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Requena M, Piñana C, Olive-Gadea M, Hernández D, Boned S, De Dios M, Rodrigo M, Rivera E, Muchada M, Cuevas JL, Rubiera M, García-Tornel Á, Gramegna LL, Molina C, Ribo M, Tomasello A. Combined technique as first approach in mechanical thrombectomy: Efficacy and safety of REACT catheter combined with stent retriever. Interv Neuroradiol 2023; 29:504-509. [PMID: 35491662 PMCID: PMC10549706 DOI: 10.1177/15910199221095798] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 04/04/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Mechanical thrombectomy (MT) with combined treatment including both a stent retriever and distal aspiration catheter may improve recanalization rates in patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO). Here, we evaluated the effectiveness and safety of the REACT aspiration catheter used with a stent retriever. METHODS This prospective study included consecutive adult patients who underwent MT with a combined technique using REACT 68 and/or 71 between June 2020 and July 2021. The primary endpoints were final and first pass mTICI 2b-3 and mTICI 2c-3 recanalization. Analysis was performed after first pass and after each attempt. Secondary safety outcomes included procedural complications, symptomatic intracranial hemorrhage (sICH) at 24 h, in-hospital mortality, and 90-day functional independence (modified Rankin Scale [mRS] 0-2). RESULTS A total of 102 patients were included (median age 78; IQR: 73-87; 50.0% female). At baseline, median NIHSS score was 19 (IQR: 11-21), and ASPECTS was 9 (IQR: 8-10). Final mTICI 2b-3 recanalization was achieved in 91 (89.2%) patients and mTICI 2c-3 was achieved in 66 (64.7%). At first pass, mTICI 2b-3 was achieved in 55 (53.9%) patients, and mTICI 2c-3 in 37 (36.3%). The rate of procedural complications was 3.9% (4/102), sICH was 6.8% (7/102), in-hospital mortality was 12.7% (13/102), and 90-day functional independence was 35.6% (36/102). CONCLUSION A combined MT technique using a stent retriever and REACT catheter resulted in a high rate of successful recanalization and first pass recanalization in a sample of consecutive patients with AIS due to LVO in clinical use.
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Affiliation(s)
- Manuel Requena
- Unitat d’Ictus, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Neurorradiologia Intervencionista, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Grup de Recerca en Ictus, Vall d’Hebron Institut de Recerca, Barcelona, Spain
| | - Carlos Piñana
- Neurorradiologia Intervencionista, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Marta Olive-Gadea
- Unitat d’Ictus, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Grup de Recerca en Ictus, Vall d’Hebron Institut de Recerca, Barcelona, Spain
| | - David Hernández
- Neurorradiologia Intervencionista, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Sandra Boned
- Unitat d’Ictus, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Grup de Recerca en Ictus, Vall d’Hebron Institut de Recerca, Barcelona, Spain
| | - Marta De Dios
- Neurorradiologia Intervencionista, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Marc Rodrigo
- Unitat d’Ictus, Hospital Universitari Vall d’Hebron, Barcelona, Spain
| | - Eila Rivera
- Neurorradiologia Intervencionista, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Grup de Recerca en Ictus, Vall d’Hebron Institut de Recerca, Barcelona, Spain
| | - Marián Muchada
- Unitat d’Ictus, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Grup de Recerca en Ictus, Vall d’Hebron Institut de Recerca, Barcelona, Spain
| | - José Luis Cuevas
- Neurorradiologia Intervencionista, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Grup de Recerca en Ictus, Vall d’Hebron Institut de Recerca, Barcelona, Spain
- Servicio Neurocirugía, Hospital de Puerto Montt, Puerto Montt, Chile
| | - Marta Rubiera
- Unitat d’Ictus, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Grup de Recerca en Ictus, Vall d’Hebron Institut de Recerca, Barcelona, Spain
| | - Álvaro García-Tornel
- Unitat d’Ictus, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Grup de Recerca en Ictus, Vall d’Hebron Institut de Recerca, Barcelona, Spain
| | - Laura Ludovica Gramegna
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Functional and Molecular Neuroimaging Unit, Bologna, Italy
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Carlos Molina
- Unitat d’Ictus, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Grup de Recerca en Ictus, Vall d’Hebron Institut de Recerca, Barcelona, Spain
| | - Marc Ribo
- Unitat d’Ictus, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Grup de Recerca en Ictus, Vall d’Hebron Institut de Recerca, Barcelona, Spain
| | - Alejandro Tomasello
- Neurorradiologia Intervencionista, Hospital Universitari Vall d’Hebron, Barcelona, Spain
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Romitti G, Liberos A, Romero P, Serra D, Garcia I, Lozano M, Sebastian R, Rodrigo M. Characterization of the Electrophysiological Characteristics of Chronic Atrial Fibrillation for Efficient Simulations. Annu Int Conf IEEE Eng Med Biol Soc 2023; 2023:1-4. [PMID: 38082841 DOI: 10.1109/embc40787.2023.10340415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Atrial biophysical simulations have the potential to enhance outcomes by enabling the simulation of pharmacological and ablative strategies. However, the high computational times associated with such simulations render them unsuitable for diagnostic purposes. To address this challenge, discrete models such as cellular automata (CA) have been developed, which consider a finite number of states, thus significantly reducing computational times. Yet, there is a pressing need to determine whether CA can replicate pathological simulations with accuracy. The analysis of simulations under different degrees of electrical remodeling shows an expected increase of Action Potential Duration (APD) with the previous Diastolic Interval (DI) interval, indicating short-term memory of atrial cardiomyocytes: shorter APD0 provoked shorter APD+1, and previous DI has a similar effect on APD+1. Independent prediction using both APD0 and DI was found to provide a far better estimation of APD+1 values, compared to relying on DI alone (p<<0.01). Finally, the CA models were able to replicate reentrant patterns and cycle lengths of different states of atrial remodeling with a high degree of accuracy when compared to biophysical simulations. Overall, the use of atrial CA with short-term memory allows accurate reproduction of arrhythmic behavior in pathological tissue within a clinically relevant timeframe.Clinical Relevance- Discrete electrophysiological models simulate pathological self-sustained arrhythmias in diagnostic times.
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Serra D, Franco P, Romero P, Romitti G, Garcia-Fernandez I, Lozano M, Liberos A, Penela D, Berruezo A, Camara O, Rodrigo M, Sebastian R. Assessment of Risk for Ventricular Tachycardia based on Extensive Electrophysiology Simulations. Annu Int Conf IEEE Eng Med Biol Soc 2023; 2023:1-4. [PMID: 38083190 DOI: 10.1109/embc40787.2023.10340169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Patients that have suffered a myocardial infarction are at high risk of developing ventricular tachycardia. Patient stratification is often determined by characterization of the underlying myocardial substrate by cardiac imaging methods. In this study, we show that computer modeling of cardiac electrophysiology based on personalized fast 3D simulations can help to assess patient risk to arrhythmia. We perform a large simulation study on 21 patient digital twins and reproduce successfully the clinical outcomes. In addition, we provide the sites which are prone to sustain ventricular tachycardias, i.e, onset sites around the scar region, and validate if they colocalize with exit sites from slow conduction channels.Clinical relevance- Fast electrophysiological simulations can provide advanced patient stratification indices and predict arrhythmic susceptibility to suffer from ventricular tachycardia in patients that have suffered a myocardial infarction.
