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Dziegielewski C, Gupta S, Begum J, Pugliese M, Lombardi J, E K, Jd M, Sy R, N S, T R, Ei B, Sk M. Clinical and health care utilization variables can predict 90-day hospital re-admission in adults with Crohn's disease for point of care risk evaluation. BMC Gastroenterol 2024; 24:172. [PMID: 38760679 PMCID: PMC11102236 DOI: 10.1186/s12876-024-03226-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 04/10/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Hospital re-admission for persons with Crohn's disease (CD) is a significant contributor to morbidity and healthcare costs. We derived prediction models of risk of 90-day re-hospitalization among persons with CD that could be applied at hospital discharge to target outpatient interventions mitigating this risk. METHODS We performed a retrospective study in persons with CD admitted between 2009 and 2016 for an acute CD-related indication. Demographic, clinical, and health services predictor variables were ascertained through chart review and linkage to administrative health databases. We derived and internally validated a multivariable logistic regression model of 90-day CD-related re-hospitalization. We selected the optimal probability cut-point to maximize Youden's index. RESULTS There were 524 CD hospitalizations and 57 (10.9%) CD re-hospitalizations within 90 days of discharge. Our final model included hospitalization within the prior year (adjusted odds ratio [aOR] 3.27, 95% confidence interval [CI] 1.76-6.08), gastroenterologist consultation within the prior year (aOR 0.185, 95% CI 0.0950-0.360), intra-abdominal surgery during index hospitalization (aOR 0.216, 95% CI 0.0500-0.934), and new diagnosis of CD during index hospitalization (aOR 0.327, 95% CI 0.0950-1.13). The model demonstrated good discrimination (optimism-corrected c-statistic value 0.726) and excellent calibration (Hosmer-Lemeshow goodness-of-fit p-value 0.990). The optimal model probability cut point allowed for a sensitivity of 71.9% and specificity of 70.9% for identifying 90-day re-hospitalization, at a false positivity rate of 29.1% and false negativity rate of 28.1%. CONCLUSIONS Demographic, clinical, and health services variables can help discriminate persons with CD at risk of early re-hospitalization, which could permit targeted post-discharge intervention.
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Affiliation(s)
- C Dziegielewski
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - S Gupta
- Department of Medicine, University of Toronto, Toronto, Ontario, ON, Canada
| | - J Begum
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
- ICES uOttawa, Ottawa, ON, Canada
| | - M Pugliese
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
- ICES uOttawa, Ottawa, ON, Canada
| | - J Lombardi
- Department of Medicine, McMaster University, Hamilton, Ontario, ON, Canada
| | - Kelly E
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - McCurdy Jd
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
- The Ottawa Hospital IBD Centre, 501 Smyth Rd, K1H 8L6, Ottawa, ON, Canada
| | - R Sy
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
- The Ottawa Hospital IBD Centre, 501 Smyth Rd, K1H 8L6, Ottawa, ON, Canada
| | - Saloojee N
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
- The Ottawa Hospital IBD Centre, 501 Smyth Rd, K1H 8L6, Ottawa, ON, Canada
| | - Ramsay T
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Benchimol Ei
- SickKids Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, ON, Canada
- Child Health Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada
- ICES, Toronto, ON, Canada
- Department of Paediatrics and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Murthy Sk
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
- Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
- ICES uOttawa, Ottawa, ON, Canada.
- The Ottawa Hospital IBD Centre, 501 Smyth Rd, K1H 8L6, Ottawa, ON, Canada.
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Lombardi J, Stec E, Edwards M, Connell T, Sandor M. Comparison of mechanical properties and host tissue response to OviTex™ and Strattice™ surgical meshes: author reply. Hernia 2024; 28:281-282. [PMID: 37855939 PMCID: PMC10891220 DOI: 10.1007/s10029-023-02911-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 10/01/2023] [Indexed: 10/20/2023]
Affiliation(s)
- J Lombardi
- Allergan Aesthetics, an AbbVie Company, 4 Millennium Way, Branchburg, NJ, 08876, USA
| | - E Stec
- Allergan Aesthetics, an AbbVie Company, 4 Millennium Way, Branchburg, NJ, 08876, USA
| | - M Edwards
- Allergan Aesthetics, an AbbVie Company, 4 Millennium Way, Branchburg, NJ, 08876, USA
| | - T Connell
- Allergan Aesthetics, an AbbVie Company, 4 Millennium Way, Branchburg, NJ, 08876, USA
| | - M Sandor
- Allergan Aesthetics, an AbbVie Company, 4 Millennium Way, Branchburg, NJ, 08876, USA.
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Lombardi J, Stec E, Edwards M, Connell T, Sandor M. Comparison of mechanical properties and host tissue response to OviTex™ and Strattice™ surgical meshes. Hernia 2023; 27:987-997. [PMID: 37031315 PMCID: PMC10374700 DOI: 10.1007/s10029-023-02769-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 03/01/2023] [Indexed: 04/10/2023]
Abstract
PURPOSE This study compared the in vitro/benchtop and in vivo mechanical properties and host biologic response to ovine rumen-derived/polymer mesh hybrid OviTex™ with porcine-derived acellular dermal matrix Strattice™ Firm. METHODS OviTex 2S Resorbable (OviTex 2S-R) and Strattice morphology were examined in vitro using histology and scanning electron microscopy; mechanical properties were assessed via tensile test; in vivo host biologic response and explant mechanics were evaluated in a rodent subcutaneous model. Separately, OviTex 1S Permanent (OviTex 1S-P) and Strattice were evaluated in a primate abdominal wall repair model. RESULTS OviTex 2S-R demonstrated layer separation, whereas Strattice retained its structural integrity and demonstrated higher maximum load than OviTex 2S-R out-of-package (124.8 ± 11.1 N/cm vs 37.9 ± 5.5 N/cm, p < 0.001), 24 h (55.7 ± 7.4 N/cm vs 5.6 ± 3.8 N/cm, p < 0.001), 48 h (45.3 ± 14.8 N/cm vs 2.8 ± 2.6 N/cm, p = 0.003), and 72 h (29.2 ± 10.5 N/cm vs 3.2 ± 3.1 N/cm, p = 0.006) following collagenase digestion. In rodents, inflammatory cell infiltration was observed between OviTex 2S-R layers, while Strattice induced a minimal inflammatory response. Strattice retained higher maximum load at 3 (46.3 ± 27.4 N/cm vs 9.5 ± 3.2 N/cm, p = 0.041) and 6 weeks (28.6 ± 14.1 N/cm vs 7.0 ± 3.0 N/cm, p = 0.029). In primates, OviTex 1S-P exhibited loss of composite mesh integrity whereas Strattice integrated into host tissue with minimal inflammation and retained higher maximum load at 1 month than OviTex 1S-P (66.8 ± 43.4 N/cm vs 9.6 ± 4.4 N/cm; p = 0.151). CONCLUSIONS Strattice retained greater mechanical strength as shown by lower susceptibility to collagenase degradation than OviTex 2S-R in vitro, as well as higher maximum load and improved host biologic response than OviTex 2S-R in rodents and OviTex 1S-P in primates.
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Affiliation(s)
- J Lombardi
- Allergan Aesthetics, an AbbVie Company, 4 Millennium Way, Branchburg, NJ, 08876, USA
| | - E Stec
- Allergan Aesthetics, an AbbVie Company, 4 Millennium Way, Branchburg, NJ, 08876, USA
| | - M Edwards
- Allergan Aesthetics, an AbbVie Company, 4 Millennium Way, Branchburg, NJ, 08876, USA
| | - T Connell
- Allergan Aesthetics, an AbbVie Company, 4 Millennium Way, Branchburg, NJ, 08876, USA
| | - M Sandor
- Allergan Aesthetics, an AbbVie Company, 4 Millennium Way, Branchburg, NJ, 08876, USA.
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Chapman CA, Polyakova M, Mueller K, Weise C, Fassbender K, Fliessbach K, Kornhuber J, Lauer M, Anderl-Straub S, Ludolph A, Prudlo J, Staiger A, Synofzik M, Wiltfang J, Riedl L, Diehl-Schmid J, Otto M, Danek A, Hartwigsen G, Schroeter ML, Engel A, Pfüller G, Pino D, Regenbrecht F, Thöne-Otto A, Oberstein T, Landwehrmeyer B, Lombardi J, Semler E, Kassubek J. Structural correlates of language processing in primary progressive aphasia. Brain Commun 2023; 5:fcad076. [PMID: 37013177 PMCID: PMC10066572 DOI: 10.1093/braincomms/fcad076] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 10/27/2022] [Accepted: 03/15/2023] [Indexed: 03/18/2023] Open
Abstract
Abstract
Understanding the relationships between brain structure and language behavior in primary progressive aphasia provides crucial information about these diseases’ pathomechanisms. However, previous investigations have been limited from providing a statistically reliable view of broad language abilities by sample size, variant focus, and task focus. In this study, the authors aimed to determine the relationship between brain structure and language behavior in primary progressive aphasia, to determine the degree to which task-associated regions were atrophied across disease variants, and to determine the degree to which task-related atrophy overlaps across disease variants. Participants were 118 primary progressive aphasia patients and 61 healthy, age-matched controls tested from 2011 to 2018 in the German Consortium for Frontotemporal Lobar Degeneration cohort. Diagnosis of primary progressive aphasia required progressive deterioration of mainly speech and language for ≥ 2 years, and variant was diagnosed by the criteria of Gorno-Tempini et al.2 Twenty-one participants not fulfilling a specific subtype were classified as mixed-variant and excluded. Language tasks of interest included the Boston Naming Test, a German adaptation of the Repeat and Point task, phonemic and category fluency tasks, and the reading/writing subtest of the Aachen Aphasia Test. Brain structure was measured by cortical thickness. We observed networks of language task-associated temporal, frontal, and parietal cortex. Overlapping task-associated atrophy was observed in the left lateral, ventral, and medial temporal lobe, middle and superior frontal gyrus, supramarginal gyrus, and insula. Some regions, primarily in the perisylvian region were associated with language behavior despite showing no significant atrophy. The results crucially extend less powerful studies associating brain and language measures in primary progressive aphasia. Cross-variant atrophy in task-associated regions suggests partially shared underlying deficits, whereas unique atrophy reinforces variant-specific deficits. Language task-related regions that are not obviously atrophied suggest regions of future network disruption and encourage understanding of task deficits beyond clearly atrophied cortex. These results may pave the way for new treatment approaches.
