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Hraiech S, Ladjal K, Guervilly C, Hyvernat H, Papazian L, Forel JM, Lopez A, Peres N, Dellamonica J, Leone M, Gragueb-Chatti I. Lung abscess following ventilator-associated pneumonia during COVID-19: a retrospective multicenter cohort study. Crit Care 2023; 27:385. [PMID: 37794402 PMCID: PMC10552315 DOI: 10.1186/s13054-023-04660-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 09/26/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Patients undergoing mechanical ventilation (MV) for COVID-19 exhibit an increased risk of ventilator-associated pneumonia (VAP). The occurrence of lung abscesses following VAP in these patients has been poorly studied. We aimed to describe the incidence, characteristics, risk factors and prognosis of lung abscesses complicating VAP after COVID-19. METHODS We conducted an observational, retrospective study in three French intensive care units. Patients admitted for acute respiratory failure with a confirmed SARS-CoV-2 PCR and requiring MV for more than 48 h were included. RESULTS Among the 507 patients included, 326 (64%) had a documented VAP. Of these, 23 (7%) developed a lung abscess. Enterobacterales (15/23, 65%) were the main documentation, followed by non-fermenting Gram-negative bacilli (10/23, 43%) and Gram-positive cocci (8/23, 35%). Lung abscesses were mainly plurimicrobial (15/23, 65%). In multivariate analysis, a plurimicrobial 1st VAP episode (OR (95% CI) 2.93 (1.16-7.51); p = 0.02) and the use of hydrocortisone (OR (95% CI) 4.86 (1.95-12.1); p = 0.001) were associated with lung abscess development. Intensive care unit (ICU) mortality of patients with lung abscesses reached 52%, but was not significantly higher than for patients with VAP but no lung abscess. Patients with lung abscesses had reduced ventilator-free days at day 60, a longer duration of MV and ICU stay than patients with VAP but no lung abscess (respectively, 0 (0-3) vs. 16 (0-42) days; p < 0.001, 49 (32-73) vs. 25 (11-41) days; p < 0.001, 52 (36-77) vs. 28 (16-47) days; p < 0.001). CONCLUSIONS Lung abscessing pneumonia is not uncommon among COVID-19 patients developing VAP. A plurimicrobial first VAP episode and the use of hydrocortisone are independently associated with this complication. In COVID-19 patients with persistent VAP, a chest CT scan investigating the evolution toward lung abscess should be considered.
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Affiliation(s)
- S Hraiech
- Service de Médecine Intensive - Réanimation, AP-HM, Hôpital Nord, Marseille, France.
- Faculté de Médecine, Aix-Marseille Université, Centre d'Etudes Et de Recherches Sur Les Services de Santé Et Qualité de Vie EA 3279, 13005, Marseille, France.
| | - K Ladjal
- Service de Médecine Intensive - Réanimation, AP-HM, Hôpital Nord, Marseille, France
| | - C Guervilly
- Service de Médecine Intensive - Réanimation, AP-HM, Hôpital Nord, Marseille, France
| | - H Hyvernat
- CHU de Nice, Hôpital Archet 1, Médecine Intensive Réanimation, 06200, Nice, France
- Equipe 2 CARRES, UR2CA, Unité de Recherche Clinique Côte d'Azur, Université Côte d'Azur, Nice, France
| | - L Papazian
- Faculté de Médecine, Aix-Marseille Université, Centre d'Etudes Et de Recherches Sur Les Services de Santé Et Qualité de Vie EA 3279, 13005, Marseille, France
- Centre Hospitalier de Bastia, 20600, Bastia, Corsica, France
| | - J M Forel
- Service de Médecine Intensive - Réanimation, AP-HM, Hôpital Nord, Marseille, France
- Faculté de Médecine, Aix-Marseille Université, Centre d'Etudes Et de Recherches Sur Les Services de Santé Et Qualité de Vie EA 3279, 13005, Marseille, France
| | - A Lopez
- Service d'Anesthésie Et de Réanimation, Aix Marseille Université, Assistance Publique Hôpitaux Universitaires de Marseille, Hôpital Nord, Marseille, France
| | - N Peres
- Service de Réanimation Polyvalente, Centre Hospitalier Intercommunal Toulon - La Seyne sur Mer, Toulon, France
| | - J Dellamonica
- CHU de Nice, Hôpital Archet 1, Médecine Intensive Réanimation, 06200, Nice, France
- Equipe 2 CARRES, UR2CA, Unité de Recherche Clinique Côte d'Azur, Université Côte d'Azur, Nice, France
| | - M Leone
- Service d'Anesthésie Et de Réanimation, Aix Marseille Université, Assistance Publique Hôpitaux Universitaires de Marseille, Hôpital Nord, Marseille, France
| | - I Gragueb-Chatti
- Service de Médecine Intensive - Réanimation, AP-HM, Hôpital Nord, Marseille, France
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Spiegel MC, Lopez A, Kilb E. A Cross-Sectional Analysis of Internal Medicine Residency Program Directors' Adherence to Guidelines for Standardized Fellowship Letters of Recommendation. J Gen Intern Med 2023; 38:2846-2848. [PMID: 37436570 PMCID: PMC10506994 DOI: 10.1007/s11606-023-08312-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 06/29/2023] [Indexed: 07/13/2023]
Affiliation(s)
- Michelle C Spiegel
- Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA.
| | - Alexandra Lopez
- Department of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Edward Kilb
- Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA
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Forst L, Chaudhry A, Lopez A, McCarthy M, Hebert-Beirne J. Protecting workers in the temporary staffing industry. Occup Med (Lond) 2023:7158596. [PMID: 37159553 DOI: 10.1093/occmed/kqad045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Workers hired through temporary staffing companies have a high rate of severe and fatal injuries despite the legally mandated, shared responsibility of the temporary staffing company and the host company to assure safe work. AIMS The aim of this study was to elucidate the perspective of temporary staffing personnel on approaches to mitigating injury risk among the workers they hire. METHODS Based on a conceptual model representing the interplay between work and health, we conducted a 'brainstorm' of temporary staffing personnel regarding perceived barriers to protecting temporary workers. A content/context analysis used standard qualitative methods, and the findings were triangulated with notes taken during the discussion. RESULTS Temporary staffing employers describe loss of control of the working conditions once workers are placed at host/client companies. Further, they describe a contentious relationship between temporary staffing and host companies, where it is difficult to hold host companies to account. Other barriers to providing temporary workers with a safe work environment include the temp companies' lack of knowledge of site-specific hazards, the poor quality of onsite Occupational Safety and Health training, and ignoring Occupational Safety and Health Administration (OSHA) requirements. CONCLUSIONS The perspective of temporary staffing companies should be considered to address the lack of cooperation and shifted responsibility described in this study. Policy and practice changes could include requiring contract language, implementing communication about safety, either sharing workers' compensation purchase or removing exclusive remedy protections from hosts, and prescribing safety training, such as an OSHA 10-h programme. Suggested interventions need further study.
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Affiliation(s)
- L Forst
- Environmental and Occupational Health Sciences, School of Public Health, Chicago, IL 60612, USA
| | - A Chaudhry
- Community Health Sciences, UIC School of Public Health, Chicago, IL 60612, USA
| | - A Lopez
- Environmental and Occupational Health Sciences, School of Public Health, Chicago, IL 60612, USA
| | - M McCarthy
- Environmental and Occupational Health Sciences, School of Public Health, Chicago, IL 60612, USA
| | - J Hebert-Beirne
- Community Health Sciences, UIC School of Public Health, Chicago, IL 60612, USA
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Martinuzzi A, Lopez A, Flores A, Sgarzini D, Ortega F, Ferrero A, Doeyo M, Matano M, Billinger C, Pagani L, Barros J, Oviedo M, Mora C, Nuñez A, Manrique E, Cabrera D, Delfabro A, Salomone P, Crivelli A. Early Nutritional Evaluation By A Nutritional Support Team. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.162] [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: 03/28/2023]
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Mendez L, Wong YS, Cespedes B, Lopez A, Rodriguez-Alvarez L, Castro FO. 236 Assessment of the antifibrotic capacity of the secretome of equine adipose mesenchymal stem cells conditioned with PGE. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab236] [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: 12/09/2022] Open
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Feliciano‐Astacio BE, Beecham GW, Hamilton‐Nelson KL, Silva‐Vergara C, Contreras M, Mena PR, Adams LD, Acosta H, Feliciano NI, Lopez A, Cuccaro ML, Vance JM, Pericak‐Vance MA. The Relationship of Alzheimer’s Disease, Stroke and Ancestry in the Puerto Rican Alzheimer Disease Population. Alzheimers Dement 2022. [DOI: 10.1002/alz.067780] [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] [Indexed: 12/24/2022]
Affiliation(s)
| | - Gary W. Beecham
- University of Miami Miami FL USA
- Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine Miami FL USA
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami Miami FL USA
- University of Miami, Miller School of Medicine, John P. Hussman Institute for Human Genomics Miami FL USA
| | - Kara L. Hamilton‐Nelson
- University of Miami Miami FL USA
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami Miami FL USA
- University of Miami Miller School of Medicine Miami FL USA
| | | | - Maricarmen Contreras
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami Miami FL USA
| | - Pedro Ramon Mena
- Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine Miami FL USA
- John P. Hussman Institute for Human Genomics, University of Miami Miami FL USA
| | - Larry D. Adams
- University of Miami Miami FL USA
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami Miami FL USA
- University of Miami Miller School of Medicine Miami FL USA
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine Miami FL USA
- Dr. John Macdonald Fundation Deparment of Human Genetics, University of Miami Miller School of Medicine Miami FL USA
| | | | | | | | - Michael L. Cuccaro
- University of Miami Miami FL USA
- Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine Miami FL USA
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami Miami FL USA
- University of Miami Miller School of Medicine Miami FL USA
- John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine Miami FL USA
| | - Jeffery M. Vance
- University of Miami Miami FL USA
- Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine Miami FL USA
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami Miami FL USA
- University of Miami Miller School of Medicine Miami FL USA
- John P. Hussman Institute for Human Genomics, University of Miami Miami FL USA
| | - Margaret A. Pericak‐Vance
- Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine Miami FL USA
- John P. Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami Miami FL USA
- Dr. John T. MacDonald Foundation Department of Human Genetics Miami FL USA
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Dupont M, Carlier C, Gower-Rousseau C, Barbier-Lider P, Botsen D, Brasseur M, Burgevin A, Chourbagi C, D’Almeida R, Hautefeuille V, Hentzien M, Lambert A, Lamuraglia M, Lavau-Denes S, Lopez A, Parent D, Slimano F, Brugel M, Bouché O. Incidence and associated factors of cetuximab-induced hypersensitivity infusion reactions in 1392 cancer patients treated in four French areas: a possible association with Lyme disease? BMC Cancer 2022; 22:1219. [PMID: 36434607 PMCID: PMC9701068 DOI: 10.1186/s12885-022-10192-4] [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] [Received: 12/28/2021] [Accepted: 10/17/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Previous studies have observed an increased incidence of Cetuximab-induced hypersensitivity infusion reactions (CI-IRs) in the southeastern states of the USA. Tick's bites were suspected of generating cross-reactions between cetuximab and alpha-gal. This study aims was to describe the incidence and associated risk factors of CI-IRs, in the French areas chosen according to their Lyme disease incidence. PATIENTS AND METHODS A retrospective chart review was conducted on patients that received cetuximab infusion from January 2010 to June 2019 in 4 French areas with different Lyme disease incidence rates. RESULTS Of 1392 patients, 117 (8.4%) experienced a CI-IR, including 68 severe (grade 3 or 4) reactions (4.9%). This CI-IR incidence was significantly higher in the Lyme disease high-risk area than in the other areas (13.2% versus 7.1%, 8.1% and 6.4%; P = 0.016). Sex (P = 0.53), premedication (P = 0.91), primary cancer location (P = 0.46) and chemotherapy regimen type (P = 0.78) had no impact on CI-IR incidence in the overall population. In the head and neck squamous cell carcinoma (HNSCC) patient subgroup, CI-IRs were significantly more frequent in the high-risk area (16.4% versus 6.7%, 7.1% and 7.0%; P = 0.0015). CONCLUSION This study suggests that patients treated in the French area with the highest incidence of Lyme disease are at a higher risk of CI-IRs.
