1
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Gonzalez A, Soto J, Babiker N, Wroblewski K, Sawicki S, Schoeller D, Luke A, Huisingh-Scheetz M. Higher baseline resting metabolic rate is associated with 1-year frailty decline among older adults residing in an urban area. BMC Geriatr 2023; 23:815. [PMID: 38062368 PMCID: PMC10704798 DOI: 10.1186/s12877-023-04534-5] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Dysregulated energy metabolism is one hypothesized mechanism underlying frailty. Resting energy expenditure, as reflected by resting metabolic rate (RMR), makes up the largest component of total energy expenditure. Prior work relating RMR to frailty has largely been done in cross section with mixed results. We investigated whether and how RMR related to 1-year frailty change while adjusting for body composition. METHODS N = 116 urban, predominantly African-American older adults were recruited between 2011 and 2019. One-year frailty phenotype (0-5) was regressed on baseline RMR, frailty phenotype, demographics and body composition (DEXA) in an ordinal logistic regression model. Multimorbidity (Charlson comorbidity scale, polypharmacy) and cognitive function (Montreal Cognitive Assessment) were separately added to the model to assess for change to the RMR-frailty relationship. The model was then stratified by baseline frailty status (non-frail, pre-frail) to explore differential RMR effects across frailty. RESULTS Higher baseline RMR was associated with worse 1-year frailty (odds ratio = 1.006 for each kcal/day, p = 0.001) independent of baseline frailty, demographics, and body composition. Lower fat-free mass (odds ratio = 0.88 per kg mass, p = 0.008) was independently associated with worse 1-year frailty scores. Neither multimorbidity nor cognitive function altered these relationships. The associations between worse 1-year frailty and higher baseline RMR (odds ratio = 1.009, p < 0.001) and lower baseline fat-free mass (odds ratio = 0.81, p = 0.006) were strongest among those who were pre-frail at baseline. DISCUSSION We are among the first to relate RMR to 1-year change in frailty scores. Those with higher baseline RMR and lower fat-free mass had worse 1-year frailty scores, but these relationships were strongest among adults who were pre-frail at baseline. These relationships were not explained by chronic disease or impaired cognition. These results provide new evidence suggesting higher resting energy expenditure is associated with accelerate frailty decline.
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Affiliation(s)
| | - J Soto
- Illinois Institute of Technology, Chicago, USA
| | | | - K Wroblewski
- Department of Public Health Sciences, University of Chicago, Chicago, USA
| | - S Sawicki
- Department of Medicine, Section of Geriatrics and Palliative Medicine, University of Chicago, Chicago, USA
| | - D Schoeller
- University of Wisconsin in Madison, Madison, USA
| | - A Luke
- Department of Public Health Sciences, Loyola University, Chicago, USA
| | - Megan Huisingh-Scheetz
- Department of Medicine, Section of Geriatrics and Palliative Medicine, University of Chicago, Chicago, USA.
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2
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Gonzalez A, Demeshko S, Meyer F, Werncke CG. A low-coordinate iron organoazide complex. Chem Commun (Camb) 2023; 59:11532-11535. [PMID: 37672291 DOI: 10.1039/d3cc03765g] [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: 09/07/2023]
Abstract
A labile organoazide iron complex is reported. Under ambient conditions, the azide adduct is subject to a dissociation equilibrium in solution, yet also undergoes intramolecular C-H bond amination. Single-crystal irradiation of the azide at 80 K leads to partial N2-extrusion and formation of a putative imido iron intermediate, which was computationally identified as a highly covalent {FeNR}8 species.
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Affiliation(s)
- Andres Gonzalez
- Philipps-University Marburg, Hans-Meerwein-Straße 4, Marburg D-35032, Germany.
| | - Serhiy Demeshko
- Institute of Inorganic Chemistry, University of Göttingen, Tammannstr. 4, Göttingen D-37077, Germany
| | - Franc Meyer
- Institute of Inorganic Chemistry, University of Göttingen, Tammannstr. 4, Göttingen D-37077, Germany
| | - C Gunnar Werncke
- Philipps-University Marburg, Hans-Meerwein-Straße 4, Marburg D-35032, Germany.
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3
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Millien V, Leo SST, Turney S, Gonzalez A. It's about time: small mammal communities and Lyme disease emergence. Sci Rep 2023; 13:14513. [PMID: 37667029 PMCID: PMC10477272 DOI: 10.1038/s41598-023-41901-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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/31/2023] [Indexed: 09/06/2023] Open
Abstract
Theory predicts that biodiversity changes due to climate warming can mediate the rate of disease emergence. The mechanisms linking biodiversity-disease relationships have been described both theoretically and empirically but remain poorly understood. We investigated the relations between host diversity and abundance and Lyme disease risk in southern Quebec, a region where Lyme disease is rapidly emerging. We found that both the abundance of small mammal hosts and the relative abundance of the tick's natural host, the white-footed mouse (Peromyscus leucopus), influenced measures of disease risk in tick vectors (Borrelia burgdorferi infection abundance and prevalence in tick vectors). Our results suggest that the increase in Lyme disease risk is modulated by regional processes involving the abundance and composition of small mammal assemblages. However, the nature and strength of these relationships was dependent both on time and geographic area. The strong effect of P. leucopus abundance on disease risk we report here is of significant concern, as this competent host is predicted to increase in abundance and occurrence in the region, with the northern shift in the range of North American species under climate warming.
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Affiliation(s)
- V Millien
- Redpath Museum, McGill University, Montréal, QC, H3A 0C4, Canada.
- Department of Biology, McGill University, Montréal, QC, H3A 1B1, Canada.
| | - S S T Leo
- Redpath Museum, McGill University, Montréal, QC, H3A 0C4, Canada
- Department of Biology, McGill University, Montréal, QC, H3A 1B1, Canada
| | - S Turney
- Redpath Museum, McGill University, Montréal, QC, H3A 0C4, Canada
- Department of Biology, McGill University, Montréal, QC, H3A 1B1, Canada
| | - A Gonzalez
- Department of Biology, McGill University, Montréal, QC, H3A 1B1, Canada
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4
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Valle D, Mujica V, Gonzalez A. Herbivore-Dependent Induced Volatiles in Pear Plants Cause Differential Attractive Response by Lacewing Larvae. J Chem Ecol 2023; 49:262-275. [PMID: 36690765 DOI: 10.1007/s10886-023-01403-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 12/02/2022] [Revised: 01/04/2023] [Accepted: 01/10/2023] [Indexed: 01/25/2023]
Abstract
Biological control may benefit from the behavioral manipulation of natural enemies using volatile organic compounds (VOCs). Among these, herbivore-induced plant volatiles (HIPVs) provide potential tools for attracting or retaining predators and parasitoids of insect pests. This work aimed to characterize the VOCs emitted by pear plants in response to attack by Cacopsylla bidens (Hemiptera: Psyllidae), a major pest in pear orchards, to compare these with VOCs induced by a leaf chewing insect, Argyrotaenia sphaleropa (Lepidoptera: Tortricidae), and to evaluate the behavioral response of Chrysoperla externa (Neuroptera: Chrysopidae) to HIPVs from pear plants damaged by either herbivore. The results demonstrated that plants damaged by the pear psylla emitted VOC blends with increased amounts of aliphatic aldehydes. Leafroller damage resulted in increased amounts of benzeneacetonitrile, (E)-4,8-dimethylnona-1,3,7-triene, β-ocimene and caryophyllene. In olfactometer bioassays, larvae of C. externa were attracted to herbivore-damaged plants when contrasted with undamaged plants. When plant odors from psylla-damaged were contrasted with those of leafroller-damaged plants, C.externa preferred the former, also showing shorter response lag-times and higher response rates when psylla-damaged plants were present. Our results suggest that pear plants respond to herbivory by modifying their volatile profile, and that psylla-induced volatiles may be used as prey-specific chemical cues by chrysopid larvae. Our study is the first to report HIPVs in pear plants attacked by C. bidens, as well as the attraction of C. externa to psyllid-induced volatiles.