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Affiliation(s)
- Curtiss A Chapman
- Max Planck Institute for Human Cognitive and Brain Sciences, Lise Meitner Group for Cognition and Plasticity , Leipzig 04103 , Germany
| | - Maryna Polyakova
- Max Planck Institute for Human Cognitive and Brain Sciences, Department of Neurology , Leipzig 04103 , Germany
- Department of Neurology, University of Leipzig Medical Center , Leipzig 04103 , Germany
| | - Karsten Mueller
- Max Planck Institute for Human Cognitive and Brain Sciences, Department of Neurology , Leipzig 04103 , Germany
| | - Christopher Weise
- Department of Neurology, University of Leipzig Medical Center , Leipzig 04103 , Germany
- Department of Neurology, University of Halle Medical Center , Halle 06120 , Germany
| | - Klaus Fassbender
- Department of Neurology, Saarland University Hospital , Homburg 66421 , Germany
| | - Klaus Fliessbach
- Department of Psychiatry and Psychotherapy, University Hospital Bonn , Bonn 53127 , Germany
- German Center for Neurodegenerative Diseases (DZNE) , Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University Hospital Erlangen , Erlangen 91054 , Germany
| | - Martin Lauer
- Department of Psychiatry and Psychotherapy, University Hospital Würzburg , Würzburg 97080 , Germany
| | | | - Albert Ludolph
- Department of Neurology, University of Ulm , Ulm 89081 , Germany
| | - Johannes Prudlo
- German Center for Neurodegenerative Diseases (DZNE) , Germany
- Department of Neurology, University Medicine Rostock , Rostock 18051 , Germany
| | - Anja Staiger
- Clinical Neuropsychology Research Group, Institute of Phonetics and Speech Processing, Ludwig-Maximilians-University Munich , Munich 80539 , Germany
| | - Matthis Synofzik
- German Center for Neurodegenerative Diseases (DZNE) , Germany
- Department of Neurodegenerative Diseases, Center of Neurology, Hertie Institute for Clinical Brain Research , Tübingen 72076 , Germany
| | - Jens Wiltfang
- German Center for Neurodegenerative Diseases (DZNE) , Germany
- Department of Psychiatry and Psychotherapy, Medical University Göttingen , Göttingen 37075 , Germany
| | - Lina Riedl
- Department of Psychiatry and Psychotherapy, Technical University of Munich , Munich 80333 , Germany
| | - Janine Diehl-Schmid
- Department of Psychiatry and Psychotherapy, Technical University of Munich , Munich 80333 , Germany
| | - Markus Otto
- Department of Neurology, University of Ulm , Ulm 89081 , Germany
| | - Adrian Danek
- Department of Neurology, Ludwig-Maximilians-University Munich , Munich 80539 , Germany
| | - Gesa Hartwigsen
- Max Planck Institute for Human Cognitive and Brain Sciences, Lise Meitner Group for Cognition and Plasticity , Leipzig 04103 , Germany
| | - Matthias L Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences, Department of Neurology , Leipzig 04103 , Germany
- Department of Neurology, University of Leipzig Medical Center , Leipzig 04103 , Germany
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Bocchetta M, Todd EG, Bouzigues A, Cash DM, Nicholas JM, Convery RS, Russell LL, Thomas DL, Malone IB, Iglesias JE, van Swieten JC, Jiskoot LC, Seelaar H, Borroni B, Galimberti D, Sanchez-Valle R, Laforce R, Moreno F, Synofzik M, Graff C, Masellis M, Tartaglia MC, Rowe JB, Vandenberghe R, Finger E, Tagliavini F, de Mendonça A, Santana I, Butler CR, Ducharme S, Gerhard A, Danek A, Levin J, Otto M, Sorbi S, Le Ber I, Pasquier F, Rohrer JD, Esteve AS, Nelson A, Heller C, Greaves CV, Benotmane H, Zetterberg H, Swift IJ, Samra K, Shafei R, Timberlake C, Cope T, Rittman T, Benussi A, Premi E, Gasparotti R, Archetti S, Gazzina S, Cantoni V, Arighi A, Fenoglio C, Scarpini E, Fumagalli G, Borracci V, Rossi G, Giaccone G, Di Fede G, Caroppo P, Tiraboschi P, Prioni S, Redaelli V, Tang-Wai D, Rogaeva E, Castelo-Branco M, Freedman M, Keren R, Black S, Mitchell S, Shoesmith C, Bartha R, Rademakers R, Poos J, Papma JM, Giannini L, van Minkelen R, Pijnenburg Y, Nacmias B, Ferrari C, Polito C, Lombardi G, Bessi V, Veldsman M, Andersson C, Thonberg H, Öijerstedt L, Jelic V, Thompson P, Langheinrich T, Lladó A, Antonell A, Olives J, Balasa M, Bargalló N, Borrego-Ecija S, Verdelho A, Maruta C, Ferreira CB, Miltenberger G, do Couto FS, Gabilondo A, Gorostidi A, Villanua J, Cañada M, Tainta M, Zulaica M, Barandiaran M, Alves P, Bender B, Wilke C, Graf L, Vogels A, Vandenbulcke M, Van Damme P, Bruffaerts R, Poesen K, Rosa-Neto P, Gauthier S, Camuzat A, Brice A, Bertrand A, Funkiewiez A, Rinaldi D, Saracino D, Colliot O, Sayah S, Prix C, Wlasich E, Wagemann O, Loosli S, Schönecker S, Hoegen T, Lombardi J, Anderl-Straub S, Rollin A, Kuchcinski G, Bertoux M, Lebouvier T, Deramecourt V, Santiago B, Duro D, Leitão MJ, Almeida MR, Tábuas-Pereira M, Afonso S. Structural MRI predicts clinical progression in presymptomatic genetic frontotemporal dementia: findings from the GENetic Frontotemporal dementia Initiative (GENFI) cohort. Brain Commun 2023; 5:fcad061. [PMID: 36970046 PMCID: PMC10036293 DOI: 10.1093/braincomms/fcad061] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/22/2022] [Accepted: 03/08/2023] [Indexed: 03/12/2023] Open
Abstract
Abstract
Biomarkers that can predict disease progression in individuals with genetic frontotemporal dementia are urgently needed. We aimed to identify whether baseline MRI-based grey and white matter abnormalities are associated with different clinical progression profiles in presymptomatic mutation carriers in the GENetic Frontotemporal dementia Initiative.
387 mutation carriers were included (160 GRN, 160 C9orf72, 67 MAPT), together with 240 non-carrier cognitively normal controls. Cortical and subcortical grey matter volumes were generated using automated parcellation methods on volumetric 3 T T1-weighted MRI scans, while white matter characteristics were estimated using diffusion tensor imaging. Mutation carriers were divided into two disease stages based on their global CDR®+NACC-FTLD score: presymptomatic (0 or 0.5) and fully symptomatic (1 or greater). W-scores in each grey matter volumes and white matter diffusion measures were computed to quantify the degree of abnormality compared to controls for each presymptomatic carrier, adjusting for their age, sex, total intracranial volume, and scanner type. Presymptomatic carriers were classified as “normal” or “abnormal” based on whether their grey matter volume and white matter diffusion measure w-scores were above or below the cut point corresponding to the 10th percentile of the controls. We then compared the change in disease severity between baseline and one year later in both the “normal” and “abnormal” groups within each genetic subtype, as measured by the CDR®+NACC-FTLD sum-of-boxes score and revised Cambridge Behavioural Inventory total score.
Overall, presymptomatic carriers with normal regional w-scores at baseline did not progress clinically as much as those with abnormal regional w-scores. Having abnormal grey or white matter measures at baseline was associated with a statistically significant increase in the CDR®+NACC-FTLD of up to 4 points in C9orf72 expansion carriers, and 5 points in the GRN group as well as a statistically significant increase in the revised Cambridge Behavioural Inventory of up to 11 points in MAPT, 10 points in GRN, and 8 points in C9orf72 mutation carriers.
Baseline regional brain abnormalities on MRI in presymptomatic mutation carriers are associated with different profiles of clinical progression over time. These results may be helpful to inform stratification of participants in future trials.
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Affiliation(s)
- Martina Bocchetta
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London , London , United Kingdom
- Centre for Cognitive and Clinical Neuroscience, Division of Psychology, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London , London , United Kingdom
| | - Emily G Todd
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London , London , United Kingdom
| | - Arabella Bouzigues
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London , London , United Kingdom
| | - David M Cash
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London , London , United Kingdom
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London , London , United Kingdom
| | - Jennifer M Nicholas
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine , London , United Kingdom
| | - Rhian S Convery
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London , London , United Kingdom
| | - Lucy L Russell
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London , London , United Kingdom
| | - David L Thomas
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London , London , United Kingdom
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London , London , United Kingdom
| | - Ian B Malone
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London , London , United Kingdom
| | - Juan Eugenio Iglesias
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London , London , United Kingdom
- Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School , Charlestown, MA , USA
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology , Cambridge, MA , USA
| | - John C van Swieten
- Department of Neurology and Alzheimer center, Erasmus Medical Center Rotterdam , Rotterdam , the Netherlands
| | - Lize C Jiskoot
- Department of Neurology and Alzheimer center, Erasmus Medical Center Rotterdam , Rotterdam , the Netherlands
| | - Harro Seelaar
- Department of Neurology and Alzheimer center, Erasmus Medical Center Rotterdam , Rotterdam , the Netherlands
| | - Barbara Borroni
- Centre for Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia , Brescia , Italy
| | - Daniela Galimberti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan , Milan , Italy
- Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico , Milan , Italy
| | - Raquel Sanchez-Valle
- Neurology Department, Hospital Clinic, Institut d’Investigacions Biomèdiques , Barcelona , Spain
| | - Robert Laforce
- Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques, CHU de Québec, Faculté de Médecine, Université Laval , Québec , Canada
| | - Fermin Moreno
- Hospital Universitario Donostia , San Sebastian , Spain
| | - Matthis Synofzik
- Division Translational Genomics of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany
- German Center for Neurodegenerative Diseases (DZNE) , Tübingen , Germany
| | - Caroline Graff
- Karolinska Institutet, Department NVS, Division of Neurogeriatrics , Stockholm , Sweden
- Unit for Hereditary Dementia, Theme Aging, Karolinska University Hospital-Solna Stockholm , Stockholm , Sweden
| | - Mario Masellis
- Campbell Cognitive Neurology Research Unit, Sunnybrook Research Institute , Toronto, ON , Canada
| | - Maria Carmela Tartaglia
- Toronto Western Hospital, Tanz Centre for Research in Neurodegenerative Disease , Toronto, ON , Canada
| | - James B Rowe
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust and Medical Research Council Cognition and brain Sciences Unit, University of Cambridge , Cambridge , United Kingdom
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences , KU Leuven, Leuven , Belgium
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, University of Western Ontario , London, ON , Canada
| | - Fabrizio Tagliavini
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Neurologico Carlo Besta , Milan , Italy
| | | | - Isabel Santana
- Neurology Department, Centro Hospitalar e Universitário de Coimbra , Coimbra , Portugal
| | - Chris R Butler
- Department of Clinical Neurology, University of Oxford , Oxford , United Kingdom
| | - Simon Ducharme
- Department of Neurology and Neurosurgery, McGill University , Montreal, Quebec , Canada
| | - Alexander Gerhard
- Division of Neuroscience and Experimental Psychology, Wolfson Molecular Imaging Centre, University of Manchester , Manchester , United Kingdom
- Departments of Geriatric Medicine and Nuclear Medicine, University of Duisburg-Essen , Essen , Germany
| | - Adrian Danek
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, Munich; German Center for Neurodegenerative Diseases (DZNE) , Munich; Munich Cluster of Systems Neurology, Munich , Germany
| | - Johannes Levin
- Neurologische Klinik und Poliklinik, Ludwig-Maximilians-Universität, Munich; German Center for Neurodegenerative Diseases (DZNE) , Munich; Munich Cluster of Systems Neurology, Munich , Germany
| | - Markus Otto
- Department of Neurology, University Hospital Ulm , Ulm , Germany
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence , Florence , Italy
- IRCCS Fondazione Don Carlo Gnocchi , Florence , Italy
| | - Isabelle Le Ber
- Sorbonne Université, Paris Brain Institute – Institut du Cerveau– ICM , Inserm U1127, CNRS UMR 7225, AP-HP - Hôpital Pitié-Salpêtrière, Paris , France
- Centre deréférence des démences rares ou précoces , IM2A, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris , France
- Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière , Paris , France
| | - Florence Pasquier
- Univ Lille , Lille , France
- Inserm 1172 , Lille , France
- CHU, CNR-MAJ, Labex Distalz, LiCENDLille , Lille , France
| | - Jonathan D Rohrer
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London , London , United Kingdom
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Dziegielewski C, Gupta S, Lombardi J, Kelly E, McCurdy J, Sy R, Ramsay T, Begum J, Murthy S. A166 RISK STRATIFICATION OF EARLY RE-HOSPITALIZATION IN PERSONS WITH INFLAMMATORY BOWEL DISEASES USING MULTIVARIABLE MODELS. J Can Assoc Gastroenterol 2023. [PMCID: PMC9991272 DOI: 10.1093/jcag/gwac036.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2023] Open
Abstract
Background Hospitalization for persons with inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), is a significant contributor to morbidity and health care costs in Canada. Recognition of individuals at high risk of re-hospitalization could help inform targeted outpatient interventions that mitigate this risk. Purpose The aim of our study is to derive prediction models of risk of early (90-day) re-hospitalization among persons with IBD. Method We conducted a retrospective cohort study of all adult persons with IBD admitted to The Ottawa Hospital, Canada, for an acute IBD-related indication between April 2009 - March 2016. Demographic, clinical, and health services variables were obtained through chart review. Persons were linked to population-based health administrative datasets to identify historical and future IBD-related hospitalizations across the greater Ottawa region. Multivariable logistic regression models of 90-day re-hospitalization in persons with CD and UC were derived, and candidate predictors that demonstrated an independent association with the outcome at a p-value of 0.1 were retained. Bootstrap internal validation (200 iterations) was performed on the final models. Model performance and calibration were evaluated using the optimism-corrected c-statistic value and Hosmer-Lemeshow goodness of fit test, respectively. Adjusted odds ratios are reported with 95% confidence intervals (CI). Optimal probability cut points for re-hospitalization were selected to optimize sensitivity, specificity, and the J (Youden’s) index. Result(s) There were 524 CD and 248 UC hospitalizations during the study period. Of these, 57 (10.9%) CD and 27 (10.9%) UC hospitalizations were associated with re-hospitalization within 90 days of discharge. Forty-two candidate predictors were tested among CD hospitalizations, and 35 were tested among UC hospitalizations. Four variables were retained in each of the final models. Model performance and calibration for each variable are described in Table 1. The optimal range of probability cut points allowed for a sensitivity/positive predictive value (PPV)/false positive rate (FPR) of 0.72/0.23/0.29 (maximum J-index of 0.43) in the model for CD, and 0.78/0.33/0.19 (maximum J-index of 0.59) in the model for UC, respectively. Image ![]()
