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Impact of carotid artery stenosis on outcomes of transcatheter aortic valve replacement: A systematic review and meta-analysis. Int J Cardiol 2024; 399:131670. [PMID: 38141726 DOI: 10.1016/j.ijcard.2023.131670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 12/03/2023] [Accepted: 12/18/2023] [Indexed: 12/25/2023]
Abstract
INTRODUCTION Carotid Artery Stenosis (CAS) is common in elderly patients undergoing Transcatheter Aortic Valve Replacement (TAVR). However, the impact of CAS on the outcomes of TAVR is unclear. PURPOSE This systematic review and meta-analysis aimed to compare the clinical and periprocedural outcomes in patients with and without CAS undergoing TAVR. METHODS PubMed, Embase, and Cochrane databases were searched until February 2023. We included studies that performed a direct comparison of outcomes of TAVR in CAS versus non-CAS patients. Data was extracted from published reports and the ROBINS-I tool was utilized for quality assessment. The R studio software (version 4.2.2) was adopted for statistical analysis. RESULTS Five observational studies and 111.915 patients were included. The mean age was 80.7 ± 8.2 years and 46.3% were female. The risk of stroke or transient ischemic attack was elevated in the group of patients with CAS (OR 1.44; 95% CI 1.07-1.95; p = 0.016). In contrast, myocardial infarction (OR 1.24; 95% CI 1.05-1.47; p = 0.074) and all-cause mortality (OR 0.99; 95% CI 0.73-1.35; p = 0.95) were not significantly different between CAS and non-CAS groups. Acute kidney injury and new pacemaker implantation did not differ between patients with and without CAS. CONCLUSIONS Our findings suggest that CAS is significantly associated with cerebrovascular events in patients undergoing TAVR, without significantly impacting all-cause mortality. Further prospective studies are needed for a more granular assessment of additional determinants of this association, such as unilateral vs. bilateral involvement and whether there is a threshold of CAS severity for increased risk.
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Burden of bradycardia and barriers to accessing bradycardia therapy in underserved countries. Eur Heart J Suppl 2023; 25:H1-H17. [PMID: 38046890 PMCID: PMC10689927 DOI: 10.1093/eurheartjsupp/suad125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Bradycardia, a condition characterized by an abnormally slow heart rate, poses significant challenges in terms of diagnosis and treatment. While it is a concern world-wide, low- and middle-income countries (LMICs) face substantial barriers in accessing appropriate bradycardia therapy. This article aims to explore the global aetiology and incidence of bradycardia, compare the prevalence and management of the condition in high-income countries versus LMICs, identify the key reasons behind the disparities in access to bradycardia therapy in LMICs, and emphasize the urgent need to address these disparities to ensure equitable healthcare on a global scale.
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Lenvatinib-Loaded Poly(lactic-co-glycolic acid) Nanoparticles with Epidermal Growth Factor Receptor Antibody Conjugation as a Preclinical Approach to Therapeutically Improve Thyroid Cancer with Aggressive Behavior. Biomolecules 2023; 13:1647. [PMID: 38002329 PMCID: PMC10668968 DOI: 10.3390/biom13111647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/06/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Lenvatinib, a tyrosine kinase inhibitor (TKI) approved for the treatment of progressive and radioactive iodine (RAI)-refractory differentiated thyroid cancer (DTC), is associated with significant adverse effects that can be partially mitigated through the development of novel drug formulations. The utilization of nanoparticles presents a viable option, as it allows for targeted drug delivery, reducing certain side effects and enhancing the overall quality of life for patients. This study aimed to produce and assess, both in vitro and in vivo, the cytotoxicity, biodistribution, and therapeutic efficacy of lenvatinib-loaded PLGA nanoparticles (NPs), both with and without decoration using antibody conjugation (cetuximab), as a novel therapeutic approach for managing aggressive thyroid tumors. METHODS Poly(lactic-co-glycolic acid) nanoparticles (NPs), decorated with or without anti-EGFR, were employed as a lenvatinib delivery system. These NPs were characterized for size distribution, surface morphology, surface charge, and drug encapsulation efficiency. Cytotoxicity was evaluated through MTT assays using two cellular models, one representing normal thyroid cells (Nthy-ori 3-1) and the other representing anaplastic thyroid cells (CAL-62). Additionally, an in vivo xenograft mouse model was established to investigate biodistribution and therapeutic efficacy following intragastric administration. RESULTS The NPs demonstrated success in terms of particle size, polydispersity index (PDI), zeta potential, morphology, encapsulation efficiency, and cetuximab distribution across the surface. In vitro analysis revealed cytotoxicity in both cellular models with both formulations, but only the decorated NPs achieved an ID50 value in CAL-62 cells. Biodistribution analysis following intragastric administration in xenografted thyroid mice demonstrated good stability in terms of intestinal barrier function and tumor accumulation. Both formulations were generally well tolerated without inducing pathological effects in the examined organs. Importantly, both formulations increased tumor necrosis; however, decorated NPs exhibited enhanced parameters related to apoptotic/karyolytic forms, mitotic index, and vascularization compared with NPs without decoration. CONCLUSIONS These proof-of-concept findings suggest a promising strategy for administering TKIs in a more targeted and effective manner.
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Increased aridity drives post-fire recovery of Mediterranean forests towards open shrublands. THE NEW PHYTOLOGIST 2023; 239:2416-2417. [PMID: 37337839 PMCID: PMC10545551 DOI: 10.1111/nph.19012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
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Eucalyptus bleached kraft pulp-ionic liquid inks for 3D printing of ionogels and hydrogels. Carbohydr Polym 2023; 313:120897. [PMID: 37182980 DOI: 10.1016/j.carbpol.2023.120897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/22/2023] [Accepted: 04/07/2023] [Indexed: 05/16/2023]
Abstract
3D printing has been recently recognized as one of the most promising technologies due to the multiple options to fabricate cost-effective and customizable objects. However, the necessity to substitute fossil fuels as raw materials is increasing the research on bio-based inks with recyclable and eco-friendly properties. In this work, we formulated inks for the 3D printing of ionogels and hydrogels with bleached kraft pulp dissolved in [Emim][DMP] at different concentrations (1-4 wt%). We explored each ink's rheological properties and printability and compared the printability parameters with a commercial ink. The rheological results showed that the 3 % and 4 % cellulose-ionic liquid inks exhibited the best properties. Both had values of damping factor between 0.4 and 0.7 and values of yield stress between 1900 and 2500 Pa. Analyzing the printability, the 4 wt% ink was selected as the most promising because the printed ionogels and the hydrogels had the best print resolution and fidelity, similar to the reference ink. After printing, ionogels and hydrogels had values of the elastic modulus (G') between 103 and 104 Pa, and the ionogels are recyclables. Altogether, these 3D printed cellulose ionogels and hydrogels may have an opportunity in the electrochemical and medical fields, respectively.
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IL1R1 + cancer-associated fibroblasts drive tumor development and immunosuppression in colorectal cancer. Nat Commun 2023; 14:4251. [PMID: 37460545 DOI: 10.1038/s41467-023-39953-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 07/05/2023] [Indexed: 07/20/2023] Open
Abstract
Fibroblasts have a considerable functional and molecular heterogeneity and can play various roles in the tumor microenvironment. Here we identify a pro-tumorigenic IL1R1+, IL-1-high-signaling subtype of fibroblasts, using multiple colorectal cancer (CRC) patient single cell sequencing datasets. This subtype of fibroblasts is linked to T cell and macrophage suppression and leads to increased cancer cell growth in 3D co-culture assays. Furthermore, both a fibroblast-specific IL1R1 knockout and IL-1 receptor antagonist Anakinra administration reduce tumor growth in vivo. This is accompanied by reduced intratumoral Th17 cell infiltration. Accordingly, CRC patients who present with IL1R1-expressing cancer-associated-fibroblasts (CAFs), also display elevated levels of immune exhaustion markers, as well as an increased Th17 score and an overall worse survival. Altogether, this study underlines the therapeutic value of targeting IL1R1-expressing CAFs in the context of CRC.
