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Pauta M, Campos B, Segura-Puimedon M, Arca G, Nadal A, Tubau A, Perez SP, Marimon E, Martín L, López-Quesada E, Sabrià J, Muñoz B, Garcia E, Paz Y Miño F, Borobio V, Gomez O, Eixarch E, Lopez M, Comas Rovira M, Borrell A. Next-Generation Sequencing Gene Panels and "Solo" Clinical Exome Sequencing Applied in Structurally Abnormal Fetuses. Fetal Diagn Ther 2021; 48:746-756. [PMID: 34775388 DOI: 10.1159/000519701] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 05/25/2021] [Accepted: 08/16/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of the study was to assess the diagnostic yield of 2 different next-generation sequencing (NGS) approaches: gene panel and "solo" clinical exome sequencing (solo-CES), in fetuses with structural anomalies and normal chromosomal microarray analysis (CMA), in the absence of a known familial mutation. METHODOLOGY Gene panels encompassing from 2 to 140 genes, were applied mainly in persistent nuchal fold/fetal hydrops and in large hyperechogenic kidneys. Solo-CES, which entails sequencing the fetus alone and only interpreting the Online Mendelian Inheritance in Man genes, was performed in multisystem or recurrent structural anomalies. RESULTS During the study period (2015-2020), 153 NGS studies were performed in 148 structurally abnormal fetuses with a normal CMA. The overall diagnostic yield accounted for 35% (53/153) of samples and 36% (53/148) of the fetuses. Diagnostic yield with the gene panels was 31% (15/49), similar to 37% (38/104) in solo-CES. CONCLUSIONS A monogenic disease was established as the underlying cause in 35% of selected fetal structural anomalies by gene panels and solo-CES.
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Affiliation(s)
- Montse Pauta
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), BCNatal, Barcelona, Spain,
| | - Berta Campos
- qGenomics. Esplugues de Llobregat, Catalonia, Spain
| | | | - Gemma Arca
- DepartmentofNeonatology, BCNatal, Hospital Clinic Barcelona, Barcelona, Spain
| | - Alfons Nadal
- Department of Pathology, Hospital Clínic Barcelona, Barcelona, Spain
| | - Albert Tubau
- Department of Obstetrics and Gynecology, Son Llàtzer Hospital, Palma de Mallorca, Spain
| | - Silvia Pina Perez
- Department of Obstetrics and Gynecology, Parc Taulí Hospital, Sabadell, Catalonia, Spain
| | - Edda Marimon
- Department of Obstetrics and Gynecology, Hospital Sant Joan de Déu, BCNatal, Esplugues de Llobregat, Catalonia, Spain
| | - Lourdes Martín
- Department of Obstetrics and Gynecology, Hospital Joan XXIII de Tarragona, Catalonia, Spain
| | - Eva López-Quesada
- Department of Obstetrics and Gynecology, Hospital Mútua de Terrassa, Terrassa, Spain
| | - Joan Sabrià
- Department of Obstetrics and Gynecology, Hospital Sant Joan de Déu, BCNatal, Esplugues de Llobregat, Catalonia, Spain
| | - Begoña Muñoz
- Department of Obstetrics and Gynecology, Hospital Sant Joan de Reus, Reus, Spain
| | - Esperanza Garcia
- Department of Obstetrics and Gynecology, Hospital Consorci Sanitari de Terrassa, Terrassa, Spain
| | - Fernanda Paz Y Miño
- Department of Obstetrics and Gynecology, BCNatal, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Virginia Borobio
- Department of Obstetrics and Gynecology, BCNatal, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Olga Gomez
- Department of Obstetrics and Gynecology, BCNatal, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Elisenda Eixarch
- Department of Obstetrics and Gynecology, BCNatal, Hospital Clínic de Barcelona, Barcelona, Spain.,Centre for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - Monica Lopez
- Department of Obstetrics and Gynecology, Hospital Joan XXIII de Tarragona, Catalonia, Spain
| | | | - Antoni Borrell
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), BCNatal, Barcelona, Spain.,Department of Obstetrics and Gynecology, BCNatal, Hospital Clínic de Barcelona, Barcelona, Spain
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Bennasar M, Ponce J, Torres X, Gómez O, Sabrià J, Gratacós E, Borrell A, Martínez JM. Perinatal outcome after selective termination in dichorionic twins discordant for congenital anomalies. Acta Obstet Gynecol Scand 2021; 100:2029-2035. [PMID: 34472083 DOI: 10.1111/aogs.14249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 07/25/2021] [Accepted: 08/13/2021] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Our objective was to evaluate the perinatal outcome of selective termination of dichorionic twin pregnancies with discordant anomalies, according to gestational age at time of procedure. MATERIAL AND METHODS Retrospective review of 147 dichorionic twin pregnancies referred to our Fetal Medicine Unit between 2003 and 2018 for selective termination. Gestational age at delivery, fetal loss, and overall and 28-day post-delivery survival rates, were evaluated according to gestational age at time of procedure. Selective termination procedure was defined as early, intermediate, and late when performed before 18 weeks, between 18 and 23 weeks, and after 23 weeks, respectively. Kruskal-Wallis and chi-squared test were used to compare groups. RESULTS Overall survival at 28 days post-delivery, pregnancy loss, and preterm delivery before 32 weeks of gestation rates were 93.4%, 6.9%, and 15.5%, respectively. When stratified by gestational age at procedure, intermediate selective termination was associated with a lower survival rate than early and late procedures (86% vs. 96.9% and 100%, respectively; p = 0.035), and a nonsignificant trend for higher pregnancy loss (12% vs. 3.1%). Preterm delivery before 32 weeks of gestation occurred in 27% of late procedures, which was significantly higher than in early (9.5%) and intermediate (18.2%) procedures. CONCLUSIONS Selective termination in dichorionic twin pregnancies with discordant fetal anomaly is associated with low pregnancy loss and preterm delivery rate, primarily when performed before 18 weeks. When legally possible, late procedures can be a good alternative, particularly in those cases diagnosed beyond the 18th week of gestation.
