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Torres-Torres C, López-Suárez A, Tamayo-Rivera L, Rangel-Rojo R, Crespo-Sosa A, Alonso JC, Oliver A. Thermo-optic effect and optical third order nonlinearity in nc-Si embedded in a silicon-nitride film. OPTICS EXPRESS 2008; 16:18390-18396. [PMID: 18958117 DOI: 10.1364/oe.16.018390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Using a self-diffraction experiment with 7ns pulses at 532nm we studied a silicon nitride film containing silicon nanoclusters (nc-Si) of 3.1+/-0.37 nm mean size. The sample was prepared by remote plasma-enhanced chemical vapor deposition (RPECVD), and we found that its nonlinearity consists of a combination of electronic and thermal contributions. By varying the repetition rate of the laser, we discriminated the responsible mechanisms for the nonlinear response. Using this procedure we determined a total /chi((3))1111/ = 3.3x10(-10)esu, n2 = 2.7x10(-16) m(2)/W, beta = 1x10(-9) m/W and dn/dT =1x10(-4) degrees C(-1) for our sample. We also show results for the optical Kerr effect using 80 fs pulses at 820 nm. The purely electronic nonlinearity measured is characterized by /chi((3))1111/=9.5 x10(-11) esu.
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Kraus C, Shahan J, Hsieh Y, Rothman R, Oliver A, Gamiel J, Laeyendecker O, Quinn T, Kelen G. 41: Seroprevalence of HSV-2 Infection Among an Urban Emergency Department Patient Population. Ann Emerg Med 2008. [DOI: 10.1016/j.annemergmed.2008.06.106] [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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103
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Kraus C, Shahan J, Rothman R, Hsieh Y, Laeyendecker O, Oliver A, Gamiel J, Quinn T, Kelen G. 2: Twenty Years Experience With HIV Testing among Emergency Department Patients at the Johns Hopkins Hospital. Ann Emerg Med 2008. [DOI: 10.1016/j.annemergmed.2008.06.067] [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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104
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Gamba C, Fernández E, Oliver A, Tirado M, Baeza C, López-Parra A, Arroyo-Pardo E. Population genetics and DNA preservation in ancient human remains from Eastern Spain. FORENSIC SCIENCE INTERNATIONAL GENETICS SUPPLEMENT SERIES 2008. [DOI: 10.1016/j.fsigss.2007.10.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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105
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Bragonzi A, Paroni M, Montanari S, Oliver A, Döring G, Tümmler B. PSEUDOMONAS AERUGINOSA PATHOGENICITY WITHIN CLONAL STRAINS FROM PATIENTS WITH CYSTIC FIBROSIS. J Cyst Fibros 2008. [DOI: 10.1016/s1569-1993(08)60535-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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106
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Oliver A, Alarcón T, Caballero E, Cantón R. Procedimientos en microbiología clínica (número 28, 2.ª edición 2008). Enferm Infecc Microbiol Clin 2008. [DOI: 10.1016/s0213-005x(08)72717-4] [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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107
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Oliver A, Freixenet J, Martí R, Pont J, Pérez E, Denton ERE, Zwiggelaar R. A novel breast tissue density classification methodology. ACTA ACUST UNITED AC 2008; 12:55-65. [PMID: 18270037 DOI: 10.1109/titb.2007.903514] [Citation(s) in RCA: 176] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
It has been shown that the accuracy of mammographic abnormality detection methods is strongly dependent on the breast tissue characteristics, where a dense breast drastically reduces detection sensitivity. In addition, breast tissue density is widely accepted to be an important risk indicator for the development of breast cancer. Here, we describe the development of an automatic breast tissue classification methodology, which can be summarized in a number of distinct steps: 1) the segmentation of the breast area into fatty versus dense mammographic tissue; 2) the extraction of morphological and texture features from the segmented breast areas; and 3) the use of a Bayesian combination of a number of classifiers. The evaluation, based on a large kappa = 0.81 and 0.67 for the two data sets) between automatic and expert-based Breast Imaging Reporting and Data System mammographic density assessment.
