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Maria Mercedes T, Romero M, Ortiz R, Gomez F, Castro J, Andrade R. 2518 Dysregulation of EMT-related microRNAs precedes the expression of cancer cell stemness regulators during prostate carcinogenesis. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31337-5] [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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Wrzosek M, Laviv A, Goldwaser B, Ortiz R, Troulis M, Kaban L. Analysis of Resident Time Spent in Traditional Versus Virtual Treatment Planning for Orthognathic Surgery. J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.joms.2015.06.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hernandez M, Neninger E, Santiesteban E, Ortiz R, Amador R, Bello L, Acosta S, Flores Y, Cala M, Martínez O, Calana A, Pichs G, Robaina M, Sánchez L, Viada C, Valdez A, Mendoza I, Guerra P, Crombet T. 536 RANIDO trial: Racotumomab-alum vaccine, Nimotuzumab or Docetaxel as switch maintenance therapy for advanced NSCLC. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30337-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Parente A, Angulo J, Burgos L, Romero R, Rivas S, Ortiz R. Percutaneous Endopyelotomy over High Pressure Balloon for Recurrent Ureteropelvic Junction Obstruction in Children. J Urol 2015; 194:184-9. [DOI: 10.1016/j.juro.2015.01.074] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2015] [Indexed: 11/16/2022]
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Chen JL, Ortiz R, Xiao Y, Steele TWJ, Stuckey DC. Rapid fluorescence-based measurement of toxicity in anaerobic digestion. WATER RESEARCH 2015; 75:123-130. [PMID: 25768985 DOI: 10.1016/j.watres.2015.02.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 02/17/2015] [Accepted: 02/18/2015] [Indexed: 06/04/2023]
Abstract
A rapid fluorescence measurement based on resazurin reduction was developed and applied for the detection of toxicants/inhibitors to anaerobic digestion metabolism. By initially using a pure facultative anaerobic strain, Enterococcus faecalis as a model organism, this technique proved to be fast and sensitive when detecting the model toxicant, pentachlorophenol (PCP). The technique revealed significant metabolic changes in Enterococcus faecalis with a PCP spike ranging from 0.05 to 100 mg/L, and could detect PCP's toxicity to E. faecalis at a concentration of only 0.05 mg/L in 8 min. Furthermore, by extending this technique to a mixed anaerobic sludge, not only could the effect of 0.05-100 mg/L PCP be determined on anaerobic digestion metabolism within 10 min, but also its rate of biogas production. These results suggest that a resazurin-based fluorescence measurement can potentially be incorporated into a microfluidic system to develop a biosensor for the real-time monitoring, control and early warning of toxicant/inhibitor loads in the influent to an anaerobic digestion system.
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Langer M, Taggart R, Ortiz R, Lewis G. Sustained acoustic medicine provides pain relief for osteoarthritis of the knee. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gilbert C, Ortiz R, Ma Y, Lee H, Yarmus L, Wang K. Transbronchial Needle Aspiration (TBNA): Past Present and Future. CURRENT RESPIRATORY MEDICINE REVIEWS 2015. [DOI: 10.2174/1573398x10666141118232214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Chen JL, Ortiz R, Steele TWJ, Stuckey DC. Toxicants inhibiting anaerobic digestion: a review. Biotechnol Adv 2014; 32:1523-34. [PMID: 25457225 DOI: 10.1016/j.biotechadv.2014.10.005] [Citation(s) in RCA: 237] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 10/08/2014] [Accepted: 10/08/2014] [Indexed: 01/18/2023]
Abstract
Anaerobic digestion is increasingly being used to treat wastes from many sources because of its manifold advantages over aerobic treatment, e.g. low sludge production and low energy requirements. However, anaerobic digestion is sensitive to toxicants, and a wide range of compounds can inhibit the process and cause upset or failure. Substantial research has been carried out over the years to identify specific inhibitors/toxicants, and their mechanism of toxicity in anaerobic digestion. In this review we present a detailed and critical summary of research on the inhibition of anaerobic processes by specific organic toxicants (e.g., chlorophenols, halogenated aliphatics and long chain fatty acids), inorganic toxicants (e.g., ammonia, sulfide and heavy metals) and in particular, nanomaterials, focusing on the mechanism of their inhibition/toxicity. A better understanding of the fundamental mechanisms behind inhibition/toxicity will enhance the wider application of anaerobic digestion.
