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Santos F, Dragomir A, Kassouf W, Franco E, Aprikian A. Urologist referral delay and its impact on survival after radical cystectomy for bladder cancer. ACTA ACUST UNITED AC 2015; 22:e20-6. [PMID: 25684993 DOI: 10.3747/co.22.2052] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Evidence shows that wait times before bladder cancer surgery have been increasing, and wait time can negatively affect survival. We aimed to determine if a long delay caused by an indirect referral before a first urologist visit affects the survival of patients undergoing radical cystectomy for bladder cancer. METHODS We analyzed data from 1271 patients who underwent surgery for bladder cancer during the decade 2000-2009. The cohort was obtained by linking two administrative databases in the province of Quebec. Patients were considered to have been directly referred to a urologist if they had 5 or fewer visits with a general practitioner before their first urologist visit; otherwise, they were considered to have been indirectly referred. The effect on survival after surgery of a longer delay before a first urologist visit was assessed using Cox regression models. RESULTS Median referral delay for the study population was 30 days (56 days for women, 23 days for men; p < 0.0001). Indirect referral was observed for 49% of women and 33% of men. Compared with patients who were directly referred, those who were indirectly referred after first symptoms of bladder cancer experienced poorer survival (hazard ratio: 1.29; 95% confidence interval: 1.10 to 1.52). Women who were indirectly referred had a significant 47% greater risk of death after radical cystectomy. Men who were indirectly referred also experienced decreased survival (adjusted hazard ratio: 1.25; 95% confidence interval: 1.03 to 1.51). CONCLUSIONS Patients indirectly referred to a urologist had an increased risk of mortality after surgery. Compared with men, women had longer wait times and poorer survival.
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Perce-da-Silva DS, Silva LA, Lima-Junior JC, Cardoso-Oliveira J, Ribeiro-Alves M, Santos F, Porto LCMS, Oliveira-Ferreira J, Banic DM. Killer cell immunoglobulin-like receptor (KIR) gene diversity in a population naturally exposed to malaria in Porto Velho, Northern Brazil. ACTA ACUST UNITED AC 2015; 85:190-9. [PMID: 25656387 DOI: 10.1111/tan.12523] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Revised: 11/10/2014] [Accepted: 01/13/2015] [Indexed: 11/28/2022]
Abstract
Killer cell immunoglobulin-like receptors (KIR) are expressed mainly in natural killer cells and specifically recognize human leukocyte antigen (HLA) class I molecules. The repertoire of KIR genes and KIR-HLA pairs is known to play a key role in the susceptibilities to and the outcomes of several diseases, including malaria. The aim of this study was to investigate the distribution of KIR genes, KIR genotypes and KIR-HLA pair combinations in a population naturally exposed to malaria from Brazilian Amazon. All 16 KIR genes investigated were present in the studied population. Overall, 46 KIR genotypes were defined. The two most common genotypes in the Porto Velho communities, genotypes 1 and 2, were present at similar frequencies as in the Americas. Principal component analysis based on the frequencies of the KIR genes placed the Porto Velho population closer to the Venezuela Mestizos, USA California hispanic and Brazil Paraná Mixed in terms of KIR gene frequencies. This analysis highlights the multi-ethnic profile of the Porto Velho population. Most of the individuals were found to have at least one inhibitory KIR-HLA pair. Seventy-five KIR-HLA pair combinations were identified. The KIR-2DL2/3_HLA-C1, KIR3DL1_HLA-Bw4 and KIR2DL1_HLA-C2 pairs were the most common. There was no association between KIR genes, KIR genotypes or KIR-HLA pair combinations and malaria susceptibility in the studied population. This is the first report on the distribution of KIR and known HLA ligands in the Porto Velho population. Taken together, these results should provide baseline information that will be relevant to population evolutionary history, malaria and other diseases studies in populations of the Brazilian Amazon.
