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Duffy JMN, Chequer S, Braddy A, Mylan S, Royuela A, Zamora J, Ip J, Hayden S, Showell M, Kinnersley P, Chenoy R, Westwood OM, Khan KS, Cushing A. Educational effectiveness of gynaecological teaching associates: a multi-centre randomised controlled trial. BJOG 2016; 123:1005-10. [PMID: 26776314 DOI: 10.1111/1471-0528.13824] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2015] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To evaluate, among medical students learning the female pelvic examination, the added benefits of training by gynaecological teaching associates compared with training involving a manikin only. DESIGN Randomised controlled trial. SETTING Nine university teaching hospitals. POPULATION Ninety-four medical students recruited prior to commencing a 4-week obstetrics and gynaecology rotation. METHODS The control training consisted of lectures, demonstration of the pelvic examination on a manikin, and opportunities to practise on this low-fidelity simulation (n = 40). The experimental group received additional gynaecological teaching associate training, delivered by pairs of experienced associates to groups of four medical students (n = 54). MAIN OUTCOME MEASURES Outcomes measured at the end of the rotation included knowledge of the correct order of examination components (Yes/No), and student comfort [Likert scales anchored between 1 (very uncomfortable) and 4 (very comfortable) on four items] and confidence [Likert scales anchored between 1 (No) and 3 (Yes) on six items]. The primary outcome, measured at the end of the academic year, was the objective structured clinical examination of a female pelvis (score range 0-54). RESULTS At baseline, the groups were similar in age, gender, and ethnicity. At the end of the clinical rotation, when compared with the control intervention, the experimental intervention had a moderate effect on student knowledge [difference 29.9% (95% CI 11.2-48.6%); P = 0.002] and confidence [difference 1 (95% CI 0-2); P < 0.001], and a large effect on student comfort [difference 1.8 (95% CI 0.6-3.0); P = 0.004]. At the end of the academic year, the experimental intervention had no impact on skills compared with the control [difference 2 (95% CI-1 to 4); P = 0.26]. CONCLUSIONS Among medical students taught the female pelvic examination by low-fidelity simulation, additional training by gynaecology teaching associates improved knowledge, comfort, and confidence at the end of the clinical rotation but did not improve examination skills at end of the academic year.
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Allen RE, Morlando M, Thilaganathan B, Zamora J, Khan KS, Thangaratinam S, Bhide A. Predictive accuracy of second-trimester uterine artery Doppler indices for stillbirth: a systematic review and meta-analysis. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2016; 47:22-27. [PMID: 26031231 DOI: 10.1002/uog.14914] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Revised: 05/06/2015] [Accepted: 05/11/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To assess the predictive accuracy for stillbirth of second-trimester uterine artery Doppler. METHODS We searched MEDLINE, EMBASE and The Cochrane Library databases from inception until March 2015 without language restrictions. The included studies were those that assessed the association of abnormal uterine artery Doppler parameters and stillbirth. Two independent reviewers selected the studies, extracted data and assessed quality. Results for studies that were performed in the second trimester were pooled and summary estimates of sensitivity, specificity, likelihood ratios and their 95% confidence intervals were obtained. An overall summary of test accuracy was provided by the diagnostic odds ratio. Subgroup analysis was performed according to whether the study population was high risk or unselected. RESULTS Literature searches returned 338 relevant citations with 32 considered in full. Thirteen studies met our search criteria (85 845 women, 508 stillbirths) and were included in the review. Bivariate pooled estimate for sensitivity was 65% (95% CI, 38-85%) and for specificity 82% (95% CI, 72-88%). The positive likelihood ratio was 3.5 (95% CI, 2.3-5.5) and negative likelihood ratio 0.43 (95% CI, 0.22-0.85). The diagnostic odds ratio was 8.3 (95% CI, 3.0-22.4). Heterogeneity was high in the studies of high-risk women. CONCLUSIONS Abnormal uterine artery Doppler indices are associated with a three- to four-fold increase in the risk of stillbirth. The heterogeneity was particularly high in the high-risk group rendering it impossible to draw firm conclusions. In view of this, there is a role for individual patient data meta-analysis to define which Doppler parameter and threshold value should be measured.