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Affiliation(s)
- Mar Bennasar
- BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Júlia Ponce
- BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Barcelona, Spain
| | - Ximena Torres
- BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Barcelona, Spain
| | - Olga Gómez
- BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Joan Sabrià
- BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Barcelona, Spain
| | - Eduard Gratacós
- BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Antoni Borrell
- BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Josep M Martínez
- BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Barcelona, Spain.,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
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Pauta M, Badenas C, Rodriguez-Revenga L, Soler A, Grande M, Sabrià J, Illanes C, Borobio V, Borrell A. A New Stepwise Molecular Work-Up After Chorionic Villi Sampling in Women With an Early Pregnancy Loss. Front Genet 2021; 11:561720. [PMID: 33519888 PMCID: PMC7841437 DOI: 10.3389/fgene.2020.561720] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 12/23/2020] [Indexed: 12/25/2022] Open
Abstract
Objective: To explore the use of a new molecular work-up based on the stepwise use of Quantitative Fluorescence PCR (QF-PCR) extended to eight chromosomes and single nucleotide polymorphism array (SNP-array) in chorionic villi obtained by chorionic villi sampling (CVS) offered to women experiencing an early pregnancy loss. Methods: During a 3-year period (January 2016–December 2018), CVS was offered to women experiencing an early pregnancy loss before the evacuation of the products of conception (POC) to retrieve chorionic villi, irrespective of the number of previous losses. A new molecular work-up was prospectively assayed encompassing a first QF-PCR round (with the 21, 18, 13, 7, X, and Y chromosomes), a second QF-PCR round (with the 15, 16, and 22 chromosomes), and a high resolution SNP-array in those cases with normal QF-PCR results. A control group in which POC were collected after surgical uterine evacuation was used to be compared with the intervention group. Results: Around 459 women were enrolled in the intervention group (CVS) and 185 in the control group (POC after uterine evacuation). The QF-PCR testing success rates were significantly higher in the intervention group (98.5%: 452/459) as compared to the control group (74%: 109/147; p < 0.001), while the chromosomal anomaly rate at the two QF-PCR rounds was similar between the two groups: 52% (234/452) in the intervention and 42% (46/109) in the control group (p = 0.073). The SNP-array was performed in 202 QF-PCR normal samples of the intervention group and revealed 67 (33%) atypical chromosomal anomalies (>10 Mb), 5 (2.5%) submicroscopic pathogenic copy number variants, and 2 (1%) variant of uncertain significance (VOUS). Conclusion: Eighty-two percent of women experiencing an early pregnancy loss opted for a CVS. The testing success rates were higher in the intervention group (CVS; 98%) as compared to the control group (POC; 74%). The overall yields were 52% by QF-PCR (including three complete hydatiform moles), and 16% by SNP-array, including 15% atypical chromosomal anomalies and 1.1% submicroscopic pathogenic copy number variants.
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Affiliation(s)
- Montse Pauta
- BCNatal, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Cèlia Badenas
- Servei de Bioquímica i Genètica Molecular, CDB, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Laia Rodriguez-Revenga
- Servei de Bioquímica i Genètica Molecular, CDB, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Anna Soler
- Servei de Bioquímica i Genètica Molecular, CDB, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Maribel Grande
- BCNatal, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Joan Sabrià
- BCNatal, Servei de Ginecologia i Obstetricia, Hospital de Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Carmen Illanes
- BCNatal Department of Maternal-Fetal Medicine, Institute Gynecology, Obstetrics and Neonatology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Virginia Borobio
- BCNatal Department of Maternal-Fetal Medicine, Institute Gynecology, Obstetrics and Neonatology, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Antoni Borrell
- BCNatal Department of Maternal-Fetal Medicine, Institute Gynecology, Obstetrics and Neonatology, Hospital Clínic de Barcelona, Barcelona, Spain
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Palacio M, Bonet-Carne E, Cobo T, Perez-Moreno A, Sabrià J, Richter J, Kacerovsky M, Jacobsson B, García-Posada RA, Bugatto F, Santisteve R, Vives À, Parra-Cordero M, Hernandez-Andrade E, Bartha JL, Carretero-Lucena P, Tan KL, Cruz-Martínez R, Burke M, Vavilala S, Iruretagoyena I, Delgado JL, Schenone M, Vilanova J, Botet F, Yeo GS, Hyett J, Deprest J, Romero R, Gratacos E, Palacio M, Cobo T, López M, Castro D, Piraquive JP, Ramírez JC, Migliorelli F, Martínez-Terrón M, Botet F, Gratacós E, Sabrià J, Martínez SF, Gómez Roig D, Bonet-Carné E, Pérez À, Domínguez M, Coronado D, Deprest J, Richter J, DeKoninck P, Kacerovsky M, Musilova I, Bestvina T, Maly J, Kokstein Z, Jacobsson B, Cedergren L, Johansson P, Tsiartas P, Sävman K, Hallingström M, García Posadas R, González FB, Fajardo MA, Quintero Prado R, Melero Jiménez V, Benavente Fernández I, Prat RS, de la Barrera Correa B, Valencia EG, Martínez Rodríguez R, Roma Mas E, Vives Argilagós À, Rodríguez Veret A, García Cancela E, Salinas PA, Parra-Cordero M, Sepúlveda-Martínez Á, Hernández-Andrade E, Romero R, Ahn H, Bartha JL, Antolín E, Carretero Lucena P, Molina García F, Jiménez Garrido N, Tallón CC, Antón BM, Yeo G, Tan KL, Cruz-Martínez R, Martínez-Rodríguez M, Hyatt J, Burke M, Mogra R, Vavilala S, Iruretagoyena JI, Delgado JL, Schenone M, Vilanova J, Bons N. Prediction of neonatal respiratory morbidity by quantitative ultrasound lung texture analysis: a multicenter study. Am J Obstet Gynecol 2017; 217:196.e1-196.e14. [PMID: 28342715 DOI: 10.1016/j.ajog.2017.03.