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Acosta A, Ramirez Marquez E, Aguayo A, Perez A, Rivera L, Oliver AL. Managing a Pigmented Corneal Ulcer in a 58-Year-Old Patient. Cureus 2023; 15:e46850. [PMID: 37954775 PMCID: PMC10637339 DOI: 10.7759/cureus.46850] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2023] [Indexed: 11/14/2023] Open
Abstract
We report on a case study involving a 58-year-old male with a pigmented corneal ulcer. The patient presented with a two-month history of an unresolved corneal ulcer in the oculus sinister (OS), accompanied by increasing ocular discomfort. His best corrected visual acuity (BCVA) was 20/20 oculus dexter and hand motion OS. Examination of OS revealed mild conjunctival injection, diffuse corneal edema, and the presence of a central pigmented lesion. Microbiological analysis via culture identified the causative agent as Ochroconis fungi, belonging to the dematiaceous species. Subsequently, the patient's condition was managed through a comprehensive regimen that included multiple topical antifungal agents, a topical antibiotic, and povidone-iodine drops. After two months of treatment, the patient exhibited improvement in his condition. His BCVA improved to counting fingers at a distance of two feet OS.
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Affiliation(s)
- Alejandro Acosta
- Ophthalmology, University of Puerto Rico, Medical Sciences Campus, San Juan, USA
| | | | - Angel Aguayo
- Ophthalmology, University of Puerto Rico, Medical Sciences Campus, San Juan, USA
| | - Alejandro Perez
- Ophthalmology, University of Puerto Rico, Medical Sciences Campus, San Juan, USA
| | - Lília Rivera
- Ophthalmology and Cornea, University of Puerto Rico, Medical Sciences Campus, San Juan, USA
| | - Armando L Oliver
- Ophthalmology, University of Puerto Rico, Medical Sciences Campus, San Juan, USA
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Acosta A, Lloyd T, McCorriston S, Lan H. The ripple effect of animal disease outbreaks on food systems: The case of African Swine Fever on the Chinese pork market. Prev Vet Med 2023; 215:105912. [PMID: 37119649 DOI: 10.1016/j.prevetmed.2023.105912] [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: 10/07/2022] [Revised: 03/11/2023] [Accepted: 04/05/2023] [Indexed: 05/01/2023]
Abstract
Research on animal health economics has emphasised the importance of accounting for the indirect economic effects of animal disease outbreaks. Although recent studies have advanced in this direction by assessing consumer and producer welfare losses due to asymmetric price adjustments, potential over-shifting effects along the supply chain and spill-overs to substitute markets have been under-examined. This study contributes to this field of research by assessing the direct and indirect effects of the African swine fever (ASF) outbreak on the pork market in China. We employ impulse response functions estimated by local projection to calculate the price adjustments for consumers and producers, as well as the cross-effect in other meat markets. The results show that the ASF outbreak led to increases in both farmgate and retail prices but the rise in retail prices exceeded the corresponding change in farmgate prices. Furthermore, beef and chicken prices also rose, demonstrating the spill-over impacts of the outbreak to other markets. Overall, the evidence illustrates that a disruption in one part of a food system can have significant ripple effects across other parts of the system.
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Affiliation(s)
- Alejandro Acosta
- Food and Agriculture Organization of the United Nations (FAO), Rome, Italy.
| | - Tim Lloyd
- Bournemouth University, Bournemouth, United Kingdom
| | | | - Hao Lan
- Xi'an Jiaotong-Liverpool University, Suzhou, China
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3
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Vezzaro V, De María M, Lucas L, Acosta A. [Translated article] Is Incontinentia Pigmenti More Serious in Males? A Report of 2 Cases. Actas Dermosifiliogr 2022; 113 Suppl 1:TS10-TS12. [PMID: 36228710 DOI: 10.1016/j.ad.2022.10.028] [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: 05/12/2021] [Accepted: 07/16/2021] [Indexed: 11/07/2022] Open
Affiliation(s)
- V Vezzaro
- Departamento de Neonatología - Centro Hospitalario Pereira Rossell, Universidad de la República, Montevideo, Uruguay
| | - M De María
- Departamento de Neonatología - Centro Hospitalario Pereira Rossell, Universidad de la República, Montevideo, Uruguay.
| | - L Lucas
- Departamento de Neonatología - Centro Hospitalario Pereira Rossell, Universidad de la República, Montevideo, Uruguay
| | - A Acosta
- Cátedra de Dermatología, Centro Hospitalario Pereira Rossell, Universidad de la República, Montevideo, Uruguay
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Frederick GA, Bonilla-Escobar FJ, Acosta A, Candelo PC, Castro A. Associated factors with pseudophakic retinal detachment: Long-term follow-up in a Colombian population. Arch Soc Esp Oftalmol (Engl Ed) 2022; 97:663-669. [PMID: 36097149 DOI: 10.1016/j.oftale.2022.09.001] [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] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/02/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To identify associated factors with the appearance of pseudophakic retinal detachment in patients with history of cataract surgery. METHODS Retrospective case-control study of 802 eyes of 783 patients with history of cataract surgery. Cases were patients with pseudophakic retinal detachment (n = 258 eyes), while controls were patients with cataract surgery who did not developed retinal detachment during a 10-year follow-up period (n = 544 eyes). RESULTS Age at cataract surgery among cases was lower than in the control group (57 ± 13 vs. 67 ± 14 years old, respectively; p < 0.0001). Age at retinal detachment was 59 ± 13 years old (range 6-88) and the time between the cataract surgery and the retinal detachment had a median of 2 years (interquartile range 1-4) with a range of 1 month to 14 years. Associated factors for pseudophakic retinal detachment were younger age (<50 years: adjusted odds ratio [aOR] = 18.03, 95% confidence interval [95%CI] = 5.92-54.87; 50-59 years: aOR = 10.09, 95%CI = 3.37-30.23; and 60-69 years: aOR = 5.48, 95%CI = 1.88-15.93), male sex (aOR = 3.71, 95%CI = 2.54-5.44), anterior vitrectomy (aOR = 3.26, 95%CI = 1.16-9.16), history of retinal detachment in the fellow eye (aOR = 6.95, 95%CI = 3.15-15.31), and intraoperative complications during cataract extraction (aOR = 7.45, 95%CI = 3.54-15.69). CONCLUSIONS This is the first report of associated factors with pseudophakic retinal detachment in a Colombian population. Surgical complications, sex, and age were found to be associated with retinal detachment. Patients should be aware of these potential risks to make informed decisions about their eye health.
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Affiliation(s)
- G A Frederick
- Retina y Vítreo, Clínica de Oftalmología de Cali, Cali, Colombia.
| | - F J Bonilla-Escobar
- Fundación Somos Ciencia al Servicio de la Comunidad, Fundación SCISCO, Servicio de Oftalmología, Universidad del Valleorg, Cali, Colombia; Grupo de investigación en Visión y Salud Ocular, VISOC, Servicio de Oftalmología, Universidad del Valle, Cali, Colombia; Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States
| | - A Acosta
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States
| | - P C Candelo
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, United States
| | - A Castro
- Retina y Vítreo, Clínica de Oftalmología de Cali, Cali, Colombia
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Vezzaro V, de María M, Lucas L, Acosta A. Is Incontinentia Pigmenti More Serious in Males? A Report of 2 Cases. Actas Dermosifiliogr 2022; 113 Suppl 1:S10-S12. [PMID: 36543461 DOI: 10.1016/j.ad.2021.07.010] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/16/2021] [Indexed: 12/30/2022] Open
Affiliation(s)
- V Vezzaro
- Departamento de Neonatología, Centro Hospitalario Pereira Rossell, Universidad de la República, Montevideo, Uruguay
| | - M de María
- Departamento de Neonatología, Centro Hospitalario Pereira Rossell, Universidad de la República, Montevideo, Uruguay.
| | - L Lucas
- Departamento de Neonatología, Centro Hospitalario Pereira Rossell, Universidad de la República, Montevideo, Uruguay
| | - A Acosta
- Cátedra de Dermatología, Centro Hospitalario Pereira Rossell, Universidad de la República, Montevideo, Uruguay
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Griffin LP, Casselberry GA, Lowerre-Barbieri SK, Acosta A, Adams AJ, Cooke SJ, Filous A, Friess C, Guttridge TL, Hammerschlag N, Heim V, Morley D, Rider MJ, Skomal GB, Smukall MJ, Danylchuk AJ, Brownscombe JW. Predator-prey landscapes of large sharks and game fishes in the Florida Keys. Ecol Appl 2022; 32:e2584. [PMID: 35333436 DOI: 10.1002/eap.2584] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 06/24/2021] [Indexed: 06/14/2023]
Abstract
Interspecific interactions can play an essential role in shaping wildlife populations and communities. To date, assessments of interspecific interactions, and more specifically predator-prey dynamics, in aquatic systems over broad spatial and temporal scales (i.e., hundreds of kilometers and multiple years) are rare due to constraints on our abilities to measure effectively at those scales. We applied new methods to identify space-use overlap and potential predation risk to Atlantic tarpon (Megalops atlanticus) and permit (Trachinotus falcatus) from two known predators, great hammerhead (Sphyrna mokarran) and bull (Carcharhinus leucas) sharks, over a 3-year period using acoustic telemetry in the coastal region of the Florida Keys (USA). By examining spatiotemporal overlap, as well as the timing and order of arrival at specific locations compared to random chance, we show that potential predation risk from great hammerhead and bull sharks to Atlantic tarpon and permit are heterogeneous across the Florida Keys. Additionally, we find that predator encounter rates with these game fishes are elevated at specific locations and times, including a prespawning aggregation site in the case of Atlantic tarpon. Further, using machine learning algorithms, we identify environmental variability in overlap between predators and their potential prey, including location, habitat, time of year, lunar cycle, depth, and water temperature. These predator-prey landscapes provide insights into fundamental ecosystem function and biological conservation, especially in the context of emerging fishery-related depredation issues in coastal marine ecosystems.