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Kovacs FM, Barriga A, Royuela A, Seco J, Zamora J. Spanish adaptation of the Quality of Life Index-Spinal Cord Injury version. Spinal Cord 2015; 54:895-900. [PMID: 26572603 DOI: 10.1038/sc.2015.200] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 09/29/2015] [Accepted: 10/08/2015] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN A cross-sectional, validation study. OBJECTIVES To (a) develop the Spanish version of the Quality of Life Index-Spinal Cord Injury version (SV-QLI/SCI) and (b) assess its psychometric characteristics among permanent wheelchair users and specifically among those with SCI. SETTING Associations of wheelchair users in Mallorca (Spain). METHODS Two forward and backward translations of the QLI/SCI into Spanish were carried out separately. Seventy-seven subjects were randomly selected among the members of the associations. They completed the SV-QLI/SCI and validated instruments to measure depression and spinal pain upon recruitment and 14 days later. Assessments included comprehensibility, reproducibility, floor and ceiling effects and correlations between quality of life, pain and depression (Spearman's correlation coefficient). Analyses were repeated excluding data from subjects without SCI. RESULTS Three items of the SV-QLI/SCI required rephrasing. Reproducibility was 'almost perfect' for the entire questionnaire and its 'Health and functioning' subscale, 'substantial' for the 'Social and economic' and 'Family' subscales and 'moderate' for the 'Psychological/spiritual' subscale. Floor effect was not observed, and only for the 'Family' subscale >3% of the subjects reached the maximum possible score. The correlation between quality of life and depression was the strongest (r=-0.628). Results were virtually identical in the subsample with SCI. CONCLUSION These results support the use of the SV-QLI/SCI among Spanish-speaking wheelchair users.
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Troncoso M, Mateluna C, Parra P, Lara S, Hidalgo M, Muñoz D, Zamora J, Balut F. Pediatric arterial ischemic stroke: outcome and prognosis features. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.09.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Cheze M, Hoizey G, Eliot E, Zamora J, Borlot AL, Toulourat T, Oudart R, Pepin G, Deveaux M. Nouvelles drogues : bilan à partir des saisies de produits analysés au laboratoire Toxlab sur la période 2012–014. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2015. [DOI: 10.1016/j.toxac.2015.03.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Romo S, Castañeda S, Hernandez CA, Mendoza JH, Trejo FJ, Zamora J, Fernandez JE, Ducolomb Y, Kjelland ME. 315 IVF-DERIVED CROSSBRED EMBRYOS PRODUCED WITH SEXED SEMEN AND TRANSFERRED IN PAIRS TO BOS TAURUS × BOS INDICUS COWS AND HEIFERS. Reprod Fertil Dev 2015. [DOI: 10.1071/rdv27n1ab315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Biotechnology has continued to evolve rapidly, allowing the development of techniques to increase reproductive efficiency and contribute to the genetic improvement of cattle. Some of these techniques include the in vitro maturation (IVM) and IVF of oocytes, sperm sexing and embryo transfer (ET) to recipient females to obtain pregnancies and offspring. These modern assisted-reproduction techniques (ART) can help produce twin pregnancies and calving of a pre-determined sex. The aim of this study was to produce a high proportion of female bovine embryos in vitro using X-chromosome-selected sexed semen and to transfer them in pairs to recipient females, in order to evaluate the efficiency of transferring two female embryos in both cows and heifers. Cebu-cross ovaries were obtained from a local slaughterhouse and transported to a nearby laboratory in Chiapas, Mexico, to obtain cumulus-oocyte complexes by follicular aspiration and culture in maturation medium for 24 h. For IVF, frozen X-sorted semen (Milking Gyr and Holstein breeds, 90% purity, Sexing Technologies, Navasota, TX, USA) was used. Gametes were co-incubated for 22 h, then moved to embryo development medium and cultured for 7 days. Recipient Cebu-cross commercial cows (n = 98) and heifers (n = 50) were synchronized, using intravaginal devices impregnated with progesterone, administering eCG and prostaglandin at withdrawal. Seven days after heat, 88 recipients were subjected to non-surgical ET (59 cows and 29 heifers). Embryo transfers were performed in Tamaulipas and Veracruz, Mexico, and were divided into 2 groups: A) cows, and B) heifers. Only grade-1 embryos were selected for ET. Two embryos were loaded in a single 0.25 mL French straw and transferred to the uterine horn ipsilateral to the ovary with a corpus luteum. Pregnancy diagnosis was performed by ultrasound or rectal palpation 60 days after ET. A Fisher's exact test (SPSS v. 16.0, SPSS Inc., Chicago, IL, USA) was used to determine statistical differences (α = 0.05). Of IVF oocytes, 176/180 (98%) and 242/300 (81%) were fertilized, producing 96/180 (53.3%) Milking Gyr (semen)-Cebu (oocytes) and 92/300 (30.7%) Holstein (semen)-Cebu (oocytes) grade-1 embryos, respectively. Of the 88 recipients, 33 were pregnant (37.5%), however, it was not possible (at that time) to determine the number and sex of fetuses developing in utero. Overall, 8 of the 29 heifers were pregnant (27.6%), compared to 25 pregnancies in 59 cows (42.4%). For heifers, the pregnancy results for transferring Milking Gyr-Cebu embryos (4/11) versus Holstein-Cebu embryos (4/18) were not significantly different (P = 0.433, two-tailed Fisher's exact test). A similar comparison could not be made for cows given smaller sample sizes due to the extra variable of having taken place on several different ranches (n = 11). The concept herein is that smaller twin female crossbred calves may reduce issues associated with freemartinism and dystocia while still maintaining the vigor of crossbred offspring. Results from this research can help contribute to the study and development of ART for increasing cattle production efficiency.