Conclusion(s) Demographic, clinical, and health services variables at the time of discharge have the potential to help identify persons with IBD at risk of early re-hospitalization, thereby permitting targeted outpatient intervention. Application of the models to our reference cohorts would earmark 1/3 or less of patients for early post-discharge intervention, with the potential to benefit more than 70% of patients destined for early re-hospitalization. Although the PPVs of our models were low, the models incorrectly predicted early re-hospitalization in less than 30% of patients. We are in process of externally validating these models in other jurisdictions across Ontario to test their generalizability. Please acknowledge all funding agencies by checking the applicable boxes below None Disclosure of Interest None Declared
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Affiliation(s)
| | - S Gupta
- Department of Medicine, University of Toronto, Toronto
| | - J Lombardi
- Department of Anesthesia, McMaster University, Hamilton
| | - E Kelly
- Department of Medicine, University of Ottawa, Ottawa,Ottawa Hospital Research Institute,The Ottawa Hospital
| | - J McCurdy
- Department of Medicine, University of Ottawa, Ottawa,Ottawa Hospital Research Institute,The Ottawa Hospital
| | - R Sy
- Department of Medicine, University of Ottawa, Ottawa,Ottawa Hospital Research Institute,The Ottawa Hospital
| | - T Ramsay
- Ottawa Hospital Research Institute,University of Ottawa
| | - J Begum
- University of Ottawa,ICES uOttawa, Ottawa, Canada
| | - S Murthy
- Department of Medicine, University of Ottawa, Ottawa,Ottawa Hospital Research Institute,The Ottawa Hospital
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7
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Halbgebauer S, Steinacker P, Riedel D, Oeckl P, Anderl-Straub S, Lombardi J, von Arnim CAF, Nagl M, Giese A, Ludolph AC, Otto M. Visinin-like protein 1 levels in blood and CSF as emerging markers for Alzheimer's and other neurodegenerative diseases. Alzheimers Res Ther 2022; 14:175. [PMID: 36419075 PMCID: PMC9682835 DOI: 10.1186/s13195-022-01122-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 11/08/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Visinin-like protein 1 (VILIP-1) belongs to the group of emerging biomarkers with the potential to support the early diagnosis of Alzheimer's disease (AD). However, studies investigating the differential diagnostic potential in cerebrospinal fluid (CSF) are rare and are not available for blood. METHODS We set up a novel, sensitive single molecule array (Simoa) assay for the detection of VILIP-1 in CSF and serum. In total, paired CSF and serum samples from 234 patients were investigated: 73 AD, 18 behavioral variant frontotemporal dementia (bvFTD), 26 parkinsonian syndromes, 20 amyotrophic lateral sclerosis (ALS), 22 Creutzfeldt-Jakob disease (CJD), and 75 non-neurodegenerative control (Con) patients. The differential diagnostic potential of CSF and serum VILIP-1 was assessed using the receiver operating characteristic curve analysis and findings were compared to core AD biomarkers. RESULTS CSF and serum VILIP-1 levels correlated weakly (r=0.32 (CI: 0.20-0.43), p<0.0001). VILIP-1 concentrations in CSF and serum were elevated in AD compared to Con (p<0.0001 and p<0.01) and CJD (p<0.0001 for CSF and serum), and an increase in CSF was observed already in early AD stages (p<0.0001). In the discrimination of AD versus Con, we could demonstrate a strong diagnostic potential for CSF VILIP-1 alone (area under the curve (AUC): 0.87), CSF VILIP-1/CSF Abeta 1-42 (AUC: 0.98), and serum VILIP-1/CSF Abeta 1-42 ratio (AUC: 0.89). CONCLUSIONS We here report on the successful establishment of a novel Simoa assay for VILIP-1 and illustrate the potential of CSF and serum VILIP-1 in the differential diagnosis of AD with highest levels in CJD.
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Affiliation(s)
- Steffen Halbgebauer
- grid.410712.10000 0004 0473 882XDepartment of Neurology, Ulm University Hospital, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany ,grid.424247.30000 0004 0438 0426Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE e.V.), Ulm, Germany
| | - Petra Steinacker
- grid.410712.10000 0004 0473 882XDepartment of Neurology, Ulm University Hospital, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany ,grid.461820.90000 0004 0390 1701Department of Neurology, University Clinic, Halle University Hospital, Martin Luther University Halle/Wittenberg, Ernst-Grube Strasse 49, 06120 Halle (Saale), Germany
| | - Daniel Riedel
- grid.410712.10000 0004 0473 882XDepartment of Neurology, Ulm University Hospital, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany
| | - Patrick Oeckl
- grid.410712.10000 0004 0473 882XDepartment of Neurology, Ulm University Hospital, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany ,grid.424247.30000 0004 0438 0426Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE e.V.), Ulm, Germany
| | - Sarah Anderl-Straub
- grid.410712.10000 0004 0473 882XDepartment of Neurology, Ulm University Hospital, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany
| | - Jolina Lombardi
- grid.410712.10000 0004 0473 882XDepartment of Neurology, Ulm University Hospital, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany
| | - Christine A. F. von Arnim
- grid.410712.10000 0004 0473 882XDepartment of Neurology, Ulm University Hospital, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany ,grid.411984.10000 0001 0482 5331Division of Geriatrics, University Medical Center Göttingen, Göttingen, Germany
| | - Magdalena Nagl
- grid.410712.10000 0004 0473 882XDepartment of Neurology, Ulm University Hospital, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany
| | - Armin Giese
- grid.5252.00000 0004 1936 973XDepartment of Neuropathology, Ludwig-Maximilians-University, Munich, Germany
| | - Albert C. Ludolph
- grid.410712.10000 0004 0473 882XDepartment of Neurology, Ulm University Hospital, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany ,grid.424247.30000 0004 0438 0426Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE e.V.), Ulm, Germany
| | - Markus Otto
- grid.410712.10000 0004 0473 882XDepartment of Neurology, Ulm University Hospital, University of Ulm, Oberer Eselsberg 45, 89081 Ulm, Germany ,grid.461820.90000 0004 0390 1701Department of Neurology, University Clinic, Halle University Hospital, Martin Luther University Halle/Wittenberg, Ernst-Grube Strasse 49, 06120 Halle (Saale), Germany
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Halbgebauer S, Steinacker P, Hengge S, Oeckl P, Abu Rumeileh S, Anderl-Straub S, Lombardi J, Von Arnim CAF, Giese A, Ludolph AC, Otto M. CSF levels of SNAP-25 are increased early in Creutzfeldt-Jakob and Alzheimer's disease. J Neurol Neurosurg Psychiatry 2022; 93:jnnp-2021-328646. [PMID: 35995553 DOI: 10.1136/jnnp-2021-328646] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/22/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Synaptosomal-associated protein 25 (SNAP-25) in cerebrospinal fluid (CSF) is an emerging synaptic biomarker for the early diagnosis of Alzheimer's disease (AD). However, comprehensive studies investigating the marker in Creutzfeldt-Jakob disease (CJD) and in the differential diagnosis of neurodegenerative diseases are still lacking. METHODS We developed a novel, sensitive ELISA for the measurement of SNAP-25 in CSF. In total, we analysed 316 patients from 6 diagnostic groups comprising patients with AD (n=96), CJD (n=55), Parkinson's disease spectrum (n=41), frontotemporal lobar degeneration (n=25) and amyotrophic lateral sclerosis (n=24) and non-neurodegenerative control patients (n=75). Using receiver operating characteristic curve analysis, we analysed the differential diagnostic potential and compared the results with core AD biomarkers. RESULTS SNAP-25 CSF concentrations were elevated in AD and CJD (p<0.0001) but not in the other neurodegenerative diseases. Increased levels were observed already at early AD and CJD stages (p<0.0001). In CJD, SNAP-25 levels correlated negatively with survival time (r=-0.33 (95% CI -0.57 to -0.04, p=0.02). For the discrimination of AD from all other diseases except CJD, we observed a good diagnostic performance for CSF SNAP-25 (area under the curve (AUC) 0.85) which was further improved by applying the ratio with CSF amyloid-β 1-42 (AUC 0.95). For CJD, we could demonstrate a strong differential diagnostic potential against all other groups including AD (AUC 0.97). CONCLUSION Using the novel established CSF SNAP-25 ELISA, we here demonstrate the applicability of SNAP-25 as an early synaptic biomarker for both AD and CJD with a possible prognostic value in patients with CJD.
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Affiliation(s)
| | - Petra Steinacker
- Department of Neurology, University of Ulm, Ulm, Germany
- Neurology, Martin-Luther-Universitat Halle-Wittenberg, Halle, Germany
| | - Sophie Hengge
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Patrick Oeckl
- Department of Neurology, University of Ulm, Ulm, Germany
- German Center for Neurodegenerative Diseases, Ulm, Germany
| | - Samir Abu Rumeileh
- Department of Neurology, University of Ulm, Ulm, Germany
- Neurology, Martin-Luther-Universitat Halle-Wittenberg, Halle, Germany
| | | | | | - Christine A F Von Arnim
- Department of Neurology, University of Ulm, Ulm, Germany
- Department of Geriatrics, University Medical Center Göttingen, Goettingen, Germany
| | - Armin Giese
- Center for Neuropathology and Prion Research, Ludwig-Maximilians-University, Munich, Germany
| | - Albert C Ludolph
- Department of Neurology, University of Ulm, Ulm, Germany
- German Center for Neurodegenerative Diseases, Ulm, Germany
| | - Markus Otto
- Department of Neurology, University of Ulm, Ulm, Germany
- Neurology, Martin-Luther-Universitat Halle-Wittenberg, Halle, Germany
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Bouzigues A, Russell LL, Peakman G, Bocchetta M, Greaves CV, Convery RS, Todd E, Rowe JB, Borroni B, Galimberti D, Tiraboschi P, Masellis M, Tartaglia MC, Finger E, van Swieten JC, Seelaar H, Jiskoot L, Sorbi S, Butler CR, Graff C, Gerhard A, Langheinrich T, Laforce R, Sanchez-Valle R, de Mendonça A, Moreno F, Synofzik M, Vandenberghe R, Ducharme S, Le Ber I, Levin J, Danek A, Otto M, Pasquier F, Santana I, Rohrer JD, Nelson A, Bouzigues A, Heller C, Greaves CV, Cash D, Thomas DL, Todd E, Benotmane H, Zetterberg H, Swift IJ, Nicholas J, Samra K, Russell LL, Bocchetta M, Shafei R, Convery RS, Timberlake C, Cope T, Rittman T, Benussi A, Premi E, Gasparotti R, Archetti S, Gazzina S, Cantoni V, Arighi A, Fenoglio C, Scarpini E, Fumagalli G, Borracci V, Rossi G, Giaccone G, Caroppo P, Tiraboschi P, Prioni S, Redaelli V, Tang-Wai D, Rogaeva E, Castelo-Branco M, Keren R, Black S, Mitchell S, Shoesmith C, Bartha R, Rademakers R, Poos J, Papma JM, Giannini L, Minkelen R, Pijnenburg Y, Nacmias B, Ferrari C, Polito C, Lombardi G, Bessi V, Veldsman M, Andersson C, Thonberg H, Öijerstedt L, Jelic V, Thompson P, Langheinrich T, Lladó A, Antonell A, Olives J, Balasa M, Bargalló N, Borrego-Ecija S, Verdelho A, Maruta C, Ferreira CB, Miltenberger G, do Couto FS, Gabilondo A, Gorostidi A, Villanua J, Cañada M, Tainta M, Zulaica M, Barandiaran M, Alves P, Bender B, Wilke C, Graf L, Vogels A, Vandenbulcke M, Van Damme P, Bruffaerts R, Poesen K, Rosa-Neto P, Gauthier S, Camuzat A, Brice A, Bertrand A, Funkiewiez A, Rinaldi D, Saracino D, Colliot O, Sayah S, Prix C, Wlasich E, Wagemann O, Loosli S, Schönecker S, Hoegen T, Lombardi J, Anderl-Straub S, Rollin A, Kuchcinski G, Bertoux M, Lebouvier T, Deramecourt V, Santiago B, Duro D, Leitão MJ, Almeida MR, Tábuas-Pereira M, Afonso S, Engel A, Polyakova M. Anomia is present pre-symptomatically in frontotemporal dementia due to MAPT mutations. J Neurol 2022; 269:4322-4332. [PMID: 35348856 PMCID: PMC9294015 DOI: 10.1007/s00415-022-11068-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 03/04/2022] [Accepted: 03/06/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION A third of frontotemporal dementia (FTD) is caused by an autosomal-dominant genetic mutation in one of three genes: microtubule-associated protein tau (MAPT), chromosome 9 open reading frame 72 (C9orf72) and progranulin (GRN). Prior studies of prodromal FTD have identified impaired executive function and social cognition early in the disease but few have studied naming in detail. METHODS We investigated performance on the Boston Naming Test (BNT) in the GENetic Frontotemporal dementia Initiative cohort of 499 mutation carriers and 248 mutation-negative controls divided across three genetic groups: C9orf72, MAPT and GRN. Mutation carriers were further divided into 3 groups according to their global CDR plus NACC FTLD score: 0 (asymptomatic), 0.5 (prodromal) and 1 + (fully symptomatic). Groups were compared using a bootstrapped linear regression model, adjusting for age, sex, language and education. Finally, we identified neural correlates of anomia within carriers of each genetic group using a voxel-based morphometry analysis. RESULTS All symptomatic groups performed worse on the BNT than controls with the MAPT symptomatic group scoring the worst. Furthermore, MAPT asymptomatic and prodromal groups performed significantly worse than controls. Correlates of anomia in MAPT mutation carriers included bilateral anterior temporal lobe regions and the anterior insula. Similar bilateral anterior temporal lobe involvement was seen in C9orf72 mutation carriers as well as more widespread left frontal atrophy. In GRN mutation carriers, neural correlates were limited to the left hemisphere, and involved frontal, temporal, insula and striatal regions. CONCLUSION This study suggests the development of early anomia in MAPT mutation carriers, likely to be associated with impaired semantic knowledge. Clinical trials focused on the prodromal period within individuals with MAPT mutations should use language tasks, such as the BNT for patient stratification and as outcome measures.
