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Hernández Requejo D, de Armas Y, Iglesias E, Díaz HM, Gravier R, Godínez López MC, Fonte L, Plascencia-Cruz M, Pacheco-Quijano K, Palomares J, Pérez-Gómez HR, Plascencia-Hernández A, Calderón EJ. Polymorphisms of CCR5, IL-6, IFN-γ and IL-10 genes in Cuban HIV/AIDS patients. Rev Clin Esp 2024; 224:96-104. [PMID: 38253256 DOI: 10.1016/j.rceng.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024]
Abstract
INTRODUCTION Genetic studies have shown associations of several single nucleotide polymorphisms (SNP) with different rates of progression and variation in susceptibility to HIV infection. This study aimed to estimate the frequency of ccr5Δ32, IL-6-174G/C, IFN-γ+874T/A and IL-10-1082A/G polymorphisms in Cuban HIV-infected patients and a group of sero-discordant couples to assess their influence on risk and disease progression. METHODS A cross-sectional study was carried out on 120 subjects registered at the Institute of Tropical Medicine «Pedro Kour» (IPK) and the Ameijeiras Hospital from June 2018 until December 2019. The amplification of fragments of the ccr5, IL-6, IFN-γ and IL-10 genes was performed by polymerase chain reaction followed by identification of polymorphisms using the restriction fragment length polymorphism analysis for IL-6 with the restriction enzymes Nla III. Amplification Refractory Mutation System was used for IFN-γ and IL-10 genes. RESULTS The allelic and genotypic distributions of the genes ccr5, IL-6, IFN-γ and IL-10 did not differ significantly between the two groups. Cell counts and plasma viral load values did not differ significantly between genotypes of the ccr5, IL-6, IFN-γ and IL-10 genes. Only the IL-6 GC genotype was associated with higher viral load values. The combination of alleles of the four considered SNPs showed a highly significant increase in the risk of HIV infection for one of them, but with a very low frequency (<1%). CONCLUSION This study contributes to evaluating the frequency of these polymorphisms and their influence on biomarkers of the progression of HIV infection in the Cuban HIV-population.
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Affiliation(s)
- D Hernández Requejo
- Departamento de Laboratorio Clínico, Centro Hospitalario, Instituto de Medicina Tropical «Pedro Kourí», La Habana, Cuba
| | - Y de Armas
- Departamento de Patología, Centro Hospitalario, Instituto de Medicina Tropical «Pedro Kourí», La Habana, Cuba; Departamento de Diagnóstico Microbiológico Clínico, Centro Hospitalario, Instituto de Medicina Tropical «Pedro Kourí», La Habana, Cuba
| | - E Iglesias
- Centro de Ingeniería Genética y Biotecnología, La Habana, Cuba
| | - H M Díaz
- Hospital Clínico Quirúrgico «Hermanos Ameijeiras», La Habana, Cuba
| | - R Gravier
- Departamento de Farmacología, Instituto de Medicina Tropical «Pedro Kourí», La Habana, Cuba
| | - M C Godínez López
- Departamento de Laboratorio Clínico, Centro Hospitalario, Instituto de Medicina Tropical «Pedro Kourí», La Habana, Cuba
| | - L Fonte
- Departamento de Parasitología, Instituto de Medicina Tropical «Pedro Kourí», La Habana, Cuba
| | - M Plascencia-Cruz
- Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - K Pacheco-Quijano
- Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - J Palomares
- Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - H R Pérez-Gómez
- Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
| | - A Plascencia-Hernández
- Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico.
| | - E J Calderón
- Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/Consejo Superior de Investigaciones Científicas/Universidad de Sevilla, Sevilla, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Departamento de Medicina, Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain.
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Ouaalaya EH, Zysman M, Berteaud É, Falque L, Monge E, Nguyen L, Ozier A, Dupis JM, Sabatini M, Nocent-Ejnaini C, Petrov L, Bernady A, Roy C, Le Guillou F, Aliati M, Prudhomme A, Quinquenel ML, Staali M, Pilard F, Iglesias E, Sapène M, Casteigt J, Moinard J, Daoudi Y, Blanchard É, Macey J, Veillon R, Demant X, Bon C, Grassion L, Molimard M, Raherison-Semjen C. Identification and analysis of clinical phenotypes in COPD patients: PALOMB Cohort. Epidemiology 2021. [DOI: 10.1183/13993003.congress-2021.pa3502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Ouaalaya EH, Zysman M, Berteaud É, Falque L, Nguyen L, Dupis JM, Sabatini M, Bernady A, Ozier A, Nocent-Ejnaini C, Roy C, Le Guillou F, Monge E, Aliati M, Prudhomme A, Petrov L, Quinquenel ML, Staali M, Pilard F, Sapène M, Casteigt J, Moinard J, Daoudi Y, Iglesias E, Blanchard É, Macey J, Veillon R, Demant X, Bon C, Grassion L, Molimard M, Raherison-Semjen C. COPD phenotypes and 5-years mortality risk prediction: PALOMB Cohort. Epidemiology 2020. [DOI: 10.1183/13993003.congress-2020.1435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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García-Mejido JA, Fernández-Palacín A, Bonomi-Barby MJ, De la Fuente Vaquero P, Iglesias E, Sainz JA. Online learning for 3D/4D transperineal ultrasound of the pelvic floor. J Matern Fetal Neonatal Med 2019; 33:2805-2811. [PMID: 30563391 DOI: 10.1080/14767058.2018.1560416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Introduction. To evaluate the feasibility of an online learning process for performing and analyzing 3D/4D transperineal ultrasound imaging of the pelvic floor.Materials and methods: A prospective study was conducted with 20 patients. The learning process of three inexperienced examiners (IEs) performing and analyzing 3D/4D transperineal ultrasound volumes was evaluated. The learning process for the IEs was conducted online by an expert examiner (EE); no face-to-face tutoring was provided. The IEs' competency and analysis of the volumes were estimated using the intraclass correlation coefficient (ICC).Results: The interobserver analysis of the levator hiatus dimensions provided by the EE and those from each IE (for the 20 studied cases) had ICCs ranging from 0.81 to 0.96. The dimensions of the levator hiatus performed by the IEs for the first 10 patients showed ICCs ranging from 0.55 to 0.9. However, when the IEs proceeded with the next 10 patients, they obtained ICCs ranging from 0.81 to 0.96.Conclusions: Conducting 3D/4D transperineal ultrasound of the pelvic floor is a technique that can be learned online in a short period of time. A learning programme designed specifically for this purpose provides excellent reliability.Key Message: Conducting 3D/4D transperineal ultrasound of the pelvic floor is a technique that can be learned online in a short period of time.
