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Menéndez R, Méndez R, Latorre A, González-Jiménez P, Peces-Barba G, Molina M, España PP, García E, Consuegra-Vanegas A, Pando-Sandoval A, Panadero C, Figueira-Gonçalves JM, De la Rosa D, Sibila O, Martínez-Pitarch MD, Toledo N, Cejudo P, Almonte-Batista W, Macías-Paredes A, Badenes D, Pérez-Rodas EN, Lázaro J, Quirós S, Cordovilla R, Cano-Pumarega I, Torres A. Residual pulmonary infiltrates, symptoms and diffusion impairment at one-year after severe COVID-19 infection have different associated factors. J Intern Med 2023. [PMID: 37038609 DOI: 10.1111/joim.13642] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
INTRODUCTION After severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia, patients may show lung sequelae on radiology and functional impairment at the 1-year follow-up. We aimed to describe the persistence of symptoms, radiological alterations, or reduced diffusing capacity of the lung for carbon monoxide (DLCO ) at 1-year follow-up in patients from the Spanish Registry RECOVID. METHODS RECOVID collected symptom and radiological and functional lung tests data on hospitalised patients with coronavirus disease 2019 during the acute phase and at the 6- and 12-month follow-up visits. RESULTS Of the 2500 enrolled survivors (90% admitted to the ward), 1874 had follow-up visits for up to a year. Of these, 42% continued to present with symptoms, 27% had radiological sequelae, and 31% had reduced DLCO . Independently associated factors included female sex, asthma, and the requirement for invasive or non-invasive mechanical ventilation. Complete radiological resolution was 72.2% at 12 months; associated factors with incomplete recovery were age, male sex, oxygen or respiratory support, corticosteroids and an initial SpO2 /FiO2 <450 or CURB65 ≥2. Reduced DLCO was observed in 31% of patients at 12 months; associated factors were older age, female sex, smoking habit, SpO2 /FiO2 <450 and CURB-65 ≥2, and the requirement of respiratory support. At 12 months, a proportion of the asymptomatic patients showed reduced DLCO (9.5%), radiological findings (25%), or both (11%). CONCLUSIONS The factors associated with symptom persistence, incomplete radiological resolution, and DLCO <80% differed according to age, sex, comorbidities, and respiratory support. The burden of symptoms, reduced DLCO , and incomplete radiological resolution were considerable in patients with SARS-CoV-2 pneumonia at the 1-year follow-up after hospitalisation. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Rosario Menéndez
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- The University of Valencia, Valencia, Spain
| | - Raúl Méndez
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- The University of Valencia, Valencia, Spain
| | - Ana Latorre
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain
| | - Paula González-Jiménez
- Hospital Universitario y Politécnico La Fe, Valencia, Spain
- Instituto de Investigación Sanitaria La Fe (IISLAFE), Valencia, Spain
- The University of Valencia, Valencia, Spain
| | | | - María Molina
- Hospital de Bellvitge, Hospitalet de Llobregat, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Irene Cano-Pumarega
- CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
- Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
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García-Gasalla M, Ferrer JM, Fraile-Ribot PA, Ferre-Beltrán A, Rodríguez A, Martínez-Pomar N, Ramon-Clar L, Iglesias A, Losada-López I, Fanjul F, Pou JA, Llompart-Alabern I, Toledo N, Pons J, Oliver A, Riera M, Murillas J. Predictive Immunological, Virological, and Routine Laboratory Markers for Critical COVID-19 on Admission. Can J Infect Dis Med Microbiol 2021; 2021:9965850. [PMID: 34422145 PMCID: PMC8373501 DOI: 10.1155/2021/9965850] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 07/28/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Early identification of COVID-19 patients at risk of critical illness is a challenging endeavor for clinicians. We aimed to establish immunological, virological, and routine laboratory markers, which, in combination with clinical information, may allow identifying such patients. METHODS Blood tests to measure neutrophil/lymphocyte ratio (NLR) and levels of ferritin, CRP, D-dimer, complement components (C3 and C4), cytokines, and lymphocyte subsets, as well as SARS-Cov-2 RT-PCR tests, were performed in COVID-19-confirmed cases within 48 hours of admission. RT-PCR cycle threshold (Ct) values from oropharyngeal or nasopharyngeal swabs were determined on the day of admission. Symptom severity was categorized as mild (grade 1), severe (grade 2), or critical (grade 3). RESULTS Of 120 patients who were included, 49 had mild, 32 severe, and 39 critical COVID-19. Levels of ferritin >370 ng/mL (OR 16.4, 95% CI 5.3-50.8), D-dimer >440 ng/mL (OR 5.45, 95% CI 2.36-12.61), CRP >7.65 mg/dL (OR 11.54, 95% CI 4.3-30.8), NLR >3.77 (OR 13.4, 95% CI 4.3-41.1), IL-6 >142.5 pg/mL (OR 8.76, 95% CI 3.56-21.54), IL-10 >10.8 pg/mL (OR 16.45, 95% CI 5.32-50.81), sIL-2rα (sCD25) >804.5 pg/mL (OR 14.06, 95% CI 4.56-43.28), IL-1Ra >88.4 pg/mL (OR 4.54, 95% CI 2.03-10.17), and IL-18 >144 pg/mL (OR 17.85, 95% CI 6.54-48.78) were associated with critical COVID-19 in the univariate age-adjusted analysis. This association was confirmed in the multivariate age-adjusted analysis only for ferritin, CRP, NLR, IL-10, sIL-2rα, and IL-18. T, B, and NK cells were significantly decreased in critical patients. SARS-CoV-2 was not detected in blood except in 3 patients who had indeterminate results. RT-PCR Ct values from oropharyngeal or nasopharyngeal swabs on admission were not related to symptom severity. CONCLUSION Ferritin, D-dimer, CRP, NLR, cytokine (IL-18 and IL-10), and cytokine receptor (IL-6, IL1-Ra, and sCD25) test results combined with clinical data can contribute to the early identification of critical COVID-19 patients.