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Affiliation(s)
- D Valle
- Protección Vegetal, Instituto Nacional de Investigación Agropecuaria, INIA Las Brujas, Canelones, Uruguay.
| | - V Mujica
- Protección Vegetal, Instituto Nacional de Investigación Agropecuaria, INIA Las Brujas, Canelones, Uruguay
| | - A Gonzalez
- Laboratorio de Ecología Química, Facultad de Química, Universidad de la República, Montevideo, Uruguay
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5
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Gonzalez A, Chen TY, Demeshko S, Meyer F, Werncke CG. Synthesis, Properties, and Reactivity of a Linear NHC-Based Chromium(I) Silylamide. Organometallics 2023. [DOI: 10.1021/acs.organomet.3c00013] [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: 03/31/2023]
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6
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Meler E, Mazarico E, Peguero A, Gonzalez A, Martinez J, Boada D, Vellve K, Arca G, Gómez-Roig MD, Gratacos E, Figueras F. Prognosis of periviable early-fetal growth restriction: Gaining accuracy. BJOG 2023; 130:688-689. [PMID: 36896613 DOI: 10.1111/1471-0528.17422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 11/22/2022] [Indexed: 03/11/2023]
Affiliation(s)
- E Meler
- Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centre for Biomedical Research on Rare Diseases (CIBER-ER), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - E Mazarico
- Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut de Recerca Sant Joan de Déu (IR-SJD), Barcelona, Spain.,Maternal and Child Health Development Network, RETICS (Redes Temáticas de Investigación Cooperativa en Salud), Research Institute Carlos III, Spanish Ministry of Economy and Competitiveness, Madrid, Spain
| | - A Peguero
- Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centre for Biomedical Research on Rare Diseases (CIBER-ER), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - A Gonzalez
- Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut de Recerca Sant Joan de Déu (IR-SJD), Barcelona, Spain.,Maternal and Child Health Development Network, RETICS (Redes Temáticas de Investigación Cooperativa en Salud), Research Institute Carlos III, Spanish Ministry of Economy and Competitiveness, Madrid, Spain
| | - J Martinez
- Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centre for Biomedical Research on Rare Diseases (CIBER-ER), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - D Boada
- Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centre for Biomedical Research on Rare Diseases (CIBER-ER), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - K Vellve
- Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centre for Biomedical Research on Rare Diseases (CIBER-ER), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - G Arca
- Department of Neonatology, Hospital Clinic, IDIBAPS, Barcelona, Spain.,Neonatal Group, NeNE Foundation, Barcelona, Spain
| | - M D Gómez-Roig
- Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut de Recerca Sant Joan de Déu (IR-SJD), Barcelona, Spain.,Maternal and Child Health Development Network, RETICS (Redes Temáticas de Investigación Cooperativa en Salud), Research Institute Carlos III, Spanish Ministry of Economy and Competitiveness, Madrid, Spain
| | - E Gratacos
- Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centre for Biomedical Research on Rare Diseases (CIBER-ER), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
| | - F Figueras
- Barcelona Centre for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Centre for Biomedical Research on Rare Diseases (CIBER-ER), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
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7
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Gonzalez A, Boies A, Swanson J, Kittelson D. Measuring the Air Quality Using Low-Cost Air Sensors in a Parking Garage at University of Minnesota, USA. Int J Environ Res Public Health 2022; 19:15223. [PMID: 36429940 PMCID: PMC9690026 DOI: 10.3390/ijerph192215223] [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] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
The concentration of air pollutants in underground parking garages has been found to be higher compared to ambient air. Vehicle emissions from cold starts are the main sources of air pollution in underground parking garages. Eight days of measurements, using low-cost air sensors, were conducted at one underground parking garage at the University of Minnesota, Minneapolis. The CO, NO, NO2, and PM2.5 daily average concentrations in the parking garage were measured to be higher, by up to more than an order of magnitude, compared to the ambient concentration. There is positive correlation between exit traffic flow and the air concentrations in the parking garage for lung deposited surface area (LDSA), CO2, NO, and CO. Fuel specific emission factors were calculated for CO, NO, and NOx. Ranging from 25 to 28 g/kgfuel for CO, from 1.3 to 1.7 g/kgfuel for NO, and from 2.1 to 2.7 g/kgfuel for NOx. Regulated emissions were also calculated for CO and NOx with values of 2.4 to 2.9 and 0.19 to 0.25 g/mile, respectively. These emissions are about 50% higher than the 2017 U.S. emission standards for CO and nearly an order magnitude higher for NOx.
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Affiliation(s)
- Andres Gonzalez
- Department of Civil, Environmental, and Geo-Engineering, University of Minnesota, Minneapolis, MN 55455, USA
| | - Adam Boies
- Department of Engineering, University of Cambridge, Cambridge CB2 1PZ, UK
| | - Jacob Swanson
- Department of Integrated Engineering, Minnesota State University, Mankato, MN 56001, USA
| | - David Kittelson
- Department of Mechanical Engineering, University of Minnesota, Minneapolis, MN 55455, USA
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8
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Mehta S, Vieira D, Guillen V, Zerpa D, Quintana A, Sanchez C, Ozair S, Brena-Pastor L, Pinos D, Fleming M, Carrera K, Rossitto F, Martinez F, Gonzalez A, Rodriguez K. Artificial intelligence-guided, single-lead EKG may be a game-changer for symptom-to-balloon time reduction in ST-elevated myocardial infarction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1170] [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: 11/12/2022] Open
Abstract
Abstract
Background
Over decades, efforts to shave off life-saving minutes from ST-Elevated Myocardial Infarction (STEMI) care centred on reducing door-to-needle and door-to-balloon times. We firmly believe that symptom-to-balloon time should prove a better focus to this end. Challenges come with this goal as it heavily relies on a patient's perception and initiative to seek care, which we deem intelligent and wearable Artificial Intelligence (AI)-driven Single Lead EKG technologies as an attractive solution in modern-day cardiology.
Purpose
To provide an accurate, accessible, and cost-effective AI-driven Single Lead STEMI detection algorithm that can be embedded into wearable devices and employed in a self-administered fashion.
Methods
Database: EKG records from Mexico, Colombia, Argentina, and Brazil from April 2014 to December 2019. Dataset: A total of 11,567 12-lead EKG records of 10[s] length with a sampling frequency of 500 Hz, including the following balanced classes: angiographically confirmed and unconfirmed STEMI, branch blocks, non-specific ST-T abnormalities, normal and abnormal (200+ CPT codes, excluding those mentioned above). Cardiologists manually checked the label of each record to ensure precision. Pre-processing: We discard the first and last 250 samples as they may contain a standardisation pulse. The study applied a digital low pass filter of order 5 with a frequency cut-off of 35 Hz. The mean was subtracted from each Lead. Classification: The determined classes were “STEMI” (Including STEMI in different locations of the myocardium – anterior, inferior, and lateral); and “Not-STEMI” (Combination of randomly sample, branch blocks, non-specific ST-T changes, and abnormal records – 25% of each). Training and Testing: A 1-D Convolutional Neural Network was trained and tested with a dataset proportion of 90/10, respectively. A different model was trained and tested for each Lead, using the central 4,500 samples of the records. The last dense layer outputs a probability for each report of being STEMI or Not-STEMI. Lead V2 showed the best overall results. The model was further tested through the same methodology using the best Lead with a subset of the previous data, excluding the unconfirmed STEMI EKG records (Total 7,230 12-lead EKG records for Confirmed Only STEMI dataset). Performance metrics were reported for each experiment and compared.
Results
Combined STEMI data: Accuracy: 91.2%; Sensitivity: 89.6%; Specificity: 92.9%. Confirmed STEMI Only dataset: Accuracy: 92.4%; Sensitivity: 93.4%; Specificity: 91.4% (Figure 1).
Conclusion
By assiduously improving the quality of the model's input, we continue to assess our algorithm's performance and reliability for future clinical validation as a potential remote monitoring and early STEMI detection device.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Mehta
- Lumen Foundation , Miami , United States of America
| | - D Vieira
- Lumen Foundation , Miami , United States of America
| | - V Guillen
- Lumen Foundation , Miami , United States of America
| | - D Zerpa
- Lumen Foundation , Miami , United States of America
| | - A Quintana
- Lumen Foundation , Miami , United States of America
| | - C Sanchez
- Lumen Foundation , Miami , United States of America
| | - S Ozair
- Lumen Foundation , Miami , United States of America
| | | | - D Pinos
- Lumen Foundation , Miami , United States of America
| | - M Fleming
- Lumen Foundation , Miami , United States of America
| | - K Carrera
- Lumen Foundation , Miami , United States of America
| | - F Rossitto
- Lumen Foundation , Miami , United States of America
| | - F Martinez
- Lumen Foundation , Miami , United States of America
| | - A Gonzalez
- Lumen Foundation , Miami , United States of America
| | - K Rodriguez
- Lumen Foundation , Miami , United States of America
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Angeli E, Reese-Petersen A, Gonzalez A, Lopez B, Ravassa S, Genovese F, Karsdal M, Diaz J. Type III collagen formation is significantly associated with risk of outcome in HFpEF patients but loses its significant association with underlying AF. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.792] [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: 11/14/2022] Open
Abstract
Abstract
Introduction
Heart failure with preserved ejection fraction (HFpEF) is the most common type of heart failure, associated with high morbidity and mortality. Atrial fibrillation (AF) has been associated with structural remodelling and fibrosis and can coexist with HFpEF. Type III collagen is the second most abundant collagen in the heart wall and has been associated with cardiac fibrosis. It has been previously shown that type III collagen formation, measured by PRO-C3, is prognostic for all-cause mortality in HFpEF.
Purpose
In this study, we aimed at investigating if the prognostic power of PRO-C3 in relation to all-cause mortality would be affected by underlying AF in HFpEF patients.
Methods
The analysis included 166 individuals with hypertensive HFpEF. The patients were classified in three groups according to NYHA classification, 43.2% in NYHA Class II, 52.5% NYHA Class III and 2.5% NYHA Class IV. A previous history of AF was present in 53.4% of the patients. Cardiac function was assessed by echocardiography and standard clinical measures. Type III collagen formation was evaluated by means of ELISA with the biomarker PRO-C3, which targets the released N-terminal pro-peptide of type III collagen.
Results
Levels of PRO-C3 were significantly elevated in HFpEF patients with AF (p=0.0063). PRO-C3 was significantly predictive of all-cause mortality in HFpEF patients (AUC=0.643, p=0.0053), but lost its significant association when factoring in AF (AUC=0.581, p=0.235). There was an increased risk of all-cause mortality (p=0.0089) but not statistically significant differences in HFpEF patients with AF (p=0.178) with increasing tertiles of PRO-C3.
