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Ferreira MSR, Victoria M, Carvalho-Costa FA, Vieira CB, Xavier MPTP, Fioretti JM, Andrade J, Volotão EM, Rocha M, Leite JPG, Miagostovich MP. Surveillance of norovirus infections in the state of Rio De Janeiro, Brazil 2005-2008. J Med Virol 2010; 82:1442-8. [PMID: 20572088 DOI: 10.1002/jmv.21831] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
A 4-year (2005-2008) norovirus (NoV) surveillance study was conducted in the state of Rio Janeiro, Brazil, to demonstrate the role of these viruses in outbreaks and sporadic cases of acute gastroenteritis. A cohort of 1,687 fecal samples was obtained from patients with gastroenteritis; 324 were rotavirus-positive. Of the remainder 1,363 rotavirus-negative samples, 1,087 samples were tested for NoV RNA in this study. The study enrolled 267 outpatients from Municipal Public Health Centers and 820 inpatients, whose samples were obtained by active surveillance in Public Hospitals. Fecal samples were tested by reverse transcription (RT) followed by polymerase chain reaction (PCR) using the MON 431-434 set of degenerate primers for NoV GI and GII detection, and there were 35.1% (381/1,087) positive samples for NoV, consisting of 30.2% (248/820) and 49.8% (133/267) from inpatient and outpatient, respectively. Children infected by NoV had significantly more frequent mucus in feces, vomiting and fever. No seasonal pattern in NoV infections was observed in patients admitted to hospital; however, two peaks of NoV infections were observed from ambulatory cases, suggesting that there was an occurrence of outbreaks in those time periods. Molecular characterization revealed GII to be the most prevalent genogroup, totaling 96.3% (104/108) of all sequences analyzed, and GII.4 was the genotype detected most frequently (80.7%), followed by GII.6, 3, 14, 7, and 8. Two GI strains, GI.2 and GI.3, were also observed. The number of outbreaks and sporadic cases described in this study highlights the need to implement diagnosis of NoV in surveillance laboratories.
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Andrade J, Cortez LD, Campos O, Arruda AL, Pinheiro J, Vulcanis L, Shiratsuchi TS, Kalil-Filho R, Cerri GG. Left ventricular twist: comparison between two- and three-dimensional speckle-tracking echocardiography in healthy volunteers. EUROPEAN JOURNAL OF ECHOCARDIOGRAPHY 2010; 12:76-9. [DOI: 10.1093/ejechocard/jeq111] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Remon J, Diaz Padilla I, Andrade J, Gasco A, Jurado JM, Perez FJ, Lianes MP. Cisplatin (CDDP) and oral vinorelbine (NVBO) concomitantly with radiotherapy (RT) after induction chemotherapy (CT) in locally advanced (LA) non-small cell lung cancer (NSCLC) treatment: Clinical experience in five institutions in Spain. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.7093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Barker LA, Andrade J, Morton N, Romanowski CAJ, Bowles DP. Investigating the 'latent' deficit hypothesis: age at time of head injury, implicit and executive functions and behavioral insight. Neuropsychologia 2010; 48:2550-63. [PMID: 20470806 DOI: 10.1016/j.neuropsychologia.2010.05.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2008] [Revised: 04/23/2010] [Accepted: 05/03/2010] [Indexed: 12/12/2022]
Abstract
This study investigated the 'latent deficit' hypothesis in two groups of head-injured patients with predominantly frontal lesions, those injured prior to steep morphological and corresponding functional maturational periods for frontal networks (<or=age 25), and those injured>28 years. The latent deficit hypothesis proposes that early injuries produce enduring cognitive deficits manifest later in the lifespan with graver consequences for behavior than adult injuries, particularly after frontal pathology (Eslinger, Grattan, Damasio & Damasio, 1992). Implicit and executive deficits both contribute to behavioral insight after frontal head injury (Barker, Andrade, Romanowski, Morton, & Wasti, 2006). On the basis of morphological and behavioral data, we hypothesized that early injury would confer greater vulnerability to impairment on tasks associated with frontal regions than later injury. Patients completed experimental tasks of implicit cognition, executive function measures and the DEX measure of behavioral insight (Behavioral Assessment of the Dysexecutive Syndrome: Wilson, Alderman, Burgess, Emslie, & Evans, 1996). The Early Injury group were more impaired on implicit cognition tasks compared to controls that Late Injury patients. There were no marked group differences on most executive function measures. Executive ability only contributed to behavioral awareness in the Early Injury Group. Findings showed that age at injury moderates the relationship between executive and implicit cognition and behavioral insight and that early injuries result in long-standing deficits to functions associated with frontal regions partially supporting the latent deficit hypothesis.