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Affiliation(s)
- Mercedes García-Gasalla
- Internal Medicine, Hospital Universitari Son Espases-Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain
| | - Juana M. Ferrer
- Immunology, Hospital Universitari Son Espases-Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain
| | - Pablo A. Fraile-Ribot
- Microbiology, Hospital Universitari Son Espases-Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain
| | - Adrián Ferre-Beltrán
- Internal Medicine, Hospital Universitari Son Espases-Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain
| | - Adrián Rodríguez
- Internal Medicine, Hospital Universitari Son Llàtzer-Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain
| | - Natalia Martínez-Pomar
- Immunology, Hospital Universitari Son Espases-Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain
| | - Luisa Ramon-Clar
- Pneumology, Hospital Universitari Son Espases-Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain
| | - Amanda Iglesias
- CIBER de Enfermedades Respiratorias, Hospital Universitari Son Espases-Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain
- CIBERES, Madrid, Spain
| | - Inés Losada-López
- Internal Medicine, Hospital Universitari Son Llàtzer-Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain
| | - Francisco Fanjul
- Internal Medicine, Hospital Universitari Son Espases-Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain
| | - Joan Albert Pou
- Internal Medicine, Hospital Universitari Son Espases-Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain
| | | | - Nuria Toledo
- Pneumology, Hospital Universitari Son Espases-Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain
| | - Jaime Pons
- Immunology, Hospital Universitari Son Espases-Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain
| | - Antonio Oliver
- Microbiology, Hospital Universitari Son Espases-Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain
| | - Melchor Riera
- Internal Medicine, Hospital Universitari Son Espases-Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain
| | - Javier Murillas
- Internal Medicine, Hospital Universitari Son Espases-Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Balearic Islands, Spain
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Hawk K, McCormack R, Edelman E, Coupet E, Toledo N, Gauiter P, Rotrosen J, Chawarski M, Fiellin D, D'Onofrio G. 260 Perceptions and Experiences of Emergency Department Patients With Opioid Use Disorder. Ann Emerg Med 2019. [DOI: 10.1016/j.annemergmed.2019.08.218] [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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Barceló A, Bauça JM, Peña-Zarza JA, Morell-Garcia D, Yáñez A, Pérez G, Piérola J, Toledo N, de la Peña M. Circulating branched-chain amino acids in children with obstructive sleep apnea. Pediatr Pulmonol 2017; 52:1085-1091. [PMID: 28672086 DOI: 10.1002/ppul.23753] [Citation(s) in RCA: 6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 06/02/2017] [Indexed: 12/31/2022]
Abstract
INTRODUCTION The effects of obstructive sleep apnea (OSA) on the metabolic system are not well understood, especially in children. Recent studies have provided evidence of the modulation of insulin action by branched-chain amino acids (BCAAs) and suggested novel mechanistic relationships between glucose and amino acid metabolic pathways. We hypothesized that plasma BCAA levels may serve as biomarkers of insulin resistance and metabolic dysfunction in children with OSA. METHODS A polysomnography was conducted for the diagnosis of OSA in 90 snoring children, in a tertiary hospital. Anthropometric and clinical data were measured and venous blood samples were collected for the measurement of plasma glucose, insulin, HbA1c, and amino acids. RESULTS Children with OSA had significantly higher levels of BCAAs (leucine, isoleucine, and total BCAAs) compared with those without OSA (P = 0.024). A positive significant correlation was observed between insulin levels and both leucine and isoleucine (r = 0.232; P < 0.05). On multivariate regression analyses, the presence of OSA was significantly associated with leucine, isoleucine, and total BCAA concentrations (P = 0.028), whereas the arousal index was associated with leucine, valine, and total BCAA levels (P = 0.037). CONCLUSIONS The presence of OSA and sleep fragmentation may induce changes in branched-chain amino acid metabolism in snoring children, independently of obesity. These data may suggest a new mechanism linking OSA and glucose homeostasis.