Conclusions
Type III collagen formation as measured by PRO-C3, was increased in patients with HFpEF and previously diagnosed AF. However, while PRO-C3 can be predictive of all-cause mortality in HFpEF patients, it lacks predicting ability when AF is considered. The presented data suggest a potential role of increased type III collagen formation in HFpEF patients with adverse outcomes, which is consistent with the presence of increased fibrosis, and can potentially be used as a tool of risk stratification.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Nordic Bioscience A/S
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Affiliation(s)
- E Angeli
- Nordic Bioscience A/S , Herlev , Denmark
| | | | - A Gonzalez
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA , Pamplona , Spain
| | - B Lopez
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA , Pamplona , Spain
| | - S Ravassa
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA , Pamplona , Spain
| | - F Genovese
- Nordic Bioscience A/S , Herlev , Denmark
| | - M Karsdal
- Nordic Bioscience A/S , Herlev , Denmark
| | - J Diaz
- Program of Cardiovascular Diseases, CIMA Universidad de Navarra and IdiSNA , Pamplona , Spain
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Mehta S, Vieira D, Zerpa D, Guillen V, Gonzalez A, Brena-Pastor L, Siyam T, Stoica S, Ozair S, Pinos D, Martinez F, Fleming M, Carrera K, Rossitto F, Whuking C. Performance metrics of AI-enhanced single lead EKG maintained after entry of organised clustered data. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2786] [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: 11/12/2022] Open
Abstract
Abstract
Background
Our experience in creating innovative Artificial Intelligence-guided single lead EKG methodologies for ST-Elevation Myocardial Infarction (STEMI) detection within complex EKG records has been previously validated.
Purpose
By expanding the intricate variables of our previously tested algorithm input, we seek to further improve our STEMI detecting tool.
Methods
11,567 12-lead EKG records (10-s length, 500 Hz sample frequency) derived from the Latin America Telemedicine Infarct Network database from April 2014 to December 2019. From these records, we included the following balanced classes: angiographically confirmed and unconfirmed STEMI (divided by wall affected), branch blocks, non-specific ST-T changes, normal, and abnormal (Remaining 200+ CPT codes). Cardiologist annotations ensured precision (Ground truth). Determined classes were “STEMI” and “Not-STEMI”. A 1-D Convolutional Neural Network model was trained and tested for each lead with dataset proportions of 90/10, respectively. The last dense layer outputs a probability for each record being STEMI/Not-STEMI. The analysis also included performance metrics and false-negative reports.
Results
Overall, the most promising Single lead for STEMI detection was V2 (91.2% Accuracy, 89.6% Sensitivity, and 92.9% Specificity). 55% of false negatives were inferior wall STEMI (Table 1).
Conclusion
Appreciable progress of our new methodology compared to our previous experiences in AI-guided Single Lead for STEMI detection, especially for lead V2. By performing a thorough analysis of false-negative reports, we aspire to identify potential areas of STEMI detection weakness which will become the focus of future ventures.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Mehta
- Lumen Foundation , Miami , United States of America
| | - D Vieira
- Lumen Foundation , Miami , United States of America
| | - D Zerpa
- Lumen Foundation , Miami , United States of America
| | - V Guillen
- Lumen Foundation , Miami , United States of America
| | - A Gonzalez
- Lumen Foundation , Miami , United States of America
| | | | - T Siyam
- Lumen Foundation , Miami , United States of America
| | - S Stoica
- Lumen Foundation , Miami , United States of America
| | - S Ozair
- Lumen Foundation , Miami , United States of America
| | - D Pinos
- Lumen Foundation , Miami , United States of America
| | - F Martinez
- Lumen Foundation , Miami , United States of America
| | - M Fleming
- Lumen Foundation , Miami , United States of America
| | - K Carrera
- Lumen Foundation , Miami , United States of America
| | - F Rossitto
- Lumen Foundation , Miami , United States of America
| | - C Whuking
- Lumen Foundation , Miami , United States of America
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11
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Mehta S, Vieira D, Zerpa D, Guillen V, Carrasquel M, Ramadan S, Martinez F, Rossitto F, Carrera K, Fleming M, Pinos D, Brena-Pastor L, Ozair S, Gonzalez A, Barco A. No need for a cardiologist for AMI diagnosis – progress of transforming a behemoth telemedicine program with artificial intelligence. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2251] [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: 11/14/2022] Open
Abstract
Abstract
Background
The Latin American Telemedicine Infarct Network (LATIN) Telemedicine is a mammoth hub and spoke model that provides an umbrella of AMI protection for 100 million patients. In the program, 826,043 patients had a telemedicine encounter; 7,400 with AMI were diagnosed; 4,332 of them managed with guidelines-based strategies. We have gradually begun implementing a system for using Artificial Intelligence (AI) algorithms embedded into EKGs for rapid and accurate STEMI detection and validated the results with a cardiologist's interpretations.
Purpose
To test whether an AI-driven EKG algorithm can effectively substitute a cardiologist for STEMI telemedicine protocols.
Methods
The AI algorithm construction was in the following fashion. Sample: a selection of 8,511 EKG and 90,592 classified heartbeats. Pre-processing: segmentation of each EKG into individual heartbeats. Training & testing: 90% and 10% of the total dataset, respectively. Classification: 1-D Convolutional Neural Network; the study constructed classes for each heartbeat. The algorithm was next deployed on a consecutive series of LATIN EKG records to diagnose STEMI. We afterwards compared the algorithm's results with eight expert cardiologists' interpretations of the same sample.
Results
This study achieved a concordance of 91% between the AI algorithm and cardiologist interpretation (Figure 1).
Conclusions
The initial results with AI algorithms for STEMI diagnosis are encouraging and may provide the base work for new tools for cardiologists to improve their efficiency. Moreover, implementing this innovative tool may overcome current limitations associated with the telemedical management of this disease.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Mehta
- Lumen Foundation , Miami , United States of America
| | - D Vieira
- Lumen Foundation , Miami , United States of America
| | - D Zerpa
- Lumen Foundation , Miami , United States of America
| | - V Guillen
- Lumen Foundation , Miami , United States of America
| | - M Carrasquel
- Lumen Foundation , Miami , United States of America
| | - S Ramadan
- Lumen Foundation , Miami , United States of America
| | - F Martinez
- Lumen Foundation , Miami , United States of America
| | - F Rossitto
- Lumen Foundation , Miami , United States of America
| | - K Carrera
- Lumen Foundation , Miami , United States of America
| | - M Fleming
- Lumen Foundation , Miami , United States of America
| | - D Pinos
- Lumen Foundation , Miami , United States of America
| | | | - S Ozair
- Lumen Foundation , Miami , United States of America
| | - A Gonzalez
- Lumen Foundation , Miami , United States of America
| | - A Barco
- Lumen Foundation , Miami , United States of America
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Rosell A, Baeza S, Lopez-SeguÍ F, Mouriño R, Saigí M, Munné M, Bechini J, Gonzalez A, Cervera E, Compte M, Garcia-Reina S, NUÑEZ A, ARA J. EP01.03-002 Implementation of the International Lung Screen Trial (ILST) in Catalonia: A Cost Analysis study. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.284] [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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Huang G, Strikarsky S, Weinstein J, Ellahi M, Gonzalez A, Idkowiak-Baldys J, Glynn J. 415 Using a cosmetic blend to produce a contraction response in human keratinocytes and deliver tightening of skin around the eye. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.424] [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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Marquez J, Dinguirard N, Gonzalez A, Kane A, Joffe N, Yoshino T, Castillo M. Molecular characterization of thioester-containing proteins in Biomphalaria glabrata and their differential gene expression upon Schistosoma mansoni exposure. Front Immunol 2022; 13:903158. [PMID: 35967434 PMCID: PMC9363628 DOI: 10.3389/fimmu.2022.903158] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/27/2022] [Indexed: 11/30/2022] Open
Abstract
Schistosomiasis is a disease caused by trematode parasites of the genus Schistosoma that affects approximately 200 million people worldwide. Schistosomiasis has been a persistent problem in endemic areas as there is no vaccine available, currently used anti-helmintic medications do not prevent reinfection, and most concerning, drug resistance has been documented in laboratory and field isolates. Thus, alternative approaches to curtail this human disease are warranted. Understanding the immunobiology of the obligate intermediate host of these parasites, which include the freshwater snail Biomphalaria glabrata, may facilitate the development of novel methods to stop or reduce transmission to humans. Molecules from the thioester-containing protein (TEP) superfamily have been shown to be involved in immunological functions in many animals including corals and humans. In this study we identified, characterized, and compared TEP transcripts and their expression upon S. mansoni exposure in resistant and susceptible strains of B. glabrata snails. Results showed the expression of 11 unique TEPs in B. glabrata snails. These transcripts present high sequence identity at the nucleotide and putative amino acid levels between susceptible and resistant strains. Further analysis revealed differences in several TEPs’ constitutive expression levels between resistant and susceptible snail strains, with C3-1, C3-3, and CD109 having higher constitutive expression levels in the resistant (BS90) strain, whereas C3-2 and TEP-1 showed higher constitutive expression levels in the susceptible (NMRI) strain. Furthermore, TEP-specific response to S. mansoni miracidia exposure reiterated their differential expression, with resistant snails upregulating the expression of both TEP-4 and TEP-3 at 2 h and 48 h post-exposure, respectively. Further understanding the diverse TEP genes and their functions in invertebrate animal vectors will not only expand our knowledge in regard to this ancient family of immune proteins, but also offer the opportunity to identify novel molecular targets that could aid in the efforts to develop control methods to reduce schistosomiasis transmission.