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Affiliation(s)
- J A García-Mejido
- Department of Obstetrics and Gynecology, University of Seville, Seville, Spain
| | - A Fernández-Palacín
- Biostatistics Unit, Department of Preventive Medicine and Public Health, University of Seville, Seville, Spain
| | - M J Bonomi-Barby
- Department of Obstetrics and Gynecology, University of Seville, Seville, Spain
| | | | - E Iglesias
- Department of Obstetrics and Gynecology, University of Seville, Seville, Spain
| | - J A Sainz
- Department of Obstetrics and Gynecology, University of Seville, Seville, Spain.,Department of Obstetrics and Gynecology, Valme University Hospital, Seville, Spain
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Pascual-Gil S, Abizanda G, Iglesias E, Garbayo E, Prósper F, Blanco-Prieto MJ. NRG1 PLGA MP locally induce macrophage polarisation toward a regenerative phenotype in the heart after acute myocardial infarction. J Drug Target 2018; 27:573-581. [DOI: 10.1080/1061186x.2018.1531417] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- S. Pascual-Gil
- Pharmacy and Pharmaceutical Technology Department, School of Pharmacy, Universidad de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, IdiSNA, Pamplona, Spain
| | - G. Abizanda
- Instituto de Investigación Sanitaria de Navarra, IdiSNA, Pamplona, Spain
- Hematology Service and Area of Cell Therapy, Clínica Universidad de Navarra, Foundation for Applied Medical Research, Universidad de Navarra, Pamplona, Spain
| | - E. Iglesias
- Instituto de Investigación Sanitaria de Navarra, IdiSNA, Pamplona, Spain
- Hematology Service and Area of Cell Therapy, Clínica Universidad de Navarra, Foundation for Applied Medical Research, Universidad de Navarra, Pamplona, Spain
| | - E. Garbayo
- Pharmacy and Pharmaceutical Technology Department, School of Pharmacy, Universidad de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, IdiSNA, Pamplona, Spain
| | - F. Prósper
- Instituto de Investigación Sanitaria de Navarra, IdiSNA, Pamplona, Spain
- Hematology Service and Area of Cell Therapy, Clínica Universidad de Navarra, Foundation for Applied Medical Research, Universidad de Navarra, Pamplona, Spain
| | - M. J. Blanco-Prieto
- Pharmacy and Pharmaceutical Technology Department, School of Pharmacy, Universidad de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, IdiSNA, Pamplona, Spain
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Abstract
The objectives of this study were the determination of CA 125 in the cytosol of healthy and carcinomatous ovarian tissue by immunoanalysis, analysis of its correlation with the biological characteristics of ovarian carcinoma, determination of serum CA 125 levels, and study of the prognostic value of the marker in cytosol. The levels of the marker depend not only on the tumor's production rate, so its determination in tissue can indicate more accurately if the tumor is a producer of the marker and establish its value for the prognosis of the disease. Determination of CA 125 in tissue was performed by immunoanalysis in 50 ovarian epithelial cancer samples, 13 benign pathology samples and 32 healthy ovary samples. The presurgical serum level of the marker was also obtained. The correlation between the CA 125 level in the cytosol and the different biological characteristics of the ovarian carcinoma, the serum levels of the marker and survival were analyzed. The CA 125 level proved to be higher in malignant tissue (p<0.0001). There was a significant association between the tissue marker and histological type (high CA 125 was associated with serous and endometrioid tumors) and between the marker and survival. No relation with stage was found. There was a correlation between the CA 125 level in the cytosol and serum, both variables being dependent, with a correlation coefficient of 0.44. This good correlation speaks in favor of the usefulness of CA 125 determination in serum in the follow-up of ovarian cancer. Tumors having high tissue expression of CA 125 were found to have a double relative risk of death, independently of tumor stage.
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Affiliation(s)
- R de la Cuesta
- Gynecology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain
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Quiroga-Varela A, Aguilar E, Iglesias E, Obeso JA, Marin C. Short- and long-term effects induced by repeated 6-OHDA intraventricular administration: A new progressive and bilateral rodent model of Parkinson's disease. Neuroscience 2017; 361:144-156. [PMID: 28823819 DOI: 10.1016/j.neuroscience.2017.08.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 07/19/2017] [Accepted: 08/09/2017] [Indexed: 12/26/2022]
Abstract
The pathological hallmark of Parkinson's disease (PD) is the progressive degeneration of dopaminergic neurons in the substantia nigra pars compacta (SNpc), and the resulting striatal dopamine deficiency, which are responsible for the classic motor features. Although a diagnosis of PD relies on the clinical effects of dopamine deficiency, this disease is also associated with other neurotransmitter deficits that are recognized as causing various motor and non-motor symptoms. However, the cause of dopaminergic nigral neurodegeneration in PD and the underlying mechanisms remain unknown. While animal models are considered valuable tools with which to investigate dopaminergic cell vulnerability, rodent models usually fail to mimic the neurodegeneration progression that occurs in human PD. To find a convenient rat model for studying the progression of dopaminergic cell degeneration and motor signs, we have developed a progressive rodent model using a repeated daily, intraventricular administration of the neurotoxin 6-hydroxydopamine (6-OHDA) (100µg/day) in awakened rats for 1 to 10 consecutive days. The short- (6-day) and long-term (32-day) progression of motor alterations was studied. This model leads to a bilateral and progressive increase in catalepsy (evident from the 3rd infusion in the short-term groups (p<0.01) and from the 7th infusion in the long-term groups (p<0.01), which was associated with a progressive nigrostriatal dopaminergic deficit. All together this makes the new model an interesting experimental tool to investigate the mechanisms involved in the progression of dopaminergic neurodegeneration.
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Affiliation(s)
- A Quiroga-Varela
- Movement Disorders Laboratory, Neurosciences Area, CIMA, University of Navarra, Pamplona, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - E Aguilar
- Laboratori de Neurologia Experimental, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - E Iglesias
- Movement Disorders Laboratory, Neurosciences Area, CIMA, University of Navarra, Pamplona, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - J A Obeso
- Movement Disorders Laboratory, Neurosciences Area, CIMA, University of Navarra, Pamplona, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
| | - C Marin
- INGENIO, IRCE, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
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García J, Jaramillo A, Iglesias E, Inarejos E, Jou C, Riera E. A propósito de un caso de miopatía inflamatoria. Cuantificación de la inflamación muscular mediante PET/TC con 18 F-FDG en la evaluación inicial y la respuesta terapéutica. Rev Esp Med Nucl Imagen Mol 2017; 36:199-200. [DOI: 10.1016/j.remn.2016.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 10/19/2016] [Accepted: 10/20/2016] [Indexed: 10/20/2022]
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Giménez-Roca C, Iglesias E, Vicente MA, Bou R, Calzada-Hernández J, Prat C, García M, Antón J. Pediatric cryoglobulinemic vasculitis successfully managed with rituximab. Dermatol Ther 2016; 30. [PMID: 27791307 DOI: 10.1111/dth.12430] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 07/26/2016] [Accepted: 08/31/2016] [Indexed: 11/29/2022]
Affiliation(s)
- C Giménez-Roca
- Pediatric Rheumatology Unit, Department of Pediatrics, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - E Iglesias
- Pediatric Rheumatology Unit, Department of Pediatrics, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - M A Vicente
- Department of Pediatric Dermatology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - R Bou
- Pediatric Rheumatology Unit, Department of Pediatrics, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - J Calzada-Hernández
- Pediatric Rheumatology Unit, Department of Pediatrics, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - C Prat
- Department of Pediatric Dermatology, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.,Department of Dermatology, Hospital Universitario de la Mútua de Terrassa, Terrassa, Barcelona, Spain
| | - M García
- Department of Pediatrics, Hospital Universitario de la Mútua de Terrassa, Terrassa, Barcelona, Spain
| | - J Antón
- Pediatric Rheumatology Unit, Department of Pediatrics, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
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Aragón JL, Quintero-Torres R, Domínguez-Juárez JL, Iglesias E, Ronda S, Montero de Espinosa F. Planar modes free piezoelectric resonators using a phononic crystal with holes. Ultrasonics 2016; 71:177-182. [PMID: 27387418 DOI: 10.1016/j.ultras.2016.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 05/24/2016] [Accepted: 06/18/2016] [Indexed: 06/06/2023]
Abstract
By using the principles behind phononic crystals, a periodic array of circular holes made along the polarization thickness direction of piezoceramic resonators are used to stop the planar resonances around the thickness mode band. In this way, a piezoceramic resonator adequate for operation in the thickness mode with an in phase vibration surface is obtained, independently of its lateral shape. Laser vibrometry, electric impedance tests and finite element models are used to corroborate the performances of different resonators made with this procedure. This method can be useful in power ultrasonic devices, physiotherapy and other external medical power ultrasound applications where piston-like vibration in a narrow band is required.