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Shiohira S, Yoshida T, Sugiura H, Nishida M, Nitta K, Tsuchiya K, Grampp S, Goppelt-Strube M, Eckardt KU, Schodel J, Kang SW, Kim Y, Seo SK, Kim T, Ong S, Yang WS, Han NJ, Lee JM, Baek CH, Park SK, Kemter E, Aigner B, Wanke R, Troyano Suarez N, Olmos Centenero G, Mora I, Griera M, Cano JL, Martin P, Zamora J, Ruiz-Torres MP, Falke LL, Leask A, Lyons K, Nguyen TQ, Goldschmeding R, Park SK, Kim D, Lee AS, Jung YJ, Yang KH, Lee S, Kim W, Kim W, Kang KP, Garcia-Jerez A, Luengo-Rodriguez A, Ramirez-Chamond R, Carracedo J, Medrano-Andres D, Rodriguez-Puyol D, Calleros L, Kim HW, Park SK, Yang WS, Lee SK, Chang JW, Seo JW, Lee CT, Chou CA, Lee YT, Ng HY, Sanchez-Nino MD, Fernandez-Fernandez B, Perez-Gomez MV, Poveda J, Sanz AB, Cannata-Ortiz P, Egido J, Selgas R, Ortiz A, Ma SK, Kim IJ, Kim CS, Bae EH, Kim SW, Kokeny G, Boo'Si M, Fazekas K, Rosivall L, Mozes MM, Mijuskovic M, Ulrich C, Berger H, Trojanowicz B, Kohler F, Wolf A, Seibert E, Fiedler R, Markau S, Glomb M, Girndt M, Lajdova I, Spustova V, Oksa A, Chorvat D, Marcek Chorvatova A, Choi SO, Kim JS, Han BG, Yang JW, Liu S, Lv J, Chang R, Su F, Liang W, Zawada AM, Rogacev KS, Hundsdorfer J, Sester U, Fliser D, Heine GH, Chen JS, Cheng CW, Chang LC, Wu CZ, Novaes AS, Borges FT, Boim MA, Tramonti G, Romiti N, Chieli E, Hamahata S, Nagasawa Y, Kawabe M, Kida A, Yahiro M, Nanami M, Hasuike Y, Kuragano T, Nakasho K, Ohyama H, Nakanishi T, Tanaka S, Yano S, Sugimoto T, Bae E, Stevens KK, Hillyard DZ, Delles C, Jardine AG, Burke M, Morais C, Soyer P, Sinnya S, Winterford C, Oliver K, Lambie D, Staatz C, Carroll R, Campbell S, Isbel N, Felaco P, Pesce M, Patruno A, Sirolli V, Speranza L, Amoroso L, Franceschelli S, Bonomini M, Thilo F, Zakrzewicz A, Tepel M, Thilo F, Zakrzewicz A, Tepel M, Liu S, Li Y, Liang W, Su F, Wang B. CELL SIGNALLING AND APOPTOSIS. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Velauthar L, Plana MN, Kalidindi M, Zamora J, Thilaganathan B, Illanes SE, Khan KS, Aquilina J, Thangaratinam S. First-trimester uterine artery Doppler and adverse pregnancy outcome: a meta-analysis involving 55,974 women. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2014; 43:500-507. [PMID: 24339044 DOI: 10.1002/uog.13275] [Citation(s) in RCA: 155] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/29/2013] [Indexed: 06/03/2023]
Abstract
OBJECTIVES To determine the accuracy with which uterine artery Doppler in the first trimester of pregnancy predicts pre-eclampsia and fetal growth restriction, particularly early-onset disease. METHODS We searched MEDLINE (1951-2012), EMBASE (1980-2012) and the Cochrane Library (2012) for relevant citations without language restrictions. Two reviewers independently selected studies that evaluated the accuracy of first-trimester uterine artery Doppler to predict adverse pregnancy outcome and performed data extraction to construct 2 × 2 tables. We synthesized sensitivity and specificity for various Doppler indices using a bivariate random-effects model. RESULTS From 1866 citations, we identified 18 studies (55,974 women). The sensitivity and specificity of abnormal uterine artery flow velocity waveform (FVW) in the prediction of early-onset pre-eclampsia were 47.8% (95% CI: 39.0-56.8) and 92.1% (95% CI: 88.6-94.6), and in the prediction of early-onset fetal growth restriction were 39.2% (95% CI: 26.3-53.8) and 93.1% (95% CI: 90.6-95.0), respectively. The sensitivities for predicting any pre-eclampsia and fetal growth restriction were 26.4% (95% CI: 22.5-30.8) and 15.4% (95% CI: 12.4-18.9), respectively, and the specificities were 93.4% (95% CI: 90.4-95.5%) and 93.3% (95% CI: 90.9-95.1), respectively. The number needed to treat (NNT) with aspirin to prevent one case of early-onset pre-eclampsia fell from 1000 to 173 and from 2500 to 421 for background risks varying between 1% and 0.4%, respectively. CONCLUSIONS First-trimester uterine artery Doppler is a useful tool for predicting early-onset pre-eclampsia, as well as other adverse pregnancy outcomes. Based on the NNT, abnormal uterine artery Doppler in low-risk women achieves a sufficiently high performance to justify aspirin prophylaxis in those who test positive.