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Affiliation(s)
- J. Marquez
- Department of Biology, New Mexico State University, Las Cruces, NM, United States
| | - N. Dinguirard
- Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, United States
| | - A. Gonzalez
- Department of Biology, New Mexico State University, Las Cruces, NM, United States
| | - A.E. Kane
- Department of Biology, New Mexico State University, Las Cruces, NM, United States
| | - N.R. Joffe
- Department of Biology, New Mexico State University, Las Cruces, NM, United States
| | - T.P. Yoshino
- Department of Pathobiological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, United States
| | - M.G. Castillo
- Department of Biology, New Mexico State University, Las Cruces, NM, United States
- *Correspondence: M.G. Castillo,
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Quintana R, Garcia L, Alba P, Roverano S, Alvarez A, Graf C, Pisoni C, Spindler A, Gomez C, Figueredo HM, Papasidero S, Paniego RH, Delavega M, Civit De Garignani EE, Gonzalez Lucero L, Martire V, Águila Maldonado R, Gordon S, Gobbi C, Nieto R, Rausch G, Góngora V, D’amico MA, Dubinsky D, Orden AO, Zacariaz J, Romero J, Pera MA, Rillo O, Baez R, Arturi V, Gonzalez A, Vivero F, Schmid M, Caputo V, Larroude MS, Gomez G, Rodriguez G, Marin J, Collado MV, Jorfen M, Bedran Z, Sarano J, Zelaya D, Sacnun M, Finucci P, Rojas Tessel R, Sattler ME, Machado Escobar M, Astesana P, Paris UV, Allievi A, Vandale JM, Pons-Estel B, Pons-Estel G, García M. POS0707 POTENTIAL USE OF BELIMUMAB IN LUPUS PATIENTS FROM ARGENTINE COHORT ACCORDING DISEASE ACTIVITY STATE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.789] [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: 11/04/2022]
Abstract
BackgroundThe goal of targeted treatment in patients with Systemic Lupus Erythematosus (SLE) is to achieve clinical remission or low disease activity, with the best quality of life, low damage rates and better survival 1-4. RELESSAR is a multicenter, cross-sectional study registry of ≥18 years SLE (ACR 97) patients 5.ObjectivesTo describe demographic, clinical characteristics and treatments in SLE patients according to disease activity state. To evaluate the proportion of SLE and refractory SLE patients that are potentially candidates for Belimumab treatment (Active SLE despite standard treatment including increased acDNA autoantibodies and low complement).MethodsWe evaluated demographic and clinical data, treatments, score of damage (SLICC), activity (SLEDAI) and comorbidity (Charlson), hospital admissions and severe infections. The patients were compared according to disease activity: remission (SLEDAI = 0 and without corticosteroids), low disease activity (LDA, SLEDAI> 0 and ≤4 and without corticosteroids) and non-optimal control (SLEDAI> 4 and any dose of corticosteroids). Refractory SLE was defined according to Rituximab (RTX) use, non-response to cyclophosphamide or two or more immunosuppressant or splenectomized patients. Potential use of Belimumab according approved prescription in Argentina was analyzed.ResultsOverall, 1277 patients were analyzed: 299 (23.4%) were in remission, 162 (12.7%) in LDA and 816 (63.9%) with non-optimal control of the disease.Patients in non-optimal control group were younger, less frequently female and they showed less time of disease and lower socioeconomic status (p < 0.001). They were also more prevalent mestizos (p= 0.004), had higher SLEDAI and SLICC indexes (p <0.001) and higher use of immunosuppressant therapy (p <0.001). There was no difference regarding biologic treatment (RTX p= 0.547 and Belimumab p= 0.08). This group had higher proportion of hospital admissions and severe infections (p<0.001, respectively).Two hundred and one SLE patients fulfilled the use of Belimumab prescription criteria but only 45/201 patients (22,3%) received it in the last visit. Malar rash was the only clinical variable associated with the use of Belimumab (72.7% vs 29.8% p= 0.005).Seventy-six patients classified as refractory SLE (15.7%) and 56/76 (75.7%) never received Belimumab. Patients on Belimumab therapy were associated to treatment with lower doses of corticoids (p= 0.018) and lower rate of hospital admission caused by SLE flare (p= 0.027).ConclusionA high percentage of patients had uncontrolled disease upon entry into the registry and were potential candidates for treatment with Belimumab. The patients who received biologic treatment showed the benefit of requiring fewer doses of corticosteroids and having a lower rate of hospitalizations.References[1]Mok CC. Treat-to-target in systemic lupus erythematosus: Are we there yet? Expert Rev Clin Pharmacol. 2016;9(5).[2]Morand EF, Mosca M. Treat to target, remission and low disease activity in SLE. Vol. 31, Best Practice and Research: Clinical Rheumatology. 2017.[3]Golder V, Tsang-A-Sjoe MWP. Treatment targets in SLE: Remission and low disease activity state. Rheumatol (United Kingdom). 2020;59.[4]Ruiz-Irastorza G, Bertsias G. Treating systemic lupus erythematosus in the 21st century: new drugs and new perspectives on old drugs. Vol. 59, Rheumatology (United Kingdom). 2021.[5]Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum [Internet]. 1997;40(9):1725. Available from: http://www.ncbi.nlm.nih.gov/pubmed/9324032Disclosure of InterestsRosana Quintana: None declared, Lucila Garcia: None declared, Paula Alba: None declared, Susana Roverano: None declared, Analia Alvarez: None declared, Cesar Graf: None declared, Cecilia Pisoni: None declared, Alberto Spindler: None declared, Catalina Gomez: None declared, Heber Matias Figueredo: None declared, Silvia Papasidero: None declared, Raul Horacio Paniego: None declared, Maria DeLaVega: None declared, Emma Estela Civit De Garignani: None declared, Luciana Gonzalez Lucero: None declared, Victoria Martire: None declared, Rodrigo Águila Maldonado: None declared, Sergio Gordon: None declared, Carla Gobbi: None declared, Romina Nieto: None declared, Gretel Rausch: None declared, Vanina Góngora: None declared, Maria Agustina D´Amico: None declared, Diana Dubinsky: None declared, Alberto Omar Orden: None declared, Johana Zacariaz: None declared, Julia Romero: None declared, Mariana Alejandra Pera: None declared, Oscar Rillo: None declared, Roberto Baez: None declared, Valeria Arturi: None declared, Andrea Gonzalez: None declared, Florencia Vivero: None declared, Marcela Schmid: None declared, Victor Caputo: None declared, Maria Silvia Larroude: None declared, Graciela Gomez: None declared, Graciela Rodriguez: None declared, Josefina Marin: None declared, Maria Victoria Collado: None declared, Marisa Jorfen: None declared, Zaida Bedran: None declared, Judith Sarano: None declared, David Zelaya: None declared, MONICA SACNUN: None declared, Pablo Finucci: None declared, Romina Rojas Tessel: None declared, Maria Emilia Sattler: None declared, MAXIMILIANO MACHADO ESCOBAR: None declared, Pablo Astesana: None declared, Ursula Vanesa Paris: None declared, Alberto Allievi: None declared, Juan Manuel Vandale: None declared, Bernardo Pons-Estel: None declared, Guillermo Pons-Estel: None declared, Mercedes García Grant/research support from: GSK grant
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Lourido L, Quaranta P, Paz González R, Calamia V, Cañete JDD, Fernandez B, González-Álvaro I, Gonzalez A, Pablos JL, Blanco FJ, Ruiz-Romero C. POS0438 IDENTIFICATION OF ANTI-CYTOKINE AUTOANTIBODIES WITH POTENTIAL TO PREDICT FLARE IN RHEUMATOID ARTHRITIS PATIENTS UNDERGOING BIOLOGICAL THERAPIES: A DISCOVERY STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4371] [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: 11/03/2022]
Abstract
BackgroundThe presence of anti-cytokine autoantibodies (ACAAs) seems to be a physiologic mechanism to control the immune response and regulate cytokine activity. Biological therapies also regulate cytokine activities and have greatly improved the quality of life of RA patients. However, alteration of the cytokine network by the use of these treatments may lead to a disbalance in the regulatory system of ACAAs. We hypothesize the ACAAs network may influence the course of immune response in RA patients and may be useful to predict the therapy efficacy.ObjectivesWe aimed to explore the potential of circulating ACAAs to predict flare in a cohort of RA patients treated with biological therapy.MethodsWe employed sera at baseline from 194 RA patients of the clinical trial OPTIBIO1 (A Coruña), whose primary endpoint is to evaluate the usefulness of standardized protocol strategies of dose reduction in patients with RA in clinical remission treated with biologics. These patients were treated with TNF inhibitors (Etanercept, N=47; Infliximab, N=12; Adalimumab, N=35; Certolizumab (CTZ), N=17; Golimumab, N=5), Tocilizumab (TCZ, N=60) and Abatacept (ABA, N=18). Patients were in clinical remission (DAS 28 <2.6 or SDAI <5 or ACR/EULAR 2011 criteria) at least from 6 months. Patients were followed during a minimum period of one year and maximum period of 3 years. Flare was considered when remission criteria were not fulfilled. The bead-based antigen array MILLIPLEX MAP Human Cytokine Autoantibody Magnetic Bead Panel was used for the simultaneous detection and quantification in sera of anti-BAFF, anti-G-CSF, anti-IFNβ, anti-IFNγ, anti-IL-1α, anti-IL-6, anti-IL-8, anti-IL-10, anti-IL-12 (p40), anti-IL-15, anti-IL-17A, anti-IL-17F, anti-IL-18, anti-IL-22, and anti-TNFα. Non-parametrical tests, ROC curves and logistic regressions were performed for the statistical data analysis using SPSS. P-value < 0.05 was considered statistically significant.ResultsThe levels of anti-17A and anti-IL-1α were increased in the sera from patients who suffered a flare during the follow-up period (N= 76), compared to those who remained in remission (N= 118), showing an area under the curve (AUC) of 0.586 and 0.594, respectively. Segregating by treatment, the levels of anti-17A were specifically increased in those relapsing patients under CTZ (N=6), ABA (N=12) and TCZ (N=20) treatment. The AUC of anti-17A within these three therapies was 0.867, 0.903 and 0.682, respectively. Logistic regression analysis also associated the levels of anti-17A with the risk of suffering a flare in TCZ-treated patients (OR=1.11; p=0.015, for 100 MFI increase). In addition, the TCZ-treated patients who suffered a flare also showed higher levels of anti-IL17F, anti-IL-1α, and anti-IL-18 compared to those that remained in remission, showing AUCs of 0.689, 0.657 and 0.698, respectively. Anti-IL-18 was also associated with the risk of flare in these patients (OR=1.65; p=0.028, for 100 MFI increase). The presence of these three ACAAs was also higher in the TCZ-treated patients who suffered a flare compared to those in remission.ConclusionAlthough further validation of our results is needed, we present a ground-breaking study showing the potential of anti-IL17A, anti-IL-1α, and anti-IL18 to predict flare in RA patients under biological therapies.References[1]Bejerano C, et al. Clinical evaluation usefulness of standardized protocol strategies of dose reduction in patients with RA in clinical remission treated with biologic therapies. The Optibio Study. Arthritis Rheumatol. 2016; 68 (suppl 10): 649.Table 1.Table showing a summary of the results. CI: confidence interval• Treatments• ACAAs• AUC (CI 95%; p)Allanti-IL17A0.586 (0.504-0.668; 0.044)anti-IL-1α0.594 (0.512-0.676; 0.028)CTZanti-IL17A0.867 (0.675,1.000; 0.017)ABAanti-IL17A0.903 (0.761-1.000; 0.007)TCZanti-IL-1α0.657 (0.494-0.820; 0.049)anti-IL-17F0.689 (0.551-0.827; 0.018)anti-IL17A0.682 (0.528-0.835; 0.023)anti-IL180.698 (0.545-0.850; 0.013)Disclosure of InterestsNone declared.