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 02/23/2017] [Accepted: 03/15/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Prediction of neonatal respiratory morbidity may be useful to plan delivery in complicated pregnancies. The limited predictive performance of the current diagnostic tests together with the risks of an invasive procedure restricts the use of fetal lung maturity assessment. OBJECTIVE The objective of the study was to evaluate the performance of quantitative ultrasound texture analysis of the fetal lung (quantusFLM) to predict neonatal respiratory morbidity in preterm and early-term (<39.0 weeks) deliveries. STUDY DESIGN This was a prospective multicenter study conducted in 20 centers worldwide. Fetal lung ultrasound images were obtained at 25.0-38.6 weeks of gestation within 48 hours of delivery, stored in Digital Imaging and Communication in Medicine format, and analyzed with quantusFLM. Physicians were blinded to the analysis. At delivery, perinatal outcomes and the occurrence of neonatal respiratory morbidity, defined as either respiratory distress syndrome or transient tachypnea of the newborn, were registered. The performance of the ultrasound texture analysis test to predict neonatal respiratory morbidity was evaluated. RESULTS A total of 883 images were collected, but 17.3% were discarded because of poor image quality or exclusion criteria, leaving 730 observations for the final analysis. The prevalence of neonatal respiratory morbidity was 13.8% (101 of 730). The quantusFLM predicted neonatal respiratory morbidity with a sensitivity, specificity, positive and negative predictive values of 74.3% (75 of 101), 88.6% (557 of 629), 51.0% (75 of 147), and 95.5% (557 of 583), respectively. Accuracy was 86.5% (632 of 730) and positive and negative likelihood ratios were 6.5 and 0.3, respectively. CONCLUSION The quantusFLM predicted neonatal respiratory morbidity with an accuracy similar to that previously reported for other tests with the advantage of being a noninvasive technique.
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Prat J, Muñoz E, Calvo E, Sabrià J, Miró E, Pertierra A, Castañón M. [When should gestation of a gastroschisis be terminated?]. Cir Pediatr 2017; 30:89-94. [PMID: 28857531] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVES In gastroschisis pregnancies, a) to correlate prenatal ultrasound variables with postnatal outcome and b) to determine the ideal time for setting the delivery in order to achieve the best neonatal outcome. MATERIAL AND METHODS Retrospective review (2000-2015) of all available gastroschisis whose prenatal findings could be correlated with the neonatal outcome. Two study groups have been defined according to the complications present after birth: favorable gastrosquisis and complicated. Prenatal variables were compared by groups using McWhitney or Chi tests as needed. RESULTS Twenty-two gastroschisis fulfilled the requirement. Twelve cases had uneventful outcomes. Ten patients experienced complications, including death in five. In the complicated group there were 15 episodes of sepsis and 17 reoperations. Any single ultrasound parameter could predict a bad follow up. In thirteen cases, delivery was forced due to sudden changes on ultrasound bowel appearance. Nine of these patients had very good neonatal outcome. CONCLUSIONS Finishing pregnancy when sudden changes on the fetal bowel were identified was the only strategy that leaded us to diminish the complication rate in gastroschisis.
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Affiliation(s)
- J Prat
- Departamento de Cirugía Pediátrica. Hospital Sant Joan de Déu. Barcelona. Universitat de Barcelona
| | - E Muñoz
- Departamento de Cirugía Pediátrica. Hospital Sant Joan de Déu. Barcelona. Universitat de Barcelona
| | - E Calvo
- Departamento de Obstetricia. Hospital Sant Joan de Déu. Barcelona. Universitat de Barcelona
| | - J Sabrià
- Departamento de Obstetricia. Hospital Sant Joan de Déu. Barcelona. Universitat de Barcelona
| | - E Miró
- Departamento de Obstetricia. Hospital Sant Joan de Déu. Barcelona. Universitat de Barcelona
| | - A Pertierra
- Departamento de Neonatología. Hospital Sant Joan de Déu. Barcelona. Universitat de Barcelona
| | - M Castañón
- Departamento de Cirugía Pediátrica. Hospital Sant Joan de Déu. Barcelona. Universitat de Barcelona
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Borrell A, Grande M, Meler E, Sabrià J, Mazarico E, Muñoz A, Rodriguez-Revenga L, Badenas C, Figueras F. Genomic Microarray in Fetuses with Early Growth Restriction: A Multicenter Study. Fetal Diagn Ther 2016; 42:174-180. [DOI: 10.1159/000452217] [Citation(s) in RCA: 22] [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] [Received: 07/26/2016] [Accepted: 10/04/2016] [Indexed: 11/19/2022]
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Grande M, Sabrià J, Borobio V, Mercadé I, Stergiotou I, Masoller N, Borrell A. Effectiveness of ovarian age as the background risk for aneuploidy screening in an unselected pregnant population. Reprod Biomed Online 2016; 33:500-505. [DOI: 10.1016/j.rbmo.2016.07.006] [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] [Received: 04/15/2016] [Revised: 06/02/2016] [Accepted: 07/20/2016] [Indexed: 10/21/2022]
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Grande M, Stergiotou I, Borobio V, Sabrià J, Soler A, Borrell A. Heterotrisomy recurrence risk: a practical maternal age-dependent approach for excess trisomy 21 risk calculation after a previous autosomal trisomy. J Matern Fetal Neonatal Med 2016; 30:1613-1615. [PMID: 27623225 DOI: 10.1080/14767058.2016.1219990] [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] [Indexed: 10/21/2022]
Abstract
A new maternal age-dependent method to estimate absolute excess risks of trisomy 21, either after a previous trisomy 21 (homotrisomy) or after another trisomy (heterotrisomy), is proposed to be added to the estimated risk by conventional screening methods. Excess risk at term for a subsequent trisomy 21 was calculated from midtrimester risks reported by Morris et al., decreasing from 0.49% at 20 years to 0.01% at 46 years at the index pregnancy. Excess risk after a previous uncommon trisomy was derived from data reported by Warburton et al., decreasing from 0.37% at 20 years to 0.01% at 50 years.