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Affiliation(s)
- Antonia Barceló
- Servei Anàlisis Clíniques, Hospital Universitari Son Espases, Palma de Mallorca, Spain.,Institut d'Investigació Sanitària de Palma (IdISPa), Palma de Mallorca, Spain.,CIBER Enfermedades Respiratorias (CibeRes) (CB06/06), Spain
| | - Josep Miquel Bauça
- Servei Anàlisis Clíniques, Hospital Universitari Son Espases, Palma de Mallorca, Spain.,Institut d'Investigació Sanitària de Palma (IdISPa), Palma de Mallorca, Spain
| | - José Antonio Peña-Zarza
- Sleep Unit, Department of Pediatrics, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Daniel Morell-Garcia
- Servei Anàlisis Clíniques, Hospital Universitari Son Espases, Palma de Mallorca, Spain.,Institut d'Investigació Sanitària de Palma (IdISPa), Palma de Mallorca, Spain
| | - Aina Yáñez
- Institut d'Investigació Sanitària de Palma (IdISPa), Palma de Mallorca, Spain
| | - Gerardo Pérez
- Servei Anàlisis Clíniques, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Javier Piérola
- Institut d'Investigació Sanitària de Palma (IdISPa), Palma de Mallorca, Spain
| | - Nuria Toledo
- Sleep Unit, Department of Respiratory Medicine, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Mónica de la Peña
- Sleep Unit, Department of Respiratory Medicine, Hospital Universitari Son Espases, Palma de Mallorca, Spain
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Barceló A, Esquinas C, Robles J, Piérola J, De la Peña M, Aguilar I, Morell-Garcia D, Alonso A, Toledo N, Sánchez-de la Torre M, Barbé F. Gut epithelial barrier markers in patients with obstructive sleep apnea. Sleep Med 2016; 26:12-15. [PMID: 28007354 DOI: 10.1016/j.sleep.2016.01.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [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: 09/29/2015] [Revised: 12/14/2015] [Accepted: 01/16/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is now being recognized as an additional contributing factor to the pathogenesis of obesity-related comorbidities. At the same time, there is now increasing evidence to suggest that intestinal wall permeability plays a role in the development of metabolic syndrome. In the present study, circulating zonulin and fatty acid binding protein (I-FABP) were measured in association with metabolic, hepatic, and inflammatory parameters. RESULTS Compared with controls, plasma I-FABP levels were significantly higher in patients with OSA (571 pg/mL [IQR 290-950] vs 396 pg/mL [IQR 234-559], p = 0.04). Zonulin levels were similar between groups. Significant relationships were observed between zonulin levels and waist circumference (p < 0.05), glucose (p < 0.05), and insulin (p < 0.05). In addition, in the OSA group, zonulin levels correlated negatively with the mean nocturnal oxygenation saturation (p < 0.05) and positively with total cholesterol (p < 0.05), alanine aminotransferase (ALT) (p < 0.005), aminotransferase (AST) (p < 0.01), gamma glutamyltransferase (GGT) (p < 0.005), and high-sensitivity C-reactive protein (hs-CRP) (p < 0.05). Multivariate analysis showed that associations between zonulin and ALT, AST, and hs-CRP were attenuated, but not eliminated, after adjustment for other variables. CONCLUSIONS The results of this study suggest that OSA is a risk factor for intestinal damage, regardless of metabolic profile, and that intestinal permeability might be a possible contributor to nonalcoholic fatty liver disease in patients with OSA.