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Ectopic pregnancy with a contralateral corpus luteum: Case report. JBRA Assist Reprod 2023. [PMID: 36952625 DOI: 10.5935/1518-0557.20220050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
The following report describes the case of an ectopic pregnancy with contralateral corpus luteum after spontaneous conception. The patient was a 33- year-old female (gravida 3, segmentary C sections 3), with positive pregnancy test, and an Intrauterine Device (IUD). The patient was asymptomatic. At vaginal ultrasound, we observed an anteverted uterus of normal shape and size, a 20 x 12 mm intramural myoma and an irregular endometrial thickness of 16.5 mm, with no intrauterine sac. An ectopic pregnancy in the left Fallopian tube and a contralateral corpus luteum were detected, possibly as consequence of ovum pick up through the opposite tube (oocyte transmigration). Further laparoscopic and histopathologic studies confirmed our findings, and the ectopic pregnancy was successfully removed. In conclusion, oocyte transmigration is a common event and should be account when we wish to provide medical advice to patients with a single Fallopian tube trying to conceive. There are real chances for a patient to become pregnant even when only a single tube is present.
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[Early lung autopsy in deceased patients with acute respiratory distress syndrome due to infection by SARS-CoV-2]. Med Intensiva 2023; 47:173-175. [PMID: 35935246 PMCID: PMC9339975 DOI: 10.1016/j.medin.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 07/12/2022] [Indexed: 11/23/2022]
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Early lung autopsy in deceased patients with acute respiratory distress syndrome due to infection by SARS-CoV-2. Med Intensiva 2023; 47:173-175. [PMID: 36272904 PMCID: PMC9579894 DOI: 10.1016/j.medine.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Effect of autohydrolysis and ionosolv treatments on eucalyptus fractionation and recovered lignin properties †. RSC Adv 2023; 13:10338-10348. [PMID: 37020891 PMCID: PMC10068429 DOI: 10.1039/d2ra08013c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/20/2023] [Indexed: 04/05/2023] Open
Abstract
Wood fractionation is key for the integral valorization of its three main components. In this sense, recovering the hemicellulosic fraction after the ionosolv treatment of lignocellulosic materials is one of the main drawbacks of this process. Thus, the incorporation of a previous autohydrolyisis step to recover the hemicellulosic sugars before the ionosolv treatment is an interesting approach. The influence of both treatments, autohydrolysis and ionosolv, on the biomass fractions recovery yields was studied by a central composite design of experiments, varying the autohydrolysis temperature in a 175–195 °C range and ionosolv time between 1–5 h. Lignin recovery and cellulose purity were maximized at 184 °C and 3.5 h of autohydrolysis temperature and ionosolv time, respectively. In addition, lignin properties were incorporated to the statistical model, revealing lignin recondensation at severe conditions and a higher influence of the ionosolv treatment on lignin characteristics. These results remarked the importance of studying the effect of both treatments in the whole fractionation process and not each process separately and enhanced the understanding of the treatments combination in a complete fractionation biorefinery approach. This work enhances the understanding of the effect of autohydrolysis and ionosolv treatments combination on fractionation yields and lignin properties.![]()
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POS1199 IS PSORIATIC ARTHRITIS A RISK FACTOR FOR SEVERE COVID -19 INFECTION? DATA FROM THE ARGENTINIAN REGISTRY SAR-COVID. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundComorbidities, particularly cardio-metabolic disorders, are highly prevalent in patients with psoriatic arthritis (PsA) and they were associated with an increased risk of atherosclerotic cardiovascular disease, which have been associated with higher morbidity and mortality. Whether PsA enhances the risk of SARS-CoV-2 infection or affects the disease outcome remains to be ascertained.ObjectivesTo describe the sociodemographic, clinical and treatment characteristics of patients with PsA with confirmed SARS-CoV-2 infection from the SAR-COVID registry and to identify the variables associated with poor COVID-19 outcomes, comparing them with those with rheumatoid arthritis (RA).MethodsCross-sectional observational study including patients ≥18 years old, with diagnosis of PsA (CASPAR criteria) and RA (ACR / EULAR 2010 criteria), who had confirmed SARS-CoV-2 infection (RT-PCR or serology) from the SAR-COVID registry. Recruitment period was between August 13, 2020 and July 31, 2021. Sociodemographic variables, comorbidities, and treatments were analyzed. To assess the severity of the infection, the ordinal scale of the National Institute of Allergy and Infectious Diseases (NIAID)1 was used, and it was considered that a patient met the primary outcome, if they presented criteria of categories 5 or higher on the severity scale. For this analysis, Chi2 test, Fisher’s test, Student’s test or Wilcoxon test, and binomial logistic regression using NIAID>=5 as dependent variable were performed.ResultsA total of 129 PsA patients and 808 with RA were included. Clinical characteristics are shown in Table 1. Regarding PsA treatment, 12.4% of PsA were receiving IL-17 inhibitors, 5.4% IL12-23 inhibitors, one patient apremilast and one abatacept. The frequency of NIAID≥5 was comparable between groups (PsA 19.5% vs RA 20.1%; p=0.976). (Figure 1).Table 1.Characteristics of patients with PsA and RA who presented COVID-19 in the SAR-COVID registry.Psoriatic arthritis (n=129)Rheumatoid arthritis (n=808)P valueTotal (n=937)Age (years), mean (SD)51.7 (12.7)53.1 (12.9)0.23952.9 (12.9)Female72 (55.8)684 (84.7)<0.001756 (80.7)Comorbidities65 (50.4)355 (43.9)0.203420 (44.8) Obesity (BMI ≥30)19 (15.2)102 (13.4)0.692121 (13.7) Morbid obesity (BMI ≥40)1 (0.8)10 (1.3)111 (1.25) Hypertension35 (28.5)205 (26.8)0.783240 (27.0) Diabetes16 (13.0)67 (8.8)0.18883 (9.39) Dyslipidemia24 (19.5)102 (13.5)0.106126 (14.4) Cardiovascular or cerebrovascular disease5 (11.4)32 (3.9)0.03337 (4.2)Two or more comorbidities55 (42.6)219 (27.1)<0.001274 (29.2)Current smoking4 (3.6)60 (8.4)0.7964 (7.7)High disease activity0 (0)29 (3.8)0.02729 (3.23)Glucocorticoids treatment5 (20.0)95 (60.1)<0.001100 (54.6)Conventional DMARDs47 (36.4)443 (54.8)<0.001490 (52.3)Biologic DMARDs60 (46.5)193 (23.9)<0.001253 (27.0)JAK inhibitors4 (3.10)72 (8.9)0.03876 (8.1)Full recovery of COVID-19105 (84.0)644 (81.7)0.127749 (82.0)COVID-19 complications16 (12.5)68 (8.7)0.22784 (9.2)Death due to COVID-191 (0.8)34 (4.3)0.07435 (3.8)Notes=values n (%) unless otherwise indicated; BMI: Body Mass Index; DMARDs: disease-modifying antirheumatic drugs; JAK inhibitors: Janus kinase inhibitors.PsA patients with NIAID≥5 in comparison with NIAID<5 were older (58.6±11.4 vs 50±12.5; p=0.002), had more frequently hypertension (52.2% vs 23%; p=0.011) and dyslipidemia (39.1% vs 15%; p=0.017). In the multivariate analysis, age (OR 1.06; 95% CI 1.02–1.11) was associated with a worse outcome of the COVID-19 (NIAID≥5) in patients with PsA, while those who received methotrexate (OR 0.34; 95% CI 0.11–0.92) and biological DMARDs (OR 0.28; 95% CI 0.09–0.78) had a better outcome.ConclusionAlthough PsA patients have a higher frequency of cardiovascular and metabolic comorbidities than those with RA, the COVID-19 severity was similar. Most of the patients had mild SARS-CoV-2 infection and a low death rate.References[1]Beigel JH, et al. Remdesivir for the Treatment of Covid-19 - Final Report. N Engl J Med. 2020 Nov 5;383(19):1813-1826.Disclosure of InterestsNone declared
