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Telles VM, Rodriguez S, Torres M, Schneider J, Haughton J, Maldonado M, Arredondo E. Barriers and facilitators to implementing a multilevel, multicomponent intervention promoting colorectal cancer screening in health centers: a qualitative study of key informant perspectives. BMC Health Serv Res 2024; 24:404. [PMID: 38553723 PMCID: PMC10981354 DOI: 10.1186/s12913-024-10749-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 02/19/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Colorectal cancer (CRC) continues to be a major cause of death in the U.S. despite the availability of effective screening tools. U.S. Latinos have lower rates of CRC screening and higher rates of death due to colorectal disease compared to non-Hispanic whites. Federally Qualified Health Centers (FQHCs) serve medically underserved populations, including many Latino patients. Given the low CRC screening rates, identifying culturally sensitive and cost-effective methods of promoting screening is a priority for many FQHCs. METHODS We interviewed FQHC leaders and providers using the Consolidated Framework for Implementation Research (CFIR) to identify barriers and facilitators to implementation of a multilevel, multicomponent (ML-MC) CRC screening intervention (i.e., promotor navigation and group-based education) in FQHCs. A rapid qualitative analysis approach was used to identify themes organized according to the following CFIR constructs: intervention characteristics, outer and inner settings, and characteristics of the individual. RESULTS We completed interviews with 13 healthcare professionals in leadership positions at six FQHCs. The participating FQHCs perceived the ML-MC screening CRC program as feasible and expressed interest in implementing the program at their sites. Facilitators included financial incentives for increasing screening rates, the need for patient education programming, and involving promotores to support the work of clinical teams. Barriers included concerns about available resources to implement new programs, lack of federal reimbursement for health education, competing priorities of other health concerns, and the need for more resources for confirmatory screening and treatment following a positive screen. CONCLUSIONS FQHCs provide essential primary care to millions of underserved patients in the U.S. and have the ability and motivation to provide screenings for colorectal cancer. Partnering with an academic institution to deliver a group-based, promotor-led CRC screening intervention for patients not up to date with screening could help increase screening rates. By identifying the specific barriers and facilitators to implementing CRC intervention, findings suggest that group-based, promotor-led interventions are a promising approach.
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Haby MM, Barreto JOM, Kim JYH, Peiris S, Mansilla C, Torres M, Guerrero-Magaña DE, Reveiz L. What are the best methods for rapid reviews of the research evidence? A systematic review of reviews and primary studies. Res Synth Methods 2024; 15:2-20. [PMID: 37696668 DOI: 10.1002/jrsm.1664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/09/2023] [Accepted: 08/07/2023] [Indexed: 09/13/2023]
Abstract
Rapid review methodology aims to facilitate faster conduct of systematic reviews to meet the needs of the decision-maker, while also maintaining quality and credibility. This systematic review aimed to determine the impact of different methodological shortcuts for undertaking rapid reviews on the risk of bias (RoB) of the results of the review. Review stages for which reviews and primary studies were sought included the preparation of a protocol, question formulation, inclusion criteria, searching, selection, data extraction, RoB assessment, synthesis, and reporting. We searched 11 electronic databases in April 2022, and conducted some supplementary searching. Reviewers worked in pairs to screen, select, extract data, and assess the RoB of included reviews and studies. We included 15 systematic reviews, 7 scoping reviews, and 65 primary studies. We found that several commonly used shortcuts in rapid reviews are likely to increase the RoB in the results. These include restrictions based on publication date, use of a single electronic database as a source of studies, and use of a single reviewer for screening titles and abstracts, selecting studies based on the full-text, and for extracting data. Authors of rapid reviews should be transparent in reporting their use of these shortcuts and acknowledge the possibility of them causing bias in the results. This review also highlights shortcuts that can save time without increasing the risk of bias. Further research is needed for both systematic and rapid reviews on faster methods for accurate data extraction and RoB assessment, and on development of more precise search strategies.