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Affiliation(s)
- J L Aragón
- Centro de Física Aplicada y Tecnología Avanzada, Universidad Nacional Autónoma de México, Apartado Postal 1-1010, Querétaro 76230, Mexico
| | - R Quintero-Torres
- Centro de Física Aplicada y Tecnología Avanzada, Universidad Nacional Autónoma de México, Apartado Postal 1-1010, Querétaro 76230, Mexico
| | - J L Domínguez-Juárez
- Centro de Física Aplicada y Tecnología Avanzada, Universidad Nacional Autónoma de México, Apartado Postal 1-1010, Querétaro 76230, Mexico
| | - E Iglesias
- Instituto de Tecnologías Físicas y de la Información "Leonardo Torres Quevedo", Consejo Superior de Investigaciones Científicas, Serrano 144, 28006 Madrid, Spain
| | - S Ronda
- Instituto de Tecnologías Físicas y de la Información "Leonardo Torres Quevedo", Consejo Superior de Investigaciones Científicas, Serrano 144, 28006 Madrid, Spain
| | - F Montero de Espinosa
- Instituto de Tecnologías Físicas y de la Información "Leonardo Torres Quevedo", Consejo Superior de Investigaciones Científicas, Serrano 144, 28006 Madrid, Spain.
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Ruiz-Ortiz E, Gonzalez-Roca E, Mensa-Vilaro A, Rius J, Plaza S, Anton C, Calvo I, Modesto C, Anton J, Arnal C, Alvarez C, Alvarez-Coca J, Becerra E, Bilbao N, Camacho M, Crespo J, de Diego C, Diez-Garcia LF, Espinosa L, Garcia-Escriva D, de Gracia F, Gonzalez MI, Iglesias E, Izquierdo S, Lastra B, Llobet P, Lopez B, Lopez-Gonzalez V, Martinez R, Martin-Mateos MA, Merino R, Ortega L, Peiro ME, de Soto IP, Perez-Mendez C, Rodriguez-Valverde V, Ribes A, Ruiz A, Sanchez B, Santos JL, Sevilla B, Sotoca J, Vilas J, Villoria A, Yagüe J, Arostegui JI. Clinical and genetic features of Spanish patients with Mevalonate kinase deficiency. Pediatr Rheumatol Online J 2015. [PMCID: PMC4597073 DOI: 10.1186/1546-0096-13-s1-p36] [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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Iglesias E, Bou R, Torrente-Segarra V, Antón J. Importancia de un estudio basal completo en pacientes con diagnóstico de dermatomiositis juvenil. An Pediatr (Barc) 2015; 82:449-50. [DOI: 10.1016/j.anpedi.2015.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 01/20/2015] [Accepted: 01/22/2015] [Indexed: 10/23/2022] Open
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Iglesias E, Cho GY, Inarejos E, Bou R, Navallas M, Rodríguez N, Sánchez-Manubens J, Torrente-Segarra V, Calzada J, Antόn J. AB0973 Temporomandibular Joint Arthroscopy in Juvenile Idiopathic Arthritis. Successfully Treatment with Synovial Electrocoagulation. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bell J, Echols S, Iglesias E, Musili N, Kebede A, Gebresilasie Mumuye Y, Nigatu B, Mmeje O, Bell J. Comparing the syndromic approach with point-of-care testing in treatment
of STIs at St. Paul's Hospital in Addis Ababa, Ethiopia. Ann Glob Health 2015. [DOI: 10.1016/j.aogh.2015.02.522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Sánchez-Matamoros A, Sánchez-Vizcaíno JM, Rodríguez-Prieto V, Iglesias E, Martínez-López B. Identification of Suitable Areas for African Horse Sickness Virus Infections in Spanish Equine Populations. Transbound Emerg Dis 2014; 63:564-73. [PMID: 25476549 DOI: 10.1111/tbed.12302] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Indexed: 11/27/2022]
Abstract
African horse sickness (AHS) is one of the most important vector-borne viral infectious diseases of equines, transmitted mainly by Culicoides spp. The re-emergence of Culicoides-borne diseases in Europe, such as the recent bluetongue (BT) or Schmallenberg outbreaks, has raised concern about the potential re-introduction and further spread of AHS virus (AHSV) in Europe. Spain has one of the largest European equine populations. In addition, its geographical, environmental and entomological conditions favour AHSV infections, as shown by the historical outbreaks in the 1990s. The establishment of risk-based surveillance strategies would allow the early detection and rapid control of any potential AHSV outbreak. This study aimed to identify the areas and time periods that are suitable or at high risk for AHS occurrence in Spain using a GIS-based multicriteria decision framework. Specifically risk maps for AHS occurrence were produced using a weighted linear combination of the main risk factors of disease, namely extrinsic incubation period, equine density and distribution of competent Culicoides populations. Model results revealed that the south-western and north-central areas of Spain and the Balearic Islands are the areas at the highest risk for AHSV infections, particularly in late summer months. Conversely, Galicia, Castile and Leon and La Rioja can be considered as low-risk regions. This result was validated with historical AHS and BT outbreaks in Spain, and with the Culicoides vector distribution area. The model results, together with current Spanish equine production features, should provide the foundations to design risk-based and more cost-effective surveillance strategies for the early detection and rapid control potential of AHS outbreaks in Spain.
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Affiliation(s)
- A Sánchez-Matamoros
- VISAVET Centre and Animal Health Department, Complutense University of Madrid, Madrid, Spain.,CEI Campus Moncloa, UCM-UPM, Madrid, Spain
| | - J M Sánchez-Vizcaíno
- VISAVET Centre and Animal Health Department, Complutense University of Madrid, Madrid, Spain
| | - V Rodríguez-Prieto
- VISAVET Centre and Animal Health Department, Complutense University of Madrid, Madrid, Spain
| | - E Iglesias
- Department of Agricultural Economics, E.T.S Agronomics Engineering, Technical University of Madrid, Madrid, Spain
| | - B Martínez-López
- VISAVET Centre and Animal Health Department, Complutense University of Madrid, Madrid, Spain.,Department of Medicine and Epidemiology, Center for Animal Disease Modeling and Surveillance (CADMS), University of California, Davis, CA, USA
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Iglesias E, Camacho Lovillo M, Delgado Pecellín I, Lirola Cruz MJ, Falcón Neyra MD, Salazar Quero JC, Bernabeu-Wittel J, González Valencia JP, Neth O. Successful management of Churg-Strauss syndrome using omalizumab as adjuvant immunomodulatory therapy: first documented pediatric case. Pediatr Pulmonol 2014; 49:E78-81. [PMID: 24136903 DOI: 10.1002/ppul.22884] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2013] [Revised: 05/30/2013] [Accepted: 06/29/2013] [Indexed: 11/09/2022]
Abstract
Churg-Strauss syndrome (CSS) is an anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis; it is extremely rare in childhood and defined according to the Chapel-Hill Consensus as an eosinophil-rich and granulomatous inflammation involving the respiratory tract and necrotizing vasculitis affecting small to medium-sized vessels. Children commonly have a history of asthma and sinusitis whilst clinical presentation typically involves pulmonary tract and less frequently skin, heart, gastrointestinal tract, and peripheral nerves. Cardiopulmonary disease is higher in children and prognosis is worse. It is associated with significant eosinophilia and raised serum IgE-levels. ANCA are only found in 25% of childhood cases. Here we report the case of a 10-year-old girl who presented to us with vomiting, abdominal pain, and weight loss, paresthesias of lower extremities and breathlessness as well as a history of asthma, sinusitis and allergic rhinitis. She was treated with corticosteroids, cyclophosphamide, intravenous immunoglobulin, mycophenolate mofetil (MMF), and rituximab. However, remission was only achieved after initiation of omalizumab therapy, a recombinant humanized anti-IgE antibody. To the best of our knowledge this is the first pediatric patient suffering from CSS successfully managed with adjuvant anti-IgE therapy resulting in the control of respiratory as well as gastrointestinal symptoms.