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Sposito A, Carvalho LS, Cintra R, Araujo AL, Ono A, Andrade J, E Silva JQ. Abstract: P400 REBOUND INFLAMMATORY RESPONSE DURING THE ACUTE PHASE OF MYOCARDIAL INFARCTION AFTER SIMVASTATIN WITHDRAWAL. ATHEROSCLEROSIS SUPP 2009. [DOI: 10.1016/s1567-5688(09)70695-6] [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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Alexandre E, Elmec A, Siqueira D, Medeiros S, Andrade J, Sousa A. IMPACT OF DIABETES AND CIGARETTE SMOKING IN WOMEN WITH CORONARY ARTERY DISEASE TREATED WITH PERCUTANEOUS CORONARY INTERVENTION. Maturitas 2009. [DOI: 10.1016/s0378-5122(09)70209-9] [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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Lefaucheur C, Nochy D, Andrade J, Verine J, Gautreau C, Charron D, Hill GS, Glotz D, Suberbielle-Boissel C. Comparison of combination Plasmapheresis/IVIg/anti-CD20 versus high-dose IVIg in the treatment of antibody-mediated rejection. Am J Transplant 2009; 9:1099-107. [PMID: 19422335 DOI: 10.1111/j.1600-6143.2009.02591.x] [Citation(s) in RCA: 203] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Different strategies appear to improve the success in treatment of antibody-mediated rejection (AMR), although no one best method has yet emerged. The objective of this study was to compare the efficacy of the combination of Plasmapheresis/intravenous immunoglobulin (IVIg)/anti-CD20-based regimes versus high-dose IVIg alone in the treatment of AMR. Group A (12 patients) was treated with high-dose IVIg between January 2000 and December 2003; group B (12 patients) was treated by Plasmapheresis/IVIg/anti-CD20 between January 2004 and December 2005. Graft survival at 36 months was 91.7% in group B versus 50% in group A (p = 0.02). Donor-specific human leukocyte antigens (DSA) levels detected by Luminex single antigen (Luminex SA) and ELISA, 3 months postrejection are significantly lower in group B than in group A: DSA ELISA class 2 score 6-8 (p = 0.02), DSA mean intensity of fluorescence (MFI) max (p = 0.009) and DSA mean MFI (p = 0.0004). The persistence of elevated DSA levels posttreatment is more frequent in patients with graft loss as compared to those with preserved renal function: score 6-8 on ELISA (p = 0.04); mean MFI (p = 0.00009) and MFImax (p = 0.018). We conclude that: (1) high dose IVIg alone is inferior to Plasmapheresis/IVIg/anti-CD20 as therapy for AMR and (2)DSA postrejection can be quantified using solid phase assays, showing that 3 months after AMR, DSA levels are higher in patients with graft loss.