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Chrisentery-Singleton T, Boggio LN, Carcao MD, Ibrahimi S, Khan O, Mahajerin A, Rajasekhar A, Sharma V, Steele M, Torres M, Rodino FJ, Carpenter SL. Long-term follow-up of patients with congenital thrombotic thrombocytopenia purpura receiving a plasma-derived factor VIII (Koate) that contains ADAMTS13. Haemophilia 2023; 29:1638-1645. [PMID: 37855744 DOI: 10.1111/hae.14891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/05/2023] [Accepted: 10/10/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Hereditary thrombotic thrombocytopenia purpura (hTTP) is an ultra-rare disorder resulting from an inherited deficiency of ADAMTS13, a von Willebrand factor (VWF)-cleaving metalloprotease. The plasma-derived factor VIII/VWF Koate (FVIII/VWFKoate ) has been shown to contain ADAMTS13, allowing for its use to treat hTTP at home by the patient/caregiver. AIM Based on prior demonstration of safe and effective use of FVIII/VWFKoate in eight patients with hTTP, we conducted a retrospective study to gather additional data regarding the use of FVIII/VWFKoate for hTTP. METHODS This was a multicentre, retrospective, noninterventional chart review of patients who had received FVIII/VWFKoate for the management of hTTP. Data collected included demographics, medical history, relevant family history, past use and tolerability of fresh frozen plasma, and details regarding FVIII/VWFKoate therapy. RESULTS The cohort included 11 patients (seven males, four females) with hTTP, ranging in age at study entry from 2 to 28 years. The average duration of FVIII/VWFKoate therapy was 4.8 years (range, 0.5-6.5 years). Among nine patients using FVIII/VWFKoate as prophylaxis, the normalized annual rate of breakthrough TTP episodes ranged from 0.2 to 1.1 episodes/year. All nine patients who received FVIII/VWFKoate prophylaxis had thrombocytopenia recorded at baseline, while eight (88.9%) did not have thrombocytopenia after using FVIII/VWFKoate . There was one AE (unspecified) attributed to FVIII/VWFKoate . CONCLUSION These data suggest that FVIII/VWFKoate is a safe and well-tolerated source of the missing ADAMTS13 enzyme in patients with hTTP, producing a marked reduction in thrombocytopenia prevalence, low frequency of TTP episodes, and with the added benefit of self- or caregiver-administration.
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Ragusa M, Tortosa F, Rada G, Vergara C, Zaragoza L, Farrell J, Torres M, Abdala V, Izcovich A, Haby M, Schunemann HJ, Garcia-Saiso S, Reveiz L. The BIGG-REC database makes available all WHO/PAHO evidence informed recommendations. J Clin Epidemiol 2023; 159:257-265. [PMID: 37059238 DOI: 10.1016/j.jclinepi.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 02/16/2023] [Accepted: 04/06/2023] [Indexed: 04/16/2023]
Abstract
OBJECTIVES To build and maintain a living database of the Pan American Health Organization/World Health Organization (PAHO/WHO) recommendations developed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). STUDY DESIGN AND SETTING Guidelines are identified from WHO and PAHO databases. We periodically extract recommendations, according to the health and well-being targets of sustainable development goal 3 (SDG-3). RESULTS As of March 2022, the International database of GRADE guidelines (https://bigg-rec.bvsalud.org/en) database hosted 2,682 recommendations contained in 285 WHO/PAHO guidelines. Recommendations were classified as follows: communicable diseases (1,581), children's health (1,182), universal health (1,171), sexual and reproductive health (910), noncommunicable diseases (677), maternal health (654), COVID-19 (224), use of psychoactive substances (99), tobacco (14) and road and traffic accidents (16). International database of GRADE guidelines allows searching by SDG-3, condition or disease, type of intervention, institution, year of publication, and age. CONCLUSION Recommendation maps provide an important resource for health professionals, organizations and member states that use evidence-informed guidance to make better decisions, providing a source for the adoption or adaptation of recommendations to meet their needs. This one-stop shop database of evidence-informed recommendations built with intuitive functionalities undoubtedly represents a long-needed tool for decision-makers, guideline developers, and the public at large.
