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Sabater-Martos M, Martínez-Pastor JC, Morales A, Ferrer M, Antequera A, Roqué M. Overview of systematic reviews of risk factors for prosthetic joint infection. Rev Esp Cir Ortop Traumatol (Engl Ed) 2023; 67:426-445. [PMID: 37116750 DOI: 10.1016/j.recot.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 04/20/2023] [Accepted: 04/23/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Prosthetic joint infection is one of the most serious complications in orthopedics. Prognostic systematic reviews (SR) detecting and assessing factors related to prosthetic joint infection, allow better prediction of risk and implementation of preventive measures. Although prognostic SR are increasingly frequent, their methodological field presents some knowledge gaps. PURPOSE To carry out an overview of SR assessing risk factors for prosthetic joint infection, describing and synthesizing their evidence. Secondarily, to assess the risk of bias and methodological quality. MATERIAL AND METHODS We conducted a bibliographic search in 4databases (May 2021) to identify prognostic SR evaluating any risk factor for prosthetic joint infection. We evaluated risk of bias with the ROBIS tool, and methodological quality with a modified AMSTAR-2 tool. We computed the overlap degree study between included SR. RESULTS Twenty-three SR were included, studying 15 factors for prosthetic joint infection, of which, 13 had significant association. The most frequently studied risk factors were obesity, intra-articular corticosteroids, smoking and uncontrolled diabetes. Overlapping between SR was high for obesity and very high for intra-articular corticoid injection, smoking and uncontrolled diabetes. Risk of bias was considered low in 8SRs (34.7%). The modified AMSTAR-2 tool showed important methodological gaps. CONCLUSIONS Identification of procedural-modifiable factors, such as intra-articular corticoids use, can give patients better results. Overlapping between SR was very high, meaning that some SR are redundant. The evidence on risk factors for prosthetic joint infection is weak due to high risk of bias and limited methodological quality.
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Affiliation(s)
- M Sabater-Martos
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Clínic de Barcelona, Barcelona, España.
| | - J C Martínez-Pastor
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Clínic de Barcelona, Barcelona, España
| | - A Morales
- Fisioterapia Vestibular, Rehabilitación del Vértigo y el Equilibrio, Fisioterapia del Aparato Locomotor, Barcelona, España
| | - M Ferrer
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Clínic de Barcelona, Barcelona, España
| | - A Antequera
- Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, España
| | - M Roqué
- Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, España
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Sabater-Martos M, Martínez-Pastor JC, Morales A, Ferrer M, Antequera A, Roqué M. [Translated article] Overview of systematic reviews of risk factors for prosthetic joint infection. Rev Esp Cir Ortop Traumatol (Engl Ed) 2023; 67:T426-T445. [PMID: 37364724 DOI: 10.1016/j.recot.2023.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 04/23/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Prosthetic joint infection is one of the most serious complications in orthopedics. Prognostic systematic reviews (SRs) detecting and assessing factors related to prosthetic joint infection, allow better prediction of risk and implementation of preventive measures. Although prognostic SRs are increasingly frequent, their methodological field presents some knowledge gaps. PURPOSE To carry out an overview of SR assessing risk factors for prosthetic joint infection, describing and synthesizing their evidence. Secondarily, to assess the risk of bias and methodological quality. MATERIAL AND METHODS We conducted a bibliographic search in 4 databases (May 2021) to identify prognostic SR evaluating any risk factor for prosthetic joint infection. We evaluated risk of bias with the ROBIS tool, and methodological quality with a modified AMSTAR-2 tool. We computed the overlap degree study between included SR. RESULTS Twenty-three SRs were included, studying 15 factors for prosthetic joint infection, of which, 13 had significant association. The most frequently studied risk factors were obesity, intra-articular corticosteroids, smoking and uncontrolled diabetes. Overlapping between SR was high for obesity and very high for intra-articular corticoid injection, smoking and uncontrolled diabetes. Risk of bias was considered low in 8 SRs (34.7%). The modified AMSTAR-2 tool showed important methodological gaps. CONCLUSIONS Identification of procedural-modifiable factors, such as intra-articular corticoids use, can give patients better results. Overlapping between SR was very high, meaning that some SRs are redundant. The evidence on risk factors for prosthetic joint infection is weak due to high risk of bias and limited methodological quality.
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Affiliation(s)
- M Sabater-Martos
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Clínic de Barcelona, Barcelona, Spain.
| | - J C Martínez-Pastor
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Clínic de Barcelona, Barcelona, Spain
| | - A Morales
- Fisioterapia Vestibular, Rehabilitación del Vértigo y el Equilibrio, Fisioterapia del Aparato Locomotor, Barcelona, Spain
| | - M Ferrer
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Clínic de Barcelona, Barcelona, Spain
| | - A Antequera
- Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - M Roqué
- Institut d'Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
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Taccetti F, Castelli L, Czelusniak C, Giambi F, Manetti M, Massi M, Mazzinghi A, Ruberto C, Arneodo F, Torres R, Castellá F, Gheco L, Mastrangelo N, Gallegos D, Morales A, Tascon M, Marte F, Giuntini L. Novel implementation of the INFN-CHNet X-ray fluorescence scanner for the study of ancient photographs, archaeological pottery, and rock art. Rend Fis Acc Lincei 2023. [DOI: 10.1007/s12210-023-01143-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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Miguélez M, Velasco C, Camblor M, Cedeño J, Serrano C, Bretón I, Arhip L, Motilla M, Carrascal M, Olivares P, Morales A, Brox N, Cuerda C. Nutritional management and clinical outcome of critically ill patients with COVID-19: A retrospective study in a tertiary hospital. Clin Nutr 2022; 41:2940-2946. [PMID: 34782169 PMCID: PMC8559438 DOI: 10.1016/j.clnu.2021.10.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND & AIMS Severe COVID-19 infection is characterized by an inflammatory response and lung injury that can evolve into an acute respiratory distress syndrome that needs support treatment in intensive care unit. Nutritional treatment is an important component of the management of critically ill patients and should be started in the first 48 h of ICU admission to avoid malnutrition. This study describes the characteristics of the patients treated in a tertiary hospital in Madrid during the months of March-May 2020 (first wave), the medical nutrition treatment employed and its influence in the clinical outcome of these patients. METHODS This is a retrospective study including COVID-19 patients admitted in ICU that needed medical nutrition treatment (MNT). Collected variables included sex, age, BMI, underlying diseases, time from hospitalisation to ICU admission, type of respiratory support (invasive mechanical ventilation (IMV) or high flow nasal cannula (HFNC) or non-invasive ventilation (non-IMV)), caloric and protein requirements (25 kcal/kg adjusted body weight (ABW), 1.3 g/kg ABW/day), MNT type (enteral nutrition (EN), parenteral nutrition (PN), mixed EN + PN), total calories (including propofol) and proteins administered, percentage of caloric and protein goal in ICU day 4th and 7th, metabolic complications, acute kidney failure (AKF), length of stay (LOS) and mortality. Data are expressed as mean ± SD, median (IQR) or frequencies. Statistical analysis was performed with the IBM SPSS Statistics for Windows, Version 25.0. p < 0.05 were considered statistically significant. RESULTS A total of 176 patients were included (72.7% male), 60.1 ± 13.5 years, BMI 29.9 ± 5.4 kg/m2. Underlying diseases included 47.4% overweight, 39.8% obesity, 49.1% hypertension, 41.4% dyslipidaemia. 88.6% of patients needed IMV, 89.1% prone position, 2.9% ECMO. Time to ICU admission: 2 (4.75) days. Estimated caloric and protein requirements were 1775 ± 202 kcal and 92.4 ± 10.3 g. Calories and proteins administered at days 4th and 7th were 1425 ± 577 kcal and 66 ± 26 g and 1574 ± 555 and 74 ± 37, respectively. Most of the patients received PN (alone or complementary to EN) to cover nutritional requirements (82.4% at day 4th and 77.9% at day 7th). IVM patients received more calories and proteins during the first week of ICU admission. Complications included 77.8% hyperglycaemia, 13.2% hypoglycaemia, 83.8% hypertriglyceridemia, and 35.1% AKF. ICU LOS was 20.5 (26) days. The mortality rate was 36.4%. CONCLUSIONS In our series, the majority of patients reached energy and protein requirements in the first week of ICU admission due to the use of PN (total or complementary to EN). Patients with HFNC or non-IMV may be at risk of malnutrition if total or complementary PN to oral diet/ONS/tube feeding is not used to cover nutritional requirements. Therefore, if EN is not possible or insufficient, PN can be safely used in critically ill patients with COVID-19 with a close monitoring of metabolic complications.
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Affiliation(s)
- M. Miguélez
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - C. Velasco
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain,Corresponding author. Nutrition Unit, Hospital General Universitario Gregorio Marañón, c/ Doctor Esquerdo 46, 28007, Madrid, Spain
| | - M. Camblor
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - J. Cedeño
- Intensive Care Service. Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - C. Serrano
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - I. Bretón
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - L. Arhip
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - M. Motilla
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - M.L. Carrascal
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - P. Olivares
- Intensive Care Service. Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - A. Morales
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - N. Brox
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - C. Cuerda
- Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
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Alonso de Leciñana M, Morales A, Martínez-Zabaleta M, Ayo-Martín Ó, Lizán L, Castellanos M. Characteristics of stroke units and stroke teams in Spain in 2018. Pre2Ictus project. Neurologia (Engl Ed) 2022; 38:173-180. [PMID: 35780047 DOI: 10.1016/j.nrleng.2022.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 05/18/2020] [Accepted: 06/12/2020] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The aim of this work is to describe the characteristics of stroke units and stroke teams in Spain. METHODS We performed a cross-sectional study based on an ad-hoc questionnaire designed by 5 experts and addressed to neurologists leading stroke units/teams that had been operational for ≥ 1 year. RESULTS The survey was completed by 43 stroke units (61% of units in Spain) and 14 stroke teams. A mean (standard deviation) of 4 (3) neurologists were assigned to each stroke unit/team; 98% of stroke units (and 38% of stroke teams) have an on-call neurologist available 24 hours a day, 98% of units (79% of stroke teams) included specialised nurses, 86% of units (71% of stroke teams) included a social worker, and 81% of units (71% of stroke teams) included a rehabilitation physician. Most stroke units (80%) had 4--6 beds with continuous non-invasive monitoring. The mean number of unmonitored beds was 14 (8) for stroke units and 12 (7) for stroke teams. The mean duration of non-invasive monitoring was 3 (1) days. All stroke units and 86% of stroke teams had intravenous thrombolysis available, and 81% of stroke units and 21% of stroke teams were able to perform mechanical thrombectomy, whereas the remaining centres had referral pathways in place. Telestroke systems were in place at 44% of stroke units, providing support to a mean of 4 (3) centres. Activity is recorded in clinical registries by 77% of stroke units and 50% of stroke teams, but less than 75% of data is completed in 25% of cases. CONCLUSIONS Most stroke units/teams comply with the current recommendations. The systematic use of clinical registries should be improved to further improve patient care.