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Affiliation(s)
- M Dupont
- Department of Medical Oncology, Godinot Cancer Institute, 1 Rue du Général Koenig, 51100 Reims, France
| | - Claire Carlier
- Department of Medical Oncology, Godinot Cancer Institute, 1 Rue du Général Koenig, 51100 Reims, France ,grid.11667.370000 0004 1937 0618Department of Gastroenterology and Digestive Oncology, CHU Reims, University of Reims Champagne-Ardenne, Reims, France
| | - C Gower-Rousseau
- grid.414215.70000 0004 0639 4792Department of Research and Public Health, CHU Reims, Reims, France
| | - P Barbier-Lider
- grid.410527.50000 0004 1765 1301Department of Pharmacy, Nancy University Hospital, Vandoeuvre-lès-Nancy, France
| | - D Botsen
- Department of Medical Oncology, Godinot Cancer Institute, 1 Rue du Général Koenig, 51100 Reims, France ,grid.11667.370000 0004 1937 0618Department of Gastroenterology and Digestive Oncology, CHU Reims, University of Reims Champagne-Ardenne, Reims, France
| | - M Brasseur
- grid.11667.370000 0004 1937 0618Department of Gastroenterology and Digestive Oncology, CHU Reims, University of Reims Champagne-Ardenne, Reims, France
| | - A Burgevin
- grid.29172.3f0000 0001 2194 6418Department of Gastroenterology and Digestive Oncology, Nancy University Hospital, Lorraine University, Vandoeuvre-lès-Nancy, France
| | - C Chourbagi
- grid.134996.00000 0004 0593 702XDepartment of Pharmacy, Amiens University Hospital, Amiens, France
| | - R D’Almeida
- grid.11667.370000 0004 1937 0618Department of Gastroenterology and Digestive Oncology, CHU Reims, University of Reims Champagne-Ardenne, Reims, France
| | - V Hautefeuille
- grid.11162.350000 0001 0789 1385Department of Gastroenterology and Digestive Oncology, Amiens University Hospital, University of Picardie Jules Verne, Amiens, France
| | - M Hentzien
- grid.11667.370000 0004 1937 0618Department of Infectious Diseases and Internal Medicine, CHU Reims, University of Reims Champagne-Ardenne, Reims, France
| | - A Lambert
- Department of Medical Oncology, Lorraine Cancer Institute, Vandoeuvre-lès-Nancy, France
| | - M Lamuraglia
- grid.11162.350000 0001 0789 1385Department of Medical Oncology, Amiens University Hospital, University of Picardie Jules-Vernes, Amiens, France
| | - S Lavau-Denes
- grid.411178.a0000 0001 1486 4131Department of Medical Oncology, Limoges University Hospital, Limoges, France
| | - A Lopez
- grid.29172.3f0000 0001 2194 6418Department of Gastroenterology and Digestive Oncology, Nancy University Hospital, Lorraine University, Vandoeuvre-lès-Nancy, France
| | - D Parent
- Department of Pharmacy, Godinot Cancer Institute, Reims, France
| | - F Slimano
- grid.11667.370000 0004 1937 0618Department of Pharmacy, CHU Reims, University of Reims Champagne-Ardenne, Reims, France
| | - M Brugel
- grid.11667.370000 0004 1937 0618Department of Gastroenterology and Digestive Oncology, CHU Reims, University of Reims Champagne-Ardenne, Reims, France
| | - O Bouché
- grid.11667.370000 0004 1937 0618Department of Gastroenterology and Digestive Oncology, CHU Reims, University of Reims Champagne-Ardenne, Reims, France
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Grattagliano I, Massaro Y, Lisi A, Di Conza A, Tinella L, Caffò AO, Lopez A, Catanesi R, Nardulli F, Bosco A. The role of personality assessment in forensic driving license renewal procedures. A study supported by the MMPI-2 test. Clin Ter 2022; 173:537-545. [PMID: 36373452 DOI: 10.7417/ct.2022.2479] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The main function of the medical-psychological assessment to evaluate fitness to drive (FTD) is to safeguard the community against risks posed by drivers who, owing to psycho-physical disease, personality disturbances, abuse of psychotropic substances or drugs, can be a hazard to safety on the roads. In the context of psychodiagnostic investigations, the Minnesota Multiphasic Personality Inventory 2 (MMPI-2) test is the gold standard tool supporting clinical assessments conducted to evaluate a subject's capacity to predict her/his own actions, attitudes, risk propensity, level of conformity to social norms. Other important features of the tool include the specific scales aimed at individuating behaviors adopted with the intent to elude or hide existing personality problems. These behaviors are very frequent in the field of medicolegal, psychological and psychiatric assessments, including FTD evaluations. In this study, the MMPI 2 test was administered to 154 subjects for whom Driving Licence (DL) Medical Commissions based in the south of Italy had required specific personality assessments, compared to a control group of 186 subjects with no clinical or psychodiagnostic problems. The question posed in our study was to understand whether the test was able to detect differences between the personalities of the subjects belonging to the two groups. The results obtained demonstrated significant differences between the experimental group and the controls, shown by the MMPI-2 variables, in particular the clinical Hs scale,the supplementary scales: GF, Re, AAS, APS and the content scales DEP and TRT, as well as the PSY-5 Disc and Nege scales.
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Affiliation(s)
- I Grattagliano
- Department of Education, Psychology and Communication Sciences University of Bari Aldo Moro, Italy
| | - Y Massaro
- Department of Education, Psychology and Communication Sciences University of Bari Aldo Moro, Italy
| | - A Lisi
- Department of Education, Psychology and Communication Sciences University of Bari Aldo Moro, Italy
| | - A Di Conza
- Department of Education, Psychology and Communication Sciences University of Bari Aldo Moro, Italy
| | - L Tinella
- Department of Education, Psychology and Communication Sciences University of Bari Aldo Moro, Italy
| | - A O Caffò
- Department of Education, Psychology and Communication Sciences University of Bari Aldo Moro, Italy
| | - A Lopez
- Department of Education, Psychology and Communication Sciences University of Bari Aldo Moro, Italy
| | - R Catanesi
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - F Nardulli
- Medical Commission for Driving License, Local Health Authority, Bari, Italy
| | - A Bosco
- Department of Education, Psychology and Communication Sciences University of Bari Aldo Moro, Italy
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Esteban Fernandez A, Gomez Otero I, Rodriguez Santamarta M, Fluvia Brugues P, Pastor F, Perez Rivera JA, Bonilla JL, Lopez Fernandez S, Lopez A, Segura Aumente JM, Martinez V, Garcia Pinilla JM, Vazquez Lopez-Ibor J, Sanchez Munoz E, Sole E. Is it possible to start quadruple therapy in patients with a new diagnosis of HF and reduced ejection fraction? Real-life data from the TIDY-HF registry. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.959] [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
Background
The 2021 European heart failure (HF) guidelines recommended treatment with an inhibitor of the renin-angiotensin-aldosterone axis (RAAS), a beta-blocker (BB), a mineralocorticoid receptor antagonist (MRA), and a cotransporter sodium-glucose type 2 inhibitor (SGLT2) in patients with HF and left ventricular ejection fraction (LVEF) ≤40%. However, there is little evidence on implementing quadruple therapy in clinical practice.
Purpose
Study the implementation of quadruple therapy in patients with a new diagnosis of HF and reduced ejection fraction in clinical practice.
Methods
A prospective multicenter registry (38 centers in Spain) was carried out, including all patients newly diagnosed with HF with LVEF ≤40% in clinical practice. Their baseline and laboratory characteristics were recorded and their pharmacological treatment: at baseline (discharged from hospitalization or first outpatient visit within a maximum period of 1 month after the echocardiographic diagnosis), one month, and 3 months later.
Results
On 1th of March 2022, 349 patients were included, with baseline treatment data in 289. The mean age was 65.0±14.2 years, and 72.1% were men. The mean LVEF was 28.5±7.3%, with 57.6% in NYHA II and 29.1% in NYHA III–IV. The most frequent causes of cardiomyopathy were: ischemic (25.1%), tachycardiomyopathy (16.6%), and idiopathic (15.7%). 46.4% were dyslipidemic, 57.5% hypertensive and 33.3% diabetic. 65.1% of the patients were in sinus rhythm. Before HF diagnosis, 44.6% had been treated with RAASi, 22.8% with BB, 7.8% with MRA, 8.1% with iSGLT2, and 24.5% with diuretics. The drugs used at baseline and the changes during follow-up are shown in Table 1.
Conclusions
According to our cohort, almost 60% of newly diagnosed patients with HF and reduced LVEF start quadruple therapy during the first month after diagnosis, with sacubitril/valsartan being the preferred RAASi in most cases. The implementation of drugs with prognostic benefit is above 70% at baseline and exceeds 80% at one month of follow-up, with a progressive reduction in loop diuretics during follow-up.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): Spanish Society of Cardiology
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Affiliation(s)
| | - I Gomez Otero
- University Hospital of Santiago de Compostela , Santiago de Compostela , Spain
| | | | | | - F Pastor
- Virgen of the Arrixaca University Hospital , Murcia , Spain
| | | | - J L Bonilla
- Hospital San Juan de la Cruz , Ubeda , Spain
| | | | - A Lopez
- Lugo University Hospital Complex , Lugo , Spain
| | | | - V Martinez
- General Hospital La Mancha Centro , Alcazar de San Juan , Spain
| | | | | | | | - E Sole
- Barcelona Hospital Clinic , Barcelona , Spain
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Righini M, Felicani C, Lopez A, Mazzotta E, De Molo C, Mancini E, Capelli I, Serra C, La Manna G. Medullary sponge kidney: unusual finding in kidney transplant recipient. Ultrasound J 2022; 14:39. [PMID: 36175746 PMCID: PMC9522951 DOI: 10.1186/s13089-022-00277-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/19/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Medullary sponge kidney is generally considered a benign condition, gold standard for the diagnosis is urography but it has almost been replaced by UroCT that did not present the same sensibility. Although it is really rare, our sonography’s findings were consistent with medullary sponge kidney in the transplanted kidneys.