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Affiliation(s)
- Maribel Grande
- a BCNatal, Department of Maternal-Fetal Medicine, Hospital Clínic Barcelona , Catalonia , Spain.,d CIBER de Enfermedades Raras, Instituto de Salud Carlos III , Spain
| | - Iosifina Stergiotou
- a BCNatal, Department of Maternal-Fetal Medicine, Hospital Clínic Barcelona , Catalonia , Spain
| | - Virginia Borobio
- a BCNatal, Department of Maternal-Fetal Medicine, Hospital Clínic Barcelona , Catalonia , Spain
| | - Joan Sabrià
- b BCNatal, Department of Obstetrics and Gynecology, Hospital Sant Joan de Déu. Esplugues de Llobregat , Catalonia , Spain
| | - Anna Soler
- c Servei Bioquímica i Genètica Molecular, CDB, Hospital Clinic Barcelona , Catalonia , Spain , and
| | - Antoni Borrell
- a BCNatal, Department of Maternal-Fetal Medicine, Hospital Clínic Barcelona , Catalonia , Spain.,d CIBER de Enfermedades Raras, Instituto de Salud Carlos III , Spain
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De Diego R, Sabrià J, Vela A, Rodríguez D, Gómez MD. Role of 3-dimensional power Doppler sonography in differentiating pregnant women with threatened preterm labor from those with an asymptomatic short cervix. J Ultrasound Med 2014; 33:673-679. [PMID: 24658947 DOI: 10.7863/ultra.33.4.673] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVES To compare cervical volumes and vascularization indices using 3-dimensional power Doppler sonography among singleton pregnancies with threatened preterm labor and an asymptomatic short cervix. METHODS Three hundred asymptomatic healthy pregnant women between 24 and 34.6 gestational weeks were prospectively scanned for cervical length. If cervical length was short, defined as below the 10th percentile for gestational age, the cervical volume and vascularization indices (vascularization index [VI], vascularization-flow index [VFI], and flow index [FI]) were measured. Women receiving any treatment for preterm delivery prevention were excluded. During this period, the same sonographic parameters were measured among patients with threatened preterm labor admitted to our institution during the first 24 hours after admission. Multiple pregnancies and fetal or maternal pathologic conditions, were exclusion criteria. Data on body mass index, maternal age, smoking, parity, family history of preterm birth, mother who was born preterm, and previous preterm birth among the pregnant women were recorded. Sonographic and medical history parameters were compared between the two groups. RESULTS Twenty-nine asymptomatic healthy women (9.6%) had a short cervix. Additionally, 71 pregnancies with threatened preterm labor were scanned. There were no statistically significant differences between the groups in medical history parameters or cervical length. The cervical volume was smaller in threatened preterm cases (12.90 versus 17.168 cm(3); P = .005). The VI and VFI were lower in women with an asymptomatic short cervix (VI, 4.369% versus 15.939%; P < .001; VFI, 1.514 versus 4.878; P < .001). The FI was higher in the short cervix group (33.581 versus 30.311; P = .006). CONCLUSIONS Three-dimensional transvaginal sonography reveals differences in cervical volume and vascularization indices between pregnancies with an asymptomatic short cervix and cases with threatened preterm labor, although cervical length is similar in both groups.
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Affiliation(s)
- Raül De Diego
- Department of Obstetrics and Gynecology, Sant Joan de Déu Hospital, Passeig Sant Joan de Déu 2, 08950 Esplugues, Barcelona, Spain.
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Sabrià J, Barceló-Vidal C, Arigita M, Jimenez JM, Puerto B, Borrell A. The CUSUM test applied in prospective nuchal translucency quality review. Ultrasound Obstet Gynecol 2011; 37:582-587. [PMID: 21520314 DOI: 10.1002/uog.8860] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVES To design a cumulative sum (CUSUM) test for prospective nuchal translucency (NT) measurement quality review that is as stringent as the retrospective quality review methods based on distribution parameters currently in use. METHODS The database including all fetal NT measurements obtained during a 2-year period in a single center was reviewed, and measurements obtained by sonologists who measured fewer than 100 cases were excluded. The NT distribution parameters proposed by The Fetal Medicine Foundation (FMF) and the Women & Infants Hospital of Rhode Island (WIHRI) were assessed in the whole NT series and in sonologist-specific distributions. A previously described CUSUM model was adapted to fulfil our objective. RESULTS Two thousand four hundred and seventy-five NT measurements were obtained by seven sonologists during the study period (January 2007-December 2008). In the assessment of sonologist-specific NT distributions, two sonologists fulfilled all the FMF and WIHRI criteria, one showed NT overestimation and four failed due to NT underestimation. Our new CUSUM test model, based on multiples of the median deviations, showed good agreement with the FMF and WIHRI methods in the assessment of sonologist-specific performance. CONCLUSIONS Our CUSUM test model showed close agreement with the retrospective quality review methods based on distribution parameters currently in use, but with the advantage that it can be applied prospectively, allowing for earlier correction of deviations from target performance.
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Affiliation(s)
- J Sabrià
- Department of Obstetrics and Gynecology, Hospital Sant Joan de Déu, Barcelona, Catalonia, Spain.
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Abstract
ABSTRACT
Objective
Quantitative analysis of the quality of nuchal translucency (NT) measurements.