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Patel J, Mahana I, Lam P, Hofmeyer M, Rao S, Kadakkal A, Afari-Armah N, Krishnan M, Molina E, Najjar S, Sheikh F, Rodrigo M, Gupta R. Calcineurin Inhibitor-Induced Atypical Hemolytic Uremic Syndrome after Heart Transplantation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.505] [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: 04/05/2023] Open
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Zuckermann A, Jacobs J, Shudo Y, Meyer D, Silvestry S, Leacche M, Sciortino C, Rodrigo M, Pham S, Takeda K, Copeland H, Vidic A, Kawabori M, Boston U, Bustamante-Munguira J, Esteve AE, Venkateswaran R, Schroder J, D'Alessandro D. Validating the 2014 Consensus Primary Graft Definition: An Analysis on the 1,056 Patients from the Multi-Center Guardian Registry. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.158] [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: 04/05/2023] Open
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Copeland H, Leacche M, D'Alessandro D, Sciortino C, Schroder J, Pham S, Rodrigo M, Silvestry S, Kawabori M, Shudo Y, Meyer D. Improved Outcomes in Older Recipients Undergoing Transplant Using the Sherpapak System: A Subgroup Analysis of the Guardian Heart Registry. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.658] [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: 04/05/2023] Open
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D'Alessandro D, Shudo Y, Meyer D, Silvestry S, Leacche M, Sciortino C, Rodrigo M, Pham S, Jacobs J, Takeda K, Copeland H, Vidic A, Kawabori M, Schroder J. Results from over 800 Transplant Recipients Enrolled in the Guardian Heart Registry. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.137] [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: 04/05/2023] Open
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Mehta A, Goldberg J, Bagchi P, Marboe C, Shah K, Najjar S, Hsu S, Rodrigo M, Jang M, Cochrane A, Tchoukina I, Kong H, Lohmar B, Mcnair E, Valantine H, Agbor-Enoh S, Berry G, Shah P. Cell-Free DNA Enhances Pathologist Interrater Reliability at the Assessment of Acute Rejection on Endomyocardial Biopsy, on Behalf of the GRAfT Investigators. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1524] [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: 04/05/2023] Open
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Meyer D, Shudo Y, Schroder J, D'Alessandro D, Silvestry S, Sciortino C, Pham S, Rodrigo M, Jacobs J, Kawabori M, Takeda K, Leacche M. Can Controlled Hypothermic Preservation Provide Clinical Benefits in the Setting of Shorter Ischemic Times Prior to Heart Transplant. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.415] [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: 04/05/2023] Open
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Schroder J, Leacche M, Sciortino C, Shudo Y, Rodrigo M, Meyer D, Kawabori M, D'Alessandro D. Leveraging Advanced Hypothermic Preservation to Achieve Transplant Program Goals. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1695] [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: 04/05/2023] Open
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Brown M, Lekan A, Hofmeyer M, Rodrigo M, Kadakkal A, Lam P, Krishnan M, Afari-Armah N, Rao S, Gupta R, Alassar A, Molina E, Sheikh F. Hemodynamic Effects of Intra-Aortic Balloon Pump as a Bridge to Durable Left Ventricular Assist Device. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1054] [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: 04/05/2023] Open
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Bernet L, Hardisson D, Rodrigo M, Córdoba A, Sancho M, Peg V, Ruiz I, Godey F, Sánchez-Méndez JI, Prat A. OSNA Total Tumor Load for the Prediction of Axillary Involvement in Breast Cancer Patients: Should We use Different Thresholds According to the Intrinsic Molecular Subtype? MOTTO Study. Clin Pathol 2023; 16:2632010X231183693. [PMID: 37534372 PMCID: PMC10392164 DOI: 10.1177/2632010x231183693] [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] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 06/05/2023] [Indexed: 08/04/2023]
Abstract
Aims To assess the impact of the molecular subtype (MS) on the total number of CK19 mRNA copies in all positive SLN (TTL) threshold, to predict non-SLN affectation, and to compare 5 years progression-free survival (PFS) according to the risk of recurrence (ROR) group by PAM50. Methods Cohort with infiltrating breast cancer with intra-operative metastatic SLN detected by one-step nucleic acid amplification (OSNA) assay who underwent subsequent ALND. Logistic regression was used to assess a possible interaction between TTL and MS(Triple Negative, Her-2-Enriched, Luminal A, or Luminal B), or hormone receptors (HR: positive or negative) by immunohistochemistry (IMH). Cox regression was used to compare PFS and OS in the 3 ROR groups (high, medium, or low). Results TTL was predictive of non-SLN affectation in both univariate (OR [95% CI]: 1.72 [1.43, 2.05], P < .001) and multivariate (1.55 [95% CI: 1.04, 2.32], P = .030) models, but MS-IMH or HR-IMH, and their interactions with TTL were not (best multivariate model: HR + main effect OR 1.16 [95% CI: 0.18, 7.64], P = .874; interaction OR: 1.04 [0.7, 1.55], P = .835; univariate model: HR + main effect OR: 1.44 [95% CI: 0.85, 2.44], P = .180). PFS was lower in the high-risk ROR group (81.1%) than in the low-risk group (93.9%) (HR: 3.68 [95 CI: 1.70, 7.94], P < .001). Conclusions our results do not provide evidence to support the utilization of subtype-specific thresholds for TTL values to make therapeutic decisions on the axilla. The ROR group was predictive of 5 years-PFS.
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Affiliation(s)
- L Bernet
- Department of Pathology, Hospital Universitario del Vinalopó, Elche, Spain
| | - D Hardisson
- Department of Pathology, Hospital Universitario La Paz, Madrid
- Hospital La Paz Institute for health Research (IdiPAZ), Universidad Autónoma de Madrid
| | - M Rodrigo
- Department of Pathology, Hospital Universitario de Burgos, Burgos, Spain
| | - A Córdoba
- Department of Pathology, Hospital Universitario de Navarra, Navarra, Spain
| | - M Sancho
- Department of Pathology, Hospital Universitario de Salamanca, Salamanca, Spain
| | - V Peg
- Department of Pathology, Vall d’Hebron University Hospital, Barcelona, Spain
- Universidad Autónoma de Barcelona, Barcelona, Spain
- Spanish Biomedical Research Network Centre in Oncology (CIBERONC), Madrid, Spain
| | - I Ruiz
- Department of Pathology, Hospital Universitario de Donostia, Donostia, Spain
| | - F Godey
- Department of Pathology, Centre Eugène Marquis, Rennes, France
| | - JI Sánchez-Méndez
- Department of Ginecology and Obstetrics, Hospital Universitario La Paz, Madrid
- Hospital La Paz Institute for Health Research (IdiPAZ), Universidad Autónoma de Madrid
| | - A Prat
- Medical Oncology department, Hospital Clínic de Barcelona, Barcelona, Spain
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Olona C, Casanova R, Vadillo J, Julià E, Varona A, Ferreres J, Rodrigo M, Jorba R. P-108 MARJOLIN'S ULCER AS A COMPLICATION OF UNRESOLVED OPEN ABDOMEN. Br J Surg 2022. [DOI: 10.1093/bjs/znac308.206] [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: 11/14/2022]
Abstract
Abstract
Introduction
Marjolin's ulcer (MU) is a rare cutaneous tumour, commonly associated with chronic wounds with difficult healing.
We present a case of UM diagnosed on a persistent unresolved open abdominal closure wound.
Materials and Methods
80-year-old male with a history of ruptured infrarenal aortic aneurysm (2010) that required aorto-unifemoral repair. Postoperative period requiring decompressive laparotomy for abdominal compartment syndrome and treated with negative pressure therapy, and impossibility of definitive abdominal closure due to abdominal muscle retraction.
Loss of outpatient follow-up for 10 years.
Consultation for worsening of the surgical wound with abdominal pain. Examination revealed abdominal incisional hernia M2–4W3 and large abdominal ulcer. Biopsies positive results for squamous cell carcinoma with infiltrative pattern. A computed tomography describes an abdominal wall mass of 14×6×11cm and space-occupying lesion in the left hepatic lobe. Liver biopsy showed a moderately differentiated hepatocarcinoma.
Surgical management consist in intramuscular injection of botulinum toxin and en bloc resection of granulation and ulcerated tissue and ileal loop attached to the lesion. Wall reconstruction with anterior separation of components and supraponeurotic mesh.
Conclusions
Marjolin's ulcer is associated with squamous cell carcinoma with a high rate of metastasis and mortality. This tumour is considered infrequent, of long-term duration and associated with developing societies.
