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Patel P, Castro P, Koohi N, Arshad Q, Gargallo L, Carmona S, Kaski D. Head shaking does not alter vestibulo ocular reflex gain in vestibular migraine. Front Neurol 2022; 13:967521. [PMID: 36247796 PMCID: PMC9561915 DOI: 10.3389/fneur.2022.967521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/08/2022] [Indexed: 12/03/2022] Open
Abstract
Vestibular Migraine (VM) is the most common cause of non-positional episodic vestibular symptoms. Patients with VM commonly report increased motion sensitivity, suggesting that vestibular responses to head movement may identify changes specific to VM patients. Here we explore whether the vestibulo-ocular reflex (VOR) gain alters in response to a clinical “headshake” maneuver in patients with VM. Thirty patients with VM in the inter-ictal phase, 16 patients with Benign Positional Paroxysmal Vertigo (BPPV) and 15 healthy controls were recruited. Patients responded to the question “Do you feel sick reading in the passenger seat of a car?” and completed a validated motion sickness questionnaire as a measure of motion sensitivity. Lateral canal vHIT testing was performed before and after headshaking; the change in VOR gain was calculated as the primary outcome. Baseline VOR gain was within normal limits across all participants. There was no significant change in VOR gain after headshaking in any group (p = 0.264). Patients were 4.3 times more likely to be in the VM group than in the BPPV group if they reported nausea when reading in the passenger seat of a car. We postulate that a headshake stimulus may be insufficient to disrupt cortical interactions and induce a change in VOR gain. Alternatively, changes in VOR gain may only be apparent in the acute phase of VM. Reading in the passenger seat of a car was considered uncomfortable in all VM patients suggesting that this specific question may be useful for the diagnosis of VM.
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Muñoz i Carrillo F, Amorós P, Pesantez Coronel D, Reyes R, Barreto Zambrano T, Carrera Domenech G, Cascos E, Castro P, Fernández-Méndez S, Font Puig M, González-Aguado L, Monge I, Padrosa J, Reguart Aransay N, Téllez A, Tuca A, Viladot M, Zamora C, Marco Hernández J. 1599P Intrapericardial cisplatin as treatment for malignant pericardial effusion: 13-year experience at Hospital Clinic of Barcelona. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Berchuck JE, Adib E, Abou Alaiwi S, Dash AK, Shin JN, Lowder D, McColl C, Castro P, Carelli R, Benedetti E, Deng J, Robertson M, Baca SC, Bell C, McClure HM, El Zarif T, Davidsohn MP, Lakshminarayanan G, Rizwan K, Skapura DG, Grimm SL, Davis CM, Ehli EA, Kelleher KM, Seo JH, Mitsiades N, Coarfa C, Pomerantz MM, Loda M, Ittmann M, Freedman ML, Kaochar S. The Prostate Cancer Androgen Receptor Cistrome in African American Men Associates with Upregulation of Lipid Metabolism and Immune Response. Cancer Res 2022; 82:2848-2859. [PMID: 35731919 PMCID: PMC9379363 DOI: 10.1158/0008-5472.can-21-3552] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 05/03/2022] [Accepted: 06/14/2022] [Indexed: 11/16/2022]
Abstract
African-American (AA) men are more likely to be diagnosed with and die from prostate cancer than European American (EA) men. Despite the central role of the androgen receptor (AR) transcription factor in prostate cancer, little is known about the contribution of epigenetics to observed racial disparities. We performed AR chromatin immunoprecipitation sequencing on primary prostate tumors from AA and EA men, finding that sites with greater AR binding intensity in AA relative to EA prostate cancer are enriched for lipid metabolism and immune response genes. Integration with transcriptomic and metabolomic data demonstrated coinciding upregulation of lipid metabolism gene expression and increased lipid levels in AA prostate cancer. In a metastatic prostate cancer cohort, upregulated lipid metabolism associated with poor prognosis. These findings offer the first insights into ancestry-specific differences in the prostate cancer AR cistrome. The data suggest a model whereby increased androgen signaling may contribute to higher levels of lipid metabolism, immune response, and cytokine signaling in AA prostate tumors. Given the association of upregulated lipogenesis with prostate cancer progression, our study provides a plausible biological explanation for the higher incidence and aggressiveness of prostate cancer observed in AA men. SIGNIFICANCE With immunotherapies and inhibitors of metabolic enzymes in clinical development, the altered lipid metabolism and immune response in African-American men provides potential therapeutic opportunities to attenuate racial disparities in prostate cancer.