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Affiliation(s)
- M Alonso de Leciñana
- Servicio de Neurología, Centro de Ictus, Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain.
| | - A Morales
- Servicio de Neurología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - M Martínez-Zabaleta
- Servicio de Neurología, Hospital Universitario de Donostia, San Sebastián, Spain
| | - Ó Ayo-Martín
- Servicio de Neurología, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - L Lizán
- Outcomes'10 SLU, Castellón, Spain; Departamento de Medicina, Universitat Jaume I, Castellón, Spain
| | - M Castellanos
- Servicio de Neurología, Hospital Universitario e Instituto de Investigación Biomédica, La Coruña, Spain
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Palacio-Portilla EJ, Roquer J, Amaro S, Arenillas JF, Ayo-Martín O, Castellanos M, Freijo MM, Fuentes B, García-Pastor A, Gomis M, Gómez-Choco M, López-Cancio E, Martínez-Sánchez P, Morales A, Rodríguez-Yáñez M, Segura T, Serena J, Vivancos-Mora J, de Leciñana MA. Dyslipidemias and stroke prevention: recommendations of the Study Group of Cerebrovascular Diseases of the Spanish Society of Neurology. Neurologia 2022; 37:61-72. [PMID: 33160722 DOI: 10.1016/j.nrl.2020.07.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 07/19/2020] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE We present an update of the Spanish Society of Neurology's recommendations for prevention of both primary and secondary stroke in patients with dyslipidaemia. DEVELOPMENT We performed a systematic review to evaluate the main aspects of the management of dyslipidaemias in primary and secondary stroke prevention and establish a series of recommendations. CONCLUSIONS In primary prevention, the patient's vascular risk should be determined in order to define target values for low-density lipoprotein cholesterol. In secondary prevention after an atherothrombotic stroke, a target value <55mg/dL is recommended; in non-atherothombotic ischaemic strokes, given the unclear relationship with dyslipidaemia, target value should be established according to the vascular risk group of each patient. In both primary and secondary prevention, statins are the drugs of first choice, and ezetimibe and/or PCSK9 inhibitors may be added in patients not achieving the target value.
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Affiliation(s)
- E J Palacio-Portilla
- Servicio de Neurología, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, España.
| | - J Roquer
- Servicio de Neurología, IMIM-Hospital del Mar, Barcelona, España.
| | - S Amaro
- Servicio de Neurología, Hospital Clínic i Universitari; Departamento de Medicina, Universidad de Barcelona. Instituto de Investigación Biomédica Augut Pi i Sunyer (IDIBAPS), Barcelona, España
| | - J F Arenillas
- Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España
| | - O Ayo-Martín
- Servicio de Neurología, Complejo Hospitalario Universitario de Albacete, Albacete, España
| | - M Castellanos
- Servicio de Neurología, Complejo Hospitalario Universitario de A Coruña, Instituto de Investigación Biomédica A Coruña, A Coruña, España
| | - M M Freijo
- Servicio de Neurología, Hospital Universitario de Cruces, Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, España
| | - B Fuentes
- Servicio de Neurología, Centro de ictus, Hospital Universitario La Paz. IdiPAZ. Universidad Autónoma de Madrid, Madrid, España
| | - A García-Pastor
- Servicio de Neurología, Hospital Universitario Gregorio Marañón. Universidad Complutense de Madrid, Madrid, España
| | - M Gomis
- Servicio de Neurología, Hospital Universitario Germans Trias i Pujol, Universidad Autónoma de Barcelona, Badalona, España
| | - M Gómez-Choco
- Servicio de Neurología, Hospital de Sant Joan Despí Moisès Broggi, Sant Joan Despí, España
| | - E López-Cancio
- Servicio de Neurología, Hospital Universitario Central de Asturias, Oviedo, España
| | - P Martínez-Sánchez
- Servicio de Neurología, Hospital Universitario Torrecárdenas, Almería, España
| | - A Morales
- Servicio de Neurología, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biomédica (IMIB), El Palmar, Murcia, España
| | - M Rodríguez-Yáñez
- Servicio de Neurología, Hospital Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - T Segura
- Servicio de Neurología, Complejo Hospitalario Universitario de Albacete, Albacete, España
| | - J Serena
- Servicio de Neurología, Biomedical Research Institute of Girona, Hospital Universitario Doctor Josep Trueta, Girona, España
| | - J Vivancos-Mora
- Servicio de Neurología, Hospital Universitario de La Princesa. Instituto de Investigación Sanitaria Princesa, Universidad Autónoma de Madrid, Madrid, España
| | - M A de Leciñana
- Servicio de Neurología, Centro de ictus, Hospital Universitario La Paz. IdiPAZ. Universidad Autónoma de Madrid, Madrid, España
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Schonrock N, Callis T, Hatchell K, Esplin E, Morales A, Garcia J, Vatta M, Nussbaum R. Precision Medicine Opportunities for Familial Arrhythmias and Cardiomyopathies Identified When Cost of Genetic Testing is Removed as a Barrier. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.04.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Schonrock N, Morales A, Mitchell A, Garcia J, McKnight D, Callis T, Moretz C, Vatta M, Aradhya S. Genetic Testing Outcomes in a Cohort of 21,159 Children With Heart Disease. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.04.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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9
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Palacio-Portilla EJ, Roquer J, Amaro S, Arenillas JF, Ayo-Martín O, Castellanos M, Freijo MM, Fuentes B, García-Pastor A, Gomis M, Gómez-Choco M, López-Cancio E, Martínez-Sánchez P, Morales A, Rodríguez-Yáñez M, Segura T, Serena J, Vivancos-Mora J, de Leciñana MA. Dyslipidemias and stroke prevention: Recommendations of the Study Group of Cerebrovascular Diseases of the Spanish Society of Neurology. Neurologia 2022; 37:61-72. [PMID: 35074190 DOI: 10.1016/j.nrleng.2020.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 07/19/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We present an update of the Spanish Society of Neurology's recommendations for prevention of both primary and secondary stroke in patients with dyslipidaemia. DEVELOPMENT We performed a systematic review to evaluate the main aspects of the management of dyslipidaemias in primary and secondary stroke prevention and establish a series of recommendations. CONCLUSIONS In primary prevention, the patient's vascular risk should be determined in order to define target values for low-density lipoprotein cholesterol. In secondary prevention after an atherothrombotic stroke, a target value <55 mg/dL is recommended; in non-atherothombotic ischaemic strokes, given the unclear relationship with dyslipidaemia, target value should be established according to the vascular risk group of each patient. In both primary and secondary prevention, statins are the drugs of first choice, and ezetimibe and/or PCSK9 inhibitors may be added in patients not achieving the target value.
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Affiliation(s)
- E J Palacio-Portilla
- Servicio de Neurología, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain.
| | - J Roquer
- Servicio de Neurología, IMIM-Hospital del Mar, Barcelona, Spain.
| | - S Amaro
- Servicio de Neurología, Hospital Clínic i Universitari, Departamento de Medicina, Universidad de Barcelona, Instituto de Investigación Biomédica Augut Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - J F Arenillas
- Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - O Ayo-Martín
- Servicio de Neurología, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - M Castellanos
- Servicio de Neurología, Complejo Hospitalario Universitario de A Coruña, Instituto de Investigación Biomédica A Coruña, A Coruña, Spain
| | - M M Freijo
- Servicio de Neurología, Hospital Universitario de Cruces, Biocruces Bizkaia Health Research Institute, Barakaldo, Bizkaia, Spain
| | - B Fuentes
- Servicio de Neurología, Centro de Ictus, Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain
| | - A García-Pastor
- Servicio de Neurología, Hospital Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain
| | - M Gomis
- Servicio de Neurología, Hospital Universitario Germans Trias i Pujol, Universidad Autónoma de Barcelona, Badalona, Spain
| | - M Gómez-Choco
- Servicio de Neurología, Hospital de Sant Joan Despí Moisès Broggi, Sant Joan Despí, Spain
| | - E López-Cancio
- Servicio de Neurología, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - P Martínez-Sánchez
- Servicio de Neurología, Hospital Universitario Torrecárdenas, Almería, Spain
| | - A Morales
- Servicio de Neurología, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biomédica (IMIB), El Palmar, Murcia, Spain
| | - M Rodríguez-Yáñez
- Servicio de Neurología, Hospital Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - T Segura
- Servicio de Neurología, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - J Serena
- Servicio de Neurología, Biomedical Research Institute of Girona, Hospital Universitario Doctor Josep Trueta, Girona, Spain
| | - J Vivancos-Mora
- Servicio de Neurología, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - M A de Leciñana
- Servicio de Neurología, Centro de Ictus, Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain
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Nilles C, Delgadillo D, Martin Duverneuil N, Mokhtari K, Mathon B, Hoang-Xuan K, Duran-Pena A, Morales A, Houillier C. P03.04 Primary CNS lymphoma of the corpus callosum: presentation and neurocognitive prognosis. Study of a monocentric cohort of 27 patients. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
BACKGROUND
The corpus callosum (CC) is frequently involved in primary central nervous system lymphomas (PCNSL). The aim of our study was to describe the impact of these lesions on neurocognition of patients presenting with PCNSL of the CC (PCNSL-CC) and their post-therapeutic evolution.
MATERIAL AND METHODS
This is a retrospective single-center study. Patients newly diagnosed at Pitié Salpêtrière Hospital from (1999–2018) were included in this study according to the following criteria: age >18, immunocompetent patient, pathological confirmation (Diffuse Large B cell lymphoma) and CC as main location of the tumor on MRI. Clinical, neuroradiological and neuropsychological data of the patients were collected. In addition, prognostic factors for the neurocognitive outcome of the patients were investigated.
RESULTS
27 patients were included (median age: 67 years, median KPS: 70). At the time of diagnosis, 74% of patients had cognitive impairment and 59% of patients had balance disorders. The cognitive functions most frequently affected were memory and executive functions. Tumor lesions in the CC had a median maximum diameter of 5 cm with a so called “butterfly pattern” in 92% of cases. All patients received a high dose methotrexate based polychemotherapy, including one with radiation therapy, and 67% of patients achieved a complete remission (CR). Median PFS and OS were 33.3 months and 177.9 months respectively. With a median follow-up of 48 months (range 6–156), despite CR, there were still abnormal values in 17% of patients on overall efficiency, 17–55% of patients on executive function tests, 45–55% of patients on memory tests. No significant impaired values were found for visuo-spatial and language tests. Splenial location and age ≥ 60 years were significantly associated with worse episodic memory scores throughout the follow-up.
CONCLUSION
PCNSL-CC are associated with frequent cognitive dysfunctions, especially memory impairment, which may recover only partially despite CR, that warrant specific rehabilitation. Older age (≥ 60) and splenial location have worse neurocognition outcome.
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Affiliation(s)
- C Nilles
- Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, France
| | - D Delgadillo
- Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, France
| | | | - K Mokhtari
- Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, France
| | - B Mathon
- Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, France
| | - K Hoang-Xuan
- Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, France
| | - A Duran-Pena
- Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, France
| | - A Morales
- Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, France
| | - C Houillier
- Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Paris, France
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11
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Morales A, González F, Bernal H, Camacho RL, Arce N, Vásquez N, González-Vega JC, Htoo JK, Viana MT, Cervantes M. Effect of arginine supplementation on the morphology and function of intestinal epithelia, and serum concentrations of amino acids in pigs exposed to heat stress. J Anim Sci 2021; 99:6291043. [PMID: 34077525 DOI: 10.1093/jas/skab179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 05/31/2021] [Indexed: 11/13/2022] Open
Abstract
The exposure of pigs to heat stress (HS) appears to damage their intestinal epithelia, affecting the absorption of amino acids (AA). Arg is involved in the restoration of intestinal epithelial cells but HS reduces Arg intake. The effect of dietary supplementation with Arg on morphology of intestinal epithelia, AA transporter gene expression, and serum concentration (SC) of free AA in HS pigs were analyzed. Twenty pigs (25.3 ± 2.4 kg BW) were randomly assigned to two dietary treatments: control (0.81% Arg), wheat-soybean meal diet supplemented with L-Lys, L-Thr, DL-Met and L-Trp, and the experimental diet where 0.16% free L-Arg was supplemented to a similar control diet (+Arg). All pigs were individually housed and exposed to HS, fed at libitum with full access to water. The ambient temperature, recorded at 15-min intervals during the 21-d trial, ranged on average from 29.6 to 39.4 °C within the same day. Blood samples were collected on d18 at 1600 h (ambient temperature peak); serum was separated by centrifugation. At the end of the trial, five pigs per treatment were sacrificed to collect samples of mucosa scratched from each small intestine segment. The expression of AA transporters in intestinal mucosa and the SC of AA were analyzed. Villi height was higher (P < 0.01) in duodenum, jejunum, and ileum but the crypt depth did not differ between the control and the +Arg pigs. Supplementation of L-Arg increased the mRNA coding for the synthesis of the cationic AA transporter b 0,+ (P < 0.01) and the neutral AA transporter B 0 (P < 0.05) in duodenum by approximately five-folds and three-folds, respectively, but no effect on mRNA abundance was observed in jejunum and ileum. The supplementation of L-Arg increased serum Arg, His, Met, Thr, Trp, and urea (P < 0.05); tended to increase Val (P < 0.10), but did not affect Ile, Lys, Leu, and Phe. These results indicate that supplementing 0.16% L-Arg to the control diet may help to improve the function of the small intestine epithelium, by increasing the villi height, the abundance of AA transporters, and the SC of most indispensable AA in pigs exposed to HS conditions. However, the lack of effect of supplemental Arg on both Lys SC and weight gain of pigs suggests that increasing the Lys content in the +Arg diet might be needed to improve the performance of HS pigs.