Case presentation
A 45-year-old woman with a long history of double-kidney transplantation complained of frequent urinary tract infections, a history of vague loin pain and came to our attention for sonography follow-up. Her kidney function was normal, we did not find signs of infections in the transplanted kidneys and urinary findings were normal. Curiously, the transplanted kidneys came from a newborn and the patient received a double-kidney transplantation in order to guarantee a satisfactory renal function.
Conclusions
Despite a long history of kidney transplantation, genetic disease should not be forgotten when symptoms and images recall to specific inherited alterations. Sonography has to be considered in diagnostic path of kidney cystic disease.
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Ormsby E, Lopez A, Van Wie J, Stejskal A, Campbell J, Ho R, Vineis M, Policastro P. Crazy About Caffeine: Assessing College Students Caffeinated Beverage Content Knowledge. J Acad Nutr Diet 2022. [DOI: 10.1016/j.jand.2022.06.187] [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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Hamon R, Jiang X, Toubia J, Coolen C, Lopez A, Reynolds P, Pitson S, Woodcock J. EP16.04-020 Dysregulation of 14-3-3 Signaling Adapters in Lung Adenocarcinoma, New Insights Into the Impact on Cancer Cell Biology. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.1128] [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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Niedmers H, Defosse JM, Wappler F, Lopez A, Schieren M. [Current approaches to anesthetic management in thoracic surgery-An evaluation from the German Thoracic Registry]. Anaesthesist 2022; 71:608-617. [PMID: 35507027 DOI: 10.1007/s00101-022-01093-z] [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: 06/15/2021] [Revised: 12/18/2021] [Accepted: 01/07/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND While many hospitals in Germany perform thoracic surgery, anesthetic techniques and methods that are actually used are usually only known for individual departments. This study describes the general anesthetic management of three typical thoracic surgical procedures across multiple institutions. MATERIAL AND METHODS The German Thoracic Registry recorded 4614 patients in 5 institutions between 2016 and 2019. Hospitals with a minimum number of more than 50 thoracic procedures per year are eligible for inclusion in the registry. To analyze the anesthetic management, a matching process yielded three comparable patient groups (n = 1506) that differed solely in the surgical procedure. Three surgical procedures with varying degrees of invasiveness were selected: Group A = video-assisted thoracoscopic surgery (VATS) with wedge resection, group B = VATS with lobectomy, group C = open thoracotomy. Statistical analysis was performed descriptively using relative and absolute frequencies. Dichotomous variables were compared using the χ2-test. RESULTS The study enrolled patients with a median age of 65.6 years. The mean value of the American Society of Anesthesiologists (ASA) classification was 2.8. One lung ventilation was most commonly performed (group A = 98.2%, group B = 99.4%, group C = 98.0%) with double lumen tubes (DLT). Bronchial blockers (group A = 0.2%, group B = 0.4%, group C = 0%) were rarely used. Primary bronchoscopy was used to control double lumen tubes after insertion in the majority of cases (group A = 77.5%, group B = 73.1%, group C= 79.7%). Continuous positive airway pressure (CPAP, group A = 1.2%, group B = 1.4%, group C = 5.1%) and jet ventilation (group A = 1.6%, group B = 1.6%, group C = 1.4%) were rarely used intraoperatively. In group C, the administration of a vasopressor was also more frequently required (group A = 59.9%, group B = 77.8%, group C = 86%). A central venous catheter was established in 30.1% of all patients in group A, 39.8% in group B and 73.3% in group C. Patients in group A received an arterial catheter less frequently (71.7%) when compared to groups B (96.4%) and C (95.2%). Total intravenous anesthesia with propofol was used in most patients (group A = 67.7%, group B 61.6%, group C 75.7%). Propofol supplemented by volatile anesthetics was used less frequently (group A = 28.5%, group B = 35.5%, group C = 23.7%). With increasing invasiveness of the surgical procedure, placement of an epidural catheter was preferred (group A = 18.9%, group B = 29.5%, group C = 64.1%). Paravertebral catheters (group A = 7.6%, group B = 4.4%, group C = 4.8%) or a single infiltration of the paravertebral space were performed less frequently (group A = 7.8%, group B = 17.7%, group C = 11.6%). Postoperatively, some patients (3.4-25.7%) were transferred to the general ward. The largest proportion of patients transferred to a general ward underwent less invasive thoracic procedures (group A). When the extent of resection was greater (group B and group C) patients were mostly transferred to an intermediate care unit (IMC) or an intensive care unit (ICU). The insertion of invasive catheters was neither associated with the patients' ASA classification nor preoperative pathologic pulmonary function. CONCLUSION Our data indicate that less invasive thoracic operations are associated with a reduction of invasive anesthetic procedures. As the presented data are descriptive, further studies are required to determine the impact of invasive anesthetic procedures on patient-related outcomes. This evaluation of the anesthetic management in experienced thoracic anesthesiology departments represents the next step towards establishing national quality standards and promoting structural quality in thoracic anesthesia.
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Affiliation(s)
- H Niedmers
- Klinik für Anästhesiologie und operative Intensivmedizin, Krankenhaus Köln-Merheim, Kliniken der Stadt Köln gGmbH, Klinikum der Universität Witten/Herdecke, Ostmerheimer Str. 200, 51109, Köln, Deutschland.
| | - J M Defosse
- Klinik für Anästhesiologie und operative Intensivmedizin, Krankenhaus Köln-Merheim, Kliniken der Stadt Köln gGmbH, Klinikum der Universität Witten/Herdecke, Ostmerheimer Str. 200, 51109, Köln, Deutschland
| | - F Wappler
- Klinik für Anästhesiologie und operative Intensivmedizin, Krankenhaus Köln-Merheim, Kliniken der Stadt Köln gGmbH, Klinikum der Universität Witten/Herdecke, Ostmerheimer Str. 200, 51109, Köln, Deutschland
| | - A Lopez
- Lungenklinik - Thoraxchirurgie, Krankenhaus Köln-Merheim, Kliniken der Stadt Köln gGmbH, Klinikum der Universität Witten/Herdecke, Köln, Deutschland
| | - M Schieren
- Klinik für Anästhesiologie und operative Intensivmedizin, Krankenhaus Köln-Merheim, Kliniken der Stadt Köln gGmbH, Klinikum der Universität Witten/Herdecke, Ostmerheimer Str. 200, 51109, Köln, Deutschland
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14
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Brunet D, Van SD, Kloeckner M, Lopez A, Gaillard M, Decante B, Lacerda C, Deleuze P, Guihaire J. Myocardial Work Index Correlates with Cardiac Performance During Ex Vivo Heart Perfusion. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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15
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Van SD, Brunet D, Lopez A, Gaillard M, Decante B, Deleuze P, Guihaire J. Relationship Between Lactate Trend and Cardiac Power Output During Ex Vivo Heart Perfusion. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.044] [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: 11/26/2022] Open
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16
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Bongiorno T, Foglio L, Proietti L, Vasconi M, Moretti V, Lopez A, Carminati D, Galafat A, Vizcaíno A, Fernández FA, Alarcón F, Parati K. Hydrolyzed microalgae from biorefinery as a potential functional ingredient in Siberian sturgeon (A. baerii Brandt) aquafeed. ALGAL RES 2022. [DOI: 10.1016/j.algal.2021.102592] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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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17
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Bianco F, Luna E, Lopez A, Gheiler E, Kaufman A, Shafizadeh F, Zachareas M, Martinez-Salamanca J, Gloria E, Kattan M. Transperineal fusion biopsies and target fusion cryoablation under local anesthesia in a clinical office-setting. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00407-9] [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: 11/24/2022]
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18
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Bianco F, Luna E, Lopez A, Shafizadeh F, Hu J, Gheiler E, Kaufman A, Martinez-Salamanca J, Barrios D, Egui G, Kattan M. Current role of prophylactic antibiotics in transperineal prostate biopsies. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00692-3] [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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19
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Bianco F, Avila L, Luna E, Lopez A, Kaufman A, Cohen D, Gheiler E. Transperineal laser ablation for BPH: 3 month outcomes. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00806-5] [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: 11/26/2022]
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20
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Bianco F, Luna E, Gheiler E, Avila L, Lopez A, Gonzalez P, Kaufman A, Cohen D, Martinez-Salamanca J. Transperineal fusion laser ablation for benign prostatic hyperplasia: Technique and 6 months results. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01278-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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21
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Martinuzzi A, Flores A, Lopez A, Doeyo M, Pagani L, Maldonado N, Matano M, Barros J, Oviedo M, Zgarzini D, Mora C, Crivelli A. Malnutrition prevalence using glim and subjective global assessment in argentinian institutions with nutritional support units. Clin Nutr ESPEN 2021. [DOI: 10.1016/j.clnesp.2021.09.141] [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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22
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Galbreath B, Nair A, Ringe J, Madison IT, Dean TC, Lopez A, Chen Q, Young L. Abstract P509: Novel Protein Kinase C Epsilon Inhibitor Attenuates Uncoupled Endothelial Nitric Oxide Synthase And Vascular Endothelial Dysfunction. Circ Res 2021. [DOI: 10.1161/res.129.suppl_1.p509] [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: 11/16/2022]
Abstract
Endothelial nitric oxide synthase (eNOS) uncoupling reduces nitric oxide (NO) production when tetrahydrobiopterin (BH
4
) is oxidized to dihydrobiopterin (BH
2
), resulting in endothelial dysfunction and leukocyte adherence. Renovascular damage following shockwave lithotripsy (SWL) may occur via the potentiation of this mechanism. We aim to modulate uncoupled eNOS activity with myristoylated protein kinase C epsilon inhibitor (
myr
-PKCε–; N-
myr
-EAVSLKPT) and activator (
myr
-PKCε+; N-
myr
-HDAPIGYD). We hypothesize that
myr
-PKCε– with uncoupled eNOS (i.e., bound to BH
2
) should reduce leukocyte-endothelial interactions in postcapillary venules and H
2
O
2
levels after SWL.
Myr
-PKCε+ should promote similar effects when eNOS is coupled (i.e., bound to BH
4
).
Mesenteric venules of anesthetized male SD rats (300g) were superfused for 120 min with 100 μM BH
2
and test solutions (Krebs’ buffer, 10 μM
myr
-PKCε+, or 10 μM
myr
-PKCε–) with or without 100 μM BH
4
. Leukocyte activity was evaluated via intravital microscopy. In separate SD rats, SWL was performed on left kidneys (16 kV, 500 shocks at 60 shocks/min and at 120 shocks/min). Then, normal saline or test solution cocktail (
myr
-PKCε+ [0.9 mg/kg]/
myr
-PKCε- [0.8 mg/kg] with BH
2
[2mg/kg] or BH
4
[0.8 mg/kg]) was given i.v. NO or H
2
O
2
levels were measured with 100 μm microsensors in left renal veins at baseline, end of SWL, and 5-min intervals for 30 min post-SWL. Data were analyzed using ANOVA Student-Newman-Keuls test.
BH
2
-induced leukocyte rolling, adherence, and transmigration were significantly increased by
myr
-PKCε+ (
n
= 6) and attenuated with
myr-
PKCε– (
n
= 5) compared to control (n=5) at 120 min (p<0.01). Following SWL, all treatments except
myr
-PKCε+ with BH
2
significantly reduced H
2
O
2
(
n
= 5,
p
< .01) and increased NO levels (
n
= 5,
p
< .01) compared to control. NO and H
2
O
2
levels following administration of
myr
-PKCε+ with BH
2
were similar to SWL control.