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Cerecedo I, Zamora J, Fox M, Voordouw J, Plana N, Rokicka E, Fernandez-Rivas M, Vázquez Cortés S, Reche M, Fiandor A, Kowalski M, Antonides G, Mugford M, Frewer LJ, De la Hoz B. The impact of double-blind placebo- controlled food challenge (DBPCFC) on the socioeconomic cost of food allergy in Europe. J Investig Allergol Clin Immunol 2014; 24:418-424. [PMID: 25668893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Double-blind placebo controlled food challenge (DBPCFC) is the gold standard diagnostic test in food allergy because it minimizes diagnostic bias. OBJECTIVE To investigate the potential effect of diagnosis on the socioeconomic costs of food allergy. METHODS A prospective longitudinal cost analysis study was conducted in Spain and Poland within the EuroPrevall project. Food-allergic patients were enrolled into the study and in all cases diagnosis was confirmed through a standardized DBPCFC. Data were collected through a self-administered survey on all aspects of health and social care resource use, costs of living, and costs of leisure activities. Costs were measured before and 6 months after the DBPCFC and reported in international dollars with 2007 as the benchmark year. RESULTS Forty-two patients were enrolled. Twenty-one patients had a negative DBPCFC and the suspected food was reintroduced into their diet. Comparing total direct costs before and after the DBPCFC, the reactive group spent a significantly higher amount (median increase of $813.1 over baseline), while the tolerant group's spending decreased by a median of $87.3 (P = .031). The amount of money spent on food 6 months after diagnosis was also significantly higher in the reactive group (P = .040). Finally, a larger, but not statistically significant, decrease in total indirect costs was observed in the tolerant group compared with the reactive group ($538.3 vs $32.3). CONCLUSION DBPCFC has an impact on indirect and direct costs of living. The main contribution to this increase was money spent on food.
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Joshi M, Royuela A, Zamora J. Proper analysis in clinical trials: how to report and adjust for missing outcome data. BJOG 2013; 120:915-9. [DOI: 10.1111/1471-0528.12219] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2013] [Indexed: 11/30/2022]
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Yildirim T, Yilmaz R, Altindal M, Turkmen E, Arici M, Altun B, Erdem Y, Guliyev O, Erkmen Uyar M, Tutal E, Bal Z, Sezer S, Erkmen Uyar M, Bal U, Bal Z, Tutal E, Say n B, Guliyev O, Erdemir B, Sezer S, O'Rourke-Potowki A, Gauge N, Penny H, Cronin A, Frame S, Goldsmith DJ, Yagan JA, Chandraker A, Velickovic Radovanovic RM, Catic Djordjevic A, Mitic B, Stefanovic N, Cvetkovic T, Serpieri N, Grosjean F, Sileno G, Torreggiani M, Esposito V, Mangione F, Abelli M, Castoldi F, Catucci D, Esposito C, Dal Canton A, Vatazin AV, Zulkarnaev AB, Borst C, Liu Y, Thoning J, Tepel M, Libetta C, Margiotta E, Borettaz I, Canevari M, Martinelli C, Lainu E, Abelli M, Meloni F, Sepe V, Dal Canton A, Miguel Costa R, Vasquez Martul E, Reboredo J, Rivera C, Simonato F, Tognarelli G, Daidola G, Gallo E, Burdese M, Cantaluppi V, Biancone L, Segoloni GP, Burdese M, Priora M, Messina M, Tamagnone M, Daidola G, Linsalata A, Lavacca A, Biancone L, Segoloni G, Zuidema W, Erdman R, van de Wetering J, Dor F, Roodnat J, Massey E, Timmerman L, IJzermans J, Weimar W, Goldsmith DJ, Sibley-Allen C, Hilton R, Moghul M, Burnapp L, Blake G, Koo TY, Park JS, Park HC, Kim GH, Lee CH, Oh IH, Kang CM, Hwang JK, Park SC, Choi BS, Chun HJ, Kim JI, Yang CW, Moon IS, Van Laecke S, Van Biesen W, Nagler EV, Taes Y, Peeters P, Vanholder R, Pruthi R, Ravanan R, Casula A, Harber M, Roderick P, Fogarty D, Cho A, Shin JH, Jang HR, Lee JE, Huh W, Kim DJK, Oh HY, Kim YG, Sancho Calabuig A, Gavela Martinez E, Kanter Berga J, Beltran Catalan S, Avila Bernabeu AI, Pallardo Mateu LM, Gonzalez E, Polanco N, Molina M, Gutierrez E, Garcia Puente L, Sevillano