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108
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Couto-Parada X, Lee A, Ushiro-Lumb I, Anderson J, Baily G, Limb S, Noble H, Orkin C, Reeves I, Oliver A, Clark D. Evaluation of Roche Cobas Taqman Quantitative HIV-1 RNA PCR against other HIV-1 commercial viral load tests to examine potential under-quantification. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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109
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Borrell M, Tirado I, Mateo J, Oliver A, Santamaria A, Fontcuberta J. IgM anti-protein S antibodies as a risk factor for venous thrombosis. Haematologica 2008; 93:1115-7. [DOI: 10.3324/haematol.12575] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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110
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Santamaría A, Oliver A, Borrell M, Belvís R, Martí-Fábregas J, Mateo J, Fontcuberta J. Higher risk of ischaemic stroke associated with factor XI levels in dyslipidaemic patients. Int J Clin Pract 2007; 61:1819-23. [PMID: 17511793 DOI: 10.1111/j.1742-1241.2007.01388.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Ischaemic stroke (IS) is a complex disease that involves genetic and environmental factors. The role of factor XI (FXI) in arterial thrombosis is unclear. We have investigated the risk of IS related to FXI levels in a case-control study. METHODS We studied 445 individuals: 218 diagnosed with IS and 227 age-gender-ethnic matched control subjects. We measured factor VIIIc, fibrinogen and factor XIc levels. FXI < 144% was taken as the reference group in the statistical analysis. RESULTS There were 104 women and 114 men in the IS group and 108 women and 119 men in the control group. The crude odds ratio (OR) of IS in dyslipidaemic patients with high levels of FXI was 4.2 [95% confidence interval (CI): 1.2-14.8] compared with dyslipidaemic controls and low levels of FXI, but the OR in the non-dyslipidaemic with high levels of FXI subgroup was 1.2 (95% CI: 0.4-3.2). The adjusted OR of IS in dyslipidaemic patients with high levels of FXI was 6.4 (95% CI: 1.6-26.1) compared with dyslipidaemic controls, but the OR in non-dyslipidaemic subgroup with high levels of FXI was 0.6 (95% CI: 0.2-2.1). CONCLUSION We found almost a sixfold higher risk of IS in patients with dyslipidaemia and high levels of FXI. Further studies should elucidate the role of FXI in IS and therapeutic approaches should become apparent for patients with dyslipidaemia and high-FXI plasma levels.
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111
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Peña C, Suarez C, Tubau F, Gutierrez O, Domínguez A, Oliver A, Pujol M, Gudiol F, Ariza J. Nosocomial spread of Pseudomonas aeruginosa producing the metallo-β-lactamase VIM-2 in a Spanish hospital: clinical and epidemiological implications. Clin Microbiol Infect 2007; 13:1026-9. [PMID: 17651449 DOI: 10.1111/j.1469-0691.2007.01784.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Thirty-four isolates of pan-resistant Pseudomonas aeruginosa producing VIM-2 metallo-beta-lactamase (MBL) were detected at a university hospital in Spain (July 2004-September 2006). Eleven (32%) patients had clinically significant infections, and three (27%) of these patients died. A single clone of MBL-producing P. aeruginosa was identified by pulsed-field gel electrophoresis. A cluster of isolates associated with the vascular surgery ward involved ten patients and appeared as a series of low-grade, sustained and misdiagnosed endemic infections in the hospital. The identification of MBL-positive P. aeruginosa should be considered mandatory in the surveillance of pan-resistant P. aeruginosa and requires a high index of suspicion in the context of endemic infections with a low attack rate.
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112
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Maciá MD, Mena A, Borrell N, Pérez JL, Oliver A. Increased susceptibility to colistin in hypermutable Pseudomonas aeruginosa strains from chronic respiratory infections. Antimicrob Agents Chemother 2007; 51:4531-2. [PMID: 17893154 PMCID: PMC2168005 DOI: 10.1128/aac.00981-07] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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113
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Torres-Torres C, Khomenko AV, Cheang-Wong JC, Rodríguez-Fernández L, Crespo-Sosa A, Oliver A. Absorptive and refractive nonlinearities by four-wave mixing for Au nanoparticles in ion-implanted silica. OPTICS EXPRESS 2007; 15:9248-9253. [PMID: 19547266 DOI: 10.1364/oe.15.009248] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We report a theoretical and experimental study on the real and imaginary part of the third-order nonlinear optical susceptibility at 532 nm and 7 ns pulse for high-purity silica samples containing Au nanoparticles prepared by ion implantation. We present a method for measuring the magnitude and sign of refractive and absorptive nonlinearities based on four-wave mixing (FWM). This method is derived from a comparison of the light intensities of incident and self-diffracted polarized waves. In the nanosecond regime the samples exhibit saturable absorption and it seems that a thermal effect is the mechanism responsible of nonlinearity of index.