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Affiliation(s)
- E Iglesias
- Department of Paediatric Infectious Diseases and Immunology, Hospital Universitario Virgen del Rocío (HUVR), Sevilla, Spain; Unit of Pediatric Rheumatology, Department of Pediatrics, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
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Torrente-Segarra V, Iglesias E, Gonzalez MI, Sanchez J, Ricart S, Bou R, Salman-Monte T, Carbonell J, Antón-López J. PReS-FINAL-2309: Juvenile systemic lupus erythematosus: a case series depiction in an urban community and a comparison to an adult case series. Pediatr Rheumatol Online J 2013. [PMCID: PMC4043330 DOI: 10.1186/1546-0096-11-s2-p299] [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: 12/02/2022] Open
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Sanchez-Manubens J, Iglesias E, Jou C, Gonzalez MI, Bou R, Torrente-Segarra V, Ricart S, Calzada-Hernandez J, Anton J. PReS-FINAL-1014: Role of MHC class I overexpression on muscle biopsy of patients with juvenile dermatomyositis. Pediatr Rheumatol Online J 2013. [PMCID: PMC4045396 DOI: 10.1186/1546-0096-11-s2-p11] [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: 12/04/2022] Open
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Iglesias E, Navallas M, Riaza L, Torrente-Segarra V, Bou R, Ricart S, González MI, Sánchez J, Antón J. PReS-FINAL-1013: Magnetic resonance imaging as a non-invasive tool to assess muscle edema in juvenile dermatomyositis. Return to normal after treatment. Pediatr Rheumatol Online J 2013. [PMCID: PMC4043662 DOI: 10.1186/1546-0096-11-s2-p10] [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: 11/30/2022] Open
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Torrente-Segarra V, Iglesias E, Bou R, Ricart S, Gonzalez MI, Sanchez J, Lopez-Vives L, Antón-López J. PReS-FINAL-2310: Successful rituximab treatment in a 14 year-old boy with lupus nephritis. Pediatr Rheumatol Online J 2013. [PMCID: PMC4044125 DOI: 10.1186/1546-0096-11-s2-p300] [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: 11/21/2022] Open
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Iglesias E, Jou C, Bou R, Antón J. [Importance of muscle biopsy in the diagnosis of juvenile dermatomyositis]. An Pediatr (Barc) 2013; 80:e25-6. [PMID: 23746465 DOI: 10.1016/j.anpedi.2013.04.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 04/18/2013] [Accepted: 04/19/2013] [Indexed: 11/25/2022] Open
Affiliation(s)
- E Iglesias
- Unidad de Reumatología Pediátrica, Servicio de Pediatría, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España.
| | - C Jou
- Servicio de Anatomía Patológica, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España
| | - R Bou
- Unidad de Reumatología Pediátrica, Servicio de Pediatría, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España
| | - J Antón
- Unidad de Reumatología Pediátrica, Servicio de Pediatría, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España
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Iglesias E, Camacho M, Delgado I, Lirola M, Bernabeu J, Neth O. AB1143 Successful control of churg-strauss syndrome with omalizumab. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Iglesias E, Camacho M, Hurtado A, Gomez C, Falcon L, Obando I, Neth O. AB1142 Severe life-threatening septic sacroiliitis in two otherwise healthy adolescents. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Santa-Maria V, Iglesias E, Neth O, Camacho-Lovillo M. AB1177 Aggressive sacroiliitis in a 4-year-old patient. Successful anti tnf treatment. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Molinero Abad S, Cuesta Lasso M, Cabo Magadán R, Dueñas Gutierrez C, Portillo Tuñón V, Iglesias E, Blanco Martinez de Morentin A, Salazar Thierold E, Quiñones M, Perez Tarrago C. P19 REVIEW OF INFECTIOUS ENDOCARDITIS IN OUR HOSPITAL IN 2008–2012. Int J Antimicrob Agents 2013. [DOI: 10.1016/s0924-8579(13)70043-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Casanova MJ, Chaparro M, Domènech E, Barreiro-de Acosta M, Bermejo F, Iglesias E, Gomollón F, Rodrigo L, Calvet X, Esteve M, García-Planella E, García-López S, Taxonera C, Calvo M, López M, Ginard D, Gómez-García M, Garrido E, Pérez-Calle JL, Beltrán B, Piqueras M, Saro C, Botella B, Dueñas C, Ponferrada A, Mañosa M, García-Sánchez V, Maté J, Gisbert JP. Safety of thiopurines and anti-TNF-α drugs during pregnancy in patients with inflammatory bowel disease. Am J Gastroenterol 2013; 108:433-40. [PMID: 23318480 DOI: 10.1038/ajg.2012.430] [Citation(s) in RCA: 163] [Impact Index Per Article: 14.8] [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: 12/11/2022]
Abstract
OBJECTIVES The safety of thiopurines and anti-tumor necrosis factor-α (TNF-α) drugs during pregnancy remains controversial, as the experience with these drugs in this situation is limited. Our aim is to assess the safety of thiopurines and anti-TNF-α drugs for the treatment of inflammatory bowel disease (IBD) during pregnancy. METHODS Retrospective, multicenter study in IBD patients. Pregnancies were classified according to the therapeutic regimens during pregnancy or during the 3 months before the conception: non-exposed group, pregnancies exposed to thiopurines alone (group A), and pregnancies exposed to anti-TNF-α drugs (group B). An unfavorable Global Pregnancy Outcome (GPO) was considered if pregnancy developed with obstetric complications in the mother and in the newborn. RESULTS A total of 187 pregnancies in the group A, 66 pregnancies in the group B, and 318 pregnancies in the non-exposed group were included. The rate of unfavorable GPO was different among the three groups (31.8% in non-exposed group, 21.9% in group A, and 34.8% in group B), being lower in pregnancies under thiopurines than among non-exposed (P = 0.01). The rate of pregnancy complications was similar among the three groups (27.7% in non-exposed, 20.9% in group A, and 30.3% in group B). The rate of neonatal complications was different among the three groups (23.3% in non-exposed group, 13.9% in group A, and 21.2% in group B), being lower in pregnancies under thiopurines than among non-exposed (P = 0.01). In the multivariate analysis, the treatment with thiopurines (odds ratio = 0.6; 95% confidence interval = 0.4-0.9, P = 0.02) was the only predictor of favorable GPO, whereas maternal age >35 years at conception was the only predictor of unfavorable GPO. The treatment with anti-TNF-α drugs was not associated with an unfavorable GPO. CONCLUSION The treatment with thiopurines and anti-TNF-α drugs does not seem to increase the risk of complications during pregnancy and does seem to be safe for the newborn.
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Affiliation(s)
- M J Casanova
- Department of Gastroenterology, Hospital Universitario de La Princesa and Instituto de Investigación Sanitaria Princesa, IP, Madrid, Spain
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Pacheu-Grau D, Gomez-Duran A, Iglesias E, Lopez-Gallardo E, Montoya J, Ruiz-Pesini E. Mitochondrial antibiograms in personalized medicine. Hum Mol Genet 2012; 22:1132-9. [DOI: 10.1093/hmg/dds517] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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Ruiz G, Perez-Alonso AJ, Ksycki M, Mazzini FN, Gonzalo R, Iglesias E, Gigena A, Vu T, Asensio-Gonzalez JA. Femoral vessel injuries; high mortality and low morbidity injuries. Eur J Trauma Emerg Surg 2012; 38:359-71. [PMID: 26816118 DOI: 10.1007/s00068-012-0206-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 06/16/2012] [Indexed: 11/29/2022]
Abstract
Femoral vessel injuries are amongst the most common vascular injuries admited in busy trauma centers. The evolution of violence and the increase in penetrating trauma from the urban battlefields of city streets has raised the incidence of femoral vessel injuries, which account for approximately 70% of all peripheral vascular injuries. Despite the relatively low mortality associated with these injuries, there is a high level of technical complexity required for the performance of these repairs. Similarly, they incur low mortality but are associated with significantly high morbidity. Prompt diagnosis and treatment are the keys to successful outcomes with the main goals of managing ischemia time, restoring limb perfusion, accomplishing limb salvage and instituting rehabilitation as soon as possible.