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Affiliation(s)
- Arabella Bouzigues
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Lucy L Russell
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Georgia Peakman
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Martina Bocchetta
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Caroline V Greaves
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Rhian S Convery
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Emily Todd
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - James B Rowe
- Trust and Medical Research Council Cognition and Brain Sciences Unit, Department of Clinical Neurosciences and Cambridge University Hospitals NHS, University of Cambridge, Cambridge, UK
| | - Barbara Borroni
- Centre for Neurodegenerative Disorders, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Daniela Galimberti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.,Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Mario Masellis
- Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Maria Carmela Tartaglia
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Canada
| | - Elizabeth Finger
- Department of Clinical Neurological Sciences, University of Western Ontario, London, ON, Canada
| | | | - Harro Seelaar
- Department of Neurology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Lize Jiskoot
- Department of Neurology, Erasmus Medical Centre, Rotterdam, Netherlands
| | - Sandro Sorbi
- Department of Neurofarba, University of Florence, Florence, Italy.,IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Chris R Butler
- Nuffield Department of Clinical Neurosciences, Medical Sciences Division, University of Oxford, Oxford, UK.,Department of Brain Sciences, Imperial College London, London, UK
| | - Caroline Graff
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Bioclinicum, Karolinska Institutet, Solna, Sweden.,Unit for Hereditary Dementias, Theme Aging, Karolinska University Hospital, Solna, Sweden
| | - Alexander Gerhard
- Division of Neuroscience and Experimental Psychology, Wolfson Molecular Imaging Centre, University of Manchester, Manchester, UK.,Departments of Geriatric Medicine and Nuclear Medicine, University of Duisburg, Essen, Germany
| | - Tobias Langheinrich
- Division of Neuroscience and Experimental Psychology, Wolfson Molecular Imaging Centre, University of Manchester, Manchester, UK.,Cerebral Function Unit, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK
| | - Robert Laforce
- Département Des Sciences Neurologiques, Clinique Interdisciplinaire de Mémoire, CHU de Québec, and Faculté de Médecine, Université Laval, Québec, QC, Canada
| | - Raquel Sanchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic, Institut d'Investigacións Biomèdiques August Pi I Sunyer, University of Barcelona, Barcelona, Spain
| | | | - Fermin Moreno
- Cognitive Disorders Unit, Department of Neurology, Donostia University Hospital, San Sebastian, Gipuzkoa, Spain.,Neuroscience Area, Biodonostia Health Research Institute, Gipuzkoa, San Sebastian, Spain
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University of Tübingen, Tübingen, Germany.,Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium.,Neurology Service, University Hospitals Leuven, Leuven, Belgium.,Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Simon Ducharme
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Canada.,Department of Neurology & Neurosurgery, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Isabelle Le Ber
- Paris Brain Institute - Institut du Cerveau - ICM, Inserm U1127, CNRS UMR 7225, Sorbonne Université, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France.,Centre de Référence Des Démences Rares Ou Précoces, IM2A, Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France.,Département de Neurologie, AP-HP - Hôpital Pitié-Salpêtrière, Paris, France
| | - Johannes Levin
- Neurologische Klinik Und Poliklinik, Ludwig-Maximilians-Universität, Munich, Germany.,Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Munich Cluster of Systems Neurology, Munich, Germany
| | - Adrian Danek
- Neurologische Klinik Und Poliklinik, Ludwig-Maximilians-Universität, Munich, Germany
| | - Markus Otto
- Department of Neurology, University of Ulm, Ulm, Germany
| | - Florence Pasquier
- Univ Lille, Lille, France.,Inserm 1172, Lille, France.,CHU, CNR-MAJ, Labex Distalz, LiCEND Lille, Lille, France
| | - Isabel Santana
- Neurology Service, Faculty of Medicine, University Hospital of Coimbra (HUC), University of Coimbra, Coimbra, Portugal.,Center for Neuroscience and Cell Biology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Jonathan D Rohrer
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK.
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Seckin M, Ricard I, Raiser T, Heitkamp N, Ebert A, Prix C, Levin J, Diehl-Schmid J, Riedl L, Roßmeier C, Hoen N, Schroeter ML, Marschhauser A, Obrig H, Benke T, Kornhuber J, Fliessbach K, Schneider A, Wiltfang J, Jahn H, Fassbender K, Prudlo J, Lauer M, Duning T, Wilke C, Synofzik M, Anderl-Straub S, Semler E, Lombardi J, Landwehrmeyer B, Ludolph A, Otto M, Danek A. Utility of the Repeat and Point Test for Subtyping Patients With Primary Progressive Aphasia. Alzheimer Dis Assoc Disord 2022; 36:44-51. [PMID: 35001030 DOI: 10.1097/wad.0000000000000482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 02/18/2021] [Accepted: 11/07/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Primary progressive aphasia (PPA) may present with three distinct clinical sybtypes: semantic variant PPA (svPPA), nonfluent/agrammatic variant PPA (nfvPPA), and logopenic variant PPA (lvPPA). OBJECTIVE The aim was to examine the utility of the German version of the Repeat and Point (R&P) Test for subtyping patients with PPA. METHOD During the R&P Test, the examiner reads out aloud a noun and the participants are asked to repeat the word and subsequently point to the corresponding picture. Data from 204 patients (68 svPPA, 85 nfvPPA, and 51 lvPPA) and 33 healthy controls were analyzed. RESULTS Controls completed both tasks with >90% accuracy. Patients with svPPA had high scores in repetition (mean=9.2±1.32) but low scores in pointing (mean=6±2.52). In contrast, patients with nfvPPA and lvPPA performed comparably in both tasks with lower scores in repetition (mean=7.4±2.7 for nfvPPA and 8.2±2.34 for lvPPA) but higher scores in pointing (mean=8.9±1.41 for nfvPPA and 8.6±1.62 for lvPPA). The R&P Test had high accuracy discriminating svPPA from nfvPPA (83% accuracy) and lvPPA (79% accuracy). However, there was low accuracy discriminating nfvPPA from lvPPA (<60%). CONCLUSION The R&P Test helps to differentiate svPPA from 2 nonsemantic variants (nfvPPA and lvPPA). However, additional tests are required for the differentiation of nfvPPA and lvPPA.
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Affiliation(s)
- Mustafa Seckin
- Neurologische Klinik und Poliklinik
- Acibadem Mehmet Ali Aydinlar University School of Medicine, Department of Neurology, İstanbul, Turkey
| | - Ingrid Ricard
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Unversität München
| | | | | | - Anne Ebert
- Neurologische Klinik, Universitätsmedizin Mannheim, Mannheim
| | | | - Johannes Levin
- Neurologische Klinik und Poliklinik
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE)
- Munich Cluster for Systems Neurology (SyNergy)
| | - Janine Diehl-Schmid
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich
| | - Lina Riedl
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich
| | - Carola Roßmeier
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich
| | - Nora Hoen
- Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich
| | - Matthias L Schroeter
- Max Planck Institute for Human Cognitive and Brain Sciences, Neurology, and Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig
| | - Anke Marschhauser
- Max Planck Institute for Human Cognitive and Brain Sciences, Neurology, and Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig
| | - Hellmuth Obrig
- Max Planck Institute for Human Cognitive and Brain Sciences, Neurology, and Clinic for Cognitive Neurology, University Hospital Leipzig, Leipzig
| | - Thomas Benke
- Universitätsklinik für Neurologie, Kognitive Neurologie und Neuropsychologie, Innsbruck, Austria
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen
| | - Klaus Fliessbach
- Klinik für Neurodegenerative Erkrankungen und Gerontopsychiatrie, Universitätsklinikum Bonn & Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Bonn
| | - Anja Schneider
- Klinik für Neurodegenerative Erkrankungen und Gerontopsychiatrie, Universitätsklinikum Bonn & Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Bonn
| | - Jens Wiltfang
- Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin Göttingen, Göttingen
| | - Holger Jahn
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - Klaus Fassbender
- Neurologische Klinik und Poliklinik, Universität des Saarlandes, KirrbergerStraße, Homburg
| | - Johannes Prudlo
- Klinik für Neurologie und Poliklinik, Universitätsklinikum Rostock, Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock
| | - Martin Lauer
- Klinik und Poliklinik für Psychiatrie, Psychosomatik und Psychotherapie, Universität Würzburg, Würzburg
| | - Thomas Duning
- Department of Neurology with Institute of Translational Neurology, University Hospital Münster, Westfälische-Wilhelms-Universität, Münster
| | - Carlo Wilke
- Department of Neurodegenerative Diseases, Centre for Neurology and Hertie-Institute for Clinical Brain Research, University Hospital
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Tübingen
| | - Matthis Synofzik
- Department of Neurodegenerative Diseases, Centre for Neurology and Hertie-Institute for Clinical Brain Research, University Hospital
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Tübingen
| | | | - Elisa Semler
- Neurologische Klinik und Poliklinik, Universität Ulm
| | | | | | - Albert Ludolph
- Neurologische Klinik und Poliklinik, Universität Ulm
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Ulm
| | - Markus Otto
- Neurologische Klinik und Poliklinik, Universität Ulm
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Anderl‐Straub S, Lausser L, Lombardi J, Uttner I, Fassbender K, Fliessbach K, Huppertz H, Jahn H, Kornhuber J, Obrig H, Schneider A, Semler E, Synofzik M, Danek A, Prudlo J, Kassubek J, Landwehrmeyer B, Lauer M, Volk AE, Wiltfang J, Diehl‐Schmid J, Ludolph AC, Schroeter ML, Kestler HA, Otto M. Predicting disease progression in behavioral variant frontotemporal dementia. Alzheimers Dement (Amst) 2021; 13:e12262. [PMID: 35005196 PMCID: PMC8719425 DOI: 10.1002/dad2.12262] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 09/24/2021] [Accepted: 10/01/2021] [Indexed: 11/09/2022]
Abstract
INTRODUCTION The behavioral variant of frontotemporal dementia (bvFTD) is a rare neurodegenerative disease. Reliable predictors of disease progression have not been sufficiently identified. We investigated multivariate magnetic resonance imaging (MRI) biomarker profiles for their predictive value of individual decline. METHODS One hundred five bvFTD patients were recruited from the German frontotemporal lobar degeneration (FTLD) consortium study. After defining two groups ("fast progressors" vs. "slow progressors"), we investigated the predictive value of MR brain volumes for disease progression rates performing exhaustive screenings with multivariate classification models. RESULTS We identified areas that predict disease progression rate within 1 year. Prediction measures revealed an overall accuracy of 80% across our 50 top classification models. Especially the pallidum, middle temporal gyrus, inferior frontal gyrus, cingulate gyrus, middle orbitofrontal gyrus, and insula occurred in these models. DISCUSSION Based on the revealed marker combinations an individual prognosis seems to be feasible. This might be used in clinical studies on an individualized progression model.