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Torres M, Schenk A. Lipoprotein (a): Does It Play a Role in Pediatric Ischemic Stroke and Thrombosis? Curr Atheroscler Rep 2023:10.1007/s11883-023-01102-5. [PMID: 37160656 DOI: 10.1007/s11883-023-01102-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE OF REVIEW The goal of this paper is to describe the current understanding of lipoprotein (a) (Lp(a)), clinical practice guidelines, and the potential pathophysiological mechanisms that appear to increase the risk of cardiovascular and thromboembolic events, specifically within the pediatric population. RECENT FINDINGS The proatherogenic and pro-thrombotic properties of Lp(a) may increase the risk of atherothrombotic disease. In adults, atherosclerotic plaques increase thrombotic risk, but antifibrinolytic and proinflammatory properties appear to have an important role in children. Although it is not well established in neonates, recent studies indicate the risk of incident thrombosis and ischemic stroke are approximately fourfold higher in children with elevated Lp(a) which also increases their risk of recurrent events. Despite this higher risk, Pediatric Lp(a) screening guidelines continue to vary among different medical societies and countries. The inconsistency is likely related to inconclusive evidence outside of observational studies and the lack of specific therapies for children with elevated levels. Additional research is needed to improve understanding of the pro-thrombotic mechanisms of Lp(a), appropriate screening guidelines for Lp(a) in the pediatric population, and to elucidate the short and long term effects of elevated Lp(a) on the risk of pediatric thrombosis and stroke.
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Ingen-Housz-Oro S, Schmidt V, Ameri MM, Abe R, Brassard A, Mostaghimi A, Paller AS, Romano A, Didona B, Kaffenberger BH, Ben Said B, Thong BYH, Ramsay B, Brezinova E, Milpied B, Mortz CG, Chu CY, Sotozono C, Gueudry J, Fortune DG, Dridi SM, Tartar D, Do-Pham G, Gabison E, Phillips EJ, Lewis F, Salavastru C, Horvath B, Dart J, Setterfield J, Newman J, Schulz JT, Delcampe A, Brockow K, Seminario-Vidal L, Jörg L, Watson MP, Gonçalo M, Lucas M, Torres M, Noe MH, Hama N, Shear NH, O’Reilly P, Wolkenstein P, Romanelli P, Dodiuk-Gad RP, Micheletti RG, Tiplica GS, Sheridan R, Rauz S, Ahmad S, Chua SL, Flynn TH, Pichler W, Le ST, Maverakis E, Walsh S, French LE, Brüggen MC. Post-acute phase and sequelae management of epidermal necrolysis: an international, multidisciplinary DELPHI-based consensus. Orphanet J Rare Dis 2023; 18:33. [PMID: 36814255 PMCID: PMC9945700 DOI: 10.1186/s13023-023-02631-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 02/06/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Long-term sequelae are frequent and often disabling after epidermal necrolysis (Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN)). However, consensus on the modalities of management of these sequelae is lacking. OBJECTIVES We conducted an international multicentric DELPHI exercise to establish a multidisciplinary expert consensus to standardize recommendations regarding management of SJS/TEN sequelae. METHODS Participants were sent a survey via the online tool "Survey Monkey" consisting of 54 statements organized into 8 topics: general recommendations, professionals involved, skin, oral mucosa and teeth, eyes, genital area, mental health, and allergy workup. Participants evaluated the level of appropriateness of each statement on a scale of 1 (extremely inappropriate) to 9 (extremely appropriate). Results were analyzed according to the RAND/UCLA Appropriateness Method. RESULTS Fifty-two healthcare professionals participated. After the first round, a consensus was obtained for 100% of 54 initially proposed statements (disagreement index < 1). Among them, 50 statements were agreed upon as 'appropriate'; four statements were considered 'uncertain', and ultimately finally discarded. CONCLUSIONS Our DELPHI-based expert consensus should help guide physicians in conducting a prolonged multidisciplinary follow-up of sequelae in SJS-TEN.
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Ahrendt C, Galbán-Malagón C, Gómez V, Torres M, Mattar C, DeCoite M, Guida Y, Příbylová P, Pozo K. Marine debris and associated organic pollutants in surface waters of Chiloé in the Northern Chilean Patagonia (42°-44°S). MARINE POLLUTION BULLETIN 2023; 187:114558. [PMID: 36652856 DOI: 10.1016/j.marpolbul.2022.114558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/19/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
We report the occurrence of plastics and associated persistent organic pollutants (POPs) in surface waters from Northern Chilean Patagonia. A total of 200 particles were found during the conducted survey. The highest number of particles found was 0.6 item m-3. We found that 53 % of the collected particles corresponded to plastic, with an average of 0.19 ± 0.18 item m-3. Microplastics (68 %) were the dominant size found in the area, followed by macroplastics (18 %) and mesoplastics (14 %). Most plastic particles were white (55 %) while others were <10 % each. Black and light blue represented 9 %; red, dark blue, and other colors 7 %; and green 6 %. Fragments were the most frequent shape of plastic debris (38 %), followed by Styrofoam (30 %) and fiber (27 %). Higher PBDE levels were found in the central zone, and those were higher than DDT, PeCB, HCB, and PCB levels. This study is the first report on POP occurrence in marine plastic debris from Chiloé Sea in the Northern Chilean Patagonia.