Results suggest that
myr
-PKCε– attenuates uncoupled eNOS activity and H
2
O
2
release in rat renal veins, after SWL. Promoting coupled eNOS activity with BH
4
yields similar results. Promoting eNOS coupling with BH
4
or inhibiting uncoupled eNOS with
myr-
PKCε– attenuates oxidative stress and endothelial dysfunction following SWL and BH
2
-induced inflammation.
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Affiliation(s)
| | - Arjun Nair
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA
| | - John Ringe
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA
| | - Ian T Madison
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA
| | - Tameka C Dean
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA
| | - Alexandra Lopez
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA
| | - Qian Chen
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA
| | - Lindon Young
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA
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23
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Fischer-Tlustos A, Lopez A, Hare K, Wood K, Steele M. Effects of colostrum management on transfer of passive immunity and the potential role of colostral bioactive components on neonatal calf development and metabolism. Can J Anim Sci 2021. [DOI: 10.1139/cjas-2020-0149] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Neonatal dairy and beef calves are required to ingest adequate volumes of high-quality colostrum during their first hours of life to acquire transfer of passive immunity (TPI). As such, immunoglobulin G (IgG) has largely been the focus of colostrum research over recent decades. Yet, little is known about the additional bioactive compounds in colostrum that potentially influence newborn calf development and metabolism. The purpose of this narrative review is to synthesize research regarding the effects of colostrum management practices on TPI, as well as to address the potential role of additional colostral bioactive molecules, including oligosaccharides, fatty acids, insulin, and insulin-like growth factor-I, in promoting calf development and metabolism. Due to the importance of IgG in ensuring calf immunity and health, we review past research describing the process of colostrogenesis and dam factors influencing the concentrations of IgG in an effort to maximize TPI. We also address the transfer of additional bioactive compounds in colostrum and prepartum management and dam factors that influence their concentrations. Finally, we highlight key areas of future research for the scientific community to pursue to ultimately improve the health and welfare of neonatal dairy calves.
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Affiliation(s)
- A.J. Fischer-Tlustos
- Department of Animal Biosciences, Animal Science and Nutrition, University of Guelph, Guelph, ON N1G 1Y2, Canada
- Department of Animal Biosciences, Animal Science and Nutrition, University of Guelph, Guelph, ON N1G 1Y2, Canada
| | - A. Lopez
- Department of Animal Biosciences, Animal Science and Nutrition, University of Guelph, Guelph, ON N1G 1Y2, Canada
- Department of Animal Biosciences, Animal Science and Nutrition, University of Guelph, Guelph, ON N1G 1Y2, Canada
| | - K.S. Hare
- Department of Animal Biosciences, Animal Science and Nutrition, University of Guelph, Guelph, ON N1G 1Y2, Canada
- Department of Animal Biosciences, Animal Science and Nutrition, University of Guelph, Guelph, ON N1G 1Y2, Canada
| | - K.M. Wood
- Department of Animal Biosciences, Animal Science and Nutrition, University of Guelph, Guelph, ON N1G 1Y2, Canada
- Department of Animal Biosciences, Animal Science and Nutrition, University of Guelph, Guelph, ON N1G 1Y2, Canada
| | - M.A. Steele
- Department of Animal Biosciences, Animal Science and Nutrition, University of Guelph, Guelph, ON N1G 1Y2, Canada
- Department of Animal Biosciences, Animal Science and Nutrition, University of Guelph, Guelph, ON N1G 1Y2, Canada
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24
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Ormsby E, Chen T, Harrison G, Lopez A, Stejskal A, Van Wie J, Viana T, Vineis M, Policastro P. Feud of the Features: Which Instagram Feature Generates the Greatest College Student Participation in Nutrition Games? J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.153] [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: 10/20/2022]
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25
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Ciruelos E, Pernas S, Perelló A, Lopez A, Salvador Bofill F, Cejalvo J, Blancas I, Ponce Lorenzo J, Servitja S, Perez M, Cruz J, Albacar C, Escrivá-de-Romaní S, Guerra J, González-Santiago S, Sanfeliu E, Rodriguez C, Tolosa P, Ferrero-Cafiero J, Prat A. 332TiP SOLTI-1907 ATREZZO: Targeting hormonal receptor negative (HR-) or PAM50 non-luminal disease with atezolizumab in combination with trastuzumab and vinorelbine in HER2+ metastatic breast cancer (MBC). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.615] [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: 10/20/2022] Open
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26
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Franch‐Sarto M, Garcia‐Calduch O, Rivas A, Lopez A, Gonzalez‐Barca E, Sureda A, Baile M, Martin A, Salar A, Gutierrez A, Bastos M, Rodriguez M, Gonzalez S, Queizán J, Cordoba R, Montalbán C, Luzardo HD, Abrisqueta P, Garcia D, Hong A, Peñalver F, Moreno M, Sancho J. CENTRAL NERVOUS SYSTEM RELAPSE IN PATIENTS WITH DIFFUSE LARGE B‐CELL LYMPHOMA TREATED WITH R‐CHOP: STUDY OF THE SPANISH LYMPHOMA GROUP GELTAMO. Hematol Oncol 2021. [DOI: 10.1002/hon.91_2880] [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] [Indexed: 11/08/2022]
Affiliation(s)
- M. Franch‐Sarto
- Hospital Universitari Germans Trias i Pujol Hematology Badalona Spain
| | - O. Garcia‐Calduch
- Hospital Universitari Germans Trias i Pujol Hematology Badalona Spain
| | - A. Rivas
- Hospital Universitari Clinic Hematology Barcelona Spain
| | - A. Lopez
- Hospital Universitari Clinic Hematology Barcelona Spain
| | | | - A. Sureda
- Hospital Duran i Reynalds Hematology Bellvitge Spain
| | - M. Baile
- Hospital Universitario de Salamanca and IBSAL. Hematology Salamanca Spain
| | - A. Martin
- Hospital Universitario de Salamanca and IBSAL. Hematology Salamanca Spain
| | - A. Salar
- Hospital del Mar Hematology Barcelona Spain
| | | | - M. Bastos
- Hospital Universitario Gregorio Marañón Hematology Madrid Spain
| | - M.‐J. Rodriguez
- Hospital Universitario de Canarias Hematology Canarias Spain
| | - S. Gonzalez
- Hospital Universitario Marqués de Valdecilla Hematology Santander Spain
| | - J.‐A. Queizán
- Hospital General de Segovia Hematology Segovia Spain
| | - R. Cordoba
- Fundación Jiméndez Díaz Hematology Madrid Spain
| | - C. Montalbán
- MD Anderson Cancer Center Hematology Madrid Spain
| | - H. D. Luzardo
- Hospital Universitario de Gran Canarias Dr Negrín Hematology Las Palmas de Gran Canaria Spain
| | - P. Abrisqueta
- Hospital Universitari Vall d'Hebron Hematology Barcelona Spain
| | - D. Garcia
- Hospital La Zarzuela Hematology Madrid Spain
| | - A. Hong
- Hospital de Lanzarote Hematology Lanzarote Spain
| | | | - M. Moreno
- Hospital Universitari Germans Trias i Pujol Hematology Badalona Spain
| | - J.‐M. Sancho
- Hospital Universitari Germans Trias i Pujol Hematology Badalona Spain
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27
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Shea AK, Frey BN, Gervais N, Lopez A, Minuzzi L. Depression in midlife women attending a menopause clinic is associated with a history of childhood maltreatment. Climacteric 2021; 25:203-207. [PMID: 33949252 DOI: 10.1080/13697137.2021.1915270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A growing body of literature has suggested that the perimenopause and the early postmenopausal years are associated with an increased risk of experiencing symptoms of depression and the development of first-onset and recurrent episodes of major depressive disorder. Multiple risk factors have been identified, including stressful life events and lower socioeconomic status, as well as early life adversity. The objective of the current study was to characterize the influence of early life childhood maltreatment and incident depression among women experiencing bothersome menopausal symptoms. Participants were recruited from two university-affiliated specialty clinics caring for women with bothersome menopausal symptoms. Assessments included the Childhood Trauma Questionnaire (CTQ), the Center for Epidemiological Studies - Depression (CES-D) scale and the Greene Climacteric Scale. Findings from this cross-sectional study indicate that adverse childhood experiences, as measured using the CTQ, were highly prevalent among women seeking care for bothersome menopausal symptoms (66%). Further, a greater score on the CTQ was significantly associated with higher CES-D scores, as well as with a greater burden of menopausal symptoms, after adjusting for confounding. Our findings lend support to the growing body of literature suggesting that early life stress affects mental health well into adulthood.
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Affiliation(s)
- A K Shea
- Department of Obstetrics and Gynecology, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.,The Research Institute, Hamilton, ON, Canada.,Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - B N Frey
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.,Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - N Gervais
- Department of Obstetrics and Gynecology, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - A Lopez
- Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - L Minuzzi
- Department of Psychiatry and Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.,Women's Health Concerns Clinic, St. Joseph's Healthcare, Hamilton, ON, Canada
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28
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Campos M, Pomeroy J, Mays MH, Lopez A, Palacios C. Intervention to promote physical activation and improve sleep and response feeding in infants for preventing obesity early in life, the baby-act trial: Rationale and design. Contemp Clin Trials 2020; 99:106185. [PMID: 33099015 PMCID: PMC7860210 DOI: 10.1016/j.cct.2020.106185] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/15/2020] [Accepted: 10/15/2020] [Indexed: 11/18/2022]
Abstract
Infant obesity is increasing in the US, particularly among Hispanics. Rapid weight gain during infancy increases the risk of obesity later in life and could be prevented through multi-modal interventions addressing multiple risk factors through population-level programs. OBJECTIVES 1) determine the extent to which the intervention, compared with the usual care control condition, improves healthy weight gain and specific behaviors (physical activity, sleep, diet) in the first year of life and 2) evaluate the cost of the intervention as a modification of the current WIC standard of care. METHODS The lifestyle intervention focuses on age-appropriate infant physical activation, healthy sleep and sedentary patterns, and response feeding, by improving parenting skills delivered through a combination of technology (web-platform and text messages) and phone counseling. It is being tested among caregivers of infant participants of the Puerto Rico WIC program through a cluster-randomized controlled trial in 14 WIC clinics in San Juan starting in pregnancy until the infant is 12 months of age. The main outcome is infant rate of weight gain at 12 months; secondary outcomes include objectively measured hours of infant movement, sedentary behaviors and sleep, diet quality score and response feeding behaviors. We are also recording fees, time and personnel involved in the intervention development, maintenance and dissemination. CONCLUSIONS If successful, the intervention could be incorporated as a 'best practice' through WIC policy as a means to strengthen obesity prevention efforts to improve minority health and eliminate health disparities among Hispanics and possibly other at-risk groups beyond the childhood period. Clinicaltrials.gov registration: NCT03517891.