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Affiliation(s)
- Lucas P Griffin
- Department of Environmental Conservation, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Grace A Casselberry
- Department of Environmental Conservation, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Susan K Lowerre-Barbieri
- Florida Fish and Wildlife Conservation Commission, Florida Fish and Wildlife Research Institute, St. Petersburg, Florida, USA
| | - Alejandro Acosta
- South Florida Regional Lab, Florida Fish and Wildlife Conservation Commission, Marathon, Florida, USA
| | - Aaron J Adams
- Bonefish & Tarpon Trust, Miami, Florida, USA
- Florida Atlantic University, Harbor Branch Oceanographic Institute, Fort Pierce, Florida, USA
| | - Steven J Cooke
- Department of Biology, Carleton University, Ottawa, Ontario, Canada
| | - Alex Filous
- Department of Environmental Conservation, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Claudia Friess
- Florida Fish and Wildlife Conservation Commission, Florida Fish and Wildlife Research Institute, St. Petersburg, Florida, USA
| | | | - Neil Hammerschlag
- Rosenstiel School of Marine and Atmospheric Science, University of Miami, Miami, Florida, USA
| | - Vital Heim
- Bimini Biological Field Station Foundation, Bimini, The Bahamas
- Department of Environmental Sciences, Zoology, University of Basel, Basel, Switzerland
| | - Danielle Morley
- Department of Environmental Conservation, University of Massachusetts Amherst, Amherst, Massachusetts, USA
- South Florida Regional Lab, Florida Fish and Wildlife Conservation Commission, Marathon, Florida, USA
| | - Mitchell J Rider
- Rosenstiel School of Marine and Atmospheric Science, University of Miami, Miami, Florida, USA
| | - Gregory B Skomal
- Massachusetts Division of Marine Fisheries, New Bedford, Massachusetts, USA
| | | | - Andy J Danylchuk
- Department of Environmental Conservation, University of Massachusetts Amherst, Amherst, Massachusetts, USA
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Brownscombe JW, Shipley ON, Griffin LP, Morley D, Acosta A, Adams AJ, Boucek R, Danylchuk AJ, Cooke SJ, Power M. Application of telemetry and stable isotope analyses to inform the resource ecology and management of a marine fish. J Appl Ecol 2022. [DOI: 10.1111/1365-2664.14123] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
| | - Oliver N. Shipley
- Department of Biology University of New Mexico Albuquerque New Mexico USA
| | - Lucas P. Griffin
- Department of Environmental Conservation University of Massachusetts Amherst Amherst MA USA
| | - Danielle Morley
- Department of Environmental Conservation University of Massachusetts Amherst Amherst MA USA
- Florida Fish and Wildlife Conservation Commission Florida USA
| | | | - Aaron J. Adams
- Bonefish and Tarpon Trust SW Florida USA
- Florida Atlantic University Harbor Branch Oceanographic Institute Fort Pierce FL USA
| | | | - Andy J. Danylchuk
- Department of Environmental Conservation University of Massachusetts Amherst Amherst MA USA
| | - Steven J. Cooke
- Department of Biology University of New Mexico Albuquerque New Mexico USA
| | - Michael Power
- Department of Biology University of Waterloo Waterloo Ontario Canada
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Yee LM, McGee P, Bailit JL, Wapner RJ, Varner MW, Thorp JM, Caritis SN, Prasad M, Tita AT, Saade GR, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, Mallett G, Grobman W, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Moseley L, Leveno K, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Iams J, Wallace M, Northen A, Grant J, Colquitt C, Rouse D, Andrews W, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Rice M, Zhao Y, Momirova V, Palugod R, Reamer B, Larsen M, Spong C, Tolivaisa S, VanDorsten J. Differences in obstetrical care and outcomes associated with the proportion of the obstetrician's shift completed. Am J Obstet Gynecol 2021; 225:430.e1-430.e11. [PMID: 33812810 DOI: 10.1016/j.ajog.2021.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/14/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Understanding and improving obstetrical quality and safety is an important goal of professional societies, and many interventions such as checklists, safety bundles, educational interventions, or other culture changes have been implemented to improve the quality of care provided to obstetrical patients. Although many factors contribute to delivery decisions, a reduced workload has addressed how provider issues such as fatigue or behaviors surrounding impending shift changes may influence the delivery mode and outcomes. OBJECTIVE The objective was to assess whether intrapartum obstetrical interventions and adverse outcomes differ based on the temporal proximity of the delivery to the attending's shift change. STUDY DESIGN This was a secondary analysis from a multicenter obstetrical cohort in which all patients with cephalic, singleton gestations who attempted vaginal birth were eligible for inclusion. The primary exposure used to quantify the relationship between the proximity of the provider to their shift change and a delivery intervention was the ratio of time from the most recent attending shift change to vaginal delivery or decision for cesarean delivery to the total length of the shift. Ratios were used to represent the proportion of time completed in the shift by normalizing for varying shift lengths. A sensitivity analysis restricted to patients who were delivered by physicians working 12-hour shifts was performed. Outcomes chosen included cesarean delivery, episiotomy, third- or fourth-degree perineal laceration, 5-minute Apgar score of <4, and neonatal intensive care unit admission. Chi-squared tests were used to evaluate outcomes based on the proportion of the attending's shift completed. Adjusted and unadjusted logistic models fitting a cubic spline (when indicated) were used to determine whether the frequency of outcomes throughout the shift occurred in a statistically significant, nonlinear pattern RESULTS: Of the 82,851 patients eligible for inclusion, 47,262 (57%) had ratio data available and constituted the analyzable sample. Deliveries were evenly distributed throughout shifts, with 50.6% taking place in the first half of shifts. There were no statistically significant differences in the frequency of cesarean delivery, episiotomy, third- or fourth-degree perineal lacerations, or 5-minute Apgar scores of <4 based on the proportion of the shift completed. The findings were unchanged when evaluated with a cubic spline in unadjusted and adjusted logistic models. Sensitivity analyses performed on the 22.2% of patients who were delivered by a physician completing a 12-hour shift showed similar findings. There was a small increase in the frequency of neonatal intensive care unit admissions with a greater proportion of the shift completed (adjusted P=.009), but the findings did not persist in the sensitivity analysis. CONCLUSION Clinically significant differences in obstetrical interventions and outcomes do not seem to exist based on the temporal proximity to the attending physician's shift change. Future work should attempt to directly study unit culture and provider fatigue to further investigate opportunities to improve obstetrical quality of care, and additional studies are needed to corroborate these findings in community settings.
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Acosta A, McCorriston S, Nicolli F, Venturelli E, Wickramasinghe U, ArceDiaz E, Scudiero L, Sammartino A, Schneider F, Steinfeld H. Immediate effects of COVID-19 on the global dairy sector. Agric Syst 2021; 192:103177. [PMID: 36569353 PMCID: PMC9759657 DOI: 10.1016/j.agsy.2021.103177] [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] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 05/07/2021] [Accepted: 05/12/2021] [Indexed: 05/09/2023]
Abstract
CONTEXT The emergence and rapid spread of the coronavirus disease (COVID-19) has posed an unprecedented threat to both societies and economies. The dairy sector is an example of the challenges that food supply chains have faced due to the pandemic. OBJECTIVE This study aims to provide primary evidence of the immediate effects of COVID-19 on the global dairy sector, particularly focusing on the outcome of the implemented response mechanisms, and the potential medium and long-term implications of the pandemic on the sector. METHODS We employed a longitudinal qualitative analysis framework that combines the use of questionnaires, media-search, focus-group discussions, semi-structured interviews, and secondary evidence reviews. Information was gathered at two points in time: three months after the beginning of the outbreak and one year later. We applied this framework in five different geographical regions: Africa, Asia, Europe, Latin America, and North America. RESULTS AND CONCLUSIONS Our study indicates that the pandemic has been perceived as a series of episodes affecting the sector from both demand and supply sides. These waves have impacted the sector differently depending on regions and countries' trade profiles, relative resource scarcity, per capita income, and market structure. Although in one year the sector has mostly recovered from the shock, the analysis concludes that the pandemic has accelerated on-going structural changes taking place in the dairy sector. SIGNIFICANCE The study expands existing knowledge about the effects of the pandemic on the dairy sector and adds to the newly evolving literature about the medium and long-term effects of the COVID-19 on food systems across the globe. Despite the preliminary nature of the results, they provide important insights to inform sectorial policy discussions.
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Affiliation(s)
- Alejandro Acosta
- Animal Production and Health Division, Food and Agriculture Organization of the United Nations (FAO), Viale delle Terme di Caracalla, 00153 Rome, Italy
| | - Steve McCorriston
- Department of Economics, University of Exeter, Exeter, EX4 4PU Devon, England, United Kingdom
| | - Francesco Nicolli
- Department of Economics and Management, University of Ferrara, Via Voltapaletto 11, 44121, Italy
- European University Institute, Florence School of Regulation - Climate, Via Giovanni Boccaccio, 121, Fiesole, Florence 50133, Italy
| | - Ester Venturelli
- Wageningen University and Research, Hollandseweg 1, 6706 KN Wageningen, the Netherlands
| | - Upali Wickramasinghe
- Markets and Trade Division, Food and Agriculture Organization of the United Nations (FAO), Viale delle Terme di Caracalla, 00153 Rome, Italy
| | - Eduardo ArceDiaz
- Animal Production and Health Division, Food and Agriculture Organization of the United Nations (FAO), Viale delle Terme di Caracalla, 00153 Rome, Italy
| | - Lavinia Scudiero
- Veterinary Epidemiology, Economics and Public Health Group, Department of Production and Population Health, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire AL9 7TA, United Kingdom
| | | | - Fritz Schneider
- Bern University of Applied Sciences, School of Agricultural, Forest and Food Sciences, Länggasse 85, Zollikofen, Switzerland
| | - Henning Steinfeld
- Animal Production and Health Division, Food and Agriculture Organization of the United Nations (FAO), Viale delle Terme di Caracalla, 00153 Rome, Italy
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Almeida B, Cabral de Oliveira J, Faiçal A, Embiruçu E, Acosta A, Alcantara L, Siqueira I. Follow up of asymptomatic infants with Congenital Zika Infection. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.1150] [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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11
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Garre A, Acosta A, Reverte-Orts JD, Periago PM, Díaz-Morcillo A, Esnoz A, Pedreño-Molina JL, Fernández PS. Microbiological and process variability using biological indicators of inactivation (BIIs) based on Bacillus cereus spores of food and fish-based animal by-products to evaluate microwave heating in a pilot plant. Food Res Int 2020; 137:109640. [PMID: 33233219 DOI: 10.1016/j.foodres.2020.109640] [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] [Received: 02/29/2020] [Revised: 07/31/2020] [Accepted: 08/21/2020] [Indexed: 11/28/2022]
Abstract
Microwave processing can be a valid alternative to conventional heating for different types of products. It enables a more efficient heat transfer in the food matrix, resulting in higher quality products. However, for many food products a uniform temperature distribution is not possible because of heterogeneities in their physical properties and non-uniformtiy in the electric field pattern. Hence, the effectiveness of microwave inactivation treatments is influenced by both intrinsic (differences between cells) and extrinsic variability (non-uniform temperature). Interpreting the results of the process and considering its impact on microbial inactivation is essential to ensure effective and efficient processing. In this work, we quantified the variability in microbial inactivation attained in a microwave pasteurization treatment with a tunnel configuration at pilot-plant scale. The configuration of the equipment makes it impossible to measure the product temperature during treatment. For that reason, variability in microbial counts was measured using Biological Inactivation Indicators (BIIs) based on spherical particles of alginate inoculated with spores of Bacillus spp. The stability of the BIIs and the uncertainty associated to them was assessed using preliminary experiments in a thermoresistometer. Then, they were introduced in the food product to analyse the microbial inactivation in different points of the products during the microwave treatment. Experiments were made in a vegetable soup and a fish-based animal by-product (F-BP). The results show that the variation in the microbial counts was higher than expected based on the biological variability estimated in the thermoresistometer and the uncertainty of the BIIs. This is due to heterogeneities in the temperature field (measured using a thermographic camera), which were higher in the F-BP than in the vegetable soup. Therefore, for the process studied, extrinsic variability was more relevant than intrinsic variability. The methodology presented in this work can be a valid method to evaluate pasteurization treatments of foods processed by heating, providing valuable information of the microbial inactivation achieved. It can contribute to design microwave processes for different types of products and for product optimization.
