteria of Marfan syndrome and identified FBN1 mutation were evaluated. Only patients with either MRI or CT angiography assessing peripheral vessels were included in this study. MRI and CT angiography studies were retrospectively evaluated to detect the presence of peripheral aneurysms. Aortic dissection-related arterial dilations were excluded. Aortic events and those related to aneurysm complications were collected during follow-up.
Results
Two hundred and nine patients with Marfan and FBN1 mutation were evaluated. Of these 136 (65.1%) had undergone either MRA or CTA with peripheral artery study during follow-up. Mean age at the last follow-up visit was 42.4±14.1yrs; 54.4% were men, and mean follow-up 7.3±3.1 years. Sixty-six aneurysms were identified in 42 (30.9%) patients. The most common locations were the iliac arteries in 23. The rest were: renal (7), vertebral (5), splenic (5), coeliac (3), brachiocephalic (1), subclavian (3), carotid (3), axillary (2), internal mammary (3), femoral (2), hypogastric (3), bronchial (2), coronary (1), hepatic (1), lumbar (1), gastroduodenal (1) and popliteal (1). Twenty-six patients (61.9%) had more than one peripheral aneurysm, and only 4 required surgery.
Patients with peripheral aneurysms were older (47.2±14.3yrs vs 40.2±13.6yrs, p=0.06) and more frequently men (69.0% vs 47.9% p=0.026). Although patients with peripheral aneurysms did not more frequently have aortic dissection (16.7% vs 17.0%, p=0.586), they did more frequently have aortic surgery (73.8% vs 47.9% p=0.05).
Conclusions
Peripheral aneurysms are present in one third of Marfan syndrome patients and are related to age and more advanced aortic disease. Systematic use of whole-body vascular assessment in Marfan patients can provide a comprehensive evaluation of the entire arterial system, identifying other sites of vascular involvement at risk of potential complications, and the subgroup of patients with more aggressive vascular disease expression.
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Affiliation(s)
- L Mila
- University Hospital Vall d'Hebron, Barcelona, Spain
| | | | - C Granato
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - J Limeres
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - L Servato
- University Hospital Vall d'Hebron, Barcelona, Spain
| | | | - L Gutierrez
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - L Galian
- University Hospital Vall d'Hebron, Barcelona, Spain
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14
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Guala A, Galian L, Teixido Tura G, Dux-Santoy L, Ruiz Munoz A, Granato C, Valente F, La Mura L, Gutierrez L, Lopez Sainz A, Johnson KM, Wieben O, Sao Aviles A, Evangelista A, Rodriguez-Palomares JF. 477Partial fusion of two aortic valve leaflets is related to alterations in ascending aorta flow: 4D flow CMR study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Bicuspid aortic valve (BAV) is the most common congenital valve defect. It consists in the fusion of two aortic valve leaflets, and it is associated with a high prevalence of proximal aorta dilation. Dilation is highly prevalent (around 30%) in BAV patient relatives with a tricuspid valve (TAV) identified by echocardiography. However, the presence of partial aortic valve leaflet fusion (also called mini-raphe or forme fruste BAV, see figure 1A) is easily missed by echocardiography. A recent study reported that 44% of patients from a small cohort of BAV patient relatives with aortic dilation followed by CT showed mini-raphe.
Purpose
We aimed to use 4D flow CMR to assess if the presence of mini-raphe is associated with aortic flow alterations, which may be concurs in the etiology of aortic dilation in BAV patient relatives.
Methods
Twenty BAV patients first-degree relatives with partial fusion (<50%) of aortic valve leaflets and proximal aorta dilation were identified by CT or cine CMR and prospectively included. One-hundred twenty-five BAV and 95 patients with TAV from our prospective dataset of 4D flow CMR were included for comparison. Propensity score matching was used throughout the study to correct the comparisons between mini-raphe and BAV and mini-raphe and TAV patients for differences in age, maximum aortic diameter, sex, height, weight, proximal aortic pulse wave velocity and, only for BAV, fusion pattern. The hemodynamic parameters previously related to aortic dilation were computed. They were jet angle, normalized flow displacement and systolic flow reversal ratio (SFRR, identifying through-plane vortexes) were computed and compared in the ascending aorta and in the aortic arch.
Results
The presence of mini-raphe was statistically-significantly associated with increase in jet angle (Figure 1B), flow displacement (Figure 1C) and vortexes (Figure 1D) in most of the ascending aorta and aortic arch when mini-raphe patients were compared with TAV patients. The severity of flow asymmetry found in mini-raphe patients was lower than the one characteristic of BAV patients, but vortexes were even higher in a small region at the distal ascending aorta.
Figure 1
Conclusion
Partial fusion of the aortic valve leaflets is related to increase in proximal aorta flow eccentricity and vorticity. These flow abnormalities are not as marked as those associated with BAV. Data regarding prevalence of mini-raphe as evaluated with CT or cine CMR are needed, especially in familiar of BAV patients.
Acknowledgement/Funding
European FP7/People 267128; Spanish Ministry of Economy and Competitiveness RTC-2016-5152-1 and Instituto de Salud Carlos III PI14/0106
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Affiliation(s)
- A Guala
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - L Galian
- University Hospital Vall d'Hebron, Barcelona, Spain
| | | | - L Dux-Santoy
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - A Ruiz Munoz
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - C Granato
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - F Valente
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - L La Mura
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - L Gutierrez
- University Hospital Vall d'Hebron, Barcelona, Spain
| | | | - K M Johnson
- University of Wisconsin-Madison, Departments of Medical Physics & Radiology, Madison, United States of America
| | - O Wieben
- University of Wisconsin-Madison, Departments of Medical Physics & Radiology, Madison, United States of America
| | - A Sao Aviles
- University Hospital Vall d'Hebron, Barcelona, Spain
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15
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Guala A, Rodriguez-Palomares JF, Ruiz Munoz A, Dux-Santoy L, Villalva N, Granato C, Galian L, Gutierrez L, Gonzalez-Alujas T, Gandara M, Sanchez V, Forteza A, Garcia-Dorado D, Evangelista A, Teixido Tura G. P412Prognostic value of proximal aorta longitudinal strain for aortic events and dilation in Marfan syndrome patients. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez118.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Guala
- University Hospital Vall d"Hebron, Department of Cardiology, Barcelona, Spain
| | | | - A Ruiz Munoz
- University Hospital Vall d"Hebron, Department of Cardiology, Barcelona, Spain
| | - L Dux-Santoy
- University Hospital Vall d"Hebron, Department of Cardiology, Barcelona, Spain
| | - N Villalva
- University Hospital Vall d"Hebron, Department of Cardiology, Barcelona, Spain
| | - C Granato
- University Hospital Vall d"Hebron, Department of Cardiology, Barcelona, Spain
| | - L Galian
- University Hospital Vall d"Hebron, Department of Cardiology, Barcelona, Spain
| | - L Gutierrez
- University Hospital Vall d"Hebron, Department of Cardiology, Barcelona, Spain
| | - T Gonzalez-Alujas
- University Hospital Vall d"Hebron, Department of Cardiology, Barcelona, Spain