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Santos F, Pinho S, Costa A. Continuous popliteal sciatic nerve block after day-care foot surgery. Anaesthesia 2015; 70:231-2. [PMID: 25583193 DOI: 10.1111/anae.12995] [Citation(s) in RCA: 1] [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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Vieira SD, Rabbani ARC, Santos F, Silva-Mann R, Arrigoni-Blank MF, Prata APN, Resende LV, Pasqual M, Blank AF. Molecular characterization of bromeliads from northeast Brazil. GENETICS AND MOLECULAR RESEARCH 2014; 13:9851-60. [PMID: 25501194 DOI: 10.4238/2014.november.27.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Bromeliaceae is an important botany family that includes many species with economic value; demand for members of this family is increasing. However, illegal collection frequently occurs, drastically reducing the species populations; thus, it is necessary to collect and store Bromeliaceae genetic material. In this study, we identified and quantified genetic variability of the Bromeliad family using dominant markers to create the first Germplasm Bank in the northeast region of Brazil. Molecular tools were used to characterize the collected accessions. The combination of 11 inter-simple sequence repeats and 13 random amplified polymorphic DNA markers were used to detect the genetic variability of wild bromeliad accessions.
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Araújo F, Sepriano A, Madureira P, Aguiar R, Bernardo A, Silva C, Sousa E, Santos F, Sequeira G, Canhão H, Santos H, Garcia J, Pereira Silva J, Canas Silva J, Oliveira M, Salvador M, Nero P, Monteiro P, Nόvoa T, Branco J. AB0660 Predictive Factors of Treatment Response to A Second Tnf-α Inhibitor in Patients with Ankylosing Spondylitis - Results from the Portuguese Register Reuma.Pt. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Santos F, Leal DC, Raso TF, Souza BMPS, Cunha RM, Martinez VHR, Barrouin-Melo SM, Franke CR. Risk factors associated with Chlamydia psittaci infection in psittacine birds. J Med Microbiol 2014; 63:458-463. [DOI: 10.1099/jmm.0.060632-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Chlamydia psittaci is the aetiological agent of chlamydiosis in birds, especially Psittaciformes. The objective of the present study was to detect C. psittaci by means of semi-nested PCR among psittacine birds sold at pet markets and kept as pet birds in Salvador, Bahia, Brazil. Questionnaires were used to identify risk factors involved in the epidemiology of the disease. In addition, the management of birds and cages was observed at each location studied. The frequency of C. psittaci infection was 10.6 % (33/311) in the psittacine birds studied. Birds kept in households were less frequently positive (3.4 %; 5/148) than those at pet markets (17.2 %; 28/163). Among the several factors analysed in the epidemiology of the disease, only population density (P = 0.001) and cage hygiene (P = 0.041) in birds at pet markets were significantly associated with C. psittaci infection. These results demonstrate the presence of C. psittaci infection in Psittaciformes kept as pets and held at pet markets in Salvador, Bahia, showing that this micro-organism is a public health concern. Control measures should be encouraged to prevent the spread of the agent among birds, as well as among employees and customers.
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Goulão V, Lafuente E, Silva J, Fernandes M, Santos F, Ferreira A. Evaluation of functional differences between two anticoagulation methods used in continuous renal replacement therapy in critical patients. Crit Care 2014. [PMCID: PMC4069852 DOI: 10.1186/cc13585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Souto C, Santos F, Fortunato M, Fernandez G, Roldão M. Assessment of dose constraints of the organs at risk on HDR brachytherapy of cervical cancer based on 3D-CT images: Dose prescription to the target volume versus the point A planning method. Phys Med 2014. [DOI: 10.1016/j.ejmp.2014.07.236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Holland C, Carey L, Santos F. Interprofessional Rounds: New Rhythm of the Cardiac ICU. Can J Cardiol 2013. [DOI: 10.1016/j.cjca.2013.07.782] [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] Open