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Banathy A, Gonzalez A, Patrie J, Sheeran D. Abstract No. 87 Splenic artery embolization in grade V blunt splenic injury: 10-year retrospective review. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.168] [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: 11/29/2022] Open
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Miranda Ruiz E, Gonzalez A, Samos P, Bellsola M, Sabate A, Leon J, Jerónimo M, Pérez-Solà V, Martin L, Corcoles D. Use of verbal de-escalation in reducing need for mechanical restraint in patients with psychotic disorders during non-voluntary transfers from home to the psychiatric emergency department. Eur Psychiatry 2022. [PMCID: PMC9567735 DOI: 10.1192/j.eurpsy.2022.1509] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Little is known about the need for mechanical restraint during non-voluntary transfers from patient’s homes to the psychiatric emergency department in patients diagnosed with Paranoid Schizophrenia. Although there is no evidence of its efficacy, one of the main tools used for the reduction of mechanical restraints is verbal de-escalation training. Objectives The aim is to describe which symptoms predispose to mechanical restrain in patients with Paranoid Schizophrenia transferred in a non-voluntary manner from home to the psychiatric emergency department, and the effect on reducing mechanical restraints after receiving verbal de-escalation training. Methods All patients with Paranoid Schizophrenia who, after being visited by a home psychiatry team, have required non-voluntary transfer from their homes to the psychiatric emergency department were selected (N = 442). Results Young age, being male, having a poor adherence to treatment, higher scores for de following variables; Excitement, Grandiosity, Suspiciousness, Hostility, Abstract thinking, Motor tension, Uncooperativeness, Poor attention, Lack of insight and Poor impulse control as well as lower scores in motor retardation on the PANSS, are related to a higher frequency of mechanical restrain (P<0,005). Before the verbal de-escalation training, 43.9% of the transferred patients required mechanical restraint, after the training, the need for restraints was reduced to 25.5% (P<0.001). Conclusions Training in verbal de-escalation has allowed an important reduction in mechanical restraints in patients with schizophrenia who have required non-voluntary transfers from home to the psychiatric emergency department. Disclosure No significant relationships.
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Aly A, Moussa A, Maybody M, Youssef E, Gonzalez A, Santos E. Abstract No. 549 Intranodal lymphangiography and embolization for management of iatrogenic chylous ascites after oncological surgery. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Pardo-Galiana B, Medina-Rodriguez M, Millan-Vazquez M, Cabezas-Rodriguez JA, Lebrato-Hernandez L, Ainz-Gomez L, Zapata-Arriaza E, Ortega J, de Albóniga-Chindurza A, Montaner J, Gonzalez A, Moniche F. Antithrombotic Treatment after Carotid Stenting in Patients with Concomitant Atrial Fibrillation. AJNR Am J Neuroradiol 2022; 43:727-730. [PMID: 35393364 PMCID: PMC9089259 DOI: 10.3174/ajnr.a7482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/09/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Antithrombotic therapy following carotid artery stent placement with concomitant atrial fibrillation is not well-established. Our aim was to assess the safety and efficacy of the combination of direct oral anticoagulants and a P2Y12 inhibitor at 30 days after carotid artery stent placement in patients with atrial fibrillation. MATERIALS AND METHODS We designed an observational single-center study including patients who underwent carotid artery stent placement with concomitant atrial fibrillation. We studied 3 groups according to antithrombotic therapy: 1) the direct oral anticoagulants plus clopidogrel (DC) group: receiving direct oral anticoagulants plus a P2Y12 inhibitor; 2) the triple therapy group: anticoagulation and dual antiplatelet therapy; and 3) the dual antiplatelet therapy group: following dual antiplatelet therapy alone. The safety outcome was a major or clinically relevant non-major bleeding event at the first month. The efficacy outcomes were the thromboembolic events (myocardial infarction, stroke, systemic embolism, or stent thrombosis). RESULTS Of 959 patients with carotid artery stent placement, 91 met the inclusion criteria, including 24 patients in the DC group, 42 patients in the triple therapy group, and 25 in the dual antiplatelet therapy group. The mean age was 72.27 (SD, 8.1 ) years, with similar baseline characteristics. The median CHA2DS2-VASc score for each group was 6 (interquartile range = 5-6), 5 (interquartile range = 4-6), and 5 (interquartile range = 4-6), respectively. The median HAS-BLED score was 4 in the 3 groups (P = .17). The primary safety end point was 23.8% in the triple therapy group compared with 4% in the dual antiplatelet therapy group (P = .032), with no bleeding events in the DC group (P = .007). There was 1 stent thrombosis in DC group and a cardioembolic stroke in the dual antiplatelet therapy group (P = .41). CONCLUSIONS Among patients with carotid artery stent placement with atrial fibrillation, triple therapy confers a high bleeding risk. A regimen of direct oral anticoagulants plus a P2Y12 inhibitor might confer a good safety profile with significantly lower rates of bleeding and optimal efficacy.
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Affiliation(s)
- B Pardo-Galiana
- From the Stroke Unit (B.P.-G., M.M.-R., J.A.C.-R., L.L.-H., L.A.-G., F.M.)
- Neurovascular Lab (B.P.-G., M.M.-R., J.A.C.-R., L.L.-H., L.A.-G., E.Z.-A., J.O., A.d.A.-C., J.M., A.G., F.M.), Biomedicine Institute of Seville, Seville, Spain
| | - M Medina-Rodriguez
- From the Stroke Unit (B.P.-G., M.M.-R., J.A.C.-R., L.L.-H., L.A.-G., F.M.)
- Neurovascular Lab (B.P.-G., M.M.-R., J.A.C.-R., L.L.-H., L.A.-G., E.Z.-A., J.O., A.d.A.-C., J.M., A.G., F.M.), Biomedicine Institute of Seville, Seville, Spain
| | | | - J A Cabezas-Rodriguez
- From the Stroke Unit (B.P.-G., M.M.-R., J.A.C.-R., L.L.-H., L.A.-G., F.M.)
- Neurovascular Lab (B.P.-G., M.M.-R., J.A.C.-R., L.L.-H., L.A.-G., E.Z.-A., J.O., A.d.A.-C., J.M., A.G., F.M.), Biomedicine Institute of Seville, Seville, Spain
| | - L Lebrato-Hernandez
- From the Stroke Unit (B.P.-G., M.M.-R., J.A.C.-R., L.L.-H., L.A.-G., F.M.)
- Neurovascular Lab (B.P.-G., M.M.-R., J.A.C.-R., L.L.-H., L.A.-G., E.Z.-A., J.O., A.d.A.-C., J.M., A.G., F.M.), Biomedicine Institute of Seville, Seville, Spain
| | - L Ainz-Gomez
- From the Stroke Unit (B.P.-G., M.M.-R., J.A.C.-R., L.L.-H., L.A.-G., F.M.)