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Affiliation(s)
- Alberto Garre
- Departamento de Ingeniería Agronómica, Instituto de Biotecnología Vegetal, Universidad Politécnica de Cartagena (ETSIA), Paseo Alfonso XIII, 48, 30203 Cartagena, Spain
| | - Alejandro Acosta
- Departamento de Ingeniería Agronómica, Instituto de Biotecnología Vegetal, Universidad Politécnica de Cartagena (ETSIA), Paseo Alfonso XIII, 48, 30203 Cartagena, Spain
| | - Juan D Reverte-Orts
- Departamento de Tecnologías de la Información y las Comunicaciones, Universidad Politécnica de Cartagena (ETSIT), Plaza del Hospital, 1, 30202 Cartagena, Spain
| | - Paula M Periago
- Departamento de Ingeniería Agronómica, Instituto de Biotecnología Vegetal, Universidad Politécnica de Cartagena (ETSIA), Paseo Alfonso XIII, 48, 30203 Cartagena, Spain
| | - Alejandro Díaz-Morcillo
- Departamento de Tecnologías de la Información y las Comunicaciones, Universidad Politécnica de Cartagena (ETSIT), Plaza del Hospital, 1, 30202 Cartagena, Spain
| | - Arturo Esnoz
- Departamento de Ingeniería Agronómica, Instituto de Biotecnología Vegetal, Universidad Politécnica de Cartagena (ETSIA), Paseo Alfonso XIII, 48, 30203 Cartagena, Spain
| | - Juan L Pedreño-Molina
- Departamento de Tecnologías de la Información y las Comunicaciones, Universidad Politécnica de Cartagena (ETSIT), Plaza del Hospital, 1, 30202 Cartagena, Spain
| | - Pablo S Fernández
- Departamento de Ingeniería Agronómica, Instituto de Biotecnología Vegetal, Universidad Politécnica de Cartagena (ETSIA), Paseo Alfonso XIII, 48, 30203 Cartagena, Spain.
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Burgos L, Talavera L, Baro Vila R, Acosta A, Cabral M, Buscio M, Diez M. Usefulness of the society for cardiovascular angiography and intervention classification for predicting in-hospital mortality in patients with acute decompensated heart failure. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1185] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Recently a multidisciplinary group of the Society for Cardiovascular Angiography and Interventions (SCAI) derived a new classification schema for cardiogenic shock (CS), simple, clinically based and suitable for rapid assessment at the bedside but also arbitrary. Validation in different clinical datasets, specifically in patients with acute decompensated heart failure (ADHF), is necessary to establish the utility of this proposed classification schema.
Purpose
We aimed to evaluate the ability of a new SCAI CS staging classification to predict in-hospital mortality in patients with ADHF.
Methods
We conducted a single-center cohort study, performing a retrospective analysis of prospectively collected data of consecutive patients admitted with ADHF as a primary diagnosis between January 2015 and January 2019. We excluded patients who were hospitalized for an acute coronary syndrome. Patients were assigned to the modified SCAI Classification for CS: Stage A is “at risk” for CS, stage B is “beginning” shock, stage C is “classic”, stage D is “deteriorating”, and E is “extremis”, and in-hospital mortality was evaluated for each group. All-cause mortality was compared across SCAI stages using Kaplan-Meier analysis and log-rank test. Cox proportional hazards models were used to determine the association between SCAI stages and in-hospital mortality after adjusting for age, gender, left ventricular ejection fraction, use of vasoactive medication, mechanical circulatory assist devices, mechanical ventilation, percutaneous coronary intervention and cardiac surgery.
Results
Among 668 patients with a mean age of 74.9±12 years, 63.9% were male. In-hospital mortality was 11.2%. According to SCAI classification, the proportion of patients in stages A through E was 51.7%, 26.7%, 14.4%, 4.6% and 2.5%. The unadjusted mortality in each stages was: A 0.6%, B 4.5%, C 32.3%, D 61.3%, and E 88.2% (Log Rank P<0.0001). After multivariable adjustment, each SCAI shock stage remained associated with increased in-hospital mortality (all P<0.001 compared to stage A). Compared with SCAI shock stage A, adjusted hazard ratio (HR) values in SCAI shock stages B through E were 5.2, 31, 107, and 185, respectively (Figure).
Conclusion
In this large clinical cohort of patients with ADHF exclusively, the new SCAI CS staging classification was associated with in-hospital mortality. This finding supports the rationale of the classification in this setting, further prospective trials are needed to validate these findings.
Adjusted in-hospital Mortality as a Func
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- L Burgos
- Instituto Cardiovascular De Buenos Aires, Buenos Aires, Argentina
| | - L Talavera
- Instituto Cardiovascular De Buenos Aires, Buenos Aires, Argentina
| | - R Baro Vila
- Instituto Cardiovascular De Buenos Aires, Buenos Aires, Argentina
| | - A Acosta
- Instituto Cardiovascular De Buenos Aires, Buenos Aires, Argentina
| | - M Cabral
- Instituto Cardiovascular De Buenos Aires, Buenos Aires, Argentina
| | - M Buscio
- Instituto Cardiovascular De Buenos Aires, Buenos Aires, Argentina
| | - M Diez
- Instituto Cardiovascular De Buenos Aires, Buenos Aires, Argentina
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Nuñez Baez M, Montero A, Chen-Zhao X, Acosta A, Alvarez B, Palma J, Lopez-Gonzalez M, Sanchez E, Hernando O, Valero J, Ciervide R, Garcia-Aranda M, Alonso R, De la Casa M, Zucca D, Martí J, Flores-Cacho I, Ruiz-Morales C, Fernandez-Leton P, Rubio Rodriguez M. PO-1233: Perioperative Radiotherapy with a Moderate Dose-Escalation for Retroperitoneal Sarcoma (RPS). Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01251-2] [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: 11/17/2022]
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14
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Mohd Amiruddin M, Ang GY, Yu CY, Falero-Diaz G, Otero O, Reyes F, Camacho F, Chin K, Sarmiento M, Norazmi M, Acosta A, Yean Yean C. Development of an immunochromatographic lateral flow dipstick for the detection of Mycobacterium tuberculosis 16 kDa antigen (Mtb-strip). J Microbiol Methods 2020; 176:106003. [DOI: 10.1016/j.mimet.2020.106003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/27/2020] [Accepted: 07/13/2020] [Indexed: 01/05/2023]
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15
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Valencia S, Trujillo N, Trujillo S, Acosta A, Rodríguez M, Ugarriza JE, López JD, García AM, Parra MA. Neurocognitive reorganization of emotional processing following a socio-cognitive intervention in Colombian ex-combatants. Soc Neurosci 2020; 15:398-407. [PMID: 32107978 DOI: 10.1080/17470919.2020.1735511] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Ex-combatants often exhibit atypical Emotional Processing (EP) such as reduced emphatic levels and higher aggressive attitudes. Social Cognitive Training (SCT) addressing socio-emotional components powerfully improve social interaction among Colombian ex-combatants. However, with narrow neural evidence, this study offers a new testimony. A sample of 28 ex-combatants from Colombian illegal armed groups took part in this study, split into 15 for SCT and 13 for the conventional program offered by the Governmental Reintegration Route. All of them were assessed before and after the intervention with a protocol that included an EP task synchronized with electroencephalographic recordings. We drew behavioral scores and brain connectivity (Coherency) metrics from task performance. Behavioral scores yielded no significant effects. Increased post-intervention connectivity in the delta band was observed during negative emotional processing only SCT group. Positive emotions exposed distinctive gamma band connectivity that differentiate groups. These results suggest that SCT can trigger covert neurofunctional reorganization in ex-combatants embarked on the reintegration process even when overt behavioral improvements are not yet apparent. Such covert functional changes may be the neural signature of compensatory mechanisms necessary to reshape behaviors adaptively. This novel framework may inspire cutting-edge translational research at the crossing of neuroscience, sociology, and public policy-making.
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Affiliation(s)
- S Valencia
- Grupo De Investigación En Salud Mental, Facultad Nacional De Salud Pública, Universidad De Antioquia UdeA , Medellín, Colombia.,Corporación Académica De Ciencias Básicas Biomédicas, Universidad De Antioquia UdeA , Medellín, Colombia
| | - N Trujillo
- Grupo De Investigación En Salud Mental, Facultad Nacional De Salud Pública, Universidad De Antioquia UdeA , Medellín, Colombia
| | - S Trujillo
- Doctoral Program in Psychology, Department of Experimental Psychology, University of Granada , Granada, Spain
| | - A Acosta
- Department of Experimental Psychology and Physiology of Behavior, University of Granada , Granada, Spain
| | - M Rodríguez
- SISTEMIC, Facultad De Ingeniería, Universidad De Antioquia UdeA , Medellín, Colombia
| | - J E Ugarriza
- Facultad De Jurisprudencia, Universidad Del Rosario , Bogotá, Colombia
| | - J D López
- SISTEMIC, Facultad De Ingeniería, Universidad De Antioquia UdeA , Medellín, Colombia
| | - A M García
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University , Buenos Aires, Argentina.,National Scientific and Technical Research Council CONICET , Buenos Aires, Argentina.,Faculty of Education, National University of Cuyo UNCuyo , Mendoza, Argentina.,Departamento de Lingüística y Literatura, Universidad de Santiago de Chile , Santiago, Chile
| | - M A Parra
- School of Psychological Sciences and Health, University of Strathclyde , Glasgow, UK
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16
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Brownscombe JW, Griffin LP, Morley D, Acosta A, Hunt J, Lowerre-Barbieri SK, Crossin GT, Iverson SJ, Boucek R, Adams AJ, Cooke SJ, Danylchuk AJ. Seasonal occupancy and connectivity amongst nearshore flats and reef habitats by permit Trachinotus falcatus: considerations for fisheries management. J Fish Biol 2020; 96:469-479. [PMID: 31823365 DOI: 10.1111/jfb.14227] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 12/10/2019] [Indexed: 06/10/2023]
Abstract
We used acoustic telemetry to quantify permit Trachinotus falcatus habitat use and connectivity in proximity to the Florida Keys, USA, and assessed these patterns relative to current habitat and fisheries management practices. From March 2017 to June 2018, 45 permit tagged within 16 km of the lower Florida Keys were detected at stationary acoustic receivers throughout the south Florida region, the majority of which remained within the Special Permit Zone, where more extensive fisheries harvest regulations are implemented. There was a high level of connectivity between nearshore flats (i.e., <3 m water depth) and the Florida reef tract (FRT; 15-40 m water depth), with 75% of individuals detected in both habitats. These locations probably function primarily as foraging and spawning habitats, respectively. Permit occupancy on the FRT peaked during the months of March-September, with the highest number of individuals occurring there in April and May. Specific sites on the FRT were identified as potentially important spawning locations, as they attracted a high proportion of individuals that exhibited frequent visits with high residency durations. There were also significant positive relationships between seasonal habitat-use metrics on the FRT and an empirical permit gonadosomatic index. Large aggregations of permit at spawning sites on the FRT are potentially vulnerable to the effects of fishing (including predation during catch and release) at a critical point in their life cycle. These data on permit space use and movement, coupled with knowledge of stressors on their ecology, provide insights for implementing science-based strategic management plans.