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Affiliation(s)
- M Campos
- Dental and Craniofacial Genomics Core, Endocrinology Section School of Medicine, University of Puerto Rico, San Juan 00936-5067, Puerto Rico.
| | - J Pomeroy
- Clinical Research Center, Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, WI, USA.
| | - M H Mays
- Biomedical Informatics Core, Puerto Rico Clinical and Translational Research Consortium, San Juan, Puerto Rico.
| | - A Lopez
- Sports and Leisure Management program and Adapted Physical Education program, School of Education, Metropolitan University, San Juan Puerto Rico.
| | - C Palacios
- Dietetics and Nutrition Department, Robert Stempel College of Public Health & Social Work, Florida International University, Miami USA.
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29
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Ortiz Gonzalez I, Gadea J, Roncero R, Maturana J, Garcia Zanoguera C, Alastuey I, Tarongi A, Lopez A, Pardo J. Hypofractionated vs Conventional Fractionated Post-Mastectomy Radiotherapy After Immediate-Autologous Reconstruction: Acute Toxicity and Patient Satisfaction. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1141] [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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30
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Lopez MA, Passarelli PC, Marra M, Lopez A, D'Angelo A, Moffa A, Martinez S, Casale M, D'Addona A. Photodynamic therapy (PDT) in non-surgical treatment of periodontitis. J BIOL REG HOMEOS AG 2020; 34:67-78. Technology in Medicine. [PMID: 33386036] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Periodontitis represents a major problem for patients, since it is not possible to eliminate the bacteria that are responsible for this pathology with a pharmacological treatment. The present study included forty-four patients with periodontitis, who had undergone disinfection via photodynamic therapy (PDT) using a laser source having a 635 nm wavelength associated with a photoactivable substance (methylene blue). Clinical assessment of plaque index (PI), bleeding on probing (BOP), probing depth (PD), calculus index (CI), gingival recession (REC) and clinical attachment level (CAL) were recorded at base line, 1 month (4 weeks) after treatment and again 3 months (12 weeks) after treatment, while site radiography (RX) and microbiological test (MT) were recorded at base line and 3 months (12 weeks) after treatment. The outcomes show a good efficacy of the PDT in the elimination of the periodontal pathogenic microflora and in the improvement of the clinical parameters considered: from the base line to the final check after 12 weeks it has been observed a reduction in REC of about 16.9%, a reduction of CAL of about 17.85%, a reduction of the BoP of about 93.3%, a reduction of the PD of about 17%, a reduction of the CI of about 66.3%, a reduction of PI of about 44%, and microbiologically a reduction of the total amount of bacteria with proven parodontopathic properties (red complex bacteria) of about 58.74%. Within the limits of the present study, PDT can be reasonably considered as a good carrier that leads to significant improvements in the parameters (clinical and microbiological) considered.
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Affiliation(s)
- M A Lopez
- Unit of Otolaryngology, UOS ORL TI, Campus-Biomedico University, Rome, Italy
| | - P C Passarelli
- Department of Head and Neck, Division of Oral Surgery and Implantology, Institute of Clinical Dentistry, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Gemelli, Rome, Italy
| | - M Marra
- Department of Head and Neck, Division of Oral Surgery and Implantology, Institute of Clinical Dentistry, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Gemelli, Rome, Italy
| | - A Lopez
- Dental Unit UEM, Madrid, Spain
| | - A D'Angelo
- Department of Head and Neck, Division of Oral Surgery and Implantology, Institute of Clinical Dentistry, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Gemelli, Rome, Italy
| | - A Moffa
- Unit of Otolaryngology, UOS ORL TI, Campus-Biomedico University, Rome, Italy
| | - S Martinez
- Department of Head and Neck, Division of Oral Surgery and Implantology, Institute of Clinical Dentistry, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Gemelli, Rome, Italy
| | - M Casale
- Unit of Otolaryngology, UOS ORL TI, Campus-Biomedico University, Rome, Italy
| | - A D'Addona
- Department of Head and Neck, Division of Oral Surgery and Implantology, Institute of Clinical Dentistry, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Gemelli, Rome, Italy
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Lopez MA, Passarelli PC, Marra M, Lopez A, Moffa A, Casale M, D'Addona A. Antimicrobial efficacy of photodynamic therapy (PDT) in periodontitis and peri-implantitis: A systematic review. J BIOL REG HOMEOS AG 2020; 34:59-65. Technology in Medicine. [PMID: 33386035] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
To systematically review the literature regarding the antimicrobial effects of photodynamic therapy (PDT) on multi-bacterial species in periodontitis and peri-implantitis disease. The addressed focused question was: "Does PDT show antimicrobial efficacy against multi-bacterial species colonization in periodontal pockets and on the surface of dental implants?" Electronic databases including MEDLINE and EMBASE up to and including December 2018 were searched. Of the ninety studied analyzed, seven were included, four for the study of PDT in peri-implantitis disease and three for periodontal disease. All studies reported the multibacterial species outcomes after the application of antimicrobial PDT. All studies showed a significant reduction in the bacterial load, both in studies based on periodontal and peri-implantary disease, with an average reduction of the total amount of bacterial load of 99.3%. Moreover, the change in clinical parameters is equally important, with an average reduction of PPD of 1.01 mm (from 4.92 to 3.49 ± SD with a percentage reduction of 29%); of BoP of 50%; of RCAL of 1.19 mm (from 9.93 to 8.74, with an average percentage reduction of 12%); of PI of 0.3 (from 1 to 0.7 with a percentage reduction of 30%) and of GI of 1.2 (from 1.8 to 0.6 with a percentage reduction of 66.6%). This review demonstrated significant reduction in the bacterial load in periodontal pocket and dental implant surface with the use of PDT. The results of this review should be considered preliminary and further studies with standardized laser parameters are needed to obtain strong conclusions.
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Affiliation(s)
- M A Lopez
- Unit of Otolaryngology, UOS ORL TI, Campus Bio-Medico University, Rome, Italy
| | - P C Passarelli
- Department of Head and Neck, Division of Oral Surgery and Implantology, Institute of Clinical Dentistry, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Gemelli, Rome, Italy
| | - M Marra
- Department of Head and Neck, Division of Oral Surgery and Implantology, Institute of Clinical Dentistry, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Gemelli, Rome, Italy
| | - A Lopez
- Universidad Europea de Madrid, Madrid, Spain
| | - A Moffa
- Unit of Otolaryngology, UOS ORL TI, Campus Bio-Medico University, Rome, Italy
| | - M Casale
- Unit of Otolaryngology, UOS ORL TI, Campus Bio-Medico University, Rome, Italy
| | - A D'Addona
- Department of Head and Neck, Division of Oral Surgery and Implantology, Institute of Clinical Dentistry, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Gemelli, Rome, Italy
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Nuñez-Rios DL, Chaskel R, Lopez A, Galeano L, Lattig MC. The role of 5-HTTLPR in autism spectrum disorder: New evidence and a meta-analysis of this polymorphism in Latin American population with psychiatric disorders. PLoS One 2020; 15:e0235512. [PMID: 32614901 PMCID: PMC7332001 DOI: 10.1371/journal.pone.0235512] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/16/2020] [Indexed: 01/15/2023] Open
Abstract
The autism spectrum disorder (ASD) is a complex disorder encompassing a broad phenotypic and genotypic variability. The short (S)/long (L) 5-HTTLPR polymorphism has a functional role in the regulation of extracellular serotonin levels and both alleles have been associated to ASD. Most studies including European, American, and Asian populations have suggested an ethnical heterogeneity of this polymorphism; however, the short/long frequencies from Latin American population have been under-studied in recent meta-analysis. Here, we evaluated the 5-HTTLPR polymorphism in Colombian individuals with idiopathic ASD and reported a non-preferential S or L transmission and a non-association with ASD risk or symptom severity. Moreover, to recognize the allelic frequencies of an under-represented population we also recovered genetic studies from Latin American individuals and compared these frequencies with frequencies from other ethnicities. Results from meta-analysis suggest that short/long frequencies in Latin American are similar to those reported in Caucasian population but different to African and Asian regions.
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Affiliation(s)
- D. L. Nuñez-Rios
- Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, Colombia
| | - R. Chaskel
- Instituto Colombiano del Sistema Nervioso Clínica Monserrat, Bogotá, Colombia
- Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - A. Lopez
- Fundación Santa Fe de Bogotá, Bogotá, Colombia
- Servicios Integrales en Genética (SIGEN) alianza Fundación Santa Fe de Bogotá – Universidad de los Andes, Bogotá, Colombia
| | - L. Galeano
- Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, Colombia
| | - M. C. Lattig
- Departamento de Ciencias Biológicas, Universidad de los Andes, Bogotá, Colombia
- Servicios Integrales en Genética (SIGEN) alianza Fundación Santa Fe de Bogotá – Universidad de los Andes, Bogotá, Colombia
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Sala R, Carrenho-Sala L, Absalon-Medina V, Lopez A, Fosado M, Moreno J, Wiltbank M, Garcia-Guerra A. 105 Optimization of a five-day fixed-time embryo transfer program in dairy heifers: Use of gonadotrophin-releasing hormone at initiation of the protocol. Reprod Fertil Dev 2020. [DOI: 10.1071/rdv32n2ab105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Optimized fixed-time embryo transfer (FTET) protocols for synchronization of recipients have the potential to improve the overall efficiency and profitability of embryo transfer (ET) programs. The objective of the present study was to evaluate the effect of dose of gonadotrophin-releasing hormone (GnRH) at initiation of a 5-day synchronization protocol for FTET. Holstein heifers (n=2689) at two locations were synchronized using a 5-day CO-Synch protocol as follows: Day 0: CIDR inserted, Day 5: CIDR removed, prostaglandin (PG)F2α treatment (500μg cloprostenol), Day 6: PGF2α treatment, Day 8: GnRH (100μg of gonadorelin). On Day 0, at the time of CIDR insertion, heifers were assigned in a completely randomised design to the following groups: Single (a single dose of GnRH; 100μg of gonadorelin), Double (200μg of gonadorelin) or No GnRH (control). All heifers received an Estrotect patch placed on Day 5 and evaluated for signs of oestrus on Day 8. At location A, heifers were evaluated by ultrasonography 5 days after GnRH to determine presence and size of corpus luteum (CL), whereas at location B presence and location of CL were determined by transrectal palpation at the time of transfer. Heifers with a CL received an embryo 7±1 days after GnRH administration, and pregnancy was determined by ultrasonography 41 and 63 days after GnRH. Data were analysed by generalized linear mixed models. Oestrus expression was greater in heifers that received Single and Double GnRH than in the No GnRH group (P=0.001). Similarly, utilisation rate (number transferred per number treated) was greater for heifers in the Single and Double GnRH group than for those in the No GnRH group (P=0.02). Pregnancy data were analysed for a subset of recipients using data from Day 41 (n=2267) and Day 63 (n=2042). The analysis of fertility outcomes included as covariates the type of embryo (invitro fresh or frozen and invivo fresh or frozen), embryo stage, embryo quality, interval from GnRH to transfer, and oestrus expression. Pregnancies per embryo transfer (P/ET) at Days 41 and 63 were not different between treatment groups (P=0.86), and there was no interaction between type of embryo and treatment (P>0.15). Pregnancy loss between Days 41 and 63 was not different (P=0.49) between treatments groups. In conclusion, the removal of the initial GnRH from a 5-day FTET protocol resulted in a slight but significant reduction in the utilisation rate and the percentage of heifers showing oestrus. However, there was no detrimental effect on fertility. As a result, the overall cost of the FTET program can be reduced by eliminating the need for the initial GnRH treatment without compromising fertility.