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Affiliation(s)
- G Ruiz
- Division of Trauma Surgery and Surgical Critical Care, Dewitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - A J Perez-Alonso
- Division of Trauma Surgery and Surgical Critical Care, Dewitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - M Ksycki
- Division of Trauma Surgery and Surgical Critical Care, Dewitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - F N Mazzini
- Division of Trauma Surgery and Surgical Critical Care, Dewitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - R Gonzalo
- Division of Trauma Surgery and Surgical Critical Care, Dewitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - E Iglesias
- Division of Trauma Surgery and Surgical Critical Care, Dewitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - A Gigena
- Division of Trauma Surgery and Surgical Critical Care, Dewitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - T Vu
- Division of Trauma Surgery and Surgical Critical Care, Dewitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - Juan A Asensio-Gonzalez
- Division of Trauma Surgery and Surgical Critical Care, Dewitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA. .,Westchester University Medical Center, New York Medical College, Trauma Department of Surgery, 100 Woods Road Taylor Pavilion, Suite E137, Valhalla, NY, 10595, USA.
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Stuebing E, Lieberman H, Vu T, Mazzini FN, De Gregorio L, Gigena A, Iglesias E, Gonzalo R, Perez-Alonso AJ, Asensio JA. Shank vessel injuries: the forgotten vascular injuries. Eur J Trauma Emerg Surg 2012; 38:393-401. [PMID: 26816120 DOI: 10.1007/s00068-012-0196-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Accepted: 05/04/2012] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Vascular injuries in branch vessels of the popliteal artery, such as the tibioperoneal trunk, and shank vessels, such as anterior, posterior tibial, and peroneal vessels, occur in both blunt and penetrating trauma. Their management has evolved significantly in the past few decades. While their incidence is variable, limb loss and morbidity remain significant. MATERIAL AND METHODS Physical examination, along with measuring an Ankle-Brachial Index (ABI), is still sometimes all that is required for diagnosis and can expeditiously triage those that require urgent operation. Despite our technological advancements and newer algorithms for lower extremity vascular trauma, operative intervention and exposure still remain difficult and pose a great challenge for surgeons that normally do not operate on this area. CONCLUSIONS Shank vessel injuries still comprise a significant proportion of combat and civilian vascular injuries, and modern advances have led to a dramatic decrease in amputation rates.
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Affiliation(s)
- E Stuebing
- Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Ryder Trauma Center, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - H Lieberman
- Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Ryder Trauma Center, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - T Vu
- Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Ryder Trauma Center, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - F N Mazzini
- Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Ryder Trauma Center, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - L De Gregorio
- Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Ryder Trauma Center, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - A Gigena
- Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Ryder Trauma Center, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - E Iglesias
- Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Ryder Trauma Center, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - R Gonzalo
- Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Ryder Trauma Center, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - A J Perez-Alonso
- Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Ryder Trauma Center, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - J A Asensio
- Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Ryder Trauma Center, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA.
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Ksycki M, Ruiz G, Perez-Alonso AJ, Sciarretta JD, Gonzalo R, Iglesias E, Gigena A, Vu T, Asensio JA. Iliac vessel injuries: difficult injuries and difficult management problems. Eur J Trauma Emerg Surg 2012; 38:347-57. [PMID: 26816117 DOI: 10.1007/s00068-012-0189-7] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Accepted: 04/02/2012] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Injury to the iliac vessels poses a serious and frustrating treatment dilemma for all trauma surgeons. Generally, patients present in profound shock secondary to severe hemorrhage from either iliac arterial, venous, or combined injuries. Despite improvements in our emergency medical services (EMS), rapid transport, standard training of trauma surgeons, and improved technology, the morbidity and mortality from iliac vessel injuries remain high, ranging from 25 to 40 %. MATERIALS AND METHODS A systematic review of the literature, with emphasis placed on the diagnosis, treatment, and outcomes of these injuries, incorporating the author's experience. CONCLUSIONS Injuries to the iliac vessel remain a daunting task, even after great advances in anatomic injury grading and damage control as well as advances in surgical techniques and critical care. Despite all the advances in treatment and appropriate management strategies, the morbidity and mortality from iliac vessel injuries remain high, demonstrating the complex challenge their treatment presents to even the modern-day trauma surgeon.
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Affiliation(s)
- M Ksycki
- Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - G Ruiz
- Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - A J Perez-Alonso
- Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - J D Sciarretta
- Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - R Gonzalo
- Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - E Iglesias
- Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - A Gigena
- Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - T Vu
- Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA
| | - J A Asensio
- Division of Trauma Surgery and Surgical Critical Care, DeWitt Daughtry Family Department of Surgery, Ryder Trauma Center, University of Miami Miller School of Medicine, 1800 NW 10 Avenue Suite T-247, Miami, FL, 33136-1018, USA.
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Blesa J, Pifl C, Sánchez-González MA, Juri C, García-Cabezas MA, Adánez R, Iglesias E, Collantes M, Peñuelas I, Sánchez-Hernández JJ, Rodríguez-Oroz MC, Avendaño C, Hornykiewicz O, Cavada C, Obeso JA. The nigrostriatal system in the presymptomatic and symptomatic stages in the MPTP monkey model: a PET, histological and biochemical study. Neurobiol Dis 2012; 48:79-91. [PMID: 22677034 DOI: 10.1016/j.nbd.2012.05.018] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2012] [Revised: 05/20/2012] [Accepted: 05/24/2012] [Indexed: 11/19/2022] Open
Abstract
Parkinson's disease (PD) is diagnosed when striatal dopamine (DA) loss exceeds a certain threshold and the cardinal motor features become apparent. The presymptomatic compensatory mechanisms underlying the lack of motor manifestations despite progressive striatal depletion are not well understood. Most animal models of PD involve the induction of a severe dopaminergic deficit in an acute manner, which departs from the typical, chronic evolution of PD in humans. We have used 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) administered to monkeys via a slow intoxication protocol to produce a more gradual development of nigral lesion. Twelve control and 38 MPTP-intoxicated monkeys were divided into four groups. The latter included monkeys who were always asymptomatic, monkeys who recovered after showing mild parkinsonian signs, and monkeys with stable, moderate and severe parkinsonism. We found a close correlation between cell loss in the substantia nigra pars compacta (SNc) and striatal dopaminergic depletion and the four motor states. There was an overall negative correlation between the degree of parkinsonism (Kurlan scale) and in vivo PET ((18)F-DOPA K(i) and (11)C-DTBZ binding potential), as well as with TH-immunoreactive cell counts in SNc, striatal dopaminergic markers (TH, DAT and VMAT2) and striatal DA concentration. This intoxication protocol permits to establish a critical threshold of SNc cell loss and dopaminergic innervation distinguishing between the asymptomatic and symptomatic parkinsonian stages. Compensatory changes in nigrostriatal dopaminergic activity occurred in the recovered and parkinsonian monkeys when DA depletion was at least 88% of control, and accordingly may be considered too late to explain compensatory mechanisms in the early asymptomatic period. Our findings suggest the need for further exploration of the role of non-striatal mechanisms in PD prior to the development of motor features.