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Affiliation(s)
- A Morales
- Universidad Autónoma de Baja California, Mexicali, B. C., México
| | - F González
- Universidad Autónoma de Baja California, Mexicali, B. C., México
| | - H Bernal
- Universidad Autónoma de Nuevo León, Monterrey, México
| | - R L Camacho
- Universidad Autónoma de Baja California, Mexicali, B. C., México
| | - N Arce
- Universidad Autónoma de Baja California, Mexicali, B. C., México
| | - N Vásquez
- Universidad Autónoma de Nuevo León, Monterrey, México
| | | | - J K Htoo
- Evonik Operations GmbH, Hanau, Germany
| | - M T Viana
- Universidad Autónoma de Baja California, Mexicali, B. C., México
| | - M Cervantes
- Universidad Autónoma de Baja California, Mexicali, B. C., México
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12
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García Pastor A, López-Cancio Martínez E, Rodríguez-Yáñez M, Alonso de Leciñana M, Amaro S, Arenillas JF, Ayo-Martín O, Castellanos M, Fuentes B, Freijo MM, Gomis M, Gómez Choco M, Martínez Sánchez P, Morales A, Palacio-Portilla EJ, Segura T, Serena J, Vivancos-Mora J, Roquer J. Recommendations of the Spanish Society of Neurology for the prevention of stroke. Interventions on lifestyle and air pollution. Neurologia 2021; 36:377-387. [PMID: 34714236 DOI: 10.1016/j.nrleng.2020.05.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 05/05/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To update the recommendations of the Spanish Society of Neurology regarding lifestyle interventions for stroke prevention. DEVELOPMENT We reviewed the most recent studies related to lifestyle and stroke risk, including randomised clinical trials, population studies, and meta-analyses. The risk of stroke associated with such lifestyle habits as smoking, alcohol consumption, stress, diet, obesity, and sedentary lifestyles was analysed, and the potential benefits for stroke prevention of modifying these habits were reviewed. We also reviewed stroke risk associated with exposure to air pollution. Based on the results obtained, we drafted recommendations addressing each of the lifestyle habits analysed. CONCLUSIONS Lifestyle modification constitutes a cornerstone in the primary and secondary prevention of stroke. Abstinence or cessation of smoking, cessation of excessive alcohol consumption, avoidance of exposure to chronic stress, avoidance of overweight or obesity, a Mediterranean diet supplemented with olive oil and nuts, and regular exercise are essential measures in reducing the risk of stroke. We also recommend implementing policies to reduce air pollution.
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Affiliation(s)
- A García Pastor
- Servicio de Neurología, Hospital Universitario Gregorio Marañon, Madrid, Spain; Servicio de Neurología, Hospital Universitario Central de Asturias, Oviedo, Spain.
| | - E López-Cancio Martínez
- Servicio de Neurología, Hospital Universitario Gregorio Marañon, Madrid, Spain; Servicio de Neurología, Hospital Universitario Central de Asturias, Oviedo, Spain.
| | - M Rodríguez-Yáñez
- Servicio de Neurología, Hospital Universitario de Santiago de Compostela, A Coruña, Spain
| | | | - S Amaro
- Servicio de Neurología, Hospital Clinic i Universitari, Barcelona, Spain
| | - J F Arenillas
- Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - O Ayo-Martín
- Servicio de Neurología, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - M Castellanos
- Servicio de Neurología, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - B Fuentes
- Servicio de Neurología, Hospital Universitario La Paz, Madrid, Spain
| | - M M Freijo
- Servicio de Neurología, Hospital Universitario de Cruces, Baracaldo, Spain
| | - M Gomis
- Servicio de Neurología, Hospital Universitario Germans Trias i Pujol, Barcelona, Spain
| | - M Gómez Choco
- Servicio de Neurología, Hospital de Sant Joan Despí Moisès Broogi, Barcelona, Spain
| | | | - A Morales
- Servicio de Neurología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - E J Palacio-Portilla
- Servicio de Neurología, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - T Segura
- Servicio de Neurología, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - J Serena
- Servicio de Neurología, Biomedical Research Institute of Girona, Girona, Spain
| | - J Vivancos-Mora
- Servicio de Neurología, Hospital Universitario de La Princesa, Madrid, Spain
| | - J Roquer
- Servicio de Neurología, IMIM-Hospital del Mar, Barcelona, Spain
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13
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Fuentes B, Amaro S, Alonso de Leciñana M, Arenillas J, Ayo-Martín O, Castellanos M, Freijo M, García-Pastor, Gomis M, Gómez Choco M, López-Cancio E, Martínez Sánchez P, Morales A, Palacio-Portilla E, Rodríguez-Yáñez M, Roquer J, Segura T, Serena J, Vivancos-Mora J. Stroke prevention in patients with type 2 diabetes mellitus or prediabetes: recommendations of the Spanish Society of Neurology’s Stroke Study Group. Neurología (English Edition) 2021. [DOI: 10.1016/j.nrleng.2020.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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14
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Rodríguez-Yañez M, Gómez-Choco M, López-Cancio E, Amaro S, Alonso de Leciñana M, Arenillas JF, Ayo-Martín O, Castellanos M, Freijo MM, García-Pastor A, Gomis M, Martínez Sánchez P, Morales A, Palacio-Portilla EJ, Roquer J, Segura T, Serena J, Vivancos-Mora J, Fuentes B. Stroke prevention in patients with arterial hypertension: Recommendations of the Spanish Society of Neurology's Stroke Study Group. Neurologia (Engl Ed) 2021; 36:462-471. [PMID: 34238528 DOI: 10.1016/j.nrleng.2020.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 04/29/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To update the recommendations of the Spanish Society of Neurology on primary and secondary stroke prevention in patients with arterial hypertension. DEVELOPMENT We proposed several questions to identify practical issues for the management of blood pressure (BP) in stroke prevention, analysing the objectives of blood pressure control, which drugs are most appropriate in primary prevention, when antihypertensive treatment should be started after a stroke, what levels we should aim to achieve, and which drugs are most appropriate in secondary stroke prevention. We conducted a systematic review of the PubMed database and analysed the main clinical trials to address these questions and establish a series of recommendations. CONCLUSIONS In primary stroke prevention, antihypertensive treatment should be started in patients with BP levels > 140/90 mmHg, with a target BP of < 130/80 mmHg. In secondary stroke prevention, we recommend starting antihypertensive treatment after the acute phase (first 24 hours), with a target BP of < 130/80 mmHg. The use of angiotensin-II receptor antagonists or diuretics alone or in combination with angiotensin-converting enzyme inhibitors is preferable.
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Affiliation(s)
- M Rodríguez-Yañez
- Servicio de Neurología, Hospital Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, Spain.
| | - M Gómez-Choco
- Servicio de Neurología, Hospital de Sant Joan Despí Moisès Broggi, Sant Joan Despí, Barcelona, Spain.
| | - E López-Cancio
- Servicio de Neurología, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - S Amaro
- Servicio de Neurología, Hospital Clínic i Universitari; Departamento de Medicina, Universidad de Barcelona. Instituto de Investigación Biomédica August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - M Alonso de Leciñana
- Servicio de Neurología, Hospital Universitario La Paz, Departamento de Medicina, Universidad Autónoma de Madrid, Área de Neurociencias. Instituto de Investigación IdiPAZ, Madrid, Spain
| | - J F Arenillas
- Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - O Ayo-Martín
- Servicio de Neurología, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - M Castellanos
- Servicio de Neurología, Complejo Hospitalario Universitario de A Coruña, Instituto de Investigación Biomédica A Coruña, A Coruña, Spain
| | - M M Freijo
- Servicio de Neurología, Hospital Universitario Cruces, Biocruces Bizkaia Health Research Institute, Barakaldo, Vizcaya, Spain
| | - A García-Pastor
- Servicio de Neurología, Hospital Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain
| | - M Gomis
- Servicio de Neurología, Hospital Universitario Germans Trias i Pujol, Universidad Autónoma de Barcelona, Badalona, Barcelona, Spain
| | | | - A Morales
- Servicio de Neurología, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biomédica (IMIB), El Palmar, Murcia, Spain
| | - E J Palacio-Portilla
- Servicio de Neurología, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, Spain
| | - J Roquer
- Servicio de Neurología, Hospital del Mar, Barcelona, Spain
| | - T Segura
- Servicio de Neurología, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - J Serena
- Servicio de Neurología, Biomedical Research Institute of Girona, Hospital Universitario Doctor Josep Trueta, Girona, Spain
| | - J Vivancos-Mora
- Servicio de Neurología, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa, Universidad Autónoma de Madrid, Madrid, Spain
| | - B Fuentes
- Servicio de Neurología, Hospital Universitario La Paz, Departamento de Medicina, Universidad Autónoma de Madrid, Área de Neurociencias. Instituto de Investigación IdiPAZ, Madrid, Spain
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15
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Schonrock N, Callis T, Hatchell K, Truty R, Esplin E, Morales A, Garcia J, Vatta M, Nussbaum R. Precision Medicine Opportunities for Familial Arrhythmias and Cardiomyopathies Identified When Cost of Genetic Testing is Removed as a Barrier. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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16
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Carrascal M, Arhip L, Rubio S, Morales A, Velasco C, Cuerda C, Bretón I, Motilla M, Serrrano C, Camblor M. Pre-surgical assessment of dietary intake of patients with peritoneal carcinomatosis who are undergoing cytoreductive surgery and hyperthermic intraoperative chemotherapy. Preliminary results. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Febrero B, Rodríguez J, Morales A, Parrilla P. Takotsubo cardiomyopathy associated with cerebral infarction following surgery for euthyroid goitre. Neurología (English Edition) 2020. [DOI: 10.1016/j.nrleng.2019.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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18
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Alonso de Leciñana M, Morales A, Martínez-Zabaleta M, Ayo-Martín Ó, Lizán L, Castellanos M. Characteristics of stroke units and stroke teams in Spain in 2018. Pre2Ictus project. Neurologia 2020; 38:S0213-4853(20)30222-X. [PMID: 32917435 DOI: 10.1016/j.nrl.2020.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 05/18/2020] [Accepted: 06/12/2020] [Indexed: 10/23/2022] Open
Abstract
INTRODUCTION The aim of this work is to describe the characteristics of stroke units and stroke teams in Spain. METHOD We performed a cross-sectional study based on an ad hoc questionnaire designed by 5 experts and addressed to neurologists leading stroke units/teams that had been operational for ≥ 1 year. RESULTS The survey was completed by 43 stroke units (61% of units in Spain) and 14 stroke teams. The mean (SD) number of neurologists assigned to each unit/team is 4±3. 98% of stroke units (and 38% of stroke teams) have a neurologist on-call available 24hours, 365 days. 98% of stroke units (79% of stroke teams) have specialised nurse, 95% of units (71% of stroke teams) auxiliary personnel, 86% of units (71% of stroke teams) social worker, 81% of stroke units (71% of stroke teams) have a rehabilitation physician and 81% of stroke units (86% of stroke teams) a physiotherapist. Most stroke units (80%) have 4-6 beds with continuous non-invasive monitoring. The mean number of unmonitored beds is 14 (8) for stroke units and 12 (7) for stroke teams. The mean duration of non-invasive monitoring is 3 (1) days. All stroke units and 86% of stroke teams have intravenous thrombolysis available, and 81% of stroke units and 21% of stroke teams are able to perform mechanical thrombectomy, whereas the remaining centres have referral pathways in place. Telestroke systems are available at 44% of stroke units, providing support to a mean of 4 (3) centres. Activity is recorded in clinical registries by 77% of stroke units and 50% of stroke teams, but less than 75% of data is completed in 25% of cases. CONCLUSIONS Most stroke units/teams comply with the current recommendations. The systematic use of clinical registries should be improved to further improve patient care.