Table 1.Reproductive performance in recipients receiving different doses of gonadotrophin-releasing hormone (GnRH) at initiation of the synchronization protocol
Treatment
Oestrus (n)
Utilisation rate (n)
P/ET1 D41 (n)
P/ET D63 (n)
Pregnancy loss (n)
No GnRH
69.2%B (621/898)
85.0%B (763/898)
41.6% (308/740)
39.9% (268/672)
4.3% (12/280)
Single GnRH
76.1%A (685/900)
88.8%A (799/900)
42.7% (329/770)
39.5% (272/689)
6.5% (19/291)
Double GnRH
75.3%A (671/891)
88.7%A (790/891)
41.5% (314/757)
38.9% (265/681)
5.4% (15/280)
A,BValues with different superscripts within a column differ (P<0.05).
1P/ET=pregnancies per embryo transfer.
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Parry B, Meliska C, Sorenson D, Martinez F, Lopez A, Dawes S, Hauger R, Kripke D. Mood and sleep improvement with critically-timed wake and light interventions in premenstrual, peripartum vs. perimenopausal depression depend on specific underlying melatonin and sleep circadian phase disturbances. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Cruz N, Serrano M, Lopez A, Medrano IH, Lozano J, Coll B. P581Electronic health records (EHRs) data validation in atherosclerotic/cardiovascular clinical phenotypes. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0191] [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
Background
Research efforts to develop strategies to effectively identify patients and reduce the burden of cardiovascular diseases is essential for the future of the health system. Most research studies have used only coded parts of electronic health records (EHRs) for case-detection obtaining missed data cases, reducing study quality and in some case bias findings. Incorporating information from free-text into case-detection through Big Data and Artificial Intelligence techniques improves research quality. Savana has developed EHRead, a powerful technology that applies Natural Language Processing, Machine Learning and Deep Learning, to analyse and automatically extracts highly valuable medical information from unstructured free text contained in the EHR to support research and practice.
Purpose
We aimed to validate the linguistic accuracy performance of Savana, in terms of Precision (P), Recall (R) and overall performance (F-Score) in the cardiovascular domain since this is one of the most prevalent disease in the general population. This means validating the extent to which the Savana system identifies mentions to atherosclerotic/cardiovascular clinical phenotypes in EHRs.
Methods
The project was conducted in 3 Spanish sites and the system was validated using a corpus that consisted of 739 EHRs, including the emergency, medical and discharge records, written in free text. These EHRs were randomly selected from the total number of clinical documents generated during the period of 2012–2017 and were fully anonymized to comply with legal and ethical requirements. Two physicians per site reviewed records (randomly selected) and annotated all direct references to atherosclerotic/cardiovascular clinical phenotypes, following the annotation guidelines previously developed. A third physician adjudicated discordant annotations. Savana's performance was automatically calculated using as validation resource the gold standard created by the experts.
Results
We found good levels of performance achieved by Savana in the identification of mentions to atherosclerotic/cardiovascular clinical phenotypes, yielding an overall P, R, and F-score of 0.97, 0.92, and 0.94, respectively. We also found that going through all the EHRs and identifying the mentions to atherosclerotic/cardiovascular clinical phenotypes, the expert spent ∼ 60h while Savana ∼ 36 min.
Conclusion(s)
Innovative techniques to identify atherosclerotic/cardiovascular clinical phenotypes could be used to support real world data research and clinical practice. Overall Savana showed a high performance, comparable with those obtained by an expert physician annotator doing the same task. Additionally, a significant reduction of time in using automatic information extraction system was achieved.
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Affiliation(s)
| | | | | | | | | | - B Coll
- Amgen Spain, Barcelona, Spain
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Randrian V, Adenis A, Desrame J, Barbier E, Di Fiore F, Lievre A, Dahan L, Laurent-Puig P, Mineur L, Breysacher G, Roquin G, Louafi S, Lopez A, Louvet C, Borg C, Metges JP, Faroux R, Gaba L, Manfredi S, Tougeron D. Nal-iri/lv5-fu versus paclitaxel as second-line therapy in patients with metastatic esophageal squamous cell carcinoma (OESIRI-PRODIGE 62): A FFCD multicenter, randomized, phase II study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Moraes LO, Pedreira CE, Barrena S, Lopez A, Orfao A. A decision-tree approach for the differential diagnosis of chronic lymphoid leukemias and peripheral B-cell lymphomas. Comput Methods Programs Biomed 2019; 178:85-90. [PMID: 31416565 DOI: 10.1016/j.cmpb.2019.06.014] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 06/07/2019] [Accepted: 06/12/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND OBJECTIVE Here we propose a decision-tree approach for the differential diagnosis of distinct WHO categories B-cell chronic lymphoproliferative disorders using flow cytometry data. Flow cytometry is the preferred method for the immunophenotypic characterization of leukemia and lymphoma, being able to process and register multiparametric data about tens of thousands of cells per second. METHODS The proposed decision-tree is composed by logistic function nodes that branch throughout the tree into sets of (possible) distinct leukemia/lymphoma diagnoses. To avoid overfitting, regularization via the Lasso algorithm was used. The code can be run online at https://codeocean.com/2018/03/08/a-decision-tree-approach-for-the-differential-diagnosis-of-chronic-lymphoid-leukemias-and-peripheral-b-cell-lymphomas/ or downloaded from https://github.com/lauramoraes/bioinformatics-sourcecode to be executed in Matlab. RESULTS The proposed approach was validated in diagnostic peripheral blood and bone marrow samples from 283 mature lymphoid leukemias/lymphomas patients. The proposed approach achieved 95% correctness in the cross-validation test phase (100% in-sample), 61% giving a single diagnosis and 34% (possible) multiple disease diagnoses. Similar results were obtained in an out-of-sample validation dataset. The generated tree reached the final diagnoses after up to seven decision nodes. CONCLUSIONS Here we propose a decision-tree approach for the differential diagnosis of mature lymphoid leukemias/lymphomas which proved to be accurate during out-of-sample validation. The full process is accomplished through seven binary transparent decision nodes.
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Affiliation(s)
- L O Moraes
- Rua Horacio Macedo 2030, Rio de Janeiro/RJ, CEP: 21941-914, Brazil.
| | - C E Pedreira
- Rua Horacio Macedo 2030, Rio de Janeiro/RJ, CEP: 21941-914, Brazil.
| | - S Barrena
- Lab 11, Centro de Investigacion del Cancer, Paseo de la Universidad de Coimbra, Campus Miguel Unamuno, 37002 Salamanca, España.
| | - A Lopez
- Lab 11, Centro de Investigacion del Cancer, Paseo de la Universidad de Coimbra, Campus Miguel Unamuno, 37002 Salamanca, España.
| | - A Orfao
- Lab 11, Centro de Investigacion del Cancer, Paseo de la Universidad de Coimbra, Campus Miguel Unamuno, 37002 Salamanca, España.
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Queen D, Lopez A, Shen Y, Samie F, Lewin J, Geskin L, Liu L. 438 Development and Validation of an 80-Gene UV Biomarker Panel for Stratification of Skin Cancer Risk. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.488] [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: 11/26/2022]
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Lopez Palacios D, Lopez A, McDonald B, Golden C, Amen D, Willeumier K, Taylor D. B-41 SPECT Differences between Obsessive Compulsive Disorder and Post-Traumatic Stress Disorder (PTSD). Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz034.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
To assess whether diagnosed Obsessive Compulsive Disorder (OCD) and Post Traumatic Stress Disorder (PTSD) interactively alter brain activity, as measured by a Single Photon Emission Computed Tomography (SPECT) imaging.
Method
The sample included adults diagnosed with OCD (n = 915) with a mean age of 34.65 and predominantly male (68.6%) and adults with PTSD (n = 1,481) which had a mean age of 41.33 and was predominantly female (57.2%). Significant differences were observed for gender . Multiple ANCOVAs were conducted to determine differences between cerebral blood flow (CBF)in 17 different brain regions.
Results
Results showed hyper-perfusion in the PTSD group as compared to the OCD group in the pariental L/R[F(1,2393) = 6.47,p < 0.01/F(1,2393) = 12.31,p < .01], motor sensory L/R[F(1,2393) = 19.33,p < .001/F(1,2393) = 17.32,p < .01] and temporal left [F(1,2393) = 12.49,p < .01].
Conclusion
Significantly higher rCBF in the pariental and motor sensory for OCD individuals may be due to visual-constructive and controlled fluency which are usually associated with compulsion. Due to the hyperalert nature related with OCD rituals, these areas are more active when compared to PTSD. Hyperfusion was reported for PTSD in the left temporal lobe compared to OCD, this region is usually associated with registering potential threasts in the environment. This can be explained by the hypervigilant conduct seen in individuals with PTSD. Overall, it appears that individuals with OCD struggle with continual inability to inhibit repetitive thoughts and behaviors due to the over activation in the motor sensory and parietal region. Alternatively, the activation in PTSD individuals can be a result of a way to help them cope with threats in the environment.
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McDonald B, Lopez A, Lopez-Palacios D, Golden C, Amen D, Willeumier K, Taylor D. B-08 Cerebral Blood Flow Differences at Baseline Between Cortical Regions in Tic Disorders Population. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz034.91] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objective
To identify CBF differences between individuals with Tic Disorder and healthy controls.
Methods
The data for this study was acquired from a de-identified archival Single-Photon Emission Computed Tomography (SPECT) database. The sample included a healthy control group (n = 83,age M = 42.02,54.22% female) and a second group included individuals diagnosed with Tic Disorder (n = 177,age M = 33.54,83.05% male). Significant differences were found for gender [χ(2) = 41.16,p < .001] between groups. As a result, ANCOVAs were conducted to measure CBF differences across the brain using SPECT scans between the two groups while controlling for gender.
Results
Results showed significant differences between the two groups and perfusion in 4 brain regions. Hypo-perfusion in the Tic Disorder group was observed in the right basal ganglia [F(1,260) = 30.959,p < .001] and left [F(1,260) = 32.16,p < .001]. Hyper-perfusion was found in the right cerebellum [F(1,260) = 16.63,p < .001], and left [F(1,260) = 22.17,p < .001] in the same group.
Conclusion
Results indicate that individuals with tic disorders have diminished CBF than healthy controls in both sides of the basal ganglia. This contrasts previous studies, which have shown that individuals with tic disorders have more CBF in the basal ganglia. Further research is needed to understand this inconsistency; a possible explanation is that there is an inhibiting effect on the basal ganglia. Increased CBF in both sides of the cerebellum supports previous research as this cortical area has been shown to have connections with the basal ganglia, activating the pathway that trigger the motor tics. Tic disorders are usually associated with other comorbidities therefore the sample may have other diagnoses that affect blood flow. Future research should control for potential comorbidities.