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Ibitoye RT, Castro P, Cooke J, Allum J, Arshad Q, Murdin L, Wardlaw J, Kaski D, Sharp DJ, Bronstein AM. A link between frontal white matter integrity and dizziness in cerebral small vessel disease. Neuroimage Clin 2022; 35:103098. [PMID: 35772195 PMCID: PMC9253455 DOI: 10.1016/j.nicl.2022.103098] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/30/2022] [Accepted: 06/21/2022] [Indexed: 11/18/2022]
Abstract
Idiopathic dizziness in older people is associated with more vascular risk. Idiopathic dizziness is also associated with impaired balance and cognition. These findings co-occur with more frontal markers of cerebral small vessel disease. Small vessel disease may contribute to dizziness through its effects on balance.
One in three older people (>60 years) complain of dizziness which often remains unexplained despite specialist assessment. We investigated if dizziness was associated with vascular injury to white matter tracts relevant to balance or vestibular self-motion perception in sporadic cerebral small vessel disease (age-related microangiopathy). We prospectively recruited 38 vestibular clinic patients with idiopathic (unexplained) dizziness and 36 age-matched asymptomatic controls who underwent clinical, cognitive, balance, gait and vestibular assessments, and structural and diffusion brain MRI. Patients had more vascular risk factors, worse balance, worse executive cognitive function, and worse ankle vibration thresholds in association with greater white matter hyperintensity in frontal deep white matter, and lower fractional anisotropy in the genu of the corpus callosum and the right inferior longitudinal fasciculus. A large bihemispheric white matter network had less structural connectivity in patients. Reflex and perceptual vestibular function was similar in patients and controls. Our results suggest cerebral small vessel disease is involved in the genesis of dizziness through its effect on balance.
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Castro P, Bancroft MJ, Arshad Q, Kaski D. Persistent Postural-Perceptual Dizziness (PPPD) from Brain Imaging to Behaviour and Perception. Brain Sci 2022; 12:brainsci12060753. [PMID: 35741638 PMCID: PMC9220882 DOI: 10.3390/brainsci12060753] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 12/17/2022] Open
Abstract
Persistent postural-perceptual dizziness (PPPD) is a common cause of chronic dizziness associated with significant morbidity, and perhaps constitutes the commonest cause of chronic dizziness across outpatient neurology settings. Patients present with altered perception of balance control, resulting in measurable changes in balance function, such as stiffening of postural muscles and increased body sway. Observed risk factors include pre-morbid anxiety and neuroticism and increased visual dependence. Following a balance-perturbing insult (such as vestibular dysfunction), patients with PPPD adopt adaptive strategies that become chronically maladaptive and impair longer-term postural behaviour. In this article, we explore the relationship between behavioural postural changes, perceptual abnormalities, and imaging correlates of such dysfunction. We argue that understanding the pathophysiological mechanisms of PPPD necessitates an integrated methodological approach that is able to concurrently measure behaviour, perception, and cortical and subcortical brain function.
