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Vijaykumar K, Leung HM, Barrios A, Wade J, Hathorne HY, Nichols DP, Tearney GJ, Rowe SM, Solomon GM. Longitudinal improvements in clinical and functional outcomes following initiation of elexacaftor/tezacaftor/ivacaftor in patients with cystic fibrosis. Heliyon 2024; 10:e29188. [PMID: 38681615 PMCID: PMC11052906 DOI: 10.1016/j.heliyon.2024.e29188] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 03/28/2024] [Accepted: 04/02/2024] [Indexed: 05/01/2024] Open
Abstract
Background Use of elexacaftor/tezacaftor/ivacaftor (ETI) for treatment of cystic fibrosis (CF) has resulted in unprecedented clinical improvements necessitating development of outcome measures for monitoring disease course. Intranasal micro-optical coherence tomography (μOCT) has previously helped detect and characterize mucociliary abnormalities in patients with CF. This study was done to determine if μOCT can define the effects of ETI on nasal mucociliary clearance and monitor changes conferred to understand mechanistic effects of CFTR modulators beyond CFTR activation. Methods 26 subjects, with at least 1 F508del mutation were recruited and followed at baseline (visit 1), +1 month (visit 2) and +6 months (visit 4) following initiation of ETI therapy. Clinical outcomes were computed at visits 1, 2 and 4. Intranasal μOCT imaging and functional metrics analysis including mucociliary transport rate (MCT) estimation were done at visits 1 and 2. Results Percent predicted forced expiratory volume in 1 s (ppFEV1) showed a significant increase of +10.9 % at visit 2, which sustained at visit 4 (+10.6 %). Sweat chloride levels significantly decreased by -36.6 mmol/L and -41.3 mmol/L at visits 2 and 4, respectively. μOCT analysis revealed significant improvement in MCT rate (2.8 ± 1.5, visit 1 vs 4.0 ± 1.5 mm/min, visit 2; P = 0.048). Conclusions Treatment with ETI resulted in significant and sustained clinical improvements over 6 months. Functional improvements in MCT rate were evident within a month after initiation of ETI therapy indicating that μOCT imaging is sensitive to the treatment effect of HEMT and suggests improved mucociliary transport as a probable mechanism of action underlying the clinical benefits.
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Affiliation(s)
- Kadambari Vijaykumar
- Department of Medicine, University of Alabama at Birmingham, AL, United States
- Gregory Fleming James CF Research Center, Birmingham, AL, United States
| | - Hui Min Leung
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, United States
| | - Amilcar Barrios
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, United States
| | - Justin Wade
- Gregory Fleming James CF Research Center, Birmingham, AL, United States
| | | | | | - Guillermo J. Tearney
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, United States
| | - Steven M. Rowe
- Department of Medicine, University of Alabama at Birmingham, AL, United States
- Gregory Fleming James CF Research Center, Birmingham, AL, United States
| | - George M. Solomon
- Department of Medicine, University of Alabama at Birmingham, AL, United States
- Gregory Fleming James CF Research Center, Birmingham, AL, United States
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Vijaykumar K, Leung HM, Barrios A, Fernandez-Petty CM, Solomon GM, Hathorne HY, Wade JD, Monroe K, Slaten KB, Li Q, Leal SM, Moates DB, Pierce HM, Olson KR, Currier P, Foster S, Marsden D, Tearney GJ, Rowe SM. COVID-19 Causes Ciliary Dysfunction as Demonstrated by Human Intranasal Micro-Optical Coherence Tomography Imaging. Am J Respir Cell Mol Biol 2023; 69:592-595. [PMID: 38195114 PMCID: PMC10633845 DOI: 10.1165/rcmb.2023-0177le] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2024] Open
Affiliation(s)
- Kadambari Vijaykumar
- University of Alabama at BirminghamBirmingham, Alabama
- Gregory Fleming James Cystic Fibrosis Research CenterBirmingham, Alabama
| | - Hui Min Leung
- Massachusetts General HospitalBoston, Massachusetts
- Harvard Medical SchoolBoston, Massachusetts
| | - Amilcar Barrios
- Massachusetts General HospitalBoston, Massachusetts
- Harvard Medical SchoolBoston, Massachusetts
| | | | - George M. Solomon
- University of Alabama at BirminghamBirmingham, Alabama
- Gregory Fleming James Cystic Fibrosis Research CenterBirmingham, Alabama
| | | | - Justin D. Wade
- Gregory Fleming James Cystic Fibrosis Research CenterBirmingham, Alabama
| | - Kathryn Monroe
- Gregory Fleming James Cystic Fibrosis Research CenterBirmingham, Alabama
| | - Katie Brand Slaten
- Gregory Fleming James Cystic Fibrosis Research CenterBirmingham, Alabama
| | - Qian Li
- Gregory Fleming James Cystic Fibrosis Research CenterBirmingham, Alabama
| | - Sixto M. Leal
- University of Alabama at BirminghamBirmingham, Alabama
| | | | | | - Kristian R. Olson
- Massachusetts General HospitalBoston, Massachusetts
- Harvard Medical SchoolBoston, Massachusetts
- Healthcare Innovation PartnersBoston, Massachusetts
| | - Paul Currier
- Healthcare Innovation PartnersBoston, Massachusetts
| | - Sam Foster
- Healthcare Innovation PartnersBoston, Massachusetts
| | - Doug Marsden
- Healthcare Innovation PartnersBoston, Massachusetts
- ELEVEN, LLCBoston, Massachusetts
| | - Guillermo J. Tearney
- Massachusetts General HospitalBoston, Massachusetts
- Harvard Medical SchoolBoston, Massachusetts
| | - Steven M. Rowe
- University of Alabama at BirminghamBirmingham, Alabama
- Gregory Fleming James Cystic Fibrosis Research CenterBirmingham, Alabama
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Ryu J, Kang D, Kim J, Chung A, Grant CN, Ryan E, Barrios A, Osman H, Tearney GJ. High-speed reflectance confocal microscopy of human skin at 1251-1342 nm. Lasers Surg Med 2023; 55:405-413. [PMID: 36924183 DOI: 10.1002/lsm.23652] [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: 12/09/2022] [Revised: 02/25/2023] [Accepted: 03/04/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVES Reflectance confocal microscopy (RCM) is an imaging method that can noninvasively visualize microscopic features of the human skin. The utility of RCM can be further improved by increasing imaging speed. In this paper, we report high-speed RCM imaging of human skin with a frame rate that is over 10 times faster and an area imaging rate that is 6-9 times faster than those of commercially available RCM devices. METHODS The higher imaging speed was achieved using a high-speed RCM technique, termed spectrally encoded confocal microscopy (SECM). SECM uses a diffraction grating and a high-speed, wavelength-swept source to conduct confocal imaging at a very high rate. We developed a handheld SECM probe using a scanned-grating approach. The SECM probe was used in conjunction with a wavelength-swept source with a spectral band of 1251-1342 nm. RESULTS The SECM probe achieved high lateral resolution of 1.3-1.6 µm and an axial resolution of 3.5 µm. SECM images of the human skin (image size = 439 × 439 µm2 ) obtained at 100 frames/s clearly show previously reported RCM features of the human skin in vivo with adequate image quality. The fast imaging speed allowed for the rapid acquisiton of volumetric SECM image data (200 frames covering a depth range of 200 µm) within 2 s. The use of 1251-1342 nm provided sufficient signal level and contrast required to visualize key cellular morphologic features. CONCLUSIONS These preliminary results demonstrate that high-speed SECM imaging of the human skin at 1251-1342 nm is feasible.