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Ferreira J, Mostarda C, Dal Lago P, Santos F, Consolim-Colombo F, Irigoyen MC. Inspiratory loaded exercises improve cardiovascular vagal modulation and barorreflex sensitivity in subjects with hypertension. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Alvarez A, Moreno P, Santos F, Vaquero J, Baamonde C, Algar F, Cerezo F, Salvatierra A. B-002EXTENDED RECIPIENTS BUT NOT EXTENDED DONORS ARE ASSOCIATED WITH POOR OUTCOMES FOLLOWING LUNG TRANSPLANTATION. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt288.2] [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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Santos F, Mourao A, Vieira-Sousa E, Costa J, Santos H, Barcelos A, Tavares V, Fonseca J, Rabiais S, Felix J, Branco J. AB0881 Quality of life determines sick leave in ankylosing spondylitis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Arango E, Espinosa D, Illana J, Carrasco G, Moreno P, Algar FJ, Alvarez A, Cerezo F, Baamonde C, Requejo A, Redel J, Vaquero J, Santos F, Salvatierra A. Lung volume reduction surgery after lung transplantation for emphysema-chronic obstructive pulmonary disease. Transplant Proc 2013; 44:2115-7. [PMID: 22974928 DOI: 10.1016/j.transproceed.2012.07.068] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Lung Volume Reduction Surgery (LVRS) has become a palliative treatment for patients with advanced emphysema and disabling dyspnea. After single lung transplantation in chronic obstructive pulmonary disease, LVRS may be indicated to improve graft dysfunction caused by native lung hyperinflation compressing the grafted lung. This common complication is the subject of our study, which showed LVRS to be helpful to manage this situation. We performed an observational retrospective and descriptive study using the data of 293 patients transplanted in our center between January 1996 and October 2011. Some of the patients who underwent a single lung transplantation developed native lung hyperinflation years after the transplantation, interfering with respiratory function due to graft compression.
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de Pablo A, Santos F, Solé A, Borro JM, Cifrian JM, Laporta R, Monforte V, Román A, de la Torre M, Ussetti P, Zurbano F. Recommendations on the use of everolimus in lung transplantation. Transplant Rev (Orlando) 2012; 27:9-16. [PMID: 23276646 DOI: 10.1016/j.trre.2012.11.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 11/09/2012] [Indexed: 01/05/2023]
Abstract
The antiproliferative effect of everolimus provides a therapeutic option in the immunosuppression therapy of lung transplantation, by reducing both the risk of acute rejection and the process of progressive fibrosis that determines chronic graft rejection. However, few data on the use of everolimus in lung transplantation have been published to date, and the specific indications of the drug, along with the most adequate time for its introduction or dosing, have not been defined yet. The aim of this article is to propose recommendations for the use of everolimus in lung transplant recipients, including indications, dosing schedules and the use of concomitant immunosuppression. This consensus document has been developed by experts of all the Spanish lung transplant groups from the review of the existing literature and the clinical experience.
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Prista A, Lopes V, Saranga S, Nhantumbo L, Santos F, Maia J. A cross cultural comparison of sedentary behavior of African and European youth. J Sci Med Sport 2012. [DOI: 10.1016/j.jsams.2012.11.021] [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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Espinosa D, Baamonde C, Illana J, Arango E, Carrasco G, Moreno P, Algar F, Álvarez A, Cerezo F, Santos F, Vaquero J, Redel J, Salvatierra A. Lung Cancer in Patients With Lung Transplants. Transplant Proc 2012; 44:2118-9. [DOI: 10.1016/j.transproceed.2012.07.067] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Ferreira A, Esperto H, Canha C, Aragão A, Santos F, Teixeira Verissimo M, Nascimento Costa J. Using the STOPP and START criteria on an internal medicine ward (January–March 2012). Eur Geriatr Med 2012. [DOI: 10.1016/j.eurger.2012.07.303] [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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Pinheiro C, Santos F, Miranda-Goncalves V, Boccardo E, Lepique A, Longatto-Filho A, Villa L, Baltazar F. 469 Role of Monocarboxylate Transporters (MCTs) in the Regulation of the Metabolic Profile of Cervical Cancer Cells by Hypoxia. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71142-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Santos F, Pinheiro C, Miranda-Goncalves V, Vieira A, Paredes J, Schmitt F, Baltazar F. 453 Regulation of the Metabolic Profile of Breast Cancer Cells by Hypoxia. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)71126-7] [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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Santos H, Isidoro L, Leite A, Costa C, Santos F. Rombencefalitis por enterovirus. An Pediatr (Barc) 2012; 76:243-5. [DOI: 10.1016/j.anpedi.2011.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2011] [Revised: 10/11/2011] [Accepted: 10/31/2011] [Indexed: 10/14/2022] Open
