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Uher R, Farmer A, Maier W, Rietschel M, Hauser J, Marusic A, Mors O, Elkin A, Williamson RJ, Schmael C, Henigsberg N, Perez J, Mendlewicz J, Janzing JGE, Zobel A, Skibinska M, Kozel D, Stamp AS, Bajs M, Placentino A, Barreto M, McGuffin P, Aitchison KJ. Measuring depression: comparison and integration of three scales in the GENDEP study. Psychol Med 2008; 38:289-300. [PMID: 17922940 DOI: 10.1017/s0033291707001730] [Citation(s) in RCA: 191] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND A number of scales are used to estimate the severity of depression. However, differences between self-report and clinician rating, multi-dimensionality and different weighting of individual symptoms in summed scores may affect the validity of measurement. In this study we examined and integrated the psychometric properties of three commonly used rating scales. METHOD The 17-item Hamilton Depression Rating Scale (HAMD-17), the Montgomery-Asberg Depression Rating Scale (MADRS) and the Beck Depression Inventory (BDI) were administered to 660 adult patients with unipolar depression in a multi-centre pharmacogenetic study. Item response theory (IRT) and factor analysis were used to evaluate their psychometric properties and estimate true depression severity, as well as to group items and derive factor scores. RESULTS The MADRS and the BDI provide internally consistent but mutually distinct estimates of depression severity. The HAMD-17 is not internally consistent and contains several items less suitable for out-patients. Factor analyses indicated a dominant depression factor. A model comprising three dimensions, namely 'observed mood and anxiety', 'cognitive' and 'neurovegetative', provided a more detailed description of depression severity. CONCLUSIONS The MADRS and the BDI can be recommended as complementary measures of depression severity. The three factor scores are proposed for external validation.
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Lopez I, Mendoza F, Aguilera-Tejero E, Perez J, Guerrero F, Martin D, Rodriguez M. The effect of calcitriol, paricalcitol, and a calcimimetic on extraosseous calcifications in uremic rats. Kidney Int 2008; 73:300-7. [DOI: 10.1038/sj.ki.5002675] [Citation(s) in RCA: 99] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Brohez M, Brady PC, Rennie CP, Slabach R, Perez J, Hall TS. Substance abuse and diagnosis of cervical spine injuries: policy consideration. CONNECTICUT MEDICINE 2008; 72:69-73. [PMID: 18306832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Cervical spine injury occurs in 2% to 6% of patients with blunt injury. Standard cervical radiographs are widely accepted as a primary screen, but may miss injuries. Diagnoses are further confounded by patients' use of alcohol or drugs, which may delay diagnosis. OBJECTIVE To compare the rate of incomplete cervical radiographs and to compare the sensitivity of cervical radiographs and neck computed tomography (CT) in patients with cervical spine injury, with and without substance abuse. DESIGN A retrospective chart review. SETTING A community teaching hospital. PATIENTS Eighty-five high-severity trauma cases between 6/1/03 and 5/28/05. METHODS Retrospective chart review of cervical spine imaging studies, alcohol levels, toxicology screens and clinical diagnosis. RESULTS Cervical radiographs generated false negatives or incomplete studies in all injured patients with significant levels of alcohol (> or = 80 mg/ dL) or drugs detected on toxicology screens. Cervical CT produced no false negatives. CONCLUSIONS Drug and alcohol screens are important adjunct studies to identify patients with substance abuse who are more prone to sustain cervical spine injury that is likely to be missed by plain cervical radiographs. Cervical CT maybe a better primary imaging study for detection of cervical spine injury in trauma patients with suspected substance abuse.