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Affiliation(s)
- Jiheun Ryu
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Dongkyun Kang
- Department of Biomedical Engineering, College of Optical Sciences, University of Arizona, Tucson, Arizona, USA
| | - Junyoung Kim
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Anita Chung
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Catriona N Grant
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Emily Ryan
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Amilcar Barrios
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Hany Osman
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Guillermo J Tearney
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard-MIT Division of Health Science and Technology, Cambridge, Massachusetts, USA
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Vijaykumar K, Leung HM, Barrios A, Fernandez-Petty CM, Solomon GM, Hathorne HY, Wade JD, Monroe K, Slaten KB, Li Q, Leal SM, Moates DB, Pierce HM, Olson KR, Currier P, Foster S, Marsden D, Tearney GJ, Rowe SM. COVID-19 Causes Ciliary Dysfunction as Demonstrated by Human Intranasal Micro-Optical Coherence Tomography Imaging. bioRxiv 2022:2022.07.08.499336. [PMID: 35860227 PMCID: PMC9298131 DOI: 10.1101/2022.07.08.499336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Severe acute respiratory syndrome coronavirus (SARS-CoV-2), causative agent of coronavirus disease 2019 (COVID-19), binds via ACE2 receptors, highly expressed in ciliated cells of the nasal epithelium. Micro-optical coherence tomography (μOCT) is a minimally invasive intranasal imaging technique that can determine cellular and functional dynamics of respiratory epithelia at 1-μm resolution, enabling real time visualization and quantification of epithelial anatomy, ciliary motion, and mucus transport. We hypothesized that respiratory epithelial cell dysfunction in COVID-19 will manifest as reduced ciliated cell function and mucociliary abnormalities, features readily visualized by μOCT. Symptomatic outpatients with SARS-CoV-2 aged ≥ 18 years were recruited within 14 days of symptom onset. Data was interpreted for subjects with COVID-19 (n=13) in comparison to healthy controls (n=8). Significant reduction in functional cilia, diminished ciliary beat frequency, and abnormal ciliary activity were evident. Other abnormalities included denuded epithelium, presence of mucus rafts, and increased inflammatory cells. Our results indicate that subjects with mild but symptomatic COVID-19 exhibit functional abnormalities of the respiratory mucosa underscoring the importance of mucociliary health in viral illness and disease transmission. Ciliary imaging enables investigation of early pathogenic mechanisms of COVID-19 and may be useful for evaluating disease progression and therapeutic response. Graphical abstract
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Otuya DO, Dechene NM, Poshtupaka D, Judson S, Carlson CJ, Zemlok SK, Sevieri E, Choy P, Shore RE, De León-Peralta E, Cirio AA, Rihm TW, Krall AA, Gavgiotaki E, Dong J, Silva SL, Baillargeon A, Baldwin G, Gao AH, Jansa Z, Barrios A, Ryan E, Bhat NGM, Balmasheva I, Chung A, Grant CN, Bablouzian AL, Beatty M, Ahsen OO, Zheng H, Tearney GJ. Passively scanned, single-fiber optical coherence tomography probes for gastrointestinal devices. Lasers Surg Med 2022; 54:935-944. [PMID: 35708124 PMCID: PMC9541095 DOI: 10.1002/lsm.23576] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/31/2022] [Accepted: 06/03/2022] [Indexed: 10/25/2022]
Abstract
BACKGROUND/OBJECTIVES Optical coherence tomography (OCT) uses low coherence interferometry to obtain depth-resolved tissue reflectivity profiles (M-mode) and transverse beam scanning to create images of two-dimensional tissue morphology (B-mode). Endoscopic OCT imaging probes typically employ proximal or distal mechanical beam scanning mechanisms that increase cost, complexity, and size. Here, we demonstrate in the gastrointestinal (GI) tracts of unsedated human patients, that a passive, single-fiber probe can be used to guide device placement, conduct device-tissue physical contact sensing, and obtain two-dimensional OCT images via M-to-B-mode conversion. MATERIALS AND METHODS We designed and developed ultrasmall, manually scannable, side- and forward-viewing single fiber-optic probes that can capture M-mode OCT data. Side-viewing M-mode OCT probes were incorporated into brush biopsy devices designed to harvest the microbiome and forward-viewing M-mode OCT probes were integrated into devices that measure intestinal potential difference (IPD). The M-mode OCT probe-coupled devices were utilized in the GI tract in six unsedated patients in vivo. M-mode data were converted into B-mode images using an M-to-B-mode conversion algorithm. The effectiveness of physical contact sensing by the M-mode OCT probes was assessed by comparing the variances of the IPD values when the probe was in physical contact with the tissue versus when it was not. The capacity of forward- and side-viewing M-mode OCT probes to produce high-quality B-mode images was compared by computing the percentages of the M-to-B-mode images that showed close contact between the probe and the luminal surface. Passively scanned M-to-B-mode images were qualitatively compared to B-mode images obtained by mechanical scanning OCT tethered capsule endomicroscopy (TCE) imaging devices. RESULTS The incorporation of M-mode OCT probes in these nonendoscopic GI devices safely and effectively enabled M-mode OCT imaging, facilitating real-time device placement guidance and contact sensing in vivo. Results showed that M-mode OCT contact sensing improved the variance of IPD measurements threefold and side-viewing probes increased M-to-B-mode image visibility by 10%. Images of the esophagus, stomach, and duodenum generated by the passively scanned probes and M-to-B-mode conversion were qualitatively superior to B-mode images obtained by mechanically scanning OCT TCE devices. CONCLUSION These results show that passive, single optical fiber OCT probes can be effectively utilized for nonendoscopic device placement guidance, device contact sensing, and two-dimensional morphologic imaging in the human GI tract in vivo. Due to their small size, lower cost, and reduced complexity, these M-mode OCT probes may provide an easier avenue for the incorporation of OCT functionality into endoscopic/nonendoscopic devices.