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González L, Fonseca Martinez M, Aragon A, Ortega de la O MC, Salido Olivares M, Villaverde V, Andres EM, Castro P. OP0299-HPR ANALYSIS OF THE ACCEPTANCE AND USEFULNESS OF A NON-PRESENTIAL CONSULTATION, IN PATIENTS WITH CHRONIC INFLAMMATORY JOINT DISEASES USING A DIGITAL PLATFORM. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundThe Covid-19 pandemic has meant a modification of the patterns of the doctor-patient relationship, favoring online visits and reducing face-to-face visits. Likewise, the implementation of Patient-Reported Outcomes (PROs) that do not require the intervention of the doctor in our clinical practice and that given their close relationship with the clinical activity of chronic inflammatory joint diseases (CIJD) has favored an empowerment of patients and can allow the development of the online visit.ObjectivesKnow the use and acceptance of patients with CIJD: rheumatoid arthritis (RA), psoriatic arthritis (PsA) and spondyloarthropathies (SpA) of a non-face-to-face online visit, through a digital environment.MethodsPatients were included in a platform called Rheumanet for access by username and passwords (https://www.laconsultacercadeti.com/). At the time of inclusion, demographic variables were collected: date of birth, sex, level of education (primary education, secondary education, vocational training, further education and higher education), distance from the hospital to the patient’s home, and clinical variables such as diagnosis: RA, PsA or SpA, as well as the duration of the disease. Prior to the appointment, patients were encouraged to complete a PRO survey to assess their clinical situation: Routine Assessment of Patient Index Data 3 (RAPID3) for RA, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for SpA and RAPID3 and / or BASDAI for the PsA. Both the RAPID3 and BASDAI were scored for the patient’s knowledge and assigned to a color scale based on disease activity in green (remission or low activity), orange (moderate activity) or red (severe activity). Likewise, they were ordered to express through a free text what they would tell us as if they were in a face-to-face consultation. Complementary tests (analytical, radiological studies and others) are obtained simultaneously from the medical records and a joint assessment of the visit is carried out.ResultsBetween September 1, 2020 and January 31, 2022, a total of 248 patients (113 RA, 53 SpA and 82 PsA) were included in the platform. 172 (69.3%) patients used the digital platform and made at least one non-face-to-face visit during follow-up. The number of online visits made by each patient ranged from 1 to a maximum of 13 visits. 80 patients (70.7%) suffered from RA, 40 (75.4%) from SpA and 52 (63.4%) from PsA. The number of patients who made non-face-to-face visits was 38 (72.3%) for a disease duration of <5 years and 137 (64.5%) for >5 years. When the ages of the patients were analyzed, the number of patients who made visits was 75 (73.5%) between 18 and 30 years old, 50 (67.7%) between 30 and 50 and 47 (66.4 %) from 50 years. According to the degree of activity of the disease, 75 patients were in remission or low activity at some point during the visits, 63 patients with moderate activity and 34 with severe activity. The distribution according to level of education was: 11 (6.3%) primary education, 21 (12.2%) secondary education, 37 (21.5%) vocational training, 63 (36.6%) further education and 40 (23.2%)higher education. The number of online visits was higher in patients who lived at a distance of 50 km or more from the hospital, reaching 100% of the visits in this subgroup of patients.ConclusionThe online visit through a digital platform through PROs is well accepted by our population with CIJD, especially in the young population, with a higher cultural level and whose home is far from the hospital. The online visit was made by patients regardless of the severity of their disease activity. Speed and ease of use using PROs already known to the patient and clinician is an important consideration for rheumatologists working in healthcare systems where patient contact time is limited. It would be interesting to obtain this information in non-pandemic situations such as COVID-19, which would make it possible to assess actual acceptance and its use in this type of patient in circumstances in which fear of contagion is not a variable to consider.Disclosure of InterestsNone declared
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Werner H, Castro P, Fazecas T, Peixoto-Filho FM, de Mello PP, Araujo Júnior E. Fetal virtual bronchoscopy in bronchial atresia: correlation with postnatal bronchoscopy. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2022; 59:693-695. [PMID: 34542200 DOI: 10.1002/uog.24776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 09/06/2021] [Indexed: 06/13/2023]
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Castro P, Papoutselou E, Mahmoud S, Hussain S, Bassaletti CF, Kaski D, Bronstein A, Arshad Q. Priming overconfidence in belief systems reveals negative return on postural control mechanisms. Gait Posture 2022; 94:1-8. [PMID: 35189573 DOI: 10.1016/j.gaitpost.2022.02.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/01/2022] [Accepted: 02/13/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Modulation of postural control strategies and heightened perceptual ratings of instability when exposed to postural threats, illustrates the association between anxiety and postural control. RESEARCH QUESTION Here we test whether modulating prior expectations can engender postural-related anxiety which, in turn, may impair postural control and dissociate the well-established relationship between sway and subjective instability. METHODS We modulated expectations of the difficulty posed by an upcoming postural task via priming. In the visual priming condition, participants watched a video of an actor performing the task with either a stable or unstable performance, before themselves proceeding with the postural task. In the verbal priming paradigm, participants were given erroneous verbal information regarding the amplitude of the forthcoming platform movement, or no prior information. RESULTS Following the visual priming, the normal relationship between trunk sway and subjective instability was preserved only in those individuals that viewed the stable but not the unstable actor. In the verbal priming experiment we observed an increase in subjective instability and anxiety during task performance in individuals who were erroneously primed that sled amplitude would increase, when in fact it did not. SIGNIFICANCE Our findings show that people's subjective experiences of instability and anxiety during a balancing task are powerfully modulated by priming. The contextual provision of erroneous cognitive priors dissociates the normally 'hard wired' relationship between objective measures and subjective ratings of sway. Our findings have potential clinical significance for the development of enhanced cognitive retraining in patients with balance disorders, e.g. via modifying expectations.