Methods
This is a retrospective single-center study. NT was measured according to the Fetal Medicine Foundation (FMF) criteria by 20 trained obstetricians (October 2003-November 2009). The performance of NT measurements was analyzed with regard to several quality control standards. Accuracy according to experience, professional profile, crown-rump length (CRL) values and FMF certification was statistically tested.
Results
A total of 14,978 NT measurements were assessed. (1) The mean operator-specific median NT-MoM values was 0.98. (2) Mean percentage of cases >95th and <5th percentiles were 5.0 and 4.2% respectively. (3) Logarithmic mean and SD of the NT-MoM values were 0.00 and 0.13 respectively. (4) The DR for trisomy 21 at screening time was 90.7% for a FPR of 6.7% for standard screening strategy. (5) According to cumulative SUM (CUSUM) figures, the performance was more acceptable in FMF-certified operators. Operator experience, exclusive dedication to FM, FMF certification and a range of CRL values > 60 mm had a statistical impact improving these standards.
Conclusion
Overall quality standards show optimal NT measurements in our unit. Experience a dedicated profile to fetal medicine ultrasound, CRL over 60 mm and FMF certification has a significant positive impact on the quality standards.
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Mazarico E, Sabrià J, Cabré S, Lailla J. Cesárea anterior por desproporción pelvi-fetal y gestación cronológicamente prolongada. Clínica e Investigación en Ginecología y Obstetricia 2010. [DOI: 10.1016/j.gine.2009.06.003] [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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Ferrero S, Esteve C, Mora I, Sabrià J, González E, Lailla J. Carcinoma de endometrio y ovario sincrónicos. Clínica e Investigación en Ginecología y Obstetricia 2007. [DOI: 10.1016/s0210-573x(07)74478-7] [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: 10/21/2022]
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Roig MDG, Sabrià J, Valls C, Borràs M, Miró E, Ponce J, Vicens JML. The use of biochemical markers in prenatal diagnosis of intrauterine growth retardation: insulin-like growth factor I, Leptin, and alpha-fetoprotein. Eur J Obstet Gynecol Reprod Biol 2005; 120:27-32. [PMID: 15866082 DOI: 10.1016/j.ejogrb.2004.07.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [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: 02/02/2004] [Revised: 06/02/2004] [Accepted: 07/30/2004] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the relation between weight deficit at birth and IGF-I, IGFBP-I, Leptin, and AFP levels in amniotic fluid after 14-18 weeks; to assess the diagnostic usefulness of these biochemical markers. STUDY DESIGN Longitudinal, prospective study. Amniocentesis was performed in pregnant women after 14-18 weeks of gestation. STUDY POPULATION 86 controls, 18 IUGR <10 percentile, and 17 IUGR <5 percentile. RESULTS No significant correlation was found between severity of IUGR and IGF-I, IGFBP-I, or Leptin. AFP was inversely correlated with severity of IUGR; results for the IUGR <10 percentile were: S: 65.7%, SP: 56.9%, PPV: 38.3%, NPV: 80.3%, and an overall diagnostic capacity of 65.6%. Results for the IUGR <5 percentile were: S: 76.4%, SP: 54.8%, PPV: 21.6%, NPV: 93.4% were obtained, and an overall capacity of 70.6%. CONCLUSIONS Elevated values of AFP in amniotic fluid may help early detection of populations at risk of developing IUGR.
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Affiliation(s)
- M Dolores Gómez Roig
- Obstetrics and Gynecology Service, Sant Joan de Déu University Hospital, Barcelona, Spain.
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Martínez SE, Vaglenova J, Sabrià J, Martínez MC, Farrés J, Parés X. Distribution of alcohol dehydrogenase mRNA in the rat central nervous system. Consequences for brain ethanol and retinoid metabolism. Eur J Biochem 2001; 268:5045-56. [PMID: 11589695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
The localization of alcohol dehydrogenase (ADH) in brain regions would demonstrate active ethanol metabolism in brain during alcohol consumption, which would be a new basis to explain the effects of ethanol in the central nervous system. Tissue sections from several regions of adult rat brain were examined by in situ hybridization to detect the expression of genes encoding ADH1 and ADH4, enzymes highly active with ethanol and retinol. ADH1 mRNA was found in the granular and Purkinje cell layers of cerebellum, in the pyramidal and granule cells of the hippocampal formation and in some cell types of cerebral cortex. ADH4 expression was detected in the Purkinje cells, in the pyramidal and granule cells of the hippocampal formation and in the pyramidal cells of cerebral cortex. High levels of ADH1 and ADH4 mRNAs were detected in the CNS epithelial and vascular tissues: leptomeninges, choroid plexus, ependymocytes of ventricle walls, and endothelium of brain vessels. Histochemical methods detected ADH activity in rodent cerebellar slices, while Western-blot analysis showed ADH4 protein in homogenates from several brain regions. In consequence, small but significant levels of ethanol metabolism can take place in distinct areas of the CNS following alcohol consumption, which could be related to brain damage caused by a local accumulation of acetaldehyde. Moreover, the involvement of ADH in the synthesis of retinoic acid suggests a role for the enzyme in the regulation of adult brain functions. The impairment of retinol oxidation by competitive inhibition of ADH in the presence of ethanol may be an additional origin of CNS abnormalities caused by ethanol.