A, Morales E, Praga M, Andres A, Banasik M, Boratynska M, Koscielska-Kasprzak K, Bartoszek D, Myszka M, Zmonarski S, Nowakowska B, Wawrzyniak E, Halon A, Chudoba P, Klinger M, Rojas-Rivera J, Gonzalez E, Polanco N, Morales E, Andres A, Morales JM, Egido J, Praga M, Kopecky CM, Haidinger M, Kaltenecker C, Antlanger M, Marsche G, Holzer M, Kovarik J, Werzowa J, Hecking M, Saemann MD, Hwang JK, Kim JM, Koh ES, Chung BH, Park SC, Choi BS, Kim JI, Yang CW, Kim YS, Moon IS, Banasik M, Boratynska M, Koscielska-Kasprzak K, Krajewska M, Mazanowska O, Kaminska D, Bartoszek D, Zabinska M, Halon A, Malkiewicz B, Patrzalek D, Klinger M, Sulowicz J, Szostek S, Wojas-Pelc A, Ignacak E, Sulowicz W, Bellizzi V, Calella P, Cupisti A, Capitanini A, D'Alessandro C, Giannese D, Camocardi A, Conte G, Barsotti M, Bilancio G, Luciani R, Locsey L, Seres I, Kovacs D, Asztalos L, Paragh G, Wohlfahrtova M, Balaz P, Rokosny S, Wohlfahrt P, Bartonova A, Viklicky O, Kers J, Geskus RB, Meijer LJ, Bemelman F, ten Berge IJM, Florquin S, Hwang JC, Jiang MY, Lu YH, Weng SF, Testa A, Porto G, Sanguedolce M, Spoto B, Parlongo R, Pisano A, Enia G, Tripepi G, Zoccali C, Zuidema W, Mamode N, Lennerling A, Citterio F, Massey E, Van Assche K, Sterckx S, Frunza M, Jung H, Pascalev A, Johnson R, Loven C, Weimar W, Dor F, Soleymanian T, Keyvani H, Jazayeri SM, Fazeli Z, Ghamari S, Mahabadi M, Chegeni V, Najafi I, Ganji MR, Meys KME, Groothoff JW, Jager K, Schaefer F, Tonshoff B, Mota C, Cransberg K, van Stralen K, Gurluler E, Gures N, Alim A, Gurkan A, Cakir U, Berber I, Van Laecke S, Caluwe R, Nagler E, Van Biesen W, Peeters P, Van Vlem B, Vanholder R, Sulowicz J, Wojas-Pelc A, Ignacak E, Betkowska-Prokop A, Kuzniewski M, Krzanowski M, Sulowicz W, Masson I, Flamant M, Maillard N, Cavalier E, Moranne O, Alamartine E, Mariat C, Delanaye P, Canas Sole LL, Iglesias Alvarez E, Pastor MCMC, Moreno Flores FF, Abujder VV, Graterol FF, Bonet Sol JJ, Lauzurica Valdemoros RR, Yoshikawa M, Kitamura K, Nakai K, Goto S, Fujii H, Ishimura T, Takeda M, Fujisawa M, Nishi S, Prasad N, Gurjer D, Bhadauria D, Gupta A, Sharma R, Kaul A, Cybulla M, West M, Nicholls K, Torras J, Sunder-Plassmann G, Feriozzi S, Lo S, Wong PYH, Ip D, Wong CK, Chow VCC, Mo SKL, Molnar M, Ujszaszi A, Czira ME, Novak M, Mucsi I, Cruzado JM, Coelho S, Porta N, Bestard O, Melilli E, Taco O, Rivas I, Grinyo J, Pouteau LM, N'Guyen JM, Hami A, Hourmant M, Ghahramani N, Karparvar Z, Shadrou S, Ghahramani M, Fauvel JP, Hadj-Aissa A, Buron F, Morelon E, Ducher M, Heine C, Glander P, Neumayer HH, Budde K, Liefeldt L, Montero N, Webster AC, Royuela A, Zamora J, Crespo M, Pascual J, Adema AY, van Dorp WTH, Mallat MJK, de Fijter HW, Kim YS, Hong YA, Chung BH, Park CW, Yang CW, Kim YS, Choi BS, Suleymanlar G, Uzundurukan Z, Kapuagas A, Sencan I, Akdag R, Pascual J, Torio A, Mas V, Perez-Saez MJ, Mir M, Faura A, Montes-Ares O, Checa MD, Crespo M, Sawinski D, Trofe-Clark J, Sparkes T, Patel P, Goral S, Bloom R, Kim HJ, Park SJ, Kim TH, Kim YW, Kim YH, Kang SW, Abdel Halim M, Gheith O, Al-Otaibi T, Mosaad A, Awadeen W, Said T, Nair P, Nampoory MRN. Transplantation: clinical studies - A. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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García-Blázquez V, Vicente-Bártulos A, Olavarria-Delgado A, Plana MN, van der Winden D, Zamora J. Accuracy of CT angiography in the diagnosis of acute gastrointestinal bleeding: systematic review and meta-analysis. Eur Radiol 2012. [PMID: 23192375 DOI: 10.1007/s00330-012-2721-x] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To assess the diagnostic accuracy of computed tomography (CT) angiography in the evaluation of patients with an episode of acute gastrointestinal haemorrhage. METHODS Systematic review and meta-analysis to estimate pooled accuracy indices. A bivariate random effects model was adjusted to obtain a summary receiver-operating characteristic (sROC) curve and the corresponding area under the curve (AUC). RESULTS Twenty-two studies were included and provided data on 672 patients (range of age 5-74) with a mean age of 65 years. The overall sensitivity of CT angiography for detecting active acute GI haemorrhage was 85.2 % (95 % CI 75.5 % to 91.5 %). The overall specificity of CT angiography was 92.1 % (95 % CI 76.7 % to 97.7 %). The likelihood ratios for positive and negative test results were 10.8 (95 % CI 3.4 to 34.4) and 0.16 (95 % CI 0.1 to 0.27) respectively, with an AUC of 0.935 (95 % CI 0.693 to 0.989). The sources of heterogeneity explored had no significant impact on diagnostic performance. CONCLUSIONS CT shows high diagnostic accuracy and is an excellent diagnostic tool for detection and localising of intestinal bleeding sites. It is highly available, provides fast detection and localisation of the bleeding site, and is minimally invasive. KEY POINTS • CT angiography is increasingly used for investigating severe gastrointestinal bleeding. • This systematic review and meta-analysis updates previous ones. • In patients with massive gastrointestinal bleeding, CT angiography/MDCT detects bleeding accurately. • CT angiography is useful in locating the bleeding site and determining appropriate treatment.
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Blake M, De La Mata D, Zamora J, Peña O, Macedo O, Flores Estrada D, Turcott J, Arrieta O. Phase II Trial: Concurrent Chemotherapy and Radiation Therapy With Nitroglycerin in Locally Advanced Non-small Cell Lung Cancer Patients. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Cáceres P, Zamora J. EP-1257 PALLIATIVE RADIOTHERAPY IN THE TREATMENT OF GASTRIC AND GASTROESOPHAGIC UNION CANCER. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)71590-6] [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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De La Mata M, Arrieta O, Blake-Cerda M, Villareal-Garza C, Martinez-Barrera L, Zamora J, Gallardo D. Long-term Survival in Patients with Non-small Cell Lung Cancer and Synchronous Brain Metastasis Treated with Whole-brain Radiotherapy and Thoracic Chemo-radiation. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.1140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Zamora J, Velásquez A, Troncoso L, Barra P, Guajardo K, Castillo-Duran C. [Zinc in the therapy of the attention-deficit/hyperactivity disorder in children. A preliminar randomized controlled trial]. ARCHIVOS LATINOAMERICANOS DE NUTRICION 2011; 61:242-246. [PMID: 22696891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The attention-deficit/hyperactivity disorder (ADHD) is a neurological/behavioral disorder which begins in childhood. Zinc has a potential role as an adjuvant therapy for ADHD. The objective was to evaluate the effect ofZn supplementation on behavior, as a complementary therapy to metylphenidate, in pediatrics patients with ADHD. In a controlled, double blind design, 40 patients with clinical criteria ofADHD (DSM-IV) and psychometric evaluation (WISC-R), were selected (31 boys and 9 girls, 7-14 years of age). They were randomized to receive methylphenidate 0.3 mg/kg/d + placebo (sucrose) (group placebo, GPL) or methylphenidate 0.3 mg/kg/d + zinc (sulfate) 10 mg/d (group Zn, GZN) for 6 weeks. A blood sample was drawn at time 0 and 6 weeks, for plasma Zn analysis. The teacher and parent ADHD rating scale (Conners' global index, CGI) was applied at both times. Among the results, plasma Zn was normal at time 0, decreasing especially in the GPL after 6 weeks (GPL: 95.9 +/- 21.5 to 77.9 +/- 15.5; GZN: 90.3 +/- 9.1 to 85.0 +/- 12.0 microg/dL; NS). The CGI by teachers showed a non-significant improvement with Zn: GPL: 18 (9-28) to 16 points (2-26); GZN: 19 (6-24) to 11 points (3-23) (p = 0.07); no significant difference in the CGI by parents by groups was found: GPL: 19 (7-25) to 13 (3-22); GZN: 19(7-25) to 11(2-19). We conclude that a decrease in plasma Zn levels in both groups was found, greater in the placebo group. An apparent improvement in ADHD signs in children was observed with the Zn supplementation, according to the Conners global index by teachers.