- Neurovascular Lab (B.P.-G., M.M.-R., J.A.C.-R., L.L.-H., L.A.-G., E.Z.-A., J.O., A.d.A.-C., J.M., A.G., F.M.), Biomedicine Institute of Seville, Seville, Spain
| | - E Zapata-Arriaza
- Interventional Neuroradiology Unit (E.Z.-A., J.O., A.d.A.-C., A.G.), Radiology Department, University Hospital Virgen del Rocio, Seville, Spain
- Neurovascular Lab (B.P.-G., M.M.-R., J.A.C.-R., L.L.-H., L.A.-G., E.Z.-A., J.O., A.d.A.-C., J.M., A.G., F.M.), Biomedicine Institute of Seville, Seville, Spain
| | - J Ortega
- Interventional Neuroradiology Unit (E.Z.-A., J.O., A.d.A.-C., A.G.), Radiology Department, University Hospital Virgen del Rocio, Seville, Spain
- Neurovascular Lab (B.P.-G., M.M.-R., J.A.C.-R., L.L.-H., L.A.-G., E.Z.-A., J.O., A.d.A.-C., J.M., A.G., F.M.), Biomedicine Institute of Seville, Seville, Spain
| | - A de Albóniga-Chindurza
- Interventional Neuroradiology Unit (E.Z.-A., J.O., A.d.A.-C., A.G.), Radiology Department, University Hospital Virgen del Rocio, Seville, Spain
- Neurovascular Lab (B.P.-G., M.M.-R., J.A.C.-R., L.L.-H., L.A.-G., E.Z.-A., J.O., A.d.A.-C., J.M., A.G., F.M.), Biomedicine Institute of Seville, Seville, Spain
| | - J Montaner
- Neurovascular Lab (B.P.-G., M.M.-R., J.A.C.-R., L.L.-H., L.A.-G., E.Z.-A., J.O., A.d.A.-C., J.M., A.G., F.M.), Biomedicine Institute of Seville, Seville, Spain
- Stroke Unit (J.M.), Neurology Department, University Hospital Virgen Macarena, Seville, Spain
| | - A Gonzalez
- Interventional Neuroradiology Unit (E.Z.-A., J.O., A.d.A.-C., A.G.), Radiology Department, University Hospital Virgen del Rocio, Seville, Spain
- Neurovascular Lab (B.P.-G., M.M.-R., J.A.C.-R., L.L.-H., L.A.-G., E.Z.-A., J.O., A.d.A.-C., J.M., A.G., F.M.), Biomedicine Institute of Seville, Seville, Spain
| | - F Moniche
- From the Stroke Unit (B.P.-G., M.M.-R., J.A.C.-R., L.L.-H., L.A.-G., F.M.)
- Neurovascular Lab (B.P.-G., M.M.-R., J.A.C.-R., L.L.-H., L.A.-G., E.Z.-A., J.O., A.d.A.-C., J.M., A.G., F.M.), Biomedicine Institute of Seville, Seville, Spain
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Abstract
Abstract
Air quality was measured before, during, and after a 4th of July fireworks display in downtown Minneapolis, Minnesota using a mix of low-cost sensors (CO, CO2, and NO) for gases and portable moderate cost instruments for particle measurements (PM2.5, lung deposited surface area, and number weighted particle size distributions). Meteorological conditions—temperature, humidity, and vertical temperature profile were also monitored. Concentrations of particles and most gaseous species peak between 10 pm and midnight on July 4th, decrease in the middle of the night but increase again and by between 6 and 7 am reach concentrations as high or higher than during fireworks. This overnight increase is likely due to a temperature inversion trapping emissions. Between 10 pm and midnight on July 4th the measures of particle concentration increase by 180–600% compared to the same period on July 3rd. Particle size distributions are strongly influenced by fireworks, shifting from traffic-like bimodal distributions before to a nearly unimodal distribution dominated by a large accumulation mode during and after. The shape of the size distribution measured during the early morning peak is nearly identical to that observed during fireworks, suggesting that the early morning peak is mainly due to trapped fireworks emissions not early morning traffic. Gaseous species are less strongly influenced by fireworks than particles. Comparing measurements made between 10 pm and midnight on July 4th and the same period on July 3rd, the concentration of CO increases 32% while the CO2 increases only 2% but increases by another 15% overnight. The NO concentration behaves oddly, decreasing during fireworks, but then recovering the next morning, more than doubling overnight. Our measurements of CO, NO, and PM2.5 are compared with those made at the nearest (~ 2 km away) Minnesota Pollution Control Agency Air Monitoring Station. Their NO results are quite different from ours with much lower concentrations before fireworks, a distinct peak during, followed by a strong overnight increase and an early morning peak somewhat similar in shape and concentration to ours. These differences are likely due mainly to malfunction of our low-cost NO sensor. Concentrations of CO and PM2.5 track ours within 25% but peak shapes are somewhat different, which is not unexpected given the spatial separation of the measurements.
Article highlights
Low-cost and moderate-cost sensors are used to monitor the impact of a 4th of July fireworks display on local air quality.
Particle concentrations and size are more strongly influenced by fireworks than are concentrations gaseous pollutants.
Particle size distributions produced by fireworks are distinctly different from those associated with urban traffic sources.
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Schwarz K, Wohldmann EL, Chen Y, Pouyat RV, Gonzalez A, Mao S, Day SD. Community Knowledge and Concerns About Urban Soil Science, Practice, and Process: Perspectives From the Healthy Soils for Healthy Communities Initiative in Los Angeles, CA, United States. Front Ecol Evol 2022. [DOI: 10.3389/fevo.2021.781587] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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
Urban soil systems research has largely relied on the narrative that soils provide ecosystem services to human populations and should be studied and managed to maximize their potential value in regards to such services. However, soil scientists have not adequately engaged with diverse stakeholders to understand the needs, opportunities, and challenges related to urban soil systems. This disconnect has resulted in urban soil system research agendas that are potentially misaligned with the needs of the communities in which they are situated. Community engagement in the priorities-setting stage of research development can create research agendas that more closely align with community needs. Here we report on findings from the Healthy Soils for Healthy Communities Initiative in which community perceptions, needs, and concerns regarding soils in Los Angeles (LA) County, California, United States were measured through four county-wide online surveys with residents, educators, policy-makers, and professionals and a series of virtual focus groups with key community representatives. The online surveys revealed that the majority of LA County residents (76%) are very or extremely concerned about soil contaminants and pollution. Likewise, 70% of policy-makers and 77% of LA County professionals are highly concerned about soil contamination. In contrast, fewer LA County educators (48%) are concerned about soil contaminants and pollution. Even though 85% of LA County residents surveyed maintain some kind of green space, 70% self-report that their knowledge regarding factors impacting soil health is low. The focus groups revealed several themes present across stakeholder groups including a need for: (1) accessible and transparent soil data and testing; (2) effective community engagement and streamlined communication that centers underserved communities; and (3) building alliances among community, policy, businesses, and science professionals and leveraging connections among organizations, individuals, and agencies that are focused on soil. The findings from this study have informed the future direction of urban soil research and community science in the region. The process of engaging communities in defining research agendas can serve as a model for other cities providing an opportunity to not only improve the relevance and impact of urban soil research, but also improve the sustainability of urban soil systems.
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Weller R, Gonzalez A, Gottschling H, Hänisch C, Werncke CG. NHC‐Stabilized Parent Phosphinidene Adducts of Metal(II) Hexamethyldisilazanides of Manganese – Cobalt and Their Lability in Solution. Z Anorg Allg Chem 2022. [DOI: 10.1002/zaac.202100338] [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: 11/11/2022]
Affiliation(s)
- Ruth Weller
- Department of Chemistry Philipps-Universität Marburg Hans-Meerwein-Straße 4 D-35032 Marburg Germany
| | - Andres Gonzalez
- Department of Chemistry Philipps-Universität Marburg Hans-Meerwein-Straße 4 D-35032 Marburg Germany
| | - Hannah Gottschling
- Department of Chemistry Philipps-Universität Marburg Hans-Meerwein-Straße 4 D-35032 Marburg Germany
| | - Carsten Hänisch
- Department of Chemistry Philipps-Universität Marburg Hans-Meerwein-Straße 4 D-35032 Marburg Germany
| | - C. Gunnar Werncke
- Department of Chemistry Philipps-Universität Marburg Hans-Meerwein-Straße 4 D-35032 Marburg Germany
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Shils JL, Arle JE, Gonzalez A. Neurophysiology during movement disorder surgery. Handb Clin Neurol 2022; 186:123-132. [PMID: 35772882 DOI: 10.1016/b978-0-12-819826-1.00004-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
During stereotactic procedures for treating medically refractory movement disorders, intraoperative neurophysiology shifts its focus from simply monitoring the effects of surgery to an integral part of the surgical procedure. The small size, poor visualization, and physiologic nature of these deep brain targets compel the surgeon to rely on some form of physiologic for confirmation of proper anatomic targeting. Even given the newer reliance on imaging and asleep deep brain stimulator electrode placement, it is still a physiologic target and thus some form of intraoperative physiology is necessary. This chapter reviews the neurophysiologic monitoring method of microelectrode recording that is commonly employed during these neurosurgical procedures today.