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Affiliation(s)
- M Alonso de Leciñana
- Servicio de Neurología, Centro de Ictus, Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, Madrid, España.
| | - A Morales
- Servicio de Neurología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - M Martínez-Zabaleta
- Servicio de Neurología, Hospital Universitario de Donostia, San Sebastián, España
| | - Ó Ayo-Martín
- Servicio de Neurología, Complejo Hospitalario Universitario de Albacete, Albacete, España
| | - L Lizán
- Outcomes'10 SLU, Castellón, España; Departamento de Medicina, Universitat Jaume I, Castellón, España
| | - M Castellanos
- Servicio de Neurología, Hospital Universitario e Instituto de Investigación Biomédica, La Coruña, España
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19
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García Pastor A, López-Cancio Martínez E, Rodríguez-Yáñez M, Alonso de Leciñana M, Amaro S, Arenillas JF, Ayo-Martín O, Castellanos M, Fuentes B, Freijo MM, Gomis M, Gómez Choco M, Martínez Sánchez P, Morales A, Palacio-Portilla EJ, Segura T, Serena J, Vivancos-Mora J, Roquer J. Recommendations of the Spanish Society of Neurology for the prevention of stroke. Interventions on lifestyle and air pollution. Neurologia 2020. [PMID: 32917433 DOI: 10.1016/j.nrl.2020.05.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE To update the recommendations of the Spanish Society of Neurology regarding lifestyle interventions for stroke prevention. DEVELOPMENT We reviewed the most recent studies related to lifestyle and stroke risk, including randomised clinical trials, population studies, and meta-analyses. The risk of stroke associated with such lifestyle habits as smoking, alcohol consumption, stress, diet, obesity, and sedentary lifestyles was analysed, and the potential benefits for stroke prevention of modifying these habits were reviewed. We also reviewed stroke risk associated with exposure to air pollution. Based on the results obtained, we drafted recommendations addressing each of the lifestyle habits analysed. CONCLUSIONS Lifestyle modification constitutes a cornerstone in the primary and secondary prevention of stroke. Abstinence or cessation of smoking, cessation of excessive alcohol consumption, avoidance of exposure to chronic stress, avoidance of overweight or obesity, a Mediterranean diet supplemented with olive oil and nuts, and regular exercise are essential measures in reducing the risk of stroke. We also recommend implementing policies to reduce air pollution.
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Affiliation(s)
- A García Pastor
- Servicio de Neurología, Hospital Universitario Gregorio Marañon, Madrid, España; Servicio de Neurología, Hospital Universitario Central de Asturias, Oviedo, España.
| | - E López-Cancio Martínez
- Servicio de Neurología, Hospital Universitario Gregorio Marañon, Madrid, España; Servicio de Neurología, Hospital Universitario Central de Asturias, Oviedo, España.
| | - M Rodríguez-Yáñez
- Servicio de Neurología, Hospital Universitario de Santiago de Compostela, A Coruña, España
| | | | - S Amaro
- Servicio de Neurología, Hospital Clinic i Universitari, Barcelona, España
| | - J F Arenillas
- Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España
| | - O Ayo-Martín
- Servicio de Neurología, Complejo Hospitalario Universitario de Albacete, Albacete, España
| | - M Castellanos
- Servicio de Neurología, Complejo Hospitalario Universitario de A Coruña, A Coruña, España
| | - B Fuentes
- Servicio de Neurología, Hospital Universitario La Paz, Madrid, España
| | - M M Freijo
- Servicio de Neurología, Hospital Universitario de Cruces, Baracaldo, España
| | - M Gomis
- Servicio de Neurología, Hospital Universitari Germans Trias i Pujol, Barcelona, España
| | - M Gómez Choco
- Servicio de Neurología, Hospital de Sant Joan Despí Moisès Broogi, Barcelona, España
| | | | - A Morales
- Servicio de Neurología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - E J Palacio-Portilla
- Servicio de Neurología, Hospital Universitario Marqués de Valdecilla, Santander, España
| | - T Segura
- Servicio de Neurología, Complejo Hospitalario Universitario de Albacete, Albacete, España
| | - J Serena
- Servicio de Neurología, Biomedical Research Institute of Girona, Girona, España
| | - J Vivancos-Mora
- Servicio de Neurología, Hospital Universitario de La Princesa, Madrid, España
| | - J Roquer
- Servicio de Neurología, IMIM-Hospital del Mar, Barcelona, España
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20
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Rodríguez-Yañez M, Gómez-Choco M, López-Cancio E, Amaro S, Alonso de Leciñana M, Arenillas JF, Ayo-Martín O, Castellanos M, Freijo MM, García-Pastor A, Gomis M, Martínez Sánchez P, Morales A, Palacio-Portilla EJ, Roquer J, Segura T, Serena J, Vivancos-Mora J, Fuentes B. Stroke prevention in patients with arterial hypertension: Recommendations of the Spanish Society of Neurology's Stroke Study Group. Neurologia 2020. [PMID: 32893074 DOI: 10.1016/j.nrl.2020.04.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To update the recommendations of the Spanish Society of Neurology on primary and secondary stroke prevention in patients with arterial hypertension. DEVELOPMENT We proposed several questions to identify practical issues for the management of blood pressure (BP) in stroke prevention, analysing the objectives of blood pressure control, which drugs are most appropriate in primary prevention, when antihypertensive treatment should be started after a stroke, what levels we should aim to achieve, and which drugs are most appropriate in secondary stroke prevention. We conducted a systematic review of the PubMed database and analysed the main clinical trials to address these questions and establish a series of recommendations. CONCLUSIONS In primary stroke prevention, antihypertensive treatment should be started in patients with BP levels >140/90mmHg, with a target BP of <130/80mmHg. In secondary stroke prevention, we recommend starting antihypertensive treatment after the acute phase (first 24hours), with a target BP of <130/80mmHg. The use of angiotensin-II receptor antagonists or diuretics alone or in combination with angiotensin-converting enzyme inhibitors is preferable.
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Affiliation(s)
- M Rodríguez-Yañez
- Servicio de Neurología, Hospital Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, España.
| | - M Gómez-Choco
- Servicio de Neurología, Hospital de Sant Joan Despí Moisès Broggi, Sant Joan Despí, Barcelona, España.
| | - E López-Cancio
- Servicio de Neurología, Hospital Universitario Central de Asturias, Oviedo, España
| | - S Amaro
- Servicio de Neurología, Hospital Clínic i Universitari; Departamento de Medicina, Universidad de Barcelona. Instituto de Investigación Biomédica August Pi i Sunyer (IDIBAPS), Barcelona, España
| | - M Alonso de Leciñana
- Servicio de Neurología, Hospital Universitario La Paz; Departamento de Medicina, Universidad Autónoma de Madrid. Área de Neurociencias. Instituto de Investigación IdiPAZ, Madrid, España
| | - J F Arenillas
- Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España
| | - O Ayo-Martín
- Servicio de Neurología, Complejo Hospitalario Universitario de Albacete, Albacete, España
| | - M Castellanos
- Servicio de Neurología, Complejo Hospitalario Universitario de A Coruña; Instituto de Investigación Biomédica A Coruña, A Coruña, España
| | - M M Freijo
- Servicio de Neurología, Hospital Universitario Cruces. Biocruces Bizkaia Health Research Institute, Barakaldo, Vizcaya, España
| | - A García-Pastor
- Servicio de Neurología, Hospital Universitario Gregorio Marañón; Universidad Complutense de Madrid, Madrid, España
| | - M Gomis
- Servicio de Neurología, Hospital Universitario Germans Trias i Pujol, Universidad Autónoma de Barcelona, Badalona, Barcelona, España
| | | | - A Morales
- Servicio de Neurología, Hospital Clínico Universitario Virgen de la Arrixaca; Instituto Murciano de Investigación Biomédica (IMIB), El Palmar, Murcia, España
| | - E J Palacio-Portilla
- Servicio de Neurología, Hospital Universitario Marqués de Valdecilla, IDIVAL, Universidad de Cantabria, Santander, España
| | - J Roquer
- Servicio de Neurología, Hospital del Mar, Barcelona, España
| | - T Segura
- Servicio de Neurología, Complejo Hospitalario Universitario de Albacete, Albacete, España
| | - J Serena
- Servicio de Neurología; Biomedical Research Institute of Girona, Hospital Universitario Doctor Josep Trueta, Girona, España
| | - J Vivancos-Mora
- Servicio de Neurología, Hospital Universitario de La Princesa; Instituto de Investigación Sanitaria Princesa, Universidad Autónoma de Madrid, Madrid, España
| | - B Fuentes
- Servicio de Neurología, Hospital Universitario La Paz; Departamento de Medicina, Universidad Autónoma de Madrid. Área de Neurociencias. Instituto de Investigación IdiPAZ, Madrid, España
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Arribas J, Garcia E, Jara R, Gutierrez F, Albert L, Bixquert D, García-Puente J, Albacete C, Canovas S, Morales A. Incidence and aetiological mechanism of stroke in cardiac surgery. Neurología (English Edition) 2020. [DOI: 10.1016/j.nrleng.2019.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Morales A, Mendez A, Perez J. Depreciación del caballo Pura Raza Española con la deformación del borde dorsal del cuello. ARCH ZOOTEC 2020. [DOI: 10.21071/az.v69i267.5358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Se plantea como objetivo estimar la depreciación de un caballo Pura Raza Española con la deformación del borde dorsal del cuello. Se estudió a una población de 500 caballos de Pura Raza Española clasificados en 4 edades: Potros (6 meses-4 años), en doma 4-8 años, adultos 8-12 años y maduros (12-20 años), pertenecientes a 65 propietarios, 10 centros de cría Pura Raza Española y un matadero en Andalucía y Extremadura, España. Se realizó la estimación de la depreciación para un año una vez detectada la deformación del borde dorsal de cuello, de manera separada por 3 grupos etarios: caballos en doma 4-8 años, caballos adultos 8-12 años y caballos maduros (12-20 años), mediante tres métodos, el método de línea recta, el método de la reducción de saldo (5%) y el método de la suma de los dígitos de los años. En relación a la depreciación del caballo de Pura Raza Española con deformación del borde dorsal del cuello, estimada para un año, es bastante alta y proporcional al costo del caballo. En conclusión, la depreciación del caballo de Pura Raza Española con la deformación del borde dorsal del cuello, se puede presentar en promedio a partir de los 6 años de edad (aproximadamente entre 4-8 años), la depreciación calculada por los tres métodos línea recta, reducción del saldo al 5% y suma de los dígitos fue similar, solo presento variación por el grupo etario 4-8 años 95%, 8-12 años 99% y 12-20 años 98% de depreciación respetivamente.