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POS1489-HPR ASSESSMENT OF TREATMENT ADHERENCE IN A COHORT OF RHEUMATOID ARTHRITIS PATIENTS TREATED WITH SUBCUTANEOUS ANTI-TNF WHO WERE EXPOSED TO A COMPREHENSIVE CARE MODEL. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundRheumatoid arthritis (RA) is an autoimmune, chronic, and inflammatory disease, which can be treated with effective medications, but requires a high level of adherence to treatment. Offering a comprehensive care model by a multidisciplinary team could increase the adherence levels of these patients and improves disease outcomes.ObjectivesCompare the level of adherence to treatment before and after the implementation of a comprehensive care model in a cohort of patients with RA, treated with subcutaneous anti-TNF, in a reference center in Bogotá-Colombia.MethodsAn analytical study was conducted before and after the implementation of a comprehensive care model on a cohort of patients over 18 years of age, diagnosed with RA, who have been prescribed management with a subcutaneous anti-TNF by their doctor during the last 12 months. Convenience sequential sampling was performed to reach a defined sample size of 130 patients to estimate a baseline versus final adherence difference of 20%, at an alpha value of 5% and a beta value of 20%. The comprehensive care model (CCM) consisted of the approach by a multidisciplinary team, offering a comprehensive care not fragmented, based on evidence (guidelines and protocols) and proposing a treatment by objectives (T2T). Adherence was measured using the CQR-19 scale, with a cut-off point ≥80.7 to consider an adherent patient.ResultsThe cohort consisted of 131 patients who were followed semiannually for 24 months, and who were incorporated into the CCM. 83.9% were women (n=110), in an age range between 30 and 84 years (Average: 62; DS: 9.9 years). 37.4% of patients were treated with etanercept (n=49), 29% with golimumab (n=38) and 33.6% with adalimumab (n=44). The median baseline of CQR-19 was 87.7 points (RIQ:84.2-91.2); while at month 24 it reached 91.2 points (RIQ: 87.7-94.7). The difference between the distributions was statistically significant (p<0.00). According to the cut-off point for CQR-19, the baseline percentage of adherent patients was 87.8% (n=115) and increased to a percentage of 96.2% at 24 months of follow-up (n=126). The difference between these two percentages of adherence was 8.39% (95% CI: 1.9-14.9%) (p: 0.012). The results of a generalized linear model binomial family, for the outcome of difference in proportions (PD) of basal and final adherence, are presented in Table 1. The estimator is adjusted for activity level (DAS28), disability level (HAQ) and anti-TNF. Golimumab appears to have an effect that increases adherence by 4.5% compared to adalimumab and etanercept, adjusting for the other predictors.Table 1.Model of the effect of MAI on adherence to treatment.Dependent variable: Adhesion according to cut-off point CQR-19(≥80.7). Proportion Difference (DP) EstimatorVariableDPCI 95%P-valueIntervention: MAI9,4%3,2-15,5%0,003Golimumab vs. Etanercept-Adalimumab4,5%0,5-8,5%0,024DAS28(-)0,85%(-)3.2% to 14.9%0,47HAQ0,00(-)0.03% to 0.045%0,85MLG-Binomial family. Identity function.ConclusionThe CCM, after a follow-up of 24 months in patients with RA in treatment with subcutaneous anti-TNF increases the percentage of adherence by 9.4%, adjusting for treatment, activity level and degree of disability. Golimumab appears to have an effect that increases adherence by 4.5% compared to adalimumab and etanercept, adjusting for the other predictors.Disclosure of InterestsWilberto Rivero: None declared, GUILLERMO SÁNCHEZ: None declared, Fernando Rodriguez: None declared, Laura Villarreal: None declared, Diana Buitrago-Garcia: None declared, CARLOS CASTRO: None declared, Pedro Santos-Moreno Speakers bureau: Pfizer, Janssen, Abbvie, Biopas-UCB, Bristol, Roche, Novartis, Lilly, Consultant of: Pfizer, Janssen, Abbvie, Biopas-UCB, Bristol, Roche, Novartis, Lilly, Grant/research support from: Pfizer, Janssen, Abbvie, Biopas-UCB, Bristol, Roche, Novartis, Lilly
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AB1101 PREVALENCE OF LONG COVID IN RHEUMATIC DISEASE PATIENTS: ANALYSIS OF SAR COVID REGISTRY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundPersistent symptoms after acute COVID have been described previously. Main symptoms reported are fatigue, arthralgias, myalgias and mental sickness. Definition and methods vary widely.1ObjectivesTo asses prevalence and related factors to long COVID in a retrospective cohort of patients with rheumatic diseases from Argentina.MethodsA total of 1915 patients were registered from August 18th, 2020 to July 29th, 2021. Patients > 18 years old, with rheumatic disease and confirmed infection by SARS-CoV-2 (antigen or RT-PCR) were included. Those dead, with unknown outcome, wrong date or missing data were excluded. Demographic data, comorbidities, rheumatic disease, and characteristics of SARS-CoV-2 infection were recorded.Long COVID was defined according to NICE guidelines (persistent symptoms for more than 4 weeks, without alternative diagnosis). Long COVID symptoms were defined by rheumatologist. Severity of infection was classified according to WHO ordinal scale.We used descriptive statistics, univariate model (Student’s test, chi square test, ANOVA) and multivariate logistic regression analysis.Results230 (12%) had long COVID. Median age was 51 (IQR 40-61]) years, 82% were females, 51% were not caucasian. Median of education was 13.3 years (IQR 12 – 16), 79 % had private health insurance and 55 % were employed. Nearly half (n=762, 46%) had comorbidities, the most prevalent was hypertension (n=396, 24%).The most frequent rheumatic diseases were rheumatoid arthritis (n=719, 42%) and systemic lupus erythematosus (n=280, 16 %). Most were in low activity/remission (79%), used Conventional DMARD (n=773 patients, 45%) and steroids (n=588, 34%) at low dose (n=415, 71%).Main laboratory findings were abnormal D-dimer (n=94, 28%) and leukopenia (n=93, 26%). Most patients had a WHO ordinal scale < 5 (n=1472, 86%). Median of hospitalization at intensive care unit (ICU) was 8 days [IQR 5, 13]. Treatment for SARS-CoV-2 infection (steroids, anticoagulation, azithromycin, convalescent plasma) was used in 461 (27%) patients.Most of long COVID (n= 152, 69%) reported 1 symptom, the most frequent was fatigue (n= 55, 22%). Figure 1.Univariate analysis is presented in Table 1. In multivariate logistic regression analysis non-caucasian ethnicity OR 1.44 (1.07-1.95), years of education OR 1.05 (1-1.09), treatment with cyclophosphamide OR 11.35 (1.56-112.97), symptoms of COVID – 19 OR 13.26 (2.75-242.08), severity scale WHO ≥ 5 OR 2.46 (1.68-3.57), and ICU hospitalization days OR 1.09 (1.05-1.14) were factors associated to long COVID.Table 1.Univariate analysis of long COVID syndrome in SAR – COVID registryVariableAcute COVID n=1486Long COVID n=221P valueAge, years, median [IQR]51 [40, 60]54 [42, 62]0.032Caucasian, n (%)744 (48)132 (53)0.227Female sex, n (%)1242 (80)215 (86)0.066Education, years, median [IQR]12 [10, 17]13 [12, 16]-Private health insurance, n (%)1161 (79)181 (82)0.325Smoking, n (%)381 (25)71 (29)0.224Comorbidities, n (%)650 (45)108 (52)0.066Dyslipidemia, n (%)173 (12)39 (19)0.008Hypertension, n (%)332 (23)60 (29)0.053Low activity/remission disease, n (%)1140 (80)179 (77)1Rheumatoid arthritis, n (%)623 (42)96 (42)1Systemic lupus erythematosus, n (%)243 (16)37 (16)0.996DMARD, n (%)664 (45)109 (47)0.486Cyclophosphamide, n (%)3 (0.2)3 (1)0.035Rituximab, n (%)19 (1)9 (34)0.008Lymphocyte66 (23)19 (30)0.011<1.500 / mm3, n (%)Ferritin > 2000 ng/ml, n (%)32 (11)16 (25)0.011ICU hospitalization, days,7 [4, 10]10 [8, 24]<0.001median [IQR]Treatment for COVID-19, n (%)394 (27)91 (41)<0.001ConclusionPrevalence of long COVID was 12%. Non-caucasian ethnicity, higher education, treatment with cyclophosphamide, symptoms of COVID – 19, severe disease and ICU hospitalization days were related to long COVID.References[1]Cabrera Martimbianco AL, Pacheco RL, Bagattini ÂM, Riera R. Frequency, signs and symptoms, and criteria adopted for long COVID-19: A systematic review. Int J Clin Pract.Disclosure of InterestsNone declared