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Affiliation(s)
| | - Ludwig Lausser
- Institute of Medical Systems BiologyUniversity of UlmUlmGermany
| | | | - Ingo Uttner
- Department of NeurologyUniversity of UlmUlmGermany
| | | | - Klaus Fliessbach
- Clinic for Neurodegenerative Diseases and Geriatric PsychiatryUniversity Hospital BonnBonnGermany
| | | | - Holger Jahn
- Department of Psychiatry and PsychotherapyUniversity Hospital Hamburg EppendorfHamburgGermany
| | - Johannes Kornhuber
- Department of Psychiatry and PsychotherapyUniversity ErlangenErlangenGermany
| | - Hellmuth Obrig
- Max‐Planck‐Institute of Human Cognitive and Brain Sciences & Clinic for Cognitive NeurologyUniversity Hospital LeipzigLeipzigGermany
| | - Anja Schneider
- Clinic for Neurodegenerative Diseases and Geriatric PsychiatryUniversity Hospital BonnBonnGermany
- German Center for Neurodegenerative Diseases (DZNE)BonnGermany
| | - Elisa Semler
- Department of NeurologyUniversity of UlmUlmGermany
| | - Matthis Synofzik
- Department of Neurodegenerative DiseasesCenter of Neurology and Hertie‐Institute for Clinical Brain ResearchUniversityTübingenGermany
- German Center for Neurodegenerative Diseases (DZNE)TübingenGermany
| | - Adrian Danek
- Department of NeurologyLudwig‐Maximilians‐Universität MünchenMunichGermany
| | - Johannes Prudlo
- Department of NeurologyRostock University Medical Center and German Center for Neurodegenerative Diseases (DZNE)RostockGermany
| | - Jan Kassubek
- Department of NeurologyUniversity of UlmUlmGermany
| | | | - Martin Lauer
- Department of Psychiatry and PsychotherapyUniversity of WürzburgWürzburgGermany
| | - Alexander E. Volk
- Institute for Human GeneticsUniversity Hospital Hamburg EppendorfHamburgGermany
| | - Jens Wiltfang
- Department of Psychiatry and PsychotherapyUniversity Medical Center Göttingen (UMG)GöttingenGermany
- German Center for Neurodegenerative Diseases (DZNE)GöttingenGermany
- Neurosciences and Signaling GroupInstitute of Biomedicine (iBiMED)Department of Medical SciencesUniversity of AveiroAveiroPortugal
| | - Janine Diehl‐Schmid
- Department of Psychiatry and PsychotherapyTechnical University of MunichMunichGermany
| | | | - Matthias L. Schroeter
- Max‐Planck‐Institute of Human Cognitive and Brain Sciences & Clinic for Cognitive NeurologyUniversity Hospital LeipzigLeipzigGermany
| | - Hans A. Kestler
- Institute of Medical Systems BiologyUniversity of UlmUlmGermany
| | - Markus Otto
- Department of NeurologyUniversity of UlmUlmGermany
- Department of NeurologyMartin Luther University Halle‐WittenbergUniversity clinic HalleHalle (Saale)Germany
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12
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Lombardi J, Mayer B, Huppertz H, Straub S, Semler E, Uttner I, Kassubek J, Diehl‐Schmid J, Danek A, Levin J, Fassbender K, Fliessbach K, Schneider A, Jahn H, Kornhuber J, Landwehrmeyer B, Lauer M, Prudlo J, Wiltfang J, Schroeter ML, Ludolph A, Otto M. Factors influencing atrophy progression in primary progressive aphasia. Alzheimers Dement 2021. [DOI: 10.1002/alz.052567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - Benjamin Mayer
- Institute for Epidemiology and Medical Biometry University of Ulm Ulm Germany
| | | | - Sarah Straub
- Department of Neurology University of Ulm Ulm Germany
| | - Elisa Semler
- Department of Neurology University of Ulm Ulm Germany
| | - Ingo Uttner
- Department of Neurology University of Ulm Ulm Germany
| | - Jan Kassubek
- Department of Neurology University of Ulm Ulm Germany
| | - Janine Diehl‐Schmid
- Klinikum rechts der Isar Technical University of Munich School of Medicine Munich Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
| | - Adrian Danek
- Department of Neurology Ludwig‐Maximilians‐Universität Munich Germany
| | - Johannes Levin
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
- LMU Munich Germany
| | | | - Klaus Fliessbach
- Department of Psychiatry and Psychotherapy University Hospital Bonn Bonn Germany
- German Center for Neurodegenerative Diseases (DZNE) Bonn Germany
| | - Anja Schneider
- German Center for Neurodegenerative Diseases (DZNE) Bonn Germany
- Department of Neurodegeneration and Geriatric Psychiatry University Hospital Bonn Bonn Germany
| | - Holger Jahn
- Department of Psychiatry and Psychotherapy University of Hamburg Hamburg Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy University Erlangen Erlangen Germany
| | | | - Martin Lauer
- Department of Psychiatry and Psychotherapy University of Würzburg Würzburg Germany
| | - Johannes Prudlo
- Department of Neurology Rostock University Medical Center and German Center for Neurodegenerative Diseases (DZNE) Rostock Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy University of Göttingen Göttingen Germany
| | - Matthias L. Schroeter
- Clinic for Cognitive Neurology University Clinic Leipzig Leipzig Germany
- Max Planck Institute for Human Cognitive and Brain Sciences Leipzig Germany
| | - Albert Ludolph
- RKU‐University and Rehabilitation Hospital Ulm Ulm Germany
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13
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Lombardi J, Mayer B, Semler E, Anderl‐Straub S, Uttner I, Kassubek J, Diehl‐Schmid J, Danek A, Levin J, Fassbender K, Fliessbach K, Schneider A, Huppertz H, Jahn H, Volk A, Kornhuber J, Landwehrmeyer B, Lauer M, Prudlo J, Wiltfang J, Schroeter ML, Ludolph A, Otto M. Quantifying progression in primary progressive aphasia with structural neuroimaging. Alzheimers Dement 2021; 17:1595-1609. [DOI: 10.1002/alz.12323] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/22/2021] [Accepted: 01/31/2021] [Indexed: 01/22/2023]
Affiliation(s)
| | - Benjamin Mayer
- Institute for Epidemiology and Medical Biometry University of Ulm Ulm Germany
| | - Elisa Semler
- Department of Neurology University Hospital Ulm Ulm Germany
| | | | - Ingo Uttner
- Department of Neurology University Hospital Ulm Ulm Germany
| | - Jan Kassubek
- Department of Neurology University Hospital Ulm Ulm Germany
| | - Janine Diehl‐Schmid
- Department of Psychiatry and Psychotherapy Technical University of Munich Munich Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
| | - Adrian Danek
- Department of Neurology Ludwig‐Maximilians‐Universität München Munich Germany
| | - Johannes Levin
- Department of Neurology Ludwig‐Maximilians‐Universität München Munich Germany
- German Center for Neurodegenerative Diseases (DZNE) Munich Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
| | - Klaus Fassbender
- Department of Neurology Saarland University Hospital Homburg Germany
| | - Klaus Fliessbach
- Department of Psychiatry and Psychotherapy University Hospital Bonn Bonn Germany
- German Center for Neurodegenerative Diseases (DZNE) Bonn Germany
| | - Anja Schneider
- Department of Psychiatry and Psychotherapy University Hospital Bonn Bonn Germany
- German Center for Neurodegenerative Diseases (DZNE) Bonn Germany
| | | | - Holger Jahn
- Department of Psychiatry and Psychotherapy University Hospital Hamburg Eppendorf Hamburg Germany
| | - Alexander Volk
- Institute for Human Genetics University Hospital Hamburg Eppendorf Hamburg Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy University Hospital Erlangen Erlangen Germany
| | | | - Martin Lauer
- Department of Psychiatry and Psychotherapy University Hospital Würzburg Würzburg Germany
| | - Johannes Prudlo
- Department of Neurology University Medicine Rostock Rostock Germany
- German Center for Neurodegenerative Diseases (DZNE) Rostock Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy Medical University Göttingen Göttingen Germany
| | - Matthias L. Schroeter
- Max‐Planck‐Institute for Human Cognitive and Brain Sciences and Clinic for Cognitive Neurology University Hospital Leipzig Leipzig Germany
| | - Albert Ludolph
- Department of Neurology University Hospital Ulm Ulm Germany
| | - Markus Otto
- Department of Neurology University Hospital Ulm Ulm Germany
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14
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Tan P, Yau K, Ukos M, Miller C, Lombardi J, Kelly E. A222 ASSOCIATION BETWEEN PROTON PUMP INHIBITOR USE AND DEVELOPMENT OF HEPATIC ENCEPHALOPATHY AND SPONTANEOUS BACTERIAL PERITONITIS IN HOSPITALIZED PATIENTS WITH CIRRHOSIS. J Can Assoc Gastroenterol 2021. [DOI: 10.1093/jcag/gwab002.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Proton pump inhibitors (PPIs) are commonly prescribed medications which are indicated in various different gastrointestinal (GI) diseases, including peptic ulcer disease, gastroesophageal reflux disorder and upper GI bleeding. There is some evidence to suggest that PPI use in cirrhosis may predispose to the development of hepatic encephalopathy (HE) and spontaneous bacterial peritonitis (SBP), albeit with some controversy.
Aims
We aim to conduct a retrospective epidemiological analysis of the association between PPI use in hospitalized patients with cirrhosis and prevalence of HE and SBP.
Methods
This was a retrospective cohort study of 953 adult patients (mean age 62.3 (SD=12.2)) with cirrhosis admitted to the Ottawa Hospital between January 1, 2011 and December 31, 2015. A chart review was conducted and relevant information extracted.
Results
Average MELD-Na on admission was 17.4 (SD = 7.5) with no significant differences when stratified by in-hospital PPI use (p=0.53). 14.7% of patients had a prior history of HE, 5.4% SBP, 31.6% ascites, 9.3% hepatocellular carcinoma and 1.2% hepatorenal syndrome. 26.4% of patients had a history of varices, of which 34.4% had previous variceal bleeding. 45.4% of patients were on a PPI prior to admission and 69.8% during their hospitalization. Patients with a previous history of HE (16.8% vs. 9.6% p=0.006), varices (31.4% vs. 14.2% p<0.001) and variceal bleed (11.6% vs. 3.1% p<0.001) were more likely to be exposed to a PPI in-hospital. Mortality rate during index admission was 19.4%.
There was no significant association noted between the incidence of HE (31.2% vs. 25.0% p=0.06) or SBP (10.4% vs. 8.0% p=0.25) and in-hospital PPI use. There was also no significant association between PPI use and infectious complications, including bacteremia (8.6% vs. 7.6% p=0.63), pneumonia (12.7% vs. 12.5% p=0.95), urinary tract infections (9.2% vs. 6.6% p=0.19) and clostridium difficile (3.8% vs. 2.1% p=0.18). Patients on a PPI had greater in-hospital mortality (22.0% vs. 13. 5% p=0.002), although there was no significance between cause of death (p=0.31) nor death from infectious complications (18.5% vs. 23.1% p=0.52) between groups. Length of stay (LOS) was longer in patients exposed to PPI (median (IQR) 7 (4–17) vs 6 (3–13) p=0.03). Similar findings were noted on subgroup analysis of decompensated patients.