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114
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Alcoceba E, Mena A, Cruz Pérez M, Ruiz de Gopegui E, Padilla E, Gil J, Ramírez A, Gallegos C, Serra A, Pérez JL, Oliver A. Molecular epidemiology of methicillin-resistant Staphylococcus aureus in Majorcan hospitals: high prevalence of the epidemic clone EMRSA-15. Clin Microbiol Infect 2007; 13:599-605. [PMID: 17378930 DOI: 10.1111/j.1469-0691.2007.01703.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Clinical isolates (n = 389) of methicillin-resistant Staphylococcus aureus (MRSA) recovered from 371 patients between January 2003 and June 2004 at the three major public hospitals on the island of Majorca, Spain were studied. The clonal relatedness of MRSA isolates was determined by pulsed-field gel electrophoresis (PFGE) after digestion with SmaI. During the study period, MRSA was found in 31% of patients with S. aureus-positive cultures. PFGE analysis identified three predominant clones, affecting 94% of the patients. The three clones had been detected since 1999 in one hospital, and were designated as clones A, B and C. Whereas clones A and B (multidrug-resistant) were related to the two most prevalent clones in Spain at this time, clone C was identical to EMRSA-15, currently one of the most common MRSA clones in UK hospitals and also detected in other countries, but rarely in Spanish hospitals. This imported epidemic clone was detected in c. 10% of patients admitted to one of the three hospitals in 2002, but its prevalence has increased significantly (32% of the patients investigated in the three hospitals in the present study), and this clone also accounted for 44% of the isolates from non-hospitalised patients. Even though EMRSA-15 showed the least multidrug resistance of the three major clones, it was apparently more virulent, since it was associated significantly (p 0.001) with bacteraemia, and positive blood cultures were documented for 21% of the patients infected by this clone, compared with only 10% and 7% of patients infected with clones A and B, respectively.
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115
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Plasencia V, Borrell N, Maciá MD, Moya B, Pérez JL, Oliver A. Influence of high mutation rates on the mechanisms and dynamics of in vitro and in vivo resistance development to single or combined antipseudomonal agents. Antimicrob Agents Chemother 2007; 51:2574-81. [PMID: 17470655 PMCID: PMC1913281 DOI: 10.1128/aac.00174-07] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
We studied the mechanisms and dynamics of the development of resistance to ceftazidime (CAZ) alone or combined with tobramycin (TOB) or ciprofloxacin (CIP) in vitro and in vivo (using a mouse model of lung infection with human antibiotic regimens). Pseudomonas aeruginosa strain PAO1 and its hypermutable derivative PAODeltamutS were used, and the results were compared with those previously obtained with CIP, TOB, and CIP plus TOB (CIP-TOB) under the same conditions. An important (200-fold) amplification of the number of resistant mutant cells was documented for PAODeltamutS-infected mice that were under CAZ treatment compared to the number for mice that received placebo, whereas the median number of resistant mutant cells was below the detection limits for mice infected by PAO1. These results were intermediate between the high amplification with CIP (50,000-fold) and the low amplification with TOB (10-fold). All CAZ-resistant single mutant cells selected in vitro or in vivo hyperproduced AmpC. On the other hand, the three combinations studied were found to be highly effective in the prevention of in vivo resistance development in mice infected with PAODeltamutS, although the highest therapeutic efficacy (in terms of mortality and total bacterial load reduction) compared to those of the individual regimens was obtained with CIP-TOB and the lowest was with CAZ-CIP. Nevertheless, mutant cells that were resistant to the three combinations tested were readily selected in vitro for PAODeltamutS (mutation rates from 1.2 x 10(-9) to 5.8 x 10(-11)) but not for PAO1, highlighting the potential risk for antimicrobial resistance development associated with the presence of hypermutable strains, even when combined therapy was used. All five independent CAZ-TOB-resistant PAODeltamutS double mutants studied presented the same resistance mechanism (AmpC hyperproduction plus an aminoglycoside resistance mechanism not related to MexXY), whereas four different combinations of resistance mechanisms were documented for the five CAZ-CIP-resistant double mutants.