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Affiliation(s)
- Jay L Shils
- Department of Anesthesiology, Rush University Medical Center, Chicago, IL, United States.
| | - Jeffrey E Arle
- Department of Neurosurgery, Harvard Medical School and Department of Neurosurgery, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Andres Gonzalez
- Department of Neuroscience, University of California Riverside, Riverside, CA, United States
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Romero-Gonzalez G, Diaz-Dorronsoro I, Ravassa S, Lopez B, Gonzalez A, Diez J. Association of soluble ST2 and right ventricular dysfunction with mortality in chronic hemodialysis patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2911] [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
End stage kidney disease (ESKD), is a triggering and facilitating factor for cardiac remodelling (i.e., morphologic hypertrophy and/or dilatation associated with deterioration of systolic and/or diastolic function) that contribute to heart failure (HF). RV dysfunction (RVD) has been demonstrated to predict mortality in ESKD patients.
Purpose
The present study aimed to investigate the potential associations between RVD and circulating biomarkers of myocardial inflammation and fibrosis with all-cause mortality in HD patients.
Method
We performed a retrospective single-centre cohort study of prevalent patients admitted in a chronic HD program for more than 3 months. Clinical characteristics and echocardiographic parameters were assessed in all patients. Pre-dialysis blood samples for measurement of inflammatory (e.g., C reactive protein, interleukin-1, interleukin-18) and fibrotic (e.g., soluble suppression of tumorigenesis-2 [sST2], galectin-3, C-terminal pro-peptide of procollagen type I and N-terminal pro-peptide of procollagen type III) biomarkers were collected. RVD was defined using tricuspid annular plane systolic excursion (TAPSE) <1.7 cm or pulsed Doppler peak annular velocity (S') <9.5 cm/s. The ability of sST2 to discriminate between mortality was assessed using AuROC curve.
Results
We enrolled forty-eight patients, mean patients age was 74 (64 – 79)years, and 62.5% were males. 95.8% of the patients had high blood pressure, and at least 70.8% had HF criteria. About 52.1% of the patients were on OnLine HDF. Regarding the echocardiogram parameters, 56.3% had no functional heart disease, 10.4% had LVD (LVEF ≤45% and diastolic dysfunction ≥ grade 2), and 33.3% had RVD (TAPSE <17mm and/or S'<9.5cm/s), with or without LVD. Mortality was higher 45.5% (log-rank, p=0.003) in patients with RVD as diagnosed by S' than in patients without RVD. No difference in mortality was observed for RVD defined by TAPSE. There were no differences in the morphology and function parameters of the left ventricle between patients with and without RVD. From all biomarkers measured only sST2 was associated with RVD. Indeed, an age- and sex-adjusted analyses showed that doubling of sST2 was inversely associated with a decreased in S' (estimate = −2.03, 95% CI [−3.04 to −1.00] cm/s; P=0.002). Mortality was increased in patients with sST2 ≥40.45 ng/mL compared to patients with sST2 <40.45 ng/mL (66.7% vs. 18.9%, log-rank; p=0.004).
Conclusion
This preliminary data would suggest that patients on chronic HD, circulating levels of sST2 were independently associated with RVD. In addition, elevated sST2 levels and RVD were associated with increased all-cause mortality. The myocardial pro-remodelling effect of sST2 in HD patients with RVD warrants further investigation.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - I Diaz-Dorronsoro
- University of Navarra Clinic, Cardiology Department, Pamplona, Spain
| | - S Ravassa
- Center for Applied Medical Research, Cardiovascular diseases, Pamplona, Spain
| | - B Lopez
- Center for Applied Medical Research, Cardiovascular diseases, Pamplona, Spain
| | - A Gonzalez
- Center for Applied Medical Research, Cardiovascular diseases, Pamplona, Spain
| | - J Diez
- Center for Applied Medical Research, Cardiovascular diseases, Pamplona, Spain
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Antonana S, Monteagudo JM, Arteagoitia A, Gonzalez A, Ortega R, Rivas S, Martinez-Moya RR, Sanroman MA, Lorente-Ros A, Rincon LM, Zamorano JL. Impact of previous cardiac conditions in prognosis and clinical management of patient with COVID-19 infection. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1123] [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
Recent studies suggest a higher mortality rate because of COVID-19 in patients with previous cardiac conditions compared to those without. Given the limited resources of intensive care units (ICU) during the pandemic outbreak, this fact has important implications.
Purpose
The main purpose of this study was to compare the 30-day mortality of the COVID-19 infection in patients with and without previous cardiac conditions. The secondary end point was to assess the differences in clinical severity of the infection (as development of Acute Respiratory Distress Syndrome – ARDS) and ICU admission amongst these patients.
Methods
A total of 1708 consecutive patients were prospectively included. The inclusion criteria were: a confirmed positive diagnosis of COVID-19 infection by PCR and being admitted to our centre between 18th and 23rd March 2020 and 22nd August and 9th January 2021. Patients were classified in two groups according to the presence of previous cardiac conditions (defined as previous history of myocardial infarction, heart failure and atrial fibrillation). Other comorbidities were extensively explored and Charlson Comorbidity Index was calculated. A propensity-score matching was performed and 145 patients with previous cardiac conditions were matched with 145 patients without.
Results
The group of patients with a previous cardiac condition included 421 patients (24.6%). The crude analysis showed a higher 30-day mortality rate among patients with previous cardiac affections (35.6% vs. 14.6%, p<0.001). They were also less likely to be admitted to the ICU (9.8% vs. 6.2%, p=0.022) and had a higher prevalence ARDS (48.9% vs. 33.9%, p<0.001). In the matched cohort, there were no significant differences between both groups regarding mortality (24.8% in the group of patients with previous cardiac conditions vs. 31.0%, p=0.272) nor ARDS prevalence (50.3% vs. 53.1%, p=0.655). There was a trend toward patients with previous cardiac conditions to be less likely to be admitted to the ICU (4.8% vs. 9.7%, p=0.090).
Conclusions
Patients with a personal history of previous cardiac conditions were less likely to be admitted to the ICU. However, our results show that when comparing cohorts with similar comorbidity burden, a previous cardiopathy “per se” does not significantly increase the risk of death in patients with a concomitant COVID infection.
Funding Acknowledgement
Type of funding sources: None. Mortality unmatched vs matched cohort
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Affiliation(s)
- S Antonana
- University Hospital Ramon y Cajal de Madrid, Cardiology, Madrid, Spain
| | - J M Monteagudo
- University Hospital Ramon y Cajal de Madrid, Cardiology, Madrid, Spain
| | - A Arteagoitia
- University Hospital Ramon y Cajal de Madrid, Cardiology, Madrid, Spain
| | - A Gonzalez
- University Hospital Ramon y Cajal de Madrid, Cardiology, Madrid, Spain
| | - R Ortega
- University Hospital Ramon y Cajal de Madrid, Cardiology, Madrid, Spain
| | - S Rivas
- University Hospital Ramon y Cajal de Madrid, Cardiology, Madrid, Spain
| | - R R Martinez-Moya
- University Hospital Ramon y Cajal de Madrid, Cardiology, Madrid, Spain
| | - M A Sanroman
- University Hospital Ramon y Cajal de Madrid, Cardiology, Madrid, Spain
| | - A Lorente-Ros
- University Hospital Ramon y Cajal de Madrid, Cardiology, Madrid, Spain
| | - L M Rincon
- University Hospital Ramon y Cajal de Madrid, Cardiology, Madrid, Spain
| | - J L Zamorano
- University Hospital Ramon y Cajal de Madrid, Cardiology, Madrid, Spain
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Reese-Petersen A, Gonzalez A, Lopez B, Ravassa S, Karsdal M, Genovese F, Diez J. Endotrophin is significantly associated with disease severity and increased risk of adverse outcome in HFpEF but not in HFrEF patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
The global burden of heart failure (HF), with either reduced (HFrEF) or preserved (HFpEF) ejection fraction, has increased dramatically over the past years, and HFpEF is projected to become the dominant type of HF. Fibrogenesis, promoted by fibroblast activity, plays an important role in the pathology of HF regardless of subtype, causing impaired cardiac function. Endotrophin is a bioactive molecule released from collagen type VI during its maturation, and it is a marker of fibroblast activity. The aim of this post-hoc analysis was to confirm the previously observed prognostic potential of endotrophin (measured by PRO-C6) for adverse outcome in HFpEF and to test its prognostic abilities in HFrEF.
Methods
234 patients with hypertension and either HFrEF (30.3%) or HFpEF (69.7%) were included for analysis. 43.2% were NYHA Class II, 52.5% NYHA Class III and 2.5% NYHA Class IV. 53.4% of patients had a previous history of atrial fibrillation. The cohort did not include diabetic patients. Cardiac function was assessed by echocardiography and standard clinical measures, including left ventricle ejection fraction (EF), blood pressure (BP) and measurement of N-terminal natriuretic brain-peptide (NT-proBNP). Circulating endotrophin was quantified at baseline in serum by means of an enzyme-linked immunosorbent assay, PRO-C6.