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Affiliation(s)
- S E Martínez
- Department of Biochemistry and Molecular Biology, Universitat Autònoma de Barcelona, E-08193 Bellaterra (Barcelona), Spain
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Ricart W, Bach C, Fernández-Real JM, Biarnés J, Sabrià J. [Impact of a selective screening for gestational diabetes in a Spanish population]. Med Clin (Barc) 1999; 113:331-3. [PMID: 10562928] [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: 02/14/2023]
Abstract
BACKGROUND Recently, the American Diabetes Association (ADA) concluded that pregnant women with low risk factors for gestational diabetes need not to be tested. The aims of this study was to determine the prevalence of gestational diabetes in a Spanish low risk pregnant women population, to analyze the criteria that define low risk pregnancies for gestational diabetes, and to compare the differences in morbidity between pregnant women with and without gestational diabetes. DESIGN AND METHODS Cohort study of 2,262 gestations (2,085 Caucasians) during a period of 7 years in a reference hospital. RESULTS The gestational diabetes prevalence was 15%. Two-hundred and seventy-four (12.1%) women were considered as a low risk group for gestational diabetes. Among these, 13 (4.7%) presented gestational diabetes in comparison with 16.6% in the remaining women (p = 0.0001). Gestational diabetes in the low risk pregnant women constituted the 3.8% of all gestational diabetes. We did not find differences in gestational outcomes or fetal antropometry between the groups. The relative risk of macrosomia in the low risk pregnant was 0.9% (95% confidence interval for the mean: 0.86-0.94). CONCLUSIONS In spite of their capacity of identifying current complications, 4% of gestational diabetes would not have been diagnosed with the new ADA criteria. The misdiagnosis will prevent in this small group of women the adoption of preventive measures for subsequent pregnancies and for diabetes in later life.
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Affiliation(s)
- W Ricart
- Unidad de Diabetología, Endocrinólogía y Nutrición, Hospital Universitario Doctor Josep Trueta., Girona.
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Pastor C, Badia A, Sabrià J. Possible involvement of alpha 1-adrenoceptors in the modulation of [3H]noradrenaline release in rat brain cortical and hippocampal synaptosomes. Neurosci Lett 1996; 216:187-90. [PMID: 8897489 DOI: 10.1016/0304-3940(96)13029-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [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: 02/02/2023]
Abstract
Nerve terminals obtained from rat brain cortex and hippocampus, were labelled with 0.04 microM of [3H]noradrenaline ([3H]NA). Thereafter the basal release of [3H]NA was measured in a Brandel superfusion apparatus, in the presence of alpha 1-adrenoceptor agonists (phenylephrine or noradrenaline) or these alpha 1-adrenoceptor agonists along with prazosin, an alpha 1-adrenoceptor antagonist. In cortical synaptosomes both alpha 1-adrenoceptor agonists increased the basal release of [3H]NA in a concentration-dependent manner (EC50 = 0.15 microM for phenylephrine and 12.6 microM for noradrenaline). Effects were reversed by 0.01 microM prazosin (EC50 = 2.46 and 130.1 microM, respectively). In synaptosomes from rat brain hippocampus, phenylephrine (EC50 = 1.28 microM) and noradrenaline (EC50 = 33.7 microM) also increased the [3H]NA release and prazosin (0.01 microM) shifted the corresponding concentration-response curves to the right (EC50 = 7.38 and 264.0 microM, respectively). Events produced by noradrenaline acting as alpha 1-adrenoceptor agonist did not show Ca2+ dependence. These results suggest (1) the presence of functional alpha 1-adrenoceptors in nerve terminals from rat brain cortex and hippocampus, (2) that these receptors seem to play a role in the presynaptic modulation of [3H]NA release, and (3) that intraterminal Ca2+ may be involved.
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Affiliation(s)
- C Pastor
- Departament de Bioquímica i Biologia Molecular, Universitat Autònoma de Barcelona, Spain
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Sabrià J, Cortada M, Giner L, Gil F, Fernández E, Manero J, Planell J. A study of load cycling in a NiTi shape memory alloy with pseudoelastic behaviour used in dental prosthetic fixators. Biomed Mater Eng 1996. [DOI: 10.3233/bme-1996-6302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- J. Sabrià
- Department of Morphological Sciences and Odonto-stomatology, Faculty of Odontology, Universitat de Barcelona, c/Feixa Llarga s/n. 08907-L'Hospitalet del Llobregat, Barcelona, Spain, Tel.: +3434024200
| | - M. Cortada
- Department of Morphological Sciences and Odonto-stomatology, Faculty of Odontology, Universitat de Barcelona, c/Feixa Llarga s/n. 08907-L'Hospitalet del Llobregat, Barcelona, Spain, Tel.: +3434024200
| | - L. Giner
- Department of Morphological Sciences and Odonto-stomatology, Faculty of Odontology, Universitat de Barcelona, c/Feixa Llarga s/n. 08907-L'Hospitalet del Llobregat, Barcelona, Spain, Tel.: +3434024200
| | - F.J. Gil
- Department of Materials Science and Metallurgy, ETSIIB, Universitat Politècnica de Catalunya, Avda. Diagonal 647, 08028-Barcelona, Spain, Tel.: +34 3 4016708
| | - E. Fernández
- Department of Materials Science and Metallurgy, ETSIIB, Universitat Politècnica de Catalunya, Avda. Diagonal 647, 08028-Barcelona, Spain, Tel.: +34 3 4016708
| | - J.M. Manero
- Department of Materials Science and Metallurgy, ETSIIB, Universitat Politècnica de Catalunya, Avda. Diagonal 647, 08028-Barcelona, Spain, Tel.: +34 3 4016708
| | - J.A. Planell
- Department of Materials Science and Metallurgy, ETSIIB, Universitat Politècnica de Catalunya, Avda. Diagonal 647, 08028-Barcelona, Spain, Tel.: +34 3 4016708
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Sabrià J, Pastor C, Clos MV, Garcia A, Badia A. Involvement of different types of voltage-sensitive calcium channels in the presynaptic regulation of noradrenaline release in rat brain cortex and hippocampus. J Neurochem 1995; 64:2567-71. [PMID: 7539054 DOI: 10.1046/j.1471-4159.1995.64062567.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.0] [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: 01/25/2023]
Abstract
Transmitter release at the nerve terminal is mediated by the influx of Ca2+ through voltage-sensitive calcium channels (VSCCs). Many types of VSCCs have been found in neurons (T, N, L, and P), but uncertainty remains about which ones are involved in neuronal excitation-secretion coupling. Specific ligands for the L- and N-type VSCCs were used to determine which of these subtypes might be involved in the K(+)-evoked [3H]noradrenaline release from superfused rat brain cortical and hippocampal synaptosomes. In cortical presynaptic terminals the 1,4-dihydropyridine agonist Bay K8644 enhanced the K+ (15 mM)-evoked [3H]noradrenaline release. This effect was reversed by the 1,4-dihydropyridine antagonists nimodipine and nitrendipine. The L-type VSCC ligands had no effect on hippocampal synaptosomes. In contrast, the N-type VSCC blocker omega-conotoxin markedly reduced the K(+)-evoked [3H]noradrenaline release in nerve terminals from both regions. Inhibition was greater in hippocampal synaptosomes. When applied together the inhibitory actions of nimodipine and omega-conotoxin were approximately additive. These findings indicate that both L- and N-type VSCCs participate in noradrenaline release in rat brain cortex and suggest that noradrenergic terminals in the two regions examined may have distinct populations of VSCCs: L type in cortex and N type in hippocampus.