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Affiliation(s)
- Jacob W Brownscombe
- Fish Ecology and Conservation Physiology Laboratory, Department of Biology, Carleton University, Ottawa, Ontario, Canada
- Department of Biology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Lucas P Griffin
- Department of Environmental Conservation, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Danielle Morley
- South Florida Regional Lab, Florida Fish and Wildlife Conservation Commission, Marathon, Florida, USA
| | - Alejandro Acosta
- South Florida Regional Lab, Florida Fish and Wildlife Conservation Commission, Marathon, Florida, USA
| | - John Hunt
- South Florida Regional Lab, Florida Fish and Wildlife Conservation Commission, Marathon, Florida, USA
| | - Susan K Lowerre-Barbieri
- Florida Fish and Wildlife Conservation Commission, Fish and Wildlife Research Institute, St. Petersburg, Florida, USA
- Fisheries and Aquatic Science Program, School of Forest Resources and Conservation, University of Florida, Gainesville, Florida, USA
| | - Glenn T Crossin
- Department of Biology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sara J Iverson
- Department of Biology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ross Boucek
- Bonefish and Tarpon Trust, Miami, Florida, USA
| | - Aaron J Adams
- Bonefish and Tarpon Trust, Miami, Florida, USA
- Florida Atlantic University Harbor Branch Oceanographic Institute, Fort Pierce, Florida, USA
| | - Steven J Cooke
- Fish Ecology and Conservation Physiology Laboratory, Department of Biology, Carleton University, Ottawa, Ontario, Canada
| | - Andy J Danylchuk
- Department of Environmental Conservation, University of Massachusetts Amherst, Amherst, Massachusetts, USA
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Brownscombe JW, Griffin LP, Chapman JM, Morley D, Acosta A, Crossin GT, Iverson SJ, Adams AJ, Cooke SJ, Danylchuk AJ. A practical method to account for variation in detection range in acoustic telemetry arrays to accurately quantify the spatial ecology of aquatic animals. Methods Ecol Evol 2019. [DOI: 10.1111/2041-210x.13322] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jacob W. Brownscombe
- Fish Ecology and Conservation Physiology Laboratory Department of Biology Carleton University Ottawa ON Canada
- Department of Biology Dalhousie University Halifax Nova Scotia Canada
| | - Lucas P. Griffin
- Department of Environmental Conservation University of Massachusetts Amherst Amherst MA USA
| | - Jacqueline M. Chapman
- Fish Ecology and Conservation Physiology Laboratory Department of Biology Carleton University Ottawa ON Canada
| | - Danielle Morley
- Florida Fish and Wildlife Conservation Commission Marathon FL USA
| | - Alejandro Acosta
- Florida Fish and Wildlife Conservation Commission Marathon FL USA
| | - Glenn T. Crossin
- Department of Biology Dalhousie University Halifax Nova Scotia Canada
| | - Sara J. Iverson
- Department of Biology Dalhousie University Halifax Nova Scotia Canada
| | - Aaron J. Adams
- Bonefish and Tarpon Trust Coral Gables FL USA
- Harbor Branch Oceanographic InstituteFlorida Atlantic University Fort Pierce FL USA
| | - Steven J. Cooke
- Fish Ecology and Conservation Physiology Laboratory Department of Biology Carleton University Ottawa ON Canada
| | - Andy J. Danylchuk
- Department of Environmental Conservation University of Massachusetts Amherst Amherst MA USA
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18
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Acosta A, De los Santos-Montero LA. What is driving livestock total factor productivity change? A persistent and transient efficiency analysis. Global Food Security 2019. [DOI: 10.1016/j.gfs.2019.06.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sarmiento ME, Alvarez N, Chin KL, Bigi F, Tirado Y, García MA, Anis FZ, Norazmi MN, Acosta A. Tuberculosis vaccine candidates based on mycobacterial cell envelope components. Tuberculosis (Edinb) 2019; 115:26-41. [PMID: 30948174 DOI: 10.1016/j.tube.2019.01.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 11/20/2018] [Revised: 01/12/2019] [Accepted: 01/16/2019] [Indexed: 12/11/2022]
Abstract
Even after decades searching for a new and more effective vaccine against tuberculosis, the scientific community is still pursuing this goal due to the complexity of its causative agent, Mycobacterium tuberculosis (Mtb). Mtb is a microorganism with a robust variety of survival mechanisms that allow it to remain in the host for years. The structure and nature of the Mtb envelope play a leading role in its resistance and survival. Mtb has a perfect machinery that allows it to modulate the immune response in its favor and to adapt to the host's environmental conditions in order to remain alive until the moment to reactivate its normal growing state. Mtb cell envelope protein, carbohydrate and lipid components have been the subject of interest for developing new vaccines because most of them are responsible for the pathogenicity and virulence of the bacteria. Many indirect evidences, mainly derived from the use of monoclonal antibodies, support the potential protective role of Mtb envelope components. Subunit and DNA vaccines, lipid extracts, liposomes and membrane vesicle formulations are some examples of technologies used, with encouraging results, to evaluate the potential of these antigens in the protective response against Mtb.
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Affiliation(s)
- M E Sarmiento
- School of Health Sciences (PPSK), Universiti Sains Malaysia (USM), 16150 Kubang Kerian, Kelantan, Malaysia
| | - N Alvarez
- Rutgers New Jersey Medical School, Public Health Research Institute, Newark, NJ, USA
| | - K L Chin
- Department of Biomedical Sciences and Therapeutic, Faculty of Medicine and Health Sciences (FPSK), Universiti Malaysia Sabah (UMS), Sabah, Malaysia
| | - F Bigi
- Institute of Biotechnology, INTA, Buenos Aires, Argentina
| | - Y Tirado
- Finlay Institute of Vaccines, La Habana, Cuba
| | - M A García
- Finlay Institute of Vaccines, La Habana, Cuba
| | - F Z Anis
- School of Health Sciences (PPSK), Universiti Sains Malaysia (USM), 16150 Kubang Kerian, Kelantan, Malaysia
| | - M N Norazmi
- School of Health Sciences (PPSK), Universiti Sains Malaysia (USM), 16150 Kubang Kerian, Kelantan, Malaysia.
| | - A Acosta
- School of Health Sciences (PPSK), Universiti Sains Malaysia (USM), 16150 Kubang Kerian, Kelantan, Malaysia.
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20
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Tita AT, Jablonski KA, Bailit JL, Grobman WA, Wapner RJ, Reddy UM, Varner MW, Thorp JM, Leveno KJ, Caritis SN, Iams JD, Saade G, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, Wallace M, Northen A, Grant J, Colquitt C, Mallett G, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Moseley L, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Shubert P, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Zhao Y, McGee P, Momirova V, Palugod R, Reamer B, Larsen M, Spong C, Tolivaisa S, VanDorsten J. Neonatal outcomes of elective early-term births after demonstrated fetal lung maturity. Am J Obstet Gynecol 2018; 219:296.e1-296.e8. [PMID: 29800541 DOI: 10.1016/j.ajog.2018.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 11/09/2016] [Accepted: 05/14/2018] [Indexed: 10/16/2022]
Abstract
BACKGROUND Studies of early-term birth after demonstrated fetal lung maturity show that respiratory and other outcomes are worse with early-term birth (370-386 weeks) even after demonstrated fetal lung maturity when compared with full-term birth (390-406 weeks). However, these studies included medically indicated births and are therefore potentially limited by confounding by the indication for delivery. Thus, the increase in adverse outcomes might be due to the indication for early-term birth rather than the early-term birth itself. OBJECTIVE We examined the prevalence and risks of adverse neonatal outcomes associated with early-term birth after confirmed fetal lung maturity as compared with full-term birth in the absence of indications for early delivery. STUDY DESIGN This is a secondary analysis of an observational study of births to 115,502 women in 25 hospitals in the United States from 2008 through 2011. Singleton nonanomalous births at 37-40 weeks with no identifiable indication for delivery were included; early-term births after positive fetal lung maturity testing were compared with full-term births. The primary outcome was a composite of death, ventilator for ≥2 days, continuous positive airway pressure, proven sepsis, pneumonia or meningitis, treated hypoglycemia, hyperbilirubinemia (phototherapy), and 5-minute Apgar <7. Logistic regression and propensity score matching (both 1:1 and 1:2) were used. RESULTS In all, 48,137 births met inclusion criteria; the prevalence of fetal lung maturity testing in the absence of medical or obstetric indications for early delivery was 0.52% (n = 249). There were 180 (0.37%) early-term births after confirmed pulmonary maturity and 47,957 full-term births. Women in the former group were more likely to be non-Hispanic white, smoke, have received antenatal steroids, have induction, and have a cesarean. Risks of the composite (16.1% vs 5.4%; adjusted odds ratio, 3.2; 95% confidence interval, 2.1-4.8 from logistic regression) were more frequent with elective early-term birth. Propensity scores matching confirmed the increased primary composite in elective early-term births: adjusted odds ratios, 4.3 (95% confidence interval, 1.8-10.5) for 1:1 and 3.5 (95% confidence interval, 1.8-6.5) for 1:2 matching. Among components of the primary outcome, CPAP use and hyperbilirubinemia requiring phototherapy were significantly increased. Transient tachypnea of the newborn, neonatal intensive care unit admission, and prolonged neonatal intensive care unit stay (>2 days) were also increased with early-term birth. CONCLUSION Even with confirmed pulmonary maturity, early-term birth in the absence of medical or obstetric indications is associated with worse neonatal respiratory and hepatic outcomes compared with full-term birth, suggesting relative immaturity of these organ systems in early-term births.