In our environment, this neoplasia can develop in patients with open abdomen treated partially or with closure by second intention, so we consider it necessary to have a high index of diagnostic suspicion in these cases and to perform biopsies for its detection.
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Affiliation(s)
- C Olona
- Abdominal Wall Unit. General Surgery Department, Hospital Universitari de Tarragona Joan XXIII , Tarragona , Spain
| | - R Casanova
- General Surgery Department, Hospital Universitari de Tarragona Joan XXIII , Tarragona , Spain
| | - J Vadillo
- Abdominal Wall Unit. General Surgery Department, Hospital Universitari de Tarragona Joan XXIII , Tarragona , Spain
| | - E Julià
- Abdominal Wall Unit. General Surgery Department, Hospital Universitari de Tarragona Joan XXIII , Tarragona , Spain
| | - A Varona
- General Surgery Department, Hospital Universitari de Tarragona Joan XXIII , Tarragona , Spain
| | - J Ferreres
- General Surgery Department, Hospital Universitari de Tarragona Joan XXIII , Tarragona , Spain
| | - M Rodrigo
- General Surgery Department, Hospital Universitari de Tarragona Joan XXIII , Tarragona , Spain
| | - R Jorba
- General Surgery Department, Hospital Universitari de Tarragona Joan XXIII , Tarragona , Spain
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Ganesan P, Rogers AJ, Deb B, Feng R, Rodrigo M, Ruiperez-Campillo S, Tjong FV, Bhatia N, Clopton P, Rappel WJ, Narayan SM. Spatiotemporal signatures of response to atrial fibrillation ablation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.601] [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
Atrial fibrillation (AF) can have organized regions, in the form of consistent dominant frequency sites, focal or reentrant sites, but it is unclear how these overlap with or differ from focal atrial tachycardias (AT) or potential drivers. We set out to develop an intuitive method based on fundamental electrogram shape and timing to separate types of AF.
Objective
To test the hypothesis that spatial regions of electrogram (EGM) in AF that show similar shapes over time based on cross-correlation analysis may separate patients with differing response to ablation.
Methods
We recruited N=133 patients (63.8±12.1 Y, 32% women), (i) N=10 had AT, (ii) N=122 AF that was or was not terminated by ablation, and (iii) N=1 pacing. All patients had left atrial mapping by 64 pole baskets. We applied repetitive activity (REACT) mapping that correlates EGMs in contiguous 2x2 regions (Fig. 1A) over 4sec. To calibrate REACT, we introduced simulated variations in shape (gaussian noise) and timing (gaussian delay) to pacing EGMs and computed nomograph over 100 random trials (Fig. 1C).
Results
Fig. 1B shows that REACT in a 71-year-old man with AT is more organized than in a 65 YO man with AF (100% vs 40% mapped field). Overall, REACT was higher in AT than AF (0.63±0.15 vs 0.36±0.22, p<0.001). There were 24 cases in which global REACT between AF and AT groups had the overlapping range of values, indicating organized “islands” in AF analogous to AT. From nomograph in Fig. 1C we identified that this overlap reflects 15 ms variation in cycle length and 20% variation in EGM shape (labelled “x” in Fig. 1C).
Conclusion
Basic electrogram properties in AF of similar shapes in spatial areas over time can separate response to ablation and may represent “islands” of AT. Future studies should investigate the mechanisms for such islands and whether they may be targeted for therapy.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): US National Institutes of Health
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Affiliation(s)
- P Ganesan
- Stanford University School of Medicine , Palo Alto , United States of America
| | - A J Rogers
- Stanford University School of Medicine , Palo Alto , United States of America
| | - B Deb
- Stanford University School of Medicine , Palo Alto , United States of America
| | - R Feng
- Stanford University School of Medicine , Palo Alto , United States of America
| | - M Rodrigo
- University of Valencia , Valencia , Spain
| | | | - F V Tjong
- Stanford University School of Medicine , Palo Alto , United States of America
| | - N Bhatia
- Emory University , Atlanta , United States of America
| | - P Clopton
- Stanford University School of Medicine , Palo Alto , United States of America
| | - W J Rappel
- University of California San Diego , San Diego , United States of America
| | - S M Narayan
- Stanford University School of Medicine , Palo Alto , United States of America
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Feng R, Deb B, Ganesan P, Rogers AJ, Ruiperez-Campillo S, Clopton P, Tjong FV, Chang HJ, Rodrigo M, Zaharia M, Narayan SM. Automatic left atrial segmentation from cardiac CT using computer graphics imaging and deep learning. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Segmenting left atrial (LA) substructures, including the LA body, appendage (LAA), and pulmonary veins (PVs), from computed tomography (CT) is central to electroanatomic mapping for ablation and functional studies in patients with atrial fibrillation (AF). However, this process requires manual outlining which needs special training, is subjective, and is difficult to scale. Computer graphics imaging (CGI) has been applied in media, film, and computer-aided design to reliably segment complex structures using their basic geometric representations.
Purpose
We hypothesized that LA substructures can be “virtually” dissected using CGI to separate geometric contours of the “convex ellipsoid” LA, “tubular” PVs, and “conical” LAA. We further hypothesized that the results of virtual dissection can be used to train a deep learning (DL) model to segment raw CT scans.
Methods
First, a mathematical method based on CGI techniques – erosion and dilation – was developed to “virtually dissect” the convex LA body from the original concave shell in publicly available digital atria with diverse simulated morphologies (Fig. 1A). The PVs and LAA were then automatically revealed and labeled by a 3D subtraction approach. Second, we refined precise LA/PV/LAA boundaries by tuning hyper-parameters from N=5 patient shells (Fig. 1B). Third, we used virtual dissection to train a DL model to segment CTs in N=20 patient atria (Fig. 1C). Finally, we applied this pipeline to segment raw CTs in a validation cohort of N=105 patients (23.8% women, 63.8±10.3Y; Fig. 1D).
Results
Virtual dissection accurately identified LA/PV/LAA boundaries in the training set (Dice coefficients 89–98%). In the independent test cohort (N=105), this automated pipeline accurately segmented raw CTs with Dice 81–95% (Fig. 1D) compared to a panel of experts (p<0.001).
