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Ramírez de Arellano A, Coca A, de la Figuera M, Rubio-Terrés C, Rubio-Rodríguez D, Gracia A, Boldeanu A, Puig-Gilberte J, Salas E. Economic evaluation of Cardio inCode®, a clinical-genetic function for coronary heart disease risk assessment. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2013; 11:531-542. [PMID: 24078223 PMCID: PMC3825137 DOI: 10.1007/s40258-013-0053-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND A clinical–genetic function (Cardio inCode®) was generated using genetic variants associated with coronary heart disease (CHD), but not with classical CHD risk factors, to achieve a more precise estimation of the CHD risk of individuals by incorporating genetics into risk equations [Framingham and REGICOR (Registre Gironí del Cor)]. OBJECTIVE The objective of this study was to conduct an economic analysis of the CHD risk assessment with Cardio inCode®, which incorporates the patient’s genetic risk into the functions of REGICOR and Framingham, compared with the standard method (using only the functions). METHODS A Markov model was developed with seven states of health (low CHD risk, moderate CHD risk, high CHD risk, CHD event, recurrent CHD, chronic CHD, and death). The reclassification of CHD risk derived from genetic information and transition probabilities between states was obtained from a validation study conducted in cohorts of REGICOR (Spain) and Framingham (USA). It was assumed that patients classified as at moderate risk by the standard method were the best candidates to test the risk reclassification with Cardio inCode®. The utilities and costs (€; year 2011 values) of Markov states were obtained from the literature and Spanish sources. The analysis was performed from the perspective of the Spanish National Health System, for a life expectancy of 82 years in Spain. An annual discount rate of 3.5 % for costs and benefits was applied. RESULTS For a Cardio inCode® price of €400, the cost per QALY gained compared with the standard method [incremental cost-effectiveness ratio (ICER)] would be €12,969 and €21,385 in REGICOR and Framingham cohorts, respectively. The threshold price of Cardio inCode® to reach the ICER threshold generally accepted in Spain (€30,000/QALY) would range between €668 and €836. The greatest benefit occurred in the subgroup of patients with moderate–high risk, with a high-risk reclassification of 22.8 % and 12 % of patients and an ICER of €1,652/QALY and €5,884/QALY in the REGICOR and Framingham cohorts, respectively. Sensitivity analyses confirmed the stability of the study results. CONCLUSIONS Cardio inCode® is a cost-effective risk score option in CHD risk assessment compared with the standard method.
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Rosas J, Llinares-Tello F, Senabre J, Santos-Ramírez C, Santos-Soler G, Salas E, Barber X, Sánchez-Barrioluengo M, Molina-García J, Llahí N, Cano C. AB0473 Evaluation of anti-TNF levels and anti-TNF antibodies in rheumatic diseases treated with infliximab and adalimumab; results from a local registry:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Rosas J, LLinares F, de la Torre I, Valor L, Barber X, Santos-Ramírez C, Hernández D, Senabre JM, Carreño L, Santos-Soler G, Salas E, Sánchez-BArrioluengo M, Molina-García J. THU0206 Clinical Usefulness of Serum Level of Adalimumab, in Patients with Rheumatoid Arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Santos-Ramírez C, Rosas J, Senabre J, Santos-Soler G, Barber X, Salas E, Sánchez-Barrioluengo M, Llahí N, Cano C. AB0360 Comparative study of the characteristics of spanish and european patients in a local registry of patients with rheumatoid arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Sánchez-Barrioluengo M, Barber X, Rosas J, Salas E, Santos-Soler G, Senabre JM, Cano C, Santos-Ramírez C, Lorente ML. THU0392 Risk Factors for Osteoporosis from a Rheumatology Bone Densitometry Registry. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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López García B, Ortonobes Roig S, Espona Quer M, Florit Sureda M, Barrantes Gonzalez M, Salas E. CPC-031 Clinical Trials Quality: Medical Journal Publication Involvement. Eur J Hosp Pharm 2013. [DOI: 10.1136/ejhpharm-2013-000276.488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Lizárraga-Mollinedo E, Alvarez C, Fernández-Millán E, Escrivá F, González-Martín C, Salas E, Pérez-Ortiz JM, Alguacil LF. Undernutrition upregulates fumarate hydratase in the rat nucleus accumbens. Metab Brain Dis 2013; 28:111-5. [PMID: 23160834 DOI: 10.1007/s11011-012-9358-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 11/09/2012] [Indexed: 01/25/2023]
Abstract
Previous comparative studies of fumarate hydratase (FH) protein density revealed that the enzyme was overexpressed in the striatum of rodents that are less influenced by rewarding stimuli, from cocaine to food. Therefore, we recently proposed FH as a potential striatal biomarker of brain reward deficiency and addiction vulnerability. This work has been focused to investigate FH activity in the Nucleus Accumbens (NAc) of undernourished rats, taking into account that malnutrition has been related to increased responsiveness to food and drug reward. To this end, we have studied adult female Wistar rats severely food restricted from the 16th day of intrauterine life until adulthood. Animals were sacrificed to dissect the NAc and obtain mitochondrial and cytosolic fractions after homogenisation and centrifugation. FH activity was measured by conversion of malate to fumarate, and protein levels were compared by Western blot analysis when fractions showed differences in activity. Undernutrition did not change cytosolic FH activity but led to a marked increase of mitochondrial FH activity (72 %) and protein content (50 %) in the NAc. This change was in the opposite direction that one would predict if it was related to addiction vulnerability of some kind, but strongly suggests that mitochondrial FH needs to be at some optimal level for normal reward responsiveness.