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POS1491-HPR THE USEFULNESS OF THE PATIENT ACTIVITY SCORE-PASS-II TO ASSESS DISEASE ACTIVITY DURING THE COVID-19 LOCKDOWN IN PATIENTS WITH RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.5108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundMany measurement tools are designed to assess disease activity for Rheumatoid Arthritis (RA) patients. One of the most used tools is the Disease Activity Score- DAS28 which assesses the number of painful joints, erythrocyte sedimentation, and a patient’s global assessment. The assessment is performed by a clinician and requires laboratory exams. Unfortunately, from March to August 2019, Colombia had one of the strictest responses to the COVID-19 pandemic according to the COVID-19 stringency Index(1). One of the main restrictions was the preventive isolation of older populations, especially those with comorbidities. These restrictions challenged the rheumatology practice because face-to-face consultations were not possible. Due to the above, measurements like the PAS-II score should be used to assess disease activity during the pandemic.ObjectivesTo describe disease activity according to the Patient Activity Score- PAS-II score patients with RA and compare its results to the most recent DAS28 assessment before the COVID-19 pandemic.MethodsWe conducted a descriptive study; patients were followed during the COVID-19- lockdown in a video consultation. The PAS-II score was applied to assess disease activity as an alternative to the DAS28 assessment. The patients were part of an educational program, clinical charts were reviewed to collect the study variables. We collected demographic data and DAS28 before the pandemic started. We present a descriptive analysis of DAS28 severity and the results obtained by the PASS-II score.ResultsThe educational program enrolled 250 participants; 196 patients had complete data. 93% of participants were women, mean age was 64 years IQR (54-67). 43% of participants were married or had a civil union, 26% were single, 20% divorced, and 11% were widowed. Regarding educational level, 25% had finished elementary school and 39% high school; the remaining 36% had higher education. When we compared the last DAS28 assessed by a rheumatologist between January, and March 2019, 67% of patients were in remission, while in July 2019, the PASS-II score reported that 7% of patients were in remission and 75% had low or minimal activity. Figure 1- Table 1.Figure 1.Table 1.DISEASE ACTIVITIYDAS28PASS-IIRemission67%6%Low (Minimal)14%75%Moderate15%18.5%High/Severe4%0.5%ConclusionThe PASS score is a helpful tool to assess disease activity in patients with RA, especially in situations where the patient cannot see a rheumatologist in a face-to-face consultation; however, patients in severe disease activity should not delay the consultation with a clinician. As other studies have demonstrated, patient-reported outcome measures should be adopted in clinical practice as an alternative for treat- to- targe strategies(2). Further studies should be conducted to assess the impact of the pandemic in countries with high levels of restrictions in the course of RA.References[1]Hale T, Angrist N, Goldszmidt R, Kira B, Petherick A, Phillips T, et al. A global panel database of pandemic policies (Oxford COVID-19 Government Response Tracker). Nature Human Behaviour. 2021;5(4):529-38.[2]Salaffi F, Di Carlo M, Farah S, Marotto D, Atzeni F, Sarzi-Puttini P. Rheumatoid Arthritis disease activity assessment in routine care: performance of the most widely used composite disease activity indices and patient-reported outcome measures: Comparison of disease activity indices in RA. Acta Biomedica Atenei Parmensis. 2021;92(4):e2021238.AcknowledgementsThis project was funded by the Ministry of Science, Technology and Innovation MINCIENCIAS. Grant number: 695180763684Disclosure of InterestsFernando Rodriguez: None declared, Diana Buitrago-Garcia: None declared, GUILLERMO SÁNCHEZ: None declared, Pedro Santos-Moreno Speakers bureau: Pfizer, Janssen, Abbvie, Biopas-UCB, Bristol, Roche, Novartis, Lilly, Consultant of: Pfizer, Janssen, Abbvie, Biopas-UCB, Bristol, Roche, Novartis, Lilly, Grant/research support from: Pfizer, Janssen, Abbvie, Biopas-UCB, Bristol, Roche, Novartis, Lilly
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POS1459 THE IMPLEMENTATION OF AN EDUCATIONAL PROGRAM TO IMPROVE PHARMACOLOGICAL ADHERENCE IN PATIENTS WITH RHEUMATOID ARTHRITIS. RESULTS FROM A QUASI-EXPERIMENTAL STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundPharmacological therapy is the principal intervention in rheumatoid arthritis (RA) patients. Currently, adherence to DMARDs therapy is a challenge that needs to be addressed[1]. On the other hand, educational programs have shown an improvement in the health status of RA patients[2].ObjectivesThis study aimed to determine if a 12-month educational program developed for patients with RA can improve medication adherence.MethodsA quasi-experimental design was conducted. Patients who attend a specialized center in RA were invited to participate in an educational program. The program was called UNIVERSITAR: PATIENT UNIVERSITY. An interdisciplinary team provided educational workshops for the patients; we included coaching sessions and leisure activities such as yoga and art lessons to avoid a conventional classroom program and provide a dynamic program. A rheumatologist with experience in centers of excellence for RA led the team. Patients attended during a year. Follow-up was planned at 6 and 12 months after enrollment. Medication adherence was assessed using the self-reported 8-item Morisky Medication Adherence Scale (MMAS-8). Patients were considered adherent when they scored 8 points, moderately adherent with a score of 6 or 7, and non-adherent with less than 6 points. The Wilcoxon signed-rank test was used to evaluate differences in MMAS-8 scores between baseline and 16 and 12-months. We also assessed if there were changes in DAS 28 in the participants who improved the level of adherence.ResultsIn total, 252 patients were enrolled in the study, and 206 completed the follow-up at 6 and 12 months (82%). The median age was 60 years IQR (54-67), 94% were female. In our study, 54% of patients received conventional and 46% Biological therapy. The proportion of patients with high adherence at baseline was 11%, at 6-months was 17% and at 12-month was 19%. At the end of the follow-up, 49% of the participants moved from being non-adherent to a moderate or high adherence level. When we compared the MMAS scores at baseline and follow-up, they showed a significant improvement (P<0.05) Figures 1-2. The majority of participants (65%) were in remission at baseline, according to DAS28. Therefore, we found no differences between the level of adherence and DAS28.ConclusionOur educational program improved medication adherence among patients with RA. Educational interventions are helpful to sustain remission in patients with RA. Further studies focused only on patients with moderate and high disease activity are necessary to assess the impact on clinical outcomes.References[1]Monchablon C, Gondé H, Pouplin S, Varin R, Vittecoq O, Lequerré T. Assessment of adherence to disease-modifying anti-rheumatic drugs in rheumatoid arthritis. Clin Rheumatol. 2020;39(1):207-16.[2]Tan YK, Teo P, Saffari SE, Xin X, Chakraborty B, Ng CT, et al. A musculoskeletal ultrasound program as an intervention to improve disease modifying anti-rheumatic drugs adherence in rheumatoid arthritis: a randomized controlled trial. Scand J Rheumatol. 2022;51(1):1-9.AcknowledgementsThis project was funded by the Ministry of Science, Technology and Innovation MINCIENCIAS. Grant number: 695180763684Disclosure of InterestsPedro Santos-Moreno Speakers bureau: Pfizer, Janssen, Abbvie, Biopas-UCB, Bristol, Roche, Novartis, Lilly, Consultant of: Pfizer, Janssen, Abbvie, Biopas-UCB, Bristol, Roche, Novartis, Lilly, Grant/research support from: Pfizer, Janssen, Abbvie, Biopas-UCB, Bristol, Roche, Novartis, Lilly, Diana Buitrago-Garcia: None declared, Fernando Rodriguez: None declared, GUILLERMO SÁNCHEZ: None declared
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Organosolv and ionosolv processes for autohydrolyzed poplar fractionation: Lignin recovery and characterization. Int J Biol Macromol 2021; 197:131-140. [PMID: 34971638 DOI: 10.1016/j.ijbiomac.2021.12.079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/29/2021] [Accepted: 12/12/2021] [Indexed: 11/05/2022]
Abstract
Biomass fractionation plays a major role in the search for competitive biorefineries, where the isolation and recovery of the three woody fractions is key. In this sense, we have used autohydrolyzed hemicellulose-free poplar as feedstock to compare two fractionation processes, organosolv and ionosolv, oriented to lignin recovery. The recovered lignins were then characterize by different techniques (NMR, GPC, TGA). Both treatments were tested at different temperatures to analyze temperature influence on lignin recovery and properties. The highest lignin recovery was obtained with the ionosolv process at 135 °C, reaching a solid yield of ~70%. Lignin characterization showed differences between both treatments. Lignins enriched in C-O linkages and G units were recovered with the organosolv process, where increasing temperature led to highly depolymerized lignins. However, lignins with higher C-C linkages and S units contents were obtained with the ionosolv process, producing more thermically stable lignins. In addition, increasing temperature caused lignin repolymerization when employing ionic liquids as solvents. Therefore, this work outlines the most important differences between ionosolv and organosolv processes for biomass fractionation, focusing on lignin recovery and its properties, which is the first step in order to valorize all biomass fractions.