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Sandoval E, Moreno-Castaño A, Pino M, Pereda D, Samanbar S, Pruna-Guillen R, Fernandez S, Roman J, Gomez V, Muro A, Castro P, Escolar G, Diaz-Ricart M. Primary Hemostasis Defect Due to Acquired Von Willebrand Disease and Platelet Activation During Extracorporeal Life Support. In Vitro Correction by Purified VWF. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Stur E, Corvigno S, Xu M, Chen K, Tan Y, Lee S, Liu J, Ricco E, Kraushaar D, Castro P, Zhang J, Sood AK. Spatially resolved transcriptomics of high-grade serous ovarian carcinoma. iScience 2022; 25:103923. [PMID: 35252817 PMCID: PMC8891954 DOI: 10.1016/j.isci.2022.103923] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/23/2021] [Accepted: 02/10/2022] [Indexed: 01/13/2023] Open
Abstract
Bulk and single-cell RNA sequencing do not provide full characterization of tissue spatial diversity in cancer samples, and currently available in situ techniques (multiplex immunohistochemistry and imaging mass cytometry) allow for only limited analysis of a small number of targets. The current study represents the first comprehensive approach to spatial transcriptomics of high-grade serous ovarian carcinoma using intact tumor tissue. We selected a small cohort of patients with highly annotated high-grade serous ovarian carcinoma, categorized them by response to neoadjuvant chemotherapy (poor or excellent), and analyzed pre-treatment tumor tissue specimens. Our study uncovered extensive differences in tumor composition between the poor responders and excellent responders to chemotherapy, related to cell cluster organization and localization. This in-depth characterization of high-grade serous ovarian carcinoma tumor tissue from poor and excellent responders showed that spatial interactions between cell clusters may influence chemo-responsiveness more than cluster composition alone.
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Ravindran A, Piyarathna DWB, Gohlke J, Putluri V, Soni T, Lloyd S, Castro P, Pennathur S, Jones JA, Ittmann M, Putluri N, Michailidis G, Rajendiran TM, Sreekumar A. Lipid Alterations in African American Men with Prostate Cancer. Metabolites 2021; 12:metabo12010008. [PMID: 35050130 PMCID: PMC8779756 DOI: 10.3390/metabo12010008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/20/2021] [Accepted: 12/20/2021] [Indexed: 12/21/2022] Open
Abstract
African-American (AA) men are more than twice as likely to die of prostate cancer (PCa) than European American (EA) men. Previous in silico analysis revealed enrichment of altered lipid metabolic pathways in pan-cancer AA tumors. Here, we performed global unbiased lipidomics profiling on 48 matched localized PCa and benign adjacent tissues (30 AA, 24 ancestry-verified, and 18 EA, 8 ancestry verified) and quantified 429 lipids belonging to 14 lipid classes. Significant alterations in long chain polyunsaturated lipids were observed between PCa and benign adjacent tissues, low and high Gleason tumors, as well as associated with early biochemical recurrence, both in the entire cohort, and within AA patients. Alterations in cholesteryl esters, and phosphatidyl inositol classes of lipids delineated AA and EA PCa, while the levels of lipids belonging to triglycerides, phosphatidyl glycerol, phosphatidyl choline, phosphatidic acid, and cholesteryl esters distinguished AA and EA PCa patients with biochemical recurrence. These first-in-field results implicate lipid alterations as biological factors for prostate cancer disparities.