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Affiliation(s)
- David O Otuya
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Nicholas M Dechene
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Darina Poshtupaka
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Seth Judson
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Camella J Carlson
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Sarah K Zemlok
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Evan Sevieri
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Peter Choy
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Rachel E Shore
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Alissa A Cirio
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Tyler W Rihm
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Alexander A Krall
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Evangelia Gavgiotaki
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Jing Dong
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Sarah L Silva
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Aaron Baillargeon
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Grace Baldwin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Anna H Gao
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Zachary Jansa
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Amilcar Barrios
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Emily Ryan
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Nitasha G M Bhat
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Indira Balmasheva
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Anita Chung
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Catriona N Grant
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Ara L Bablouzian
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Matthew Beatty
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Osman O Ahsen
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Hui Zheng
- Harvard Medical School, Boston, Massachusetts, USA.,Massachusetts General Hospital Biostatistics, Boston, Massachusetts, USA
| | - Guillermo J Tearney
- Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA.,Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard-MIT Division of Health Sciences and Technology (HST), Boston, Massachusetts, USA
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Dong J, Grant C, Vuong B, Nishioka N, Gao AH, Beatty M, Baldwin G, Bailargeon A, Bablouzian A, Grahmann P, Bhat N, Ryan E, Barrios A, Giddings S, Ford T, Beaulieu-Ouellet E, Hosseiny SH, Lerman I, Trasischker W, Reddy R, Singh K, Gora M, Hyun D, Queneherve L, Wallace M, Wolfsen H, Sharma P, Wang KK, Leggett CL, Poneros J, Abrams JA, Lightdale C, Leeds S, Rosenberg M, Tearney G. Feasibility and Safety of Tethered Capsule Endomicroscopy in Patients With Barrett's Esophagus in a Multi-Center Study. Clin Gastroenterol Hepatol 2022; 20:756-765.e3. [PMID: 33549871 PMCID: PMC8715859 DOI: 10.1016/j.cgh.2021.02.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 02/02/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Tethered capsule endomicroscopy (TCE) involves swallowing a small tethered pill that implements optical coherence tomography (OCT) imaging, procuring high resolution images of the whole esophagus. Here, we demonstrate and evaluate the feasibility and safety of TCE and a portable OCT imaging system in patients with Barrett's esophagus (BE) in a multi-center (5-site) clinical study. METHODS Untreated patients with BE as per endoscopic biopsy diagnosis were eligible to participate in the study. TCE procedures were performed in unsedated patients by either doctors or nurses. After the capsule was swallowed, the device continuously obtained 10-μm-resolution cross-sectional images as it traversed the esophagus. Following imaging, the device was withdrawn through mouth, and disinfected for subsequent reuse. BE lengths were compared to endoscopy findings when available. OCT-TCE images were compared to volumetric laser endomicroscopy (VLE) images from a patient who had undergone VLE on the same day as TCE. RESULTS 147 patients with BE were enrolled across all sites. 116 swallowed the capsule (79%), 95/114 (83.3%) men and 21/33 (63.6%) women (P = .01). High-quality OCT images were obtained in 104/111 swallowers (93.7%) who completed the procedure. The average imaging duration was 5.55 ± 1.92 minutes. The mean length of esophagus imaged per patient was 21.69 ± 5.90 cm. A blinded comparison of maximum extent of BE measured by OCT-TCE and EGD showed a strong correlation (r = 0.77-0.79). OCT-TCE images were of similar quality to those obtained by OCT-VLE. CONCLUSIONS The capabilities of TCE to be used across multiple sites, be administered to unsedated patients by either physicians or nurses who are not expert in OCT-TCE, and to rapidly and safely evaluate the microscopic structure of the esophagus make it an emerging tool for screening and surveillance of BE patients. Clinical trial registry website and trial number: NCT02994693 and NCT03459339.
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Affiliation(s)
- Jing Dong
- Wellman Center for Photomedicine, Massachusetts General Hospital, MA,Harvard Medical School, MA
| | - Catriona Grant
- Wellman Center for Photomedicine, Massachusetts General Hospital, MA
| | - Barry Vuong
- Wellman Center for Photomedicine, Massachusetts General Hospital, MA,Harvard Medical School, MA
| | - Norman Nishioka
- Wellman Center for Photomedicine, Massachusetts General Hospital, MA,Harvard Medical School, MA
| | - Anna Huizi Gao
- Wellman Center for Photomedicine, Massachusetts General Hospital, MA
| | - Matthew Beatty
- Wellman Center for Photomedicine, Massachusetts General Hospital, MA
| | - Grace Baldwin
- Wellman Center for Photomedicine, Massachusetts General Hospital, MA
| | - Aaron Bailargeon
- Wellman Center for Photomedicine, Massachusetts General Hospital, MA
| | - Ara Bablouzian
- Wellman Center for Photomedicine, Massachusetts General Hospital, MA
| | - Patricia Grahmann
- Wellman Center for Photomedicine, Massachusetts General Hospital, MA
| | - Nitasha Bhat
- Wellman Center for Photomedicine, Massachusetts General Hospital, MA
| | - Emily Ryan
- Wellman Center for Photomedicine, Massachusetts General Hospital, MA
| | - Amilcar Barrios
- Wellman Center for Photomedicine, Massachusetts General Hospital, MA
| | - Sarah Giddings
- Wellman Center for Photomedicine, Massachusetts General Hospital, MA
| | - Timothy Ford
- Wellman Center for Photomedicine, Massachusetts General Hospital, MA,Harvard Medical School, MA
| | | | | | - Irene Lerman
- Wellman Center for Photomedicine, Massachusetts General Hospital, MA
| | - Wolfgang Trasischker
- Wellman Center for Photomedicine, Massachusetts General Hospital, MA,Harvard Medical School, MA
| | - Rohith Reddy
- Wellman Center for Photomedicine, Massachusetts General Hospital, MA,Harvard Medical School, MA
| | - Kanwarpal Singh
- Wellman Center for Photomedicine, Massachusetts General Hospital, MA,Harvard Medical School, MA
| | - Michalina Gora
- Wellman Center for Photomedicine, Massachusetts General Hospital, MA,Harvard Medical School, MA,ICube Laboratory, CNRS, Strasbourg University, France
| | - Daryl Hyun
- Wellman Center for Photomedicine, Massachusetts General Hospital, MA
| | - Lucille Queneherve
- Wellman Center for Photomedicine, Massachusetts General Hospital, MA,Harvard Medical School, MA
| | - Michael Wallace
- Division of Gastroenterology and Hepatology, Mayo Clinic Jacksonville, FL
| | - Herbert Wolfsen
- Division of Gastroenterology and Hepatology, Mayo Clinic Jacksonville, FL
| | - Prateek Sharma
- Department of Gastroenterology, Kansas City Veterans Administration and University of Kansas School of Medicine, MO
| | - Kenneth K. Wang
- Division of Gastroenterology and Hepatology,, Mayo Clinic Rochester, MN
| | - Cadman L. Leggett
- Division of Gastroenterology and Hepatology,, Mayo Clinic Rochester, MN
| | | | | | | | | | - Mireille Rosenberg
- Wellman Center for Photomedicine, Massachusetts General Hospital, MA,Harvard Medical School, MA
| | - Guillermo Tearney
- Wellman Center for Photomedicine, Massachusetts General Hospital, MA,Harvard Medical School, MA,Department of Pathology, Massachusetts General Hospital, MA,Harvard-MIT Division of Health Science and Technology (HST)
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Méndez R, Figuerola A, Chicot M, Barrios A, Pascual N, Ramasco F, Rodríguez D, García I, von Wernitz A, Zurita N, Semiglia A, Jiménez D, Navarro S, Rubio MJ, Vinuesa M, Del Campo L, Bautista A, Pizarro A. Sepsis Code: dodging mortality in a tertiary hospital. Rev Esp Quimioter 2022; 35:43-49. [PMID: 34812031 PMCID: PMC8790636 DOI: 10.37201/req/105.2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Introducción En el hospital de La Princesa comienza el “Código Sepsis” (CSP) en el año 2015, como un grupo multidisciplinar que dota al personal sanitario de herramientas clínicas, analíticas y organizativas, con el objetivo de la detección y el tratamiento precoz del paciente con sepsis. El objetivo de este estudio es evaluar el impacto de la implantación de CSP en la mortalidad y determinar las variables asociadas con un aumento de la misma. Material y métodos Se realizó un estudio analítico retrospectivo de los pacientes con activación de la alerta CSP de 2015 a 2018. Se recogieron variables clínico-epidemiológicas, parámetros analíticos y factores de gravedad como el ingreso en Unidades de Cuidados Críticos (UCC) y la necesidad de aminas. La significación estadística se estableció en una p < 0,05. Resultados Se incluyeron 1.121 pacientes. La estancia media fue de 16 días y un 32% requirieron ingreso en UCC. La mortalidad mostró una tendencia lineal descendente estadísticamente significativa del 24% en 2015 hasta el 15% en 2018. Las variables predictivas de mortalidad con asociación estadísticamente significativa fueron el lactato > 2 mmol/L, la creatinina > 1,6 mg/dL y la necesidad de aminas. Conclusiones La implementación de Código Sepsis disminuye la mortalidad de los pacientes con sepsis y shock séptico. La presencia de una cifra de lactato > 2 mmol/L, los niveles de creatinina > 1,6 mg/dL y/o la necesidad de administrar aminas en las primeras 24 horas, se asocian con un aumento de la mortalidad en el paciente con sepsis.