Conclusion
CGI of basic cardiac geometry combined with deep learning in small datasets can accurately segment raw CT scans in large populations. This computational pipeline may automate and simplify cardiac image processing and ablation procedures, and could be applied to the ventricle or other organ systems for diverse therapeutic strategies or to train machine learning.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institutes of Health
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Affiliation(s)
- R Feng
- Stanford University, School of Medicine , Palo Alto , United States of America
| | - B Deb
- Stanford University, School of Medicine , Palo Alto , United States of America
| | - P Ganesan
- Stanford University, School of Medicine , Palo Alto , United States of America
| | - A J Rogers
- Stanford University, School of Medicine , Palo Alto , United States of America
| | | | - P Clopton
- Stanford University, School of Medicine , Palo Alto , United States of America
| | - F V Tjong
- Amsterdam UMC , Amsterdam , The Netherlands
| | - H J Chang
- Stanford University, School of Medicine , Palo Alto , United States of America
| | - M Rodrigo
- University of Valencia , Valencia , Spain
| | - M Zaharia
- Stanford University, Computer Science , Palo Alto , United States of America
| | - S M Narayan
- Stanford University, School of Medicine , Palo Alto , United States of America
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Marques VG, Rodrigo M, Guillem MS, Salinet J. A robust wavelet-based approach for dominant frequency analysis of atrial fibrillation in body surface signals. Physiol Meas 2020; 41:075004. [PMID: 32470949 DOI: 10.1088/1361-6579/ab97c1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Atrial dominant frequency (DF) maps undergoing atrial fibrillation (AF) presented good spatial correlation with those obtained with the non-invasive body surface potential mapping (BSPM). In this study, a robust BSPM-DF calculation method based on wavelet analysis is proposed. APPROACH Continuous wavelet transform along 40 scales in the pseudo-frequency range of 3-30 Hz is performed in each BSPM signal using a Gaussian mother wavelet. DFs are estimated from the intervals between the peaks, representing the activation times, in the maximum energy scale. The results are compared with the traditionally widely applied Welch periodogram and the robustness was tested on different protocols: increasing levels of white Gaussian noise, artificial DF harmonics presence and reduction in the number of leads. A total of 11 AF simulations and 12 AF patients are considered in the analysis. For each patient, intracardiac electrograms were acquired in 15 locations from both atria. The accuracy of both methods was assessed by calculating the absolute errors of the highest DF BSPM (HDF BSPM ) with respect to the atrial HDF, either simulated or intracardially measured, and assumed correct if ≤1 Hz. The spatial distribution of the errors between torso DFs and atrial HDFs were compared with atria driving mechanism locations. Torso HDF regions, defined as portions of the maps with [Formula: see text] Hz were identified and the percentage of the torso occuping these regions was compared between methods. The robustness of both methods to white Gaussian noise, ventricular influence and harmonics, and to lower spatial resolution BSPM lead layouts was analyzed: computer AF models (567 leads vs 256 leads down to 16 leads) and patient data (67 leads vs 32 and 16 leads). MAIN RESULTS The proposed method allowed an improvement in non-invasive estimation of the atria HDF. For the models the median relative errors were 7.14% for the wavelet-based algorithm vs 60.00% for the Welch method; in patients, the errors were 10.03% vs 12.66%, respectively. The wavelet method outperformed the Welch approach in correct estimations of atrial HDFs in models (81.82% vs 45.45%, respectively) and patients (66.67% vs 41.67%). A low positive BSPM-DF map correlation was seen between the techniques (0.47 for models and 0.63 for patients), highlighting the overall differences in DF distributions. The wavelet-based algorithm was more robust to white Gaussian noise, residual ventricular activity and harmonics, and presented more consistent results in lead layouts with low spatial resolution. SIGNIFICANCE Estimation of atrial HDFs using BSPM is improved by the proposed wavelet-based algorithm, helping to increase the non-invasive diagnostic ability in AF.
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Affiliation(s)
- V G Marques
- Biomedical Engineering, Center for Engineering, Modeling and Applied Social Sciences, Federal University of ABC, São Bernardo do Campo São Paulo Brazil
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Kitahara H, Najjar S, Ahmed S, Lam P, Kadakkal A, Mohammed S, Rodrigo M, HOfmeyer M, Sheikh F, Molina E. One-Year Survival Rate after Thoracotomy for Left Ventricular Assist Device Implantation Compared with Sternotomy. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.249] [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: 11/27/2022] Open
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Rodilla Sala E, Colomer V, Perseguer Z, Jordá A, Jordá R, Prats R, García M, Vidal L, Sanchis M, Córcoles M, Mud F, Bellver O, Adell M, Ferrer F, Hernández M, Llopis T, Rodrigo M, Baixauli V, Climent M, Moreno L. DIFFERENCES IN AORTIC AUGMENTATION PRESSURE BETWEEN NORMOTENSIVE AND HYPERTENSIVE SUBJECTS MEASURED IN COMMUNITY PHARMACIES IN SPAIN. J Hypertens 2019. [DOI: 10.1097/01.hjh.0000572696.06657.f1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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De Backer G, Jankowski P, Kotseva K, Mirrakhimov E, Reiner Ž, Rydén L, Tokgözoğlu L, Wood D, De Bacquer D, De Backer G, Jankowski P, Kotseva K, Mirrakhimov E, Reiner Z, Rydén L, Tokgözoğlu L, Wood D, De Bacquer D, Kotseva K, De Backer G, Abreu A, Aguiar C, Badariene J, Bruthans J, Castro Conde A, Cifkova R, Crowley J, Davletov K, Bacquer DD, De Smedt D, De Sutter J, Deckers J, Dilic M, Dolzhenko M, Druais H, Dzerve V, Erglis A, Fras Z, Gaita D, Gotcheva N, Grobbee D, Gyberg V, Hasan Ali H, Heuschmann P, Hoes A, Jankowski P, Lalic N, Lehto S, Lovic D, Maggioni A, Mancas S, Marques-Vidal P, Mellbin L, Miličić D, Mirrakhimov E, Oganov R, Pogosova N, Reiner Ž, Rydén L, Stagmo M, Störk S, Sundvall J, Tokgözoğlu L, Tsioufis K, Vulic D, Wood D, Wood D, Kotseva K, Jennings C, Adamska A, Adamska S, Rydén L, Mellbin L, Tuomilehto J, Schnell O, Druais H, Fiorucci E, Glemot M, Larras F, Missiamenou V, Maggioni A, Taylor C, Ferreira T, Lemaitre K, Bacquer DD, De Backer G, Raman L, Sundvall J, DeSmedt D, De Sutter J, Willems A, De Pauw M, Vervaet P, Bollen J, Dekimpe E, Mommen N, Van Genechten G, Dendale P, Bouvier C, Chenu P, Huyberechts D, Persu A, Dilic M, Begic A, Durak Nalbantic A, Dzubur A, Hadzibegic N, Iglica A, Kapidjic S, Osmanagic Bico A, Resic N, Sabanovic Bajramovic N, Zvizdic F, Vulic D, Kovacevic-Preradovic T, Popovic-Pejicic S, Djekic D, Gnjatic T, Knezevic T, Kovacevic-Preradovic T, Kos L, Popovic-Pejicic S, Stanetic B, Topic G, Gotcheva N, Georgiev B, Terziev A, Vladimirov G, Angelov A, Kanazirev B, Nikolaeva S, Tonkova D, Vetkova M, Milicic D, Reiner Ž, Bosnic A, Dubravcic M, Glavina M, Mance M, Pavasovic S, Samardzic J, Batinic T, Crljenko K, Delic-Brkljacic D, Dula K, Golubic K, Klobucar I, Kordic K, Kos N, Nedic M, Olujic D, Sedinic V, Blazevic T, Pasalic A, Percic M, Sikic J, Bruthans J, Cífková R, Hašplová K, Šulc P, Wohlfahrt P, Mayer O, Cvíčela M, Filipovský J, Gelžinský J, Hronová M, Hasan-Ali H, Bakery S, Mosad E, Hamed H, Ibrahim A, Elsharef M, Kholef E, Shehata A, Youssef M, Elhefny E, Farid H, Moustafa T, Sobieh M, Kabil H, Abdelmordy A, Lehto S, Kiljander E, Kiljander P, Koukkunen H, Mustonen J, Cremer C, Frantz S, Haupt A, Hofmann U, Ludwig K, Melnyk H, Noutsias M, Karmann