Conclusions
We did not observe a significant difference in HE, SBP or infectious complications among this cohort of cirrhotic patients by in-hospital PPI use. However, there was a significantly higher mortality rate noted in hospital and longer LOS, despite similar baseline MELD-Na and causes of death. Further study and judicious PPI prescribing practices in this vulnerable population of patients is warranted.
Funding Agencies
None
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Affiliation(s)
- P Tan
- Ottawa Hospital, Ottawa, ON, Canada
| | - K Yau
- Ottawa Hospital, Ottawa, ON, Canada
| | - M Ukos
- Ottawa Hospital, Ottawa, ON, Canada
| | - C Miller
- Ottawa Hospital, Ottawa, ON, Canada
| | | | - E Kelly
- Ottawa Hospital, Ottawa, ON, Canada
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15
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Tan P, Ukos M, Miller C, Lombardi J, Kelly EM. A70 ASSOCIATION BETWEEN PROTON PUMP INHIBITOR USE IN HOSPITALIZED CIRRHOTICS AND DEVELOPMENT OF HEPATIC ENCEPHALOPATHY AND SPONTANEOUS BACTERIAL PERITONITIS. J Can Assoc Gastroenterol 2020. [DOI: 10.1093/jcag/gwz047.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Proton pump inhibitors (PPI) are commonly prescribed medications which are indicated in various different gastrointestinal (GI) diseases, including peptic ulcer disease, gastroesophageal reflux disorder and upper GI bleeding. There is some evidence to suggest that PPI use in cirrhosis may predispose to the development of hepatic encephalopathy (HE) and spontaneous bacterial peritonitis (SBP), albeit with some controversy.
Aims
We aim to conduct a retrospective epidemiological analysis of the association between PPI use in hospitalized patients with cirrhosis, and prevalence of HE and SBP.
Methods
This was a retrospective cohort study of 600 adult patients (mean age 61.4 (SD=12.2)) admitted the Ottawa Hospital between January 1, 2011 and December 31, 2015 with cirrhosis. A chart review was conducted and relevant information extracted.
Results
Average MELD-Na on admission was 16.2 (sd=6.7). 14.8% of patients had a history of HE, 5.0% SBP, 7.8% with history of hepatocellular carcinoma and 1.0% with history of hepatorenal syndrome. 28.5% of patients had a history of varices, of which 11.0% had previous variceal bleeding. 69.3% of patients were on a PPI during their hospitalization. Not surprisingly, patients admitted with variceal bleeding were more likely to be exposed to PPI in hospital (97.2% vs 63.2%, p<0.01) Patients with a diagnosis of cirrhosis prior to index admission were more likely to be on a PPI in hospital (p=0.001) and on discharge (p=0.001). Patients with ascites were less likely to be on a PPI than those without ascites (64.1% vs 77.6%, p<0.01). There was no significant correlation between in hospital PPI use and MELD score (p=0.42). Amongst patients on PPI in hospital, 85.9% remained on a PPI at discharge. Although numerically greater, no statistically significant differences were observed in terms of prevalence of HE (21.3% in patients on PPI vs 8.3% in those not on PPI (p=0.37)), nor SBP (5.7% on PPI vs. 3.7% in those not on PPI (p=0.29)).
Conclusions
We did not observe a significant difference in HE and SBP among this cohort of cirrhotic patients by in-hospital PPI use. We did however note significantly higher PPI use in patients with previous diagnosis of cirrhosis as compared to those who were newly diagnosed, as well as those whose admissions were related to bleeding. Patients with ascites had lower prevalence of PPI use. Prescribing patterns for PPIs in patients with cirrhosis warrant further attention, including clinical utility and longer-term risks and benefits of this therapy.
Funding Agencies
None
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Affiliation(s)
- P Tan
- University of Ottawa, Ottawa, ON, Canada
| | - M Ukos
- University of Ottawa, Ottawa, ON, Canada
| | - C Miller
- University of Ottawa, Ottawa, ON, Canada
| | - J Lombardi
- University of Ottawa, Ottawa, ON, Canada
| | - E M Kelly
- Gastroenterology and Hepatology, University of Ottawa, Ottawa, ON, Canada
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16
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Abramson T, Sanko S, Eckstein M, Lombardi J. 105 Cardiac Arrest Masquerading as Seizure: Dispatch for Agonal Breathing. Ann Emerg Med 2019. [DOI: 10.1016/j.annemergmed.2019.08.110] [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: 11/16/2022]
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17
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Abramson T, Conroy M, Sanko S, Eckstein M, Lombardi J. 166 Disproportionate Use of EMS Resources by Homeless Patients. Ann Emerg Med 2019. [DOI: 10.1016/j.annemergmed.2019.08.172] [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: 10/25/2022]
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18
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Lombardi J, Anderl-Straub S, Semler E, Uttner I, Kassubek J, Diehl-Schmid J, Danek A, Fassbender K, Fliessbach K, Huppertz HJ, Jahn H, Kornhuber J, Landwehrmeyer B, Lauer M, Mayer B, Prudlo J, Schneider A, Schroeter ML, Ludolph A, Otto M. P4-297: MRI AS OBJECTIVE FOLLOW-UP PARAMETER IN PATIENTS OF PRIMARY PROGRESSIVE APHASIAS. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | | | - Elisa Semler
- Department of Neurology; University of Ulm; Ulm Germany
| | - Ingo Uttner
- Department of Neurology; University of Ulm; Ulm Germany
| | - Jan Kassubek
- Department of Neurology; University of Ulm; Ulm Germany
| | | | - Adrian Danek
- Ludwig-Maximilians-Universität München; Munich Germany
| | | | - Klaus Fliessbach
- Clinic for Neurodegenerative Diseases Geriatric Psychiatry; University Hospital Bonn; Bonn Germany
- German Center for Neurodegenerative Diseases (DZNE); Bonn Germany
| | | | | | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy; University Erlangen; Erlangen Germany
| | | | - Martin Lauer
- Department of Psychiatry and Psychotherapy; University of Würzburg; Würzburg Germany
| | - Benjamin Mayer
- Institute for Epidemiology and Medical Biometry; University of Ulm; Ulm Germany
| | - Johannes Prudlo
- Department of Neurology; Rostock University Medical Center and German Center for Neurodegenerative Diseases (DZNE); Rostock Germany
| | - Anja Schneider
- Universitätsmedizin Göttingen; Klink für Psychiatrie und Psychotherapie; Göttingen Germany
| | | | | | - Markus Otto
- Department of Neurology; University of Ulm; Ulm Germany
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Alhussein M, Battioni L, Runeckles K, Duero Posada J, Moayedi Y, Lombardi J, Ross H, Billia F, Rao V, Butany J, McDonald M. Pathological Correlation Between Apical Core Biopsies at the Time of Left Ventricular Assist Device Implantation and Excised Heart at Time of Transplant or Autopsy. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.774] [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: 10/17/2022] Open
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20
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Lombardi J, Semama D. Stabilité physico-chimique des nutritions parentérales individualisées en néonatologie. Annales Pharmaceutiques Françaises 2018; 76:154-162. [DOI: 10.1016/j.pharma.2018.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 12/20/2017] [Accepted: 01/04/2018] [Indexed: 11/25/2022]
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21
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Darmstadt GL, Khan NZ, Lombardi J, Richter LM. Scaling up early childhood development programmes in low and middle-income countries. Child Care Health Dev 2018; 44:1-3. [PMID: 29235168 DOI: 10.1111/cch.12441] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 11/27/2016] [Indexed: 11/30/2022]
Affiliation(s)
- G L Darmstadt
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - N Z Khan
- Department of Pediatric Neuroscience, Dhaka Shishu Hospital, Bangladesh Institute of Child Health, Dhaka, Bangladesh
| | - J Lombardi
- Bernard van Leer Foundation, Washington, DC, USA
| | - L M Richter
- DST-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
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22
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Hao YN, Bi K, O'Brien S, Wang XX, Lombardi J, Pearsall F, Li WL, Lei M, Wu Y, Li LT. Interface structure, precursor rheology and dielectric properties of BaTiO3/PVDF–hfp nanocomposite films prepared from colloidal perovskite nanoparticles. RSC Adv 2017. [DOI: 10.1039/c7ra03250a] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A novel and greatly simplified strategy was developed to fabricate high-permittivity dielectric nanocomposites. Interface structure, precursor rheology and dielectric properties of the 0–3 BaTiO3/PVDF–hfp nanocomposite film were investigated.
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23
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Hao YN, Bi K, O’Brien S, Wang XH, Lombardi J, Pearsall F, Li WL, Lei M, Wu Y, Li LT. Correction: Interface structure, precursor rheology and dielectric properties of BaTiO 3/PVDF–hfp nanocomposite films prepared from colloidal perovskite nanoparticles. RSC Adv 2017. [DOI: 10.1039/c7ra90094e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Correction for ‘Interface structure, precursor rheology and dielectric properties of BaTiO3/PVDF–hfp nanocomposite films prepared from colloidal perovskite nanoparticles’ by Y. N. Hao et al., RSC Adv., 2017, 7, 32886–32892.
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Triozzi P, Gochnour D, Martin E, Aldrich W, Powell J, Kim J, Young D, Lombardi J. Clinical and immunological effects of a synthetic Beta-human chorionic-gonadotropin vaccine. Int J Oncol 2012; 5:1447-53. [PMID: 21559734 DOI: 10.3892/ijo.5.6.1447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We treated 23 patients with non-trophoblastic cancers with escalating doses of a synthetic vaccine consisting of the carboxy-terminal peptide of beta human chorionic gonadotropin conjugated to diphtheria toroid (CTP37), a muramyl dipeptide as an adjuvant, and squalene/mannide monooleate as a vehicle. Toxicity consisted of pain and sterile abscess formation at the injection site and of constitutional symptoms. Diphtheria toxoid hypersensitivity developed in one patient. Immunizations elicited anti-beta hCG IgG antibody which persisted for more than 10 months. Disappearance of circulating hCG present pre-immunization and tumor regressions were observed. Active specific immunotherapy with CTP37 vaccine is well-tolerated and has biological activity in patients with cancer.
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Affiliation(s)
- P Triozzi
- OHIO STATE UNIV,CTR COMPREHENS CANC,ARTHUR G JAMES CANC HOSP & RES INST,COLUMBUS,OH 43210
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Lee A, Fischer L, DiMatteo C, Wrigley C, Golesorkhi N, Carabasi A, Lombardi J, Larson R, Tulenko T, DiMuzio P. Differentiation of human adipose-derived adult stem (ADAS) cells into endothelial cells. J Surg Res 2006. [DOI: 10.1016/j.jss.2005.11.300] [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: 11/15/2022]
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Schindler N, Calligaro KD, Lombardi J, Dougherty MJ, Raviola CA, D'Orazio E. Has arteriography gotten a bad name? Current accuracy and morbidity of diagnostic contrast arteriography for aortoiliac and lower extremity arterial disease. Ann Vasc Surg 2001; 15:417-20. [PMID: 11525530 DOI: 10.1007/s100160010114] [Citation(s) in RCA: 5] [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: 10/26/2022]
Abstract
Recently, contrast arteriography has been challenged as the diagnostic test of choice for lower extremity arterial disease because of its associated morbidity and questionable accuracy in identifying suitable distal outflow arteries. The purpose of this report was to analyze our experience to determine if these concerns were justified. We reviewed 500 consecutive contrast arteriograms performed at our hospital for aortoiliac and lower extremity arterial disease between November 1994 and November 1998. Arteriograms performed in conjunction with therapeutic procedures such as balloon angioplasty, stent placement, and thrombolysis were excluded, leaving 244 diagnostic cases for analysis. Forty-six percent (112) of patients had diabetes mellitus, 14% (34) had an elevated baseline serum creatinine (> or =1.5 mg/dL), and an additional 7% (17) were dialysis dependent. Radiologists limited contrast volume by imaging only the symptomatic extremity when appropriate and using digital subtraction techniques as indicated. Our results showed that diagnostic contrast arteriography is associated with an acceptably low morbidity, has an accuracy that is unlikely to be surpassed by other modalities, and remains the diagnostic test of choice for lower extremity arterial disease.