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Affiliation(s)
- R Méndez
- Rosa Méndez Hernández. Servicio de Anestesia y Reanimación. Hospital Universitario de La Princesa. Calle Diego de León 62. 28006. Madrid, Spain.
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Barrios A, Dimo K. Single centre evaluation of heparin administration by body mass index in elective cardiac surgery. J Cardiothorac Vasc Anesth 2020. [DOI: 10.1053/j.jvca.2020.09.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Montes A, Cecconi A, Alvarado T, Vera A, Barrios A, Caballero P, Olivera MJ, De Rueda C, Gonzalez E, De La Cuerda F, Jimenez C, Perich J, Gamarra A, Jimenez Borreguero LJ, Alfonso F. 1095 Effective image-guided medical management in effusive constrictive pericarditis. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.646] [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: 11/15/2022] Open
Abstract
Abstract
A 59 year old man was admited to hospitalization for persistent chest pain related to acute pericarditis. Within the admision tests, a transthoracic echography was performed, showing a moderate pericardial effusion with ventricular septal bounce and significant respiratory variations in mitral and tricuspid inflows, all of it consistent with effusive-constrictive pericarditis (Panel A). Anti-inflammatory treatment with ibuprofen and colchicine was started.
During the first 48 hours of admission there was a clinical and hemodinamic worsening in the patient’s condition that forced the performance of a pericardial window, obtaining a very little quantity of dense pericardial fluid. Looking for a more accurate study of the pericardium, a cardiovascular magnetic resonance (CMR) was performed, revealing a thick heterogeneous pericardial effusion (Panel B) and a significant late gadolinium enhancement of both pericardial layers (Panel C). All these findings where consistent with an effusive constrictive pericarditis with persistent inflammatory activity despite high doses of conventional inflammatory treatment. Furthermore, the growth of Propionibacterium acnes in the pericardial fluid disclosed the etiology of this condition.
Medical treatment was enhanced with high doses of intravenous corticosteroid, ceftriaxone and doxycycline. During the following days, the patient showed an excellent response achieving the complete clinical and echocardiographic relief of constrictive signs (Panel D).
Effusive constrictive pericarditis is characterized by the presence of pericardial effusion and constriction secondary to an inflammatory process of the pericardium. Pericardiectomy might be necessary in case of failure of medical treatment, a very common scenario in this kind of .pericarditis.
Our case is remarkable because it demonstrates the value of CMR to detect persistent inflammation of pericardium despite high doses of conventional medical treatment for pericaricarditis guiding the successful escalation to intravenous corticosteroid and avoiding the risk of an unnecessary cardiac surgery.
Abstract 1095 Figure.
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Affiliation(s)
- A Montes
- University Hospital De La Princesa, Madrid, Spain
| | - A Cecconi
- University Hospital De La Princesa, Madrid, Spain
| | - T Alvarado
- University Hospital De La Princesa, Madrid, Spain
| | - A Vera
- University Hospital De La Princesa, Madrid, Spain
| | - A Barrios
- University Hospital De La Princesa, Madrid, Spain
| | - P Caballero
- University Hospital De La Princesa, Madrid, Spain
| | - M J Olivera
- University Hospital De La Princesa, Madrid, Spain
| | - C De Rueda
- University Hospital De La Princesa, Madrid, Spain
| | - E Gonzalez
- University Hospital De La Princesa, Madrid, Spain
| | | | - C Jimenez
- University Hospital De La Princesa, Madrid, Spain
| | - J Perich
- University Hospital De La Princesa, Madrid, Spain
| | - A Gamarra
- University Hospital De La Princesa, Madrid, Spain
| | | | - F Alfonso
- University Hospital De La Princesa, Madrid, Spain
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10
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Ruíz J, Barrios A, Lora A, Vega V, Florez G, Mendivelso F. Extraperitoneal laparoscopic ventral hernia repair: one step beyond. Hernia 2019; 23:909-914. [PMID: 30903515 DOI: 10.1007/s10029-019-01904-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 01/30/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE The objective of the study was to analyze the experience of the Department of Surgery of two institutions of high complexity in Colombia, with the extra peritoneal ventral hernia repair by laparoscopy during the last 2 years and characterize the clinical and surgical aspects most relevant in the procedures performed. METHODS Observational, descriptive, retrospective study, case series type: collection of data by clinical history and analysis thereof including calculation of frequency and central tendency measurements. RESULTS 59 Cases of Ventral Hernia Repair by laparoscopy, 41 with Transabdominal Preperitoneal approach and 18 totally Extraperitoneal. In total, 7 complications were presented as follows: 1 Case of recurrence, 1 case of chronic pain, 2 complications Dindo-Clavien IIIa and 1 complication IIIb. CONCLUSIONS The repair of the ventral hernia by Extraperitoneal route is an innovative approach of increasing popularity, which avoids the contact of the mesh with the intestines, thus avoiding the potential complications that this situation generates with good outcomes and at a lower cost.