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Affiliation(s)
- Antonia Barceló
- Servei de Anàlisis Clíniques, Hospital Universitari Son Espases, Palma de Mallorca, Spain; Institut de investigacio (IdISPa), Hospital Universitari Son Espases, Palma de Mallorca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain
| | - Cristina Esquinas
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain
| | - Juan Robles
- Servei de Anàlisis Clíniques, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Javier Piérola
- Institut de investigacio (IdISPa), Hospital Universitari Son Espases, Palma de Mallorca, Spain; Servei de Unitat de Investigació, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Mónica De la Peña
- Institut de investigacio (IdISPa), Hospital Universitari Son Espases, Palma de Mallorca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain; Servei de Pneumologia, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Irene Aguilar
- Servei de Anàlisis Clíniques, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Daniel Morell-Garcia
- Servei de Anàlisis Clíniques, Hospital Universitari Son Espases, Palma de Mallorca, Spain.
| | - Alberto Alonso
- Institut de investigacio (IdISPa), Hospital Universitari Son Espases, Palma de Mallorca, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain; Servei de Pneumologia, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Nuria Toledo
- Servei de Pneumologia, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Manuel Sánchez-de la Torre
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain; Respiratory Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, IRBLleida, Lleida, Catalonia, Spain
| | - Ferran Barbé
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain; Respiratory Department, Hospital Universitari Arnau de Vilanova and Santa Maria, Lleida, IRBLleida, Lleida, Catalonia, Spain
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Braun PA, Quissell DO, Henderson WG, Bryant LL, Gregorich SE, George C, Toledo N, Cudeii D, Smith V, Johs N, Cheng J, Rasmussen M, Cheng NF, Santo W, Batliner T, Wilson A, Brega A, Roan R, Lind K, Tiwari T, Shain S, Schaffer G, Harper M, Manson SM, Albino J. A Cluster-Randomized, Community-Based, Tribally Delivered Oral Health Promotion Trial in Navajo Head Start Children. J Dent Res 2016; 95:1237-44. [PMID: 27439724 DOI: 10.1177/0022034516658612] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The authors tested the effectiveness of a community-based, tribally delivered oral health promotion (OHP) intervention (INT) at reducing caries increment in Navajo children attending Head Start. In a 3-y cluster-randomized trial, we developed an OHP INT with Navajo input that was delivered by trained Navajo lay health workers to children attending 52 Navajo Head Start classrooms (26 INT, 26 usual care [UC]). The INT was designed as a highly personalized set of oral health-focused interactions (5 for children and 4 for parents), along with 4 fluoride varnish applications delivered in Head Start during academic years of 2011 to 2012 and 2012 to 2013. The authors evaluated INT impact on decayed, missing, and filled tooth surfaces (dmfs) increment compared with UC. Other outcomes included caries prevalence and caregiver oral health-related knowledge and behaviors. Modified intention-to-treat and per-protocol analyses were conducted. The authors enrolled 1,016 caregiver-child dyads. Baseline mean dmfs/caries prevalence equaled 19.9/86.5% for the INT group and 22.8/90.1% for the UC group, respectively. INT adherence was 53% (i.e., ≥3 child OHP events, ≥1 caregiver OHP events, and ≥3 fluoride varnish). After 3 y, dmfs increased in both groups (+12.9 INT vs. +10.8 UC; P = 0.216), as did caries prevalence (86.5% to 96.6% INT vs. 90.1% to 98.2% UC; P = 0.808) in a modified intention-to-treat analysis of 897 caregiver-child dyads receiving 1 y of INT. Caregiver oral health knowledge scores improved in both groups (75.1% to 81.2% INT vs. 73.6% to 79.5% UC; P = 0.369). Caregiver oral health behavior scores improved more rapidly in the INT group versus the UC group (P = 0.006). The dmfs increment was smaller among adherent INT children (+8.9) than among UC children (+10.8; P = 0.028) in a per-protocol analysis. In conclusion, the severity of dental disease in Navajo Head Start children is extreme and difficult to improve. The authors argue that successful approaches to prevention may require even more highly personalized approaches shaped by cultural perspectives and attentive to the social determinants of oral health (ClinicalTrials.gov NCT01116739).