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Affiliation(s)
- J Sabrià
- Departament de Bioquímica i de Biologia Molecular, Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain
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21
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Sunyer J, Antó JM, Sabrià J, Roca J, Morell F, Rodríguez-Roisin R, Rodrigo MJ. Relationship between serum IgE and airway responsiveness in adults with asthma. J Allergy Clin Immunol 1995; 95:699-706. [PMID: 7897153 DOI: 10.1016/s0091-6749(95)70175-3] [Citation(s) in RCA: 74] [Impact Index Per Article: 2.6] [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: 01/27/2023]
Abstract
BACKGROUND General population studies have shown a relationship between total serum IgE levels and airway responsiveness, but this association has not been documented in patients with asthma. OBJECTIVE The study assesses the cross-sectional relationship between IgE levels and airway responsiveness in 208 subjects who had had emergency department treatment for asthma at least 2 years earlier. METHODS All participants completed a standardized respiratory questionnaire and underwent spirometry, allergy skin testing, and a dose-response methacholine challenge test. RESULTS After adjusting for age and gender, the percentage of patients with asthma and airway responsiveness (provocative concentration causing a 20% fall in forced expiratory volume in 1 second [PC20] < or = 8 mg/ml) increased from 52% in the lower quintile of IgE to 72% in the upper quintile (p < 0.01). After adjusting for age, gender, baseline percent predicted forced expiratory volume in 1 second, and smoking, the association between IgE (both in quintiles and continuous) and PC20 appeared consistent and statistically significant (p < 0.01). This association was stronger in patients who were not given inhaled steroid (odds ratio for twice the concentration of IgE, 1.42; 95% confidence interval, 1.09 and 1.84), than in patients treated with inhaled steroid (odds ratio, 1.10; 95% confidence interval, 0.82 and 1.50). Eosinophilia and skin reactivity were associated with PC20 although to a lesser extent. CONCLUSION These findings strengthen the role played by IgE in facilitating the development of bronchial responsiveness in patients with asthma.
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Affiliation(s)
- J Sunyer
- Department d'Epidemiologia i Salut Pública, Universitat Autònoma de Barcelona, Spain
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Sabrià J, Antó JM, Sunyer J, Roca J, Morell F, Rodríguez-Roisín R, Rodrigo MJ, Codina R. Clinical and functional characteristics of patients two years after being affected by the soybean asthma epidemic in Barcelona. Thorax 1994; 49:906-9. [PMID: 7940432 PMCID: PMC475189 DOI: 10.1136/thx.49.9.906] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [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: 01/28/2023]
Abstract
BACKGROUND Patients affected during the asthma outbreaks caused by soybean dust inhalation in Barcelona presented with sudden onset of severe asthma followed by the rapid relief of symptoms after treatment. Two years after the epidemics ended, a case-control study was conducted in which the clinical, functional, and immunological characteristics of these asthma patients (a randomised sample of asthmatic patients admitted as emergency cases on epidemic days, n = 213) were compared with those of a control group (a random sample of asthmatic patients admitted as emergency cases for attacks of asthma on non-epidemic days, n = 170). METHODS The study included the administration of the ATS-DLD78 standardised respiratory questionnaire, the measurement of atopy, and performance of spirometric tests and a methacholine inhalation test. RESULTS Patients with epidemic asthma reported fewer symptoms of asthma, had attended emergency departments less frequently during the previous year for acute attacks of asthma, were taking fewer inhaled corticosteroids at the time of the study, and attended medical follow up less frequently than did the patients with non-epidemic asthma. However, the cases and controls showed no differences in ventilatory capacity or reactivity to the methacholine bronchoprovocation test. CONCLUSIONS Two years after the end of the soybean epidemics, people affected by epidemic asthma had a favourable prognosis. This finding contrasts with a higher risk of life threatening asthma and death during the epidemics. This paradox could be the result of a complex interaction between host and conditions of exposure.