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Calderillo-Ruiz G, Lopez H, Padilla A, Diaz C, Miranda G, Lopez A, Carbajal B, Herrera A, Meneses A. Surgery specialization as a prognostic factor in colon cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.146] [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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42
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Samalin E, Turpin A, Khemissa F, Zaanan A, Benabdelghani M, Senellart H, Gilabert M, Evesque L, Dahan L, Sefrioui D, Bouché O, De la Fouchardière C, Hennequin A, Monard L, Gourgou S, Lopez A. Regorafenib combined with irinotecan as second-line treatment in patients with metastatic gastro-oesophageal adenocarcinomas: A randomized phase 2 trial (PRODIGE 58 – UCGI 35 – REGIRI). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.079] [Citation(s) in RCA: 2] [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] [Indexed: 11/13/2022] Open
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Cottereau A, Vercellino L, Casasnovas O, Tilly H, Feugier P, Fruchart C, Roulin L, Oberic L, Pica G, Ribrag V, Abraham J, Simon M, Gonzalez H, Bouabdallah R, Fitoussi O, Sebban C, Lopez A, Macro M, Sahnes L, Morschhauser F, Trotman J, Corront B, Choufi B, Snauwaert S, Godmer P, Copie-Bergman C, Briere J, Salles G, Gaulard P, Meignan M, Thieblemont C. HIGH TOTAL METABOLIC TUMOR VOLUME AT BASELINE ALLOWS TO DISCRIMINATE FOR SURVIVAL PATIENTS IN RESPONSE AFTER R-CHOP: AN ANCILLARY ANALYSIS OF THE REMARC STUDY. Hematol Oncol 2019. [DOI: 10.1002/hon.19_2629] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - L. Vercellino
- Medecine Nucleaire; APHP, Saint-Louis Hospital; Paris France
| | | | - H. Tilly
- Hematology; Centre H. Becquerel; Rouen France
| | - P. Feugier
- Hematology; CHU Brabois - Nancy; Nancy France
| | | | - L. Roulin
- Hematology; APHP, Henri Mondor Hospital; Créteil France
| | - L. Oberic
- Hematology; CHU Toulouse; Toulouse France
| | - G. Pica
- Hematology; CHU Annecy; Annecy France
| | | | | | - M. Simon
- Hematology; CH Valenciennes; Valenciennes France
| | | | | | - O. Fitoussi
- Hematology; Hopital Bordeaux Nord; Bordeaux France
| | - C. Sebban
- Hematology; Centre L. Berard; Lyon France
| | - A. Lopez
- Hematology; IOB; Barcelona Spain
| | - M. Macro
- Hematology; CHU Caen; Caen France
| | - L. Sahnes
- Hematology; CH Perpignan; Perpignan France
| | | | - J. Trotman
- Hematology; Concord Hospital; Sydney Australia
| | | | - B. Choufi
- Hematology; CH Boulogne; Boulogne France
| | | | - P. Godmer
- Hematology; CH Vannes; Vannes France
| | | | - J. Briere
- Pathology; APHP, Saint-Louis Hospital; Paris France
| | - G. Salles
- Hematology; CHU Lyon; Pierre-Benite France
| | - P. Gaulard
- Pathology; APHP, Henri Mondor Hospital; Créteil France
| | - M. Meignan
- Medecine Nucleaire; APHP, Henri Mondor Hospital; Créteil France
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Rodriguez CA, Garcia-Gomez J, Ribelles N, Gavila J, Pernas S, Rodriguez-Lescure A, Urrutikoetxea A, Pernaut C, Lopez A, Garcia-Mata J. Abstract P2-13-04: Impact of the adjuvant treatment with trastuzumab in HER2 positive breast cancer in the real-world setting. Analysis of two cohorts (1997-2005/2006-2015) in 1970 patients. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-13-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
INTRODUCTION: Although large randomized trials assessing the benefit of adjuvant trastuzumab in HER2-positive (HER2+) breast cancer have clearly demonstrated a significant improvement in long-term survival, it is necessary to know the impact of the use of trastuzumab adjuvant in the real life population, which includes patients frequently excluded from clinical trials, such as those with very small tumors without node involvement, or advanced age. The objective of this study is to describe the outcomes of women who received adjuvant trastuzumab for HER2+ cáncer since it was approved in 2006, compared with a previous cohort of HER2+ patients not treated with trastuzumab in 7 Spanish centers.
METHODS: Women with newly diagnosed stage I-III, HER2+ breast cancer, between 1997 and 2015 were included in the study. Two cohorts were considered: The No-Trastuzumab cohort (No-T), between 1997 and 2005, and the Trastuzumab cohort (T) with trastuzumab-treated women between 2006 and 2015. Kaplan-Meier estimates were used to evaluate DFS and OS. Additionally, cohorts were analyzed by pathologic tumour size, lymph node involvement and hormonal receptor status to stratify outcome measures.
RESULTS: A total of 2134 patients were identified. In 164 cases, data were insufficient or the follow-up incomplete. Therefore, the final analysis included 1970 patients, of whom 539 belong to the "No-T" cohort and 1431 to the "T" cohort. The median follow-up was 81 months. Median age: 53 years [22-98]. A total of 699 patients had T1 tumors [43% in the "No-T" cohort vs 33% in the "T" cohort]. 55% of the cases were N0 [58% and 54% in the "No-T" and "T" cohorts respectively]. The status of the hormonal receptors was well balanced between groups [36% ER negative in both]. Regarding the type of adjuvant treatment administered, in the "T" cohort more patients received adjuvant chemotherapy [65% vs 97%] and also in the “T” group combinations of taxanes and anthracyclines were more frequent [14% vs 72%]. The proportion of adjuvant endocrine therapy was similar in both groups [37% vs 34%].
In the “T” cohort, median Disease Free Survival (DFS) was not-reached, compared with 149 months in the “No-T” group. 5-year DFS was 83% vs 65% respectively [p<0.001]. 5-year DFS was also superior and statistically significant in all the subgroups analyzed, including patients with T1 tumors (87% vs 57%), N0 (87% vs 78%), patients T1N0 (88% vs 74%) and HR positive (86% vs 71%) or negative (78% vs 50%). Similarly, Overall Survival (OS) was increased in patients treated with Trastuzumab (median: 224 months vs not-reached, 5-year OS: 92% vs 75% [p <0.001].) 5-year OS was also statistically superior in the T1 subgroup (92% vs 72%), and N0 (95% vs 88%). [p<0.001 in all subanalysis].
CONCLUSIONS: Adjuvant treatment with Trastuzumab under conditions of real clinical practice in HER2+ early breast cancer, shows a highly significant benefit in terms of DFS and OS, regardless of the stage of the disease or other clinical variables. A very important benefit was reached in patients with small tumors, node-negative disease, or both conditions (T1N0). The benefit was also obtained regardless of the expression of hormonal receptors.
Citation Format: Rodriguez CA, Garcia-Gomez J, Ribelles N, Gavila J, Pernas S, Rodriguez-Lescure A, Urrutikoetxea A, Pernaut C, Lopez A, Garcia-Mata J. Impact of the adjuvant treatment with trastuzumab in HER2 positive breast cancer in the real-world setting. Analysis of two cohorts (1997-2005/2006-2015) in 1970 patients [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-13-04.
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Affiliation(s)
- CA Rodriguez
- Hospital Universitario de Salamanca-IBSAL, Salamanca, Spain; Complejo Hospitalario de Orense, Orense, Spain; Hospital Universitario Virgen de la Victoria, Malaga, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Instituto Catalan de Oncologia, L'Hospitalet, Barcelona, Spain; Hospital General Universitario de Elche, Elche, Alicante, Spain; Onkologikoa, San Sebastian, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Complejo Asistencial Universitario de Leon, Leon, Spain
| | - J Garcia-Gomez
- Hospital Universitario de Salamanca-IBSAL, Salamanca, Spain; Complejo Hospitalario de Orense, Orense, Spain; Hospital Universitario Virgen de la Victoria, Malaga, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Instituto Catalan de Oncologia, L'Hospitalet, Barcelona, Spain; Hospital General Universitario de Elche, Elche, Alicante, Spain; Onkologikoa, San Sebastian, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Complejo Asistencial Universitario de Leon, Leon, Spain
| | - N Ribelles
- Hospital Universitario de Salamanca-IBSAL, Salamanca, Spain; Complejo Hospitalario de Orense, Orense, Spain; Hospital Universitario Virgen de la Victoria, Malaga, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Instituto Catalan de Oncologia, L'Hospitalet, Barcelona, Spain; Hospital General Universitario de Elche, Elche, Alicante, Spain; Onkologikoa, San Sebastian, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Complejo Asistencial Universitario de Leon, Leon, Spain
| | - J Gavila
- Hospital Universitario de Salamanca-IBSAL, Salamanca, Spain; Complejo Hospitalario de Orense, Orense, Spain; Hospital Universitario Virgen de la Victoria, Malaga, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Instituto Catalan de Oncologia, L'Hospitalet, Barcelona, Spain; Hospital General Universitario de Elche, Elche, Alicante, Spain; Onkologikoa, San Sebastian, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Complejo Asistencial Universitario de Leon, Leon, Spain
| | - S Pernas
- Hospital Universitario de Salamanca-IBSAL, Salamanca, Spain; Complejo Hospitalario de Orense, Orense, Spain; Hospital Universitario Virgen de la Victoria, Malaga, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Instituto Catalan de Oncologia, L'Hospitalet, Barcelona, Spain; Hospital General Universitario de Elche, Elche, Alicante, Spain; Onkologikoa, San Sebastian, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Complejo Asistencial Universitario de Leon, Leon, Spain
| | - A Rodriguez-Lescure
- Hospital Universitario de Salamanca-IBSAL, Salamanca, Spain; Complejo Hospitalario de Orense, Orense, Spain; Hospital Universitario Virgen de la Victoria, Malaga, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Instituto Catalan de Oncologia, L'Hospitalet, Barcelona, Spain; Hospital General Universitario de Elche, Elche, Alicante, Spain; Onkologikoa, San Sebastian, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Complejo Asistencial Universitario de Leon, Leon, Spain
| | - A Urrutikoetxea
- Hospital Universitario de Salamanca-IBSAL, Salamanca, Spain; Complejo Hospitalario de Orense, Orense, Spain; Hospital Universitario Virgen de la Victoria, Malaga, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Instituto Catalan de Oncologia, L'Hospitalet, Barcelona, Spain; Hospital General Universitario de Elche, Elche, Alicante, Spain; Onkologikoa, San Sebastian, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Complejo Asistencial Universitario de Leon, Leon, Spain
| | - C Pernaut
- Hospital Universitario de Salamanca-IBSAL, Salamanca, Spain; Complejo Hospitalario de Orense, Orense, Spain; Hospital Universitario Virgen de la Victoria, Malaga, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Instituto Catalan de Oncologia, L'Hospitalet, Barcelona, Spain; Hospital General Universitario de Elche, Elche, Alicante, Spain; Onkologikoa, San Sebastian, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Complejo Asistencial Universitario de Leon, Leon, Spain
| | - A Lopez
- Hospital Universitario de Salamanca-IBSAL, Salamanca, Spain; Complejo Hospitalario de Orense, Orense, Spain; Hospital Universitario Virgen de la Victoria, Malaga, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Instituto Catalan de Oncologia, L'Hospitalet, Barcelona, Spain; Hospital General Universitario de Elche, Elche, Alicante, Spain; Onkologikoa, San Sebastian, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Complejo Asistencial Universitario de Leon, Leon, Spain
| | - J Garcia-Mata
- Hospital Universitario de Salamanca-IBSAL, Salamanca, Spain; Complejo Hospitalario de Orense, Orense, Spain; Hospital Universitario Virgen de la Victoria, Malaga, Spain; Instituto Valenciano de Oncología, Valencia, Spain; Instituto Catalan de Oncologia, L'Hospitalet, Barcelona, Spain; Hospital General Universitario de Elche, Elche, Alicante, Spain; Onkologikoa, San Sebastian, Spain; Hospital Universitario 12 de Octubre, Madrid, Spain; Complejo Asistencial Universitario de Leon, Leon, Spain
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Fernandez S, Garcia A, Vethencourt A, Vazquez S, Petit A, Pla MJ, Ortega R, Pérez J, Gil M, Ponce J, Pernas S, Lopez A, Falo C. Abstract P2-08-58: Prognostic factors of survival in node positive breast cancer patients after neoadjuvant chemotherapy in a large series after 5y follow-up: Can response overcome the poor prognosis of nodal stage? Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-08-58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Status of the axilla is one of the most significant prognostic factors in breast cancer (BC) patients. On the other hand, response to neoadjuvant chemotherapy (NACT) is related to survival. The aim of the present study is to analyze which prognostic factors impact most on Node positive (N+) BC patient survival after NATC. Material and methods: Retrospective analyses on a series of N+ BC patients treated with NATC based on anthracyclines and taxanes +/- trastuzumab if HER2 positive tumors, between June 2008 and December 2016. Clinical, radiological and pathological outcomes have been evaluated. Residual cancer burden (RCB) 1 and the neoadjuvant response index (INR) 2 have been recorded. Survival was calculated with Kaplan-Meier survival curve since the start of NATC to the first documented disease recurrence (DFS) or death (OS). Hazard ratios (HRs) with 95% CIs were estimated with cox proportional hazards regression analysis and subgroups were compared with a two-sided log-rank test. Results: A total of 345 N+ BC patients were included. Pathological complete response was achieved in 72 (20.8%) patients. After NACT, 137 (39.6%) become ypN0, 9 (2.6%) ypN1 mic, 113 (32.7%) ypN1, 60 (17.3%) ypN2 and 26 (7.6%) N3. Those independent predictive factor of ypN0 were molecular subtype (TN and Her2+) with OR: 7.7, p<0.001 and clinical response with OR 6.88, p: 0.04. At a mean follow-up of 58 months there have been 73 (21.1%) recurrences: 9 (2.3%) local, 45 (13%) systemic, 15 (4.3%) systemic+ local, 3 (0.9%) axilla, 1 (0.3%) supraclavicular. The estimated 5y OS was 87.8%. The univariate analysis according to DSF is detailed in Table1.