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Qiao Y, Haertel J, Voon YT, Ortiz R, Agar D. Power-to-Gas: Chemische Speicherung regenerativer Energie durch eine Sabatier-Reaktion. CHEM-ING-TECH 2014. [DOI: 10.1002/cite.201450221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Ortiz R, Domínguez E, López Fernández S, Miguel M, Pérez-Grueso FS, Martínez L, Tovar JA. [Cervico-sternotomy for thoracic inlet conditions in children]. CIRUGIA PEDIATRICA : ORGANO OFICIAL DE LA SOCIEDAD ESPANOLA DE CIRUGIA PEDIATRICA 2014; 27:125-130. [PMID: 25845101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND/AIM Neither cervicotomy nor postero-lateral thoracotomy allow safe surgical access to the lower cervical spine and high posterior mediastinum with full control of the vascular and neural structures involved. We report our favorable experience with cervico-sternotomy for accessing this region. PATIENTS AND METHODS Six patients were operated upon between 1998 and 2011 for either removal of huge cervico-thoracic neural ganglioneuromas (n = 2) or anterior arthrodesis for congenital (n = 2), neuropathic (n = 1) or osteolytic scoliosis (n = 1). In all cases, cervicotomy was followed by sternotomy, thymectomy, division of the innominate vein and dissection of jugular veins, carotid arteries and vagus nerves. RESULTS The tumors measured 10.9 x 3.9 x 8.7 cm and 8 x 6 x 5 cm, and involved the paravertebral chain from the aortic arch to the base of the skull and from the left lung hilus to the thyroid region respectively. In the scoliosis patients, anterior vertebral fixation between C5 and T5 was readily feasible. Blood transfusion was avoided. Horner's syndrome and transient lymphedema were the only complications. Median operative time was 210 minutes (range 180-240 minutes) and median estimated blood loss was 2.7 cc/kg (0-13.8 cc/kg). Median hospital stay was 7 days (range 5-18 days). CONCLUSIONS Cervico-sternotomy is an optimal approach for this anatomical region in children. It offers better exposure of the anterior cervico-thoracic spine and the thoracic inlet than cervicotomy or thoracotomy. Control of the nervous and vascular structures was safely achieved in all cases and postoperative discomfort was surprisingly limited.
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Mills A, Crofoot G, Ortiz R, Rashbaum B, Towner W, Ward D, Brinson C, Kulkarni R, Garner W, Ebrahimi R, Cao H, Cheng A, Szwarcberg J. Switching from twice-daily raltegravir plus tenofovir disoproxil fumarate/emtricitabine to once-daily elvitegravir/cobicistat/emtricitabine/tenofovir disoproxil fumarate in virologically suppressed, HIV-1-infected subjects: 48 weeks data. HIV CLINICAL TRIALS 2014; 15:51-6. [PMID: 24710918 DOI: 10.1310/hct1502-51] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Pill burden, dosing frequency, and concerns about safety and tolerability are important obstacles to maintaining adequate medication adherence. Raltegravir (RAL) is indicated for twice-daily dosing and when taken with emtricitabine (FTC)/tenofovir disoproxil fumarate (TDF), it becomes a twice-daily multiple-tablet regimen. Elvitegravir (EVG)/cobicistat (COBI)/FTC/TDF, STB, is the first approved once-a-day integrase strand transfer inhibitor (INSTI) containing single-tablet regimen that combines EVG, an INSTI, and COBI, a novel pharmacoenhancer, with the preferred nucleos(t)ide backbone of FTC/TDF. METHODS This was a 48-week prospective, single-arm open-label study of the switch to STB in virologically sup-pressed HIV-1-infected adult patients on FTC/TDF and twice-daily RAL for at least 6 months. Objectives were to evaluate the tolerability and safety of a regimen simplification to once-a-day STB, while maintaining viral suppression through 48 weeks. RESULTS Forty-eight individuals in the United States were enrolled. The median age was 44 years, 96% were male, and 83% were White. The median time on RAL + FTC/TDF treatment prior to enrollment was 34 months. Ninety-six percent of participants cited regimen simplification as the reason to enroll in the switch study. At base-line, the median CD4 count was 714 cell/µL and estimated glomerular filtration rate (eGFR) was 105 mL/min. At week 48, all assessed study participants remained viro-logically suppressed to the lower limit of quantification (HIV-1 RNA<50 copies/mL) and maintained high CD4 cell count (median, 751 cells/mL) and stable eGFR (median, 100.5 mL/min). STB was well tolerated with no discontinuations, no study drug-related serious adverse events, and no study drug-related grade 3/4 adverse events. CONCLUSIONS All participants switching to 1 tablet once-a-day STB from a twice-daily RAL + FTC/TDF regimen remained virologically suppressed. STB was well tolerated. Switching to STB may be a viable option for virologically suppressed patients wanting to simplify from a twice-daily RAL-containing regimen.