W, Prondzinsky R, Herdeg C, Hövelborn T, Daaboul A, Geisler T, Keller T, Sauerbrunn D, Walz-Ayed M, Ertl G, Leyh R, Störk S, Heuschmann P, Ehlert T, Klocke B, Krapp J, Ludwig T, Käs J, Starke C, Ungethüm K, Wagner M, Wiedmann S, Tsioufis K, Tolis P, Vogiatzi G, Sanidas E, Tsakalis K, Kanakakis J, Koutsoukis A, Vasileiadis K, Zarifis J, Karvounis C, Crowley J, Gibson I, Houlihan A, Kelly C, O'Donnell M, Bennati M, Cosmi F, Mariottoni B, Morganti M, Cherubini A, Di Lenarda A, Radini D, Ramani F, Francese M, Gulizia M, Pericone D, Davletov K, Aigerim K, Zholdin B, Amirov B, Assembekov B, Chernokurova E, Ibragimova F, Kodasbayev A, Markova A, Mirrakhimov E, Asanbaev A, Toktomamatov U, Tursunbaev M, Zakirov U, Abilova S, Arapova R, Bektasheva E, Esenbekova J, Neronova K, Asanbaev A, Baigaziev K, Toktomamatov U, Zakirov U, Baitova G, Zheenbekov T, Erglis A, Andrejeva T, Bajare I, Kucika G, Labuce A, Putane L, Stabulniece M, Dzerve V, Klavins E, Sime I, Badariene J, Gedvilaite L, Pečiuraite D, Sileikienė V, Skiauteryte E, Solovjova S, Sidabraite R, Briedis K, Ceponiene I, Jurenas M, Kersulis J, Martinkute G, Vaitiekiene A, Vasiljevaite K, Veisaite R, Plisienė J, Šiurkaitė V, Vaičiulis Ž, Jankowski P, Czarnecka D, Kozieł P, Podolec P, Nessler J, Gomuła P, Mirek-Bryniarska E, Bogacki P, Wiśniewski A, Pająk A, Wolfshaut-Wolak R, Bućko J, Kamiński K, Łapińska M, Paniczko M, Raczkowski A, Sawicka E, Stachurska Z, Szpakowicz M, Musiał W, Dobrzycki S, Bychowski J, Kosior D, Krzykwa A, Setny M, Kosior D, Rak A, Gąsior Z, Haberka M, Gąsior Z, Haberka M, Szostak-Janiak K, Finik M, Liszka J, Botelho A, Cachulo M, Sousa J, Pais A, Aguiar C, Durazzo A, Matos D, Gouveia R, Rodrigues G, Strong C, Guerreiro R, Aguiar J, Abreu A, Cruz M, Daniel P, Morais L, Moreira R, Rosa S, Rodrigues I, Selas M, Gaita D, Mancas S, Apostu A, Cosor O, Gaita L, Giurgiu L, Hudrea C, Maximov D, Moldovan B, Mosteoru S, Pleava R, Ionescu M, Parepa I, Pogosova N, Arutyunov A, Ausheva A, Isakova S, Karpova A, Salbieva A, Sokolova O, Vasilevsky A, Pozdnyakov Y, Antropova O, Borisova L, Osipova I, Lovic D, Aleksic M, Crnokrak B, Djokic J, Hinic S, Vukasin T, Zdravkovic M, Lalic N, Jotic A, Lalic K, Lukic L, Milicic T, Macesic M, Stanarcic Gajovic J, Stoiljkovic M, Djordjevic D, Kostic S, Tasic I, Vukovic A, Fras Z, Jug B, Juhant A, Krt A, Kugonjič U, Chipayo Gonzales D, Gómez Barrado J, Kounka Z, Marcos Gómez G, Mogollón Jiménez M, Ortiz Cortés C, Perez Espejo P, Porras Ramos Y, Colman R, Delgado J, Otero E, Pérez A, Fernández-Olmo M, Torres-LLergo J, Vasco C, Barreñada E, Botas J, Campuzano R, González Y, Rodrigo M, de Pablo C, Velasco E, Hernández S, Lozano C, González P, Castro A, Dalmau R, Hernández D, Irazusta F, Vélez A, Vindel C, Gómez-Doblas J, García Ruíz V, Gómez L, Gómez García M, Jiménez-Navarro M, Molina Ramos A, Marzal D, Martínez G, Lavado R, Vidal A, Rydén L, Boström-Nilsson V, Kjellström B, Shahim B, Smetana S, Hansen O, Stensgaard-Nake E, Deckers J, Klijn A, Mangus T, Peters R, Scholte op Reimer W, Snaterse M, Aydoğdu S, Ç Erol, Otürk S, Tulunay Kaya C, Ahmetoğlu Y, Ergene O, Akdeniz B, Çırgamış D, Akkoyun H Kültürsay S, Kayıkçıoğlu M, Çatakoğlu A, Çengel A, Koçak A, Ağırbaşlı M, Açıksarı G, Çekin M, Tokgözoğlu L, Kaya E, Koçyiğit D, Öngen Z, Özmen E, Sansoy V, Kaya A, Oktay V, Temizhan A, Ünal S, İ Yakut, Kalkan A, Bozkurt E, Kasapkara H, Dolzhenko M, Faradzh C, Hrubyak L, Konoplianyk L, Kozhuharyova N, Lobach L, Nesukai V, Nudchenko O, Simagina T, Yakovenko L, Azarenko V, Potabashny V, Bazylevych A, Bazylevych M, Kaminska K, Panchenko L, Shershnyova O, Ovrakh T, Serik S, Kolesnik T, Kosova H, Wood D, Adamska A, Adamska S, Jennings C, Kotseva K, Hoye P Atkin A, Fellowes D, Lindsay S, Atkinson C, Kranilla C, Vinod M, Beerachee Y, Bennett C, Broome M, Bwalya A, Caygill L, Dinning L, Gillespie A, Goodfellow R, Guy J, Idress T, Mills C, Morgan C, Oustance N, Singh N, Yare M, Jagoda J, Bowyer H, Christenssen V, Groves A, Jan A, Riaz A, Gill M, Sewell T, Gorog D, Baker M, De Sousa P, Mazenenga T, Porter J, Haines F, Peachey T, Taaffe J, Wells K, Ripley D, Forward H, McKie H, Pick S, Thomas H, Batin P, Exley D, Rank T, Wright J, Kardos A, Sutherland SB, Wren L, Leeson P, Barker D, Moreby B, Sawyer J, Stirrup J, Brunton M, Brodison A, Craig J, Peters S, Kaprielian R, Bucaj A, Mahay K, Oblak M, Gale C, Pye M, McGill Y, Redfearn H, Fearnley M. Management of dyslipidaemia in patients with coronary heart disease: Results from the ESC-EORP EUROASPIRE V survey in 27 countries. Atherosclerosis 2019; 285:135-146. [DOI: 10.1016/j.atherosclerosis.2019.03.014] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/22/2019] [Accepted: 03/19/2019] [Indexed: 12/16/2022]
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Grinstein J, Kadakkal A, Rodrigo M, Hofmeyer M, Mohammed S, Craig P, Torguson R, Molina E, Najjar S, Sheikh F. Advanced Kidney Disease in the Left Ventricular Assist Device Population: Impact on Disease Progression, Morbidity and Mortality. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.582] [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: 10/27/2022] Open
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Grinstein J, Kadakkal A, Rodrigo M, Hofmeyer M, Mohammed S, Butt N, Craig P, Torguson R, Molina E, Najjar S, Sheikh F. Early Renal Recovery after Left Ventricular Assist Device Implantation is Associated with Improved Clinical Outcomes in Patients with Kidney Disease at Baseline. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Rocha P, Rodrigo M, Moliner L, Hardy-Werbin M, Casadevall Aguilar D, Durán X, Arpí O, Clavé S, Salido M, Riera X, Menendez S, Taus Á, Pijuan L, Comerma L, Arriola Aperribay E. Higher PD-L1 expression correlates with lymphocyte infiltration in early non-small cell lung cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz064.013] [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: 11/14/2022] Open
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Liberos A, Rodrigo M, Hernandez-Romero I, Quesada A, Fernandez-Aviles F, Atienza F, Climent AM, Guillem MS. Phase singularity point tracking for the identification of typical and atypical flutter patients: A clinical-computational study. Comput Biol Med 2018; 104:319-328. [PMID: 30558815 DOI: 10.1016/j.compbiomed.2018.11.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 11/24/2018] [Accepted: 11/26/2018] [Indexed: 11/17/2022]
Abstract
Atrial Flutter (AFL) termination by ablating the path responsible for the arrhythmia maintenance is an extended practice. However, the difficulty associated with the identification of the circuit in the case of atypical AFL motivates the development of diagnostic techniques. We propose body surface phase map analysis as a noninvasive tool to identify AFL circuits. Sixty seven lead body surface recordings were acquired in 9 patients during AFL (i.e. 3 typical, 6 atypical). Computed body surface phase maps from simulations of 5 reentrant behaviors in a realistic atrial structure were also used. Surface representation of the macro-reentrant activity was analyzed by tracking the singularity points (SPs) in surface phase maps obtained from band-pass filtered body surface potential maps. Spatial distribution of SPs showed significant differences between typical and atypical AFL. Whereas for typical AFL patients 70.78 ± 16.17% of the maps presented two SPs simultaneously in the areas defined around the midaxialliary lines, this condition was only satisfied in 5.15 ± 10.99% (p < 0.05) maps corresponding to atypical AFL patients. Simulations confirmed these results. Surface phase maps highlights the reentrant mechanism maintaining the arrhythmia and appear as a promising tool for the noninvasive characterization of the circuit maintaining AFL. The potential of the technique as a diagnosis tool needs to be evaluated in larger populations and, if it is confirmed, may help in planning ablation procedures.