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Affiliation(s)
- N Schindler
- Section of Vascular Surgery, Pennsylvania Hospital, Philadelphia 19106, USA
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27
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Vivoni A, Birke R, Lombardi J. Optimization of force constants with an Urey-Bradley force field avoiding normal mode crossings. Spectrochim Acta A Mol Biomol Spectrosc 2001; 57:535-544. [PMID: 11300565 DOI: 10.1016/s1386-1425(00)00406-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
We present a method that simplifies the refinement of force constants in normal mode calculations and makes the results more reliable. The method avoids normal mode crossings by constraining the force constants during refinement. It was tested with pyrrole, imidazole, benzene, pyridine, pyrimidine, aniline and adenine using a Urey-Bradley force field. The global error of the frequency fit for these molecules was 0.61%. The method reproduced with fewer parameters the accuracy of similar calculations of the single ring aromatic compounds. It improved the accuracy and isotopic shifts of previous empirical calculations of adenine by 40%. The C-C and C-N stretchings differed by less than 7% from the values of force constant-bond length empirical relations.
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Affiliation(s)
- A Vivoni
- Department of Biology, Chemistry and Environmental Sciences, Inter American University, San Germán, Puerto Rico, USA.
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Calligaro KD, Dougherty MJ, Lombardi J, Krug R, Raviola CA. Converting from general anesthesia to cervical block anesthesia for carotid endarterectomy. Vasc Surg 2001; 35:103-6. [PMID: 11668377 DOI: 10.1177/153857440103500203] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Between January 1, 1992 and June 30, 1998, vascular and general surgery residents performed 401 carotid endarterectomies (185 cervical block, 216 general anesthesia) under supervision of vascular attending surgeons. In January 1995, cervical block anesthesia was newly instituted. Initially anesthesiologists were randomly assigned to these cases and anesthetic technique was not standardized. At the surgeons' insistence later in the series, three specially trained anesthesiologists routinely administered cervical block anesthesia. As experience grew, surgeons realized that operating time greater than 2 hours and high neck dissections requiring mandibular retraction were poorly tolerated by cervical block anesthesia patients but that repeat carotid endarterectomies could be safely performed. Shunts were selectively inserted if significant electroencephalographic changes occurred or carotid stump pressures were less than 50 mm Hg systolic when general anesthesia was used; neurologic changes occurred when cervical block anesthesia was used; or there was a history of ipsilateral stroke for either anesthetic method. Despite an initial learning curve with cervical block anesthesia, the stroke-mortality rate was similar between the two groups (general anesthesia: 1.9% [four cerebrovascular accidents, two deaths]; cervical block anesthesia: 1.6% [two cerebrovascular accidents, two deaths]). Eight (12%) of the first 66 cervical block anesthesia patients were converted to general anesthesia compared to 2 (1.7%) of the most recent 119 patients with cervical block anesthesia (p = 0.03). After cervical block anesthesia was initiated, seven of the first eight repeat carotid endarterectomies were performed using general anesthesia compared to one of the most recent six repeat cases (p = 0.02). As surgeons' comfort with cervical block anesthesia increased, 94% (100) of the most recent consecutive 106 carotid endarterectomies were performed using this technique. These results suggest that carotid endarterectomy can be performed as safely using cervical block anesthesia as general anesthesia, specialized anesthesiologists are essential to achieve a successful outcome, selected repeat carotid endarterectomies can be performed using cervical block anesthesia, very cephalad lesions are best treated using general anesthesia, and surgical trainees can safely perform carotid endarterectomy under attending surgeon supervision if the operation is carried out expeditiously.
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Affiliation(s)
- K D Calligaro
- Section of Vascular Surgery, Pennsylvania Hospital, Philadelphia, PA 19106, USA.
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29
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Ryan SV, Dougherty MJ, Chang M, Lombardi J, Raviola C, Calligaro K. Abnormal duplex findings at the proximal anastomosis of infrainguinal bypass grafts: does revision enhance patency? Ann Vasc Surg 2001; 15:98-103. [PMID: 11221953 DOI: 10.1007/s100160010004] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Using color duplex ultrasound (CDU) surveillance of autogenous infrainguinal bypasses, a peak systolic flow velocity (PSFV) ratio of greater than 3 to 1 within the graft relative to adjacent PSFV has been accepted as predicting significant stenosis mandating revision. At the proximal anastomosis, where significant vessel diameter differences and turbulent flow exist, the validity of these criteria is less clear. Our purpose was to review our experience with proximal anastomotic abnormalities in a CDU surveillance protocol. Routine CDU surveillance for all infrainguinal bypass gratis consisted of evaluation in an accredited vascular laboratory at 1 month postoperatively, every 3 months for the first year, every 6 months in the second year, and annually thereafter. Grafts with a PSFV ratio of >3 at the proximal anastomosis on any CDU study were included in this review. From our results we conclude that currently accepted CDU criteria for graft-threatening stenosis may not be valid for abnormalities at the proximal anastomosis of infrainguinal grafts. Regression of these abnormalities is common. Better CDU criteria are needed for predicting not only severity of proximal anastomotic stenosis but also likelihood of graft thrombosis.
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Affiliation(s)
- S V Ryan
- Section of Vascular Surgery, Pennsylvania Hospital, Philadelphia 19106, USA
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30
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Duarte DS, Dolabela MF, Salas CE, Raslan DS, Oliveiras AB, Nenninger A, Wiedemann B, Wagner H, Lombardi J, Lopes MT. Chemical characterization and biological activity of Macfadyena unguis-cati (Bignoniaceae). J Pharm Pharmacol 2000; 52:347-52. [PMID: 10757425 DOI: 10.1211/0022357001773904] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [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: 10/31/2022]
Abstract
Macfadyena unguis-cati (L.) has been widely used in folk medicine as an anti-inflammatory, antimalarial and antivenereal. The purpose of this study was to chemically characterize the main plant components, and to evaluate the biological properties of some of the fractions derived from leaves (MACb) and liana (MACa) of this plant. Chemical characterization allowed the identification of the compounds corymboside, vicenin-2, quercitrin, chlorogenic acid, isochlorogenic acid, lupeol, beta-sitosterol, beta-sitosterylglucoside, allantoin and lapachol. The biological screening of fractions and/or purified substances derived from fractions revealed antitumoral and antitrypanosomal activities in fractions MACa/lapachol and MACb/MACb21, respectively. The anti-lipoxygenase and anti-cyclooxygenase effect seen in fractions MACa and MACb showed a partial correlation with the anti-inflammatory property attributed to this plant.
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Affiliation(s)
- D S Duarte
- Departamento de Física/Química, CECET, UNIVALE, Brasil
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31
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Lombardi J. Voluntary intercourse and fetal rights. J Soc Philos 2000; 31:338-352. [PMID: 15106657 DOI: 10.1111/0047-2786.00051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
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32
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Harvey PD, Lombardi J, Leibman M, Parrella M, White L, Powchik P, Mohs RC, Davidson M. Verbal fluency deficits in geriatric and nongeriatric chronic schizophrenic patients. J Neuropsychiatry Clin Neurosci 1998; 9:584-90. [PMID: 9447501 DOI: 10.1176/jnp.9.4.584] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This study examined age-related differences and correlates of deficits on phonological and category fluency tasks performed by schizophrenic patients. Equal numbers (n = 41) of geriatric (age > 64) and nongeriatric chronically hospitalized schizophrenic patients were examined with tests of phonological and category fluency, verbal learning and delayed recall, confrontation naming, and reading, as well as overall estimates of cognitive impairment. Both types of fluency tests were performed very poorly by both groups. Age-related differences were found to be statistically significant. In both groups, category fluency impairments were correlated with deficits in naming, while phonological fluency deficits were best predicted by memory impairments. These data suggest that category fluency impairments are part of a general profile of impaired semantic functioning, whereas phonological fluency deficits may be induced by alterations in information processing capacity.
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Affiliation(s)
- P D Harvey
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA
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Harvey PD, Lombardi J, Leibman M, Parrella M, White L, Powchik P, Mohs RC, Davidson M, Davis KL. Age-related differences in formal thought disorder in chronically hospitalized schizophrenic patients: a cross-sectional study across nine decades. Am J Psychiatry 1997; 154:205-10. [PMID: 9016269 DOI: 10.1176/ajp.154.2.205] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study used a cross-sectional design to examine the frequency of occurrence and severity of 10 different signs of thought disorder in schizophrenic patients across the lifespan. METHOD Schizophrenic patients, who ranged in age from 19 to 96 years (N = 392), were examined with the Scale for Assessment of Thought, Language, and Communication. The cognitive functioning of the geriatric patients (patients over the age of 64, N = 120) was also assessed. RESULTS Poverty of speech was more common and more severe in geriatric patients, while four different signs of thought disorder that reflect disconnected speech were less common and less severe in geriatric patients. Analysis of covariance found that the lower severity of disconnection thought disorders in the older patients was not attributable to differences in the amount of speech produced. CONCLUSIONS Aspects of disconnected speech were less severe in older patients, while the severity and frequency of poverty of speech were greater. These findings suggest that the two previously identified separate dimensions of communication disorder in schizophrenia vary differently with age and possibly in their cognitive and biological underpinnings.
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Affiliation(s)
- P D Harvey
- Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029, USA
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Harvey PD, Lombardi J, Leibman M, White L, Parrella M, Powchik P, Davidson M. Cognitive impairment and negative symptoms in geriatric chronic schizophrenic patients: a follow-up study. Schizophr Res 1996; 22:223-31. [PMID: 9000319 DOI: 10.1016/s0920-9964(96)00075-8] [Citation(s) in RCA: 78] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Cognitive impairment is increasingly recognized as an important aspect of schizophrenia. Since cognitive impairment has many features in common with the negative symptoms of the illness, it is possible that some of the characteristics attributed to negative symptoms are due to an association with cognitive impairments. In order to test this hypothesis, 174 chronically hospitalized geriatric schizophrenic patients were examined twice at a 1-year follow-up with ratings of the severity of their symptoms (using the Positive and Negative Syndrome Scale: PANSS) and assessments of cognitive functions with the Mini-Mental State Examination and a brief neuropsychological battery aimed at the typical impairments seen in dementia. Positive symptoms were unassociated with any of the cognitive variables, while negative symptom severity was correlated with each of the cognitive measures. In the cross-temporal analyses, cognitive impairments were more stable over time than negative symptom scores, but cognitive impairment did not predict the severity of any negative symptom over time. At each assessment, however, cognitive impairment was strongly correlated with each of the seven negative symptoms studied. These data indicate that cognitive impairments and negative symptoms are related, but discriminable, features in schizophrenia and that the considerable overlap between some negative symptoms and estimates of cognitive function may suggest a rethinking of the definition of some of these symptoms.
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Affiliation(s)
- P D Harvey
- Mt. Sinai School of Medicine, New York, NY, USA
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Lubowitz J, Bartolozzi A, Rubinstein D, Ciccotti M, Schweitzer M, Nazarian L, Lombardi J, Dellose S, Landsdorf A, Miller L. How much does inferior capsular shift reduce shoulder volume? Clin Orthop Relat Res 1996:86-90. [PMID: 8653983 DOI: 10.1097/00003086-199607000-00015] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.1] [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: 02/01/2023]
Abstract
The purpose of this study was to quantitate the effect of inferior capsular shift on shoulder volume. Four fresh frozen cadaveric shoulders were analyzed. Volume before and after shift was determined using 3 techniques: (1) Magnetic resonance imaging sequences were digitized to computer and analyzed for volume via a 35-mm camera using Cue 2 software. The capsule was delineated by contrast between light and dark regions. Volume was calculated by summing the total area of respective slices. (2) Ultrasound images, obtained after surgical exposure of the capsule, were digitized. Volume was calculated using the formula for a prolate ellipsoid. (3) An 18-gauge needle was used to inject and evacuate saline via an anterior approach. Quantity of aspirated fluid provided a direct measure of volume. Inferior capsular shift was performed. After the operation, measurements were repeated. Inferior capsular shift reduced volume in all shoulders with each technique. On average, inferior capsular shift reduced joint volume by 57 %). A measurable reduction in shoulder joint volume is an effect of capsular shift. This measurement may have clinical application if volume is an indicator of instability or laxity.
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Affiliation(s)
- J Lubowitz
- Taos Orthopaedic Institute, Taos, NM 87571, USA
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Abstract
Age disorientation was studied in 45 geriatric patients with chronic mood disorders. In a yearly assessment of cognitive functions, subjects were questioned about their age, year of birth, and the current year. Patients who misstated their age by > or = 5 years were considered age disoriented. Among the 45 patients, age-disorientation data were available for 32 patients, with the remainder either stating that they did not know their age or providing age-delusional responses. Six of the 32 patients were characterized as age disoriented at baseline and again at 12- to 18-month follow-up assessment. Age-disoriented patients performed worse overall on the Mini-Mental State Examination compared with patients who did not show age disorientation. Future studies of brain function and structure should include poor-outcome patients with mood disorders as well as patients with schizophrenia in attempts to identify the possible neurological dysfunctions that may underlie the phenomenon of age disorientation.