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Chan YY, Jayaprakasan K, Zamora J, Thornton JG, Raine-Fenning N, Coomarasamy A. The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review. Hum Reprod Update 2011; 17:761-71. [PMID: 21705770 PMCID: PMC3191936 DOI: 10.1093/humupd/dmr028] [Citation(s) in RCA: 349] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The prevalence of congenital uterine anomalies in high-risk women is unclear, as several different diagnostic approaches have been applied to different groups of patients. This review aims to evaluate the prevalence of such anomalies in unselected populations and in women with infertility, including those undergoing IVF treatment, women with a history of miscarriage, women with infertility and recurrent miscarriage combined, and women with a history of preterm delivery. METHODS Searches of MEDLINE, EMBASE, Web of Science and the Cochrane register were performed. Study selection and data extraction were conducted independently by two reviewers. Studies were grouped into those that used ‘optimal’ and ‘suboptimal’ tests for uterine anomalies. Meta-analyses were performed to establish the prevalence of uterine anomalies and their subtypes within the various populations. RESULTS We identified 94 observational studies comprising 89 861 women. The prevalence of uterine anomalies diagnosed by optimal tests was 5.5% [95% confidence interval (CI), 3.5–8.5] in the unselected population, 8.0% (95% CI, 5.3–12) in infertile women, 13.3% (95% CI, 8.9–20.0) in those with a history of miscarriage and 24.5% (95% CI, 18.3–32.8) in those with miscarriage and infertility. Arcuate uterus is most common in the unselected population (3.9%; 95% CI, 2.1–7.1), and its prevalence is not increased in high-risk groups. In contrast, septate uterus is the most common anomaly in high-risk populations. CONCLUSIONS Women with a history of miscarriage or miscarriage and infertility have higher prevalence of congenital uterine anomalies compared with the unselected population.
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García‐Castillo M, del Campo R, Baquero F, Morosini M, Turrientes M, Zamora J, Cantón R. Stationary biofilm growth normalizes mutation frequencies and mutant prevention concentrations in Pseudomonas aeruginosa from cystic fibrosis patients. Clin Microbiol Infect 2011; 17:704-11. [DOI: 10.1111/j.1469-0691.2010.03317.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Vañó-Galván S, Hidalgo Á, Aguayo-Leiva I, Gil-Mosquera M, Ríos-Buceta L, Plana M, Zamora J, Martorell-Calatayud A, Jaén P. Teledermatología diferida: análisis de validez en una serie de 2.000 observaciones. ACTAS DERMO-SIFILIOGRAFICAS 2011; 102:277-83. [DOI: 10.1016/j.ad.2010.11.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2010] [Revised: 11/03/2010] [Accepted: 11/03/2010] [Indexed: 11/27/2022] Open
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Arana E, Kovacs FM, Royuela A, Estremera A, Sarasíbar H, Amengual G, Galarraga I, Martínez C, Muriel A, Abraira V, Zamora J, Campillo C. Influence of nomenclature in the interpretation of lumbar disk contour on MR imaging: a comparison of the agreement using the combined task force and the nordic nomenclatures. AJNR Am J Neuroradiol 2011; 32:1143-8. [PMID: 21493764 DOI: 10.3174/ajnr.a2448] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The CTF nomenclature had not been tested in clinical practice. The purpose of this study was to compare the reliability and diagnostic confidence in the interpretation of disk contours on lumbar 1.5T MR imaging when using the CTF and the Nordic nomenclatures. MATERIALS AND METHODS Five general radiologists from 3 hospitals blindly and independently assessed intravertebral herniations (Schmorl node) and disk contours on the lumbar MR imaging of 53 patients with low back pain, on 4 occasions. Measures were taken to minimize the risk of recall bias. The Nordic nomenclature was used for the first 2 assessments, and the CTF nomenclature, in the remaining 2. Radiologists had not previously used either of the 2 nomenclatures. κ statistics were calculated separately for reports deriving from each nomenclature and were categorized as almost perfect (0.81-1.00), substantial (0.61-0.80), moderate (0.41-0.60), fair (0.21-0.40), slight (0.00-0.20), and poor (<0.00). RESULTS Categorization of intra- and interobserver agreement was the same across nomenclatures. Intraobserver reliability was substantial for intravertebral herniations and disk contour abnormalities. Interobserver reliability was moderate for intravertebral herniations and fair to moderate for disk contour. CONCLUSIONS In conditions close to clinical practice, regardless of the specific nomenclature used, a standardized nomenclature supports only moderate interobserver agreement. The Nordic nomenclature increases self-confidence in an individual observer's report but is less clear regarding the classification of disks as normal versus bulged.