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Almeida B, Cabral J, Faiçal A, Oliveira J, Souza M, Salles C, Vianna M, D’Agostino E, Ferreira N, Reis L, Embiruçu E, Santos C, Duarte A, Acosta A, Siqueira I. Discordant congenital Zika virus infection in dizygotic twins: a case report. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3662] [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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22
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Cabral J, Faiçal A, Almeida B, Oliveira J, Embiruçu E, Ferreira N, Reis L, Salles C, Cabral B, Costa B, Francisco M, Santos C, Alcantara L, Acosta A, Siqueira I. Neurodevelopmental delays arising from in utero exposure to Zika virus in Salvador, Brazil. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Chedid V, Vijayvargiya P, Carlson P, Van Malderen K, Acosta A, Zinsmeister A, Camilleri M. Allelic variant in the glucagon-like peptide 1 receptor gene associated with greater effect of liraglutide and exenatide on gastric emptying: A pilot pharmacogenetics study. Neurogastroenterol Motil 2018; 30:e13313. [PMID: 29488276 PMCID: PMC6003833 DOI: 10.1111/nmo.13313] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 01/22/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Weight loss in response to the long-acting GLP-1 receptor (GLP1R) analog, liraglutide, is correlated with delay in gastric-emptying (GE). The aim of this pilot study was to assess whether specific genetic variants in GLP1R or TCF7L2 are associated with delayed GE and weight loss in obese patients treated with liraglutide or the short-acting GLP-1 agonist, exenatide. METHODS We evaluated in obese individuals the associations of genetic variations of GLP1R (rs6923761) and TCF7L2 (rs7903146) on GE T1/2 and weight from two trials that evaluated separately exenatide, 5 μg BID for 30 days, or liraglutide, 3 mg daily for 5 weeks. Data were analyzed using the dominant genetic model and intention-to-treat analysis. KEY RESULTS There was a significant correlation between changes in weight and GE T1/2 (rs = -.382, P = .004). GLP1R rs6923761 minor allele A (AA_AG) carriers who received either exenatide or liraglutide had greater delay in GE T1/2 relative to baseline (117.9 ± 27.5 [SEM] minutes and 128.9 ± 38.32 minutes) compared to GG genotype (95.8 ± 30.4 minutes and 61.4 ± 21.4 minutes, respectively; P = .11). There was a non-significant difference in weight loss based on GLP1R rs6923761 genotype after 5 weeks of treatment. There were no significant correlations with TCF7L2 (rs7903146) genotype. CONCLUSIONS & INFERENCES The minor A allele of GLP1R (rs6923761) is associated with greater delay in GE T1/2 in response to liraglutide and exenatide. These studies provide data to plan pharmacogenetics testing of the hypothesis that GLP1R (rs6923761) influences weight loss in response to GLP1R agonists.
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Affiliation(s)
- V Chedid
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - P Vijayvargiya
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - P Carlson
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - K Van Malderen
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - A Acosta
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - A Zinsmeister
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - M Camilleri
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN, USA
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Halawi H, Vijayvargiya P, Busciglio I, Oduyebo I, Khemani D, Ryks M, Rhoten D, Burton D, Szarka LA, Acosta A, Camilleri M. Effects of naloxegol on whole gut transit in opioid-naïve healthy subjects receiving codeine: A randomized, controlled trial. Neurogastroenterol Motil 2018; 30:e13298. [PMID: 29405492 PMCID: PMC5924457 DOI: 10.1111/nmo.13298] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 01/04/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Nausea, vomiting, and constipation (OIC) are common adverse effects of acute or chronic opioid use. Naloxegol (25 mg) is an approved peripherally active mu-opiate opioid receptor antagonist. AIM To compare the effects on pan-gut transit of treatment with codeine, naloxegol, or combination in healthy volunteers. METHODS We conducted a randomized, double-blind, placebo-controlled, single-center, parallel-group study in 72 healthy opioid-naïve adults, randomized to: codeine (30 mg q.i.d.), naloxegol (25 mg daily), codeine and naloxegol, or matching placebo. During 3 days of treatment, we measured gastric emptying (GE) T1/2 , colonic filling at 6 hours (CF6), colonic geometric center at 24 and 48 hours, and ascending colon emptying (ACE) T1/2 . KEY RESULTS Participants were 59.7% women, median BMI 25.0 kg/m2 , and median age 33.8 years. Codeine significantly retarded GE T1/2, CF6, overall colonic transit, and ACE T1/2 . There was significant difference (P = .026) in GE T1/2 between codeine (144.0 min [IQR 110.5-238.6]) and naloxegol (95.5 min [89.1-135.4]). There was a significant overall group difference in CF6 (P = .023), with significant difference (P = .019) between codeine (11.0% [0.0-45.0]) and naloxegol (51% [18.8-76.2]). However, no significant differences were found between codeine-treated participants concomitantly receiving placebo or naloxegol. CONCLUSIONS AND INFERENCES Short-term administration of naloxegol (25 mg) in healthy, opioid-naïve volunteers does not reverse the retardation of gastric, small bowel, or colonic transit induced by acute administration of codeine. Further studies with naloxegol at higher dose are warranted to assess the ability to reverse the retardation of transit caused by acute administration of codeine in opioid-naïve subjects.
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Affiliation(s)
- H. Halawi
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Division of Gastroenterology and Hepatology; Mayo Clinic; Rochester MN USA
| | - P. Vijayvargiya
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Division of Gastroenterology and Hepatology; Mayo Clinic; Rochester MN USA
| | - I. Busciglio
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Division of Gastroenterology and Hepatology; Mayo Clinic; Rochester MN USA
| | - I. Oduyebo
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Division of Gastroenterology and Hepatology; Mayo Clinic; Rochester MN USA
| | - D. Khemani
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Division of Gastroenterology and Hepatology; Mayo Clinic; Rochester MN USA
| | - M. Ryks
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Division of Gastroenterology and Hepatology; Mayo Clinic; Rochester MN USA
| | - D. Rhoten
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Division of Gastroenterology and Hepatology; Mayo Clinic; Rochester MN USA
| | - D. Burton
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Division of Gastroenterology and Hepatology; Mayo Clinic; Rochester MN USA
| | - L. A. Szarka
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Division of Gastroenterology and Hepatology; Mayo Clinic; Rochester MN USA
| | - A. Acosta
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Division of Gastroenterology and Hepatology; Mayo Clinic; Rochester MN USA
| | - M. Camilleri
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Division of Gastroenterology and Hepatology; Mayo Clinic; Rochester MN USA
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Alvarez B, Montero Luis A, Acosta A, Sanchez E, Ciervide R, Chen X, Valero J, Garcia-Aranda M, Aramburu F, Calvo E, Hernando O, Lopez M, Rodriguez S, Alonso R, Garcia de la Peña P, Rubio C. EP-1705: Radiotherapy: a promising alternative treatment for painful osteoarticular degenerative diseases. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32014-0] [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: 11/16/2022]
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Montero A, Hernandez M, Ciervide R, Garcia-Aranda M, Alvarez B, Valero J, Acosta A, Alonso R, Lopez M, Sanchez E, Hernando O, Rubio C. Efficacy of an accelerated hypofractionted schedule for whole breast and regional node irradiation: Short term results of safety and efficacy. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30393-9] [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: 12/01/2022]
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Ciervide R, López M, Hernando O, Sánchez E, Montero A, Valero J, García-Aranda M, Chen X, Alonso R, Alvarez B, Acosta A, Rubio C. EP-1195: Hypofractionated stereotactic radiotherapy (HFSRT) for 50 brain metastases: Institutional experience. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31505-6] [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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Oliveira MR, Schwartz I, Costa LS, Maia H, Ribeiro M, Guerreiro LB, Acosta A, Rocha NS. Quality of life in mucopolysaccharidoses: construction of a specific measure using the focus group technique. BMC Res Notes 2018; 11:28. [PMID: 29334993 PMCID: PMC5769464 DOI: 10.1186/s13104-018-3157-4] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 01/11/2018] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To describe the perceptions of patients, their caregivers, and their healthcare providers to the development of a new specific instrument for assessment of the quality of life (QoL) in patients with mucopolysaccharidoses (MPS) using a qualitative focus group (FG) design. FGs were held in two Brazilian states (Rio Grande do Sul and Rio de Janeiro). RESULTS Three versions of the new instrument were developed, each for a different age group: children (age 8-12 years), adolescents (age 13-17), and adults (age ≥ 18). The FGs mostly confirmed the relevance of items. All FGs unanimously agreed on the facets: School, Happiness, Life Prospects, Religiosity, Pain, Continuity of Treatment, Trust in Treatment, Relationship with Family, Relationship with Healthcare Providers, Acceptance, and Meaning of Life. The overall concept of QoL (as proposed by the WHO-World Health Organization) and its facets apply to this patient population. However, other specific facets-particularly concerning clinical manifestations and the reality of the disease-were suggested, confirming the need for the development of a specific QoL instrument for MPS.
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Affiliation(s)
- M R Oliveira
- Universidade Federal do Rio Grande do Sul, Hospital de Clinicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Santa Cecília, Porto Alegre, RS, 90035-903, Brazil
| | - I Schwartz
- Universidade Federal do Rio Grande do Sul, Hospital de Clinicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Santa Cecília, Porto Alegre, RS, 90035-903, Brazil
| | - L S Costa
- Universidade Federal do Rio Grande do Sul, Hospital de Clinicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Santa Cecília, Porto Alegre, RS, 90035-903, Brazil
| | - H Maia
- Universidade Federal Fluminense, Rua Miguel de Frias, 9 Icaraí, Niterói, RJ, 24220-008, Brazil
| | - M Ribeiro
- Universidade Federal do Rio de Janeiro, Av. Pedro Calmon, 550, Cidade Universitária, Rio de Janeiro, RJ, 21941-901, Brazil
| | - L B Guerreiro
- Universidade Federal Fluminense, Rua Miguel de Frias, 9 Icaraí, Niterói, RJ, 24220-008, Brazil
| | - A Acosta
- Universidade Federal da Bahia, R. Auristides, 2, Federacao, Salvador, BA, 40210-340, Brazil
| | - N S Rocha
- Universidade Federal do Rio Grande do Sul, Hospital de Clinicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Santa Cecília, Porto Alegre, RS, 90035-903, Brazil. .,, Ramiro Barcelos, 2400 2º andar, Porto Alegre, RS, 90 003-035, Brazil.
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Garrido Haro AD, Barrera Valle M, Acosta A, J Flores F. Phylodynamics of classical swine fever virus with emphasis on Ecuadorian strains. Transbound Emerg Dis 2018; 65:782-790. [PMID: 29322688 DOI: 10.1111/tbed.12803] [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: 09/04/2017] [Indexed: 11/26/2022]
Abstract
Classic swine fever virus (CSFV) is a Pestivirus from the Flaviviridae family that affects pigs worldwide and is endemic in several Latin American countries. However, there are still some countries in the region, including Ecuador, for which CSFV molecular information is lacking. To better understand the epidemiology of CSFV in the Americas, sequences from CSFVs from Ecuador were generated and a phylodynamic analysis of the virus was performed. Sequences for the full-length glycoprotein E2 gene of twenty field isolates were obtained and, along with sequences from strains previously described in the Americas and from the most representative strains worldwide, were used to analyse the phylodynamics of the virus. Bayesian methods were used to test several molecular clock and demographic models. A calibrated ultrametric tree and a Bayesian skyline were constructed, and codons associated with positive selection involving immune scape were detected. The best model according to Bayes factors was the strict molecular clock and Bayesian skyline model, which shows that CSFV has an evolution rate of 3.2 × 10-4 substitutions per site per year. The model estimates the origin of CSFV in the mid-1500s. There is a strong spatial structure for CSFV in the Americas, indicating that the virus is moving mainly through neighbouring countries. The genetic diversity of CSFV has increased constantly since its appearance, with a slight decrease in mid-twentieth century, which coincides, with eradication campaigns in North America. Even though there is no evidence of strong directional evolution of the E2 gene in CSFV, codons 713, 761, 762 and 975 appear to be selected positively and could be related to virulence or pathogenesis. These results reveal how CSFV has spread and evolved since it first appeared in the Americas and provide important information for attaining the goal of eradication of this virus in Latin America.