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Morales A, Garcia-Montaño E, Barrios-Ortega C, Niebles-Charris J, Garcia-Roncallo P, Abello-Luque D, Gomez-Lugo M, Saavedra D, Vallejo-Medina P, Espada J, Lightfoot M, Martínez O. P-04-15 From Spain to Colombia: Adaptation Process of Competences for Adolescents With a Healthy Sexuality Program (COMPAS). J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Morales A, Orgilés M, Fernández-Martínez I, Escribano S, Espada J. P-04-14 "Mom, Dad, I´m Still a Virgin": Is Paternal Pressure Towards Sexual Abstinence Associated to Their Teenagers' Sexual Behavior? J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Matías-Guiu J, Matias-Guiu JA, Alvarez-Sabin J, Ramon Ara J, Arenillas J, Casado-Naranjo I, Castellanos M, Jimenez-Hernandez MD, Lainez-Andres JM, Moral E, Morales A, Rodriguez-Antigüedad A, Segura T, Serrano-Castro P, Diez-Tejedor E. Will neurological care change over the next 5 years due to the COVID-19 pandemic? Key informant consensus survey. Neurologia 2020; 35:252-257. [PMID: 32364126 PMCID: PMC7165283 DOI: 10.1016/j.nrl.2020.04.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 04/17/2020] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION The COVID-19 pandemic will give rise to long-term changes in neurological care, which are not easily predictable. MATERIAL AND METHODS A key informant survey was used to enquire about the changes expected in the specialty over the next 5 years. The survey was completed by heads of neurology departments with broad knowledge of the situation, having been active during the pandemic. RESULTS Despite a low level of consensus between participants, there was strong (85%) and moderate consensus (70%) about certain subjects, mainly the increase in precautions to be taken, the use of telemedicine and teleconsultations, the reduction of care provided in in-person consultations to avoid the presence of large numbers of people in waiting rooms, the development of remote training solutions, and the changes in monitoring visits during clinical trials. There was consensus that there would be no changes to the indication of complementary testing or neurological examination. CONCLUSION The key informant survey identified the foreseeable changes in neurological care after the pandemic.
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Affiliation(s)
- J Matías-Guiu
- Servicio de Neurología, Hospital Clínico San Carlos, Madrid, España.
| | - J A Matias-Guiu
- Servicio de Neurología, Hospital Clínico San Carlos, Madrid, España
| | - J Alvarez-Sabin
- Servicio de Neurología, Hospital Universitario de Vall d'Hebron, Barcelona, España
| | - J Ramon Ara
- Servicio de Neurología, Hospital Miguel Servet, Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, España
| | - J Arenillas
- Servicio de Neurología, Hospital Clínico de Valladolid, Valladolid, España
| | - I Casado-Naranjo
- Servicio de Neurología, Complejo Hospitalario Universitario de Cáceres, Cáceres, España
| | - M Castellanos
- Servicio de Neurología, Complejo Hospitalario Universitario A Coruña, Instituto de Investigación Biomédica A Coruña, A Coruña, España
| | | | - J M Lainez-Andres
- Servicio de Neurología, Hospital Clínico Universitario de Valencia, Valencia, España
| | - E Moral
- Hospital Moisès Broggi y Hospital General de l'Hospitalet, Barcelona, España
| | - A Morales
- Servicio de Neurología, Hospital Universitario Virgen de la Arrixaca, Murcia, España
| | | | - T Segura
- Servicio de Neurología, Hospital General Universitario de Albacete, Albacete, España
| | - P Serrano-Castro
- Servicio de Neurología, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España
| | - E Diez-Tejedor
- Servicio de Neurología, Hospital Universitario La Paz, Madrid, España
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Zupancic P, Dreon D, Li X, Baumgärtner A, Morales A, Zheng W, Cooper NR, Esslinger T, Donner T. P-Band Induced Self-Organization and Dynamics with Repulsively Driven Ultracold Atoms in an Optical Cavity. Phys Rev Lett 2019; 123:233601. [PMID: 31868492 DOI: 10.1103/physrevlett.123.233601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Indexed: 06/10/2023]
Abstract
We investigate a Bose-Einstein condensate strongly coupled to an optical cavity via a repulsive optical lattice. We detect a stable self-ordered phase in this regime, and show that the atoms order through an antisymmetric coupling to the P band of the lattice, limiting the extent of the phase and changing the geometry of the emergent density modulation. Furthermore, we find a nonequilibrium phase with repeated intense bursts of the intracavity photon number, indicating nontrivial driven-dissipative dynamics.
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Affiliation(s)
- P Zupancic
- Institute for Quantum Electronics, Eidgenössische Technische Hochschule Zürich, Otto-Stern-Weg 1, 8093 Zurich, Switzerland
| | - D Dreon
- Institute for Quantum Electronics, Eidgenössische Technische Hochschule Zürich, Otto-Stern-Weg 1, 8093 Zurich, Switzerland
| | - X Li
- Institute for Quantum Electronics, Eidgenössische Technische Hochschule Zürich, Otto-Stern-Weg 1, 8093 Zurich, Switzerland
| | - A Baumgärtner
- Institute for Quantum Electronics, Eidgenössische Technische Hochschule Zürich, Otto-Stern-Weg 1, 8093 Zurich, Switzerland
| | - A Morales
- Institute for Quantum Electronics, Eidgenössische Technische Hochschule Zürich, Otto-Stern-Weg 1, 8093 Zurich, Switzerland
| | - W Zheng
- T.C.M. Group, Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, United Kingdom
| | - N R Cooper
- T.C.M. Group, Cavendish Laboratory, University of Cambridge, JJ Thomson Avenue, Cambridge CB3 0HE, United Kingdom
| | - T Esslinger
- Institute for Quantum Electronics, Eidgenössische Technische Hochschule Zürich, Otto-Stern-Weg 1, 8093 Zurich, Switzerland
| | - T Donner
- Institute for Quantum Electronics, Eidgenössische Technische Hochschule Zürich, Otto-Stern-Weg 1, 8093 Zurich, Switzerland
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Febrero B, Rodríguez JM, Morales A, Parrilla P. Takotsubo cardiomyopathy associated with cerebral infarction following surgery for euthyroid goiter. Neurologia 2019; 35:592-593. [PMID: 31103314 DOI: 10.1016/j.nrl.2019.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 01/25/2019] [Accepted: 01/29/2019] [Indexed: 11/26/2022] Open
Affiliation(s)
- B Febrero
- Unidad de Cirugía Endocrina, Servicio de Cirugía General, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biomédica (IMIB), El Palmar, Murcia, España.
| | - J M Rodríguez
- Unidad de Cirugía Endocrina, Servicio de Cirugía General, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biomédica (IMIB), El Palmar, Murcia, España
| | - A Morales
- Servicio de Neurología, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biomédica (IMIB), El Palmar, Murcia, España
| | - P Parrilla
- Unidad de Cirugía Endocrina, Servicio de Cirugía General, Hospital Clínico Universitario Virgen de la Arrixaca, Instituto Murciano de Investigación Biomédica (IMIB), El Palmar, Murcia, España
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Ravichandran K, McCaffrey C, Grifo J, Morales A, Perloe M, Munne S, Wells D, Fragouli E. Corrigendum. Mitochondrial DNA quantification as a tool for embryo viability assessment: retrospective analysis of data from single euploid blastocyst transfers. Hum Reprod 2019; 34:781. [DOI: 10.1093/humrep/dez013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Ravichandran
- Reprogenetics, A Cooper Surgical Company, 3 Regent Street, Livingston, NJ, USA
| | - C McCaffrey
- NYU Langone Medical Center, 333 E 38th Street, New York, MY, USA
| | - J Grifo
- NYU Langone Medical Center, 333 E 38th Street, New York, MY, USA
| | - A Morales
- Fertility Specialists Medical Group, 8010 Frost Street, San Diego, CA, USA
| | - M Perloe
- Georgia Reproductive Specialists, 5445 Meridian Mark Road, Altanta, GA, USA
| | - S Munne
- Reprogenetics, A Cooper Surgical Company, 3 Regent Street, Livingston, NJ, USA
| | - D Wells
- Reprogenetics UK, Institute for Reproductive Sciences, Oxford Business Park North, Oxford, UK
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - E Fragouli
- Reprogenetics UK, Institute for Reproductive Sciences, Oxford Business Park North, Oxford, UK
- Nuffield Department of Obstetrics and Gynaecology, University of Oxford, John Radcliffe Hospital, Oxford, UK
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Garcia J, Castañeda A, Morales A, Bassa P, Soler M, Riera E. Staging and follow-up of a Ewing sarcoma patient using 18F-FDG PET/CT. Rev Esp Med Nucl Imagen Mol 2018. [DOI: 10.1016/j.remnie.2017.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Abstract
Se plantea como objetivo estudio de la incidencia de la deformación del borde dorsal del cuello en burros en Andalucía y Extremadura, España. Se practicó un examen clínico a cada uno de los burros mediante la inspección detallada y la palpación. Se realizó un estudio morfológico siguiendo el protocolo de adiposidad para la evaluación del borde dorsal del cuello descrito. Se analizo el grado de deformación del cuello, diámetro del cuello, largo del cuello, peso, actividad atlética, localización geográfica y tipo de alimentación, tipo de manejo, instalaciones. Se estudiaron a un total de 853 burros, la deformación del borde dorsal del cuello presento una mayor incidencia en burros de raza Andaluza de 70%, en raza Miniatura 14%, en Zamorano-Leonesa 9% y por último en la raza Catalana 7%. En relación al sexo el 65% fue macho y hembras 35%. El nivel de correlación entre el grado de deformidad y el sistema de manejo fue positivo de 0.18, también para la deformación del cuello y la altura del comedero 0.0835. La deformación del borde dorsal del cuello (Cuello de gato, cresta o cresty neck), presento una incidencia de 40%, con mayor número de observaciones en burros de raza Andaluza de 70%, en raza Miniatura 14%, en Zamorano-Leonesa 9% y por último en la raza Catalana 7%.