| | - M Gandara
- University Hospital Vall d"Hebron, Department of Cardiology, Barcelona, Spain
| | - V Sanchez
- University Hospital 12 de Octubre, Madrid, Spain
| | - A Forteza
- University Hospital Puerta de Hierro Majadahonda, Madrid, Spain
| | - D Garcia-Dorado
- University Hospital Vall d"Hebron, Department of Cardiology, Barcelona, Spain
| | - A Evangelista
- University Hospital Vall d"Hebron, Department of Cardiology, Barcelona, Spain
| | - G Teixido Tura
- University Hospital Vall d"Hebron, Department of Cardiology, Barcelona, Spain
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16
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Guala A, Galian L, Teixido Tura G, Ruiz Munoz A, Granato C, Valente F, Johnson KM, Wieben O, Sao Aviles A, Gutierrez L, Gonzalez-Alujas T, Evangelista A, Rodriguez-Palomares JF. 520Thoracic aorta flow by 4D flow CMR is altered in patients presenting partial fusion of two aortic valve leaflets. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez124.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- A Guala
- University Hospital Vall d"Hebron, Department of Cardiology, Barcelona, Spain
| | - L Galian
- University Hospital Vall d"Hebron, Department of Cardiology, Barcelona, Spain
| | - G Teixido Tura
- University Hospital Vall d"Hebron, Department of Cardiology, Barcelona, Spain
| | - A Ruiz Munoz
- University Hospital Vall d"Hebron, Department of Cardiology, Barcelona, Spain
| | - C Granato
- University Hospital Vall d"Hebron, Department of Cardiology, Barcelona, Spain
| | - F Valente
- University Hospital Vall d"Hebron, Department of Cardiology, Barcelona, Spain
| | - K M Johnson
- University of Wisconsin-Madison, Departments of Medical Physics & Radiology, Madison, United States of America
| | - O Wieben
- University of Wisconsin-Madison, Departments of Medical Physics & Radiology, Madison, United States of America
| | - A Sao Aviles
- University Hospital Vall d"Hebron, Department of Cardiology, Barcelona, Spain
| | - L Gutierrez
- University Hospital Vall d"Hebron, Department of Cardiology, Barcelona, Spain
| | - T Gonzalez-Alujas
- University Hospital Vall d"Hebron, Department of Cardiology, Barcelona, Spain
| | - A Evangelista
- University Hospital Vall d"Hebron, Department of Cardiology, Barcelona, Spain
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17
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Caldeira DB, de Souza Luna LK, Watanabe A, Perosa AH, Granato C, Bellei N. The occurrence of polyomaviruses WUPyV and KIPyV among patients with severe respiratory infections. Braz J Microbiol 2018; 50:133-137. [PMID: 30637634 PMCID: PMC6863251 DOI: 10.1007/s42770-018-0038-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Accepted: 10/15/2018] [Indexed: 12/30/2022] Open
Abstract
In 2007, the new polyomaviruses WUPyV and KIPyV were identified in patients with acute respiratory infections. The aim of this study was to investigate these viruses in hospitalized patients with severe acute respiratory infection (SARI). A retrospective study was conducted with 251 patients, from April 2009 to November 2010, using nasopharyngeal aspirates, naso- and oropharyngeal swab samples from hospitalized patients (children < 12 years and adults) who had SARI within 7 days of the onset of symptoms, including fever (> 38.8 °C), dyspnea, and cough. Clinical and epidemiological information was obtained through standardized questionnaire. Enrolled patients were initially suspected to have influenza A(H1N1)pdm09 infections. WUPyV and KIPyV were detected by real-time PCR. Samples were also tested for influenza A and B viruses, human respiratory syncytial virus, rhinovirus, metapneumovirus, coronavirus, adenovirus, and parainfluenza viruses. WUPyV and KIPyV were detected in 6.77% (4.78% and 1.99%, respectively) of hospitalized patients with SARI. All samples from children showed coinfections (rhinovirus was the most commonly detected). Six adults had polyomavirus infection and four (1.6%) had monoinfection. Of them, 3 reported comorbidities including immunosuppression and 1 patient had worse outcome, requiring ICU admission. These preliminary data may suggest a possible role of polyomaviruses in SARI among immunocompromised adult patients.
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Affiliation(s)
- Débora Bellini Caldeira
- Medicine Department, Clinical Virology Laboratory, Infectious Diseases Unit, Sao Paulo Federal University, Rua Pedro de Toledo, 781, 15 andar, Sao Paulo, Brazil.
| | - Luciano Kleber de Souza Luna
- Medicine Department, Clinical Virology Laboratory, Infectious Diseases Unit, Sao Paulo Federal University, Rua Pedro de Toledo, 781, 15 andar, Sao Paulo, Brazil
| | - Aripuana Watanabe
- Department of parasitology, microbiology and immunology, Biologic Sciences Institute, Federal University of Juiz de Fora, Minas Gerais, Brazil
| | - Ana Helena Perosa
- Medicine Department, Clinical Virology Laboratory, Infectious Diseases Unit, Sao Paulo Federal University, Rua Pedro de Toledo, 781, 15 andar, Sao Paulo, Brazil
| | - Celso Granato
- Medicine Department, Clinical Virology Laboratory, Infectious Diseases Unit, Sao Paulo Federal University, Rua Pedro de Toledo, 781, 15 andar, Sao Paulo, Brazil
| | - Nancy Bellei
- Medicine Department, Clinical Virology Laboratory, Infectious Diseases Unit, Sao Paulo Federal University, Rua Pedro de Toledo, 781, 15 andar, Sao Paulo, Brazil
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18
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da Silva I, da Costa Vieira R, Stella C, Loturco E, Carvalho AL, Veo C, Neto C, Silva SM, D'Amora P, Salzgeber M, Matos D, Silva CR, Oliveira JR, Rabelo I, Yamakawa P, Maciel R, Biscolla R, Chiamolera M, Fraietta R, Reis F, Mori M, Marchioni D, Carioca A, Maciel G, Tomioka R, Baracat E, Silva C, Granato C, Diaz R, Scarpellini B, Egle D, Fiegl H, Himmel I, Troi C, Nagourney R. Inborn-like errors of metabolism are determinants of breast cancer risk, clinical response and survival: a study of human biochemical individuality. Oncotarget 2018; 9:31664-31681. [PMID: 30167086 PMCID: PMC6114970 DOI: 10.18632/oncotarget.25839] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 07/12/2018] [Indexed: 01/16/2023] Open
Abstract
Breast cancer remains a leading cause of morbidity and mortality worldwide yet methods for early detection remain elusive. We describe the discovery and validation of biochemical signatures measured by mass spectrometry, performed upon blood samples from patients and controls that accurately identify (>95%) the presence of clinical breast cancer. Targeted quantitative MS/MS conducted upon 1225 individuals, including patients with breast and other cancers, normal controls as well as individuals with a variety of metabolic disorders provide a biochemical phenotype that accurately identifies the presence of breast cancer and predicts response and survival following the administration of neoadjuvant chemotherapy. The metabolic changes identified are consistent with inborn-like errors of metabolism and define a continuum from normal controls to elevated risk to invasive breast cancer. Similar results were observed in other adenocarcinomas but were not found in squamous cell cancers or hematologic neoplasms. The findings describe a new early detection platform for breast cancer and support a role for pre-existing, inborn-like errors of metabolism in the process of breast carcinogenesis that may also extend to other glandular malignancies. Statement of Significance: Findings provide a powerful tool for early detection and the assessment of prognosis in breast cancer and define a novel concept of breast carcinogenesis that characterizes malignant transformation as the clinical manifestation of underlying metabolic insufficiencies.