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Affiliation(s)
- A D Garrido Haro
- Ecuadorian Agency for Quality Assurance in Agriculture, Tumbaco, Ecuador
| | - M Barrera Valle
- Facultad de Ciencias Veterinarias, Universidad Técnica de Manabí, Portoviejo, Ecuador
| | - A Acosta
- Ecuadorian Agency for Quality Assurance in Agriculture, Tumbaco, Ecuador
| | - F J Flores
- Centro de Investigación de Alimentos, CIAL, Facultad de Ciencias de la Ingeniería e Industrias, Universidad Tecnológica Equinoccial, Quito, Ecuador.,Departamento de Ciencias de la Vida y la Agricultura, Universidad de las Fuerzas Armadas ESPE, Sangolquí, Ecuador
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Albarrán JV, Montero A, Sanchez E, Acosta A, Alvarez B, Chen X, Hernando O, Pérez J, Zucca D, LÃpez M, Ciervide R, Aranda MDLOG, Garcia J, Leton PF, Rubio C. Hypofractionated IMRT-IGRT With Internal Markers in Prostate Cancer Treatment: Mature Results. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1244] [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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Park SY, Khemani D, Acosta A, Eckert D, Camilleri M. Rectal gas volume: Defining cut-offs for screening for evacuation disorders in patients with constipation. Neurogastroenterol Motil 2017; 29:10.1111/nmo.13044. [PMID: 28261935 PMCID: PMC5466461 DOI: 10.1111/nmo.13044] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 01/10/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Diagnosis of rectal evacuation disorders (RED) is currently based on anorectal manometry (ARM) and evacuation tests in specialized laboratories; we recently showed higher rectal gas volume (RGV) and maximum rectal gas transaxial area (MRGTA) measured on abdominal and pelvic computed tomography (CT) in patients with documented RED.The aim of this study was to obtain cut-off values of RGV, MRGTA, and rectal area on scout film (RASF) to differentiate constipated patients with RED from those without RED, based on ARM, balloon expulsion test (BET), and colon transit test. METHODS We identified 118 constipated patients (65 with RED) with prior record of CT. Using standard CT software, we used a variable region of interest (ROI) program to measure RGV, MRTGA, and RASF, as previously described. We constructed receiver operating characteristics curves based on different values, and we estimated AUC, specificity, and positive predictive value (PPV) to detect RED in patients with constipation. KEY RESULTS Receiver operating characteristics of the models to predict RED showed AUC 0.751 for RGV and 0.737 for MRGTA (both P<.001), and 0.623 for RASF (P=.029). At specificity of 90%, RGV of 30 mL had a PPV 77.3%, MRGTA of 10 cm2 had a PPV 75.0%, and RFAS of 9 cm2 had a PPV of 68.8% for identifying constipated patients with RED. CONCLUSIONS & INFERENCES Rectal gas measurements on abdominal imaging may indicate RED in patients with constipation. At ~90% specificity for RED, RGV of 20 or 30 mL or MRGTA of 10 cm2 on CT has PPV ~75%, and RASF of >9 cm2 has PPV of ~69%.
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Affiliation(s)
- S.-Y. Park
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.); Mayo Clinic; Rochester MN USA
| | - D. Khemani
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.); Mayo Clinic; Rochester MN USA
| | - A. Acosta
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.); Mayo Clinic; Rochester MN USA
| | - D. Eckert
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.); Mayo Clinic; Rochester MN USA
| | - M. Camilleri
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.); Mayo Clinic; Rochester MN USA
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Nelson AD, Camilleri M, Acosta A, Boldingh A, Busciglio I, Burton D, Ryks M, Zinsmeister AR. A single-center, prospective, double-blind, sham-controlled, randomized study of the effect of a vibrating capsule on colonic transit in patients with chronic constipation. Neurogastroenterol Motil 2017; 29. [PMID: 28177172 DOI: 10.1111/nmo.13034] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 12/23/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND In an open-label study of 26 patients with IBS-C and chronic constipation, treatment with a vibrating (VIBRANT) capsule twice a week for 7.5 weeks resulted in 88.5% responders. Effects on colonic transit are unclear. We aimed to compare effects of VIBRANT and sham capsule treatment on colonic transit in patients with functional constipation. METHODS Patients with functional constipation (Rome III criteria) were randomized to VIBRANT or sham capsule treatment for 8 weeks and underwent scintigraphic colonic transit measurements during week 8. We estimated the overall rate of colonic transit from the slope of progression of colonic geometric center over 48 hours. The capsule was activated 8 hours after ingestion, and the vibration sequence included 240 cycles. KEY RESULTS There were no significant group differences in overall colonic transit [GC48, 2.76 (IQR 2.42-4.03) for sham group and 3.46 (2.55-4.61) for active treatment group (P=.13)]. Additionally, the progression of the isotope through the colon was numerically faster, though not significantly different (slope, P=.14) in the VIBRANT capsule group compared to the sham group. Three participants in the VIBRANT capsule group had accelerated colonic transit at 32 hours and faster colonic transit slope compared to the 95th percentile of the sham group. CONCLUSIONS AND INFERENCES Although there were no group differences between VIBRANT and sham capsule treatment on colonic transit, at least one (and possibly three) of 12 patients receiving the VIBRANT capsule had faster colonic transit. The vibration parameters to accelerate colonic transit in patients with functional constipation require further optimization.
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Affiliation(s)
- A D Nelson
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Mayo Clinic, Rochester, MN, USA
| | - M Camilleri
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Mayo Clinic, Rochester, MN, USA
| | - A Acosta
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Mayo Clinic, Rochester, MN, USA
| | - A Boldingh
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Mayo Clinic, Rochester, MN, USA
| | - I Busciglio
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Mayo Clinic, Rochester, MN, USA
| | - D Burton
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Mayo Clinic, Rochester, MN, USA
| | - M Ryks
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Mayo Clinic, Rochester, MN, USA
| | - A R Zinsmeister
- Division of Biomedical Statistics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
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Valero Albarran J, Ruiz Herrero A, Montero A, Sanchez E, Castro E, Olmos D, Hernandez M, Ciervide R, Chen X, Alvarez B, Garcia Aranda M, Lopez M, Serrano M, Osorio L, Asenjo M, Fernandez Leton P, Acosta A, Hernando Requejo O, Rubio C. EP-1357: moderate hypofractionated-imrt of prostate bed after radical prostatectom : acute toxicity. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31792-9] [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: 10/19/2022]
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Khemani D, Camilleri M, Roldan A, Nelson AD, Park SY, Acosta A, Zinsmeister AR. Opioid analgesic use among patients presenting with acute abdominal pain and factors associated with surgical diagnoses. Neurogastroenterol Motil 2017; 29:10.1111/nmo.13000. [PMID: 28019066 PMCID: PMC5393942 DOI: 10.1111/nmo.13000] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 10/26/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND The prevalence of chronic opioid use among non-cancer patients presenting with acute abdominal pain (AAP) is unknown. The aim was to characterize opioid use, constipation, diagnoses, and risk factors for surgical diagnoses among non-cancer patients presenting with AAP to an emergency department (ED). METHODS We performed a retrospective, observational cohort study of all (n=16,121) adult patients (88% from MN, IA and WI) presenting during 2014 with AAP. We used electronic medical records, and focused on 2352 adults with AAP who underwent abdominal CT scan within 24 hours of presentation. We determined odds ratios of association with constipation and features predicting conditions that may require surgery (surgical diagnosis). KEY RESULTS There were 2352 eligible patients; 18.8% were opioid users. Constipation was more frequent in opioid (35.1%) compared to non-opioid users [OR 2.88 (95% CI 2.28, 3.62)]. Prevalence of surgical diagnosis in the opioid and non-opioid users was 35.3% and 41.7% respectively (P=.019). By univariate analysis, age and neutrophil count independently predicted increased risk, and chronic opioid use decreased risk of surgical diagnosis. Internal validation of logistic models using a randomly selected validation subset (25% of entire cohort, 587/2352) showed receiver operating characteristic (ROC) curves for the validation and full cohorts were similar. CONCLUSIONS AND INFERENCES Approximately 19% of adults presenting with AAP were opioid users; constipation is almost three times as likely in opioid users compared to non-opioid users presenting with AAP. Factors significantly associated with altered risk of surgical diagnoses were age, opioid use, and neutrophil count.
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Affiliation(s)
- D Khemani
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Mayo Clinic, Rochester, MN, USA
| | - M Camilleri
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Mayo Clinic, Rochester, MN, USA
| | - A Roldan
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Mayo Clinic, Rochester, MN, USA
| | - A D Nelson
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Mayo Clinic, Rochester, MN, USA
| | - S-Y Park
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Mayo Clinic, Rochester, MN, USA
| | - A Acosta
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Mayo Clinic, Rochester, MN, USA
| | - A R Zinsmeister
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
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Nelson AD, Camilleri M, Acosta A, Busciglio I, Linker Nord S, Boldingh A, Rhoten D, Ryks M, Burton D. Effects of ghrelin receptor agonist, relamorelin, on gastric motor functions and satiation in healthy volunteers. Neurogastroenterol Motil 2016; 28:1705-1713. [PMID: 27283792 PMCID: PMC5083171 DOI: 10.1111/nmo.12870] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 05/06/2016] [Indexed: 12/27/2022]
Abstract
BACKGROUND Synthetic human ghrelin accelerates gastric emptying, reduces gastric accommodation, and results in numerical increases in postprandial symptom scores. The ghrelin receptor agonist, relamorelin, accelerates gastric emptying in patients with diabetic gastroparesis. AIM To measure pharmacological effects of relamorelin on gastric accommodation, distal antral motility, and satiation in healthy volunteers. METHODS In a placebo-controlled, double-blind, randomized study of 16 healthy volunteers, we compared effects of 30 μg subcutaneous (s.c.) relamorelin to placebo on: (i) gastric volumes measured by single photon emission computed tomography, (ii) 1-h postprandial distal antral motility index (MI) by 15-lumen perfusion gastroduodenal manometry, and (iii) satiation tested by Ensure nutrient drink test. Primary endpoints were: fasting and postprandial gastric volumes, distal antral phasic pressure activity (number of contractions, mean amplitude, and MI), and maximum tolerated volume. Results were normally distributed and the two treatment groups were compared using t-test. KEY RESULTS Relamorelin, 30 μg s.c., significantly increased the number of contractions in the distal antrum during 0-60 min postmeal when compared to placebo (p = 0.022); this was also observed in the first two 15-min periods (p = 0.005 and 0.015 for number of contractions 0-15 and 16-30). There was borderline increase in MI0-15 (p = 0.055) and numerically increased MI0-60 (p = 0.139) and MI16-30 (p = 0.116). The amplitude of contractions was not significantly increased. Relamorelin did not significantly alter fasting or postprandial gastric volumes, gastric accommodation, or satiation volumes and symptoms. CONCLUSIONS & INFERENCES Relamorelin increases frequency of distal antral motility contractions without significant effects on amplitude of contractions. The lack of inhibition of accommodation and absence of increase in satiation symptoms support relamorelin for the treatment of symptomatic gastroparesis (ClinicalTrials.gov NCT02466711).