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Mas D, Espinosa J, Perez J, Illueca C. Three dimensional analysis of chromatic aberration in diffractive elements with extended depth of focus. OPTICS EXPRESS 2007; 15:17842-17854. [PMID: 19551079 DOI: 10.1364/oe.15.017842] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The paper presents the polychromatic analysis of two diffractive optical elements with extended depth of focus: the linear axicon and the light sword optical element. Chromatic aberration produces axial displacement of the focal segment line. Thus, we explore the possibility of extending the focal depth of these elements to permit superposition of the chromatic foci. In the case of an axicon, we achieve an achromatic zone where focusing is produced. In the case of the light sword element, we show that the focusing segment is out of axis. Therefore a superposition of colors is produced, but not on axis overlapping. Instead, three colored and separated foci are simultaneously obtained in a single plane. Three dimensional structures of the propagated beams are analyzed in order to provide better understanding of the properties and applications of such elements.
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Nielsen HM, Minthon L, Londos E, Blennow K, Miranda E, Perez J, Crowther DC, Lomas DA, Janciauskiene SM. Plasma and CSF serpins in Alzheimer disease and dementia with Lewy bodies. Neurology 2007; 69:1569-79. [PMID: 17761554 DOI: 10.1212/01.wnl.0000271077.82508.a0] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Serine protease inhibitors (serpins), the acute phase reactants and regulators of the proteolytic processing of proteins, have been recognized as potential contributors to the pathogenesis of Alzheimer disease (AD). We measured plasma and CSF levels of serpins in controls and patients with dementia. METHODS Using rocket immunoelectrophoresis, ELISA, and Luminex xMAP technology, we analyzed plasma levels of alpha(1)-antichymotrypsin and alpha(1)-antitrypsin, and CSF levels of alpha(1)-antichymotrypsin, alpha(1)-antitrypsin, and neuroserpin along with three standard biomarkers (total tau, tau phosphorylated at threonine-181, and the A beta(1-42)) in patients with AD (n = 258), patients with dementia with Lewy bodies (DLB; n = 38), and age-matched controls (n = 37). RESULTS The level of CSF neuroserpin was significantly higher in AD compared with controls and DLB, whereas CSF alpha(1)-antichymotrypsin and alpha(1)-antitrypsin were significantly higher in both AD and DLB groups than in controls. Results from logistic regression analyses demonstrate a relationship between higher CSF levels of alpha(1)-antichymotrypsin and neuroserpin and increased predicted probability and odds ratios (ORs) of AD (OR 5.3, 95% CI 1.3 to 20.8 and OR 3.3, CI 1.3 to 8.8). Furthermore, a logistic regression model based on CSF alpha(1)-antichymotrypsin, neuroserpin, and A beta(1-42) enabled us to discriminate between AD patients and controls with a sensitivity of 94.7% and a specificity of 77.8%. CONCLUSIONS Higher CSF levels of neuroserpin and alpha(1)-antichymotrypsin were associated with the clinical diagnosis of Alzheimer disease (AD) and facilitated the diagnostic classification of AD vs controls. CSF serpin levels did not improve the diagnostic classification of AD vs dementia with Lewy bodies.
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Barr DB, Leng G, Berger-Preiss E, Hoppe HW, Weerasekera G, Gries W, Gerling S, Perez J, Smith K, Needham LL, Angerer J. Cross validation of multiple methods for measuring pyrethroid and pyrethrum insecticide metabolites in human urine. Anal Bioanal Chem 2007; 389:811-8. [PMID: 17828527 DOI: 10.1007/s00216-007-1463-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2007] [Revised: 06/14/2007] [Accepted: 06/21/2007] [Indexed: 11/29/2022]
Abstract
The objective of our study was to compare three vastly different analytical methods for measuring urinary metabolites of pyrethroid and pyrethrum insecticides to determine whether they could produce comparable data and to determine if similar analytical characteristics of the methods could be obtained by a secondary laboratory. This study was conducted as a part of a series of validation studies undertaken by the German Research Foundation's Committee on the Standardization of Analytical Methods for Occupational and Environmental Medicine. We compared methods using different sample preparation methods (liquid-liquid extraction and solid-phase extraction with and without chemical derivatization) and different analytical detection methods (gas chromatography-mass spectrometry (single quadrupole), gas chromatography-high resolution mass spectrometry (magnetic sector) in both electron impact ionization and negative chemical ionization modes, and high-performance liquid chromatography-tandem mass spectrometry (triple quadrupole) with electrospray ionization). Our cross validation proved that similar analytical characteristics could be obtained with any combination of sample preparation/analytical detection method and that all methods produced comparable analytical results on unknown urine samples.