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Lefaucheur C, Suberbielle-Boissel C, Hill GS, Nochy D, Andrade J, Antoine C, Gautreau C, Charron D, Glotz D. Clinical relevance of preformed HLA donor-specific antibodies in kidney transplantation. CONTRIBUTIONS TO NEPHROLOGY 2008; 162:1-12. [PMID: 19001809 DOI: 10.1159/000170788] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Since the pioneering work of Patel and Terazaki, the presence of an anti-donor anti-body of the IgG isotype, as demonstrated by a lymphocytotoxic assay on T cells, has been a contraindication to transplantation, due to the very high rate of graft loss reported (>80% in the first few weeks posttransplant). The advent of more sensible and specific techniques of detection of anti-HLA antibodies (such as ELISA or Luminex techniques) has questioned this dogma, with a number of reports showing that transplantation, despite the presence of an donor-specific antibody (DSA), could be done without excessive graft losses, despite higher rates of rejection. We thus decided to retrospectively screen a cohort of 237 patients consecutively transplanted in our unit. This study analyzes the influence of preformed DSA, identified by HLA-specific ELISA assays, on graft survival and evaluates the incidence of antibody-mediated rejection (AMR). Kidney graft survival at 8 years was significantly worse in patients with DSA. The incidence of AMR in patients with DSA was 9-fold higher than in patients without DSA and led to a significantly worse graft survival. The prevalence for AMR in patients with DSA detected on historic serum was 32.3% and was significantly more elevated in patients with strongly positive DSA (score 6-8) and in patients with his-toric positive crossmatches. Interestingly, those patients with DSA that did not experience AMR had the same graft survival as patients without DSA. Thus, the presence of preformed DSA is strongly associated with increased graft loss in kidney transplants, related to an increased risk of AMR. Our findings demonstrate the importance of detection and charac-terization of DSA before transplantation. Stratification of this immunological risk should be used both to determine kidney allocation and to devise specific strategies for these patients.
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Sepetiba RJC, Andrade J, Hirata RDC, Hirata MH, Sepetiba CRG, Nakamura Y, Matsumoto LO, Cavalli SA, Bertolami MC. Lipoprotein lipase PvuII polymorphism is associated with variations in serum lipid levels in non-diabetic pregnant women. ACTA ACUST UNITED AC 2008; 40:919-26. [PMID: 17653444 DOI: 10.1590/s0100-879x2006005000102] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2006] [Accepted: 03/02/2007] [Indexed: 11/22/2022]
Abstract
The aim of the present study was to determine if there is an association between the single nucleotide polymorphisms (SNPs) of the lipoprotein lipase (LPL) and apolipoprotein E (apo E) genes and the serum lipid profile in pregnancy and puerperium. Non-diabetic women of European descent in the third semester of pregnancy (N = 120) were selected. Those with diseases or other condition that could modify their lipid profile were excluded from the study (N = 32). Serum lipids were measured by routine laboratory procedures and genomic DNA was extracted by a salting out method. LPL (PvuII and HindIII) and apo E (HhaI) SNPs were detected by the polymerase chain reaction and restriction fragment length polymorphism. Categorical and continuous variables were compared by the chi-square test and Student t-test or ANOVA, respectively. Women carrying the LPL P1P1 genotype had higher serum LDL cholesterol (N = 21; 155 +/- 45 mg/dL) than women carrying the P1P2/P2P2 genotypes (N = 67; 133 +/- 45 mg/dL; P = 0.032). During the puerperium period, serum levels of triglycerides and VLDL cholesterol were significantly reduced in women carrying the P1P1 (73%, P = 0.006) and P1P2 (51%, P = 0.002) genotypes but not in women carrying the P2P2 genotype (23%, P > 0.05). On the other hand, serum concentrations of lipids did not differ between the LPL HindIII and apo E genotypes during pregnancy and after delivery. We conclude that LPL PvuII SNP is associated with variations in serum lipids during pregnancy and the puerperal period in non-diabetic women.
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Andrade J, Deeprose C, Barker I. Awareness and memory function during paediatric anaesthesia. Br J Anaesth 2008; 100:389-96. [DOI: 10.1093/bja/aem378] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Lefaucheur C, Suberbielle-Boissel C, Hill GS, Nochy D, Andrade J, Antoine C, Gautreau C, Charron D, Glotz D. Clinical relevance of preformed HLA donor-specific antibodies in kidney transplantation. Am J Transplant 2008; 8:324-31. [PMID: 18162086 DOI: 10.1111/j.1600-6143.2007.02072.x] [Citation(s) in RCA: 161] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
This study analyzes the influence of preformed DSA, identified by HLA-specific ELISA assays, on graft survival and evaluates the incidence of antibody-mediated rejection (AMR) in patients with and without pregraft desensitization. Kidney graft survival at 8 years was significantly worse in patients with DSA (n = 43) than in those without DSA (n = 194)(p = 0.03). The incidence of AMR in patients with DSA is 9-fold higher than in patients without DSA (p < 0.001) and their graft survival is significantly worse than in DSA patients without AMR and in non-DSA patients (p = 0.005). The prevalence for AMR in patients with DSA detected on historic serum is 32.3% in nondesensitized patients and 41.7% in desensitized patients. The risk for AMR is significantly more elevated in patients with strongly positive DSA (score 6-8) compared to those with DSA score 4 (p < 0.001), and in patients with historic DSA+/CXM+ compared to those with DSA+/CXM- (p = 0.01). The presence of preformed DSA is strongly associated with graft loss in kidney transplants, related to an increased risk of AMR. Our findings demonstrate the importance of detection and characterization of DSA before transplantation. Stratification of this risk could be used to determine kidney allocation and to devise specific strategies for these patients.