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Affiliation(s)
- A. D. Nelson
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER); Mayo Clinic; Rochester MN USA
| | - M. Camilleri
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER); Mayo Clinic; Rochester MN USA
| | - A. Acosta
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER); Mayo Clinic; Rochester MN USA
| | - I. Busciglio
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER); Mayo Clinic; Rochester MN USA
| | - S. Linker Nord
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER); Mayo Clinic; Rochester MN USA
| | - A. Boldingh
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER); Mayo Clinic; Rochester MN USA
| | - D. Rhoten
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER); Mayo Clinic; Rochester MN USA
| | - M. Ryks
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER); Mayo Clinic; Rochester MN USA
| | - D. Burton
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER); Mayo Clinic; Rochester MN USA
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Wagenmakers EJ, Beek T, Dijkhoff L, Gronau QF, Acosta A, Adams RB, Albohn DN, Allard ES, Benning SD, Blouin-Hudon EM, Bulnes LC, Caldwell TL, Calin-Jageman RJ, Capaldi CA, Carfagno NS, Chasten KT, Cleeremans A, Connell L, DeCicco JM, Dijkstra K, Fischer AH, Foroni F, Hess U, Holmes KJ, Jones JLH, Klein O, Koch C, Korb S, Lewinski P, Liao JD, Lund S, Lupianez J, Lynott D, Nance CN, Oosterwijk S, Ozdoğru AA, Pacheco-Unguetti AP, Pearson B, Powis C, Riding S, Roberts TA, Rumiati RI, Senden M, Shea-Shumsky NB, Sobocko K, Soto JA, Steiner TG, Talarico JM, van Allen ZM, Vandekerckhove M, Wainwright B, Wayand JF, Zeelenberg R, Zetzer EE, Zwaan RA. Registered Replication Report. Perspect Psychol Sci 2016; 11:917-928. [DOI: 10.1177/1745691616674458] [Citation(s) in RCA: 201] [Impact Index Per Article: 25.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
According to the facial feedback hypothesis, people’s affective responses can be influenced by their own facial expression (e.g., smiling, pouting), even when their expression did not result from their emotional experiences. For example, Strack, Martin, and Stepper (1988) instructed participants to rate the funniness of cartoons using a pen that they held in their mouth. In line with the facial feedback hypothesis, when participants held the pen with their teeth (inducing a “smile”), they rated the cartoons as funnier than when they held the pen with their lips (inducing a “pout”). This seminal study of the facial feedback hypothesis has not been replicated directly. This Registered Replication Report describes the results of 17 independent direct replications of Study 1 from Strack et al. (1988), all of which followed the same vetted protocol. A meta-analysis of these studies examined the difference in funniness ratings between the “smile” and “pout” conditions. The original Strack et al. (1988) study reported a rating difference of 0.82 units on a 10-point Likert scale. Our meta-analysis revealed a rating difference of 0.03 units with a 95% confidence interval ranging from −0.11 to 0.16.
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Garcia-Donas J, Milagro NL, Alia EG, Garrido M, Guarch R, Acosta A, Herrador A, Pozuelo MP, Rodriguez-Moreno J. Quantification of genetic variants as marker of Brca-like phenotype in ovarian cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw374.25] [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: 11/14/2022] Open
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Manuck TA, Rice MM, Bailit JL, Grobman WA, Reddy UM, Wapner RJ, Thorp JM, Caritis SN, Prasad M, Tita AT, Saade GR, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, Varner M, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Leveno K, Moseley L, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Iams J, Wallace M, Northen A, Grant J, Colquitt C, Rouse D, Andrews W, Mallett G, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Zhao Y, McGee P, Momirova V, Palugod R, Reamer B, Larsen M, Williams T, Spangler T, Lozitska A, Spong C, Tolivaisa S, VanDorsten J. Preterm neonatal morbidity and mortality by gestational age: a contemporary cohort. Am J Obstet Gynecol 2016; 215:103.e1-103.e14. [PMID: 26772790 DOI: 10.1016/j.ajog.2016.01.004] [Citation(s) in RCA: 290] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 12/28/2015] [Accepted: 01/02/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although preterm birth <37 weeks' gestation is the leading cause of neonatal morbidity and mortality in the United States, the majority of data regarding preterm neonatal outcomes come from older studies, and many reports have been limited to only very preterm neonates. Delineation of neonatal outcomes by delivery gestational age is needed to further clarify the continuum of mortality and morbidity frequencies among preterm neonates. OBJECTIVE We sought to describe the contemporary frequencies of neonatal death, neonatal morbidities, and neonatal length of stay across the spectrum of preterm gestational ages. STUDY DESIGN This was a secondary analysis of an obstetric cohort of 115,502 women and their neonates who were born in 25 hospitals nationwide, 2008 through 2011. All liveborn nonanomalous singleton preterm (23.0-36.9 weeks of gestation) neonates were included in this analysis. The frequency of neonatal death, major neonatal morbidity (intraventricular hemorrhage grade III/IV, seizures, hypoxic-ischemic encephalopathy, necrotizing enterocolitis stage II/III, bronchopulmonary dysplasia, persistent pulmonary hypertension), and minor neonatal morbidity (hypotension requiring treatment, intraventricular hemorrhage grade I/II, necrotizing enterocolitis stage I, respiratory distress syndrome, hyperbilirubinemia requiring treatment) were calculated by delivery gestational age; each neonate was classified once by the worst outcome for which criteria was met. RESULTS In all, 8334 deliveries met inclusion criteria. There were 119 (1.4%) neonatal deaths. In all, 657 (7.9%) neonates had major morbidity, 3136 (37.6%) had minor morbidity, and 4422 (53.1%) survived without any of the studied morbidities. Deaths declined rapidly with each advancing week of gestation. This decline in death was accompanied by an increase in major neonatal morbidity, which peaked at 54.8% at 25 weeks of gestation. As frequencies of death and major neonatal morbidity fell, minor neonatal morbidity increased, peaking at 81.7% at 31 weeks of gestation. The frequency of all morbidities fell >32 weeks. After 25 weeks, neonatal length of hospital stay decreased significantly with each additional completed week of pregnancy; among babies delivered from 26-32 weeks of gestation, each additional week in utero reduced the subsequent length of neonatal hospitalization by a minimum of 8 days. The median postmenstrual age at discharge nadired around 36 weeks' postmenstrual age for babies born at 31-35 weeks of gestation. CONCLUSION Our data show that there is a continuum of outcomes, with each additional week of gestation conferring survival benefit while reducing the length of initial hospitalization. These contemporary data can be useful for patient counseling regarding preterm outcomes.
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Mouchli MA, Camilleri M, Lee T, Parthasarathy G, Vijayvargiya P, Halland M, Acosta A, Bharucha AE. Evaluating the safety and the effects on colonic compliance of neostigmine during motility testing in patients with chronic constipation. Neurogastroenterol Motil 2016; 28:871-8. [PMID: 26840188 PMCID: PMC4877263 DOI: 10.1111/nmo.12786] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 01/04/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Neostigmine, an acetyl cholinesterase inhibitor, stimulates colonic motor activity and may induce vagally mediated cardiovascular effects. Our aim was to evaluate effects of i.v. neostigmine on colonic compliance and its safety in patients with chronic constipation. METHODS We retrospectively reviewed medical records of a selected group of 144 outpatients with chronic constipation who were refractory to treatment. These patients had undergone intracolonic motility and compliance measurements with an infinitely compliant balloon linked to a barostat. Data abstracted included barostat balloon mean volumes with increases in pressure (4 mmHg steps from 0 to 44 mmHg) before and after i.v. neostigmine. Vital signs and oxygen saturation before and after neostigmine were recorded. KEY RESULTS Of the 144 patients, 133 were female, mean age was 41.0 ± 15.4 years (SD), and duration of constipation was 12.9 ± 13.8 years. Among patients who had undergone colonic transit measurement by scintigraphy, the overall colonic transit at 24 h (geometric center, GC24 [n = 115]) was 1.5 ± 0.7 (normal >1.3), and at 48 h (GC48 [n = 75]) it was 2.3 ± 0.9 (normal >1.9). Neostigmine decreased colonic compliance at lower distension pressures (e.g., 12 and 20 mmHg [both p < 0.001]), but not at 40 mmHg. There were expected minor changes in vital signs in response to neostigmine in 144 patients; however, one patient developed unresponsiveness, significant bradycardia, hypotension, and muscular rigidity that responded to 400 mcg i.v. atropine. CONCLUSIONS & INFERENCES Neostigmine significantly decreases colonic compliance in patients with refractory chronic constipation. Symptomatic bradycardia in response to neostigmine should be promptly reversed with atropine.