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Barrantes-González M, Marín-Casino M, Lopez B, Ortonobes S, Salas E, Grau S. PHC-001 Amikacin Dosing to Treat Respiratory Tract Infections According to Patient’s Body Mass Index. Eur J Hosp Pharm 2013. [DOI: 10.1136/ejhpharm-2013-000276.346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Alberdi F, Azaldegui F, Zabarte M, García I, Atutxa L, Santacana J, Elósegui I, González N, Iriarte M, Pascal M, Salas E, Cabarcos E. [Epidemiological profile of late mortality in severe polytraumatisms]. Med Intensiva 2012; 37:383-90. [PMID: 22999375 DOI: 10.1016/j.medin.2012.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 06/04/2012] [Accepted: 07/15/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE A study is made of the epidemiology, chronogramand causes of late mortality in traumatized patients. DESIGN A prospective, observational cohort study of adult trauma patients was carried out. SETTINGS Province of Guipúzcoa (Basque Country, Spain). Intensive care unit of a tertiary hospital. PATIENTS Patients with severe trauma (Injury Severity Score > 15), admitted to the ICU from January 1995 to December 2009, with late death (> 7 days). VARIABLES Epidemiological, laboratory test, hemodynamic and transfusional data were collected. Severity scores: Abbreviated Injury Scale (AIS) and ISS. RESULTS Patients: 2003; ISS: 24.3±14.2. Total deaths: 405 (20%). Late mortality (>7 days): 102 (25.2%) patients, 9 years older and with a lower (18 points) ISS score than the patients who died early (48 hours). Most frequent injuries: AIS-Head-Cervical spine ≥ 4 (52%); AIS-Abdomen ≥ 4 (19.6%); AIS-Chest ≥ 4 (11.7%); AIS-Extremities ≥ 4 (4.9%). Causes of death: 1) brain death (14.7%); 2) multiorgan failure (67.6%), in two injury contexts: a) severe brain trauma in the vegetative state and high spinal cord injuries with tetraplegia (35.3%); and b) non-neurological injuries (32.3%) with a high prevalence of hypovolemic shock, multiple transfusion and coagulopathy; 3) miscellaneous (10.7%): post-resuscitation anoxic-ischemic encephalopathy, pulmonary embolism and massive stroke; 4) non-evaluable (7%). CONCLUSIONS Age, severity and type of injuries have an influence upon the time distribution and causality of late mortality. Brain death remains predominant, with multiorgan failure as the most frequent cause. This knowledge should contribute to the identification of problems, and to better organization of the structural and educational resources, thereby reducing the likely factors leading to death from trauma.