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Affiliation(s)
- P A Braun
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - D O Quissell
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - W G Henderson
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - L L Bryant
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - S E Gregorich
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - C George
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - N Toledo
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - D Cudeii
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - V Smith
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - N Johs
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - J Cheng
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - M Rasmussen
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - N F Cheng
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - W Santo
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - T Batliner
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - A Wilson
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - A Brega
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - R Roan
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - K Lind
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - T Tiwari
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - S Shain
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - G Schaffer
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - M Harper
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - S M Manson
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - J Albino
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Tiwari T, Sharma T, Harper M, Zacher T, Roan R, George C, Swyers E, Toledo N, Batliner T, Braun PA, Albino J. Community Based Participatory Research to Reduce Oral Health Disparities in American Indian Children. J Fam Med 2015; 2:1028. [PMID: 26090520 PMCID: PMC4469184] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Community based participatory research is an approach aimed to equitably involve community members, representatives, and academic researchers in all aspects of the research process. Using this methodology can help integrate cultural knowledge into interventions, supporting researchers to effectively partner with communities in addressing health disparities. The Center for Native Oral Health Research (CNOHR) collaborates with two American Indian (AI) tribes to advance oral health knowledge and practice, including the conduct of randomized controlled clinical trials of culturally sensitive behavioral interventions for primary prevention of early childhood caries (ECC). This manuscript describes the development of researcher-community partnership, and the development and implementation of the two clinical trial in the community. It also gives a detailed account of the strategies developed through the community input in recruitment and retention of the study participants and finally the lessons learnt during the study implementation.
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Affiliation(s)
- T Tiwari
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, USA
| | - T Sharma
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, USA
| | - M Harper
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, USA
| | - T Zacher
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, USA
| | - R Roan
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, USA
| | - C George
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, USA
| | - E Swyers
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, USA
| | - N Toledo
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, USA
| | - T Batliner
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, USA
| | - PA Braun
- Children’s Outcomes Research Program, University of Colorado Anschutz Medical Campus, USA
| | - J Albino
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, USA
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Toledo N, Bargo MS, Cassini GH, Vizcaíno SF. The Forelimb of Early Miocene Sloths (Mammalia, Xenarthra, Folivora): Morphometrics and Functional Implications for Substrate Preferences. J MAMM EVOL 2012. [DOI: 10.1007/s10914-012-9185-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Colón MD, Toledo N, Valiente CL, Rodríguez N, Yano N, Mathews H, Yamamura Y. Anti-fungal and cytokine producing activities of CD8 + T lymphocytes from HIV-1 infected individuals. Bol Asoc Med P R 1998; 90:21-6. [PMID: 9734153] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Lymphokine activated killer (LAK) cells are capable of killing not only malignant cells but also hyphal form of Candida albicans in vitro. When peripheral blood mononuclear cells (PBMC) from normal healthy donors were cultured for 72-96 hrs with 1,500 international unit (IU)/ml interleukin-2 (IL-2), marked LAK activity was induced. However, even prior to IL-2 activation, PBMC isolated from some normal subjects and those from almost all individuals who are infected by human immunodeficiency virus type 1 (HIV-1) exhibited significant levels of anti-fungal activity. Such pre-activation ("in situ") antifungal activity of PBMC decreased during the initial 48 hrs of IL-2 activation. PBMC from HIV-1 seropositive subjects showed higher levels of "in situ" anti-fungal activity than normal PBMC did. After a decline of "in situ" activity during the initial 48 hours, LAK activity gradually increased and reached near maximal levels by day 4 and remained more or less constant until day 6. No significant difference was observed between the LAK activity of normal and HIV-1(+) PBMCs on days 4-6. In IL-2 activated normal and HIV-1(+) PBMC cultures, both CD4 and CD8 T cells produced IL-2, INF-gamma as well as TNF-alpha. Production of IL-2 by both CD4 and CD8 T cells was suppressed in HIV-1(+) PBMC cultures, but no significant suppression of INF-gamma production was noted. Meanwhile, TNF-alpha production by CD4 was very much suppressed but no significant changes in TNF-alpha production by CD8 T cells was noted in HIV-1(+) PBMC cultures.
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Affiliation(s)
- M D Colón
- Ponce School of Medicine AIDS Research Program, PR 00732
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