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Lefaucheur C, Suberbielle-Boissel C, Hill G, Nochy D, Andrade J, Antoine C, Gautreau C, Charron D, Glotz D. Title Page / Table of Contents. CONTRIBUTIONS TO NEPHROLOGY 2008. [DOI: 10.1159/000170787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Andrade J, Ares J, García R, Presa J, Rodríguez S, Piñeiro-Iglesias M, López-Mahía P, Muniategui S, Prada D. Development of a web-based support system for both homogeneous and heterogeneous air quality control networks: process and product. ENVIRONMENTAL MONITORING AND ASSESSMENT 2007; 133:139-48. [PMID: 17295109 DOI: 10.1007/s10661-006-9567-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2006] [Accepted: 10/30/2006] [Indexed: 05/13/2023]
Abstract
The Environmental Laboratories Automation Software System or PALMA (Spanish abbreviation) was developed by a multidisciplinary team in order to support the main tasks of heterogeneous air quality control networks. The software process for PALMA development, which can be perfectly applied to similar multidisciplinary projects, was (a) well-defined, (b) arranged between environmental technicians and informatics, (c) based on quality guides, and (d) clearly user-centred. Moreover, it introduces some interesting advantages with regard to the classical step-by-step approaches. PALMA is a web-based system that allows 'off-line' and automated telematic data acquisition from distributed inmission stations belonging not only to homogeneous but also to heterogeneous air quality control networks. It provides graphic and tabular representations for a comprehensive and centralised analysis of acquired data, and considers the daily work that is associated with such networks: validation of the acquired data, alerts with regard to (periodical) tasks (e.g., analysers verification), downloading of files with environmental information (e.g., dust forecasts), etc. The implantation of PALMA has provided qualitative and quantitative improvements in the work performed by the people in charge of the considered control network.
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Mendez M, Andrade J, Esquerdo G, Morales S, Garcia-Gomez R, Garcia-Bueno J, Blancas I, Trujillo R, Juarez J, Gayo J. 6605 POSTER Oral vinorelbine as single-agent first-line treatment in elderly patients (pts) with advanced non-small-cell lung cancer (NSCLC). EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)71433-7] [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] Open
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Andrade J, Iha K, Rocco JAFF, Franco GP, Moreira ED, Suárez-Iha MEV. Estudo da cinética de consumo do estabilizante 2NDPA no propelente base dupla. ECLÉTICA QUÍMICA 2007. [DOI: 10.1590/s0100-46702007000400001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Este trabalho tem como propósito avaliar a cinética de consumo do estabilizante 2NDPA presente em uma amostra de propelente tipo base-dupla (BD). Tópicos relativos ao método analítico empregado e, a interferências na cinética de consumo do estabilizante pela nitroglicerina e o salicilato de chumbo presente no propelente, também são abordados. Foram obtidos, ainda, os parâmetros cinéticos de consumo do 2NDPA. Para isto, foi empregada a técnica da Cromatografia Líquida de Alta Eficiência (CLAE). Os dados experimentais foram bem ajustados para uma cinética de pseudoprimeira ordem. A energia de ativação (Ea) e o fator pré-exponencial (A) determinados foram, respectivamente, (1,22 ± 0,42) 10² kJ mol-1 e (10(16) ±10(6)) dia-1.