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116
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Garcìa-Castillo M, Morosini M, Oliver A, Baquero F, Martìnez J, Cantòn R. P880 Single-step selection of double mutations leading to high antibiotic-resistance in hyper-mutable Pseudomonas aeruginosa. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)70721-5] [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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117
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Picon E, Rodriguez-Bano J, Gijon P, Hernandez J, Ruiz M, Pena C, Almirante B, Almela M, Canton R, Guerrero A, Gimenez M, Oliver A, Horcajada J, Navarro G, Coloma A, Pascual A. P1652 Susceptibility of extended-spectrum β-lactamase-producing Escherichia coli strains causing nosocomially- and community-acquired bacteraemia. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71491-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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118
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Maciá MD, Borrell N, Segura M, Gómez C, Pérez JL, Oliver A. Efficacy and potential for resistance selection of antipseudomonal treatments in a mouse model of lung infection by hypermutable Pseudomonas aeruginosa. Antimicrob Agents Chemother 2006; 50:975-83. [PMID: 16495260 PMCID: PMC1426455 DOI: 10.1128/aac.50.3.975-983.2006] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Hypermutable Pseudomonas aeruginosa strains are found with high frequency in the lungs of patients with chronic infections and are associated with high antibiotic resistance rates. The in vivo consequences of hypermutation for treatment in a mouse model of lung infection using strain PAO1 and its hypermutable derivative PAOdeltamutS are investigated. Groups of 30 mice were treated for 3 days with humanized regimens of ciprofloxacin (CIP), tobramycin (TOB), CIP plus TOB, or placebo, and mortality, total lung bacterial load, and 4x- and 16x-MIC mutants were recorded. The rates of mutation and the initial in vivo frequencies of mutants (at the onset of treatment) were also estimated and the in vitro- and in vivo-selected mutants characterized. Since both strains had identical MICs, the same pharmacokinetic/pharmacodynamic (PK/PD) parameters were obtained: area under the 24-h concentration-time curve (fAUC)/MIC = 385 for CIP and maximum concentration of drug in serum (fC(max))/MIC = 19 for TOB. Despite adequate PK/PD parameters, persistence of high bacterial numbers and amplification (50,000-fold) of resistant mutants (MexCD-OprJ hyperexpression) were documented with CIP treatment for PAOdeltamutS, in contrast to complete resistance suppression for PAO1 (P < 0.01), showing that conventional PK/PD parameters may not be applicable to infections by hypermutable strains. On the other hand, the efficacy of TOB monotherapy in terms of mortality reduction and bacterial load was very low regardless of the strain but not due to resistance development, since mutants were not selected for PAO1 and were only modestly amplified for PAOdeltamutS. Finally, the CIP-plus-TOB combination was synergistic, further reducing mortality and bacterial load and completely preventing resistance even for PAOdeltamutS (P < 0.01 compared to monotherapy), showing that it is possible to suppress resistance selection in infections by hypermutable P. aeruginosa using appropriate combined regimens.
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119
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Asher J, Oliver A, Wilson C, Gupta A, Gok M, Balupuri S, Shenton B, Del Rio Martin J, Rix D, Soomro N, Jaques B, Manas D, Ward M, Talbot D. A simple cardiovascular risk score can predict poor outcome in NHBD renal transplantation. Transplant Proc 2006; 37:3292-3. [PMID: 16298577 DOI: 10.1016/j.transproceed.2005.09.136] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A simple cardiovascular risk score used in our center to plan cardiovascular workup for renal transplantation can predict outcome in non-heart-beating donor (NHBD) renal transplantation. Patients in the higher risk group, with a score of >12 out of a maximum of 36 are likely to have a longer duration of delayed graft function, poorer glomerular filtration rate at 6 months, and inferior graft and patient survival, together with an relative rate of graft loss within 60 days of >4 (P = .053). Although a high cardiovascular risk score should not be regarded as a contraindication to NHBD transplantation, the score can be used to facilitate recipient selection.