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Affiliation(s)
- J Blesa
- Movement Disorders Group, Neurosciences Division, CIMA, and Department of Neurology and Neurosurgery, Clínica Universidad de Navarra, Pamplona, Spain
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Siso C, Morales S, Iglesias E, Gonzalez S, Canosa C, Pon M. 603 Could Axillary Dissection Be Avoided After Neoadjuvant Chemotherapy in Patients with Prior Positive Axillary Sentinel Lymph Node by a RT-PCR Method? Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)70668-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Chaparro M, Burgueño P, Iglesias E, Panés J, Muñoz F, Bastida G, Castro L, Jiménez C, Mendoza JL, Barreiro-de Acosta M, Senent SG, Gomollón F, Calvet X, García-Planella E, Gómez M, Hernández V, Hinojosa J, Mañosa M, Nyssen OP, Gisbert JP. Infliximab salvage therapy after failure of ciclosporin in corticosteroid-refractory ulcerative colitis: a multicentre study. Aliment Pharmacol Ther 2012; 35:275-83. [PMID: 22142227 DOI: 10.1111/j.1365-2036.2011.04934.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [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: 12/16/2022]
Abstract
BACKGROUND Ciclosporin has proven to be effective in patients with corticosteroid-refractory ulcerative colitis (UC). When therapy with this drug fails, infliximab can be considered to avoid colectomy. The efficacy and safety of this sequential approach remain unknown. AIM To assess the efficacy and safety profile of treatment with infliximab after failure of ciclosporin in patients with a corticosteroid-refractory flare of UC. METHODS Retrospective review of medical records of patients with a corticosteroid-refractory flare of UC who did not respond to ciclosporin and received salvage therapy with infliximab within a month of discontinuing ciclosporin. The severity of the flare and response to the treatment were graded using the Lichtiger index. Cumulative rates of colectomy were calculated using Kaplan-Meier analysis. Cox regression analysis was performed to identify predictors of colectomy. To evaluate the safety profile of this treatment strategy, any adverse event occurring after the first infusion of infliximab was considered. RESULTS The study population comprised 47 patients with corticosteroid-refractory UC treated with infliximab after failure of ciclosporin. The median baseline Lichtiger index was 13. The mean time from the last ciclosporin dose to the first infliximab infusion was 6 days. After the first infliximab infusion, 13% of patients achieved remission, and 74% partial response. Of the 35 patients who received the third infliximab infusion, 60% achieved remission, and 37% partial response. Fourteen patients (30%) underwent colectomy. The rate of adverse events was 23%. One death occurred in a 40-year-old man who failed ciclosporin and infliximab and underwent surgery 10 days after the first infliximab infusion; he died of nosocomial pneumonia. CONCLUSIONS Treatment with infliximab makes it possible to avoid colectomy in two-thirds of corticosteroid-refractory UC patients in whom ciclosporin fails. However, the rates of adverse events and mortality mean that the decision to administer sequential therapy (ciclosporin-infliximab) should be taken on an individual basis.
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Affiliation(s)
- M Chaparro
- Gastroenterology Department, Hospital Universitario de La Princesa and Instituto de Investigación Sanitaria Princesa, Madrid, Spain.
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Iglesias E, Antón J, Ricart S, Ros J, Torrente V, Bou R, González MA, Vicente A. Juvenile dermatomyositis: clinical and laboratory charateristics of 18 patients. Pediatr Rheumatol Online J 2011. [PMCID: PMC3194709 DOI: 10.1186/1546-0096-9-s1-p50] [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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Lovillo MSC, Iglesias E, Neth O, Santa-María V, Gavilán JL. Recurrent poliserositis succesfully treated with IL-1 receptor antagonist Anakinra. Pediatr Rheumatol Online J 2011. [PMCID: PMC3194697 DOI: 10.1186/1546-0096-9-s1-p4] [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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Lovillo MSC, Iglesias E, Neth O, Santa-María V, Sánchez A, Bernabeu J. Familial mediterranean fever and pauciimmune renal vasculitis: the role of IL-1 blockade (Anakinra). Pediatr Rheumatol Online J 2011. [PMCID: PMC3194708 DOI: 10.1186/1546-0096-9-s1-p5] [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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Iglesias E, Antón J, Ricart S, Ros J, Torrente V, Bou R, González MA, Vicente A. Juvenile localized scleroderma: review of 44 patients. Pediatr Rheumatol Online J 2011. [PMCID: PMC3194736 DOI: 10.1186/1546-0096-9-s1-p75] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Perez-Medina T, Garcia-Espantaleon M, San-Frutos L, Pereira A, Iglesias E. Laparoscopic Transperitoneal Infrarenal Paraaortic Lymphadenectomy in Gynaecological Cancer. J Minim Invasive Gynecol 2011. [DOI: 10.1016/j.jmig.2011.08.196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Velasco A, Morales S, Panades MJ, Gonzalez S, Vilardell F, Canosa C, Iglesias E. May axillary dissection be avoided after micro metastases in sentinel lymph node analyzed by OSNA method? J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.27_suppl.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
18 Background: The study of the sentinel node biopsy is a common method to assess axillary involvement before surgical resection. The OSNA assay based on reverse transcriptase loop mediated amplification (RT-LAMP) and quantification of cytokeratin 19 (CK19) mRNA allows a rapid intra-operative detection of the metastases in the sentinel lymph node in breast cancer patients. Pathologists considered micro metastases when the size of the node involvement was between 0.2 and 2 mm and the OSNA method assess micro metastases when the copy number of CK19 is between 250 and 5000. Methods: From a total of 341 patients in which sentinel node had been analyzed, we studied a series of 32 patients whose sentinel nodes had micro metastases assessed by OSNA and who underwent subsequent axillary dissection. Median breast tumour size was 1.6 cm, 10 patients (31%) had less than 1 cm in size and only 6 patients (19%) had >2 cm. 78% of patients shown positive oestrogen receptor and 14 patients (44%) had low Ki67 (<14%). The CK19 mRNA was quantified in all patients (32) resulting in a median value of 540 (210-4800). Results: The median value of the nodes removed by axillary dissection was 14 (9-19). We found tumor invasion in none of them by histopathological conventional study. Conclusions: Since we have found no axillary involvement when the sentinel node have micro metastases analyzed by the OSNA method it seems that quantitative measure of CK19 by OSNA may be a useful procedure in order to avoid axillary dissection, although it would be necessary to perform larger studies to demonstrate this effect.
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Affiliation(s)
- A. Velasco
- Pathology Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Medical Oncology Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Surgery Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain
| | - S. Morales
- Pathology Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Medical Oncology Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Surgery Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain
| | - M. J. Panades
- Pathology Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Medical Oncology Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Surgery Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain
| | - S. Gonzalez
- Pathology Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Medical Oncology Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Surgery Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain
| | - F. Vilardell
- Pathology Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Medical Oncology Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Surgery Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain
| | - C. Canosa
- Pathology Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Medical Oncology Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Surgery Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain
| | - E. Iglesias
- Pathology Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Medical Oncology Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain; Surgery Department, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, Spain
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Fernández Ibieta M, Cano JMB, Amador JTR, González-Tomé MI, Martín SG, Gómez MN, de José MI, Beceiro J, Iglesias E, Prieto L, Santos MJ, Guardia NM, Roa MA, Regidor J. [In-utero antiretroviral exposure and mitochondrial toxicity in a cohort of uninfected infants born to HIV-1-infected women]. An Pediatr (Barc) 2010; 73:180-8. [PMID: 20951949 DOI: 10.1016/j.anpedi.2010.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2009] [Revised: 12/24/2009] [Accepted: 02/02/2010] [Indexed: 10/18/2022] Open
Abstract
INTRODUCTION In this study, we attempt to find out the percentage of uninfected infants born to HIV-infected women and exposed in-utero and perinatally to Antiretroviral Treatment (ART) that show high lactate levels, or any other mitochondrial damage markers (such as hypertransaminasaemia or hyperamylasaemia), during the first three months of age. We shall also establish whether certain drugs used in-utero are associated with higher lactate, transaminase or amylase levels. METHODS We analysed the available data from 623 uninfected infants born in the Spanish FIPSE cohort that were born in the period 2000-2005. The normal values for lactate, transaminases and amylase were set according to AIDS Clinical Groups Trials toxicity tables for infants. RESULTS The percentages of children with high lactate levels at 0.5; 1.5 and 3 months of age were 48%, 51.4% and 43% among those infants with available data. Respectively, the percentages of children with high AST values were 13.2; 10.4 and 17.2%. The values for high ALT were 3.3%; 3.4% and 5%. The percentages for hyperamylasaemia were 0%; 0.6% and 2.6%. We found no significant difference among the drugs used in utero for the four analysed biochemical markers along the first three months of age. CONCLUSIONS We have found a high proportion of hyperlactataemia among infants exposed in-utero to ART, as shown in other cohorts of similar characteristics. No morbidity or mortality was communicated to the cohort analysis group. No ART drug among those used in-utero was statistically associated with a higher proportion of high lactate levels in these infants.