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Tilley J, Schenk A, Acosta F, Herring R, Torres M. Abstract TMP24: Successful Implementation Of A Pediatric Stroke Alert System At A Non-academic Hospital. Stroke 2023. [DOI: 10.1161/str.54.suppl_1.tmp24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Introduction:
Extensive research exists on the acute treatment of adult strokes, but delayed radiologic diagnosis prevents children from receiving the same interventions. Some academic institutions have implemented pediatric stroke protocols to improve early diagnosis, but without 24/7 in-house pediatric stroke coverage, the protocols are challenging to translate to non-academic hospitals. The goal of this study is to assess the implementation of a pediatric stroke alert protocol at a non-academic institution on time to diagnosis and access to acute treatment.
Methods:
This was an observational study. Pre-stroke alert patients admitted Feb. 19, 2014-Feb. 18, 2019 were retrospectively identified by stroke/TIA ICD-10 codes. Post-stroke alert patients were prospectively identified using our hospital notification system beginning Feb. 19, 2019- July 31, 2022 for ED stroke alerts and Feb. 19, 2020-July 31, 2022 for inpatient stroke alerts. Patients transferred with an existing stroke/TIA were excluded from the study. Non-parametric tests were used for statistical analysis.
Results:
19 ED and 25 inpatient pre-stroke alert patients were identified. Post-stroke alert implementation, stroke/TIA was identified in 20/157 ED stroke alerts (12.74%) and 14/33 inpatient stroke alerts (42.42%). No significant difference was seen in time from ED arrival to diagnosis. However, time last seen well to diagnosis of stroke/TIA was significantly decreased for both ED and inpatient alerts (Table 1), resulting in 3 patients receiving intravenous thrombolysis.
Conclusions:
Although no significant difference was observed in time from ED arrival to diagnosis, implementation of a pediatric stroke alert protocol helped decrease time last seen well to stroke diagnosis. We speculate that increased awareness of pediatric stroke within the community and among medical staff, together with a defined stroke alert process, helped decrease the time of symptom onset to diagnosis.
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Torres M, Silberberg G, Wheelock C, Bachar-Wikstrom E, Wikstrom J. 416 The overwhelming omics in psoriasis, a systematic review. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Michaelson D, Dignam J, Hamstra D, Bachand F, Master V, Bruner D, Torres M, Saylor P, Wallace R, Vapiwala N, Efstathiou J, Roach M, Rosenthal S, Raben A, Morgan S, Kavadi V, Spratt D, Michalski J, Rodgers J, Sandler H. Phase III Trial of Dose Escalated Radiation Therapy and Standard Androgen Deprivation Therapy (ADT) vs. Dose Escalated Radiation Therapy and Enhanced ADT with TAK-700 for Men with High-Risk Prostate Cancer (NRG Oncology/RTOG 1115). Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bruner D, Pugh S, Michaelson D, Hamstra D, Bachand F, Master V, Torres M, Kaplan I, Rosenthal S, Roach M, Raben A, Michalski J, Kavadi V, Ferguson M, Morgan S, D'Souza D, DeMora L, Sandler H, Movsas B. RTOG/NRG 1115 Quality of Life of Phase III Dose Escalated Radiation Therapy (RT) and Standard Androgen Deprivation Therapy (ADT) with GnRH Agonist vs. Dose Escalated RT and ADT with GnRH Agonist and Orteronel (TAK-700) for Men with High-Risk Prostate. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Barbaglia G, Robles N, Hilarión P, Torres M, Gotsens M, Colell E, Puigdomènech E, de la Torre JA, Espallargues M. Integrated health and social care evaluation framework for mental health and drug addiction care. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac130.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Guiding the decision-making process in mental health investments is advisable. The objective of the study is to develop a framework for evaluating the quality of integrated health and social care in Mental Health and Drug Addiction (MH&DA)
Methods
A literature review helped to establish a definition of integrated care specific to MH&DA and to identify potential indicators for its evaluation. The quality of integrated care was assessed through focus groups (FGs) and interviews (INs) with three different profiles: professionals (2FGs & 2 INs), patients (3 FGs & 2 INs) and families/carers (2FGs & 2 INs). Additional indicators were also obtained from them.