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120
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Fernández E, Oliver A, Turbón D, Arroyo-Pardo E. MtDNA analysis of ancient samples from Castellón (Spain): Diachronic variation and genetic relationships. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.ics.2005.11.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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121
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Díaz JM, Sainz Z, Gich I, Guirado LL, Puig T, Oliver A, Montañés R, Chuy E, Solà R. Factors involved in baseline hyperhomocysteinemia in renal transplantation. Transplant Proc 2006; 37:3799-801. [PMID: 16386543 DOI: 10.1016/j.transproceed.2005.10.056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Hyperhomocysteinemia (hyperHcy) is one cardiovascular risk. The objective of this study was to establish the prevalence demographic, and clinical and analytical factors related to hyperhomocysteinemia among renal transplant patients. The mean Hcy level was 17.3 micromol/L; the prevalence of hyperHcy was 61.2%. The population was categorized as hyperHcy and normal-homocysteinemia (Hcy) patients. Those subjects with hyperHcy were mostly men, with lower intraerythrocyte folate and vitamin B(12) levels, higher fibrinogen levels, and poorer renal function. Multivariate evaluation showed that creatinine clearance, plasma intraerythrocyte folate and vitamin B(12) levels, and plasma fibrinogen levels were independently associated with Hcy levels. Even though the Hcy level was slightly higher among patients who suffered a posttransplantation cardiovascular event, this was statistically significant.
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122
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Juan C, Gutiérrez O, Oliver A, Ayestarán JI, Borrell N, Pérez JL. Contribution of clonal dissemination and selection of mutants during therapy to Pseudomonas aeruginosa antimicrobial resistance in an intensive care unit setting. Clin Microbiol Infect 2005; 11:887-92. [PMID: 16216103 DOI: 10.1111/j.1469-0691.2005.01251.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Rates of antibiotic resistance in Pseudomonas aeruginosa isolates from intensive care unit (ICU) patients are expected to be dependent on the selection of resistance mutations during therapy, the availability of exogenous resistance determinants and their dissemination potential, and the efficiency of transmission of the resistant strains. The relative contributions of these three factors were studied in an ICU with no apparent outbreak in 216 sequential P. aeruginosa isolates recovered from 102 patients between September 2002 and November 2003. Analysis of pulsed-field gel electrophoresis patterns revealed the presence of 82 different clones. Thus, the dissemination of particular resistant clones had a minimal effect on the relatively high overall resistance frequencies found for imipenem (32%), cefepime (25%), ceftazidime (24%), meropenem (22%), ciprofloxacin (18%) and tobramycin (2%). Rates of primary resistance were relatively low, and resistance development during treatment (secondary resistance) was the main factor contributing to the overall high resistance rates. In ICU settings with a low prevalence of epidemic resistant strains, the main strategy for resistance control should focus on the design of targeted regimens to avoid the development of resistance.
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123
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Díaz JM, Sainz Z, Gich I, Guirado LL, Puig T, Oliver A, Montañés R, Facundo C, Chuy E, Solà R. Determining Factors of the Response to Hyperhomocysteinemia Treatment in Renal Transplant Patients. Transplant Proc 2005; 37:3785-7. [PMID: 16386538 DOI: 10.1016/j.transproceed.2005.10.055] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Hyperhomocysteinemia (hyperHcy) is a risk factor for cardiovascular disease. The benefits of lowering homocysteinemia (Hcy) in renal transplant recipients through vitamin treatment are not clearly understood. The objective of this study was to establish the demographic, renal, Hcy metabolism, and microinflammation factors that determined the response to folic acid and vitamin B complex treatment in stable patients with renal transplants and hyperHcy. We studied 65 renal transplant patients with baseline hyperHcy. The mean baseline Hcy level of these patients was 22.5 micromol/L. Following treatment it fell to 14.5 micromol/L, an overall reduction of 35.5%. Forty-one patients (63%) were classified as responders; the remainder (37%), nonresponders. A bivariance analysis suggested the only significant differences between responding and nonresponding patients were the pre-treatment Hcy level and the renal function level.