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Ortiz R, Moreno-Flores S, Quintana I, Vivanco M, Sarasua J, Toca-Herrera J. Ultra-fast laser microprocessing of medical polymers for cell engineering applications. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2014; 37:241-50. [DOI: 10.1016/j.msec.2013.12.039] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 12/11/2013] [Accepted: 12/27/2013] [Indexed: 01/20/2023]
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Prados J, Melguizo C, Ortiz R, Perazzoli G, Cabeza L, Alvarez PJ, Rodriguez-Serrano F, Aranega A. Colon cancer therapy: recent developments in nanomedicine to improve the efficacy of conventional chemotherapeutic drugs. Anticancer Agents Med Chem 2014; 13:1204-16. [PMID: 23574385 DOI: 10.2174/18715206113139990325] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 02/27/2013] [Accepted: 02/28/2013] [Indexed: 11/22/2022]
Abstract
The number of patients with colorectal cancer, the third most frequently diagnosed malignancy in the world, has increased markedly over the past 20 years and will continue to increase in the future. Despite recent advances in chemotherapy, currently used anticancer molecules are unable to improve the prognosis of advanced or recurrent colorectal cancer, which remains incurable. The transport of classical drugs by nanoparticles has shown great promise in terms of improving drug distribution and bioavailability, increasing tissue half-life and concentrating anticancer molecules in the tumor mass, providing optimal drug delivery to tumor tissue, and minimizing drug toxicity, including those effects associated with pharmaceutical excipients. In addition, colon cancer targeting may be improved by incorporating ligands for tumor-specific surface receptors. Similarly, nanoparticles may interact with key drug-resistance molecules to prevent a reduction in intracellular drug levels drug. Recently published data have provided convincing pre-clinical evidence regarding the potential of active-targeted nanotherapeutics in colon cancer therapy, although, unfortunately, only a few of these therapies have been translated into early-phase clinical trials. As nanotechnology promises to be a new strategy for improving the prognosis of colon cancer patients, it would be very useful to analyze recent progress in this field of research. This review discusses the current status of nanoparticle-mediated cancer-drug delivery, the challenges restricting its application, and the potential implications of its use in colon cancer therapy.
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Stratton P, Sinaii N, Khachikyan I, Ortiz R, Gemmill J, Shah J. Interrelationship among levator spasm, sensitization, myofascial dysfunction, anxiety and depression in patients with endometriosis and chronic pelvic pain. Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.07.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Alvarez P, Carrillo E, Vélez C, Hita-Contreras F, Martínez-Amat A, Rodríguez-Serrano F, Boulaiz H, Ortiz R, Melguizo C, Prados J, Aránega A. Regulatory systems in bone marrow for hematopoietic stem/progenitor cells mobilization and homing. BIOMED RESEARCH INTERNATIONAL 2013; 2013:312656. [PMID: 23844360 PMCID: PMC3703413 DOI: 10.1155/2013/312656] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 04/22/2013] [Accepted: 05/24/2013] [Indexed: 12/14/2022]
Abstract
Regulation of hematopoietic stem cell release, migration, and homing from the bone marrow (BM) and of the mobilization pathway involves a complex interaction among adhesion molecules, cytokines, proteolytic enzymes, stromal cells, and hematopoietic cells. The identification of new mechanisms that regulate the trafficking of hematopoietic stem/progenitor cells (HSPCs) cells has important implications, not only for hematopoietic transplantation but also for cell therapies in regenerative medicine for patients with acute myocardial infarction, spinal cord injury, and stroke, among others. This paper reviews the regulation mechanisms underlying the homing and mobilization of BM hematopoietic stem/progenitor cells, investigating the following issues: (a) the role of different factors, such as stromal cell derived factor-1 (SDF-1), granulocyte colony-stimulating factor (G-CSF), and vascular cell adhesion molecule-1 (VCAM-1), among other ligands; (b) the stem cell count in peripheral blood and BM and influential factors; (c) the therapeutic utilization of this phenomenon in lesions in different tissues, examining the agents involved in HSPCs mobilization, such as the different forms of G-CSF, plerixafor, and natalizumab; and (d) the effects of this mobilization on BM-derived stem/progenitor cells in clinical trials of patients with different diseases.