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Corredor G, Toro P, Koyuncu C, Lu C, Buzzy C, Bera K, Fu P, Mehrad M, Ely KA, Mokhtari M, Yang K, Chute D, Adelstein DJ, Thompson LDR, Bishop JA, Faraji F, Thorstad W, Castro P, Sandulache V, Koyfman SA, Lewis JS, Madabhushi A. An Imaging Biomarker of Tumor-Infiltrating Lymphocytes to Risk-Stratify Patients With HPV-Associated Oropharyngeal Cancer. J Natl Cancer Inst 2021; 114:609-617. [PMID: 34850048 PMCID: PMC9002277 DOI: 10.1093/jnci/djab215] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/03/2021] [Accepted: 11/19/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) has excellent control rates compared to nonvirally associated OPSCC. Multiple trials are actively testing whether de-escalation of treatment intensity for these patients can maintain oncologic equipoise while reducing treatment-related toxicity. We have developed OP-TIL, a biomarker that characterizes the spatial interplay between tumor-infiltrating lymphocytes (TILs) and surrounding cells in histology images. Herein, we sought to test whether OP-TIL can segregate stage I HPV-associated OPSCC patients into low-risk and high-risk groups and aid in patient selection for de-escalation clinical trials. METHODS Association between OP-TIL and patient outcome was explored on whole slide hematoxylin and eosin images from 439 stage I HPV-associated OPSCC patients across 6 institutional cohorts. One institutional cohort (n = 94) was used to identify the most prognostic features and train a Cox regression model to predict risk of recurrence and death. Survival analysis was used to validate the algorithm as a biomarker of recurrence or death in the remaining 5 cohorts (n = 345). All statistical tests were 2-sided. RESULTS OP-TIL separated stage I HPV-associated OPSCC patients with 30 or less pack-year smoking history into low-risk (2-year disease-free survival [DFS] = 94.2%; 5-year DFS = 88.4%) and high-risk (2-year DFS = 82.5%; 5-year DFS = 74.2%) groups (hazard ratio = 2.56, 95% confidence interval = 1.52 to 4.32; P < .001), even after adjusting for age, smoking status, T and N classification, and treatment modality on multivariate analysis for DFS (hazard ratio = 2.27, 95% confidence interval = 1.32 to 3.94; P = .003). CONCLUSIONS OP-TIL can identify stage I HPV-associated OPSCC patients likely to be poor candidates for treatment de-escalation. Following validation on previously completed multi-institutional clinical trials, OP-TIL has the potential to be a biomarker, beyond clinical stage and HPV status, that can be used clinically to optimize patient selection for de-escalation.
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Mesquida J, Caballer A, Cortese L, Vila C, Karadeniz U, Pagliazzi M, Zanoletti M, Pacheco AP, Castro P, García-de-Acilu M, Mesquita RC, Busch DR, Durduran T. Peripheral microcirculatory alterations are associated with the severity of acute respiratory distress syndrome in COVID-19 patients admitted to intermediate respiratory and intensive care units. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2021; 25:381. [PMID: 34749792 PMCID: PMC8575160 DOI: 10.1186/s13054-021-03803-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/25/2021] [Indexed: 12/12/2022]
Abstract
Background COVID-19 is primarily a respiratory disease; however, there is also evidence that it causes endothelial damage in the microvasculature of several organs. The aim of the present study is to characterize in vivo the microvascular reactivity in peripheral skeletal muscle of severe COVID-19 patients. Methods This is a prospective observational study carried out in Spain, Mexico and Brazil. Healthy subjects and severe COVID-19 patients admitted to the intermediate respiratory (IRCU) and intensive care units (ICU) due to hypoxemia were studied. Local tissue/blood oxygen saturation (StO2) and local hemoglobin concentration (THC) were non-invasively measured on the forearm by near-infrared spectroscopy (NIRS). A vascular occlusion test (VOT), a three-minute induced ischemia, was performed in order to obtain dynamic StO2 parameters: deoxygenation rate (DeO2), reoxygenation rate (ReO2), and hyperemic response (HAUC). In