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Martínez-Payo C, Savirón R, Iglesias E. Diagnóstico ecográfico prenatal de un caso de síndrome de bandas amnióticas. Clínica e Investigación en Ginecología y Obstetricia 2010. [DOI: 10.1016/j.gine.2009.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Fernández Ibieta M, Bellón Cano JM, Ramos Amador JT, González-Tomé MI, Guillén Martín S, Navarro Gómez M, De José MI, Beceiro J, Iglesias E, Prieto L, Santos MJ, Martínez Guardia N, Roa MA, Regidor J. [Growth of uninfected infants exposed to antiretrovirals born to HIV-infected woman]. An Pediatr (Barc) 2009; 71:299-309. [PMID: 19660998 DOI: 10.1016/j.anpedi.2009.06.019] [Citation(s) in RCA: 7] [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: 11/27/2008] [Revised: 05/30/2009] [Accepted: 06/15/2009] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Recent reports show that Antiretroviral Treatment (ART) during pregnancy does not affect somatic growth of children born to HIV-infected mothers, are reassuring. The aim of this study is to perform an anthropometric analysis of the uninfected children followed in the Spanish FIPSE cohort during their first 18 months of life, and to describe the possible risk factors during pregnancy that may influence low birth weight. METHODS The FIPSE cohort includes 8 public hospitals in Madrid, and prospectively follows children born to HIV-infected women at these hospitals. We collected data on 601 uninfected children, following standardised protocols, during their first 2 years of life. A P value<0.05 was considered statistically significant. Data from the Pablo Orbegozo Foundation were used to compare the means of our population with the standard weight, longitude an occipitofrontal circumference (OFC) of the Spanish population during the first 18 months of life. RESULTS The mean weight was 2766g (+/-590), and 2967g (+/-427) when premature neonates were excluded. The proportion of Intrauterine Growth Restriction among non- premature neonates was 19.8% (95% CI: 16.3-23.8). Children born to mothers that used illicit drugs weighed less: 2752g (+/-325) vs. 3002g (+/ 435), P<0.001, as did children born to mothers who smoked during pregnancy: 2842g (+/-363) vs. 3018g (+/-444), P>0.001. Maternal anaemia did not influence the low birth weight of the children when premature neonates were excluded. We found no statistically significant differences depending on the ART received during pregnancy. Children born to mothers who had CD4 > 500 cell /mm were heavier (2834g +/-503) than those whose mothers had CD4 of less than 200 cell/mm (2565g +/-702), P=0.008. These differences disappeared when premature neonates were excluded. Children born to mothers with undetectable viral load were heavier (2866g +/-532 vs. 2704g +/-588, P=0.005), but these differences also disappeared when the prematures were excluded from the analysis. Mean weight, length, and OFC of our population at birth (excluding premature neonates) were lower than the Spanish standards. (z for weight=-0.83; z for length =-1.02; z for OFC=-1.00), but these differences are not statistically significant and disappear at 18 months of age (z for weight=-0.08; z for height=-0.32; z for OFC=-0.31). The type of ART did not have any significant influence. DISCUSSION There is a very significant difference between the weight of the children born to mothers addicted to illicit drugs and the rest of the children. Similarly, the weight of the children born to smoking mothers is significantly lower. There was no association between maternal anaemia and the type of ART. The children of our population have lower weights, length and OFC at birth, but this may due to the high number of scheduled caesarean births, practised at 38 weeks of pregnancy (54.5%). Our children catch-up with anthropometric measurements during the first and second year of life, and these are similar to Spanish standards at 18 months old.
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Fernández Ibieta M, Ramos Amador JT, González Tomé MI, Guillén Martín S, Bellón Cano JM, Navarro Gómez M, de José MI, Beceiro J, Iglesias E, Rubio B, Relaño Garrido P, Santos MJ, Martínez Guardia N, Roa MA, Regidor J. [Anaemia and neutropenia in a cohort of non-infected children of HIV-positive mothers]. An Pediatr (Barc) 2009; 69:533-43. [PMID: 19128766 DOI: 10.1016/s1695-4033(08)75236-6] [Citation(s) in RCA: 8] [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] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION Mother-to-child HIV transmission is currently around 1% in western countries, due to prevention measures. Antiretroviral drugs do have adverse effects, anaemia and myelosupression caused by AZT being the most observed effects. In the present study, we analyse the prevalence of anaemia and neutropenia in an uninfected children cohort born to HIV-infected women. MATERIAL AND METHODS We followed up 623 uninfected children belonging to the FIPSE cohort according to standardised protocols. This cohort groups 8 hospitals from Madrid and follows up HIV infected pregnant women and their children. Anaemia and neutropenia were defined according to the ACTG (AIDS Clinical Trails Group) toxicity tables. Children were classified according to prematurity, ethnic origin, birth weight, withdrawal syndrome, in-utero treatment and neonatal prophylaxis. Categorical variables were compared with the chi2 or the Fisher tests. RESULTS Anaemia was observed in 188 (30.1%) children during follow-up and 161 (25.8%) had anaemia grade 2 or higher. Prematurity (p < 0.001), low birth weight (p = 0.005) and Highly Active Antiretroviral Treatment (HAART) with Protease Inhibitors (p = 0.016) were associated with higher percentages of anaemia in children. Nadir haemoglobin values were reached by 6 weeks of life and anaemia was transient and disappeared by six months of age. Neutropenia was present in 41.9% (261 children) and 22.7% of the children had moderate-severe neutropenia. Prematurity was again associated with neutropenia (p = 0.01) and low birth weigh was associated only with moderate-severe neutropenia (p = 0.023). African infants had a higher percentage of neutropenia than the rest of the children (50% vs. 44%), although the differences were not significant. The type of in-utero treatment did not appear to influence the neutropenia. Neutropenia was still present in 12.5% of infants at 18 months of age. The type of neonatal prophylaxis to prevent mother-to-child transmission (monotherapy, dual therapy or triple therapy) did not influence either cytopenia. CONCLUSION In our series, the proportion of children with anaemia is high: 30.1% Prematurity, low birth weight and HAART with IP were associated with a higher proportion of anaemia, which was transient and had little clinical relevance. The proportion of children with neutropenia was higher (41.9%) and was associated with prematurity, low birth weight and African origin. The type of neonatal prophylaxis does not seem to influence the development of cytopenias. Persistence of neutropenia (without clinical significance) was observed in a small percentage of the children 12.5%, at 18 months of age.
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Affiliation(s)
- M Fernández Ibieta
- Servicio de Pediatría, Hospital Universitario de Getafe, Madrid, España.