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Affiliation(s)
- J Ruíz
- Clínica Colombia, Cl 127 #20-78, Bogotá, Colombia.,Clínica Reina Sofía, Cl 127 #20-78, Bogotá, Colombia.,Fundación Universitaria Sanitas, Cl 127 #20-78, Bogotá, Colombia
| | - A Barrios
- Clínica Reina Sofía, Cl 127 #20-78, Bogotá, Colombia.,Fundación Universitaria Sanitas, Cl 127 #20-78, Bogotá, Colombia
| | - A Lora
- Clínica Colombia, Cl 127 #20-78, Bogotá, Colombia.,Fundación Universitaria Sanitas, Cl 127 #20-78, Bogotá, Colombia
| | - V Vega
- Clínica Reina Sofía, Cl 127 #20-78, Bogotá, Colombia
| | - G Florez
- Fundación Universitaria Sanitas, Cl 127 #20-78, Bogotá, Colombia.
| | - F Mendivelso
- Clínica Reina Sofía, Cl 127 #20-78, Bogotá, Colombia.,Fundación Universitaria Sanitas, Cl 127 #20-78, Bogotá, Colombia
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11
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García-Purriños F, Martínez-Lozano F, Barrios A, Zayas GD. Survival of a micro-vascular free flap after a prolonged cardiac arrest. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132:307. [PMID: 26499435 DOI: 10.1016/j.anorl.2014.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 12/17/2014] [Accepted: 12/19/2014] [Indexed: 11/18/2022]
Affiliation(s)
- F García-Purriños
- ENT-Head and Neck Department, Hospital Universitario del Mar Menor, Paraje Torre Octavio, 54, Pozo Aledo (San Javier), 30739 Murcia, Spain.
| | - F Martínez-Lozano
- Intensive Care Unit, Reina Sofía Universitary Hospital, Avda, Intendente Jorge Palacios, 1, 30003 Murcia, Spain
| | - A Barrios
- ENT-Head and Neck Department, Hospital Universitario del Mar Menor, Paraje Torre Octavio, 54, Pozo Aledo (San Javier), 30739 Murcia, Spain
| | - G D Zayas
- ENT-Head and Neck Department, Hospital Universitario del Mar Menor, Paraje Torre Octavio, 54, Pozo Aledo (San Javier), 30739 Murcia, Spain
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12
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Troncoso M, Santander P, Quintana C, Muñoz D, Troncoso L, Guerra P, Hidalgo M, Díaz R, Flandez A, Barrios A. Central nervous system hypomyelination related to PLP1 defects: clinical and imaging description. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.09.035] [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: 10/22/2022]
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13
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Troncoso M, Santander P, Balut F, Barrios A, Faure F, Vergara D, Troncoso L, Rojas M, Galleguillos C. Clinical phenotype, genetic and imaging features in vanishing white matter disease/cach. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.09.072] [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: 10/22/2022]
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14
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Hidalgo M, Munoz D, Troncoso M, Lara S, Mateluna C, Parra P, Balut F, Barrios A, Faure F. Clinical profile, risk factors and severity in patients with pediatric arterial ischemic stroke. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.09.079] [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: 10/22/2022]
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15
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Troncoso M, Barrios A, Balut F, Witting S, López C, Saez V, Guzmán G, Coria C, Díaz C, Flandes A, Henríquez K. Paroxysmal dyskinesias in pediatric patients. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.09.070] [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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16
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Witting S, Troncoso M, Micolich V, Santander P, Troncoso L, Barrios A, Rojas C, Faure F, Henríquez K, Araya S. Epilepsy in patients with metabolic diseases, clinical features, study and treatment. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.09.068] [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: 10/22/2022]
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17
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Santander P, Troncoso M, Mateluna C, Barrios A, Guerra P, Flandes A, Troncoso L, Millan F. Clinical and genetic manifestations of chilean patients with DNA mitochondrial disease. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.09.082] [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: 10/22/2022]
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18
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Horrillo L, San Martín JV, Molina L, Madroñal E, Matía B, Castro A, García-Martínez J, Barrios A, Cabello N, Arata IG, Casas JM, Ruiz Giardin JM. Atypical presentation in adults in the largest community outbreak of leishmaniasis in Europe (Fuenlabrada, Spain). Clin Microbiol Infect 2014; 21:269-73. [PMID: 25658537 DOI: 10.1016/j.cmi.2014.10.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 10/18/2014] [Accepted: 10/21/2014] [Indexed: 11/27/2022]
Abstract
Since 2009, the largest reported outbreak of leishmaniasis by Leishmania infantum in Europe was reported in Fuenlabrada, Spain. In our hospital, 90 adults with localized leishmanial lymphadenopathy (LLL) or visceral leishmaniasis (VL) were treated during this outbreak; 72% were men, and the mean age was 46.2 years (range 15-95 years). A total of 17 cases (19%) were LLL, an atypical form with isolated lymphadenopathies without other symptoms. All LLL cases occurred in immunocompetent subjects, and only one subject (6%) was a native of sub-Saharan Africa. Diagnosis was performed by fine needle aspiration cytology of the lymphadenopathy. Serology was negative in 38%. LLL outcomes at 6 months were benign, even with doses of liposomal amphotericin B that were often lower (10 mg/kg) than those recommended for VL in Mediterranean areas. A total of 73 subjects (81%) presented with typical VL; 66% of this group were immunocompetent, and 50% of those who were immunocompetent were descendants of natives of sub-Saharan Africa. The rK39 test and polymerase chain reaction were the most useful tests for confirmation of the diagnosis. An initial response to treatment was observed in 99% of cases, and relapses occurred in 14% of cases. Leishmaniasis should be included in the differential diagnosis of isolated lymphadenopathies in endemic areas. LLL could be considered a more benign entity, one different than VL, and less aggressive management should be studied in future investigations.
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Affiliation(s)
- L Horrillo
- Department of Internal Medicine, Madrid, Spain.
| | - J V San Martín
- Department of Internal Medicine, Madrid, Spain; Infectious Diseases Area, Madrid, Spain
| | - L Molina
- Microbiology Area, Laboratory Medicine Department, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - E Madroñal
- Department of Internal Medicine, Madrid, Spain
| | - B Matía
- Department of Internal Medicine, Madrid, Spain
| | - A Castro
- Department of Internal Medicine, Madrid, Spain
| | - J García-Martínez
- Microbiology Area, Laboratory Medicine Department, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - A Barrios
- Department of Internal Medicine, Madrid, Spain; Infectious Diseases Area, Madrid, Spain
| | - N Cabello
- Department of Internal Medicine, Madrid, Spain; Infectious Diseases Area, Madrid, Spain
| | - I G Arata
- Microbiology Area, Laboratory Medicine Department, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | - J M Casas
- Department of Internal Medicine, Madrid, Spain
| | - J M Ruiz Giardin
- Department of Internal Medicine, Madrid, Spain; Infectious Diseases Area, Madrid, Spain
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Sanchez F, Barrios A, Lopez-Lopez M, Lopez-Cornejo P, Bernal E, Sarrion B, Lebron J, Marchena M. A New Formulation for Quenching Processes under Restricted Geometry Conditions in the Slow Exchange Limit. Progress in Reaction Kinetics and Mechanism 2014. [DOI: 10.3184/146867814x13981545065017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A quantitative treatment of quenching processes under restricted geometry conditions in the Slow Exchange Limit is presented. The expressions for KSV have been obtained for this limit in some common situations that can arise in studies under restricted geometry conditions, such as an inhomogeneous quencher distribution in the solution, the presence of oxygen in solution, or the case of solutions containing a mixture of receptors. These situations have been considered and incorporated into the treatment.