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Cassina M, Johnson DL, Robinson LK, Braddock SR, Xu R, Jimenez JL, Mirrasoul N, Salas E, Luo YJ, Jones KL, Chambers CD. Pregnancy outcome in women exposed to leflunomide before or during pregnancy. ACTA ACUST UNITED AC 2012; 64:2085-94. [DOI: 10.1002/art.34419] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Azkárate I, Sebastián R, Cabarcos E, Choperena G, Pascal M, Salas E. Registro observacional y prospectivo de sepsis grave/shock séptico en un hospital terciario de la provincia de Guipúzcoa. Med Intensiva 2012; 36:250-6. [DOI: 10.1016/j.medin.2011.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Revised: 10/10/2011] [Accepted: 10/14/2011] [Indexed: 11/29/2022]
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Florit M, Barrantes M, Luque S, Berenguer N, Comín-Colet J, Carmona A, Salas E. Pharmacist educational interventions program for outpatients with chronic heart failure. Eur J Hosp Pharm 2012. [DOI: 10.1136/ejhpharm-2012-000074.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Conde-Estévez D, Gómez-Ulloa D, Bundó AV, Antonio JMD, Florit M, Ferrándiz RB, Salas E, Albanell J. Oral anticancer agents: a prospective pilot study of a patient educational surgery run by a pharmacist and a nurse. Eur J Hosp Pharm 2012. [DOI: 10.1136/ejhpharm-2012-000074.265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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O'Connor P, Reader T, Salas E, Yule S, Sundt T, Musson D, Wiegmann D. Techniques for Improving the Performance of Healthcare Teams: Learning from Aviation and Other HROs. ACTA ACUST UNITED AC 2011. [DOI: 10.1177/1071181311551139] [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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Heyne K, Pavlas D, Salas E. An Investigation on the Effects of Flow State on Team Process and Outcomes. ACTA ACUST UNITED AC 2011. [DOI: 10.1177/1071181311551098] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Grau S, Conde-Estévez D, Luque S, Alvarez-Lerma F, Horcajada JP, Mateu-De Antonio J, Berenguer N, Salas E. Factors associated with adherence to guidelines for the use of tigecycline in a tertiary care hospital. J Chemother 2010; 22:339-44. [PMID: 21123158 DOI: 10.1179/joc.2010.22.5.339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
We assessed the adherence to the prescribing hospital protocol for tigecycline and factors associated with noncompliance. A total of 103 patients were included in the study. In 23 (22.3%) patients, tigecycline was not administered according to the protocol, mostly because of the availability of other therapeutic alternatives and prescription for indications that were not included in the guidelines. factors independently associated with nonadherence to the protocol were community-acquired infection (OR, 14.01; 95% CI, 1.54-127.12; P=0.019), and empirical tigecycline treatment (OR, 6.97; 95% CI, 0.88-55.40; P=0.066). penicillin allergy (OR, 0.004; 95% CI, 0.000-0.071; P=0.001) and previous antibiotic treatment (OR, 0.025; 95% CI, 0.003-0.233; P=0.001) were factors associated with adherence to the hospital protocol. A positive time trend between total number of prescriptions and non-compliant prescriptions with the protocol was observed (Spearman's rho coefficient 0.971; P=0.001). Adherence to tigecycline protocol could be improved by focusing on protocols for community-acquired infections, mainly skin and soft tissue infections.
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Bandoli G, Johnson DL, Jones KL, Lopez Jiminez J, Salas E, Mirrasoul N, Van Voorhees AS, Chambers CD. Potentially modifiable risk factors for adverse pregnancy outcomes in women with psoriasis. Br J Dermatol 2010; 163:334-9. [PMID: 20545678 DOI: 10.1111/j.1365-2133.2010.09899.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Data on pregnancy outcomes among women with psoriasis are lacking. However, there are several known comorbidities of psoriasis, including obesity, smoking and depression, each of which increases the risk for negative birth outcomes. OBJECTIVES To determine if pregnant women with psoriasis have an excess of potentially modifiable risk factors for adverse pregnancy outcomes. METHODS Prospectively collected data from the Organization of Teratology Information Specialists (OTIS) Autoimmune Diseases in Pregnancy Project were analysed to compare the prevalence of selected risk factors between 170 pregnant women with psoriasis and 158 nondiseased controls. RESULTS Women with psoriasis were more likely to be overweight/obese prior to pregnancy (P < 0.0001), to smoke (P < 0.0001), or to have a diagnosis of depression (P = 0.03), and were less likely to have been taking preconceptional vitamin supplements (P = 0.004). After controlling for race/ethnicity and socioeconomic status, women with psoriasis were 2.37 (95% confidence interval 1.45-3.87) times more likely to be overweight/obese as women without psoriasis. Duration of disease, age at onset, measures of disease impact during pregnancy, or use of biologics in pregnancy were not significant predictors of overweight/obesity in the subset of psoriatic women. CONCLUSIONS Pregnant women with psoriasis may be at increased risk for adverse pregnancy outcomes due to comorbidities or other health behaviours associated with the disease. These should be taken into consideration during clinical treatment of women with psoriasis who are in their childbearing years.