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Jones FR, Miller G, Gadea N, Meza R, Leon S, Perez J, Lescano AG, Pajuelo J, Caceres CF, Klausner JD, Coates TJ. Prevalence of bacterial vaginosis among young women in low-income populations of coastal Peru. Int J STD AIDS 2007; 18:188-92. [PMID: 17362553 DOI: 10.1258/095646207780132505] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The goal of this study was to determine the prevalence of bacterial vaginosis (BV) in Peruvian women from socioeconomically deprived populations and to determine the association between BV and risk factors for sexually transmitted diseases (STDs). Women were administered an epidemiologic survey to determine sexual risk behaviour and they provided biological samples to test for BV and STDs. The prevalence of BV was high (27%) and was significantly associated with having a bacterial STD or trichomoniasis. Age, marital status, and a history of sex work, but not of sexual experience, frequency of intercourse, and unprotected intercourse, were associated with BV. As BV may be a marker for STDs, screening for STDs should be performed in individuals with BV to promote early detection and treatment of co-infecting sexually transmitted pathogens.
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Najt P, Perez J, Sanches M, Peluso MAM, Glahn D, Soares JC. Impulsivity and bipolar disorder. Eur Neuropsychopharmacol 2007; 17:313-20. [PMID: 17140772 DOI: 10.1016/j.euroneuro.2006.10.002] [Citation(s) in RCA: 136] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2006] [Revised: 09/29/2006] [Accepted: 10/05/2006] [Indexed: 11/18/2022]
Abstract
Impulsivity is frequently associated with bipolar disorder (BD) during manic episodes, but may also be present in euthymic bipolar patients. Aggression is an impulsivity-related behavior also found during manic episodes. The objective of this review is to further clarify the relationship between impulsivity and BD. A search in Medline and Psycinfo databases, combined with a manual search of selected references, was conducted to identify available literature on BD and impulsivity-related features. Although few studies have directly measured impulsivity in BD, available findings suggest that impulsivity is not only state-related, but also a trait component of BD, which could represent a core feature of the illness. Further research exploring the neurobiology of the impulsivity/BD relationship may contribute to elucidate the pathophysiology and to improve the diagnosis and treatment of this severe illness.
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Perez J, Culebras E, Gomez M, Picazo J. P886 Macrolide resistance in Streptococcus spp. and Enterococcus spp. clinical isolates: phenotypic and genotypic analysis. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)70727-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Meaume S, Ourabah Z, Charru P, Meyer P, Perez J, Sauvadet A, Bohbot S. Optimizing wound care with a new lipido-colloid dressing (Urgotul® Duo). ACTA ACUST UNITED AC 2007; 16:S4, S6, S8 passim. [PMID: 17505400 DOI: 10.12968/bjon.2007.16.sup1.27088] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This non-comparative, multicentre clinical trial includes 43 patients whose acute or chronic wounds were treated with a new lipido-colloid dressing, Urgotul Duo, for at most 4 weeks, or until healing first occurred. The efficacy, tolerance and acceptability results obtained from this 'ready-for-use' dressing were similar to those reported for the Urgotul dressing in numerous previous clinical trials, and for all the different types of acute and chronic wounds. This well-tolerated new dressing greatly facilitates care operations in terms of execution (reduced use of supplementary gauzes for the secondary dressing) and duration (shorter nursing time), while improving patient comfort. This dressing is indicated for the local treatment of moderate exudative acute and chronic wounds in the granulation and epidermization phases.