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Peña C, Valjalo R, Rocca X, Roa M, Morales A, Méndez GP. Anti-glomerular basement membrane disease due to monoclonal IgG Lambda antibodies: a very rare case of monoclonal gammopathy of renal significance. Ann Hematol 2018; 98:1045-1046. [PMID: 30302532 DOI: 10.1007/s00277-018-3513-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 10/02/2018] [Indexed: 10/28/2022]
Affiliation(s)
- C Peña
- Hematology Department, Hospital del Salvador, Santiago de Chile, Chile.
| | - R Valjalo
- Nephrology Department, Hospital del Salvador, Santiago de Chile, Chile
| | - X Rocca
- Nephrology Department, Hospital del Salvador, Santiago de Chile, Chile
| | - M Roa
- Hematology Department, Hospital del Salvador, Santiago de Chile, Chile
| | - A Morales
- Nephrology Department, Hospital del Salvador, Santiago de Chile, Chile
| | - G P Méndez
- Pathology Department, Facultad de Medicina, Pontificia Universidad Católica, Santiago de Chile, Chile
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Morales A, Chávez M, Vásquez N, Htoo JK, Buenabad L, Espinoza S, Cervantes M. Increased dietary protein or free amino acids supply for heat stress pigs: effect on performance and carcass traits. J Anim Sci 2018; 96:1419-1429. [PMID: 29471400 DOI: 10.1093/jas/sky044] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 02/15/2018] [Indexed: 12/31/2022] Open
Abstract
Heat stress (HS) pigs reduce their voluntary feed intake (VFI) and ingestion of indispensable amino acids (AA). Increasing the dietary crude protein (CP) content may help to correct the reduced AA intake by HS pigs, but it may further increase their body heat load. Increasing the AA intake by adding free AA to the diet does not affect the heat load of HS pigs. Two 21-d experiments were conducted. In Exp. 1, 30 pigs (31.1 ± 1.2 kg initial body weight) were used to determine the performance depression because of HS. Treatments were: thermo neutral pigs fed a 22% CP control diet (TN-C); HS pigs fed the control diet (HS-C); HS pigs fed a 14% CP, AA supplemented diet (HS-AA). HS pigs had lower ADG and Lys utilization efficiency, and consumed 20 and 25% less Lys and Thr, respectively, than the TN-C pigs (P < 0.05). In Exp. 2 (comparative slaughter), 25 pigs (33.6 ± 0.65 kg initial body weight) were used to evaluate the effect of extra dietary AA either as protein-bound or free AA on the performance and carcass traits of HS pigs. Treatments were: control wheat-SBM-free Lys, Thr and Met diet (CON); diet with 30% more CP than CON (HSxP); diet added with free AA to contain at least 25% more of each AA than the recommended level (HSxAA). Ambient temperature (AT) ranged from 27.7 to 37.7°C, and body temperature (39.9 to 41.2°C) followed a similar daily pattern as the AT did. There was no dietary treatment effect on daily feed and NE intake (P > 0.10), but the Lys, Thr, and Met intake was higher in pigs fed the HSxP or HSxAA diets than in pigs fed the CON diet (P < 0.05). The daily weight gain (ADG) was not affected (P > 0.10) but G:F tended to be higher and the Lys utilization efficiency (ADG, g/g Lys intake) tended to be lower in HSxP pigs than in CON pigs (P < 0.10). The HSxAA pigs had higher ADG (P < 0.05), and tended to have higher weight of hot carcass and leg muscle, and the weight gain of hot carcass and leg muscle than the CON pigs (P < 0.10). The weight and daily weight gain of loin muscle was higher in the HSxAA than in the HSxP pigs (P < 0.05). Kidney weight and serum urea in HSxP pigs were higher than in CON and HSxAA pigs, but spleen weight was higher in HSxAA pigs than in CON and HSxP pigs (P < 0.05). These results confirm that HS reduces the VFI, and show that increased levels of AA either as free or protein-bound do not additionally reduce the VFI of HS pigs. These also show that extra free AA supply rather than protein-bound AA better ameliorate the reduced growth performance of HS pigs.
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Affiliation(s)
- A Morales
- Instituto de Ciencias Agrícolas, Universidad Autónoma de Baja California, Mexicali, México
| | - M Chávez
- Instituto de Ciencias Agrícolas, Universidad Autónoma de Baja California, Mexicali, México
| | - N Vásquez
- Instituto de Ciencias Agrícolas, Universidad Autónoma de Baja California, Mexicali, México
| | - J K Htoo
- Evonik Nutrition & Care GmbH, Hanau, Germany
| | - L Buenabad
- Instituto de Ciencias Agrícolas, Universidad Autónoma de Baja California, Mexicali, México
| | - S Espinoza
- Instituto de Ciencias Agrícolas, Universidad Autónoma de Baja California, Mexicali, México
| | - M Cervantes
- Instituto de Ciencias Agrícolas, Universidad Autónoma de Baja California, Mexicali, México
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Redondo MJ, Geyer S, Steck AK, Sharp S, Wentworth JM, Weedon MN, Antinozzi P, Sosenko J, Atkinson M, Pugliese A, Oram RA, Antinozzi P, Atkinson M, Battaglia M, Becker D, Bingley P, Bosi E, Buckner J, Colman P, Gottlieb P, Herold K, Insel R, Kay T, Knip M, Marks J, Moran A, Palmer J, Peakman M, Philipson L, Pugliese A, Raskin P, Rodriguez H, Roep B, Russell W, Schatz D, Wherrett D, Wilson D, Winter W, Ziegler A, Benoist C, Blum J, Chase P, Clare-Salzler M, Clynes R, Eisenbarth G, Fathman C, Grave G, Hering B, Kaufman F, Leschek E, Mahon J, Nanto-Salonen K, Nepom G, Orban T, Parkman R, Pescovitz M, Peyman J, Roncarolo M, Simell O, Sherwin R, Siegelman M, Steck A, Thomas J, Trucco M, Wagner J, Greenbaum ,CJ, Bourcier K, Insel R, Krischer JP, Leschek E, Rafkin L, Spain L, Cowie C, Foulkes M, Krause-Steinrauf H, Lachin JM, Malozowski S, Peyman J, Ridge J, Savage P, Skyler JS, Zafonte SJ, Kenyon NS, Santiago I, Sosenko JM, Bundy B, Abbondondolo M, Adams T, Amado D, Asif I, Boonstra M, Bundy B, Burroughs C, Cuthbertson D, Deemer M, Eberhard C, Fiske S, Ford J, Garmeson J, Guillette H, Browning G, Coughenour T, Sulk M, Tsalikan E, Tansey M, Cabbage J, Dixit N, Pasha S, King M, Adcock K, Geyer S, Atterberry H, Fox L, Englert K, Mauras N, Permuy J, Sikes K, Berhe T, Guendling B, McLennan L, Paganessi L, Hays B, Murphy C, Draznin M, Kamboj M, Sheppard S, Lewis V, Coates L, Moore W, Babar G, Bedard J, Brenson-Hughes D, Henderson C, Cernich J, Clements M, Duprau R, Goodman S, Hester L, Huerta-Saenz L, Karmazin A, Letjen T, Raman S, Morin D, Henry M, Bestermann W, Morawski E, White J, Brockmyer A, Bays R, Campbell S, Stapleton A, Stone N, Donoho A, Everett H, Heyman K, Hensley H, Johnson M, Marshall C, Skirvin N, Taylor P, Williams R, Ray L, Wolverton C, Nickels D, Dothard C, Hsiao B, Speiser P, Pellizzari M, Bokor L, Izuora K, Abdelnour S, Cummings P, Paynor S, Leahy M, Riedl M, Shockley S, Karges C, Saad R, Briones T, Casella S, Herz C, Walsh K, Greening J, Hay F, Hunt S, Sikotra N, Simons L, Keaton N, Karounos D, Oremus R, Dye L, Myers L, Ballard D, Miers W, Sparks R, Thraikill K, Edwards K, Fowlkes J, Kinderman A, Kemp S, Morales A, Holland L, Johnson L, Paul P, Ghatak A, Phelen K, Leyland H, Henderson T, Brenner D, Law P, Oppenheimer E, Mamkin I, Moniz C, Clarson C, Lovell M, Peters A, Ruelas V, Borut D, Burt D, Jordan M, Leinbach A, Castilla S, Flores P, Ruiz M, Hanson L, Green-Blair J, Sheridan R, Wintergerst K, Pierce G, Omoruyi A, Foster M, Linton C, Kingery S, Lunsford A, Cervantes I, Parker T, Price P, Urben J, Doughty I, Haydock H, Parker V, Bergman P, Liu S, Duncum S, Rodda C, Thomas A, Ferry R, McCommon D, Cockroft J, Perelman A, Calendo R, Barrera C, Arce-Nunez E, Lloyd J, Martinez Y, De la Portilla M, Cardenas I, Garrido L, Villar M, Lorini R, Calandra E, D’Annuzio G, Perri K, Minuto N, Malloy J, Rebora C, Callegari R, Ali O, Kramer J, Auble B, Cabrera S, Donohoue P, Fiallo-Scharer R, Hessner M, Wolfgram P, Maddox K, Kansra A, Bettin N, McCuller R, Miller A, Accacha S, Corrigan J, Fiore E, Levine R, Mahoney T, Polychronakos C, Martin J, Gagne V, Starkman H, Fox M, Chin D, Melchionne F, Silverman L, Marshall I, Cerracchio L, Cruz J, Viswanathan A, Miller J, Wilson J, Chalew S, Valley S, Layburn S, Lala A, Clesi P, Genet M, Uwaifo G, Charron A, Allerton T, Milliot E, Cefalu W, Melendez-Ramirez L, Richards R, Alleyn C, Gustafson E, Lizanna M, Wahlen J, Aleiwe S, Hansen M, Wahlen H, Moore M, Levy C, Bonaccorso A, Rapaport R, Tomer Y, Chia D, Goldis M, Iazzetti L, Klein M, Levister C, Waldman L, Muller S, Wallach E, Regelmann M, Antal Z, Aranda M, Reynholds C, Leech N, Wake D, Owens C, Burns M, Wotherspoon J, Nguyen T, Murray A, Short K, Curry G, Kelsey S, Lawson J, Porter J, Stevens S, Thomson E, Winship S, Wynn L, O’Donnell R, Wiltshire E, Krebs J, Cresswell P, Faherty H, Ross C, Vinik A, Barlow P, Bourcier M, Nevoret M, Couper J, Oduah V, Beresford S, Thalagne N, Roper H, Gibbons J, Hill J, Balleaut S, Brennan C, Ellis-Gage J, Fear L, Gray T, Pilger J, Jones L, McNerney C, Pointer L, Price N, Few K, Tomlinson D, Denvir L, Drew J, Randell T, Mansell P, Roberts A, Bell S, Butler S, Hooton Y, Navarra H, Roper A, Babington G, Crate L, Cripps H, Ledlie A, Moulds C, Sadler K, Norton R, Petrova B, Silkstone O, Smith C, Ghai K, Murray M, Viswanathan V, Henegan M, Kawadry O, Olson J, Stavros T, Patterson L, Ahmad T, Flores B, Domek D, Domek S, Copeland K, George M, Less J, Davis T, Short M, Tamura R, Dwarakanathan A, O’Donnell P, Boerner B, Larson L, Phillips M, Rendell M, Larson K, Smith C, Zebrowski K, Kuechenmeister L, Wood K, Thevarayapillai M, Daniels M, Speer H, Forghani N, Quintana R, Reh C, Bhangoo A, Desrosiers P, Ireland L, Misla T, Xu P, Torres C, Wells S, Villar J, Yu M, Berry D, Cook D, Soder J, Powell A, Ng M, Morrison M, Young K, Haslam Z, Lawson M, Bradley B, Courtney J, Richardson C, Watson C, Keely E, DeCurtis D, Vaccarcello-Cruz M, Torres Z, Alies P, Sandberg K, Hsiang H, Joy B, 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Trunnel S, Transue D, Surhigh J, Bezzaire D, Moltz K, Zacharski E, Henske J, Desai S, Frizelis K, Khan F, Sjoberg R, Allen K, Manning P, Hendry G, Taylor B, Jones S, Couch R, Danchak R, Lieberman D, Strader W, Bencomo M, Bailey T, Bedolla L, Roldan C, Moudiotis C, Vaidya B, Anning C, Bunce S, Estcourt S, Folland E, Gordon E, Harrill C, Ireland J, Piper J, Scaife L, Sutton K, Wilkins S, Costelloe M, Palmer J, Casas L, Miller C, Burgard M, Erickson C, Hallanger-Johnson J, Clark P, Taylor W, Galgani J, Banerjee S, Banda C, McEowen D, Kinman R, Lafferty A, Gillett S, Nolan C, Pathak M, Sondrol L, Hjelle T, Hafner S, Kotrba J, Hendrickson R, Cemeroglu A, Symington T, Daniel M, Appiagyei-Dankah Y, Postellon D, Racine M, Kleis L, Barnes K, Godwin S, McCullough H, Shaheen K, Buck G, Noel L, Warren M, Weber S, Parker S, Gillespie I, Nelson B, Frost C, Amrhein J, Moreland E, Hayes A, Peggram J, Aisenberg J, Riordan M, Zasa J, Cummings E, Scott K, Pinto T, Mokashi A, McAssey K, Helden E, Hammond P, Dinning L, Rahman S, Ray S, Dimicri C, Guppy S, Nielsen H, Vogel C, Ariza C, Morales L, Chang Y, Gabbay R, Ambrocio L, Manley L, Nemery R, Charlton W, Smith P, Kerr L, Steindel-Kopp B, Alamaguer M, Tabisola-Nuesca E, Pendersen A, Larson N, Cooper-Olviver H, Chan D, Fitz-Patrick D, Carreira T, Park Y, Ruhaak R, Liljenquist D. A Type 1 Diabetes Genetic Risk Score Predicts Progression of Islet Autoimmunity and Development of Type 1 Diabetes in Individuals at Risk. Diabetes Care 2018; 41:1887-1894. [PMID: 30002199 PMCID: PMC6105323 DOI: 10.2337/dc18-0087] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 06/06/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE We tested the ability of a type 1 diabetes (T1D) genetic risk score (GRS) to predict progression of islet autoimmunity and T1D in at-risk individuals. RESEARCH DESIGN AND METHODS We studied the 1,244 TrialNet Pathway to Prevention study participants (T1D patients' relatives without diabetes and with one or more positive autoantibodies) who were genotyped with Illumina ImmunoChip (median [range] age at initial autoantibody determination 11.1 years [1.2-51.8], 48% male, 80.5% non-Hispanic white, median follow-up 5.4 years). Of 291 participants with a single positive autoantibody at screening, 157 converted to multiple autoantibody positivity and 55 developed diabetes. Of 953 participants with multiple positive autoantibodies at screening, 419 developed diabetes. We calculated the T1D GRS from 30 T1D-associated single nucleotide polymorphisms. We used multivariable Cox regression models, time-dependent receiver operating characteristic curves, and area under the curve (AUC) measures to evaluate prognostic utility of T1D GRS, age, sex, Diabetes Prevention Trial-Type 1 (DPT-1) Risk Score, positive autoantibody number or type, HLA DR3/DR4-DQ8 status, and race/ethnicity. We used recursive partitioning analyses to identify cut points in continuous variables. RESULTS Higher T1D GRS significantly increased the rate of progression to T1D adjusting for DPT-1 Risk Score, age, number of positive autoantibodies, sex, and ethnicity (hazard ratio [HR] 1.29 for a 0.05 increase, 95% CI 1.06-1.6; P = 0.011). Progression to T1D was best predicted by a combined model with GRS, number of positive autoantibodies, DPT-1 Risk Score, and age (7-year time-integrated AUC = 0.79, 5-year AUC = 0.73). Higher GRS was significantly associated with increased progression rate from single to multiple positive autoantibodies after adjusting for age, autoantibody type, ethnicity, and sex (HR 2.27 for GRS >0.295, 95% CI 1.47-3.51; P = 0.0002). CONCLUSIONS The T1D GRS independently predicts progression to T1D and improves prediction along T1D stages in autoantibody-positive relatives.