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Roman A, Ussetti P, Zurbano F, Borro JM, Solé A, Carreño MC, Santos F. A retrospective 12-month study of conversion to everolimus in lung transplant recipients. Transplant Proc 2012; 43:2693-8. [PMID: 21911148 DOI: 10.1016/j.transproceed.2011.06.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Revised: 05/16/2011] [Accepted: 06/06/2011] [Indexed: 12/22/2022]
Abstract
BACKGROUND Everolimus has potent antifibrotic effects that may potentially affect the clinical course of bronchiolitis obliterans syndrome (BOS) or provide nephroprotective immunosuppressive regimens for lung transplantation. METHODS We retrospectively assessed the 12-month outcomes of the conversion to everolimus among lung recipients in six Spanish centers. RESULTS From March 2005 to December 2007, 65 lung recipients who were at a mean posttransplantation time of 10.2 ± 7.9 months were converted to everolimus, mainly because of BOS (64.6%) or renal insufficiency (RI; 12.3%). The initial dose of everolimus was 1.9 ± 0.6 mg/d and the mean blood trough levels were stable over time (6.4 ± 2.8 ng/mL at 12 months). Conversion to everolimus allowed us to eliminate the calcineurin inhibitor (CNI) in 21% of patients. Among the overall population, the forced expiratory volume at 1 second (FEV(1)) and renal function remained stable. Mean FEV(1) did not change among the 35 (81%) patients surviving BOS at 12 months: preconversion FEV(1): 1.449.5 ± 641.9 mL vs 12-month FEV(1): 1420.0 ± 734.6 mL (P = .866). There was a significant improvement in renal function among the RI patients with mean glomerular filtration rates of 42.2 ± 15.2 mL/min/1.73 m(2) (P = .043) at 6 and 44.4 ± 18.8 mL/min/1.73 m(2) at 12 months, (P = .063) and a decrease in the use of CNIs from 1% of RI patients preconversion to 57% at 6 and 75% at 12 months. With a mean of 8.1- months follow-up (range: 1-31.3) overall survival was 84.6% at 1 year and 50% at 22.3 months. Progressive BOS was the main cause of death. Reasons for everolimus discontinuation were patient death (n = 10), lack of efficacy (n = 4), gastrointestinal adverse events (n = 2), and edema (n = 2). CONCLUSIONS BOS and RI were the main indications for conversion to everolimus among lung recipients. Conversion to everolimus improved renal function among patients converted because of RI. The present results were inconclusive regarding effects of everolimus on BOS.
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Stefano JT, Cogliati B, Santos F, Lima VMR, Mazo DC, Matte U, Alvares-da-Silva MR, Silveira TR, Carrilho FJ, Oliveira CPMS. S-Nitroso-N-acetylcysteine induces de-differentiation of activated hepatic stellate cells and promotes antifibrotic effects in vitro. Nitric Oxide 2011; 25:360-5. [PMID: 21820071 DOI: 10.1016/j.niox.2011.07.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Revised: 06/22/2011] [Accepted: 07/04/2011] [Indexed: 01/24/2023]
Abstract
Nitric oxide (NO) has been shown to act as a potent antifibrogenic agent by decreasing myofibroblast differentiation. S-Nitroso-N-acetylcysteine (SNAC), a NO donor, attenuates liver fibrosis in rats, but the cellular and molecular mechanisms on liver myofibroblast-like phenotype still remain unknown. Here, we investigate the antifibrotic effects of SNAC on hepatic stellate cells, the major fibrogenic cell type in the liver. A murine GRX cell line was incubated with SNAC (100μM) or vehicle (control group) for 72h. Cell viability was measured by MTT colorimetric assay and the conversion of myofibroblast into quiescent fat-storing cell phenotype was evaluated by Oil-Red-O staining. TGFβ-1, TIMP-1, and MMP-13 levels were measure in the supernatant by ELISA. Profibrogenic- and fibrolytic-related gene expression was quantified using real-time qPCR. SNAC induced phenotype conversion of myofibroblast-like phenotype into quiescent cells. SNAC decreased gene and protein expression of TGFβ-1 and MMP-2 compared to control groups. Besides, SNAC down-regulated profibrogenic molecules and up-regulated MMP-13 gene expression, which plays a key role in the degradation of interstitial collagen in liver fibrosis. In conclusion, these findings demonstrate that SNAC efficiently can modulate the activation and functionality of murine hepatic stellate cells and could be considered as an antifibrotic treatment to human liver fibrosis.