Results
Out of 2,226 publications identified, 87 (4%) were reviewed in full. According to the literature, integrated care in MH&DA is based on four main components: case management, comprehensive assessment, individualised care plan and care coordination among different providers. Based on these components, an operational definition of integrated care was developed and validated in the FGs and INs. Positive aspects identified were a respectful approach and positive experiences of coordination between social and community network. Regarding indicators about 400 were identified, after screening were reduced to 60: 25% corresponded to accessibility, 20% person-centred care, 16% each to care coordination and to effectiveness. In general, the main threats to the quality of care, identified in FGs and INs, matched the dimensions with the highest proportion of indicators (i.e., limited care resources, poor coordination and communication among professionals and services, and barriers in accessing specialized treatment).
Conclusions
According to literature, integrated care in MH&DA seems to be mainly evaluated in terms of accessibility and person-centred care. In a following phase, a large group of experts will be key to select the most relevant dimensions and indicators for the evaluation in a Delphi study.
Key messages
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Quevedo NM, Simbine REB, Bellagamba CCA, Torres M. Combined cardiopulmonary test and exercise Doppler echocardiography in systemic sclerosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cardiopulmonary exercise test (CPET) and exercise Doppler echocardiography (EDE) may be useful for the early detection of pulmonary hypertension in systemic sclerosis (SSc)
Aim
To assess the feasibility of CPET and EDE in detecting early changes in gas exchange and/or pulmonary hemodynamics in SSc
Methods
From 2016 to 2021, we evaluated 19 SSc patients (Group 1, age = 52.58±11.27, women 17 (89.5%)), and age 32.10±6.67, men 17 (89.4%) matched healthy controls (Group 2). Simultaneous CPET and EDE were performed. With CPET, we assessed peak oxygen uptake (VO2), peak respiratory quotient (RQ), respiratory equivalent ratio for carbonic gas (VE/VCO2), and maximal respiratory equivalent divided by maximal ventilatory ventilation (V̇E Max/VVM). With EDE, we assessed tricuspid regurgitant velocity (TRV) jet and pulmonary flow acceleration time (ACT) to derive systolic pulmonary arterial pressure (SPAP).
Results
Exercise duration was similar in the 2 groups (Group 1 = 9.2±2.93 vs Group 2 = 10.14±1.78 minutes). Among CPET parameters, SSc patients showed lower peak VO2 (Group 1 = 1.23±0.55 vs Group 2 = 2.45±0.7, p<0.001), similar RQ (1.10±0.10 vs 1.17±0.09;. p=0.036), VE/VCO2 (Group 1 = 31.90±3.65 vs Group 2 = 23.79±2.64, p<0.001) and V̇E Max/VVM (Group 1 = 1.93±0.60 vs Group 2 = 1.76±0.36, p=NS). With EDE, feasibility at peak stress was low for TRV (Group 1 = 42% vs Group 2 = 58%, p=NS), moderate for ACT (Group 1 = 53% vs Group 2 = 78%, p=NS) and high when at least one was technically adequate (Group 1 = 73% vs Group 2 = 100%, p<0.001). Rest TRV (Group 1 = 2.48±0.14 vs Group 2 = 2.08±0.12 m/s, p=0.033) and ACT (Group 1 = 100.14±10.63 vs Group 2 = 108.86±6.38 ms, p=0.482) showed similar values in the 2 groups (será que ficou similar?). During stress, TRV increased more markedly in SSc (Group 1 = 3.33±0.32 vs Group 2 = 2.34±0.09 m/s, p=0.004) and ACT decreased (Group 1 = 81.9±6.54 vs 73.39±5.18 ms, p=0.304), with estimated peak SPAP higher in SSc (Group 1 = 53.34±7.88 vs Group 2 = 43.33±5.49, p<0.001): see figure.