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Díaz JM, Sainz Z, Oliver A, Guirado LI, Facundo C, García-Maset R, Solà R. Post–Renal Transplantation Weight Gain: Its Causes and Its Consequences. Transplant Proc 2005; 37:3839-41. [PMID: 16386557 DOI: 10.1016/j.transproceed.2005.09.200] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE A tendency to increased body mass index (BMI) occurs after renal transplantation. The objective of this study was to analyze the causes and consequences of this weight gain. METHODS Two hundred twelve renal transplant recipients were divided into 3 groups according to the evolution of their BMI: BMI loss (group 1); BMI increase <10% (group 2); and BMI increase >10% (group 3). RESULTS The mean BMI gain was 6.2%, weight gain was 3.9 kg, and BMI gain was 1.4 kg/m(2). The patients in group 3 were younger, but there were no other significant differences in gender, preoperative diabetes, acute rejection, or prior BMI. Blood pressure was similar in all 3 groups, but more group 3 patients needed antihypertensive treatment. A progressive increase in total and low-density lipoprotein (LDL)-cholesterol was also observed as patients showed increased BMI. No differences were observed regarding carbohydrate metabolism. Groups 1 and 3 showed a more unfavorable micro-inflammatory profile. The creatinine clearance level was better in group 3 compared with group 1. We found no differences regarding the number of nonfatal postoperative cardiovascular events.
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Cantón R, Cobos N, de Gracia J, Baquero F, Honorato J, Gartner S, Alvarez A, Salcedo A, Oliver A, García-Quetglas E. Antimicrobial therapy for pulmonary pathogenic colonisation and infection by Pseudomonas aeruginosa in cystic fibrosis patients. Clin Microbiol Infect 2005; 11:690-703. [PMID: 16104983 DOI: 10.1111/j.1469-0691.2005.01217.x] [Citation(s) in RCA: 112] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Pseudomonas aeruginosa colonisation has a negative effect on pulmonary function in cystic fibrosis patients. The organism can only be eradicated in the early stage of colonisation, while reduction of bacterial density is desirable during chronic colonisation or exacerbations. Monthly, or at least 3-monthly, microbiological culture is advisable for patients without previous evidence of P. aeruginosa colonisation. Cultures should be performed at least every 2-3 months in patients with well-established colonisation, and always during exacerbations or hospitalisations. Treatment of patients following the first isolation of P. aeruginosa, but with no clinical signs of colonisation, should be with oral ciprofloxacin (15-20 mg/kg twice-daily for 3-4 weeks) plus inhaled tobramycin or colistin (intravenous treatment with or without inhaled treatment can be used as an alternative), while patients with acute infection should be treated for 14-21 days with high doses of two intravenous antimicrobial agents, with or without an inhaled treatment during or at the end of the intravenous treatment. Maintenance treatment after development of chronic P. aeruginosa infection/colonisation (pathogenic colonisation) in stable patients (aged>6 years) should be with inhaled tobramycin (300 mg twice-daily) in 28-day cycles (on-off) or, as an alternative, colistin (1-3 million units twice-daily). Colistin is also a possible choice for patients aged<6 years. Treatment can be completed with oral ciprofloxacin (3-4 weeks every 3-4 months) for patients with mild pulmonary symptoms, or intravenously (every 3-4 months) for those with severe symptoms or isolates with ciprofloxacin resistance. Moderate and serious exacerbations can be treated with intravenous ceftazidime (50-70 mg/kg three-times-daily) or cefepime (50 mg/kg three-times-daily) plus tobramycin (5-10 mg/kg every 24 h) or amikacin (20-30 mg/kg every 24 h) for 2-3 weeks. Oral ciprofloxacin is recommended for patients with mild pulmonary disease. If multiresistant P. aeruginosa is isolated, antimicrobial agents that retain activity are recommended and epidemiological control measures should be established.
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