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Affiliation(s)
- J Lombardi
- Pilgrim Psychiatric Center, West Brentwood, NY 11717, USA
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Harvey PD, Lombardi J, Kincaid MM, Parrella M, White L, Powchik P, Davidson M. Cognitive functioning in chronically hospitalized schizophrenic patients: age-related changes and age disorientation as a predictor of impairment. Schizophr Res 1995; 17:15-24. [PMID: 8541246 DOI: 10.1016/0920-9964(95)00026-i] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Although schizophrenic patients manifest cognitive impairments, there is considerable variability across patients in the severity of this impairment. Very chronic patients with a poor outcome, particularly geriatric patients, manifest the most severe impairments, which have often been characterized as resembling dementia. This study examined age-related changes in cognitive functioning in a sample of schizophrenic patients (n = 393) ranging from 25 to 95 years of age, with a specific focus on identifying aspects of performance that were impaired in the youngest patients and preserved in the oldest patients. Age disorientation was examined in detail because it was previously found to predict global intellectual impairment in chronic patients. All 22 test items changed linearly over time (with age), with aspects of orientation, concentration, and delayed recall most impaired in young patients and naming and sentence repetition most preserved in the oldest patients. Age disoriented patients had more severe cognitive impairments at each age and the age-related changes in global impairment were more severe for these patients. The prevalence of age disorientation was consistent with previous reports and a one-year retest of the sample found that age disorientation was extremely stable over time within patients. The types of functions that are preserved in the oldest patients underscore previous findings of differences between geriatric schizophrenic patients and patients with degenerative diseases and the stability of age disorientation suggests that it is a trait of a subset of schizophrenic patients, those who appear to have the most severely declining course of illness.
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Affiliation(s)
- P D Harvey
- Department of Psychiatry, Mt. Sinai School of Medicine, New York, NY 10029, USA
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Lombardi J. Looking at the child care landscape. Pediatrics 1993; 91:179-81. [PMID: 8417437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
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39
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Dran JC, Lombardi J, Magonthier MC, Moulin V, Petit JC, Trotignon L. Leaching of Borosilicate Glasses by Solutions Containing Humic Acids: Behaviour of Metallic Elements. ACTA ACUST UNITED AC 1992. [DOI: 10.1524/ract.1992.5859.1.17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | | | - M. C. Magonthier
- Commissariat à l'Energie Atomique, Direction du Cycle du Combustible, Département Stockage Déchets, BP 6, F-92265 Fontenay-aux-Roses, France
| | - V. Moulin
- Commissariat à l'Energie Atomique, Direction du Cycle du Combustible, Département Stockage Déchets, BP 6, F-92265 Fontenay-aux-Roses, France
| | - J. C. Petit
- Commissariat à l'Energie Atomique, Direction du Cycle du Combustible, Département Stockage Déchets, BP 6, F-92265 Fontenay-aux-Roses, France
| | - L. Trotignon
- Commissariat à l'Energie Atomique, Direction du Cycle du Combustible, Département Stockage Déchets, BP 6, F-92265 Fontenay-aux-Roses, France
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Cottafava F, Cosso D, Guglieri F, Siri F, Tosca P, Morreale G, Lombardi J. [Cardiac involvement in juvenile rheumatoid arthritis]. Minerva Pediatr 1991; 43:505-9. [PMID: 1944004] [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: 12/29/2022]
Abstract
Four cases with cardiac involvement in patients suffering from systemic outset of juvenile rheumatoid arthritis are reported. The cases were chosen out of 83 juvenile rheumatoid arthritis patients studied from 1975 to 1988. They developed respectively myopericarditis (case 1), myocarditis (case 2), endopericarditis (case 3), myopericarditis (case 4). The drug employed in the acute disease phase was exclusively prednisone; in all subjects the acute inflammatory stage resolved.
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Affiliation(s)
- F Cottafava
- Clinica Pediatrica I G. Gaslini, Università di Genova
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Cottafava F, Cosso D, Faraci M, Carpi A, Lombardi J. [Sjögren's syndrome in childhood. Description of a clinical case]. Minerva Pediatr 1990; 42:499-501. [PMID: 2082178] [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: 12/30/2022]
Abstract
A case is reported of Sjögren's syndrome in childhood. According to Fox's classification, this patient presented all four inclusion criteria for the diagnosis of the disease. The Authors report the satisfactory evolution of the disease using therapy with FANS and corticosteroids and immunosuppressors during acute exacerbations.
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Carvajal C, Bustamante M, Lombardi J, Giordano J, Contreras JE, Otaiza E. [The CRAMS system of quantitative evaluation in trauma]. Rev Med Chil 1988; 116:238-41. [PMID: 3244932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Nieri S, Prestandrea C, Lombardi J, Cotellessa M, Cottafava F. [Description of a case: Beckwith-Wiedemann syndrome]. Minerva Pediatr 1988; 40:113-7. [PMID: 2898726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Lombardi J, Wourms JP. The trophotaenial placenta of a viviparous goodeid fish. III: Protein uptake by trophotaeniae, the embryonic component. J Exp Zool 1985; 236:165-79. [PMID: 4067530 DOI: 10.1002/jez.1402360207] [Citation(s) in RCA: 37] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Protein uptake and degradation by trophotaenial cells of the viviparous goodeid fish Ameca splendens were studied colorimetrically and ultrastructurally using horseradish peroxidase (HRP) as a tracer and acid (ACPase) and alkaline (ALPase) phosphatase cytochemistry. Trophotaeniae are ribbon-like external projections of the embryonic gut that are equivalent to greatly hypertrophied intestinal villi. During gestation within the ovarian lumen, trophotaeniae are directly apposed to the internal ovarian epithelium (IOE) where they establish a placental association between the developing embryo and maternal organism. Trophotaenial absorptive cells possess an ALPase reactive brush border, an endocytotic apparatus, and ACPase reactive standing lysosomes. Ultrastructural studies of protein uptake indicate that cells of the trophotaenial epithelium take up HRP by micropinocytosis and degrade it within lysosomes. Initially (from 1.5-10 min), HRP is taken up in vitro at 22 degrees C at the apical cell surface and passes via endocytotic vesicles into an apical canalicular system. From 1.5 to 10 min exposure, HRP passes passes from the apical canalicular system to a series of small collecting vesicles. After 10 min, HRP is detected within large ACPase reactive supranuclear lysosomes. Three hours after an initial 1 h exposure to HRP, most peroxidase activity within supranuclear lysosomes is no longer detected. Presence of Golgi complexes, residual bodies, and secretory granules in the infranuclear cytoplasm suggest that products of protein uptake and hydrolysis are discharged across basal and lateral cell surfaces and into the trophotaenial circulation. Trophotaeniae of embryos incubated in vitro in HRP-saline take up HRP at an initial rate of 13.5 ng HRP/mg trophotaenial protein/min. The system becomes saturated after 3 h. Trophotaeniae incubated at 4 degrees C show little or no uptake. In trophotaeniae continuously pulsed with HRP for 1 h, then incubated in HRP-free saline, levels of absorbed peroxidase declined at a rate of 0.5 ng/mg trophotaenial protein/min. HRP does not appear to enter the embryo via extra-trophotaenial routes. These findings are consistent with the putative role of trophotaeniae as the embryonic component of the functional placenta of goodeid fishes. Trophotaenial uptake of maternal nutrients accounts for a massive (15,000%) increase in embryonic dry weight during gestation.
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Lombardi J, Wourms JP. The trophotaenial placenta of a viviparous goodeid fish. II. Ultrastructure of trophotaeniae, the embryonic component. J Morphol 1985; 184:293-309. [PMID: 4057261 DOI: 10.1002/jmor.1051840305] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Embryos of the viviparous goodeid fish Ameca spendens develop within the ovarian lumen, where they establish a placental association with the maternal organism and undergo a 15,000% increase in embryonic dry weight. The placenta consists of an embryonic component, the trophotaeniae, and a maternal component, the internal ovarian epithelium. Examination with light microscopy and with transmission and scanning electron microscopy reveals that trophotaeniae of A. splendens are extraembryonic membranes consisting of five ribbon-like processes originating from a tube-like mass of tissue that extends outward from the perianal region of developing embryos. There are two sets of lateral processes and a longer single median process. Trophotaeniae possess an outer epithelium that surrounds a highly vascularized core of loose connective tissue. Epithelial cells possess apical microvilli and a pronounced endocytotic apparatus. Cells of the trophotaenial epithelium are either tightly apposed along their lateral margins or separated by enlarged intercellular spaces. Regions of the trophotaenial epithelium possessing enlarged intercellular spaces are distributed in patches. The trophotaenial epithelium is continuous with the embryonic hindgut epithelium and is considered to be derived from it. Comparison of trophotaenial morphology in A. splendens with that reported in Xenotoca eiseni reveals differences in histological organization. The former possess unsheathed trophotaeniae, whereas the latter are sheathed. We postulate that the apposition of trophotaenial epithelium to the internal ovarian epithelium constitutes a placental association equivalent to a noninvasive, epithelioform of an inverted yolk sac placenta. Structural relationships of embryonic and maternal tissues of the trophotaenial placenta are discussed in relation to maternal-embryonic nutrient transfer processes.
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Lombardi J, Wourms JP. The trophotaenial placenta of a viviparous goodeid fish. I. Ultrastructure of the internal ovarian epithelium, the maternal component. J Morphol 1985; 184:277-92. [PMID: 4057260 DOI: 10.1002/jmor.1051840304] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Embryos of goodeid fishes develop to term within the ovarian lumen, where they undergo considerable increase in weight due to transfer of maternal nutrients across a trophotaenial placenta. The placenta consists of an embryonic component, the trophotaeniae, and a maternal component, the ovarian lining. The latter was examined by transmission electron microscopy, scanning electron microscopy, and light microscopy in both gravid and nongravid ovaries of the viviparous goodeid fish, Ameca splendens. The single median ovary of A. splendens is a hollow structure whose lumen is divided into lateral chambers by a highly folded longitudinal ovarian septum. Germinal tissue occurs within folds of the ovarian lining that extend into each of the two lateral chambers. Matrotrophic embryonic development takes place within ovarian chambers. During gestation, the lining of the ovarian lumen is in direct apposition to body surfaces and trophotaenial epithelia of developing embryos. The ovarian lining consists of a simple cuboidal epithelium, termed the internal ovarian epithelium (IOE), overlying a well-vascularized bed of connective tissue. Cells of the IOE are apically convex. Well-developed granular and agranular endoplasmic reticula and numerous large membrane-bound vesicles with electron-dense content occupy the apical cytoplasm of IOE cells. Two functional states of the same cell type are distinguished within the IOE. Phase I cells contain few, if any, large apically situated vesicles; Phase II cells contain many. Secretory products of the IOE are presumed to be an important source of nutrients for embryonic development. Structural and functional relationships of the IOE to the trophotaenial epithelium of developing embryos are discussed in relation to maternal-embryonic nutrient transfer processes.
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Elejalde BR, de Elejalde MM, Samter T, Burgess J, Lombardi J, Gilbert EF. Manifestations of pseudoxanthoma elasticum during pregnancy: a case report and review of the literature. Am J Med Genet 1984; 18:755-62. [PMID: 6385710 DOI: 10.1002/ajmg.1320180422] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
A 30-year-old white woman with pseudoxanthoma elasticum (PXE) was followed throughout her pregnancy with several fetal ultrasonographic examinations and other diagnostic studies; these showed normal development up to the 26th wk and then a marked deceleration of fetal growth. The ultrasonographic appearance of the placenta was abnormal at all times probably related to the microscopic changes. The baby, born at 36 wk, showed severe intrauterine growth retardation as a probable consequence of the abnormal placenta detected by ultrasound and corroborated at birth. The cotyledons were small and more numerous than normal. One third of the placenta was hypoplastic or atrophic, with focal calcification in septa, stroma, villi, and decidua, and increased deposition of fibrin around villi. The most striking change was the increased number of septa and the abnormal elastic tissue.
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Klein J, Lombardi J. Training early childhood teachers. The CDA Program. Child Today 1982; 11:2-6. [PMID: 7160246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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