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Prados J, Alvarez PJ, Melguizo C, Rodriguez-Serrano F, Carrillo E, Boulaiz H, Vélez C, Marchal JA, Caba O, Ortiz R, Rama A, Aranega A. How is gene transfection able to improve current chemotherapy? The role of combined therapy in cancer treatment. Curr Med Chem 2012; 19:1870-88. [PMID: 22414080 DOI: 10.2174/092986712800099820] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Revised: 02/08/2012] [Accepted: 02/13/2012] [Indexed: 11/22/2022]
Abstract
Despite advances in cancer treatment, a large number of patients eventually develop metastatic disease that is generally incurable. Systemic chemotherapy remains the standard treatment for these patients. Several chemotherapeutic combinations have proven effective in the management of cancer. Paradoxically, although the purpose of polychemotherapy is to improve the prognosis and prolong the survival of patients, it often carries considerable toxicity that causes substantial adverse symptoms. For this reason, a major goal of cancer research is to improve the effectiveness of these cytotoxic agents and reduce their adverse effects. Gene transfer has been proposed as a new strategy to enhance the efficacy of anti-tumor drugs in the treatment of intractable or metastatic cancers. In fact, the association of gene therapy and drugs (combined therapy) has been reported to increase the anti-proliferative effect of classical treatments in lung, bladder, pancreatic, colorectal and breast cancers, among others. Various especially promising therapies have been proposed in this context, including the use of suicide genes, antisense oligonucleotides, ribozymes and RNA interference. In this chapter, we review recent progress in the development of novel anti-cancer strategies that associate cytotoxic agents with gene transfer to enhance their antitumor effect.
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Hernández G, Ortiz R, Pedrosa A, Cuena R, Vaquero Collado C, González Arenas P, García Plaza S, Canabal Berlanga A, Fernández R. The indication of tracheotomy conditions the predictors of time to decannulation in critical patients. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.medine.2012.10.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Marti J, Diez-Gil JL, Ortiz R. Conduction model for the thermal influence of lithic clasts in mixtures of hot gases and ejecta. ACTA ACUST UNITED AC 2012. [DOI: 10.1029/91jb02149] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Nicholson JW, Meng L, Fini JM, Windeler RS, DeSantolo A, Monberg E, DiMarcello F, Dulashko Y, Hassan M, Ortiz R. Measuring higher-order modes in a low-loss, hollow-core, photonic-bandgap fiber. OPTICS EXPRESS 2012; 20:20494-20505. [PMID: 23037097 DOI: 10.1364/oe.20.020494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
We perform detailed measurements of the higher-order-mode content of a low-loss, hollow-core, photonic-bandgap fiber. Mode content is characterized using Spatially and Spectrally resolved (S2) imaging, revealing a variety of phenomena. Discrete mode scattering to core-guided modes are measured at small relative group-delays. At large group delays a continuum of surface modes and core-guided modes can be observed. The LP11 mode is observed to split into four different group delays with different orientations, with the relative orientations preserved as the mode propagates through the fiber. Cutback measurements allow for quantification of the loss of different individual modes. The behavior of the modes in the low loss region of the fiber is compared to that in a high loss region of the fiber. Finally, a new measurement technique is introduced, the sliding-window Fourier transform of high-resolution transmission spectra of hollow-core fibers, which displays the dependence of HOM content on both wavelength and group delay. This measurement is used to illustrate the HOM content as function of coil diameter.
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Valdes G, Schneider D, Corthorn J, Ortiz R. OS059. Blockade of the bradykinin B2 receptor in early pregnancy reduces fetal growth and trophoblast invasion in guinea-pigs. Pregnancy Hypertens 2012; 2:208-9. [DOI: 10.1016/j.preghy.2012.04.060] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Rosado-Pérez J, Santiago-Osorio E, Ortiz R, Mendoza-Núñez VM. Tai chi diminishes oxidative stress in Mexican older adults. J Nutr Health Aging 2012; 16:642-6. [PMID: 22836707 DOI: 10.1007/s12603-012-0029-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To determine the effect of Tai Chi on oxidative stress in a population of elderly Mexican subjects. DESIGN It was carried out a quasi-experimental study with a sample of 55 healthy subjects randomly divided into two age-matched groups: (i) a control group with 23 subjects and (ii) an experimental group with 32 subjects. The experimental group received daily training in Tai Chi for 50 min. MEASUREMENTS It was measured before and after 6-month of exercise period: thiobarbituric acid reactive substances (TBARS), total antioxidant status (TAS), superoxide dismutase (SOD), and glutathione peroxidase (GPx). RESULTS It was found that the experimental group exhibited a statistically significant decrease in glucose levels, total cholesterol, low-density lipoprotein cholesterol (LDLC), and systolic blood pressure, as well as an increase in SOD and GPx activity and TAS compared with the control group (p < 0.05). CONCLUSIONS Our findings suggest that the daily practice of Tai Chi is useful for reducing OxS in healthy older adults.