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Cellulose ionogels, a perspective of the last decade: A review. Carbohydr Polym 2021; 274:118663. [PMID: 34702482 DOI: 10.1016/j.carbpol.2021.118663] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/04/2021] [Accepted: 09/08/2021] [Indexed: 11/19/2022]
Abstract
Cellulose ionogels have been extensively studied due to the variability of their properties and applications. The capability of trapping an ionic liquid in a biodegradable solid matrix without losing its properties makes this type of material a promising substitute for fossil fuel-derived materials. The possibility to formulate ionogels chemically or physically, to choose between different ionic liquids, cellulose types, and the possibility to add a wide range of additives, make these ionogels an adaptable material that can be modified for each target application in many fields such as medicine, energy storage, electrochemistry, etc. The aim of this review is to show its versatility and to provide a summary picture of the advances in the field of cellulose ionogels formulation (chemical or physical methods), as well as their potential applications, so this review will serve as a stimulus for research on these materials in the future.
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Viral-like reaction or hypersensitivity? Erythema multiforme minor reaction and moderate eosinophilia after receiving Pfizer-BioNTech BNT162b2 (mRNA-based SARS-CoV-2 vaccine). J Investig Allergol Clin Immunol 2021; 32:77-78. [PMID: 34588156 DOI: 10.18176/jiaci.0757] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Der Protective-Mental-Work-Demands Questionnaire – Entwicklung eines Instruments zur Messung von mentalen Anforderungen am Arbeitsplatz, welche protektiv gegen Demenz und kognitiven Abbau im Alter wirken. DAS GESUNDHEITSWESEN 2021. [DOI: 10.1055/s-0041-1732003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Self-perceived problems in daily activities and strategy building in people without, with mild and severe dementia. DAS GESUNDHEITSWESEN 2021. [DOI: 10.1055/s-0041-1732184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Risk for disorientation: Longitudinal evidence from three old age cohorts in Germany (AgeDifferent.de platform). DAS GESUNDHEITSWESEN 2021. [DOI: 10.1055/s-0041-1732021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Multidisciplinary Approach to Explain the Association between Mental Demands at Work on Cognitive Functioning in Old Age. DAS GESUNDHEITSWESEN 2021. [DOI: 10.1055/s-0041-1732022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Association of social deprivation with cognitive status and decline in older adults. DAS GESUNDHEITSWESEN 2021. [DOI: 10.1055/s-0041-1732130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Learning to implement Smart Healthy Age-Friendly Environments. TRANSLATIONAL MEDICINE AT UNISA 2021; 23:1-5. [PMID: 34447703 PMCID: PMC8370529 DOI: 10.37825/2239-9747.1021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
To develop trainings on the implementation of smart healthy age-friendly environments for people who aim to support, for example, their parents, their neighbours or local community, there are precautionary measures that have to be taken into account: the role of the facilitator (volunteer or self-employed), the level of skills, the needs of the end-users, training content and methodologies together with the sustainability of the learning. This article examines these aspects, based on desk research and expert interviews in the Smart Healthy Age-Friendly Environments (SHAFE) fields.
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Prognostic Factors in De Novo Metastatic Renal Cell Carcinoma: A Report From the Latin American Renal Cancer Group. JCO Glob Oncol 2021; 7:671-685. [PMID: 33974442 PMCID: PMC8162501 DOI: 10.1200/go.20.00621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To assess the effect of clinical and pathological variables on cancer-specific and overall survival (OS) in de novo metastatic patients from a collaborative of primarily Latin American countries. PATIENTS AND METHODS Of 4,060 patients with renal cell carcinoma diagnosed between 1990 and 2015, a total of 530 (14.5%) had metastasis at clinical presentation. Relationships between clinical and pathological parameters and treatment-related outcomes were analyzed by Cox regression and the log-rank method. RESULTS Of 530 patients, 184 (90.6%) had died of renal cell carcinoma. The median OS of the entire cohort was 24 months. American Society of Anesthesiology classification 3-4 (hazard ratio [HR]: 1.64), perirenal fat invasion (HR: 2.02), and ≥ 2 metastatic organ sites (HR: 2.19) were independent prognostic factors for 5-year OS in multivariable analyses. We created a risk group stratification with these variables: no adverse risk factors (favorable group), median OS not reached; one adverse factor (intermediate group), median OS 33 months (HR: 2.04); and two or three adverse factors (poor risk group), median OS 14 months (HR: 3.58). CONCLUSION Our study defines novel prognostic factors that are relevant to a Latin American cohort. With external validation, these easily discerned clinical variables can be used to offer prognostic information across low- and middle-income countries.
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Treating Opioid Use Disorder in Puerto Rico During the COVID-19 Pandemic: Providers' Leadership Efforts in Unprecedented Times. J Addict Med 2021; 15:276-279. [PMID: 33229933 PMCID: PMC8327765 DOI: 10.1097/adm.0000000000000764] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/26/2020] [Indexed: 11/25/2022]
Abstract
Opioid use disorder (OUD) is an unprecedented medical and public health issue both in Puerto Rico (PR) and the greater US with an increase incidence of opioid use every year. Unprecedented and compounded emergencies in PR such as those caused by hurricanes, earthquakes, and the COVID-19 pandemic coupled with limited national and local governmental support, has forced most clinics in PR to take action to be able to continue providing care. This commentary summarizes the leadership and clinical initiatives of 3 community organizations in PR to maintain services for people with OUD during the COVID-19 pandemic. Local legislation that supported the continuity of OUD care is summarized, along with unique experiences specific to each organization. In addition, the vulnerability of economically disadvantaged people or experiencing homelessness as well as those affected by these compounded events in PR is discussed, with an emphasis on how some challenges were addressed and future directions for continuity of care as our country adjusts to new demands caused by the COVID-19 pandemic.
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SARS-CoV-2 detection and sequencing in heart tissue associated with myocarditis and persistent arrhythmia: A case report. IDCases 2021; 25:e01187. [PMID: 34136351 PMCID: PMC8192838 DOI: 10.1016/j.idcr.2021.e01187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 06/10/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND SARS-CoV-2 uses the human cell receptor angiotensin-converting enzyme (ACE2). ACE2 is widely present in the cardiovascular system including the myocardium and the conduction system. COVID-19 patients that present severe symptoms have been reported to have complications involving myocardial injuries caused by the virus. Here we report the detection of SARS-CoV-2 by whole genome sequencing in the endocardium of a patient with severe bradycardia. CASE PRESENTATION We report a case of a 34-year-old male patient with COVID-19 tested by PCR, he started with gastrointestinal symptoms, however, he quickly deteriorated his hemodynamic state by means of myocarditis and bradycardia. After performing an endocardium biopsy, it was possible to identify the presence of SARS-CoV-2 in the heart tissue and to sequence its whole genome using the ARTIC-Network protocol and a modified tissue RNA extraction method. The patient's outcome was improved after a permanent pacemaker was implanted. CONCLUSIONS It was possible to identify a SARS-CoV-2 clade 20A in the endocardium of the reported patient.