COVID-19 patients, the severity of ARDS was evaluated by the ratio between peripheral arterial oxygen saturation (SpO2) and the fraction of inspired oxygen (FiO2) (SF ratio). Results Healthy controls (32) and COVID-19 patients (73) were studied. Baseline StO2 and THC did not differ between the two groups. Dynamic VOT-derived parameters were significantly impaired in COVID-19 patients showing lower metabolic rate (DeO2) and diminished endothelial reactivity. At enrollment, most COVID-19 patients were receiving invasive mechanical ventilation (MV) (53%) or high-flow nasal cannula support (32%). Patients on MV were also receiving sedative agents (100%) and vasopressors (29%). Baseline StO2 and DeO2 negatively correlated with SF ratio, while ReO2 showed a positive correlation with SF ratio. There were significant differences in baseline StO2 and ReO2 among the different ARDS groups according to SF ratio, but not among different respiratory support therapies. Conclusion Patients with severe COVID-19 show systemic microcirculatory alterations suggestive of endothelial dysfunction, and these alterations are associated with the severity of ARDS. Further evaluation is needed to determine whether these observations have prognostic implications. These results represent interim findings of the ongoing HEMOCOVID-19 trial. Trial registration ClinicalTrials.gov NCT04689477. Retrospectively registered 30 December 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s13054-021-03803-2.
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Zapatero A, Castro P, Roch M, Buchser D, de Vidales C, González S, Rodríguez P, Murillo M. VMAT Focal Boost to MRI-Defined Intraprostatic Lesion in Localized Prostate Cancer: Results of a Phase II Trial. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.939] [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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Schmelz M, Sanderson-November M, Humeida R, Cloete M, Mims M, Castro P, Leong A, Wisner L, Silver S. A Plan for Emergency Shutdown and Reopening for a Consortium of Biobanks. Biopreserv Biobank 2021; 19:394-398. [PMID: 34610247 DOI: 10.1089/bio.2021.0038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background: The AIDS and Cancer Specimen Resource (ACSR) is a network of four regional biospecimen repositories and a technical core in the United States and South Africa. Its mission is to acquire, store, and distribute HIV-associated malignancy specimens and related clinical data to support translational research. At the outset of the COVID-19 pandemic, it became apparent that existing ACSR Standard Operating Procedures (SOPs) were not sufficient to ensure long-term maintenance and integrity of inventories during periods of extended shutdown. The ACSR needed an administrative SOP for situations pertaining to epidemics/pandemics. The ACSR Quality Working Group (QWG), comprised of representatives from each of the five ACSR sites and an external member who directs a large university medical center biorepository, addressed the issue. Methods: To understand the individual problems the sites faced, questions were developed to query each of the six QWG sites' contingency plans to cover this type of emergency, the amount of work allowed onsite and by whom, the challenges sites experienced, and the lessons learned to assist with future similar situations, while remaining consistent with the existing IRB protocols. Results: Reported challenges spanned all activities of classical biobanks and differed within the geographical locations of the sites and the local COVID-19 infection rate. Review of the responses to the questions revealed that the general shutdown of society external to the biorepositories presented them with a homogeneous collection of problems, limitations, and needs. This led to creating an SOP that addresses planning for pandemic emergencies, scaling down of activities, shutting down, and reopening plans. Conclusions: The ACSR QWG sites now have a structured response SOP for their sites, including guidance on how to develop and implement an emergency shutdown and reopening plan. The complete SOP is publicly available on the ACSR website.