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Santos F, Sheehy O, Perreault S, Ferreira E, Berard A. Exposure to anti-infective drugs during pregnancy and the risk of small-for-gestational-age newborns: a case-control study. BJOG 2011; 118:1374-82. [PMID: 21749628 DOI: 10.1111/j.1471-0528.2011.03041.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the association between anti-infective exposure during the last two trimesters of pregnancy and the risk of small-for-gestational-age (SGA) newborns. DESIGN Case-control study within the Québec Pregnancy Registry. SETTING Province of Québec, Canada. SAMPLE Analyses were performed on prospectively collected data of 63,338 pregnant women that met eligibility criteria for the study (8192 cases and 55,146 controls). METHODS Unconditional logistic regression models were used to quantify the association between exposure to anti-infective drugs and the risk of SGA. MAIN OUTCOME MEASURES A case of SGA was defined as a pregnancy resulting in a baby that weighs below the tenth percentile, adjusted for gestational age and gender, according to the Canadian gender-specific reference curves. A control was defined as a pregnancy resulting in a baby that weighs greater or equal to the tenth percentile, adjusted for gestational age and gender. RESULTS Exposure to all combined anti-infective drugs was not associated with the risk of SGA (OR 0.97; 95% CI 0.91-1.04). The use of sulfamethoxazole/trimethoprim was associated with SGA (OR 1.61; 95% CI 1.16-2.23), whereas the use of urinary anti-infective drugs decreased the risk (OR 0.80; 95% CI 0.65-0.97). CONCLUSIONS Exposure to sulfamethoxazole/trimethoprim during the last two trimesters of pregnancy was associated with SGA. Further research is needed to address the use of other therapeutic alternatives in the management of infections that predispose infants being born SGA in pregnant women with other risk factors for this condition.
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Santos F, Bley C, Helman R, Perini G, Esteves I, Silva L, Bello I, Ribeiro M, Araujo S, Kassab C, Esposito B, Nomura C, Kay F, Baroni R, Velloso E, Hamerschlak N. 349 Magnetic resonance imaging (MRI) detection of iron overload in patients with myelodysplastic syndrome (MDS). Leuk Res 2011. [DOI: 10.1016/s0145-2126(11)70351-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Espinosa D, Algar FJ, Moreno P, Illana J, Alvarez A, Cerezo F, Baamonde C, Santos F, Vaquero JM, Redel J, Salvatierra A. Experience of the Reina Sofia hospital in lobar lung transplantation. Transplant Proc 2011; 42:3214-6. [PMID: 20970656 DOI: 10.1016/j.transproceed.2010.05.048] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The number of patients awaiting lung transplantation has steadily increased over the past decade, but the number of donors has remained relatively stable. Owing to the increasing scarcity of donor lungs, especially for pediatric and small adult recipients, advanced operative strategies for the use of larger grafts for smaller recipients have been developed. Size matching between donors and recipients represents one of the organ distribution criteria widely accepted by lung transplantation teams. However, in some cases it is not possible to allocate a donor to the corresponding size-compatible recipient. To avoid possible complications derived from the implantation of oversized lungs into smaller recipients, various methods of downsizing are applied for cadaveric donor lungs, such as lobar transplantation. We review our experience in 6 patients undergoing volume reduction of the lung graft by lobar resection at the time of transplantation. Graft volume reduction by anatomic resection (lobar transplantation) is a reliable and safe procedure to overcome size disparities between the donor and the recipient of a lung transplant, and thus to maximize the number of donors.
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