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Affiliation(s)
- J Sabrià
- Departament d'Epidemiologia i Salut Pública, Universitat Autònoma de Barcelona, Spain
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Fernández E, Gil F, Cortada M, Sabrià J, Planell J. Abrasive wear of different dental alloys. J Biomech 1994. [DOI: 10.1016/0021-9290(94)91409-5] [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: 11/26/2022]
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Antó JM, Sunyer J, Reed CE, Sabrià J, Martínez F, Morell F, Codina R, Rodríguez-Roisín R, Rodrigo MJ, Roca J. Preventing asthma epidemics due to soybeans by dust-control measures. N Engl J Med 1993; 329:1760-3. [PMID: 8232484 DOI: 10.1056/nejm199312093292402] [Citation(s) in RCA: 81] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND The inhalation of soybean dust released during the unloading of soybeans into a silo caused outbreaks of asthma in Barcelona, Spain. This study was designed to determine morbidity due to asthma and serum IgE reactivity before and after the installation of filters in the silo. METHODS We measured soybean-allergen concentrations in 136 samples of air collected for 9 months before and 24 months after the installation of filters. We compared the number of days on which there was an unexpected increase in emergency room visits for asthma, the number of days on which the number of emergency room visits for asthma in one four-hour period was so high that it was unlikely to be due to chance, and the mean daily number of emergency room and intensive care unit admissions for asthma for a total of 60 months before and after filter installation. Serum IgE antibodies against soybean allergens were measured in 38 patients before and after filter installation. RESULTS The concentration of airborne soybean allergens on days when soybeans were unloaded decreased from 324 to 25 U per cubic meter after the installation of filters (P < 0.001). The number of days on which there was an unusually large number of visits to the hospital for asthma and the number of days on which asthma was epidemic both decreased significantly (both P < 0.001), from 29 to 6 and from 18 to 0, respectively. The mean daily number of emergency room and intensive care unit admissions for asthma on days when soybeans were unloaded decreased from 8.3 to 5.4 and from 0.26 to 0.01, respectively (both P < 0.001). The mean serum IgE antibody concentrations in the 38 patients studied decreased from 2 Pharmacia reference units per milliliter to 1 (P < 0.001). CONCLUSIONS Installing filters on silos to prevent airborne dissemination of allergenic soybean dust eliminates outbreaks of asthma caused by inhalation of the dust, thus supporting the idea that the avoidance of allergens helps prevent asthma.
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Affiliation(s)
- J M Antó
- Department d'Epidemiologia i Salut Pública, Institut Municipal d'Investigació Mèdica, Barcelona, Spain
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Cabezas C, Martín A, Comín E, Sabrià J, Boix C, Espínola A, Sanz E, Gené J. [Compliance of antibiotic treatment in primary health care. Value of the personalized prescription]. Rev Clin Esp 1989; 185:366-9. [PMID: 2695999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A controlled clinical study was carried out in order to evaluate the efficacy of a personalized prescription as a measure to improve the fulfillment of a short course antibiotic treatment. 180 patients completed the study (96 in the active group and 88 in the control group) finding no differences in selected variables between the two groups. Evaluation of treatment fulfillment was performed with an interview and counting the pills, finding with this method that 57.94% of the patients fulfilled the treatment. Except for a higher incidence of adverse side effects in the control group (p less than 0.05) no other significant differences were found between the two groups. The interview showed a 37% sensibility and a 97% specificity, which was specially usefull in the detection of nonfulfillers. The correlation coefficient between both groups was 0.66 (p less than 0.001). Our results suggest that the personalized prescription does not improve the patient compliance achieved by a good verbal information in the short course antibiotic treatment.
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Abstract
Dibutyryl cyclic AMP, in a concentration-dependent manner, increased synaptosomal (Ca2+-Mg2+)-ATPase activity, but in synaptic plasma membranes lacked any effect. The maximal enzyme activity in synaptosomes was increased by 38%, leaving unaltered the extrasynaptosomal Ca2+ concentration necessary to reach it. In the presence of 5 microM cyclic AMP, cyclic AMP-dependent protein kinase increased (30%) maximal (Ca2+-Mg2+)-ATPase activity in synaptic plasma membranes, but the apparent affinity for Ca2+ was not modified. This effect was partially inhibited (60%) by a cyclic AMP-dependent protein kinase inhibitor. The data suggest that synaptosomal (Ca2+-Mg2+)-ATPase activity is modulated by a cyclic AMP-dependent phosphorylation reaction.
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Affiliation(s)
- R Rodriguez
- Departamento de Bioquímica y Biología Molecular, Facultad de Medicina, Universidad Autónoma de Barcelona, Spain
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Rodriguez R, Toledo A, Brandner R, Sabrià J, Rodriguez J, Blanco I. Histamine stimulated synaptosomal Ca2+ uptake through activation of calcium channels. Biochem Biophys Res Commun 1988; 153:1136-43. [PMID: 2455514 DOI: 10.1016/s0006-291x(88)81346-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [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: 01/01/2023]
Abstract
Histamine stimulated Ca2+ uptake in synaptosomes was completely inhibited by the slow Ca2+ channel antagonists verapamil, cinnarizine and flunarizine, and slightly inhibited by nifedipine and diltiazem. Ca2+ uptake in synaptosomes depolarized or predepolarized with varying K+ concentrations was increased by histamine, in both conditions, until 30mM K+. At higher K+ concentrations histamine was not able to alter K+ effects in either conditions. 30mM K+ stimulated uptake of Ca2+ in the absence or presence of histamine was not inhibited by verapamil and diltiazem. However nifedipine slightly inhibited K+ and K+ +histamine effects. 3-Isobutyl-1-methyl-xanthine and dibutyryl cyclicAMP potentiated (10%) the uptake of Ca2+ in synaptosomes induced by histamine. Dibutyryl cyclicAMP alone however decreased the basal Ca2+ uptake in a concentration-dependent manner. Verapamil, but not diltiazem, antagonized the effects elicited by 3-isobutyl-1-methyl-xanthine and dibutyryl cyclicAMP in the presence of histamine. The data suggest that the increase in synaptosomal Ca2+ uptake induced by histamine is mediated by the activation of the voltage sensitive calcium channels, and possibly a cyclicAMP-dependent protein kinase phosphorylation can modulate the opening of Ca2+ channels.
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Affiliation(s)
- R Rodriguez
- Departamento de Bioquímica y Biología Molecular Facultad de Medicina, Universidad Autónoma de Barcelona, Spain
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