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Koohi N, Bancroft M, Patel J, Castro P, Akram H, Warner T, Kaski D. Saccadic bradykinesia in Parkinson's disease: Preliminary observations. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.119532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ibitoye R, Castro P, Cooke J, Allum J, Murdin L, Wardlow J, Kaski D, Sharp D, Bronstein A. Frontal white matter integrity and idiopathic dizziness in cerebral small vessel disease. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.118504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ibitoye R, Castro P, Desowska A, Cooke J, Edwards A, Guven O, Arshad Q, Murdin L, Kaski D, Bronstein A. Small vessel disease disrupts EEG postural brain networks in ‘unexplained dizziness in the elderly’. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.118505] [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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Ibitoye RT, Castro P, Desowska A, Cooke J, Edwards AE, Guven O, Arshad Q, Murdin L, Kaski D, Bronstein AM. Small vessel disease disrupts EEG postural brain networks in 'unexplained dizziness in the elderly'. Clin Neurophysiol 2021; 132:2751-2762. [PMID: 34583117 PMCID: PMC8559782 DOI: 10.1016/j.clinph.2021.07.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 06/15/2021] [Accepted: 07/25/2021] [Indexed: 11/28/2022]
Abstract
Unexplained dizziness in the elderly may result from
cerebral small vessel disease. Dizzy elderly patients differed from controls in EEG
power when standing. EEG power when standing correlated with subjective
(perceived) instability.
Objective To examine the hypothesis that small vessel disease
disrupts postural networks in older adults with unexplained dizziness in the
elderly (UDE). Methods Simultaneous electroencephalography and postural sway
measurements were undertaken in upright, eyes closed standing, and sitting
postures (as baseline) in 19 younger adults, 33 older controls and 36 older
patients with UDE. Older adults underwent magnetic resonance imaging to
determine whole brain white matter hyperintensity volumes, a measure of small
vessel disease. Linear regression was used to estimate the effect of instability
on electroencephalographic power and connectivity. Results Ageing increased theta and alpha desynchronisation on
standing. In older controls, delta and gamma power increased, and theta and
alpha power reduced with instability. Dizzy older patients had higher white
matter hyperintensity volumes and more theta desynchronisation during periods of
instability. White matter hyperintensity volume and delta power during periods
of instability were correlated, positively in controls but negatively in dizzy
older patients. Delta power correlated with subjective dizziness and
instability. Conclusions Neural resource demands of postural control increase
with age, particularly in patients with UDE, driven by small vessel
disease. Significance EEG correlates of postural control saturate in older
adults with UDE, offering a neuro-physiological basis to this common
syndrome.
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Montes JL, De Herreros MG, Padrosa J, Zambrano TB, Zamora C, Viladot M, Fernandez-Mañas L, Gorria T, Ghiglione L, Solis ES, Chicote M, Barrera C, Font E, Fernandez-Mendez S, Téllez A, Castro P, Nicolas J, Tuca A, Prat A, Marco-Hernández J. 1726P The optimal care study: Outcomes of patients with solid malignancies admitted to intensive care unit. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Castro P, Vadera S, Bancroft MJ, Buttell J, Kaski D. Case Report: Acute Onset Fear of Falling and Treatment With "Cognitive Physical Therapy". Front Neurol 2021; 12:707840. [PMID: 34421806 PMCID: PMC8377200 DOI: 10.3389/fneur.2021.707840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 07/14/2021] [Indexed: 11/13/2022] Open
Abstract
Fear of falling (FoF) is prevalent in older adults, especially those with previous falls, and typically starts insidiously. We present a 78-year-old woman with an abrupt onset FoF and no history of falls, balance problems, vertigo, oscillopsia, psychiatric or psychological issues to account for this. These cognitive changes led to a behavioural alteration of her gait that became slow and wide-based, with her gaze fixed on the floor. She began a tailored program of "Cognitive Physical Therapy (CPT)" combining cognitive behavioural therapy (CBT) and physical rehabilitation. 1 month later her 6 m walk time and steps were reduced by a 25 and 35%, respectively, and the stride length increased by 34%, with further improvement 2 months later. We postulate that the abrupt onset of symptoms triggered a central shift toward postural hypervigilance and anxiety, suppression of anticipatory (feed forward) postural adjustments (APA) leading to FoF. CPT improved objective gait parameters related to FoF and reduced postural anxiety suggesting that early diagnosis and prompt treatment may avoid chronic symptoms and social isolation.