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Affiliation(s)
- M. A. Mouchli
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.); Mayo Clinic; Rochester MN USA
| | - M. Camilleri
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.); Mayo Clinic; Rochester MN USA
| | - T. Lee
- Institute for Digestive Research; Soonchunhyang University; Seoul Hospital Seoul Korea
| | - G. Parthasarathy
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.); Mayo Clinic; Rochester MN USA
| | - P. Vijayvargiya
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.); Mayo Clinic; Rochester MN USA
| | - M. Halland
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.); Mayo Clinic; Rochester MN USA
| | - A. Acosta
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.); Mayo Clinic; Rochester MN USA
| | - A. E. Bharucha
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.); Mayo Clinic; Rochester MN USA
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Moncada D, Arenas A, Acosta A, Molina D, Hernández A, Cardona N, Gomez-Yepes M, Gomez-Marin JE. Role of the 52 KDa thioredoxin protein disulfide isomerase of Toxoplasma gondii during infection to human cells. Exp Parasitol 2016; 164:36-42. [DOI: 10.1016/j.exppara.2016.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 02/05/2016] [Accepted: 02/08/2016] [Indexed: 10/22/2022]
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Nelson AD, Mouchli MA, Valentin N, Deyle D, Pichurin P, Acosta A, Camilleri M. Ehlers Danlos syndrome and gastrointestinal manifestations: a 20-year experience at Mayo Clinic. Neurogastroenterol Motil 2015; 27:1657-66. [PMID: 26376608 DOI: 10.1111/nmo.12665] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 08/01/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Gastrointestinal (GI) manifestations are found in Ehlers Danlos syndrome (EDS) hypermobility subtype (HM). We aimed to assess associations between EDS HM and other EDS subtypes with GI manifestations. METHODS We reviewed medical records of EDS patients evaluated at Mayo Clinic's Medical Genetics Clinic 1994-2013. We extracted information regarding EDS subtypes, GI manifestations, and treatments. KEY RESULTS We identified 687 patients; 378 (56%) had associated GI manifestations (female 86.8%, diagnosis mean age 29.6 years). Of the patients identified, 58.9% (43/73) had EDS classic, 57.5% (271/471) EDS HM, 47.3% (27/57) EDS vascular subtypes. In addition, 86 patients had EDS that could not be classified in any of those three subtypes. Commonest GI symptoms were: abdominal pain (56.1%), nausea (42.3%), constipation (38.6%), heartburn (37.6%), and irritable bowel syndrome-like symptoms (27.5%). Many GI symptoms were commoner in EDS HM than the other subtypes together. Among 37.8% of the 378 patients who underwent esophagogastroduodenoscopy, the commonest abnormalities were gastritis, hiatal hernia and reflux esophagitis. Abnormal gastric emptying was observed in 22.3% (17/76): 11.8% delayed and 10.5% accelerated. Colonic transit was abnormal in 28.3% (13/46): 19.6% delayed and 8.7% accelerated. Rectal evacuation disorder was confirmed in 18/30 patients who underwent anorectal manometry. Angiography showed aneurysms in abdominal vessels in EDS vascular type. Proton pump inhibitors (38%) and drugs for constipation (23%) were the most commonly used medications. A minority underwent colectomy (2.9%) or small bowel surgery (4%). CONCLUSIONS & INFERENCES EDS HM and other subtypes should be considered in patients with chronic functional GI symptoms and abdominal vascular lesions.
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Affiliation(s)
- A D Nelson
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) , Rochester, MN, USA
| | - M A Mouchli
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) , Rochester, MN, USA
| | - N Valentin
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) , Rochester, MN, USA
| | - D Deyle
- Division of Medical Genetics, Mayo Clinic, Rochester, MN, USA
| | - P Pichurin
- Division of Medical Genetics, Mayo Clinic, Rochester, MN, USA
| | - A Acosta
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) , Rochester, MN, USA
| | - M Camilleri
- Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER) , Rochester, MN, USA
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Franco-Hernandez EN, Acosta A, Cortés-Vecino J, Gómez-Marín JE. Survey for Toxoplasma gondii by PCR detection in meat for human consumption in Colombia. Parasitol Res 2015; 115:691-5. [DOI: 10.1007/s00436-015-4790-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Accepted: 10/12/2015] [Indexed: 11/27/2022]
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Iturrino J, Camilleri M, Acosta A, O’Neill J, Burton D, Edakkanambeth J, Zinsmeister A, Hurt R. MON-PP111: Acute Effects of a Glucagon-Like Peptide 2 Analog, Teduglutide, on Gastrointestinal Functions in Adults with Short Bowel Syndrome. Clin Nutr 2015. [DOI: 10.1016/s0261-5614(15)30543-4] [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: 10/23/2022]
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Magallares Lόpez B, Acosta A, Barcelό M, Rodriguez de la Serna A. AB0888 Poor Adherence to Osteoporosis Treatment in Patients with Hip Fracture: A Retrospective Study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3188] [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: 11/04/2022]
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Camilleri M, Acosta A. Emerging treatments in Neurogastroenterology: relamorelin: a novel gastrocolokinetic synthetic ghrelin agonist. Neurogastroenterol Motil 2015; 27:324-32. [PMID: 25545036 PMCID: PMC4424792 DOI: 10.1111/nmo.12490] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 11/20/2014] [Indexed: 02/06/2023]
Abstract
BACKGROUND Synthetic ghrelin agonists, predominantly small molecules, are being developed as prokinetic agents that may prove useful in the treatment of gastrointestinal motility disorders. Relamorelin (RM-131) is a pentapeptide synthetic ghrelin analog that activates the growth hormone secretagogue (GHS)-1a (also called the ghrelin) receptor with approximately sixfold greater potency than natural ghrelin. The ability of relamorelin to stimulate growth hormone (GH) release is comparable to that of native ghrelin. Relamorelin has enhanced efficacy and plasma stability compared to native ghrelin. PURPOSE In this review, we discuss the pharmacokinetics, pharmacodynamics and potential indications for relamorelin. Relamorelin is administered subcutaneously, dosed daily or twice daily. Relamorelin is being studied for the treatment of patients with gastrointestinal motility disorders. Phase IIA pharmacodynamic studies have demonstrated acceleration of gastric emptying in patients with type 1 diabetes mellitus (T1DM) and type 2 DM (T2DM) and upper gastrointestinal symptoms. In a phase IIA study in patients with diabetic gastroparesis, relamorelin accelerated gastric emptying and significantly improved vomiting frequency compared to placebo and improved other symptoms of gastroparesis in a prespecified subgroup of patients with vomiting at baseline. In patients with chronic idiopathic constipation with defined transit profile at baseline, relamorelin relieved constipation and accelerated colonic transit compared to placebo. These characteristics suggest that this new ghrelin analog shows great promise to relieve patients with upper or lower gastrointestinal motility disorders.
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Affiliation(s)
- M. Camilleri
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.); Mayo Clinic; Rochester MN USA
| | - A. Acosta
- Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.); Mayo Clinic; Rochester MN USA
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Bailit JL, Grobman W, Zhao Y, Wapner RJ, Reddy UM, Varner MW, Leveno KJ, Caritis SN, Iams JD, Tita AT, Saade G, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, VanDorsten JP, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Mallett G, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Thorp J, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Moseley L, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Shubert P, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Iams J, Wallace M, Northen A, Grant J, Colquitt C, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Rice M, McGee P, Momirova V, Palugod R, Reamer B, Larsen M, Williams T, Spong C, Tolivaisa S. Nonmedically indicated induction vs expectant treatment in term nulliparous women. Am J Obstet Gynecol 2015; 212:103.e1-7. [PMID: 24983681 DOI: 10.1016/j.ajog.2014.06.054] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 05/27/2014] [Accepted: 06/23/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The purpose of this study was to compare maternal and neonatal outcomes in nulliparous women with nonmedically indicated inductions at term vs those expectantly treated. STUDY DESIGN Data were obtained from maternal and neonatal charts for all deliveries on randomly selected days across 25 US hospitals over a 3-year period. A low-risk subset of nulliparous women with vertex nonanomalous singleton gestations who delivered 38 0/7 to 41 6/7 weeks were selected. Maternal and neonatal outcomes for nonmedically indicated induction within each week were compared with women who did not undergo nonmedically indicated induction during that week. Multivariable analysis was used to adjust for hospital, maternal age, race/ethnicity, body mass index, cigarette use, and insurance status. RESULTS We found 31,169 women who met our criteria. Neonatal complications were either less frequent with nonmedically indicated induction or no different between groups. Nonmedically indicated induction was associated with less frequent peripartum infections (odds ratio [OR], 0.39; 95% confidence interval [CI], 0.16-0.98) at 38 weeks of gestation and less frequent third- and fourth-degree lacerations (OR, 0.60; 95% CI, 0.42-0.86) and less frequent peripartum infections (OR, 0.66; 95% CI, 0.49-0.90) at 39 weeks of gestation. Nonmedically indicated induction was associated with a longer admission-to-delivery time by approximately 3-4 hours and increased odds of cesarean delivery at 38 (OR, 1.50; 95% CI, 1.08-2.08) and 40 weeks (OR, 1.30; 95% CI, 1.15-1.46) of gestation. CONCLUSION At 39 weeks of gestation, nonmedically indicated induction is associated with lower maternal and neonatal morbidity than women who are expectantly treated.
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Rodríguez A, Acosta A, Rodríguez C. Fungicide resistance of Botrytis cinerea in tomato greenhouses in the Canary Islands and effectiveness of non-chemical treatments against gray mold. World J Microbiol Biotechnol 2014; 30:2397-406. [PMID: 24817605 DOI: 10.1007/s11274-014-1665-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 05/05/2014] [Indexed: 12/01/2022]
Abstract
Tomato greenhouses in the Canary Islands, Spain, were surveyed to estimate frequencies of resistance to benzimidazoles, dicarboximides, anilinopyrimidines and N-phenylcarbamates in Botrytis cinerea. Resistance to carbendazim, iprodione, pyrimethanil and diethofencarb was found in 74.2, 86.4, 28.8 and 31.8% of isolates, respectively. Benzimidazole- and anilinopyrimide-resistant isolates were highly resistant, showing EC50 values above 500 µg/ml carbendazim and a mean EC50 value of 28.42 µg/ml pyrimethanil, respectively. By contrast, a low level of resistance was observed among dicarboximide-resistant isolates (mean EC50 value of 1.81 µg/ml iprodione). Phenotypes with double resistance to carbendazim and iprodione, and triple resistance to carbendazim, iprodione and pyrimethanil were the most common, occurring in 36.4 and 28.8% of isolates. The surveyed greenhouses had never been treated with fenhexamid and Signum™ (pre-packed mixture of boscalid and pyraclostrobin), and baseline sensitivities of B. cinerea isolates to these fungicides were determined. The EC50 values were within the range of 0.009-0.795 µg/ml fenhexamid and of 0.014-0.48 µg/ml Signum. In addition, available formulations based on elicitors of plant defense response and biocontrol agents were evaluated against B. cinerea in tomato plants under semi-controlled greenhouse conditions, the yeast Candida sake CPA-1 being able to reduce gray mold significantly when it was applied on petiole wounds and the plants were inoculated 24 h later. Likewise, C. sake was effective against B. cinerea in harvested tomato fruits, yeast-treated tomatoes showed a 70.66 and 30.31% reduction in the diameters of decay lesions compared with controls after 10 days of storage at 20 and 9 °C, respectively.
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Affiliation(s)
- A Rodríguez
- Departamento de Bioquímica, Microbiología, Biología Celular y Genética, Facultad de Farmacia, Universidad de La Laguna, 38206, La Laguna, Tenerife, Canary Islands, Spain,
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Prendergast H, Dudley S, Kane J, Bunney E, Acosta A, Marcucci J. Antihypertensive medications and diastolic dysfunction progression in an African American population. Afr J Emerg Med 2013. [DOI: 10.1016/j.afjem.2013.08.060] [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: 10/26/2022] Open
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Acosta A, Garassus P, Martinez Zuluaga A, Yurrebasso Santamaria I, Garcia-Larrea L. Neuropathic pain in leprosy late onset neuropathy. Neurophysiol Clin 2013. [DOI: 10.1016/j.neucli.2013.10.033] [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: 10/25/2022] Open
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