Conclusion
CPET and EDE offer complementary information on gas exchange and pulmonary hemodynamics in SSc and can detect early alterations missed by resting assessment. The success rate of EDE increases significantly with the combination of TRV and ACT.
Funding Acknowledgement
Type of funding sources: None.
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Torres M, Ahmed S, Ireland E, Johnston E. Dietetic Interns Teaching Practical Nutrition and Cooking Tips to Medical Students. J Acad Nutr Diet 2022. [DOI: 10.1016/j.jand.2022.06.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Deschamps V, Torres M, Verdot C, Salanave B. Évolution des consommations alimentaires des enfants et des adultes entre 2006 et 2015 en France. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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Torres M, Manghera P, Miller C. Prediction of Treatment Response in Patients with Major Depressive Disorder: A Meta-Analysis of Functional Magnetic Resonance Imaging Studies. Eur Psychiatry 2022. [PMCID: PMC9567359 DOI: 10.1192/j.eurpsy.2022.758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Identifying the optimal treatment for individuals with major depressive disorder (MDD) is often a long and complicated process. Functional magnetic resonance imaging (fMRI) studies have been used to help predict and explain differences in treatment response among individuals with MDD.
Objectives
We conducted a comprehensive meta-analysis of treatment prediction studies utilizing fMRI in patients with MDD to provide evidence that neural activity can be used to predict response to antidepressant treatment.
Methods
A multi-level kernel density analysis was applied to these primary fMRI studies, in which we analyzed brain activation patterns of depressed patients (N= 364) before receiving antidepressant treatment.
Results
The results of this analysis demonstrated that hyperactivity in six brain regions significantly predicted treatment response in patients with MDD: the right anterior cingulate, right cuneus, left fusiform gyrus, left middle frontal gyrus, right cingulate gyrus, and left superior frontal gyrus.
Conclusions
This study provides evidence that neural activity, as measured by standard fMRI paradigms, can be used to successfully predict response to antidepressant treatment. This may be used in the future clinically to improve decision-making processes and treatment outcomes for patients.
Disclosure
No significant relationships.
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Ramon y Cajal T, Lopez-Fernandez À, Pardo M, Darder E, Perez E, Costal A, Teule A, Perez A, Torres M, Alfonso R, Vallmajó A, Tuset Der-Abrain N, Cruellas Lapena M, Espinosa-Bravo M, Diez O, Lázaro C, Feliubadaló L, Llort Pursals G, Brunet Vidal J, Balmaña J. 139P Breast cancer risk estimation (CanRisk tool) and perception in unaffected women with family history of breast cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Kamat V, Boutot C, Rafique A, Granados C, Wang J, Badithe A, Torres M, Chatterjee I, Olsen O, Olson W, Huang T. High affinity human Fc specific monoclonal antibodies for capture kinetic analyses of antibody-antigen interactions. Anal Biochem 2022; 640:114455. [PMID: 34788604 DOI: 10.1016/j.ab.2021.114455] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 11/05/2021] [Accepted: 11/08/2021] [Indexed: 12/12/2022]
Abstract
We recently demonstrated that capturing human monoclonal antibodies (hmAbs) using high affinity anti-human Fc (AHC) antibodies allows reliable characterization of antibody-antigen interactions. Here, we characterized six human Fc specific mouse monoclonal antibodies (mAbs) and compared their binding profiles with three previously characterized goat AHC polyclonal antibodies (pAbs), exhibiting properties of a good capture reagent. All six mouse AHC mAbs specifically bound with high affinity to the Fc region of hIgG1, hIgG2, hIgG4 and to 43 different hIgG variants, containing substitutions and/or mutations in the hinge and/or Fc region, that have been reported to exhibit modified antibody effector function and/or pharmacokinetics. Biacore sensor surfaces individually derivatized with mouse AHC mAbs exhibited >2.5-fold higher hIgG binding capacity compared to the three goat AHC pAb surfaces and reproducibly captured hIgG over 300 capture-regeneration cycles. The results of the capture kinetic analyses performed on 31 antibody-antigen interactions using surfaces derivatized with either of the two highest affinity AHC mAbs (REGN7942 or REGN7943) were in concordance with those performed using goat AHC pAb surfaces. Our data demonstrate that AHC mAbs such as REGN7942 and REGN7943 that have properties superior than the three goat AHC pAbs are highly valuable research reagents, especially to perform capture kinetic analyses of antibody-antigen interactions on optical biosensors.