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Affiliation(s)
- Ismael da Silva
- Gynecology Department, College of Medicine of the Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil.,Fleury Laboratories, São Paulo, Brazil.,Barretos Cancer Hospital (HCB), Barretos, Brazil
| | | | - Carolina Stella
- Gynecology Department, College of Medicine of the Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
| | - Edson Loturco
- Department of Surgery, Urology Unit, Human Reproduction Division, College of Medicine of the Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
| | | | - Carlos Veo
- Barretos Cancer Hospital (HCB), Barretos, Brazil
| | | | | | - Paulo D'Amora
- Gynecology Department, College of Medicine of the Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
| | - Marcia Salzgeber
- Gynecology Department, College of Medicine of the Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
| | - Delcio Matos
- Department of Surgery, Surgical Gastroenterology Division, College of Medicine of the Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
| | - Celso R Silva
- Clinical and Experimental Oncology Department, Hematology and Hemotherapy Division, College of Medicine of the Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
| | - Jose R Oliveira
- Clinical and Experimental Oncology Department, Hematology and Hemotherapy Division, College of Medicine of the Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
| | - Iara Rabelo
- Clinical and Experimental Oncology Department, Hematology and Hemotherapy Division, College of Medicine of the Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
| | - Patricia Yamakawa
- Clinical and Experimental Oncology Department, Hematology and Hemotherapy Division, College of Medicine of the Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
| | - Rui Maciel
- Fleury Laboratories, São Paulo, Brazil.,Department of Medicine, Endocrinology Division, College of Medicine of the Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
| | - Rosa Biscolla
- Department of Medicine, Endocrinology Division, College of Medicine of the Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
| | - Maria Chiamolera
- Department of Medicine, Endocrinology Division, College of Medicine of the Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
| | - Renato Fraietta
- Department of Surgery, Urology Unit, Human Reproduction Division, College of Medicine of the Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
| | - Felipe Reis
- Biophysics Department, College of Medicine of the Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
| | - Marcelo Mori
- Department of Biochemistry and Tissue Biology, State University of Campinas (UNICAMP), Campinas, Brazil
| | - Dirce Marchioni
- Nutrition Department, School of Public Health, University of São Paulo School of Medicine (FMUSP), São Paulo, Brazil
| | - Antonio Carioca
- Nutrition Department, School of Public Health, University of São Paulo School of Medicine (FMUSP), São Paulo, Brazil
| | - Gustavo Maciel
- Fleury Laboratories, São Paulo, Brazil.,Department of Obstetrics and Gynecology, University of São Paulo School of Medicine (HCFMUSP), São Paulo, Brazil
| | - Renato Tomioka
- Department of Obstetrics and Gynecology, University of São Paulo School of Medicine (HCFMUSP), São Paulo, Brazil
| | - Edmund Baracat
- Department of Obstetrics and Gynecology, University of São Paulo School of Medicine (HCFMUSP), São Paulo, Brazil
| | - Clovis Silva
- Department of Pediatrics, Children's Hospital, University of São Paulo School of Medicine (HCFMUSP), São Paulo, Brazil
| | - Celso Granato
- Fleury Laboratories, São Paulo, Brazil.,Retrovirology Laboratory, Infectious Diseases Unit, Medicine Department, College of Medicine of the Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
| | - Ricardo Diaz
- Retrovirology Laboratory, Infectious Diseases Unit, Medicine Department, College of Medicine of the Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
| | - Bruno Scarpellini
- Fleury Laboratories, São Paulo, Brazil.,Retrovirology Laboratory, Infectious Diseases Unit, Medicine Department, College of Medicine of the Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil
| | - Daniel Egle
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - Heidi Fiegl
- Department of Gynecology, Meran Hospital, Meran, Italy
| | | | - Christina Troi
- Department of Gynecology, Brixen Hospital, Brixen, Italy
| | - Robert Nagourney
- Department of Obstetrics and Gynecology, Gynecological Oncology Unit, University of California Irvine (UCI), California, USA
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19
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Fernandez-Galera R, Rodriguez-Palomares JF, Gutierrez Garcia-Moreno L, Galian Gay L, Teixido Tura G, Baneras Rius J, Granato C, Dentamaro I, Villalva N, Valente F, Pariggiano I, Pereda C, Barron JL, Evangelista Masip A, Gonzalez-Alujas MT. P4517Long-term treatment in survivors after an acute prosthetic valve thrombosis: is it possible to improve clinical outcomes? Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | | | - L Galian Gay
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - G Teixido Tura
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - J Baneras Rius
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - C Granato
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - I Dentamaro
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - N Villalva
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - F Valente
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - I Pariggiano
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - C Pereda
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
| | - J L Barron
- University Hospital Vall d'Hebron, Cardiology, Barcelona, Spain
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20
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Guala A, Teixido-Tura G, Rodriguez-Palomares F, Ruiz-Munoz A, Dux-Santoy L, Granato C, Dentamaro I, Villalva N, Fernandez R, Valente F, Gutierrez L, Galian L, Gonzalez-Alujas T, Garcia-Dorado D, Evangelista A. P6500Intrinsic aortic ellipticity and curvature are related to abnormal flow pattern in Marfan patients: a 4D flow MRI study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Guala
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - G Teixido-Tura
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | | | - A Ruiz-Munoz
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - L Dux-Santoy
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - C Granato
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - I Dentamaro
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - N Villalva
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - R Fernandez
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - F Valente
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - L Gutierrez
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - L Galian
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - T Gonzalez-Alujas
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - D Garcia-Dorado
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - A Evangelista
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
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21
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Guala A, Dux-Santoy L, Rodriguez-Palomares J, Teixido-Tura G, Ruiz-Munoz A, Valente F, Villalva N, Granato C, Sao-Aviles A, Galian L, Gutierrez L, Fernandez R, Gonzalez-Alujas T, Garcia-Dorado D, Evangelista A. P675Are there flow dynamics implications of raphe in bicuspid aortic valve patients? Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Guala
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - L Dux-Santoy
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | | | - G Teixido-Tura
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - A Ruiz-Munoz
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - F Valente
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - N Villalva
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - C Granato
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - A Sao-Aviles
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - L Galian
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - L Gutierrez
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - R Fernandez
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - T Gonzalez-Alujas
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - D Garcia-Dorado
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - A Evangelista
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
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22
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Guala A, Rodriguez-Palomares J, Teixido-Tura G, Dux-Santoy L, Ruiz-Munoz A, Valente F, Granato C, Galian L, Gutierrez L, Gonzalez-Alujas T, Johnson KM, Wieben O, Sao-Aviles A, Garcia-Dorado D, Evangelista A. P5492Regional aortic stiffness in bicuspid aortic valve patients assessed by 4D-flow CMR: influence of aortic dilation and comparison with Marfan syndrome and degenerative aortic aneurysm. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Guala
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | | | - G Teixido-Tura
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - L Dux-Santoy
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - A Ruiz-Munoz
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - F Valente
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - C Granato
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - L Galian
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - L Gutierrez
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - T Gonzalez-Alujas
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - K M Johnson
- University of Wisconsin-Madison, Departments of Medical Physics & Radiology, Madison, United States of America
| | - O Wieben
- University of Wisconsin-Madison, Departments of Medical Physics & Radiology, Madison, United States of America
| | - A Sao-Aviles
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - D Garcia-Dorado
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
| | - A Evangelista
- University Hospital Vall d'Hebron, Department of Cardiology, Barcelona, Spain
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Galian-Gay L, Granato C, Calvo F, Sevilla-Ruiz T, Bermejo J, Mendez I, Sanchez-Sanchez V, Robledo-Carmona J, Alegret-Colome JM, Ferrer-Sistach E, Saura D, Teixid-Tura G, Gonzalez-Alujas T, Rodriguez-Palomares J, Evangelista A. P1759Relation between semi-quantitative echocardiographic assessment of aortic valve calcification and quantitative calcium score by computed tomography in patients with bicuspid aortic valve. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - C Granato
- Hospital Vall d'Hebron, Barcelona, Spain
| | - F Calvo
- Hospital of Meixoeiro, Cardiology Department, Vigo, Spain
| | - T Sevilla-Ruiz
- University Hospital Clinic of Valladolid, Valladolid, Spain
| | - J Bermejo
- University Hospital Gregorio Maranon, Madrid, Spain
| | - I Mendez
- University Hospital of Virgen Macarena, Seville, Spain
| | | | | | | | | | - D Saura
- Hospital Clínico Univeristario Virgen de la Arrixaca, Murcia, Spain
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Costa-Carvalho BT, Sullivan KE, Fontes PM, Aimé-Nobre F, Gonzales IGS, Lima ES, Granato C, de Moraes-Pinto MI. Low Rates of Poliovirus Antibodies in Primary Immunodeficiency Patients on Regular Intravenous Immunoglobulin Treatment. J Clin Immunol 2018; 38:628-634. [PMID: 30006913 DOI: 10.1007/s10875-018-0531-x] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 07/03/2018] [Indexed: 12/15/2022]
Abstract
PURPOSE Poliovirus has been nearly eliminated as part of a world-wide effort to immunize and contain circulating wild-type polio. Nevertheless, poliovirus has been detected in water supplies and represents a threat to patients with humoral immunodeficiencies where infection can be fatal. To define the risk, we analyzed antibodies to poliovirus 1, 2, and 3 in serum samples collected over a year from patients with primary immunodeficiency diseases (PID) on regular intravenous immunoglobulin (IVIG) replacement. METHODS Twenty-one patients on regular IVIG replacement therapy were evaluated: Twelve patients with common variable immune deficiency (CVID), six with X-linked agammaglobulinemia (XLA), and three with hyper IgM syndrome (HIGM). Over 1 year, four blood samples were collected from each of these patients immediately before immunoglobulin infusion. One sample of IVIG administered to each patient in the month before blood collection was also evaluated. Poliovirus antibodies were quantified by seroneutralization assay. RESULTS All IVIG samples had detectable antibodies to the three poliovirus serotypes. Despite that, only 52.4, 61.9, and 19.0% of patients showed protective antibody titers for poliovirus 1, 2, and 3, respectively. Only two patients (9.5%) had protective antibodies for the three poliovirus serotypes on all samples. Most patients were therefore susceptible to all three poliovirus serotypes. CONCLUSIONS This study demonstrates the need for ongoing vigilance regarding exposure of patients with PID to poliovirus in the community.