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Affiliation(s)
- F. Sanchez
- The Department of Physical Chemistry, University of Sevilla, C/Profesor Garcia Gonzalez s/n, 41012 Sevilla, Spain
| | - A. Barrios
- The Department of Physical Chemistry, University of Sevilla, C/Profesor Garcia Gonzalez s/n, 41012 Sevilla, Spain
| | - M. Lopez-Lopez
- Department of Chemical Engineering, Physical Chemistry and Organic Chemistry, University of Huelva, Avenida de las Fuerzas Armadas s/n, Huelva, 21071, Spain
| | - P. Lopez-Cornejo
- The Department of Physical Chemistry, University of Sevilla, C/Profesor Garcia Gonzalez s/n, 41012 Sevilla, Spain
| | - E. Bernal
- The Department of Physical Chemistry, University of Sevilla, C/Profesor Garcia Gonzalez s/n, 41012 Sevilla, Spain
| | - B. Sarrion
- The Department of Physical Chemistry, University of Sevilla, C/Profesor Garcia Gonzalez s/n, 41012 Sevilla, Spain
| | - J.A. Lebron
- The Department of Physical Chemistry, University of Sevilla, C/Profesor Garcia Gonzalez s/n, 41012 Sevilla, Spain
| | - M. Marchena
- The Department of Physical Chemistry, University of Sevilla, C/Profesor Garcia Gonzalez s/n, 41012 Sevilla, Spain
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20
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Casimiro C, Rodrigo J, Mendiola MA, Rey F, Barrios A, Gilsanz F. Levobupivacaine plus fentanyl versus racemic bupivacaine plus fentanyl in epidural anaesthesia for lower limb surgery. Minerva Anestesiol 2008; 74:381-391. [PMID: 18414370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND To compare the anaesthetic epidural effects of levobupivacaine plus fentanyl versus bupivacaine plus fentanyl in patients undergoing lower limb surgery. METHODS A single blind, randomised, prospective, multicentre study was designed to compare both therapies. The study was conducted in 10 tertiary hospitals. A total of 96 patients who were ASA I or II, who required at least a 24-hour-stay in the hospital and who were subjected to surgery of lower limbs with epidural anaesthesia were enrolled in this study. Treatments were administered at a dosage of 1.2 ml per metamera,including a test dose (3 mL) and the dose of fentanyl (100 mg). Patients were then randomly allocated to receive either Levobupivacaine (n = 49) or bupivacaine (N.= 47). The primary endpoint was sensory blockade (SB) duration. Secondary evaluations included motor blockade (MB), post-surgery analgesic medication usage, safety and the investigator global evaluation. RESULTS SB duration was similar for both interventions: 195 min (165-205) in the bupivacaine group versus 170 min (140-185) in the levobupivicaine group (log-rank test, P=0.884). However, the lack of MB as evaluated by the modified Bromage scale was significantly higher in the levobupivacaine group than in the bupivacaine group (39% vs 13%, P=0.017). Although no significant differences in MB duration were observed between the groups, a trend was observed in the levobupivacaine group, which had a lesser MB (P=0.093). Investigator satisfaction was high and was assessed to a similar extent for both interventions. Forty-one adverse events were detected in 28 patients, with no differences between groups: 15 (33%) with bupivacaine and 13 (27%) with levobupivacaine, P=0.516. CONCLUSION Although both interventions showed similar anaesthetic effects, a higher proportion of patients receiving levobupivacaine lacked MB.
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Affiliation(s)
- C Casimiro
- Medical Department, Abbott Laboratories Spain, Madrid, Spain.
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21
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Gaspar G, Melero JA, Contés E, Sanz J, Jusdado JJ, Castilla V, Barrios A, de Guzmán MT. Is prognosis after first AIDS-defining pathology incidence becoming better in recent years of HAART era? J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p251] [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: 11/10/2022] Open
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22
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Cervero M, Torres R, Aparicio JLA, Barros C, Gaspar G, Casas E, Hervás R, Barrios A. Loss to follow-up in HIV immigrant patients. Is it a relevant problem? Results of the Spanish COMESEM cohort. J Int AIDS Soc 2008. [DOI: 10.1186/1758-2652-11-s1-p173] [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: 11/10/2022] Open
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23
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Martín-Pedrosa J, del Río L, Torres A, San José I, González-Fajardo J, Barrios A, del Blanco I, Gutiérrez V, Carrera S, Vaquero C, Herreros J, Abril C. Seudoaneurismas infecciosos en pacientes drogadictos: ligadura o revascularización. Cir Esp 2001. [DOI: 10.1016/s0009-739x(01)71808-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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24
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Pietri E, Barrios A, Gonzalez O, Goldwasser M, Pérez-Zurita M, Cubeiro M, Goldwasser J, Leclercq L, Leclercq G, Gingembre L. Perovskites as Catalysts Precursors for Methane Reforming: Ru Based Catalysts. Natural Gas Conversion VI 2001. [DOI: 10.1016/s0167-2991(01)80333-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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25
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Williams JA, Barrios A, Gatchalian C, Rubin L, Wilson SW, Holder N. Programmed cell death in zebrafish rohon beard neurons is influenced by TrkC1/NT-3 signaling. Dev Biol 2000; 226:220-30. [PMID: 11023682 DOI: 10.1006/dbio.2000.9860] [Citation(s) in RCA: 82] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Rohon Beard (RB) cells are embryonic primary sensory neurons that are removed by programmed cell death during larval development in zebrafish. RB somatosensory functions are taken over by neurons of the dorsal root ganglia (DRG), suggesting that RB cell death may be triggered by the differentiation of these ganglia, as has been proposed to be the case in Xenopus. However, here we show that the timing of RB cell death correlates with reduced expression of trkC1, the receptor for neurotrophin NT-3, but not with the appearance of DRG, which differentiate only after most RB cells die. trkC1 is expressed in subpopulations of RB neurons during development, and cell death is initiated only in trkC1-negative neurons, suggesting a role for TrkC1 and its ligand, NT-3, in RB cell survival. In support of this, antibodies that deplete NT-3 induce RB cell death while exogenous application of NT-3 reduces death. In addition, we show that RB cell death can be prevented using a caspase inhibitor, zVADfmk, showing that during normal development, RB cells die by a caspase-dependent programmed cell death pathway possibly triggered by reduced signaling via TrkC1.
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Affiliation(s)
- J A Williams
- Department of Anatomy and Developmental Biology, University College of London, London, United Kingdom
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26
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Durbin L, Sordino P, Barrios A, Gering M, Thisse C, Thisse B, Brennan C, Green A, Wilson S, Holder N. Anteroposterior patterning is required within segments for somite boundary formation in developing zebrafish. Development 2000; 127:1703-13. [PMID: 10725246 DOI: 10.1242/dev.127.8.1703] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Somite formation involves the establishment of a segmental prepattern in the presomitic mesoderm, anteroposterior patterning of each segmental primordium and formation of boundaries between adjacent segments. How these events are co-ordinated remains uncertain. In this study, analysis of expression of zebrafish mesp-a reveals that each segment acquires anteroposterior regionalisation when located in the anterior presomitic mesoderm. Thus anteroposterior patterning is occurring after the establishment of a segmental prepattern in the paraxial mesoderm and prior to somite boundary formation. Zebrafish fss(−), bea(−), des(−) and aei(−) embryos all fail to form somites, yet we demonstrate that a segmental prepattern is established in the presomitic mesoderm of all these mutants and hox gene expression shows that overall anteroposterior patterning of the mesoderm is also normal. However, analysis of various molecular markers reveals that anteroposterior regionalisation within each segment is disturbed in the mutants. In fss(−), there is a loss of anterior segment markers, such that all segments appear posteriorized, whereas in bea(−), des(−) and aei(−), anterior and posterior markers are expressed throughout each segment. Since somite formation is disrupted in these mutants, correct anteroposterior patterning within segments may be a prerequisite for somite boundary formation. In support of this hypothesis, we show that it is possible to rescue boundary formation in fss(−) through the ectopic expression of EphA4, an anterior segment marker, in the paraxial mesoderm. These observations indicate that a key consequence of the anteroposterior regionalisation of segments may be the induction of Eph and ephrin expression at segment interfaces and that Eph/ephrin signalling subsequently contributes to the formation of somite boundaries.