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Affiliation(s)
- A Liberos
- ITACA Institute, Universitat Politècnica de València, Spain; Cardiology Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERCV, Spain.
| | - M Rodrigo
- ITACA Institute, Universitat Politècnica de València, Spain; Cardiology Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERCV, Spain
| | - I Hernandez-Romero
- Cardiology Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERCV, Spain; Department of Signal Theory and Communications, Rey Juan Carlos University, Spain
| | - A Quesada
- Department of Cardiology, Hospital General Universitari de València, Spain
| | - F Fernandez-Aviles
- Cardiology Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERCV, Spain
| | - F Atienza
- Cardiology Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERCV, Spain
| | - A M Climent
- Cardiology Department, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERCV, Spain.
| | - M S Guillem
- ITACA Institute, Universitat Politècnica de València, Spain
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Liberos A, Hernandez-Romero I, De La Nava AS, Rodrigo M, Bueno-Orovio A, Rodriguez B, Guillem MS, Atienza F, Climent AM, Fernandez-Aviles F. P503Inter-subject variability explains juxtaposed effects in pharmacological treatments: an in-silico approach for the personalization of atrial fibrillation drug treatments. Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy060.360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- A Liberos
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, Madrid, Spain
| | - I Hernandez-Romero
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, Madrid, Spain
| | - A S De La Nava
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, Madrid, Spain
| | - M Rodrigo
- Universitat Politècnica de València, ITACA, València, Spain
| | - A Bueno-Orovio
- University of Oxford, Department of Computer Science, Oxford, United Kingdom
| | - B Rodriguez
- University of Oxford, Department of Computer Science, Oxford, United Kingdom
| | - M S Guillem
- Universitat Politècnica de València, ITACA, València, Spain
| | - F Atienza
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, Madrid, Spain
| | - A M Climent
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, Madrid, Spain
| | - F Fernandez-Aviles
- Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, Madrid, Spain
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Valantine H, Shah P, Shah K, Hsu S, Feller E, Rodrigo M, Najjar S, Fideli U, Gorham S, Marishta A, Yang Y, Jang M, Tunc I, Agbor-Enoh S. Validation of Donor-derived Cell-free DNA to Detect Heart-transplant Rejection. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Rodrigo M, Climent AM, Hernadez-Romero I, Alhusseini M, Kowalewski CAB, Fernandez-Aviles F, Guillem MS, Narayan SM, Atienza F. P847Comparison of driver location by simultaneous body-surface and endocardial basket mapping of human atrial fibrillation. Europace 2018. [DOI: 10.1093/europace/euy015.450] [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: 11/12/2022] Open
Affiliation(s)
- M Rodrigo
- Polytechnic University of Valencia, ITACA Institute, Valencia, Spain
| | - A M Climent
- Hospital General Universitario Gregorio Marañón, CIBERCV, Instituto de investigación sanitaria Gregorio Marañón, Madrid, Spain
| | - I Hernadez-Romero
- Hospital General Universitario Gregorio Marañón, CIBERCV, Instituto de investigación sanitaria Gregorio Marañón, Madrid, Spain
| | - M Alhusseini
- Stanford University, Cardiovascular Department, Palo Alto, United States of America
| | - CAB Kowalewski
- Stanford University, Cardiovascular Department, Palo Alto, United States of America
| | - F Fernandez-Aviles
- Hospital General Universitario Gregorio Marañón, CIBERCV, Instituto de investigación sanitaria Gregorio Marañón, Madrid, Spain
| | - M S Guillem
- Polytechnic University of Valencia, ITACA Institute, Valencia, Spain
| | - S M Narayan
- Stanford University, Cardiovascular Department, Palo Alto, United States of America
| | - F Atienza
- Hospital General Universitario Gregorio Marañón, CIBERCV, Instituto de investigación sanitaria Gregorio Marañón, Madrid, Spain
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Liberos A, Bueno-Orovio A, Rodrigo M, Guillem M, Hernandez-Romero I, Rodriguez B, Atienza F, Fernandez-Aviles F, Climent A. P454Balance between sodium and calcium currents determine efficacy of pharmacological antiarrhythmic strategies for atrial fibrillation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rodrigo M, Climent AM, Liberos A, Fernández-Aviles F, Atienza F, Guillem MS, Berenfeld O. Minimal configuration of body surface potential mapping for discrimination of left versus right dominant frequencies during atrial fibrillation. Pacing Clin Electrophysiol 2017; 40:940-946. [PMID: 28586103 DOI: 10.1111/pace.13133] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 05/02/2017] [Accepted: 05/26/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND Ablation of drivers maintaining atrial fibrillation (AF) has been demonstrated as an effective therapy. Drivers in the form of rapidly activated atrial regions can be noninvasively localized to either left or right atria (LA, RA) with body surface potential mapping (BSPM) systems. This study quantifies the accuracy of dominant frequency (DF) measurements from reduced-leads BSPM systems and assesses the minimal configuration required for ablation guidance. METHODS Nine uniformly distributed lead sets of eight to 66 electrodes were evaluated. BSPM signals were registered simultaneously with intracardiac electrocardiograms (EGMs) in 16 AF patients. DF activity was analyzed on the surface potentials for the nine leads configurations, and the noninvasive measures were compared with the EGM recordings. RESULTS Surface DF measurements presented similar values than panoramic invasive EGM recordings, showing the highest DF regions in corresponding locations. The noninvasive DFs measures had a high correlation with the invasive discrete recordings; they presented a deviation of <0.5 Hz for the highest DF and a correlation coefficient of >0.8 for leads configurations with 12 or more electrodes. CONCLUSIONS Reduced-leads BSPM systems enable noninvasive discrimination between LA versus RA DFs with similar results as higher-resolution 66-leads system. Our findings demonstrate the possible incorporation of simplified BSPM systems into clinical planning procedures for AF ablation.