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Garcia-Esteve L, Botet F, Perez J, Soler C, Figueras J, Navarro P, Martin-Santos R, Gelabert E, Imaz M. Antidepressant treatment during pregnancy: Pros and cons. Eur Psychiatry 2007. [DOI: 10.1016/j.eurpsy.2007.01.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Placentino A, Pedrini L, Di Tommaso N, Giovannini C, Basso P, Bignotti S, Perez J. Affective patients in residential setting. Eur Psychiatry 2007. [DOI: 10.1016/j.eurpsy.2007.01.811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Perez J, Meinhardt M, Baier G, Hagen R, Roosen K. Advantage of a Structured Trainee Program in Surgery of Vestibular Schwannomas: Retrospective Analysis of 615 Cases. Skull Base 2007. [DOI: 10.1055/s-2007-983962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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239
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Bautista CT, Sanchez JL, Montano SM, Laguna-Torres A, Suarez L, Sanchez J, Campos P, Gallardo C, Mosquera C, Villafane M, Aguayo N, Avila MM, Weissenbacher M, Ramirez E, Child R, Serra M, Aponte C, Mejia A, Velazques N, Gianella A, Perez J, Olson JG, Carr JK. Seroprevalence of and risk factors for HIV-1 infection among female commercial sex workers in South America. Sex Transm Infect 2006; 82:311-6. [PMID: 16877581 PMCID: PMC2564717 DOI: 10.1136/sti.2005.018234] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Assessment of HIV prevalence and associated risk behaviours among female commercial sex workers (FCSW) across major cities in South America. METHODS Seroepidemiological, cross sectional studies of 13 600 FCSW were conducted in nine countries of South America during the years 1999-2002. Participants were recruited in brothels, massage parlours, hotels, and streets where anonymous questionnaires and blood samples were collected. HIV infection was determined by enzyme linked immunosorbent assay (ELISA) screening and western blot confirmatory tests. RESULTS The overall HIV seroprevalence was 1.2% (range 0.0%-4.5%). The highest HIV seroprevalences were reported in Argentina (4.5%) and Paraguay (2.6%); no HIV infected FCSW were detected in Venezuela and Chile. Consistent predictors of HIV seropositivity were: (1) a previous history of sexually transmitted infections (STI, AORs = 3.8-8.3), and (2) 10 years or more in commercial sex work (AORs = 2.2-24.8). In addition, multiple (> or =3) sexual contacts (AOR = 5.0), sex with foreigners (AOR = 6.9), use of illegal drugs (AOR = 3.2), and marijuana use (AOR = 8.2) were associated with HIV seropositivity in Southern Cone countries. CONCLUSIONS Consistently low HIV seroprevalences were detected among FCSW in South America, particularly in the Andean region. Predictors of HIV infection across the continent were STI and length of commercial sex work; however, use of illegal drugs, especially marijuana, and sexual contacts with foreigners were also found to be associated risk factors in the Southern Cone region. Interventions for the control of HIV and other STI need to be region and country specific; drug use appears to have an ever increasing role in the spread of HIV among heterosexually active populations.