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Andrade J, Iha K, Rocco JAFF, Franco GP, Suzuki N, Suárez-Iha MEV. Determinação dos parâmetros cinéticos de decomposição térmica para propelentes BS e BD. ECLÉTICA QUÍMICA 2007. [DOI: 10.1590/s0100-46702007000300007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O propósito deste trabalho foi determinar os parâmetros cinéticos de decomposição térmica para uma amostra de propelente base simples e base dupla. Os dados obtidos pela calorimetria exploratória diferencial foram ajustados para o modelo cinético de pseudo-primeira ordem de Flynn, Wall e Ozawa. Os respectivos parâmetros obtidos foram: BS REX 1200 (Ea) (2,3 ± 0,2) 10² kJ mol-1 e (A) 1,34 10(25) min-1; BD-111 (Ea) (1,6 ± 0,1) 10² kJ mol-1 e (A) 3,31 10(17) min-1. O espectro de infravermelho da amostra de propelente base dupla indicou a presença de salicilato, justificando o comportamento de decomposição observado na respectiva curva térmica.
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Mercke Odeberg J, Andrade J, Holmberg K, Hoglund P, Malmqvist U, Odeberg J. UGT1A polymorphisms in a Swedish cohort and a human diversity panel, and the relation to bilirubin plasma levels in males and females. Eur J Clin Pharmacol 2006; 62:829-37. [PMID: 16909274 DOI: 10.1007/s00228-006-0166-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2005] [Accepted: 04/07/2006] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The objective of this study was to investigate the prevalence of different polymorphisms and haplotypes associated with individual variations in pharmacokinetics and drug toxicity in the uridine-diphosphate glucuronosyl transferase (UGT) 1A gene in a Swedish cohort (248 healthy volunteers) and in 14 different ethnic groups. We also estimated UGT1A genotype-dependent glucuronidation efficiency using the endogenous substrate bilirubin as an indicator. METHODS Pyrosequencing-based genotyping assays were used to determine the different polymorphisms and haplotypes. RESULTS Haplotype analysis of the UGT1A1 (*1*28), UGT1A6 (*1*2), and UGT1A7(*1*2*3*4) allelic variants showed that three major haplotypes constituted 84% of the allelic variants in the cohort. We identified 15 haplotypes altogether from all groups, including previously undescribed haplotypes. Testing for the association of genotype and total bilirubin levels (nonfasting) in plasma disclosed that homozygous carriers of the TA allele, irrespective of haplotype combinations, had increased levels of bilirubin compared with noncarriers, but a gender-associated difference was observed. CONCLUSIONS In a Swedish cohort, several genetic variants in the UGT1A gene are common, but prevalence in a population may differ because of ethnicity. A phenotype based on bilirubin levels has limitations in serving as an indicator of pharmacogenetic differences in glucuronidation due to the influence of gender. Because of possible substrate overlap regarding different UGT1A isoforms, determination of haplotypes of potential cis-acting polymorphisms in the UGT1A gene should be considered in pharmacogenetic association studies regarding drugs that undergo glucuronidation.
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Aalto TJ, Malmivaara A, Kovacs F, Herno A, Alen M, Salmi L, Kröger H, Andrade J, Jiménez R, Tapaninaho A, Turunen V, Savolainen S, Airaksinen O. Preoperative predictors for postoperative clinical outcome in lumbar spinal stenosis: systematic review. Spine (Phila Pa 1976) 2006; 31:E648-63. [PMID: 16915081 DOI: 10.1097/01.brs.0000231727.88477.da] [Citation(s) in RCA: 221] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Systematic review. OBJECTIVE To define preoperative factors predicting clinical outcome after lumbar spinal stenosis (LSS) surgery. SUMMARY OF BACKGROUND DATA LSS is the most common reason requiring lumbar spine surgery in adults older than 65 years. There are no published systematic reviews on this topic. METHODS A literature search was done until April 30, 2005. Included were randomized controlled or controlled trials or prospective studies dealing with operated LSS. The preoperative predictors had to be presented. Included articles were assessed as high-quality (HQ) and low-quality studies. The predictors in HQ studies were considered as the main results. RESULTS A total of 21 articles were included. Depression and walking capacity were predictors according to 2 HQ studies. Predictors reported in 1 HQ study were cardiovascular/overall comorbidity, disorder influencing walking ability, self-rated health, income, severity of central stenosis, and scoliosis. CONCLUSION Depression, cardiovascular comorbidity, disorder influencing walking ability, and scoliosis predicted poorer subjective outcome. Better walking ability, self-rated health, higher income, less overall comorbidity, and pronounced central stenosis predicted better subjective outcome. Male gender and younger age predicted better postoperative walking ability. The predictive value may be outcome specific; thus, the use of all relevant outcome measures is recommended when studying predictors of LSS.