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Hernandez D, Castro P, Roch M, Fayos-Sola R, Botella P, Valiente A, Escobar M, Talaya M, Murillo M. Po-1634 Transit Dosimetry With Portal Images For Ultrahypofractionated Radiation Therapy For Breast Cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)08085-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Aldave D, Gonzalo S, Hernandez D, Zaragoza L, Cruz-Conde J, Casado M, Castro P, Roch M, Talaya M, Rubiato R, Murillo M. PO-1152 Analysis of chest wall toxicity predictors in lung SBRT. 3-fraction schemes for peripheral lesions? Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07603-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Martignon S, Cortes A, Douglas GVA, Newton JT, Pitts NB, Avila V, Usuga-Vacca M, Gamboa LF, Deery C, Abreu-Placeres N, Bonifacio C, Braga MM, Carletto-Körber F, Castro P, P Cerezo M, Chavarría N, Cifuentes OL, Echeverri B, Jácome-Liévano S, Kuzmina I, Lara JS, Manton D, Martínez-Mier EA, Melo P, Muller-Bolla M, Ochoa E, Osorio JR, Ramos K, Sanabria AF, Sanjuán J, San-Martín M, Squassi A, Velasco AK, Villena R, Zandona AF, Beltrán EO. CariesCare International adapted for the pandemic in children: Caries OUT multicentre single-group interventional study protocol. BMC Oral Health 2021; 21:329. [PMID: 34210281 PMCID: PMC8248759 DOI: 10.1186/s12903-021-01674-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/14/2021] [Indexed: 01/27/2023] Open
Abstract
Background Comprehensive caries care has shown effectiveness in controlling caries progression and improving health outcomes by controlling caries risk, preventing initial-caries lesions progression, and patient satisfaction. To date, the caries-progression control effectiveness of the patient-centred risk-based CariesCare International (CCI) system, derived from ICCMS™ for the practice (2019), remains unproven. With the onset of the COVID-19 pandemic a previously planned multi-centre RCT shifted to this “Caries OUT” study, aiming to assess in a single-intervention group in children, the caries-control effectiveness of CCI adapted for the pandemic with non-aerosols generating procedures (non-AGP) and reducing in-office time.
Methods In this 1-year multi-centre single-group interventional trial the adapted-CCI effectiveness will be assessed in one single group in terms of tooth-surface level caries progression control, and secondarily, individual-level caries progression control, children’s oral-health behaviour change, parents’ and dentists’ process acceptability, and costs exploration. A sample size of 258 3–5 and 6–8 years old patients was calculated after removing half from the previous RCT, allowing for a 25% dropout, including generally health children (27 per centre). The single-group intervention will be the adapted-CCI 4D-cycle caries care, with non-AGP and reduced in-office appointments’ time. A trained examiner per centre will conduct examinations at baseline, at 5–5.5 months (3 months after basic management), 8.5 and 12 months, assessing the child’s CCI caries risk and oral-health behaviour, visually staging and assessing caries-lesions severity and activity without air-drying (ICDAS-merged Epi); fillings/sealants; missing/dental-sepsis teeth, and tooth symptoms, synthetizing together with parent and external-trained dental practitioner (DP) the patient- and tooth-surface level diagnoses and personalised care plan. DP will deliver the adapted-CCI caries care. Parents’ and dentists’ process acceptability will be assessed via Treatment-Evaluation-Inventory questionnaires, and costs in terms of number of appointments and activities. Twenty-one centres in 13 countries will participate. Discussion The results of Caries OUT adapted for the pandemic will provide clinical data that could help support shifting the caries care in children towards individualised oral-health behaviour improvement and tooth-preserving care, improving health outcomes, and explore if the caries progression can be controlled during the pandemic by conducting non-AGP and reducing in-office time. Trial registration: Retrospectively-registered-ClinicalTrials.gov-NCT04666597-07/12/2020: https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000AGM4&selectaction=Edit&uid=U00019IE&ts=2&cx=uwje3h. Protocol-version 2: 27/01/2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01674-1.
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Ortega L, Lobos-González L, Reyna-Jeldes M, Cerda D, De la Fuente-Ortega E, Castro P, Bernal G, Coddou C. Corrigendum to "The Ω-3 fatty acid docosahexaenoic acid selectively induces apoptosis in tumor-derived cells and suppress tumor growth in gastric cancer" [Eur. J. Pharmacol. (2021) 173910]. Eur J Pharmacol 2021; 906:174287. [PMID: 34183147 DOI: 10.1016/j.ejphar.2021.174287] [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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