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Affiliation(s)
- M Rodrigo
- ITACA, Universitat Politècnica de València, Valencia, Spain
| | - A M Climent
- CIBERCV, Hospital General Universitario Gregorio Marañón, Instituto de investigación sanitaria Gregorio Marañón, Madrid, Spain
| | - A Liberos
- CIBERCV, Hospital General Universitario Gregorio Marañón, Instituto de investigación sanitaria Gregorio Marañón, Madrid, Spain
| | - F Fernández-Aviles
- CIBERCV, Hospital General Universitario Gregorio Marañón, Instituto de investigación sanitaria Gregorio Marañón, Madrid, Spain.,Facultad de Medicina. Universidad Complutense de Madrid, Spain
| | - F Atienza
- CIBERCV, Hospital General Universitario Gregorio Marañón, Instituto de investigación sanitaria Gregorio Marañón, Madrid, Spain.,Facultad de Medicina. Universidad Complutense de Madrid, Spain
| | - M S Guillem
- ITACA, Universitat Politècnica de València, Valencia, Spain
| | - O Berenfeld
- Center for Arrhythmia Research, University of Michigan, Ann Arbor, MI
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Gazulla M, Rodrigo M, Orduña M, Ventura M, Andreu C. High precision measurement of silicon in naphthas by ICP-OES using isooctane as diluent. Talanta 2017; 164:563-569. [DOI: 10.1016/j.talanta.2016.12.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 12/07/2016] [Accepted: 12/09/2016] [Indexed: 11/24/2022]
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Rodrigo M. Book reviews : Processing Vegetables. Science and Technology. D.S. Smith, J.N. Cash, W.K. Nip y H. Hui. Publicado en 1998 por Technomic Publishing Co., 851 New Holland Avenue, Box 3535, Lancaster, Pennsylvania 17604, USA. XIII + 273 pp., ISBN 1 56676 507 2. FOOD SCI TECHNOL INT 2016. [DOI: 10.1177/108201329800400512] [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: 11/17/2022]
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Mateu A, Rodrigo M. Book reviews : Food Engineering Laboratory Manual. Editado por G.V. Barbosa-Cánovas, L. Ma y B. Barletta. Publicado en 1997 por Technomic Publishing Company, Inc., 851 New Holland Avenue, Box 3535, Lancaster, Pennsylvania 17604, USA. XIII + 141 pp., ISBN 1 56676 541 2. FOOD SCI TECHNOL INT 2016. [DOI: 10.1177/108201329800400411] [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: 11/17/2022]
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Rodrigo M. Book reviews : Nonthermal Preservation of Foods. G.V. Barbosa- Canóvas, U.R. Pothakamury, E. Palou, E. Enrique y B.G. Swanson. Publicado en 1997 por Marcel Dekker Inc., 270 Madison Avenue, New York 10016, USA. 296 pp. ISBN 0 8247 9979 8. FOOD SCI TECHNOL INT 2016. [DOI: 10.1177/108201329800400410] [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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Rodrigo M. Book reviews : Freezing Effects on Food Quality. Editado por Lester E. Jeremiah. Publicado en 1998 por Marcel Dekker, Inc., 270 Madison Avenue, New York. 520 pp., ISBN 0 8247 9350. FOOD SCI TECHNOL INT 2016. [DOI: 10.1177/108201329900500311] [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: 11/17/2022]
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Sampedro F, Rodrigo D, Martínez A, Barbosa-Cánovas GV, Rodrigo M. Review: Application of Pulsed Electric Fields in Egg and Egg Derivatives. FOOD SCI TECHNOL INT 2016. [DOI: 10.1177/1082013206070430] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This work overviews works published on the application of pulsed electric fields (PEF) in egg and egg derivatives, grouped by subject, and arranged chronologically in terms of the factor studied (microorganisms, quality aspects, shelf life and structural changes in gel formation properties). The inactivation of microorganisms by PEF in egg is very considerable, 3.5 decimal reductions in egg white were achieved by PEF in Salmonella enteritidis, 5.5 log reductions of Listeria innocua by means of a synergistic effect of PEF and nisin in liquid whole egg, and 5.6 log reductions of Escherichia coli in beaten fresh liquid egg by PEF treatment applied continuously or discontinuously in five steps. The shelf life of PEF-treated fresh liquid egg was extended to 4 weeks in refrigeration, and quality (colour, viscosity and sensory attributes) was not affected by PEF treatment. PEF treatment did not cause notable changes in proteins in a solution of ovalbumin and dialysed fresh egg white. However, some structural changes and functional modifications were observed in fresh egg white as a result of PEF treatment. The texture and microstructure of gels were affected by the application of PEF, and therefore PEF treatment conditions in egg white must be optimised to minimise possible modifications.
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Affiliation(s)
- F. Sampedro
- Instituto de Agroquímica y Tecnología de Alimentos, CSIC, Apartado postal 73, 46100 Burjassot, Valencia, Spain
| | - D. Rodrigo
- Instituto de Agroquímica y Tecnología de Alimentos, CSIC, Apartado postal 73, 46100 Burjassot, Valencia, Spain
| | - A. Martínez
- Instituto de Agroquímica y Tecnología de Alimentos, CSIC, Apartado postal 73, 46100 Burjassot, Valencia, Spain
| | - G. V. Barbosa-Cánovas
- Department of Biological Systems Engineering, Washington State University, Pullman, WA, 99164-6120, USA
| | - M. Rodrigo
- Instituto de Agroquímica y Tecnología de Alimentos, CSIC, Apartado postal 73, 46100 Burjassot, Valencia, Spain,
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Rodrigo M. Book reviews : Procesado de Frutas. Arthey y Ashurst. Traducido al castellano por Justino Burgos González y Carmen Argón Robles. Editorial Acribia Royo 23, Zaragoza. XIII + 273 pp., ISBN 84-200-0839-2. FOOD SCI TECHNOL INT 2016. [DOI: 10.1177/108201329900500312] [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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Rodrigo M. Book Review: Phytochemicals as Bioactive Agents. FOOD SCI TECHNOL INT 2016. [DOI: 10.1106/6k85-am10-avyd-2bve] [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: 11/14/2022]
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Mateo S, Gonzalez del Campo A, Lobato J, Rodrigo M, Cañizares P, Fernandez-Morales F. Long-term effects of the transient COD concentration on the performance of microbial fuel cells. Biotechnol Prog 2016; 32:883-90. [DOI: 10.1002/btpr.2278] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 03/02/2016] [Indexed: 11/08/2022]
Affiliation(s)
- S. Mateo
- Chemical Engineering Dept., ITQUIMA; University of Castilla-La Mancha; Avenida Camilo José Cela S/N Ciudad Real 13071 Spain
| | - A. Gonzalez del Campo
- Chemical Engineering Dept., ITQUIMA; University of Castilla-La Mancha; Avenida Camilo José Cela S/N Ciudad Real 13071 Spain
| | - J. Lobato
- Chemical Engineering Dept., Faculty of Chemical Sciences and Technologies; University of Castilla-La Mancha, Edificio Enrique Costa Novella; Avenida Camilo José Cela S/N Ciudad Real 13071 Spain
| | - M. Rodrigo
- Chemical Engineering Dept., Faculty of Chemical Sciences and Technologies; University of Castilla-La Mancha, Edificio Enrique Costa Novella; Avenida Camilo José Cela S/N Ciudad Real 13071 Spain
| | - P. Cañizares
- Chemical Engineering Dept., Faculty of Chemical Sciences and Technologies; University of Castilla-La Mancha, Edificio Enrique Costa Novella; Avenida Camilo José Cela S/N Ciudad Real 13071 Spain
| | - F.J. Fernandez-Morales
- Chemical Engineering Dept., ITQUIMA; University of Castilla-La Mancha; Avenida Camilo José Cela S/N Ciudad Real 13071 Spain
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Agbor-Enoh S, Fideli U, Doveikis J, Zhu J, Tunc I, Shah P, Russell S, Feller E, Shah K, Rodrigo M, Shah P, Pham S, Iacono A, Nathan S, Orens J, GRAfT Investigators N, Valantine H. Genomic Research Alliance for Transplantation (GRAfT): A Model for Long Term Transplant Studies in Thoracic Organ Transplantation. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Majure D, Sheikh F, Hofmeyer M, Rodrigo M, Bither C, Parunashvili N, Boyce S, Najjar S. Comparison of Hospitalization Rates With the HeartWare HVAD and HeartMate II Left Ventricular Assist Devices. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.542] [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: 10/23/2022] Open
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Olariu E, Rodrigo M, Alvarez Lopez P, Castro-Rodriguez JI, Martin-Lopez LM, Alonso J, Garcia Forero C. Diagnosing Anxiety Disorders in Primary Care: a Systematic Review and Meta-Analysis. Value Health 2014; 17:A325. [PMID: 27200538 DOI: 10.1016/j.jval.2014.08.578] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- E Olariu
- PRBB - IMIM Instituto Hospital del Mar de Investigaciones Médicas, Barcelona, Spain
| | - M Rodrigo
- Pompeu Fabra University, Barcelona, Spain
| | | | | | | | - J Alonso
- IMIM-Research Institute Hospital del Mar, Barcelona, Spain
| | - C Garcia Forero
- PRBB - IMIM Instituto Hospital del Mar de Investigaciones Médicas, Barcelona, Spain
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Soto-Insuga V, López-Villanueva L, Rodrigo M, Aroyo IM, Losada R, Soriano-Guillén L. Confusion as a presentation symptom of pseudomigraine with pleocytosis in a paediatric patient. Anales de Pediatría (English Edition) 2014. [DOI: 10.1016/j.anpede.2013.10.004] [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] Open
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Soto-Insuga V, López-Villanueva L, Rodrigo M, Mois Aroyo I, Losada R, Soriano-Guillén L. [Confusion as a presentation symptom of pseudomigraine with pleocytosis in a paediatric patient]. An Pediatr (Barc) 2013; 80:394-8. [PMID: 24286871 DOI: 10.1016/j.anpedi.2013.10.025] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 10/11/2013] [Accepted: 10/14/2013] [Indexed: 11/28/2022] Open
Abstract
Transient headache and neurological deficits with cerebrospinal fluid lymphocytic pleocytosis (Handl) syndrome is a rare condition of unknown origin that is characterized by episodes of severe headache, transient neurological deficits that recur over less than 3 months, and lymphocytic pleocytosis in CSF. We report the case of a 14 year-old girl who presented with headache and vomiting that lasted 4 days, later combined with a clinical presentation of confusion, with a decrease in the level of consciousness, aphasia, peripheral facial paralysis, ataxia and fever for 24 hours. CSF analysis showed pleocytosis (110 cells/ml) and proteinorrachia (87 mg/dl). Electroencephalogram in the acute time showed generalized slowing, and later a focal slowing in the left hemisphere. She suffered 7 episodes of migraine (severe headache and vomiting) in the following two months, remaining asymptomatic thereafter. This is the first pediatric case published in the literature that presents with an agitated and/or confused state. This condition must be considered in the differential diagnosis of patients with headache and acute altered level of consciousness, in order to avoid prolonged treatments or unnecessary invasive testing.