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Zaidat O, Meagher S, Brant-Zawadzki M, Farkas J, Malek R, Crandall B, Frei D, Hui F, Alexander M, Chong B, Janjua N, Shaff D, Yavagal D, Heck D, Malisch T, Turk, III A, Hayakawa M, Miskolczi L, Tarr R, Ortiz R, Zauner A, Klucznik R, Zylak C, Yoo A, Mualem E, Bose A, Sit SP, For the PICS Investigators. Image Guided Patient Selection and Its Impact on Outcome: Results of the Penumbra Imaging Collaborative Study (PICS) (S03.004). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s03.004] [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] Open
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Zaidat O, Meagher S, Brant-Zawadzki M, Farkas J, Malek R, Crandall B, Frei D, Hui F, Alexander M, Chong B, Janjua N, Shaff D, Yavagal D, Heck D, Malisch T, Turk, III A, Hayakawa M, Miskolczi L, Tarr R, Ortiz R, Zauner A, Klucznik R, Zylak C, Yoo A, Mualem E, Bose A, Sit SP, For the PICS Investigators. Image Guided Patient Selection and Its Impact on Outcome: Results of the Penumbra Imaging Collaborative Study (PICS) (IN2-1.002). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.in2-1.002] [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] Open
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Gutiérrez R, Vega S, Radilla C, Radilla M, Ramírez A, Pérez JJ, Schettino B, Ramírez ML, Ortiz R, Fontecha J. La importancia de los ácidos grasos en la leche materna y en las fórmulas lácteas. GRASAS Y ACEITES 2012. [DOI: 10.3989/gya.083411] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Hernández G, Ortiz R, Pedrosa A, Cuena R, Vaquero Collado C, González Arenas P, García Plaza S, Canabal Berlanga A, Fernández R. The indication of tracheotomy conditions the predictors of time to decannulation in critical patients. Med Intensiva 2012; 36:531-9. [PMID: 22398327 DOI: 10.1016/j.medin.2012.01.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Revised: 12/08/2011] [Accepted: 01/22/2012] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Variables predicting optimal timing for tracheostomy decannulation remain unknown. We aimed to determine whether classifying patients into two groups according to their indications for tracheostomy could identify variables associated with time to decannulation. DESIGN A prospective, observational cohort study was carried out. LOCATION Two medical-surgical ICUs. PATIENTS We included all patients tracheostomized during ICU stay, excluding patients with do-not-resuscitate orders, tracheostomies for long-term airway control, neuromuscular disease, or neurological damage. Patients were classified into two groups: patients tracheostomized due to prolonged weaning and/or prolonged mechanical ventilation (Group 1), and patients tracheostomized due to low level of consciousness or inability to manage secretions (Group 2). INTERVENTIONS Patients were weaned and decannulated according to established protocols. MAIN VARIABLES We recorded the following variables: time to tracheostomy, forced vital capacity, peak flow, suctioning requirements, Glasgow Coma Score (GCS), characteristics of respiratory secretions, and swallowing function. Statistical analyses included Cox-proportional multivariate analysis with time to decannulation as the dependent variable. RESULTS A total of 227 patients were tracheostomized in the ICUs; of these, 151 were finally included in the study. In the multivariate analysis, time to decannulation in Group 1 was associated with the male gender (HR 1.74 (1.04-2.89), p= 0.03), age>60 years (HR 0.58 (0.36-0.91), p= 0.02), high suctioning frequency (HR 0.81 (0.67-0.97), p= 0.02), low forced vital capacity (HR 0.48 (0.28-0.82), p<0.01), and low peak flow (HR 0.25 (0.14-0.46), p<0.01). In Group 2 time to decannulation was associated to GCS >13 (HR 2.73 (1.51-4.91), p<0.01), high suctioning frequency (HR 0.7 (0.54-0.91), p<0.01), and inadequate swallowing (HR 1.97 (1.11-3.52), p=0.02). CONCLUSION Variables associated with longer time to decannulation in ICU-tracheostomized patients differ with the indications for tracheostomy.
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