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Re: Vascular control by infrarenal aortic cross-clamping in placenta accreta spectrum disorders: description of technique. BJOG 2021; 128:1101-1102. [PMID: 33624926 DOI: 10.1111/1471-0528.16656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2020] [Indexed: 01/25/2023]
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Statin Prescription Rates, Adherence, and Associated Clinical Outcomes Among Women With PAD and ICVD. J Vasc Surg 2020. [DOI: 10.1016/j.jvs.2020.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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A biorefinery strategy for the manufacture and characterization of oligosaccharides and antioxidants from poplar hemicelluloses. FOOD AND BIOPRODUCTS PROCESSING 2020. [DOI: 10.1016/j.fbp.2020.07.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Effect of functionalized silica nanoparticles on the mass transfer process in active PLA nanocomposite films obtained by supercritical impregnation for sustainable food packaging. J Supercrit Fluids 2020. [DOI: 10.1016/j.supflu.2020.104844] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Abstract
In the present work, the thermal degradation kinetics of a phenolic (PF) and lignin particle-reinforced phenolic (LRPF) foam and the lignin used as the reinforcement (LR) were studied. The activation energies of the degradation processes were obtained using a discrete distributed activation energy model (discrete DAEM) and the Vyazovkin model-free kinetic (MFK) method. The discrete DAEM was validated by comparing the predicted values with the data obtained at 8 °C min−1. Heating ramps of 6 and 12 °C min−1 were used to calculate the kinetic parameters through the model. The effect of the reinforcement on the kinetics of the LRPF was studied by comparison with the results obtained for the PF. For reactions with non-zero mass fractions, the activation energies of the PF were in the range between 79.9 and 177.6 kJ mol−1, and the activation energy for the LRPF ranged from 91 to 187 kJ mol−1. For the LR, the activation energy values were in a narrower range than for the foams: 150–187 kJ mol−1. The degradation process of the LRPF was modified due to the use of LR: the range of activation energy for LRPF was between the ranges for the PF and LR. The activation energy dependence on conversion was also calculated using the Vyazovkin method and compared with the DAEM results; no compensation effect for the kinetic parameters was found.
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AB1305-HPR IS BETTER AND SAFER TOFACITINIB AS A FIRST LINE OF TREATMENT IN PATIENTS WITH RHEUMATOID ARTHRITIS? – A COHORT STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Tofacitinib is the first oral Janus Kinasa inhibitor approved for the treatment of rheumatoid arthritis (RA); and although it is approved both after conventional treatment and after biological therapy, it is not well known its real-life effectiveness in both cases and if it is preferable to use it after cDMARDs or biologics.Objectives:We compare the effectiveness and safety of Tofacitinib in patients with RA analyzing if better and safer Tofacitinib after cDMARDs or biologics.Methods:A retrospective analysis of a real-world cohort of patients with RA, who were treated with Tofacitinib in last 3 years, as first line of treatment (T1) after failure with cDMARDS and second line of treatment after biologic drug failure (T2). The therapy was considered effective with the change from moderate-high disease activity to low disease activity or remission measured by DAS28, in those who met criteria of high adherence, without change or addition of other conventional DMARDs, without new dose or increase of dose of oral glucocorticoids. A logistic model of regression was performed to evaluate de differences between T1 and T2, using as covariates sex, age, comorbidities, time of disease evolution, adverse events and other causes of discontinuation. Medication survival time and the main causes of suspension were measured. Mixed model regression and least-squared means were used to estimate the baseline changes and a Kaplan-Meyer survival analysis to estimate time to remission and drug survival.Results:105 patients with RA were included (median age: 56.1 ± 11.7 years; 80.9% female, median disease duration 11.48 ± 10.1 years); 43% (45/105) of patients with positive rheumatoid factor and 73% (77/105) positive anti-citrulline antibodies. Regarding treatment 51% (54/105) used Tofacitinib as 1T, after failure to cDMARDs; on the other hand, Tofacitinib was used as 2T, after failure to biologics in 49% (51/105) of patients. DAS28 levels were reduced at 8, 16 and 24 weeks with statistical difference (p value 0.004, <0.0001, and <0.001, respectively). HAQ-DI also reported reduction but without statistical difference. The use of Tofacitinib was more effective after failure to cDMARDs (p value 0.014) and patients with more than 3 years of disease (p value 0.04), a statistically better response. Also, corticoids use, positive RF, extended release tablet of tofacitinib reported better changes of DAS28 but without statistical significance. Patients with high disease activity treated with Tofacitinib 1T decreased from 30% at baseline to 19% at the last follow-up; patients in 2T way were in moderate activity of the disease in 57% at baseline and went to 37% in the last follow-up. There was an increase in patients who achieved remission in both groups, but higher in 1T where they went from 9% to 41%, while in 2T they went from 22% to 33% (p < 0.05). The survival rate of the medication was 1.7 years in 1T and 2.1 in 2T; in terms of time to remission, the use of Tofacitinib monotherapy presented statistical difference (p value <0.001). The main cause of suspension of treatment was therapeutic failure 12% (13/105), 9% in 1T (5/54) and 16% (8/51) in 2T (p <0.005). 6% of patients (6/105) presented suspension due to the occurrence of adverse events, 4% (2/54) in 1T and 8% (4/51) in 2T (p <0.005).Conclusion:In patients with RA, the use of Tofacitinib as the first line of treatment (after failure to cDMARDs) is better in effectiveness and safer in comparison with its use as a second line of treatment (after biologics), with significant differences in the rates of therapeutic failure and occurrence of adverse events/reactions. On the other hand, concomitant corticoids use, positive RF, extended release tablet of Tofacitinib seem to increase the effectiveness of Tofacitinib in terms of DAS28 and HAQ-DI.Disclosure of Interests:Omaira Valencia: None declared, Michael Cabrera: None declared, Fernando Rodriguez: None declared, Pedro Santos-Moreno Grant/research support from: I have received research grants from Abbvie, Biopas-UCB, Janssen, Novartis, Pfizer., Speakers bureau: I have been a speaker for Abbvie, Biopas-UCB, Janssen, Lilly, Novartis, Pfizer, Roche, Sanofi.
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AB1296-HPR PREVALENCE OF COMORBIDITIES IN A COHORT OF PATIENTS IN AN EDUCATIONAL MULTIDISCIPLINARY PROGRAM. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Rheumatoid arthritis (RA) is a chronic inflammatory and complex disease. Patients with RA face other diseases that might lead to increase morbidity. In patients with RA it has been stablished a high prevalence of comorbidities and their risk factors (1).Objectives:The aim of this study was to evaluate the prevalence of comorbidities in Colombian patients with RA enrolled in an educational multidisciplinary program and possible correlation with disease activityMethods:We performed a cross-sectional study; we included patients with confirmed diagnosis of rheumatoid arthritis in a specialized RA center. We collected sociodemographic data, and markers of disease activity DAS28. We collected data regarding the history of comorbidities such as hypertension, dyslipidemia, osteoporosis, type 2 diabetes mellitus, hypothyroidism, malignancies, among others. We performed a descriptive analysis, variables with a normal distribution were described using mean and standard deviation (SD), and non- normal distributed variables were described using median and interquartile range. Categorical variables were presented as rates. We evaluated the relationship between disease activity and comorbidities.Results:We included 251 patients; mean age was 59 ± 9.8 years old, with a high proportion of women 93%; median disease duration was 15 years RIQ (8-20); in this study, 145 (65%) of patients were in remission; 35 (11%) had low, 44 (20%) moderate and 10 (4%) high disease activity. Regarding pharmacological therapy, 55% were receiving conventional DMARDs. The prevalence of comorbidities was 85%, the most common were high blood pressure 25% followed by hypothyroidism 12% and diabetes 10%, 0.7% of patients had malignancies such as thyroid cancer or breast cancer, 1.29% of patients had renal comorbidities. Among comorbidities related to RA 30% had osteoporosis and 20% arthrosis. We did not find a statistical association between DAS28 and comorbidities.Conclusion:As other studies have shown, there is a high prevalence of comorbidities among RA patients, mainly high blood pressure. Due to the above, it is relevant to evaluate the risks factors of patients with RA, especially cardiovascular risks. We consider that a multidisciplinary program represents an opportunity not only to educate patients about healthy life styles and the management of RA, but also other diseases in order to increase the empowering of the health status in these poly pathological patients(2).References:[1]Gullick NJ, Scott DL. Co-morbidities in established rheumatoid arthritis. Best practice & research Clinical rheumatology. 2011;25(4):469-83.[2]Galarza-Delgado DA, Azpiri-Lopez JR, Colunga-Pedraza IJ, Cardenas-de la Garza JA, Vera-Pineda R, Wah-Suarez M, et al. Prevalence of comorbidities in Mexican mestizo patients with rheumatoid arthritis. Rheumatology international. 2017;37(9):1507-11.Acknowledgments:This project has been funded by a collaboration between the Ministry of Science, Technology and Innovation COLCIENCIAS (contract 746-2018), the Fundación Universitaria de Ciencias de la Salud and Biomab - Center for Rheumatoid ArthrtitisDisclosure of Interests:Michael Cabrera: None declared, Fernando Rodriguez: None declared, Diana Buitrago-Garcia: None declared, GUILLERMO SÁNCHEZ: None declared, Pedro Santos-Moreno Grant/research support from: I have received research grants from Abbvie, Biopas-UCB, Janssen, Novartis, Pfizer., Speakers bureau: I have been a speaker for Abbvie, Biopas-UCB, Janssen, Lilly, Novartis, Pfizer, Roche, Sanofi.