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Chacon J, López L, Quintanar T, Rubio G, Blanca M, Andrade J, Carbonero I, G Esteban C, Cruz MA. Every-other week capecitabine (C7) combinations: An active and well tolerated treatment in heavily pretreated patients (p) with advanced solid tumours. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.10649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10649 Background: Standard C schedule is 14 days every 3 w (C14). However, data have shown that C7 schedule is as effective as and significantly less toxic than C14. The objective is to evaluate retrospectively the response rate and toxicity of C7 as single agent or in combination in heavily pretreated p with advanced solid tumours. Methods: p with advanced solid tumour, age ≤ 75 years, ECOG PS <2 and adequate bone marrow, renal and hepatic functions were analyzed. p received C7: 1250 mg/m2/12 h x 7 days every-other week. The combination drugs doses were adjusted to be used days 1 and 15. Cycles every 28 days. Response was evaluated every 3 cycles according to RECIST criteria Results: 20 p received C7. Cancer type: 11 breast (BC), 7 colo-rectal (CRC), 1 H&N and 1 gastric (GC). Median age 56 y (33–75). M/F: 8p/12p. ECOG 0/1: 39%/61%. 19 p stage IV and 1 (H&N) stage III. The most frequent metastatic site was liver 42.2%. 90% p had been heavily pretreated with chemotherapy (CT): 55% p had received ≥ 2 CT lines. 15% p had been treated with taxanes, 45% p taxanes + anthracyclines, 10% p 5-FU, 15% p oxaliplatin (Oxa) and/or raltritexed. 2 BC p had also received herceptin (Her) and 2 p (1BC/1CRC) had been previously treated with C14. Median nº cycles: 6 (1–19). C7 combinations were: 5/7 CRC p Oxa or CPT-11 and 11/11 BC p docetaxel (1p) or gemcitabine (1 p) or carboplatin (9 p) ± Her. 4 p received C7 alone. Toxicity (20 p). Grade I/II: HFS 55%, diarrhoea 25%, nausea/vomiting 15%, mucositis 5%, skin 5% and parestesias 5%. Grade III/IV: diarrhoea in 2 p (1CRC and 1 BC). Response (20 p): 2 CR (10%) both CRC p; 6 PR (30%) 5 BC p and 1 CRC p; 4 SD (20%) and 8 PD (40%). 40% ORR rate and 60% TGC. Median response duration: 37 w (22–44 w). 2 p who achieved CR received C7 combined with CPT-11. C7 combination in p with PR were Oxa (1 CRC p) and carboplatin ± Her (5 BC p). Conclusions: C7 schedule is an active regimen in patients with advanced CRC and BC heavily pretreated with CT and it shows a very favourable toxicity profile. These results warrant a phase II trial of carboplatin-C7 in MBC as front line therapy that will by lauched by Feb-2006. No significant financial relationships to disclose.