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Affiliation(s)
- Beatriz T Costa-Carvalho
- Division of Allergy Clinical Immunology and Rheumatology, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Kathleen E Sullivan
- Division of Allergy Immunology, The Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Patrícia M Fontes
- Division of Allergy Clinical Immunology and Rheumatology, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Fernanda Aimé-Nobre
- Division of Allergy Clinical Immunology and Rheumatology, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Isabela G S Gonzales
- Division of Allergy Clinical Immunology and Rheumatology, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Elaine S Lima
- Division of Infectious Diseases, Department of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Celso Granato
- Division of Infectious Diseases, Department of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Maria Isabel de Moraes-Pinto
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil.
- Research Laboratory, Division of Pediatric Infectious Diseases, Federal University of Sao Paulo, Rua Pedro de Toledo, 781/9°andar, São Paulo, SP, 04039-032, Brazil.
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Gouveia-Alves F, Gouveia R, Ginani VC, Seber A, Kuramoto DA, Murad GFA, Spina FG, Petrilli AS, Zecchin VG, Granato C, Carlesse F, de Moraes-Pinto MI. Adherence and immune response to revaccination following hematopoietic stem cell transplantation at a pediatric onco-hematology reference center. Transpl Infect Dis 2018; 20:e12903. [PMID: 29668078 DOI: 10.1111/tid.12903] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 09/10/2017] [Revised: 03/14/2018] [Accepted: 03/18/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Revaccination after hematopoietic stem cell transplantation (HSCT) is necessary to compensate for the loss of immunological memory. The aims of this study were to evaluate the adherence to revaccination schedule and the humoral immune response to different vaccine antigens in HSCT pediatric and young adult patients. METHODS Patients submitted to HSCT for over 3 years were recruited. After written informed consent, a questionnaire was filled in, the vaccination card was analyzed, a blood sample was collected and tested by ELISA for diphtheria, Haemophilus influenzae type b (Hib), hepatitis A, hepatitis B, tetanus, measles, rubella, and varicella antibodies. RESULTS Sixty-three patients (mean age at HSCT, 10.7 years) were evaluated. Forty-one (65%) were male; 34 (54%) had allogeneic and 29 (46%), autologous HSCT. Complete adherence to diphtheria revaccination was found in 79.4% patients and seropositivity was found in 92% of those who completed the revaccination schedule; for Hib, 68.3% adherence and 95.3% seropositivity were observed; for hepatitis A, 63.5% adherence and 92.5% seropositivity; for 3 doses of hepatitis B, 86.8% adherence and 79.2% seropositivity; for tetanus, 79.4% adherence and 100% seropositivity; for measles and rubella, 17.5% adherence and 100% seropositivity; for varicella, 7.9% adherence and 100% seropositivity. The existence of a Vaccination Center for Special Immunobiologicals in patients' municipality was positively associated with completed vaccine schedule; on the other hand, chronic GVHD was negatively associated with revaccination adherence. CONCLUSION Hematopoietic stem cell transplantation patients showed good seropositivity rates after complete vaccination schedule. However, a low coverage rate was observed for live attenuated antigens.
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Affiliation(s)
| | | | | | | | - Danielle A Kuramoto
- Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Gabriel F A Murad
- Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Fernanda G Spina
- Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Antonio S Petrilli
- Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Victor G Zecchin
- Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Celso Granato
- Department of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil.,Fleury Group, São Paulo, Brazil
| | - Fabianne Carlesse
- Department of Pediatrics, Universidade Federal de São Paulo, São Paulo, Brazil
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Moreira LP, Watanabe ASA, Camargo CN, Melchior TB, Granato C, Bellei N. Respiratory syncytial virus evaluation among asymptomatic and symptomatic subjects in a university hospital in Sao Paulo, Brazil, in the period of 2009-2013. Influenza Other Respir Viruses 2018; 12:326-330. [PMID: 29078028 PMCID: PMC5907818 DOI: 10.1111/irv.12518] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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] [Accepted: 09/14/2017] [Indexed: 12/27/2022] Open
Abstract
Background The respiratory syncytial virus (RSV) is recognized as an important cause of respiratory tract infections. Immunocompromised patients, healthcare workers (HCWs) and children contacts are at increased risk of acquiring the infection. However, the impact of asymptomatic infection in transmission has not been well studied. Objectives: this study evaluated the frequency and viral load (VL) of RSV in nasal swab samples of individuals with different risk factors for acquiring infection in a university hospital in Sao Paulo, Brazil. Methods We included 196 symptomatic children and their 192 asymptomatic caregivers, 70 symptomatic and 95 asymptomatic HCWs, 43 samples from symptomatic HIV‐positive outpatients, and 100 samples of asymptomatic HIV patients in the period of 2009‐2013. Results RSV infection was detected in 10.1% (70/696) of samples, 4.4% (17/387) of asymptomatic patients, and 17.1% (53/309) from symptomatic patients. (P < .0001). The VL of symptomatic patients (4.7 log copies/mL) was significantly higher compared to asymptomatic patients (2.3 log copies/mL). RSV detection among asymptomatic caregivers (6.8%; 13/192) was significantly higher compared to other asymptomatic adults, HIV and HCWs (2.0%; 4/195; P = .0252). A close contact with an infected child at home was an important risk to RSV acquisition [OR 22.6 (95% CI 4.8‐106.7)]. Children who possibly transmitted the virus to their asymptomatic contacts had significantly higher viral load than children who probably did not transmit (P < .0001). Conclusions According to our results, it is important to know if people circulating inside the hospital have close contact with acute respiratory infected children.