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AB1279-HPR A DESCRIPTIVE STUDY RELATED TO THE ADHERENCE BEFORE AND AFTER ENROLLING IN A MULTIDISCIPLINARY EDUCATIONAL PROGRAM. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Rheumatoid arthritis (RA) is an inflammatory, chronic disease. It leads to deformity and destruction of joints through the erosion of cartilage and bone. Patients with RA report to suffer symptoms in hands, joints, swelling, loss of motion, muscle weakness among others.(1).Centers of excellence in RA have proposed a multidisciplinary model of care with an initial diagnosis, treatment prescription and follow-up with a rheumatologist, periodic consultations with a physiatrist, psychologist, physiotherapist, occupational therapy, nutrition and a patient focused program(2). With this model of care, the patient is seen as a whole, and the expectation is to achieve the best results in the management of RA. However, if the patient does adhere the model becomes ineffective.Objectives:The aim of this to report the attendance to a multidisciplinary model of care for patients with RA that attend to a specialized center in Colombia, before and after enrolling in a educational program.Methods:We performed a descriptive study. Patients enrolled our educational program in July 2019. In our institution patients are followed-up under T2T standards and a multidisciplinary approach, as part of our model of care they have periodic consultations with a rheumatology, physiatrist, psychologist, physiotherapist, occupational therapy and nutrition. We collected sociodemographic data, DAS28, and compare the attendance to each specialty at the beginning and at 6-month follow-up. Descriptive epidemiology was done, we calculated means, and standard deviations for continuous variables and categorical variables were presented as rates. We compared disease activity and adherence at the beginning of the program and after six months of attendance.Results:We included 229 patients; mean age was 59 years ±10; 93% were female. At the beginning of our program, mean DAS28 was 2.57 ± 1.19, from all patients 65% were at remission, 11% at low disease activity 19% at moderate disease activity and, 5% at severe disease activity. Regarding adherence to our model, the medical specialty with the highest attendance was rheumatology (30%) followed by, physical therapy (16%) physiatrist consultation (15%) psychology (13%) and, occupational therapy (11%); the specialty with the lowest attendance was nutrition (8%). After six months of attendance to the educational program, we found an increasing number of patients in remission 67%, low disease activity 15%, moderate disease activity 18%, we did not have patients with severe DA28. Regarding the medical specialties, we found a 3% rise in the attendance to the nutrition consultation and psychology consultation. We did not find statistical association between disease activity and adherence to the model.Conclusion:These results are a clear example of how an educational program is capable of increasing awareness and improving the clinical outcomes and adherence to a multidisciplinary model for approaching RA. As other studies have shown(3), patient education interventions improve adherence to medication and to attendance to health care specialists.References:[1]Santos-Moreno P, Castaneda O, Garro B, Flores D, Sanchez G, Castro C. From the model of integral attention to the creation of centers of excellence in rheumatoid arthritis. Clinical rheumatology. 2015;34 Suppl 1:S71-7.[2]Taibanguay N, Chaiamnuay S, Asavatanabodee P, Narongroeknawin P. Effect of patient education on medication adherence of patients with rheumatoid arthritis: a randomized controlled trial. Patient preference and adherence. 2019;13:119-29.Acknowledgments:This project has been funded by a collaboration between the Ministry of Science, Technology and Innovation COLCIENCIAS (contract 746-2018), the Fundación Universitaria de Ciencias de la Salud and Biomab - Center for Rheumatoid ArthritisDisclosure of Interests:Diana Buitrago-Garcia: None declared, Fernando Rodriguez: None declared, GUILLERMO SÁNCHEZ: None declared, Pedro Santos-Moreno Grant/research support from: I have received research grants from Abbvie, Biopas-UCB, Janssen, Novartis, Pfizer., Speakers bureau: I have been a speaker for Abbvie, Biopas-UCB, Janssen, Lilly, Novartis, Pfizer, Roche, Sanofi.
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AB1340-HPR PATIENTS’ OUT-OF-POCKET EXPENSES ANALYSIS IN PATIENTS WITH RHEUMATOID ARTHRITIS ENROLLED IN A EDUCATIONAL PROGRAM. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:The increasing health and economic burdens of deaths and disabilities from non-communicable diseases (NCDs) are emerging as major concerns worldwide, particularly for low- and middle-income countries (LMICs)(1). Rheumatoid arthritis (RA) NCD is considered as one of the most common causes of disability. RA affects from 0.5% to 1% of the worldwide population. Little is known about the out-of-pocket (OOP) expenditures for prescription of pharmacological treatment for patients with RA, including drugs, diagnostic tests, mobility aids among others.Objectives:To describe the out of pocket costs in patients with rheumatoid arthritisMethods:We performed a cross-sectional study among patients who are participating in an educational program in a specialized center for RA. We collected sociodemographic variables; in addition, we collected data related to the expenditures in drugs, diagnostic tests and mobility aids that were not covered by the health system. Descriptive epidemiology was done, we calculated means, and standard deviations for continuous variables and categorical variables were presented as rates. The costs are presented in the US dollars with the average exchange rate for 2019Results:We included 181 patients, 92% were female. Mean age was 59 years ±9.5. Regarding occupation, 24% were employees, 40% were economically inactive, and 36% were pensioners. Most of patients 45% had a low income, 43 % middle income and only 12% high income according to the Colombian socioeconomic classification. Most of out of pocket expenses (47%) were associated to the acquisition of medical devices such as reading glasses or orthopedic braces. Secondly, the OOP expenses were related to medications (38%) such as antibiotics prednisone or pain control medications. Finally, 25% of patients reported that they had pay for their diagnostic tests such as x rays or laboratory tests. When assessed the costs patients expended between 30-100 USD purchasing aid devices, medications or laboratory tests.Conclusion:In the Colombian context OPP are relevant and represent an important expenditure for patients with RA especially for those who have low or middle income. Due to the above, it is important to find alternatives in order to help vulnerable segments of the population. Additionally, OPP needed to be taken into account due to its association with treatment adherence(2).References:Datta BK, Husain MJ, Fatehin S. The crowding out effect of out-of-pocket medication expenses of two major non-communicable diseases in Pakistan. International health. 2020;12(1):50-9.Acknowledgments:This project has been funded by a collaboration between the Ministry of Science, Technology and Innovation COLCIENCIAS (contract 746-2018), the Fundación Universitaria de Ciencias de la Salud and Biomab - Center for Rheumatoid ArthritisDisclosure of Interests:Diana Buitrago-Garcia: None declared, Fernando Rodriguez: None declared, GUILLERMO SÁNCHEZ: None declared, Pedro Santos-Moreno Grant/research support from: I have received research grants from Abbvie, Biopas-UCB, Janssen, Novartis, Pfizer., Speakers bureau: I have been a speaker for Abbvie, Biopas-UCB, Janssen, Lilly, Novartis, Pfizer, Roche, Sanofi.