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Affiliation(s)
- Maria J. Redondo
- Texas Children’s Hospital, Baylor College of Medicine, Houston, TX
| | | | - Andrea K. Steck
- Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Seth Sharp
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
| | - John M. Wentworth
- Walter and Eliza Hall Institute of Medical Research and Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Michael N. Weedon
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
| | | | | | | | | | - Richard A. Oram
- Institute of Biomedical and Clinical Science, University of Exeter, Exeter, U.K
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Morales A, Sanchez O, Suntravat M, Sanchez E. Purification and characterization of cysteine-rich secretory proteins (SVCRIPSS) from 5 different species of North America venomous snakes. Toxicon 2018. [DOI: 10.1016/j.toxicon.2018.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Diaz V, Agostinho J, Gonzalez B, Rivas C, Velayos P, Puertas M, Ros A, Benito N, Morales A, Cachero M, Lupon J, De Antonio M, Moliner P, Domingo M, Bayes-Genis A. 26Perception of symptoms, concerns and global disease experience in patients with heart failure. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- V Diaz
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - J Agostinho
- Cardiology Department, Santa Maria Hospital, CHLN, CCUL, Lisbon University, Lisbon, Portugal
| | - B Gonzalez
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - C Rivas
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - P Velayos
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - M Puertas
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - A Ros
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - N Benito
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - A Morales
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - M Cachero
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - J Lupon
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - M De Antonio
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - P Moliner
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - M Domingo
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - A Bayes-Genis
- Germans Trias i Pujol University Hospital, Badalona, Spain
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Gonzalez B, Cachero M, Rivas C, Diaz V, Ros A, Benito N, Puertas M, Morales A, Velayos P, Lupon J, De Antonio M, Moliner P, Domingo M, Zamora E, Bayes-Genis A. 411Mini nutritional assessment short form tool for nurse quick screening of nutritional status in an outpatient heart failure unit. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- B Gonzalez
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - M Cachero
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - C Rivas
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - V Diaz
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - A Ros
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - N Benito
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - M Puertas
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - A Morales
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - P Velayos
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - J Lupon
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - M De Antonio
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - P Moliner
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - M Domingo
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - E Zamora
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - A Bayes-Genis
- Germans Trias i Pujol University Hospital, Badalona, Spain
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Suntravat M, Marquez J, Morales A, Sanchez O, Szteiter S, Sanchez E. The acute effects of snake venom crisp toxins on blood and lymphatic endothelial cell permeability: New insights into the pathophysiology of snakebite. Toxicon 2018. [DOI: 10.1016/j.toxicon.2018.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Arhip L, García-Peris P, Romero RM, Frías L, Bretón I, Camblor M, Motilla M, Velasco C, Morales A, Carrascal ML, Herranz A, Sanjurjo M, Cuerda C. Direct costs of a home parenteral nutrition programme. Clin Nutr 2018; 38:1945-1951. [PMID: 30005903 DOI: 10.1016/j.clnu.2018.06.972] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 05/06/2018] [Accepted: 06/21/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND & AIMS Home parenteral nutrition (HPN) is a lifesaving treatment for people with chronic intestinal failure and its cost has been reported to be very high. The purpose of the present paper was to study the direct healthcare and non-healthcare costs associated with the HPN programme managed by a tertiary hospital. METHODS Observational, retrospective study of all adult patients on HPN from 11.1.2014 to 10.31.2015 treated at Gregorio Marañón University Hospital (Madrid, Spain). An economic evaluation was undertaken to calculate the direct healthcare (HPN provision, outpatient monitoring and management of complications) and non-healthcare costs (transportation process) of the HPN programme. The variables were collected from medical records, the dispensary and the hospital's financial services. The unit costs were taken from official price lists. RESULTS Thirty-two patients met the inclusion criteria. Total direct healthcare and non-healthcare costs amounted to €13,363.53 per patient (€124.02 per patient per day). The direct healthcare costs accounted for 98.32% of overall costs, while the non-healthcare costs accounted for the remaining 1.68%. HPN provision accounted for the majority of the costs (74.25%), followed by management of complications (21.85%) and outpatient monitoring (2.23%). CONCLUSIONS The direct healthcare costs accounted for the majority of HPN expenditure, specifically HPN provision was the category with the highest percentage.
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Affiliation(s)
- L Arhip
- Nutrition Unit, University General Hospital Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain.
| | - P García-Peris
- Nutrition Unit, University General Hospital Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - R M Romero
- Pharmacy Service, University General Hospital Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - L Frías
- Nutrition Unit, University General Hospital Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - I Bretón
- Nutrition Unit, University General Hospital Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - M Camblor
- Nutrition Unit, University General Hospital Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - M Motilla
- Nutrition Unit, University General Hospital Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - C Velasco
- Nutrition Unit, University General Hospital Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - A Morales
- Nutrition Unit, University General Hospital Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - M L Carrascal
- Nutrition Unit, University General Hospital Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - A Herranz
- Pharmacy Service, University General Hospital Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - M Sanjurjo
- Pharmacy Service, University General Hospital Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - C Cuerda
- Nutrition Unit, University General Hospital Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
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Trincado P, Playán J, Acha J, De Castro P, Sanz A, Albero R, Morales A. Adrenal Failure Due to Metastasis Both to the Hypothalamic-Pituitary Area and the Adrenals. Tumori 2018; 82:401-4. [PMID: 8890980 DOI: 10.1177/030089169608200422] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A 61-year-old white male was admitted to our hospital with a big-cell bronchogenic carcinoma whose first clinical manifestation was diabetes insipidus (01) secondary to metastasis to the hypothalamic-pituitary area (MHP). In three months, and progressively, he developed anterior pituitary failure, as well as primary adrenal insufficiency (PAI) due to metastasis in both adrenals. Panhypopituitarism or PAI due to both MHP and adrenals has been rarely reported in the literature. A thorough examination of the oncologic patient led us to diagnose hormone insufficiency properly. The absence of reported cases might be due to the fact that the symptoms resulting from hormone insufficiency are veiled by the severe condition of the patients suffering from disseminated cancer.
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Affiliation(s)
- P Trincado
- Department of Endocrinology, Hospital Miguel Servet, Zaragoza, Spain
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Ravichandran K, McCaffrey C, Grifo J, Morales A, Perloe M, Munne S, Wells D, Fragouli E. Mitochondrial DNA quantification as a tool for embryo viability assessment: retrospective analysis of data from single euploid blastocyst transfers. Hum Reprod 2018; 32:1282-1292. [PMID: 28387858 DOI: 10.1093/humrep/dex070] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 03/17/2017] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Does the amount of mitochondrial DNA (mtDNA) in blastocyst biopsy specimens have the potential to serve as a biomarker of euploid embryo implantation ability, independent of morphology? SUMMARY ANSWER The results of this study strongly suggest that elevated mtDNA levels, above a previously defined threshold, are strongly associated with blastocyst implantation failure and represent an independent biomarker of embryo viability. WHAT IS KNOWN ALREADY Improved methods of embryo selection are highly desirable in order to increase the efficiency of IVF treatment. At present, even the transfer of chromosomally normal embryos of high morphological grade cannot guarantee that a pregnancy will follow. Recently, it has been proposed that the quantity of mtDNA in embryonic cells may be an indicator of developmental potential, with higher levels of mtDNA associated with reduced implantation. However, thus far reported data sets have been relatively small and in some cases have lacked appropriate validation. STUDY DESIGN, SIZE, DURATION This large, blinded, retrospective study involved the analysis of relative mtDNA levels in 1505 euploid blastocysts obtained from 490 couples undergoing preimplantation genetic testing for aneuploidy. Implantation outcomes were compared to mtDNA levels in order to determine the capacity of the method to predict viability and to assess the validity of previously established thresholds. PARTICIPANTS/MATERIALS, SETTING, METHODS DNA from blastocyst biopsy samples was amplified and then subjected to aneuploidy analysis using next generation sequencing or array comparative genomic hybridization. Only those embryos classified as chromosomally normal had their mtDNA levels assessed. This analysis was undertaken retrospectively using quantitative real-time PCR, without knowledge of the outcome of embryo transfer. Predictions of implantation failure, based upon mtDNA levels were subsequently compared to the observed clinical results. All cycles involved the transfer of a single embryo. MAIN RESULTS AND THE ROLE OF CHANCE Of all blastocysts analyzed, 9.2% (139/1505) contained mtDNA levels above a previously established viability threshold and were therefore predicted to have reduced chances of implantation. To the date of analysis, 282 euploid blastocysts had been transferred with an overall implantation rate of 65.6% (185/282). Of the transferred embryos, 249 contained levels of mtDNA in the normal range, 185 of which produced a pregnancy, giving an implantation rate of 74.3% for euploid embryos with 'normal' quantities of mtDNA. However, 33 of the transferred embryos were determined to have elevated mtDNA quantities. None of these led to a pregnancy. Therefore, the negative predictive value of mtDNA assessment in this cohort was 100% (33/33). The difference between the implantation rates for embryos with normal and elevated mtDNA levels was highly significant (P < 0.0001). The mtDNA thresholds, used for classification of embryos, were unaffected by female age or the clinic in which the IVF was undertaken. The probability of an embryo having elevated levels of mtDNA was not influenced by variation in embryo morphology. LIMITATIONS, REASONS FOR CAUTION This study provides strong evidence that mtDNA quantification can serve as a valuable tool to assist the evaluation of blastocyst viability. However, to determine the true extent of any clinical benefits, other types of investigations, such as non-selection studies and randomized controlled trials, will also be necessary. WIDER IMPLICATIONS OF THE FINDINGS The results of this study suggest that mtDNA quantity can serve as an independent biomarker for the prediction of euploid blastocyst implantation potential. Prospective studies should now be undertaken to confirm these results. Additionally, investigations into the underlying biological cause(s) of elevated mtDNA levels and an enhanced understanding of how they relate to diminished implantation potential would be invaluable. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by funding provided by Reprogenetics. None of the authors have any competing interests.