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Johari GP, Jones SJ, Perez J. The orientational correlation tensor in ice I, III, IV, V and VI. ACTA ACUST UNITED AC 2006. [DOI: 10.1080/13642818408238821] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Etienne S, Cavaille JY, Perez J, Johari GP. Effect of physical ageing on the mechanical relaxation of a chalcogenide glass. ACTA ACUST UNITED AC 2006. [DOI: 10.1080/01418618508237572] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Collado A, Torres X, Arias A, Perez J, Farres M, Gomez E, Muñoz J, Suso S, Gomar C, Valdes M. 418 MULTIDISCIPLINARY PAIN TREATMENT IN DISABLED FIBROMYALGIA PATIENTS WILLING TO RETURN TO WORK. Eur J Pain 2006. [DOI: 10.1016/s1090-3801(06)60421-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bas A, Lopez I, Perez J, Rodriguez M, Aguilera-Tejero E. Reversibility of calcitriol-induced medial artery calcification in rats with intact renal function. J Bone Miner Res 2006; 21:484-90. [PMID: 16491297 DOI: 10.1359/jbmr.051211] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2005] [Revised: 12/08/2005] [Accepted: 12/14/2005] [Indexed: 11/18/2022]
Abstract
UNLABELLED VC is an important clinical entity; however, very little information is available on its resolution. Induction and regression of calcitriol-induced VC was studied in 47 rats. After calcitriol withdrawal, there was a relatively rapid regression of VC mediated by an active cellular process. INTRODUCTION Vascular calcifications (VCs) represent an important risk factor for cardiovascular death. Although VCs are prevalent in relevant diseases (e.g., chronic kidney disease, osteoporosis, diabetes), the reversibility of extraskeletal calcifications is an unresolved issue. This study was conducted to investigate (1) the in vivo effect of calcitriol on VC and (2) whether calcitriol-induced VC would regress after suppression of calcitriol treatment. MATERIALS AND METHODS The calcifying effect of calcitriol was studied in four groups of rats (n = 8) that received calcitriol (1 mug/kg, IP) for 2, 4, 6, and 8 days. The reversibility of VC was studied in three additional groups (n = 5) treated with 1 mug/kg of calcitriol for 8 days that were subsequently killed 1, 2, and 9 weeks after the last calcitriol dose. Aortic VC was assessed by histology and by quantification of aortic calcium and phosphorus content. The aortic wall was studied by histology and immunohistochemistry. Statistical analysis was performed by ANOVA and t-tests. RESULTS Calcitriol administration resulted in a time-dependent induction of VC, with aortic calcium and phosphorus being significantly increased at 6 and 8 days. Treatment with calcitriol for 8 days resulted in massive medial calcification of the aorta with a 10- to 30-fold increase in the aortic Ca and P content. After suppressing calcitriol administration, a progressive decrease in von Kossa staining and aortic Ca (from 32.8 +/- 2.5 to 9.3 +/- 1.8 mg/g of tissue, p < 0.001) and P (from 11.9 +/- 1.2 to 2.7 +/- 1.8 mg/g of tissue, p = 0.001) content was evidenced. Histology of the aortic wall showed monocytes adhered to the aortic endothelium and macrophages involved in the reabsorption of calcium deposits. CONCLUSIONS Our results show that calcitriol treatment induces time-dependent VC. After calcitriol withdrawal, VC regress rapidly with aortic calcium and phosphorus decreasing by 75% in the course of 9 weeks. An active cellular process seems to be involved in regression of VC.
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Lopez I, Aguilera-Tejero E, Mendoza FJ, Almaden Y, Perez J, Martin D, Rodriguez M. Calcimimetic R-568 Decreases Extraosseous Calcifications in Uremic Rats Treated with Calcitriol. J Am Soc Nephrol 2006; 17:795-804. [PMID: 16467452 DOI: 10.1681/asn.2005040342] [Citation(s) in RCA: 102] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Calcimimetics decrease parathyroid hormone (PTH) levels in uremic patients with secondary hyperparathyroidism without increasing serum calcium (Ca). The aim of this study was to evaluate the effect of calcimimetic R-568 alone or in combination with calcitriol on vascular and other soft tissue calcifications in uremic rats with secondary hyperparathyroidism. Sham-operated and 5/6 nephrectomized Wistar rats were studied. 5/6 Nephrectomized rats were treated with vehicle, calcitriol (80 ng/kg every other day), R-568 (1.5 and 3 mg/kg per d), and both calcitriol and R-568 1.5 mg/kg, as above. Rats were killed after 14 or 56 d of treatment. Blood was drawn for biochemical measurements. Aortic, heart, kidney, lung, and stomach tissue samples were processed for histopathology and measurement of tissue Ca and phosphorus content. PTH concentrations were significantly reduced by all treatments. Treatment with calcitriol induced significant vascular calcification (aortic Ca increased to 4.2+/-1.2 mg/g at day 14 and to 11.4+/-0.7 mg/g at day 56; P<0.05 versus vehicle). Treatment with R-568 did not induce vascular calcification. Concurrent administration of R-568 with calcitriol reduced the aortic Ca (1.9+/-0.2 mg/g at day 14 and 7.5+/-1.4 mg/g at day 56) in relation to calcitriol alone. Soft tissue calcifications mirrored aortic mineralizations. Survival was significantly (P<0.001) reduced in calcitriol-treated rats, and mortality was attenuated (P=0.01) by concurrent treatment with R-568. In uremic rats, R-568 reduces elevated PTH levels without inducing vascular calcification, prevents calcitriol-induced vascular calcification, and decreases mortality.