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Influence of graphene‐based compounds on the mechanical toughness and thermal stability of polypropylene. J Appl Polym Sci 2020. [DOI: 10.1002/app.48258] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Increased aridity drives post-fire recovery of Mediterranean forests towards open shrublands. THE NEW PHYTOLOGIST 2020; 225:1500-1515. [PMID: 31605639 PMCID: PMC7004039 DOI: 10.1111/nph.16252] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 10/03/2019] [Indexed: 05/17/2023]
Abstract
Recent observations suggest that repeated fires could drive Mediterranean forests to shrublands, hosting flammable vegetation that regrows quickly after fire. This feedback supposedly favours shrubland persistence and may be strengthened in the future by predicted increased aridity. An assessment was made of how fires and aridity in combination modulated the dynamics of Mediterranean ecosystems and whether the feedback could be strong enough to maintain shrubland as an alternative stable state to forest. A model was developed for vegetation dynamics, including stochastic fires and different plant fire-responses. Parameters were calibrated using observational data from a period up to 100 yr ago, from 77 sites with and without fires in Southeast Spain and Southern France. The forest state was resilient to the separate impact of fires and increased aridity. However, water stress could convert forests into open shrublands by hampering post-fire recovery, with a possible tipping point at intermediate aridity. Projected increases in aridity may reduce the resilience of Mediterranean forests against fires and drive post-fire ecosystem dynamics toward open shrubland. The main effect of increased aridity is the limitation of post-fire recovery. Including plant fire-responses is thus fundamental when modelling the fate of Mediterranean-type vegetation under climate-change scenarios.
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Respiratory viral infection in lung transplantation induces exosomes that trigger chronic rejection. J Heart Lung Transplant 2020; 39:379-388. [PMID: 32033844 PMCID: PMC7102671 DOI: 10.1016/j.healun.2019.12.009] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 11/25/2019] [Accepted: 12/29/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Respiratory viral infections can increase the risk of chronic lung allograft dysfunction after lung transplantation, but the mechanisms are unknown. In this study, we determined whether symptomatic respiratory viral infections after lung transplantation induce circulating exosomes that contain lung-associated self-antigens and assessed whether these exosomes activate immune responses to self-antigens. METHODS Serum samples were collected from lung transplant recipients with symptomatic lower- and upper-tract respiratory viral infections and from non-symptomatic stable recipients. Exosomes were isolated via ultracentrifugation; purity was determined using sucrose cushion; and presence of lung self-antigens, 20S proteasome, and viral antigens for rhinovirus, coronavirus, and respiratory syncytial virus were determined using immunoblot. Mice were immunized with circulating exosomes from each group and resulting differential immune responses and lung histology were analyzed. RESULTS Exosomes containing self-antigens, 20S proteasome, and viral antigens were detected at significantly higher levels (p < 0.05) in serum of recipients with symptomatic respiratory viral infections (n = 35) as compared with stable controls (n = 32). Mice immunized with exosomes from recipients with respiratory viral infections developed immune responses to self-antigens, fibrosis, small airway occlusion, and significant cellular infiltration; mice immunized with exosomes from controls did not (p < 0.05). CONCLUSIONS Circulating exosomes isolated from lung transplant recipients diagnosed with respiratory viral infections contained lung self-antigens, viral antigens, and 20S proteasome and elicited immune responses to lung self-antigens that resulted in development of chronic lung allograft dysfunction in immunized mice.
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Predictors of Survival Outcomes in Non-Metastatic Renal Cell Carcinoma in Latin America and Spain: A Multicentric Analysis. KIDNEY CANCER 2019. [DOI: 10.3233/kca-190068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Oviductal Proteins Effect in Rooster Spermatic Cryopreservation. CRYO LETTERS 2019; 40:352-356. [PMID: 33966062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Cryopreservation induces spermatic cryo capacitation, which can decrease thawed sperm fertilizing capability. OBJECTIVE To evaluate the effect of uterus-vaginal union protein factors to inhibit sperm cryo capacitation and maintain viability and fertilizing capability of rooster spermatozoa. MATERIALS AND METHODS Rooster spermatozoa was cryopreserved using Lake extender supplemented with different hen's uterus-vaginal junction protein concentrations, to determine spermatic viability, sperm physiological condition and fertilizing capability in vivo. RESULTS It was possible to induce spermatic decapacitation in vitro, inhibiting cryo capacitation and allowing fertility results comparable to those obtained with fresh semen. CONCLUSION Uterus-vaginal protein extracts induce spermatic decapacitation in vitro.
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3D Strain in 2D Materials: To What Extent is Monolayer Graphene Graphite? PHYSICAL REVIEW LETTERS 2019; 123:135501. [PMID: 31697529 DOI: 10.1103/physrevlett.123.135501] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 05/28/2019] [Indexed: 06/10/2023]
Abstract
This work addresses a fundamental question: To what extent is graphene graphite? In particular does 2D graphene have many of the same 3D mechanical properties as graphite, such as the bulk modulus and elastic constant c_{33}? We have obtained, for the first time, unambiguous Raman spectra from unsupported monolayer graphene under pressure. We have used these data to quantify the out-of-plane stiffness of monolayer graphene, which is hard to define due to its 2D nature. Our data indicate a first physically meaningful out-of-plane stiffness of monolayer graphene, and find it to be consistent with that of graphite. We also report a shift rate of the in-plane phonon frequency of unsupported monolayer graphene to be 5.4 cm^{-1} GPa^{-1}, very close to that of graphite (4.7 cm^{-1} GPa^{-1}), contrary to the previous value for supported graphene. Our results imply that monolayer graphene has similar in-plane and out-of-plane stiffnesses, and anharmonicities to graphite.
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Ciguatera-Causing Dinoflagellate Gambierdiscus spp. (Dinophyceae) in a Subtropical Region of North Atlantic Ocean (Canary Islands): Morphological Characterization and Biogeography. Toxins (Basel) 2019; 11:toxins11070423. [PMID: 31331083 PMCID: PMC6669716 DOI: 10.3390/toxins11070423] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 07/16/2019] [Accepted: 07/17/2019] [Indexed: 12/04/2022] Open
Abstract
Dinoflagellates belonging to the genus Gambierdiscus produce ciguatoxins (CTXs), which are metabolized in fish to more toxic forms and subsequently cause ciguatera fish poisoning (CFP) in humans. Five species of Gambierdiscus have been described from the Canary Islands, where CTXs in fish have been reported since 2004. Here we present new data on the distribution of Gambierdiscus species in the Canary archipelago and specifically from two islands, La Palma and La Gomera, where the genus had not been previously reported. Gambierdiscus spp. concentrations were low, with maxima of 88 and 29 cells·g−1 wet weight in samples from La Gomera and La Palma, respectively. Molecular analysis (LSUrRNA gene sequences) revealed differences in the species distribution between the two islands: only G. excentricus was detected at La Palma whereas four species, G. australes, G. caribaeus, G. carolinianus, and G. excentricus, were identified from La Gomera. Morphometric analyses of cultured cells of the five Canary Islands species and of field specimens from La Gomera included cell size and a characterization of three thecal arrangement traits: (1) the shape of the 2′ plate, (2) the position of Po in the anterior suture of the 2′ plate, and (3) the length–width relationship of the 2″″ plate. Despite the wide morphological variability within the culture and field samples, the use of two or more variables allowed the discrimination of two species in the La Gomera samples: G. cf. excentricus and G. cf. silvae. A comparison of the molecular data with the morphologically based classification demonstrated important coincidences, such as the dominance of G. excentricus, but also differences in the species composition of Gambierdiscus, as G. caribaeus was detected in the study area only by using molecular methods.
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Viscoelastic properties of physical cellulosic bionogels of cholinium lysinate. Int J Biol Macromol 2019; 133:262-269. [DOI: 10.1016/j.ijbiomac.2019.04.057] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 04/08/2019] [Accepted: 04/09/2019] [Indexed: 10/27/2022]
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VALIDITY OF INSTRUMENTS MEASURING COGNITIVE FUNCTIONING IN OLDER ADULT HISPANICS: A SYSTEMATIC REVIEW. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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HEALTH AND SOCIAL PREDICTORS OF FRAILTY ONSET IN A U.S. NATIONAL SAMPLE. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.3086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Cognitive Functioning I. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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EXPOSURE-DEPENDENT IMPACT OF SPECIFIC MENTAL WORK DEMANDS ON COGNITIVE FUNCTIONING IN OLD AGE. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Technology. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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