Adjusted univariate anaalysis cox regression of clinical and pathological factors of desease free survivalBMI10.989-1.010.963AGE0.9960.953-1.0420.876Dose NATC0.9940.979-1.0080.402Clinical Stage1.4021.077-1.8260.012Rx Image1.260.803-1.9940.311Rx size1.0090.995-1.0240.217Number suspicious ALN1.0950.801-1.4970.57Molecular subtype TN,HER20.8800.534-1.450.616Nottinghan grade1.0460.753-1.4530.789Histological subtype1.4651.044-2.0570.27MOlecular subtype1.1510.956-1.3850.137Vascular invasion1.6761.137-24710.009Clinical response2.3691.709-3.284<0.001Fibrosis tumor bed0.980.972-0.989<0.001Nodal fibrosis>50%1.7950.874-3.6860.111Pathological tumoral response1.6861.175-2.4180.005ypN03.561.853-6.838<0.001NRI0.330.192-0.565<0.001RCB1.2741.106-1.4680.001
In the multivariate model those parameters that were independently prognostic were clinical response HR: 5.44 (IC95% 2.275-13.042, p<0.001) and clinical stage HR: 2.364 (IC95% 1.018-5.490, p: 0.045). Conclusions: The most significant prognostic factor in our N+ series was response to NATC, followed by clinical stage. Those independently predictive factors of axillar response (ypN0) were molecular subtype (TN and Her2+) and clinical response. In conclusion, in those patients with chemo sensitive tumors, lymphadenectomy could be safely spared with a more selective axillary approach.
Citation Format: Fernandez S, Garcia A, Vethencourt A, Vazquez S, Petit A, Pla MJ, Ortega R, Pérez J, Gil M, Ponce J, Pernas S, Lopez A, Falo C. Prognostic factors of survival in node positive breast cancer patients after neoadjuvant chemotherapy in a large series after 5y follow-up: Can response overcome the poor prognosis of nodal stage? [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-58.
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Affiliation(s)
- S Fernandez
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - A Garcia
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - A Vethencourt
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - S Vazquez
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - A Petit
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - MJ Pla
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - R Ortega
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - J Pérez
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - M Gil
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - J Ponce
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - S Pernas
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - A Lopez
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - C Falo
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
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Calvo AG, Gomez R, Lopez A, Sanchez S, Villarejo P, Padilla D, Manzanedo I, Pereira F, Perez-Viejo E, Gonzalez L, Lopez-Tomassetti E, Hernandez J, Diaz E, Fabra I, Titos A, Pitarch M, Ochando F, Lacueva F. Morbimortality of patients undergoing cytoreduction + closed hipec with co2 agitation system: a multicentre study. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.493] [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: 10/27/2022] Open
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Perez Fidalgo J, Lopez A, Gambardella V, Navarro S, Iranzo A, Diaz Fernandez N, Tolosa P, Silvestre A, Iriarte Moncho E, Garcia Mora M, De la Paz A, Soler J, Cervantes A. Soft tissue sarcomas (STS) in elder patients: No impact of age on overall survival (OS) in an unselected cohort. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy299.051] [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: 11/12/2022] Open
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Shree R, Harrington WE, Kanaan SB, Forsyth A, Cousin E, Lopez A, Nelson JL, Gammill HS. Fetal microchimerism by mode of delivery: a prospective cohort study. BJOG 2018; 126:24-31. [PMID: 30102819 DOI: 10.1111/1471-0528.15432] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To compare fetal microchimerism (FMc) in pregnancies with uncomplicated vaginal delivery (VD) versus caesarean delivery (CD). DESIGN Prospective cohort study. SETTING University of Washington and Fred Hutchinson Cancer Research Center, USA. POPULATION Women delivering singleton pregnancies without pertinent antenatal complications with uncomplicated deliveries (n = 36). METHODS We collected maternal predelivery, postdelivery and umbilical cord blood for each mother-baby pair. Following maternal and fetal genotyping, FMc was measured with quantitative polymerase chain reaction assays targeting fetus-specific polymorphisms. Quantification of FMc is expressed as genome equivalents (gEq) of fetal DNA/100 000 total gEq tested. FMc detection was evaluated by logistic regression while controlling for total number of cell equivalents tested and clinically relevant covariates. FMc concentrations were compared using negative binomial regression while controlling for the same covariates and predelivery FMc positivity. MAIN OUTCOME MEASURE Detection and concentration of FMc by mode of delivery. RESULTS Twenty-four mother-baby pairs had a VD and 12 had a CD. Postdelivery FMc detection was higher following CD than after VD (58.3% versus 16.7%, P = 0.02). After controlling for covariates, the likelihood of postdelivery FMc detection was almost nine-fold higher after CD than VD (odds ratio 8.8, 95% CI 1.6-47.6; P = 0.01). With respect to postdelivery FMc concentration, the detection rate ratio for CD versus VD in the adjusted negative binomial regression model was 14.7 (95% CI 3.2-66.8; P = 0.001). CONCLUSION Postdelivery peripheral FMc detection and concentration are significantly higher after CD than after VD. As FMc is associated with long-term maternal health, our findings suggest that the mode of delivery may impact this risk. TWEETABLE ABSTRACT Greater fetal microchimerism found in maternal blood following caesarean delivery compared with vaginal delivery.
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Affiliation(s)
- R Shree
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
| | - W E Harrington
- Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, WA, USA
| | - S B Kanaan
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - A Forsyth
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - E Cousin
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - A Lopez
- Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
| | - J L Nelson
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Division of Rheumatology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - H S Gammill
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA.,Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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Panisello-Rosello A, Castro-Benítez C, Lopez A, Balloji S, Folch-Puy E, Adam R, Roselló-Catafau J. Graft Protection Against Cold Ischemia Preservation: An Institute George Lopez 1 and Histidine-tryptophan-ketoglutarate Solution Appraisal. Transplant Proc 2018; 50:714-718. [PMID: 29661422 DOI: 10.1016/j.transproceed.2018.02.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Cold storage of organs in preservation solutions, such as Institute George Lopez 1 (IGL-1) or histidine-tryptophan-ketoglutarate (HTK), is a mandatory step for organ transplantation. This preservation leads to an ischemic injury that affects the outcome of the organ. This article studies the liver graft eluate after organ recovery using IGL-1 or HTK solutions. We explore the influence of the volume used for washing out the liver and the consequences in the graft preservation when both solutions are used. Livers were washed out with different volumes of HTK and IGL-1 according to manufacturers' instructions and then preserved in both solutions for 24 hours at 4°C. Tissue and eluates were collected for subsequent analyses. We measured transaminases (aspartate aminotransferase and alanine aminotransferase), histology by hematoxylin/eosin staining, and red blood cell and hemoglobin counts, respectively. After washing out and cold storage, the IGL-1 processed livers showed better preservation than those with HTK solution; however, in this latter case, an important accumulation of erythrocytes was found when compared to IGL-1. These data were consistent with the higher hemoglobin and red blood cell counts observed for IGL-1 eluates after 24 hours. The volume used for washing out the organ depends on the composition and properties of the organ preservation solutions (ie, IGL-1 and HTK); this is an important factor for the graft cold preservation. The total volume used for washing out the graft should be considered because it has a direct impact on the total cost for clinical transplantations.
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Affiliation(s)
- A Panisello-Rosello
- Institut d'Investigacions Biomèdiques de Barcelona (IIBB), CSIC-IDIBAPS, Catalonia, Barcelona, Spain
| | - C Castro-Benítez
- Centre Hepato-Biliare, AP-P-HP Hôpital Paul Brousse, Inserm U776, Univesité Paris-Sud, Villejuif, Paris, France
| | - A Lopez
- Centre Hepato-Biliare, AP-P-HP Hôpital Paul Brousse, Inserm U776, Univesité Paris-Sud, Villejuif, Paris, France
| | - S Balloji
- Institut d'Investigacions Biomèdiques de Barcelona (IIBB), CSIC-IDIBAPS, Catalonia, Barcelona, Spain
| | - E Folch-Puy
- Institut d'Investigacions Biomèdiques de Barcelona (IIBB), CSIC-IDIBAPS, Catalonia, Barcelona, Spain
| | - R Adam
- Centre Hepato-Biliare, AP-P-HP Hôpital Paul Brousse, Inserm U776, Univesité Paris-Sud, Villejuif, Paris, France
| | - J Roselló-Catafau
- Institut d'Investigacions Biomèdiques de Barcelona (IIBB), CSIC-IDIBAPS, Catalonia, Barcelona, Spain.
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Ramirez P, Frumovitz M, Pareja R, Lopez A, Vieira M, Ribeiro R. Phase III randomized trial of laparoscopic or robotic versus abdominal radical hysterectomy in patients with early-stage cervical cancer: LACC Trial. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.552] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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