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Morris RK, Malin G, Robson SC, Kleijnen J, Zamora J, Khan KS. Fetal umbilical artery Doppler to predict compromise of fetal/neonatal wellbeing in a high-risk population: systematic review and bivariate meta-analysis. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2011; 37:135-142. [PMID: 20922778 DOI: 10.1002/uog.7767] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/02/2010] [Indexed: 05/29/2023]
Abstract
OBJECTIVE We investigated the accuracy of fetal umbilical artery Doppler to predict the risk of compromise of fetal/neonatal wellbeing in a high-risk population. METHODS Searches in MEDLINE, Embase, The Cochrane Library and Medion (from inception to March 2009) were carried out, together with hand searching of relevant journals, reference list checking of included articles and contact with experts. Criteria for selection were observational studies with umbilical artery Doppler used in a high-risk pregnant population with an outcome measure for compromise of fetal/neonatal wellbeing. Data on study design, quality and results were extracted to construct 2 × 2 tables. Bivariate meta-analysis was performed. Likelihood ratios (LRs) were used as the summary measure of accuracy. RESULTS One-hundred and four studies met the selection criteria (19 191 fetuses). In a high-risk population, umbilical artery Doppler predicted small-for-gestational age with a pooled LR+ of 3.76 (2.96, 4.76) and pooled LR- of 0.52 (0.45, 0.61), and compromise of fetal/neonatal wellbeing with a pooled LR+ of 3.41 (2.68, 4.34) and pooled LR- of 0.55 (0.48, 0.62). In this group it was also possible to predict, with accuracy, intrauterine death (pooled LR+ = 4.37 (0.88, 21.8); pooled LR- = 0.25 (0.07, 0.91)) and acidosis (pooled LR+ = 2.75 (1.48, 5.11); pooled LR- = 0.58 (0.36, 0.94)). CONCLUSIONS In a high-risk population, fetal umbilical artery Doppler is a moderately useful test with which to predict mortality and risk of compromise.
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Vañó-Galván S, Hidalgo Á, Aguayo-Leiva I, Gil-Mosquera M, Ríos-Buceta L, Plana M, Zamora J, Martorell-Calatayud A, Jaén P. Store-and-Forward Teledermatology: Assessment of Validity in a Series of 2000 Observations. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/s1578-2190(11)70803-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Ruvolo G, Giovannelli L, Schillaci R, Alimondi P, Pane A, Perino A, Cittadini E, Lambers MJ, Groeneveld E, Stakelbeek MEF, van den Belt-Dusebout AW, Mooij TM, Heymans MW, Schats R, Hompes PGA, Hoek A, Burger CW, van Leeuwen FE, Lambalk CB, Cobo Cabal A, Garrido N, Castello D, de los Santos MJ, Pellicer A, Remohi J, Sunkara SK, Rittenberg V, Raine-Fenning N, Bhattacharya S, Zamora J, Coomarasamy A, Ahuja KK, Andonov M, Wang JJ, Linara E, Nair S. SELECTED ORAL COMMUNICATION SESSION, SESSION 21: FEMALE FERTILITY AND ART, Monday 4 July 2011 15:15 - 16:30. Hum Reprod 2011. [DOI: 10.1093/humrep/26.s1.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Zamora J, Alonso O, Martin R. Brucelosis canina en Valdivia, Chile Estudio serológico y bacteriológico en perros de ciudad1. ACTA ACUST UNITED AC 2010. [DOI: 10.1111/j.1439-0450.1980.tb01649.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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