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Burgos G, Auqui S, Amoros W, Salas E, Bonierbale M. Ascorbic acid concentration of native Andean potato varieties as affected by environment, cooking and storage. J Food Compost Anal 2009. [DOI: 10.1016/j.jfca.2008.05.013] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Burgos G, de Haan S, Salas E, Bonierbale M. Protein, iron, zinc and calcium concentrations of potatoes following traditional processing as “chuño”. J Food Compost Anal 2009. [DOI: 10.1016/j.jfca.2008.09.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rodriguez-Paz JM, Kennedy M, Salas E, Wu AW, Sexton JB, Hunt EA, Pronovost PJ. Beyond "see one, do one, teach one": toward a different training paradigm. Postgrad Med J 2009; 85:244-9. [DOI: 10.1136/qshc.2007.023903] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Alguacil LF, Pérez-García C, Salas E, González-Martín C, Castillo C, Polanco MJ, Herradón G, Morales L. Subcutaneous tetrodotoxin and inflammatory pain. Br J Anaesth 2008; 100:729-30. [PMID: 18407950 DOI: 10.1093/bja/aen066] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Mansilla E, Drago H, Sturla F, Bossi S, Salas E, Marín GH, Ibar R, Soratti C. Matrix superhighways configurations: new concepts for complex organ regeneration. Transplant Proc 2007; 39:2431-3. [PMID: 17889211 DOI: 10.1016/j.transproceed.2007.06.070] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
New ideas and experimental models for tissue and organ regeneration are urgently needed. There are several exciting challenges in the field of organogenesis that need to be defined. The integrated signals and molecular repertoires that shape the particular architecture of specific organs like the kidney or the liver are not completely understood yet. To develop a new scientific platform to be able to build up complex organs we have established a research program using basically Acellular Xenogeneic Isomorphic Matrices (AXIMs) and mesenchymal stem cells (MSCs) generating the necessary concepts for the definition, production, and application of the specific configurations of these matrices for organ regeneration. New and interesting pathways for MSC differentiation were identified. We believe that all extracellular matrices were created fundamentally equal or at least very similar in nature. We also believe that there are true "matrix superhighway configurations" with different three-dimensional geometrical architectures as well as biochemical, electrical, and molecular properties that are tissue and organ specific that influence cell differentiation and organogenesis and will be fundamental for the in vitro regeneration of complex organs for transplantation.
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Salas E, Rosen MA, King H. Managing teams managing crises: principles of teamwork to improve patient safety in the Emergency Room and beyond. THEORETICAL ISSUES IN ERGONOMICS SCIENCE 2007. [DOI: 10.1080/14639220701317764] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Zafar MU, Vilahur G, Choi BG, Ibanez B, Viles-Gonzalez JF, Salas E, Badimon JJ. A novel anti-ischemic nitric oxide donor (LA419) reduces thrombogenesis in healthy human subjects. J Thromb Haemost 2007; 5:1195-200. [PMID: 17389007 DOI: 10.1111/j.1538-7836.2007.02543.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Platelet and endothelial production of nitric oxide (NO) is known to be impaired in coronary artery disease patients. Compounds that release NO (e.g. nitrates) have antiplatelet effects, but at supratherapeutic doses with hypotensive side effects. OBJECTIVES To investigate the antithrombotic effect on human blood of a novel NO donor (LA419) with known anti-ischemic properties but without hypotensive side effects and to compare with abciximab. PATIENTS/METHODS Healthy subjects (n = 8; 32 +/- 3 years) received daily aspirin starting three days prior to the study day. Treatments (LA419 10 and 20 microm, and abciximab 4 microm) were added ex vivo to non-anticoagulated blood, and the antithrombotic properties were assessed by measuring changes in thrombus size from pretreatment baseline in the Badimon perfusion chamber at low and high shear rates. Platelet surface adhesion using a Cone and Platelet Analyzer (CPA) and platelet fibrinogen-receptor activation with flow cytometry were also evaluated. RESULTS At low shear rates, LA419 displayed a reduction in thrombus area of 43% +/- 8% (10 microm) and 56% +/- 6% (20 microm), whereas at high shear rates the reductions were 44% +/- 3% (10 microm) and 62% +/- 6% (20 microm). Platelet surface adhesion with the CPA was also reduced. Abciximab exhibited a strong inhibitory effect on thrombus formation, platelet surface adhesion and fibrinogen receptor activation. CONCLUSIONS The novel NO donor, LA419, shows a strong antithrombotic effect in human blood, which is comparable to abciximab, especially under high shear rate conditions. Our observations suggest that the availability of an NO donor could prove beneficial in the prevention of thrombotic complications of cardiovascular disease. Further clinical studies are warranted.
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Herrero F, Morales D, Baamonde C, Salas E, Berrazueta JR, Casanova D. Ischemic Preconditioning and Kidney Transplantation: In Vivo Nitric Oxide Monitoring in a Rat Ischemia-Reperfusion Experimental Model. Transplant Proc 2006; 38:2600-2. [PMID: 17098013 DOI: 10.1016/j.transproceed.2006.08.044] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Direct nitric oxide measurement in live tissue would help us to understand its role in ischemia-reperfusion injury and its relationship to ischemic preconditioning (IP). We constructed four experimental groups of ischemia-reperfusion in the rat kidney: G1 were controls; G2, 1 hour of renal ischemia; G3 and G4: one or two 15/10 minute cycles, respectively, of IP prior to 1 hour of ischemia. Real-time in vivo nitric oxide measurements were compared with functional parameters of kidney damage at 24 hours. The peaks of nitric oxide production in the IP periods increased less in the rising curve of nitric oxide production during the 1 hour ischemia time. No improvement in the IP groups was observed based on serum creatinine levels at 24 hours.
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