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Affiliation(s)
- K Ravichandran
- Reprogenetics, A Cooper Surgical Company, 3 Regent Street, Livingston, NJ 07039, USA
| | - C McCaffrey
- NYU Langone Medical Center, 333 E 38th Street, New York, NY 10016, USA
| | - J Grifo
- NYU Langone Medical Center, 333 E 38th Street, New York, NY 10016, USA
| | - A Morales
- Fertility Specialists Medical Group, 8010 Frost Street, San Diego, CA 92123, USA
| | - M Perloe
- Georgia Reproductive Specialists, 5445 Meridian Mark Road, Atlanta, GA 30342, USA
| | - S Munne
- Reprogenetics, A Cooper Surgical Company, 3 Regent Street, Livingston, NJ 07039, USA
| | - D Wells
- Reprogenetics UK, Institute for Reproductive Sciences, Oxford Business Park North, Oxford OX4 2HW, UK.,Nuffield Department of Obstetrics and Gynaecology, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - E Fragouli
- Reprogenetics UK, Institute for Reproductive Sciences, Oxford Business Park North, Oxford OX4 2HW, UK.,Nuffield Department of Obstetrics and Gynaecology, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK
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Arribas JM, Garcia E, Jara R, Gutierrez F, Albert L, Bixquert D, García-Puente J, Albacete C, Canovas S, Morales A. Incidence and etiological mechanism of stroke in cardiac surgery. Neurologia 2017; 35:458-463. [PMID: 29249300 DOI: 10.1016/j.nrl.2017.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 10/01/2017] [Accepted: 10/15/2017] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE We studied patients who had experienced a stroke in the postoperative period of cardiac surgery, aiming to analyse their progression and determine the factors that may influence prognosis and treatment. METHODS We established a protocol for early detection of stroke after cardiac surgery and collected data on stroke onset and a number of clinical, surgical, and prognostic variables in order to perform a descriptive analysis. RESULTS Over the 15-month study period we recorded 16 strokes, which represent 2.5% of the patients who underwent cardiac surgery. Mean age in our sample was 69 ± 8 years; 63% of patients were men. The incidence of stroke in patients aged 80 and older was 5.1%. Five patients (31%) underwent emergency surgery. By type of cardiac surgery, 7% of patients underwent mitral valve surgery, 6.5% combined surgery, 3% aortic valve surgery, and 2.24% coronary surgery. Most cases of stroke (44%) were due to embolism, followed by hypoperfusion (25%). Stroke occurred within 2 days of surgery in 69% of cases. The mean NIHSS score in our sample of stroke patients was 9; code stroke was activated in 10 cases (62%); one patient (14%) underwent thrombectomy. Most patients progressed favourably: 13 (80%) scored≤2 on the modified Rankin Scale at 3 months. None of the patients died during the postoperative hospital stay. CONCLUSION In our setting, strokes occurring after cardiac surgery are usually small and have a good long-term prognosis. Most of them occur within 2 days, and they are mostly embolic in origin. The incidence of stroke in patients aged 80 and older and undergoing cardiac surgery is twice as high as that of the general population.
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Affiliation(s)
- J M Arribas
- Servicio de Cirugía Cardiovascular, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España.
| | - E Garcia
- Servicio de Neurología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - R Jara
- Servicio de Cuidados Intensivos, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - F Gutierrez
- Servicio de Cirugía Cardiovascular, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - L Albert
- Servicio de Neurología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - D Bixquert
- Servicio de Cuidados Intensivos, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - J García-Puente
- Servicio de Cirugía Cardiovascular, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - C Albacete
- Servicio de Cuidados Intensivos, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - S Canovas
- Servicio de Cirugía Cardiovascular, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - A Morales
- Servicio de Neurología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
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Machado V, Alvarado T, Barrios L, Morales A, Sharkey M, Mavian C, Salemi M, Stevenson M. Identification of macrophage reservoirs through tropism of HIV-1 envelope. J Virus Erad 2017. [DOI: 10.1016/s2055-6640(20)30574-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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43
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Comino RO, Morales A, Minchole E, Diez-Ferrer M, Lopez-Lisbona R, Cubero N, Dorca J, Rosell A. P1.12-009 Experience with Fully Covered Metallic Stents in Patients with Malignant Airway Obstruction. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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44
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Morales A, Ibarra N, Chávez M, Gómez T, Suárez A, Valle JA, Camacho RL, Cervantes M. Effect of feed intake level and dietary protein content on the body temperature of pigs housed under thermo neutral conditions. J Anim Physiol Anim Nutr (Berl) 2017; 102:e718-e725. [DOI: 10.1111/jpn.12824] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 08/31/2017] [Indexed: 12/14/2022]
Affiliation(s)
- A. Morales
- Instituto de Ciencias Agrícolas; Universidad Autónoma de Baja California; Mexicali México
| | - N. Ibarra
- Instituto de Ciencias Agrícolas; Universidad Autónoma de Baja California; Mexicali México
| | - M. Chávez
- Instituto de Ciencias Agrícolas; Universidad Autónoma de Baja California; Mexicali México
| | - T. Gómez
- Instituto de Ciencias Agrícolas; Universidad Autónoma de Baja California; Mexicali México
| | - A. Suárez
- Instituto de Ciencias Agrícolas; Universidad Autónoma de Baja California; Mexicali México
| | - J. A. Valle
- Instituto de Ciencias Agrícolas; Universidad Autónoma de Baja California; Mexicali México
| | - R. L. Camacho
- Instituto de Ciencias Agrícolas; Universidad Autónoma de Baja California; Mexicali México
| | - M. Cervantes
- Instituto de Ciencias Agrícolas; Universidad Autónoma de Baja California; Mexicali México
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Otero JA, Monsivais G, Morales A, Gutiérrez L, Díaz-de-Anda A, Flores J. Further understanding of doorway states in elastic systems. J Acoust Soc Am 2017; 142:646. [PMID: 28863612 DOI: 10.1121/1.4996500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In a previous work an elastic bar with a groove or notch that presents a doorway state was studied when the system was excited with 20 cycles of harmonic signals. The strength function had a Lorentzian width Γd = 1/πτd, where τd is the decay time of the prompt response. In the present paper, the doorway-state phenomenon is analyzed again for the same harmonic signals but for a very large number of cycles. The strength-function phenomenon is once more obtained, but now with a Lorentzian width Γ' which is larger than Γd. A qualitative and numerical explanation of this fact is given, leading therefore to further understanding of doorway states in elastic systems. The numerical results show a very good agreement with the values measured in the laboratory.
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Affiliation(s)
- J A Otero
- Tecnológico de Monterrey, Campus Estado de México, Atizapán de Zaragoza, 52926 Estado de México, Mexico
| | - G Monsivais
- Instituto de Física, Universidad Nacional Autónoma de México, P.O. Box 20-364, 01000 Ciudad de México, Mexico
| | - A Morales
- Instituto de Ciencias Físicas, Universidad Nacional Autónoma de México, P.O. Box 48-3, 62251 Cuernavaca, Morelos, Mexico
| | - L Gutiérrez
- Instituto de Ciencias Físicas, Universidad Nacional Autónoma de México, P.O. Box 48-3, 62251 Cuernavaca, Morelos, Mexico
| | - A Díaz-de-Anda
- Instituto de Física, Benemérita Universidad Autónoma de Puebla, P.O. Box J-48, 72570 Puebla, Puebla, Mexico
| | - J Flores
- Instituto de Física, Universidad Nacional Autónoma de México, P.O. Box 20-364, 01000 Ciudad de México, Mexico
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Gonzalez B, Gastelurrutia P, Lupon J, Rodriguez M, Moliner P, Rivas C, De Antonio M, Domingo M, Diaz V, Zamora E, Armesto T, Puertas M, Cachero M, Morales A, Bayes-Genis A. P2986Frailty and quality of life in heart failure patients with mid-range ejection fraction. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p2986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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47
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Aguayo KMD, Barragán HB, Sáenz EO, Dávila FS, Ramírez MC, Morales A, Aguilar NCV. 083 Egg production and quality from laying quails fed three levels of moringa meal. J Anim Sci 2017. [DOI: 10.2527/asasann.2017.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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48
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Morales A, Ibarra N, Espinoza S, Reyes F, Avelar E, Camacho RL, Ramírez MC. 324 Diurnal ambient temperature variations in warm climate regions affect the serum concentrations of free amino acids in growing pigs. J Anim Sci 2017. [DOI: 10.2527/asasmw.2017.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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49
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López-Picazo JJ, Palazón B, Morales A. [Redesigning the informed consent process for patients with acute ischemic stroke]. Rev Calid Asist 2017; 32:122-124. [PMID: 27174649 DOI: 10.1016/j.cali.2016.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 03/09/2016] [Accepted: 03/09/2016] [Indexed: 06/05/2023]
Affiliation(s)
- J J López-Picazo
- Unidad de Calidad Asistencial, Área 1 Murcia-Oeste, Murcia, España.
| | - B Palazón
- Unidad de Ictus, Área 1 Murcia-Oeste, Murcia, España
| | - A Morales
- Unidad de Ictus, Área 1 Murcia-Oeste, Murcia, España
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Morales A, Eidinger D, Bruce AW. Intracavitary Bacillus Calmette-Guerin in the Treatment of Superficial Bladder Tumors. J Urol 2016; 197:S142-S145. [PMID: 28012770 DOI: 10.1016/j.juro.2016.10.101] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/1975] [Indexed: 10/20/2022]
Abstract
Patients with recurrent superficial bladder tumors have been treated by vesical and intradermal administration of Bacillus Calmette-Guerin. The pattern of recurrence in 9 patients has been altered favorably. Although the findings are still preliminary they appear to hold promise of a new therapeutic approach to the treatment of a group of neoplasms for which effective therapy is still lacking.
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Affiliation(s)
- A Morales
- Departments of Urology, and Microbiology and Immunology, Queen's University, Kingston, Ontario, Canada
| | - D Eidinger
- Departments of Urology, and Microbiology and Immunology, Queen's University, Kingston, Ontario, Canada
| | - A W Bruce
- Departments of Urology, and Microbiology and Immunology, Queen's University, Kingston, Ontario, Canada
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