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Affiliation(s)
| | | | | | | | - Celso Granato
- Medicine Department, Sao Paulo Federal University, Sao Paulo, Brazil
| | - Nancy Bellei
- Medicine Department, Sao Paulo Federal University, Sao Paulo, Brazil
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Granato C, Maldonado G, Italiano G, Dentamaro I, Mendez I, Castro M, Vazquez M, Rodriguez-Bailon I, Fernandez-Casare S, De La Morena G, Sevilla T, Evangelista A. P6350Non-dilated aorta in bicuspid aortic valve patients: prevalence and determinants. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6350] [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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Maldonado G, Galian L, Carro A, Gallego P, Calvo-Iglesias F, Bermejo J, Robledo-Carmona J, Sanchez V, Saura D, Arnold R, Teixido G, Granato C, Gutierrez L, Rodriguez-Palomares J, Evangelista A. P6314Echocardiography screening of first degree relatives of bicuspid aortic valve. Heritability and performance evaluation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6314] [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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29
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Maldonado G, Galian L, Gallego P, Calvo F, Bermejo J, Robledo-Carmona J, Sanchez V, Saura D, Arnold R, Teixido G, Villalva N, Granato C, Gutierrez L, Rodriguez-Palomares J, Evangelista A. P5176Aortic dilation heterogeneity in bicuspid aortic valve patients. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5176] [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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Paulini I, Siqueira-Silva J, Thomaz L, Rocha L, Harsi C, Bellei N, Granato C. Development of a prototype immunochromatographic test for rapid diagnosis of respiratory adenovirus infection. Braz J Infect Dis 2017. [PMID: 28623675 PMCID: PMC9425546 DOI: 10.1016/j.bjid.2017.03.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 11/27/2022] Open
Abstract
Human adenoviruses comprise an important group of etiologic agents that are responsible for various diseases in adults and children, such as respiratory, ocular, gastroenteric, and urinary infections. In immunocompromised and organ-transplanted individuals, these agents can cause generalized infections. Rapid diagnostic methods for detecting these infectious agents are not widely available. The aim of this work was to produce monoclonal and polyclonal anti-adenovirus antibodies to be used in a rapid diagnostic test for respiratory infections. Adenovirus hexons were satisfactorily purified by ultracentrifugation and chromatography. After virus purification, anti-hexon monoclonal antibodies were produced and characterized, following classical methods. Antibodies were specific for adenoviruses 2, 3, 5, and 41. The proposed immunochromatographic test was standardized using colloidal gold. The standardization of the rapid test was sufficient to detect adenovirus antigens (in nasopharyngeal lavage samples) with sensitivity of 100% and specificity of 85% when compared to direct immunofluorescence. The immunochromatographic assay prototype was sufficiently sensitive to detect B (3), C (2 and 5), and F (41) adenovirus samples. Although based on preliminary data, the test demonstrated the same performance as direct immunofluorescence, but with the advantage of being a point-of-care test. Further studies are still needed to confirm its effectiveness in clinical practice.
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Affiliation(s)
- Inarei Paulini
- Universidade Federal de São Paulo, Departamento de Medicina, Laboratório de Virologia, Disciplina de Infectologia, São Paulo, SP, Brazil.
| | - Joselma Siqueira-Silva
- Universidade de São Paulo, Instituto de Biociências, Departamento de Microbiologia, Laboratório de Adenovírus, São Paulo, SP, Brazil
| | - Luciana Thomaz
- Instituto de Biociências, Departamento de Microbiologia, Laboratório de Micologia, São Paulo, SP, Brazil
| | - Leticia Rocha
- Instituto Butantan, Laboratório de Bacteriologia, São Paulo, SP, Brazil
| | - Charlotte Harsi
- Universidade de São Paulo, Instituto de Biociências, Departamento de Microbiologia, Laboratório de Adenovírus, São Paulo, SP, Brazil
| | - Nancy Bellei
- Universidade Federal de São Paulo, Departamento de Medicina, Laboratório de Virologia, Disciplina de Infectologia, São Paulo, SP, Brazil
| | - Celso Granato
- Universidade Federal de São Paulo, Departamento de Medicina, Laboratório de Virologia, Disciplina de Infectologia, São Paulo, SP, Brazil
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31
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Parmezan SN, Camargo C, Watanabe A, Godoy-Martínez P, Granato C, Bellei N. [Detection of parainfluenza virus in immunocompromised and immunocompetent patients in a tertiary hospital in Sao Paulo, Brazil]. Rev Chilena Infectol 2017; 33:501-504. [PMID: 28112331 DOI: 10.4067/s0716-10182016000500002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 08/30/2016] [Indexed: 11/17/2022] Open
Abstract
Parainfluenza virus infections (PIV) were evaluated in patients with mild and severe infections through real time PCR. One thousand and sixty-seven samples were collected from subjects as follows: 233 adult renal transplanted outpatients, 129 children with congenital heart disease, 381 with adult hematopoietic stem cell patients and 324 hospitalized patients suspected of influenza A (H1N1) pdm09 infection. PIV was detected in 74 (6.9%) samples. VPI-3 was the most frequent (60.8%) and a higher risk was observed for older adults (p = 0.018) and for those who were hematopoietic stem cell transplanted. Further studies are needed to understand the VPI role in patients' at risk for developing serious illness.
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Affiliation(s)
- Sheila N Parmezan
- Laboratorio de Virología Clínica, Unidad de Enfermedades Infecciosas, Departamento de Medicina, Universidad Federal de São Paulo, São Paulo, Brasil
| | - Clarice Camargo
- Laboratorio de Virología Clínica, Unidad de Enfermedades Infecciosas, Departamento de Medicina, Universidad Federal de São Paulo, São Paulo, Brasil
| | - Aripuanã Watanabe
- Laboratorio de Virología Clínica, Unidad de Enfermedades Infecciosas, Departamento de Medicina, Universidad Federal de São Paulo, São Paulo, Brasil
| | - Patricio Godoy-Martínez
- Instituto de Microbiología Clínica, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | - Celso Granato
- Laboratorio de Virología Clínica, Unidad de Enfermedades Infecciosas, Departamento de Medicina, Universidad Federal de São Paulo, São Paulo, Brasil
| | - Nancy Bellei
- Laboratorio de Virología Clínica, Unidad de Enfermedades Infecciosas, Departamento de Medicina, Universidad Federal de São Paulo, São Paulo, Brasil
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Passos-Castilho AM, Lo Turco E, Ferraz ML, Matos C, Silva I, Parise E, Pilau E, Gozzo F, Granato C. Plasma lipidomic fingerprinting to distinguish among hepatitis C-related hepatocellular carcinoma, liver cirrhosis, and chronic hepatitis C using MALDI-TOF mass spectrometry: a pilot study. J Gastrointestin Liver Dis 2016; 24:43-9. [PMID: 25822433 DOI: 10.15403/jgld.2014.1121.pas] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND AND AIMS Hepatitis C (HC) is a major cause of hepatocellular carcinoma (HCC), and a late diagnosis is the main factor for the poor survival of patients. There is an urgent need for identifying sensitive and specific biomarkers for HCC diagnosis. In the present study, plasma lipid patterns of patients with HC-HCC, HC-liver cirrhosis (LC), and chronic HC (CHC) were assessed by matrix-assisted laser desorption/ionization mass spectrometry (MALDI-MS). METHODS Plasma samples of 25 patients with HC-HCC, 15 patients with HC-LC, and 25 patients with CHC were evaluated by MALDI-MS using a Q-ToF premier (Synapt) mass spectrometer (Waters, Manchester, UK) equipped with a 200-Hz solid-state laser in the mass range between m/z (mass-to-charge ratio) of 700-1200. RESULTS A total of 2205 ions were initially obtained and 7 ions (m/z) were highlighted as corresponding to the most important lipids to differentiate HCC patients from LC and CHC patients. The specific lipidomic expression signature generated resulted in an overall predictive accuracy of 93% of HC-HCC and HC-LC, and 100% of HC-HCC and CHC. The 7-peak algorithm distinguished HCC from LC with a sensitivity of 96% and a specificity of 87%, and HCC from CHC with both sensitivity and specificity of 100%. CONCLUSION MALDI-MS-specific signature peaks accurately distinguished patients with HC-HCC from those with HC-LC and CHC. The results indicate the potential of MALDI-MS and the selected peaks to improve HCC surveillance in patients with viral C cirrhosis and chronic hepatitis C.