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Affiliation(s)
- V Soto-Insuga
- Servicio de Pediatría, Fundación Jiménez Díaz, Madrid, España.
| | | | - M Rodrigo
- Servicio de Pediatría, Fundación Jiménez Díaz, Madrid, España
| | - I Mois Aroyo
- Servicio de Pediatría, Fundación Jiménez Díaz, Madrid, España
| | - R Losada
- Servicio de Pediatría, Fundación Jiménez Díaz, Madrid, España
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Lekamwasam S, Rodrigo M, de Silva KIS, Munidasa D. Comparison of phalangeal bone mineral content and density between the dominant and non-dominant sides. Ceylon Med J 2009; 50:149-51. [PMID: 16538908 DOI: 10.4038/cmj.v50i4.1404] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Compared to the non-dominant side, higher bone mineral content (BMC) and density (BMD) have been demonstrated in the forearm bones in the dominant side. Clinicians are compelled to scan the dominant side when deformities or artifacts are found in the non-dominant side. This study was done to evaluate the differences in phalangeal BMC and BMD, measured using accuDXA, between the dominant and non-dominant hands. Design and participants A group of 333 subjects, comprising 267 healthy volunteers (185 women and 82 men) and 66 women with rheumatoid arthritis. Phalangeal BMD and BMC, were measured using accuDEXA, both in the non-dominant and dominant hands. Main results BMC and BMD showed strong correlations between the two sides (r = 0.95, p < 0.001 for both). Compared to the non-dominant side, dominant side BMC was 5% higher (mean values =1.54 and 1.47, mean difference = 0.064, 95% CI for the mean difference = 0.048-0.081 g, p < 0.001) and BMD was 4% higher (mean values = 0.480 and 0.463, mean difference = 0.018, 95% CI for the mean difference = 0.014-0.021 g/cm2, p < 0.001). In the subgroup analysis, percentage differences of BMD between the two sides were found to be similar among men (n=82), women (n=251), people below 50 years (n=24), people above 50 years (n=122) and also among patients with rheumatoid arthritis (n=66). Conclusions When the non-dominant hand is not suitable for scanning, the clinician should consider scanning the dominant hand instead. However, the differences in BMD between the two hands should be taken into consideration when interpreting results.
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Affiliation(s)
- S Lekamwasam
- Centre for Metabolic Bone Diseases, Teaching Hospital, Karapitiya, Sri Lanka.
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Lekamwasam S, Wijayaratne LS, Rodrigo M, Hewage U. Physical activity and bone mineral density. Ceylon Med J 2009; 52:36-7. [PMID: 17585584 DOI: 10.4038/cmj.v52i1.1052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Abstract
Acute necrotizing esophagitis or black esophagus is a rare affection, described in the medical literature since 1990. Although its mechanism is not fully understood, ischemic compromise appears to be the fundamental physiopathological factor. When acute necrotizing esophagitis is found in the endoscopic study of an upper digestive haemorrhage, the prognosis is good. We present a case in which diagnosis of black esophagus was an endoscopic finding, secondary to a situation of underlying hemodynamic instability, with a fatal outcome.
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Affiliation(s)
- M Rodrigo
- Servicio de Urgencias, Hospital Virgen del Camino, 31008, Pamplona, Spain.
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Ferrer C, Rodrigo D, Pina M, Klein G, Rodrigo M, Martínez A. The Monte Carlo simulation is used to establish the most influential parameters on the final load of pulsed electric fields E. coli cells. Food Control 2007. [DOI: 10.1016/j.foodcont.2006.05.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Rivas A, Rodrigo D, Martínez A, Barbosa-Cánovas G, Rodrigo M. Effect of PEF and heat pasteurization on the physical–chemical characteristics of blended orange and carrot juice. Lebensm Wiss Technol 2006. [DOI: 10.1016/j.lwt.2005.07.002] [Citation(s) in RCA: 119] [Impact Index Per Article: 6.6] [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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Pina MC, Ferrer C, Rodrigo M, Klein G, Martínez A. Organization of risk analysis in the EU and the new EU food regulation. Dtsch Tierarztl Wochenschr 2006; 113:407-12. [PMID: 17147150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Given the scope and magnitude of the food supply in modern societies, there is no way to ensure that all foods are kept free from potential sources of contamination. Instead, food safety is enhanced by systematically concentrating upon minimizing opportunities for contamination at every point from food production and processing to distribution, preparation, and consumption. Although previous advances, such as pasteurization and refrigeration, and contemporary improvements in hazard analysis and control have significantly improved the safety of the food supply, foodborne disease remains a major cause of morbidity and mortality. Consequently, the food policy of the European Union and member states must reach the highest food safety standards in order to reduce the incidence of the illness produced by consumption of foods. To reach this goal, the new food regulation is in force since 2002 with the amendment through the hygiene package, which is in force since 2006. Risk Analysis forms the foundation on which food safety policy is based and an important part is aimed at microbiolgogical contamination. Additionally a European Food Safety Authority was established to carry out risk assessment and communication of food safety issues. At the same time, member states have created their own Food Safety Agencies working closely with the European Food Safety Authority. In this work, a description of the structure and work of the European Food Safety Authority and as an example the Spanish Food Safety Agency as well as key elements of the new regulation with special respect to the hygiene package is given.
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Affiliation(s)
- M C Pina
- Instituto de Agroquímica y Tecnología de Alimentos, Valencia, Spain
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Ferrer C, Tejedor W, Klein G, Rodrigo D, Rodrigo M, Martínez A. Monte Carlo Simulation to establish the effect of pH, temperature and heating time on the final load of Bacillus stearothermophilus spores. Eur Food Res Technol 2006. [DOI: 10.1007/s00217-006-0307-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Rivas A, Sampedro F, Rodrigo D, Martínez A, Rodrigo M. Nature of the inactivation of Escherichia coli suspended in an orange juice and milk beverage. Eur Food Res Technol 2006. [DOI: 10.1007/s00217-005-0234-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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