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Torres M, Ragusa M, Abdala V, Brocard E, Schunemann H, Garcia-Saiso S, Reveiz L. BIGG, the international database of GRADE Guidelines. THE LANCET REGIONAL HEALTH - AMERICAS 2022; 6:None. [PMID: 35233554 PMCID: PMC8863112 DOI: 10.1016/j.lana.2021.100099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/14/2021] [Accepted: 09/21/2021] [Indexed: 11/29/2022]
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Viguera L, Blasi A, Reverter E, Arjona B, Caballero M, Chocron I, García-López JA, Gutierrez R, Martin MJ, Pérez-Peña J, Pitera J, Zarragoikoetxea I, Sabaté A, Belmonte C, Bustamante J, Beltran J, Colmenero J, Costa M, Fondevila C, Galan P, García-Palenciano C, Garrido JL, Gomez-Serrano J, Gonzalez S, de la Fuente JC, Jimeno C, Leon A, Lopez-Toribio P, Marín A, Del Mazo A, de Nadal M, Ojinaga G, Padilla J, Tevar J, Torres M, Zaballos M. Liver transplant with controlled donors after circulatory death with normothermic regional perfusion and brain dead donors: A multicenter cohort study of transfusion, one-year graft survival and mortality. Int J Surg 2021; 96:106169. [PMID: 34848373 DOI: 10.1016/j.ijsu.2021.106169] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 09/14/2021] [Accepted: 11/02/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Controlled donation after circulatory death (cDCD) has expanded the donor pool for liver transplantation (LT). However, transfusion requirements and perioperative outcomes should be elucidated. The aim of this multicenter study was to assess red blood cell (RBC) transfusions, one-year graft and patient survival after LT after cDCD with normothermic regional perfusion (NRP) compared with donors after brain death (DBD). METHODS 591 LT carried out in ten centers during 2019 were reviewed. Thromboelastometry was used to manage coagulation and blood product transfusion in all centers. Normothermic regional perfusion was the standard technique for organ recovery. RESULTS 447 patients received DBD and 144 cDCD with NRP. Baseline MCF Extem was lower in the cDCD group There were no differences in the percentage of patients (63% vs. 61% p = 0.69), nor in the number of RBC units transfused (4.7 (0.2) vs 5.5 (0.4) in DBD vs cDCD, p = 0.11. Twenty-six patients (6%) died during admission for LT in the DBD group compared with 3 patients (2%) in the cDCD group (p = 0.15). To overcome the bias due to a worse coagulation profile in cDCD recipients, matched samples were compared. No differences in baseline laboratory data, or in intraoperative use of RBC or one-year outcome data were observed between DBD and cDCD recipients. CONCLUSIONS cDCD with NRP is not associated with increased RBC transfusion. No differences in graft and patient survival between cDCD and DBD were found. Donors after controlled circulatory death with NRP can increasingly be utilized with safety, improving the imbalance between organ donors and the ever-growing demand.
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Schlafstein A, Torres M, Rupji M, Brown G, Green I, Kesarwala A, Miller A, Lin J. Radiotherapy for Breast Cancer, Systemic Inflammation, and Cancer Recurrence. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Torres M, Boudko D, Meleshkevitch E, Coquelin M, Yu X, Eby J, Ishimaru D, Hennig M, Bridges R, Wustman B. 583: Variant-agnostic CFTR rescue using aerosolized delivery of CFTR mRNA using the SORT-LNP in primary human bronchial epithelial cells derived from patients with cystic fibrosis. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)02006-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Haneef R, Constantinou P, Rachas A, Ghosn W, Kudjawu Y, Grave C, Torres M, Fayad M, Ung A, Bonaldi C. Quantifying the burden of premature mortality at national level in France in 2016. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Efforts to accurately measure premature mortality are important to monitor the impact of diseases and injuries on population health and to set policy priorities. This is an ongoing study with a strong collaboration between Santé Publique France and the French National Health Insurance, whose main objective is to provide the first national estimates of Years of Life Lost (YLLs) for all causes of death in France.