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Hatum R, Andrade J, Davi C. Crit Care 2006; 10:P232. [DOI: 10.1186/cc4579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Barker LA, Andrade J, Romanowski CAJ, Morton N, Wasti A. Implicit cognition is impaired and dissociable in a head-injured group with executive deficits. Neuropsychologia 2006; 44:1413-24. [PMID: 16436286 DOI: 10.1016/j.neuropsychologia.2005.12.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2005] [Accepted: 12/12/2005] [Indexed: 11/30/2022]
Abstract
Implicit or non-conscious cognition is traditionally assumed to be robust to pathology but Gomez-Beldarrain et al. recently showed deficits on a single implicit task after head injury. Laboratory research suggests that implicit processes dissociate. This study therefore examined implicit cognition in 20 head-injured patients and age- and IQ-matched controls using a battery of four implicit cognition tasks: a serial reaction time task (SRT), mere exposure effect task, automatic stereotype activation and hidden co-variation detection. Patients were assessed on an extensive neuropsychological battery, and MRI scanned. Inclusion criteria included impairment on at least one measure of executive function. The patient group was impaired relative to the control group on all the implicit cognition tasks except automatic stereotype activation. Effect size analyses using the control mean and standard deviation for reference showed further dissociations across patients and across implicit tasks. Patients impaired on implicit tasks had more cognitive deficits overall than those unimpaired, and a larger dysexecutive self/other discrepancy (DEX) score suggesting greater behavioural problems. Performance on the SRT task correlated with a composite measure of executive function. Head injury thus produced heterogeneous impairments in the implicit acquisition of new information. Implicit activation of existing knowledge structures appeared intact. Impairments in implicit cognition and executive function may interact to produce dysfunctional behaviour after head injury. Future comparisons of implicit and explicit cognition should use several measures of each function, to ensure that they measure the latent variable of interest.
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Souza P, Lain J, Andrade J, Lugarinho M, Amaral M, Turon R. Crit Care 2005; 9:P256. [DOI: 10.1186/cc3319] [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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David C, Hatum R, Andrade J, Knibel M, Gomes M, Duarte J, Damasceno M, Pereira P. Crit Care 2005; 9:P207. [DOI: 10.1186/cc3270] [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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Deeprose C, Andrade J, Harrison D, Edwards N. Unconscious auditory priming during surgery with propofol and nitrous oxide anaesthesia: a replication. Br J Anaesth 2005; 94:57-62. [PMID: 15486010 DOI: 10.1093/bja/aeh289] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Priming during anaesthesia has been hard to replicate and the conditions under which it occurs remain poorly understood. We replicated and extended a recent study to determine whether intraoperative priming during propofol and nitrous oxide anaesthesia is a reliable phenomenon, whether it occurs due to awareness during word presentation and whether it is suppressed by a dose of fentanyl at induction. METHODS Words were played through headphones during surgery to 62 patients receiving propofol and nitrous oxide anaesthesia. Thirty-two patients received fentanyl 1.5 microg kg(-1) at induction and 30 received no fentanyl. Neuromuscular blocking drugs were not used. Depth of anaesthesia was measured using the bispectral index (BIS). Anaesthetic variables were recorded at 1 min intervals during word presentation. On recovery, implicit and explicit memory were assessed using an auditory word-stem completion test and a yes-no word-recognition test, respectively. RESULTS BIS, blood pressure, end-tidal carbon dioxide and heart rate during word presentation did not differ between the study groups. The infusion rate of propofol and the patients' ventilatory frequency were significantly higher in the group not receiving fentanyl. No patient had unprompted explicit recall of surgery, although there was above-zero performance in six patients on the yes-no recognition task (P<0.05). There was no physiological evidence of awareness during anaesthesia (median mean-BIS=38 in the no-fentanyl group and 42 in the fentanyl group). There was evidence for priming (mean priming score=0.09, P<0.05 in the no-fentanyl study group; mean priming score=0.07, P<0.05 in the fentanyl group) even when patients with momentary light anaesthesia (maximum recorded BIS> or =60) and/or positive recognition scores were excluded from the analysis. CONCLUSIONS Existing knowledge can be primed by information presented during propofol and nitrous oxide anaesthesia. This priming is evidence of unconscious information processing and not the result of moments of awareness.
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Barker LA, Andrade J, Romanowski CAJ. Impaired implicit cognition with intact executive function after extensive bilateral prefrontal pathology: a case study. Neurocase 2004; 10:233-48. [PMID: 15788261 DOI: 10.1080/13554790490495096] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
LR has extensive bilateral pathology to prefrontal cortices after head injury and marked changes to interpersonal and social behavior relative to his premorbid state. WAIS scores revealed intact IQ at superior levels, equivalent to premorbid ability as measured by the NART. LR performed at normal levels on a battery of executive function tasks, as did eight age- and IQ-matched controls. However, he showed impaired implicit learning on a serial reaction time task, and performed differently from controls on a mere exposure effect task. This case supports claims that implicit cognition may underpin some aspects of normal social functioning.
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