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Ridgway JM, Guo S, Vokes D, Perez J, Su J, Armstrong WB, Shibuya T, Crumley RL, Chen Z, Wong BJ. 554 IN VIVO OPTICAL COHERENCE TOMOGRAPHY OF THE PEDIATRIC AERODIGESTIVE TRACT. J Investig Med 2006. [DOI: 10.2310/6650.2005.x0004.553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Alfageme I, Vazquez R, Reyes N, Muñoz J, Fernández A, Hernandez M, Merino M, Perez J, Lima J. Clinical efficacy of anti-pneumococcal vaccination in patients with COPD. Thorax 2005; 61:189-95. [PMID: 16227328 PMCID: PMC2080738 DOI: 10.1136/thx.2005.043323] [Citation(s) in RCA: 132] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND A study was undertaken to evaluate the clinical efficacy of the 23-valent pneumococcal polysaccharide vaccine (PPV) in immunocompetent patients with chronic obstructive pulmonary disease (COPD). METHODS A randomised controlled trial was carried out in 596 patients with COPD of mean (SD) age 65.8 (9.7) years, 298 of whom received PPV. The main outcome was radiographically proven community acquired pneumonia (CAP) of pneumococcal or unknown aetiology after a mean period of 979 days (range 20-1454). RESULTS There were 58 first episodes of CAP caused by pneumococcus or of unknown aetiology, 25 in the intervention group and 33 in the non-intervention group. Kaplan-Meier survival curves for CAP did not show significant differences between the intervention and non-intervention arms (log rank test = 1.15, p = 0.28) in the whole group of patients. The efficacy of PPV in all patients was 24% (95% CI -24 to 54; p = 0.333). In the subgroup aged <65 years the efficacy of PPV was 76% (95% CI 20 to 93; p = 0.013), while in those with severe functional obstruction (forced expiratory volume in 1 second <40%) it was 48% (95% CI -7 to 80; p = 0.076). In younger patients with severe airflow obstruction the efficacy was 91% (95% CI 35 to 99; p = 0.002). There were only five cases of non-bacteraemic pneumococcal CAP, all in the non-intervention group (log rank test = 5.03; p = 0.025). Multivariate analysis gave a hazard ratio for unknown and pneumococcal CAP in the vaccinated group, adjusted for age, of 0.20 (95% CI 0.06 to 0.68; p = 0.01). CONCLUSIONS PPV is effective in preventing CAP in patients with COPD aged less than 65 years and in those with severe airflow obstruction. No differences were found among the other groups of patients with COPD.
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Sharma P, Rosas N, Cabrera A, Toscano A, Silva MDJ, Perez D, Velasco L, Perez J, Gutierez R. First synthesis and structural report on selenophen-2-yl containing pnictogens: Biological activities of tris(selenophen-2-yl)stibine. J Organomet Chem 2005. [DOI: 10.1016/j.jorganchem.2005.03.047] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cardenal F, Arnaiz M, Valencia J, Casas F, Perez A, Perez J, Chus M, Sanz X, Baron F, Calvo F. P-706 Randomized phase II study of sequetial versus concurrent chemoradiotherapy (CRT) in poor risk patients with inoperable stage III non-small cell lung cancer (NSCLC): Interim analysis. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)81199-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Fibla J, Simon C, Perez J, Molins L. P-870 When to perform a mediastinoscopy in the staging of lung cancer? Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)81363-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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