Methods
The French national health data system (SNDS) contains detailed nationwide causes of death data, reported using ICD-10 codes. We used the underlying cause, as defined by the Center for Epidemiology on Medical Causes of deaths, of all deaths for year 2016 (the last year available). For this preliminary study without redistribution of ill-defined deaths (IDDs), national sex-specific life expectancy tables were used to estimate YLLs by age class, sex, and cause of death categories at national level. We identified and quantified IDDs and also compared YLLs to crude mortality.
Results
In 2016, we estimated approximately 7.3 million YLLs (586,519 registered deaths), of which 35.1% were due to neoplasms, 17.8% to cardiovascular diseases (respectively 34.5% and 17.3% in men; 35.8% and 18.4% in women) and 10.3% to injuries (4.9% among people aged 65 or more at time of death; 34.5% among people aged 25-44). Approximately 27% of the deaths registered were IDDs, representing approximately 1.8 million YLLs.
Conclusions
These preliminary results confirm the importance of YLLs as a metric to target preventive strategies according to age. Moreover, by quantifying IDDs, we highlight that data gaps are important even in settings with highly developed health information systems. Next steps include applying an IDD redistribution methodology, aspirational life table and computing subnational YLLs. The French collaborative initiative should address those gaps and propose national and subnational burden metrics in the following months.
Key messages
Methodological and data requirements to compute YLLs constitute a challenge even in settings with developed health information systems, highlighting the need of national institutional collaborations. Highlight data gaps in terms of ill-defined deaths in mortality database.
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Bellagamba C, Quevedo N, Torres M. Blunted heart rate reserve with dobutamine stress echocardiography predicts outcome in diabetes and/or chronic kidney disease. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
A blunted heart rate reserve (HRR) during dobutamine stress echo (DSE) is an index of the altered cardiac sympathetic reserve, which is frequently present in diabetes mellitus (DM) or chronic kidney disease (CKD).
Aim
To assess the prognostic value of HRR during DSE.
Methods
We recruited 280 patients (mean age 62.9±13.1 years; 128 (45.7%) male; 28.2% on beta-blockers at the time of testing) who underwent DSE for known or suspected coronary artery disease and/or heart failure and were followed-up. Four subsets were identified: Group 1 (111 pts without DM or CKD); group 2 (37 with DM without CKD); group 3 (90 with CKD with or without DM); and group 4 (42 with CKD on dialysis). HRR was calculated by EKG as the peak/rest HR ratio.
Results
Ischemia was identified in 34/280 (12.1%) pts. During a median follow-up time of 40.3±30.5 months, 120 events occurred: 46 deaths, 15 non-fatal myocardial infarctions, 23 hospital admissions for acute decompensated heart failure, and 36 myocardial revascularizations. Multivariable comparison of HRR among the 4 groups using post hoc test showed a blunted HRR in group 3 (1.66±0.32) and 4 (1.65±0.27) when compared with group 1 (HRR 1.85±0.35), p<0.01. Group 2 (1.73±0.28) was not different from any group (p=ns). Groups 3 and 4 were not different between them (p=ns). A post hoc Tukey test for HRR separated in tercils, 1st: HRR <1.59, 2nd: 1.59 < HRR <1.86 and 3rd: HRR >1.86 (p<0.000). Kaplan-Meier curves showed blunted HRR as an independent predictor of event-free survival in the overall group - 1st: 66.08±5.9 months, 95% CI 54.3–77.7; 2nd: 69.52±6.5, 95% CI 56.6–82.3; 3rd: 90.05±5.3, 95% CI 79.5–100.5. See Figure. HRR was comparable in patients with and without inducible ischemia and off or on beta-blockers.
Conclusion
A blunted HRR during DSE is frequent in patients with DM and CKD, independent of inducible ischemia and use of beta-blockers, and is a useful non-imaging predictor of adverse events.
Funding Acknowledgement
Type of funding sources: None.
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Ortner J, Vives A, Moya D, Torres M, Grau N, Farrús X, Manzanera R, Mira JJ. [Use of the Trigger Tool to detect security incidents in an occupational mutual insurance company in Spain]. J Healthc Qual Res 2021; 37:125-126. [PMID: 34598905 DOI: 10.1016/j.jhqr.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 07/22/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
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