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Affiliation(s)
- L Durbin
- Department of Anatomy and Developmental Biology, University College London, Gower Street, London, WC1E 6BT, UK.
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Durbin L, Brennan C, Shiomi K, Cooke J, Barrios A, Shanmugalingam S, Guthrie B, Lindberg R, Holder N. Eph signaling is required for segmentation and differentiation of the somites. Genes Dev 1998; 12:3096-109. [PMID: 9765210 PMCID: PMC317186 DOI: 10.1101/gad.12.19.3096] [Citation(s) in RCA: 223] [Impact Index Per Article: 8.6] [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: 03/05/1998] [Accepted: 07/10/1998] [Indexed: 11/25/2022]
Abstract
Somitogenesis involves the segmentation of the paraxial mesoderm into units along the anteroposterior axis. Here we show a role for Eph and ephrin signaling in the patterning of presomitic mesoderm and formation of the somites. Ephrin-A-L1 and ephrin-B2 are expressed in an iterative manner in the developing somites and presomitic mesoderm, as is the Eph receptor EphA4. We have examined the role of these proteins by injection of RNA, encoding dominant negative forms of Eph receptors and ephrins. Interruption of Eph signaling leads to abnormal somite boundary formation and reduced or disturbed myoD expression in the myotome. Disruption of Eph family signaling delays the normal down-regulation of her1 and Delta D expression in the anterior presomitic mesoderm and disrupts myogenic differentiation. We suggest that Eph signaling has a key role in the translation of the patterning of presomitic mesoderm into somites.
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Affiliation(s)
- L Durbin
- Department of Anatomy and Developmental Biology, University College, London, WC1E 6BT, UK
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29
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Terg R, Llano K, Cobas SM, Brotto C, Barrios A, Levi D, Wasen W, Bartellini MA. Effects of oral ciprofloxacin on aerobic gram-negative fecal flora in patients with cirrhosis: results of short- and long-term administration, with daily and weekly dosages. J Hepatol 1998; 29:437-42. [PMID: 9764991 DOI: 10.1016/s0168-8278(98)80062-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND/AIMS Selective intestinal decontamination has been proposed to prevent spontaneous bacterial peritonitis in cirrhosis. Because of the cost of antibiotics and the development of resistant bacteria, we have evaluated the effect of different schemes and doses of oral ciprofloxacin on aerobic gram-negative fecal flora in cirrhotic patients. METHOD Twenty-nine cirrhotic patients were allocated to four groups to receive: Group 1: 500 mg/day for 2 weeks (six patients); Group 2: 1000 mg twice a week for 2 weeks (six patients); Group 3: 1000 mg once a week for 2 weeks (six patients); and Group 4: 1000 mg once a week for 12 weeks (11 patients). Quantitative analysis of the gram-negative fecal flora was performed before and 1 and 2 weeks after initiation of treatment in patients in Groups 1, 2 and 3 and before and 4, 8 and 12 weeks after initiation of treatment in patients in Group 4. RESULTS Complete eradication of gram-negative bacilli was observed in four of six patients in Group 1. In contrast, only one patient eradicated gram-negative bacilli in Group 2 and Group 3. In long-term administration of ciprofloxacin (Group 4), only two of 11 patients had persistent eradication of gram-negative bacilli. Four patients developed E. coli resistant to ciprofloxacin (one of them associated to resistant Klebsiella). No patient developed bacterial infection during the study period. CONCLUSION Oral ciprofloxacin administered in a weekly dose is ineffective in selective intestinal decontamination. Different mechanisms, including the emergence of ciprofloxacin-resistant organisms, could account for this failure. Therefore, our results suggest that weekly administration of ciprofloxacin is not useful in preventing spontaneous bacterial peritonitis.
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Affiliation(s)
- R Terg
- Unidad de Hepatología, Hospital Municipal de Gastroenterología Dr Bonorino Udaondo, Buenos Aires, Argentina
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30
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Barrios A, Kotak D. Anesthesia for the diabetic patient undergoing ophthalmological procedures. Int Ophthalmol Clin 1998; 38:195-211. [PMID: 9604747] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- A Barrios
- University Department of Anaesthetics and Intensive Care, Queen Elizabeth University Hospital, Birmingham, England
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31
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Doweck J, Quintana C, Barrios A, Monastra L, Lopetegui G, Zerbo O, Schenone L, Giordano A, Valero J, Kogan Z, Bartellini MA, Corti R. [Evaluation of sensitivity, specificity and predictive value of six qualitative serological methods for the detection of Helicobacter pylori antibodies]. Acta Gastroenterol Latinoam 1998; 27:259-61. [PMID: 9527723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Screening tests for IG g antibodies against Helicobacter pylori are usefull for a long follow up of patients who were well eradicated. The aim of this study was to determinate and compared sensibility, specificity, positive and negative predictive value of six qualitative serological tests for IG g antibodies detection in the diagnosis of H. Pylori infections. Between May and October 1996 52 patients (30 males and 22 females; median age 42.4 years, range 21-68) with H. Pylori infection assessed on two antral and two corpus biopsies by means of Giema stain and a rapid urease test were tested for IG g antibodies detection. The serological tests used were: Inmunocomb II (Orgenics) Enzimo Inmuno Assay Inmunoadsorbent qualitative, Flex Pack (Smith Kline Diagnostics, Abbott) inmunocromatographic cualitative, Pylori Stat test (Biowhittaker) Enzimo Inmuno Assay (ELISA) qualitative, Premier (Meridian Diagnostics) Enzimo Inmuno Assay ELISA) qualitative. Pyloristest (Orion Diagnóstica) latex aglutination qualitative, H. Pylori (Bio Tre) Enzimo Inmuno Assay cualitative. 10 healthy subjects with negative gastric biopsies and negative rapid ureasa test were used as control group. The six evaluated serological tests have a comparable sensibility (89-95%) and specificity (77-83%) for the diagnosis of HP infection. The presence of specific HP antibodies in infected patients revealed a strong correlation with the histological demonstration of the microrganisms. We can recommend this qualitative serological tests due to their high sensibility and specificity, simplicity and low cost.