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Affiliation(s)
| | - Edson Lo Turco
- Department of Surgery, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Maria Lúcia Ferraz
- Department of Gastroenterology, Federal University of Sao Paulo,Sao Paulo, Brazil
| | - Carla Matos
- Department of Gastroenterology, Federal University of Sao Paulo,Sao Paulo, Brazil
| | - Ivonete Silva
- Department of Gastroenterology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Edison Parise
- Department of Gastroenterology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Eduardo Pilau
- Chemistry Institute, University of Campinas, Campinas, SP; Department of Chemistry, University of Maringa, Maringa, PR, Brazil
| | - Fabio Gozzo
- Chemistry Institute, University of Campinas, Campinas, Brazil
| | - Celso Granato
- Department of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil
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Affiliation(s)
- Celso Granato
- Discipline of Infectious Disease, São Paulo Federal University, São Paulo, Brazil; Fleury Medical Group, São Paulo, Brazil
| | - Carolina Lázari
- Fleury Medical Group, São Paulo, Brazil; Department of Infectious Diseases, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Paulo C Serafini
- Department of Obstetrics and Gynecology, Discipline of Gynecology, University of São Paulo, São Paulo, Brazil; Reproductive Endocrinology, Huntington Reproductive Medicine, São Paulo, Brazil; Human Reproductive Service, University of Sao Paulo, São Paulo, Brazil.
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Gillespie JI, Rouget C, Palea S, Granato C, Birder L, Korstanje C. Erratum to: The characteristics of intrinsic complex micro-contractile activity in isolated strips of the rat bladder. Naunyn Schmiedebergs Arch Pharmacol 2015; 388:997. [PMID: 26246052 DOI: 10.1007/s00210-015-1158-6] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- J I Gillespie
- Uro-physiology Research Group, The Dental and Medical School, Newcastle University, Newcastle upon Tyne, NE2 4HH, England, UK,
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Perosa AH, Granato C, Bellei N. Detection of influenza B lineages from 2001 to 2013 in a tertiary hospital in the city of São Paulo, Brazil. Mem Inst Oswaldo Cruz 2015; 110:606-10. [PMID: 26132429 PMCID: PMC4569822 DOI: 10.1590/0074-02760150044] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 06/03/2015] [Indexed: 11/21/2022] Open
Abstract
Two antigenically distinct lineages of influenza B viruses, the Victoria-like and
Yamagata-like strains, currently circulate among humans. Surveillance from United
States of America and Europe over the last 10 years showed that the chance of a
correct matching between vaccine and the circulating lineage had been 50%. We
investigated influenza B infection in different patient groups (asymptomatic, general
community, with comorbidities and hospitalised) attended at a tertiary hospital in
the city of São Paulo, Brazil between 2001-2013. All samples were screened for
influenza B virus by one-step real-time reverse transcription-polymerase chain
reaction. From 2,992 respiratory samples collected, 114 (3.8%) tested positive for
influenza B. Teenagers (13-18 years) presented the highest rate of 18.5% (odds ratio
22.87, 95% confidence interval 2.90-180.66, p < 0.001). One hundred nine samples
could be characterised: 50 were Yamagata-like and 59 were Victoria-like strains.
Mismatching between the vaccine and predominant circulating strain was observed in
2002 and 2013 seasons. Based on data collected during a period of 12 years, we found
that influenza B was more frequent in teenagers. Co-circulation of both lineages and
mismatch with the vaccine strain can occur. Our data highlighted the importance of
quadrivalent vaccines and future analysis of the age groups included in vaccination
programs.
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Affiliation(s)
- Ana Helena Perosa
- Laboratório de Virologia Clínica, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, BR
| | - Celso Granato
- Laboratório de Virologia Clínica, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, BR
| | - Nancy Bellei
- Laboratório de Virologia Clínica, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, BR
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Granato C, Korstanje C, Guilloteau V, Rouget C, Palea S, Gillespie JI. Prostaglandin E2 excitatory effects on rat urinary bladder: a comparison between the β-adrenoceptor modulation of non-voiding activity in vivo and micro-contractile activity in vitro. Naunyn Schmiedebergs Arch Pharmacol 2015; 388:727-35. [DOI: 10.1007/s00210-015-1139-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 05/25/2015] [Indexed: 12/18/2022]
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Gillespie J.I, Rouget C, Palea S, Granato C, Korstanje C. Beta adrenergic modulation of spontaneous microcontractions and electrical field-stimulated contractions in isolated strips of rat urinary bladder from normal animals and animals with partial bladder outflow obstruction. Naunyn Schmiedebergs Arch Pharmacol 2015; 388:719-26. [DOI: 10.1007/s00210-015-1136-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 05/20/2015] [Indexed: 01/20/2023]
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Melchior TB, Perosa AH, Camargo CN, Granato C, Bellei N. Influenza virus prevalence in asymptomatic and symptomatic subjects during pandemic and postpandemic periods. Am J Infect Control 2015; 43:460-4. [PMID: 25792101 DOI: 10.1016/j.ajic.2015.01.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 09/26/2014] [Revised: 01/29/2015] [Accepted: 01/29/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND In 2009, Influenza A(H1N1)pdm09 had a major effect on global health, causing thousands of deaths. However, the results of asymptomatic infection in transmission has not been well studied. We analyzed asymptomatic influenza infection in individuals with different risk factors for acquiring influenza in a university hospital. METHODS Respiratory samples from 100 children with respiratory symptoms, their asymptomatic caregivers, 100 asymptomatic HIV-infected patients, and 100 health care workers collected during 2009-2011 were tested for influenza by real time real-time polymerase chain reaction. RESULTS Influenza infection rate in symptomatic children was 44% and in asymptomatic adults it was 8.3% (P < .01). Children older than age 5 years had a 3.4 times greater chance of being infected during influenza season than younger children. Among the asymptomatic group, influenza was more frequent in caregivers (14%; P = .032) and a higher rate (31.8%) was observed if a child was infected during the 2009 pandemic. Contact with an infected child was an important risk factor for influenza acquisition (odds ratio, 3.8; 95% confidence interval, 1.1-13.2) among caregivers. The mean cluster of differentiation 4 T-cell count of HIV-positive patients infected with influenza was not statistically different from uninfected patients (P = .29). CONCLUSIONS Asymptomatic household contacts of symptomatic children may play an important role in community transmission and a more proactive intervention should be considered during future pandemics.