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Fernández Ibieta M, Ramos Amador JT, Bellón Cano JM, González-Tomé MI, Guillén Martín S, Navarro Gómez M, de José MI, Beceiro J, Iglesias E, Prieto L, Santos MJ, Martínez Guardia N, Roa MA, Regidor J. [Birth defects in a cohort of uninfected children born to HIV-infected women]. An Pediatr (Barc) 2009; 70:253-64. [PMID: 19246263 DOI: 10.1016/j.anpedi.2008.10.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2008] [Revised: 10/29/2008] [Accepted: 10/30/2008] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Mother-to-Child HIV transmission is now just 1% in western countries, due to prevention measures. Antiretroviral Treatment (ART) drugs do have adverse effects, anaemia and myelosupression caused by cidovudina being the most commonly observed effects. In the present study, we have analysed the proportion and characteristics of congenital malformations (CM) or birth defects (BD) in a cohort of uninfected children born to HIV-infected women. METHODS A total of 623 uninfected children belonging to the FIPSE cohort were followed up according to standardised protocols. This cohort includes 8 public hospitals from Madrid and follows up HIV-infected pregnant women and their children. Children were classified according to prematurity, ethnic origin, birth weight, withdrawal syndrome, in-utero treatment. Birth defects were described and defined according to the EUROCAT, the European registry for BD. Mild errors of morphogenesis were excluded from the analysis. Categorical variables were compared with the X(2) or the Fisher test. RESULTS A total of 78% (486) of the mothers were of Caucasian origin; 18.8% (117) used some illicit drug (heroine, cocaine or methadone) during gestation; 51 mothers (8.1%) received no ART, 10 (1.6%) received monotherapy and 469 (75.3%) received HAART. BD were seen in 52 children, with the most frequent being genitourinary and cardiological. Anaemia in the first trimester was an associated risk for BD (17.9% vs. 8.1%, P = 0,04). Similarly, mothers who used any illicit drug (plus methadone), had a slightly higher risk for BD in their offspring (13.8% vs. 7.6%, P = 0,04) There was no increased risk for BD significantly associated with any of the in-utero used antiretrovirals, although Nevirapine use in-utero showed a protective effect. Children born to mothers who received ART in the first trimester had the same rate of BD (7.4%) as those whose mothers started ART in the second trimester (8.8%), P = 0,67. CONCLUSIONS The proportion of BD that we have observed seems higher than those shown in other European teratogenicity studies and also higher than those shown in cohorts with HIV and antiretroviral exposed infants. This may be due to the fact that our series show the results of an active surveillance system (that includes ultrasound), where BD classically appear in a higher proportion. Immunovirological characteristics of the mother did not influence the proportion of BD, but anaemia in the fist trimester and the use of illicit drugs (or methadone) did. No specific antiretroviral drug was associated with an increase in BD, although Nevirapine showed a possible protective effect in the statistical analysis. Mothers who started antiretrovirals in the first trimester do not have more BD in their offspring than mothers who started on antiretrovirals later on.
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Affiliation(s)
- M Fernández Ibieta
- Servicio de Pediatría, Hospital Universitario de Getafe, Madrid, España.
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Thomas S, Iglesias E, Curry G, Lovinger D, Whelan C, Abbo E, Walter J. 293: An Experience With the Transfer of Admitted Patients From an Emergency Department to an Off-Site Hospitalist Service. Ann Emerg Med 2008. [DOI: 10.1016/j.annemergmed.2008.06.315] [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: 10/21/2022]
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Abstract
BACKGROUND Bone metastases are common in lung cancer and are leading to increasing consumption of health care resources. The therapeutic choice for the clinician is extensive, from biphosphonates to percutaneous vertebroplasty. In the absence of official guidelines the management varies from centre to centre. There are very few economic analyses of these patients. METHODS Study 06-01 of the French Lung Oncology Group is a medico-economic analysis of the management of bone metastases in lung cancer. It is a national, multicentre, observational, epidemiological study. The primary objective is to assess the epidemiology, the management strategies and the costs of bone metastases in lung cancer. The secondary objective is to develop a medico-economic model of the management based on a Markov model in order to evaluate the effectiveness of different therapeutic strategies. EXPECTED RESULTS The aim of this study is a better understanding of theses patients at a time when few observational studies have been undertaken.
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Affiliation(s)
- C Decroisette
- Service de Pathologie Respiratoire, Hôpital Universitaire du Cluzeau, Limoges, France.
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Iglesias E, García Y, Sanjuan M, Camacho O, Smith C. Fuzzy surface-based sliding mode control. ISA Trans 2007; 46:73-83. [PMID: 17291502 DOI: 10.1016/j.isatra.2006.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2005] [Accepted: 04/06/2006] [Indexed: 05/13/2023]
Abstract
A new controller based on a combination of Sliding Mode Control and Fuzzy Logic is proposed. The conventional sliding surface is modified using a set of fuzzy rules. This combination confers controller robustness and flexibility. A neutralization process and a mixing process are used to compare the performance of the new controller to that of a conventional sliding mode controller and a PID controller.
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Affiliation(s)
- E Iglesias
- Escuela de Ingeniería Química, Universidad de los Andes, Mérida, Venezuela
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Borget I, Tilleul P, Baud M, Granghaud A, Iglesias E, Chouaid C. [A prospective study of quality of life and treatment of chemotherapy-induced anaemia in lung cancer]. Rev Mal Respir 2007; 24:41-7. [PMID: 17268364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
INTRODUCTION The impact of chemotherapy-induced anemia on the quality of life (QOL) of patients with lung cancer has been little studied. OBJECTIVE We evaluated the feasibility of measuring QOL among patients receiving chemotherapy for lung cancer, and the possible correlation of QOL with the haemoglobin level. METHODS This was a prospective study of 53 patients starting chemotherapy (total 155 cycles); QOL was measured with the specific Fact-An scale. RESULTS The mean haemoglobin level before treatment was 13.1+/-2.3 g/dl. During chemotherapy 45.3% of patients received erythrocytic growth factors and 15.1% were transfused; 26.4% of patients refused to answer or could not answer the QOL questionnaire. There was a strong correlation between the Hb level and overall QOL (r=0.343, p=0.0004), as well as the physical and functional subscales (but not the cognitive and social subscales). CONCLUSIONS Although QOL could not be measured in one-quarter of cases, it was clearly affected by anaemia, which supports a strategy of early diagnosis and management of anaemia due to chemotherapy for lung cancer.
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Affiliation(s)
- I Borget
- Services de pharmacie, Hôpital Saint-Antoine, Paris, France
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Muzio V, Aguilar J, Aguilar A, Lobaina Y, Iglesias E, García D, Penton E, Pichardo D, Urquiza D, Rodriguez D, Guillen G. P.339 A nasal vaccine candidate for chronic hepatitis B immunotherapy: from preclinical studies to phase I. J Clin Virol 2006. [DOI: 10.1016/s1386-6532(06)80513-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Aguilar JC, Lobaina Y, Muzio V, García D, Pentón E, Iglesias E, Pichardo D, Urquiza D, Rodríguez D, Silva D, Petrovsky N, Guillén G. Development of a nasal vaccine for chronic hepatitis B infection that uses the ability of hepatitis B core antigen to stimulate a strong Th1 response against hepatitis B surface antigen. Immunol Cell Biol 2005; 82:539-46. [PMID: 15479440 DOI: 10.1111/j.0818-9641.2004.01278.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
There are estimated to be 350 million chronic carriers of hepatitis B infection worldwide. Patients with chronic hepatitis B are at risk of liver cirrhosis with associated mortality because of hepatocellular carcinoma and other complications. An important goal, therefore, is the development of an effective therapeutic vaccine against chronic hepatitis B virus (HBV). A major barrier to the development of such a vaccine is the impaired immune response to HBV antigens observed in the T cells of affected patients. One strategy to overcome these barriers is to activate mucosal T cells through the use of nasal vaccination because this may overcome the systemic immune downregulation that results from HBV infection. In addition, it may be beneficial to present additional HBV epitopes beyond those contained in the traditional hepatitis B surface antigen (HbsAg) vaccine, for example, by using the hepatitis B core antigen (HBcAg). This is advantageous because HBcAg has a unique ability to act as a potent Th1 adjuvant to HbsAg, while also serving as an immunogenic target. In this study we describe the effect of coadministration of HBsAg and HBcAg as part of a strategy to develop a more potent and effective HBV therapeutic vaccine.
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Affiliation(s)
- J C Aguilar
- Biomedical Branch, Center for Genetic Engineering and Biotechnology, Havana, Cuba.
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