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Affiliation(s)
- J Doweck
- Servicio de Laboratorio, Endoscopía y Patología, Hospital Municipal de Gastroenterología Dr. Carlos Bonorino Udaondo
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Troncoso M, Badilla L, Bravo E, Miranda M, Gajewski C, Barrios A, Villagra R. [Neuroradiological findings in 2 cases of Wilson disease with neurological involvement]. Rev Med Chil 1998; 126:81-7. [PMID: 9629758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Wilson disease is an inborn error of copper metabolism that has neurological and hepatic manifestations. We report a 13 years old girl and a 12 years old boy with Wilson disease. In both patient, brain computed tomography and magnetic resonance imaging showed marked involvement of basal ganglia and other deep gray nuclei. Considering that this is a treatable disease, it should be included in the differential diagnosis of the so called "striatal necrosis of childhood".
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Affiliation(s)
- M Troncoso
- Servicio de Neurología Infantil, Hospital Clínico San Borja Arriarán, Santiago-Chile
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Cabrera-Gómez JA, Collazo H, García-Francisco L, López-Hernández O, Rodríguez-Roque MO, Gómez A, Echazabal N, Barrios A, Solano R, Cruz L, Acuña V, Sánchez V, Casanova M, Cabrera-Núnez JA, Vega-Robles J. [Clinical characteristics of the peripheral form of epidemic neuropathy in the province of Cienfuegos]. Rev Neurol 1997; 25:1852-8. [PMID: 9580289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION From October 1992 to September 1993 clinical observations of the civil population of Cienfuegos revealed the presence of epidemic neuropathy (EN) reaching about 2,000 patients. The clinical manifestations were not uniform. Although numerous studies have been carried out in our country, none have established the characteristics of EN 'the peripheral form'. MATERIAL AND METHODS We studied the first 50 patients assisted by the neurological services of the clinical surgical hospital Dr. Gustavo Aldereguia Lima of Cienfuegos diagnosed of EN 'peripheral form' according to the procedure established by Ministry of Public Health of Cuba. A clinical history was made for each patient consisting of: General data, history of toxic, nutritional, malabsorption factors and chronic illnesses; symptoms and a neurological examinations. Laboratory test, in a group of patients, were done in sera, urine, cerebrospinal fluid (CSF), gastric juice and neurophysiological studies that included computerized evoked potentials and electroencephalograms registers. RESULTS Upon analysis of the clinical history, nutritional factors was common to all the patients associated to toxic and malabsorption. The clinical forms were neuropathy (NP) 48%, myeloneuropathy (MNP) 42% and myelopathy (MP) 10%. Retrobulbar optic neuropathy was observed in 42% of the patients and auditory neuropathy in 22%. CONCLUSIONS The clinical characteristics of NP, in our cases, indicated that this disease fundamentally affects the sensorial neurons and the sensitive peripheral nerves, bilaterally, symmetrically, distally and predominantly in lower limbs. The pathological process has been associated with a distal axonopathy. However, clinic signs of myelopathy can be found up to 40% frequently combined with neuropathy or in isolated form, and seems to affect the posterior and lateral columns of the spinal cord, mainly at thoraciclumbar level. Neuropathy of central nervous system is unknown since no patient has died of EN.
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Affiliation(s)
- J A Cabrera-Gómez
- Departamento de Neurología, hospitales Clínico-Quirúrgico Dr. Gustavo Aldereguía Lima
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Talavera A, Larraona JL, Ramos JL, López T, Maraver A, Arias J, Barrios A. Hereditary angioedema: an infrequent cause of abdominal pain with ascites. Am J Gastroenterol 1995; 90:471-4. [PMID: 7872288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Patients with hereditary angioedema have episodes of local swelling, usually affecting the face, extremities, upper airway, and gastrointestinal tract. Only infrequently does it cause recurrent abdominal pain (with or without ascites); however, because it has potentially life-threatening complications, an early diagnosis is important. We describe a case of type I hereditary angioedema (a quantitative deficit of C1 inhibitor), the sole initial symptom of which was severe recurrent and self-limited abdominal pain, accompanied by ascites during these episodes. During a 4-yr period of treatment with danazol, the patient was virtually asymptomatic, despite levels of C4 and C1 inhibitor that remained below normal limits, and there have been no major side effects that could be attributed to treatment with androgens.
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Affiliation(s)
- A Talavera
- Department of Internal Medicine (Section of Gastroenterology and Hepatology), Hospital Infanta Elena, Huelva, Spain
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Fernández-Samos R, Suarez D, Ortega JM, Zorita A, Vazquez J, Morán CF, Morán O, Arias R, Barrios A, Vaquero F. Multiple cholesterol embolization syndrome: a lethal complication of vascular procedures. Report of two histologically proven cases. J Cardiovasc Surg (Torino) 1995; 36:87-91. [PMID: 7721931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Two cases of multiple cholesterol embolization syndrome (MCES) leading to death are presented. Rarely described and labeled as a "great masquerader", its presence in the medical literature is growing, since it is best diagnosed, but despite the high frequency with which MCES may occur, only a few cases are reported. This syndrome is not universally recognised.
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de Armas R, Barrios A, Castro F, Solano R. In vitro survival of micromanipulated rabbit embryos frozen in two different cryoprotectants. Theriogenology 1995. [DOI: 10.1016/0093-691x(95)92346-b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
Our efforts to determine the carbohydrate binding specificity of two myeloid-specific monoclonal antibodies (VIM-1 and VIM-10) resulted in the purification of three fucosylated glycosphingolipids from human chronic myelogenous leukemia cells. After repeated high-performance liquid chromatographic separations, two forms of fucosylated glycosphingolipids were resolved. VIM-1 and VIM-10 were found to bind to the heptaosylceramide Gal beta 1-4 (Fuc alpha 1-3)GlcNAc beta 1-3Gal beta 1-4GlcNAc beta 1-3Gal beta 1-4Glc beta 1-1Cer with the Le(x) (Lewis X) epitope, but not to either the hexaosylceramide Fuc alpha 1-2Gal beta 1-4(Fuc alpha 1-3)GlcNAc beta 1-3Gal beta 1-4Glc beta 1-1-Cer or the octaosylceramide Fuc alpha 1-2Gal beta 1-4(Fuc alpha 1-3)GlcNAc beta 1-3Gal beta 1-4GlcNAc beta 1-3Gal beta 1-4Glc beta 1-1Cer, each with the Le(y) (Lewis Y) epitope. The latter two glycosphingolipids are the first Le(y) antigens to be purified from human leukocytes and structurally characterized. Binding studies with a range of glycosphingolipids from myeloid cells and other biological sources demonstrated that VIM-1 and VIM-10 bind to Le(x) glycosphingolipids with five or more sugar residues, but not to a glycosphingolipid (III3Fuc-nLc6Cer) with an internal Le(x) trisaccharide.
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Affiliation(s)
- R K Kong
- Department of Chemistry and Biochemistry, San Francisco State University, California 94132
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Barrios A, Sheldon JW, Hardy KA, Peterson JR. Superthermal component in an effusive beam of metastable krypton: Evidence of Kr2+ dissociative recombination. Phys Rev Lett 1992; 69:1348-1351. [PMID: 10047194 DOI: 10.1103/physrevlett.69.1348] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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