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Affiliation(s)
- Thaís Boim Melchior
- Clinical Virology Laboratory - Infectious Disease Unit, Medicine Department, Federal University of Sao Paulo, SP, Brazil
| | - Ana Helena Perosa
- Clinical Virology Laboratory - Infectious Disease Unit, Medicine Department, Federal University of Sao Paulo, SP, Brazil.
| | - Clarice Neves Camargo
- Clinical Virology Laboratory - Infectious Disease Unit, Medicine Department, Federal University of Sao Paulo, SP, Brazil
| | - Celso Granato
- Clinical Virology Laboratory - Infectious Disease Unit, Medicine Department, Federal University of Sao Paulo, SP, Brazil
| | - Nancy Bellei
- Clinical Virology Laboratory - Infectious Disease Unit, Medicine Department, Federal University of Sao Paulo, SP, Brazil
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Puerari D, Camargo C, Gratura S, Watanabe ASA, Granato C, Bellei NCJ. [Application of molecular assay for adenovirus detection among different pediatric patients]. Rev Paul Pediatr 2015; 33:136-41. [PMID: 25890444 PMCID: PMC4516365 DOI: 10.1016/j.rpped.2014.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 09/22/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE: Adenoviruses play an important role in the etiology of severe acute lower
respiratory infection, especially in young children. The aim of the present study
was to evaluate the Human Adenovirus (HAdV) detection by different methods (Direct
Fluorescence Assay DFA and Nested Polymerase Chain Reaction nested PCR), among
samples collected from different groups of pediatric patients. METHODS: Collection of samples was made in children with congenital heart disease (CHD 123
nasal aspirates collected in the years of 2005, 2007 and 2008) and in community
children (CC 165 nasal aspirates collected in 2008). Children were eligible if
they presented acute respiratory infection (ARI) of probable viral etiology,
within up to 7 days of symptoms' onset. All studied samples were evaluated by DFA
and nested PCR assay. RESULTS: Of the 290 samples included during the study period, 43 (14.8%) were positive on
at least one test: 17/165 (10.3%) of the CC and 26/125 (20.8%) of the CHD
children. The nested PCR detection rates in the community children were 15/165
(9.1%), and for children with CHD, 24/125 (19.2%). Molecular method showed higher
detection rates when compared to the DFA test (p<0.001).
Univariate analysis showed that children with congenital heart disease presented a
significantly higher chance for acquiring the HAdV (Odds Ratio 2.3; 95% CI:
1.18-4.43). CONCLUSIONS: Based on data obtained in the present evaluation, we suggest that a routine
surveillance should be performed in high risk patients by molecular methods, thus
improving diagnostic flow and efficiency.
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Affiliation(s)
- Diane Puerari
- Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
| | - Clarice Camargo
- Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
| | - Sandra Gratura
- Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
| | | | - Celso Granato
- Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil
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Hering T, Passos AM, Perez RM, Bilar J, Fragano D, Granato C, Medina-Pestana JO, Ferraz MLG. Past and current hepatitis E virus infection in renal transplant patients. J Med Virol 2014; 86:948-53. [DOI: 10.1002/jmv.23915] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2014] [Indexed: 12/19/2022]
Affiliation(s)
- Tiago Hering
- Department of Gastroenterology; Federal University of Sao Paulo; Sao Paulo Brazil
| | - Ana Maria Passos
- Department of Infectious Diseases; Federal University of Sao Paulo; Sao Paulo Brazil
| | - Renata Mello Perez
- Department of Internal Medicine; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - Juliana Bilar
- Department of Gastroenterology; Federal University of Sao Paulo; Sao Paulo Brazil
| | - Daniel Fragano
- Department of Gastroenterology; Federal University of Sao Paulo; Sao Paulo Brazil
| | - Celso Granato
- Department of Infectious Diseases; Federal University of Sao Paulo; Sao Paulo Brazil
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Olivieri AN, Gicchino MF, Granato C, Mauro A, Mellos A. PReS-FINAL-2197: Teenage boy suffering from diabetes mellitus type 1 and heterozygous Familial Mediterranean Fever: a case report. Pediatr Rheumatol Online J 2013. [PMCID: PMC4042319 DOI: 10.1186/1546-0096-11-s2-p187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Cabeça TK, Granato C, Bellei N. Epidemiological and clinical features of human coronavirus infections among different subsets of patients. Influenza Other Respir Viruses 2013; 7:1040-7. [PMID: 23462106 PMCID: PMC4634278 DOI: 10.1111/irv.12101] [Citation(s) in RCA: 95] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2013] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Epidemiological and clinical data of human coronaviruses (HCoVs) infections are restricted to span 1-3 years at most. We conducted a comprehensive 9-year study on HCoVs by analyzing 1137 respiratory samples from four subsets of patients (asymptomatic, general community, with comorbidities, and hospitalized) in São Paulo, Brazil. METHODS A pan-coronavirus RT-PCR screening assay was performed, followed by species-specific real-time RT-PCR monoplex assays. RESULTS Human coronaviruses were detected in 88 of 1137 (7.7%) of the samples. The most frequently detected HCoV species were NL63 (50.0%) and OC43 (27.3%). Patients with comorbidities presented the highest risk of acquiring coronavirus infection (odds ratio=4.17; 95% confidence interval=1.9-9.3), and children with heart diseases revealed a significant HCoV infection presence. Dyspnea was more associated with HCoV-229E infections (66.6%), and cyanosis was reported only in HCoV-OC43 infections. There were interseasonal differences in the detection frequencies, with HCoV-229E being predominant in the year 2004 (61.5%) and HCoV-NL63 (70.8%) in 2008. CONCLUSIONS Our data provide a novel insight into the epidemiology and clinical knowledge of HCoVs among different subsets of patients, revealing that these viruses may cause more than mild respiratory tract disease.
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Affiliation(s)
- Tatiane K Cabeça
- Laboratory of Clinical Virology, Discipline of Infectology, Department of Medicine, Federal University of São Paulo, Sao Paulo, Brazil
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Moreira LP, Watanabe ASA, Carraro E, da Silva ERM, Guatura SB, Granato C, Bellei NJ. A survey strategy for human respiratory syncytial virus detection among haematopoietic stem cell transplant patients: epidemiological and methodological analysis. Mem Inst Oswaldo Cruz 2013; 108:119-22. [PMID: 23440127 PMCID: PMC3974330 DOI: 10.1590/s0074-02762013000100021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 07/19/2012] [Indexed: 11/24/2022] Open
Abstract
Human respiratory syncytial virus (HRSV) causes severe infections among children and immunocompromised patients. We compared HRSV infections among Haematopoietic Stem Cell Transplant program (HSCT) patients and children using direct immunofluorescence (DFA), point-of-care RSV Bio Easy(r) and a polymerase chain reaction (PCR) assay. Overall, 102 samples from HSCT patients and 128 from children obtained positivity rate of 18.6% and 14.1% respectively. PCR sensitivity was highest mainly on samples collected after five days of symptoms onset. A combination of both DFA and reverse transcriptase-PCR methods for HSCT high-risk patients is the best diagnostic flow for HRSV diagnosis among these patients.
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Affiliation(s)
- Luciana Peniche Moreira
- Disciplina de Infectologia, Laboratório de Virologia Clínica, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
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Perosa AH, Watanabe ASA, Guatura SB, Silva ERM, Granato C, Bellei N. Comparison of the direct fluorescence assay and real-time polymerase chain reaction for the detection of influenza virus A and B in immunocompromised patients. Clinics (Sao Paulo) 2013; 68:1206-9. [PMID: 24141835 PMCID: PMC3782734 DOI: 10.6061/clinics/2013(09)05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 04/18/2013] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE This study evaluated the diagnostic performance of two methods for the detection of influenza virus in immunocompromised transplant patients. METHODS A total of 475 respiratory samples, 236 from patients in a hematopoietic stem cell transplantation program and 239 from kidney transplant patients, were analyzed by a direct fluorescence assay and the Centers for Disease Control real-time polymerase chain reaction protocol for influenza A and B detection. RESULTS Influenza detection using either method was 7.6% in the hematopoietic stem cell transplant group and 30.5% in the kidney transplant patient group. Influenza detection by real-time polymerase chain reaction yielded a higher positive rate compared with fluorescence than that reported by other studies, and this difference was more pronounced for influenza A. The fluorescence assay sensitivity, specificity, positive and negative predictive values, and kappa coefficient were 17.6%, 100%, 1, 0.83, and 0.256, respectively, and lower detection rates occurred in the kidney transplant patients. CONCLUSIONS The real-time polymerase chain reaction performance and the associated turnaround time for a large number of samples support the choice of this method for use in different routine diagnostic settings and influenza surveillance in high-risk patients.
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Affiliation(s)
- Ana Helena Perosa
- Clinical Virology Laboratory, Infections Disease Unit, Medicine Department, Federal University of São Paulo, São PauloSP, Brazil
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Guatura SB, Watanabe ASA, Camargo CN, Passos AM, Parmezan SN, Tomazella TKC, Carraro E, Kamikawa J, Granato C, Bellei N. Surveillance of influenza A H1N1 2009 among school children during 2009 and 2010 in São Paulo, Brazil. Rev Soc Bras Med Trop 2013; 45:563-6. [PMID: 23152337 DOI: 10.1590/s0037-86822012000500005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Accepted: 03/13/2012] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Influenza A H1N1 2009 is associated with a high morbidity rate among children around the world, including Brazil. This survey was conducted on samples of symptomatic children (< 12 years) to investigate the influenza virus as the etiological agent of respiratory infections in a day care school in a health facility during the first and second pandemic wave of H1N1 (2009-2010) in São Paulo, Brazil. METHODS Influenza infections were determined by real-time PCR in 34% (47/137) of children with a median age of 5 years (8 months - 12 years), from June to October 2009 and in 16% (14/85) of those with median age of 6 years (1-12 years), from March to November 2010. RESULTS In general, most positive cases (64%) occurred in children aged 5-12 years, this age group was significantly the most affected (39.8%, p = 0.001, OR = 8.3, CI 95% 1.9-36.9). Wheezing was reported by 31% (19/61) and dyspnea by 23% (14/61) of the studied patients. An outbreak of influenza H1N1 with an attack rate of 35.7% among children (median age 6 years) was documented in April 2010, before the vaccination campaign against the pandemic virus was extended for children up to 5 years in Brazil. CONCLUSIONS Therefore, the study reinforces the recommendation to immunize school children to reduce the incidence of the disease.
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Affiliation(s)
- Sandra Baltazar Guatura
- Laboratório de Virologia Clínica, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP
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Cabeça TK, Passos AM, Granato C, Bellei N. Human coronavirus ocurrence in different populations of Sao Paulo: A comprehensive nine-year study using a pancoronavirus RT-PCR assay. Braz J Microbiol 2013; 44:335-9. [PMID: 24159325 PMCID: PMC3804219 DOI: 10.1590/s1517-83822013000100049] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 06/07/2012] [Indexed: 01/24/2023] Open
Abstract
Human coronaviruses (HCoVs) are considered one of the most common respiratory viruses associated with respiratory tract illnesses. An emergent human coronavirus was identified as the causal agent of an epidemic of severe acute respiratory syndrome (SARS) during 2002–2003. The severity of the disease combined with its rapid spread requires the continuous surveillance of coronaviruses in worldwide populations. Epidemiological and clinical data of HCoVs infectious in the Brazilian population are scarce and restricted to one or two groups of patients. Our study aimed to investigate retrospectively the presence of HCoVs in different populations of São Paulo presenting acute respiratory tract infections (ARIs) during the years of 2001–2010. A pancoronavirus RT-PCR was performed in this study. Coronaviruses were detected in 126 (11.5%) of 1,087 specimens. Peaks detection frequency was observed during 2002–2004 and 2008–2009, with the highest detection in 2008. The prevalence of HCoVs was higher among children with heart diseases (24.6%), patients under stem cell transplantation program (24.3%) and renal transplanted patients (20.2%). Coryza, cough and fever were the most common symptoms at presentation of positive cases and wheezing, a lower respiratory tract infection symptom was reported by 12% of the total, and 27% of high at-risk patients. HCoVs may have an important role among patients with underlying conditions and transplanted ones.
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Affiliation(s)
- Tatiane K Cabeça
- Clinical Virology Laboratory, Department of Medicine, Universidade Federal de São Paulo, São Paulo, SP, Brazil
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Caccia ERB, Watanabe ASA, Carraro E, Leal E, Granato C, Bellei N. Frequency of human bocavirus respiratory infections among at-risk patients in São Paulo, Brazil. Rev Inst Med Trop Sao Paulo 2013; 54:307-10. [PMID: 23152312 DOI: 10.1590/s0036-46652012000600003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Accepted: 06/15/2012] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Human Bocavirus (HBoV) has been described since 2005 as an etiological agent of respiratory virus infections. From 2001 to 2008 we investigated the etiology of HBoV among adults and children in different groups at risk of presenting complications arising from acute respiratory infection, the investigation was carried out in a tertiary hospital health care system in Brazil. METHODS HBoV DNA was assayed in 598 respiratory samples from community and hospitalized patients by PCR. RESULTS Of the 598 tested samples, 2.44% (8/328) of children, including five children with heart disease, and 0.4% (1/270) of adult bone-marrow-transplant were HBoV positive. CONCLUSIONS These data suggested lower HBoV frequency among different at-risk patients and highlights the need to better understand the real role of HBoV among acute respiratory symptomatic patients.
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Affiliation(s)
- Elaine Regina Baptista Caccia
- Clinical Virology Laboratory, Infectious Diseases Unit, Medicine Department, Sao Paulo Federal University, Sao Paulo, Brazil.
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Cabeça TK, Carraro E, Watanabe A, Granato C, Bellei N. Infections with human coronaviruses NL63 and OC43 among hospitalised and outpatient individuals in São Paulo, Brazil. Mem Inst Oswaldo Cruz 2013; 107:693-4. [PMID: 22850964 DOI: 10.1590/s0074-02762012000500020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Accepted: 01/11/2012] [Indexed: 11/22/2022] Open
Abstract
The incidence and clinical features of human coronaviruses (HCoVs) among Brazilian patients with respiratory illness are not well known. We investigated the prevalence of HCoVs among Brazilian outpatients and hospitalised patients with respiratory illnesses during 2009 and 2010. To identify the HCoVs, pancoronavirus and species-specific reverse-transcriptase polymerase chain reaction assays were performed. Five of 394 samples were positive for HCoVs (1.2%): 1/182 (0.5%) outpatients and 4/212 (1.8%) hospitalised patients. The OC43 and NL63 HCoVs were identified. Two patients were admitted to the intensive care unit. Underlying chronic disease was reported in cases and one diabetic adult died. HCoVs can cause lower respiratory infections and hospitalisation. Patients with pre-existing conditions and respiratory infections should be evaluated for HCoV infections.
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Affiliation(s)
- Tatiane Karen Cabeça
- Laboratório de Virologia Clínica, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
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Watanabe A, Carraro E, Camargo C, Puerari D, Guatura S, Granato C, Bellei N. Human adenovirus detection among immunocompetent and immunocompromised patients presenting acute respiratory infection. Rev Soc Bras Med Trop 2013; 46:161-5. [DOI: 10.1590/0037-8682-1699-2013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Accepted: 03/14/2013] [Indexed: 11/21/2022] Open
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