Results
PRO-C6 levels increased significantly with disease severity in HFpEF patients (NYHA Class III vs II, p=0.0003), but not in HFrEF patients (NYHA Class III vs II, p=0.33). In HFpEF patients, PRO-C6 was able to discriminate between patients that were hospitalized for HF (AUC=0.69, p<0.001), died from cardiovascular (CV) causes (AUC=0.74, p<0.001), or by any other cause (AUC=0.73, p<0.001). PRO-C6 was not associated with none of these outcomes in HFrEF patients (AUC=0.56, p=0.42; AUC=0.53, p=0.73; AUC=0.56, p=0.53, respectively). Adding PRO-C6 to a risk prediction model containing age, sex, body mass index and systolic BP significantly increased the discriminatory power of the model for mortality (deltaAUC=0.037, p=0.04). When looking at patients stratified in PRO-C6 tertiles, patients in the upper tertile had a significantly higher risk of mortality (p<0.0001, hazard ratios 3 vs 1=4.1, 3 vs 2=3.5, respectively) and HF hospitalization (p<0.0001, hazard ratio 3 vs 1=4.4, 3 vs 2=1.6, respectively) compared to tertiles 1 and 2.
Conclusion
In this population of hypertensive HF patients, circulating endotrophin, measured by PRO-C6, was increased with increasing disease severity, and associated with a higher risk of adverse outcome in HFpEF, but not in HFrEF patients. The data presented here suggest a potential role of endotrophin in HFpEF pathophysiology and further underline the differences between HFpEF and HFrEF. These data confirm previous observations, and strengthen the usefulness of endotrophin, measured by the PRO-C6 biomarker, as a prognostic tool aiding in assessment of HFpEF patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | | | | | | | - M Karsdal
- Nordic Bioscience, Copenhagen, Denmark
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Pérez-Segura P, Paz-Cabezas M, Núñez-Gil IJ, Arroyo-Espliguero R, Maroun Eid C, Romero R, Fernández Rozas I, Uribarri A, Becerra-Muñoz VM, García Aguado M, Huang J, Rondano E, Cerrato E, Rodríguez EA, Ortega-Armas ME, Raposeiras Roubin S, Pepe M, Feltes G, Gonzalez A, Cortese B, Buzón L, El-Battrawy I, Estrada V. Prognostic factors at admission on patients with cancer and COVID-19: Analysis of HOPE registry data. ACTA ACUST UNITED AC 2021; 157:318-324. [PMID: 34632069 PMCID: PMC8489183 DOI: 10.1016/j.medcle.2021.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 02/24/2021] [Indexed: 01/08/2023]
Abstract
Background Previous works seem to agree in the higher mortality of cancer patients with COVID-19. Identifying potential prognostic factors upon admission could help identify patients with a poor prognosis. Methods We aimed to explore the characteristics and evolution of COVID-19 cancer patients admitted to hospital in a multicenter international registry (HOPE COVID-19). Our primary objective is to define those characteristics that allow us to identify cancer patients with a worse prognosis (mortality within 30 days after the diagnosis of COVID-19). Results 5838 patients have been collected in this registry, of whom 770 had cancer among their antecedents. In hospital mortality reached 258 patients (33.51%). The median was 75 years (65–82). Regarding the distribution by sex, 34.55% of the patients (266/770) were women. The distribution by type of cancer: genitourinary 238/745 (31.95%), digestive 124/745 (16.54%), hematologic 95/745 (12.75%). In multivariate regression analysis, factors that are independently associated with mortality at admission are: renal impairment (OR 3.45, CI 97.5% 1.85–6.58), heart disease (2.32, 1.47–3.66), liver disease (4.69, 1.94–11.62), partial dependence (2.41, 1.34–4.33), total dependence (7.21, 2.60–21.82), fatigue (1.84, 1.16–2.93), arthromialgias (0.45, 0.26–0.78), SatO2 < 92% (4.58, 2.97–7.17), elevated LDH (2.61, 1.51–4.69) and abnormal decreased Blood Pressure (3.57, 1.81–7.15). Analitical parameters are also significant altered. Conclusion In patients with cancer from the HOPE registry, 30-day mortality from any cause is high and is associated with easily identifiable clinical factors upon arrival at the hospital. Identifying these patients can help initiate more intensive treatments from the start and evaluate the prognosis of these patients.
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Affiliation(s)
| | - M Paz-Cabezas
- Medical Oncology Dpt. Hospital Clinico San Carlos, Madrid, Spain
| | | | | | - C Maroun Eid
- Hospital Universitario La Paz. Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - R Romero
- Hospital Universitario Getafe, Madrid, Spain
| | | | - A Uribarri
- Hospital Clinico Universitario de Valladolid, Valladolid, Spain
| | | | - M García Aguado
- Hospital Puerta de Hierro de Majadahonda. Majadahonda, Madrid, Spain
| | - J Huang
- The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - E Rondano
- Sant'Andrea Hospital, Vercelli, Italy
| | - E Cerrato
- San Luigi Gonzaga University Hospital, Orbassano and Rivoli Infermi Hospital, Rivoli, Turin, Italy
| | | | - M E Ortega-Armas
- Hospital General del Norte de Guayaquil IESS Los Ceibos, Guayaquil, Ecuador
| | | | - M Pepe
- Azienda ospedaliero-universitaria consorziale policlinico di Bari, Bari, Italy
| | - G Feltes
- Nuestra Señora de América, Madrid, Spain
| | - A Gonzalez
- Hospital Universitario Infanta Sofia. San Sebastian de los Reyes, Madrid, Spain
| | | | - L Buzón
- Hospital Universitario de Burgos, Burgos, Spain
| | - I El-Battrawy
- First Department of Medicine, Medical Faculty Mannheim, University Heidelberg, Mannheim, 68167, Germany, DZHK (German Center for Cardiovascular Research), Partner Site, Heidelberg-Mannheim, Mannheim, Germany
| | - V Estrada
- Hospital Clinico San Carlos, Madrid, Spain
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Levitt EE, Amlung MT, Gonzalez A, Oshri A, MacKillop J. Consistent evidence of indirect effects of impulsive delay discounting and negative urgency between childhood adversity and adult substance use in two samples. Psychopharmacology (Berl) 2021; 238:2011-2020. [PMID: 33782722 DOI: 10.1007/s00213-021-05827-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 03/15/2021] [Indexed: 01/13/2023]
Abstract
RATIONALE Exposure to adverse life experiences (ACEs) is robustly associated with problematic alcohol and other drug use. In addition, both ACEs and substance use have been independently associated with impulsivity. OBJECTIVE To examine whether impulsivity is implicated in the link between ACE and adult substance use in two samples. METHODS The primary sample was a cohort of community adults (N = 1431) who completed a one-time in-person assessment. A second sample was crowdsourced using Amazon Mechanical Turk (N = 3021). All participants were assessed for ACEs using the Adverse Childhood Experience Questionnaire and for current alcohol and other drug use. Given its multidimensional nature, impulsivity was assessed using the UPPS-P measure of impulsive personality traits, Go/NoGo (GNG) task (in-person community adult sample only), and delay discounting (Monetary Choice Questionnaire [MCQ] in the community adults and Effective Delay-50 [ED50] in the crowdsourced sample. Structural equation modeling was used to examine the hypothesized indirect effects for the measures of impulsivity between ACEs and substance use. RESULTS In the community adults, significant indirect effects were observed from ACEs to substance use via UPPS-Negative Urgency (β = 0.07, SE = 0.02, 95% CI [0.04, 0.10]), and the MCQ (β = 0.02 SE = .01, 95% CI [0.01, 0.03]). In the crowdsourced sample, significant indirect effects were observed from ACEs to substance use via UPPS-Negative Urgency (β = 0.05, SE = .01, 95% CI [0.04, 0.07]), UPPS-Premeditation (β = 0.04, SE = .01, 95% CI [0.02, 0.05), and the ED50 (β = 0.02, SE = .01; 95% CI [0.01, 0.03]). CONCLUSION These findings provide consistent evidence that decrements in regulation of negative emotions and overvaluation of immediate rewards indirectly link ACE and substance use. These robust cross-sectional findings support the need for elucidating the underlying neural substrates implicated and for longitudinal evaluations.
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Affiliation(s)
- E E Levitt
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8P 3P2, Canada
- Homewood Research Institute, Guelph, ON, Canada
| | - M T Amlung
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8P 3P2, Canada
| | - A Gonzalez
- Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
| | - A Oshri
- Department of Human Development and Family Science, University of Georgia, Athens, GA, USA
| | - J MacKillop
- Peter Boris Centre for Addictions Research, McMaster University & St. Joseph's Healthcare Hamilton, 100 West 5th Street, Hamilton, ON, L8P 3P2, Canada.
- Homewood Research Institute, Guelph, ON, Canada.
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Calamia V, Lourido L, Fernández Puente P, Illiano A, Paz González R, Rocha Loureda B, Collado Rodríguez L, Perez-Pampín E, Ruiz-Romero C, Gonzalez A, Blanco FJ. POS0185 IDENTIFICATION AND VALIDATION OF TWO NOVEL SERUM BIOMARKERS ASSOCIATED WITH THE SEROLOGICAL STATUS OF RHEUMATOID ARTHRITIS PATIENTS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2533] [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: 11/03/2022]
Abstract
Background:Despite the diagnostic value of Rheumatoid Factor (RF) and Anti-Citrullinated Protein Antibodies (ACPA), more serological markers are needed in order to improve early diagnosis and treatment response of the Rheumatoid Arthritis (RA) patients. Increased knowledge about how these two major autoreactivities arise is crucial for understanding how RA develops and what mechanisms drive pathogenesis.Objectives:We aimed to investigate, using a proteomic strategy, novel protein biomarkers associated with RF and/or ACPA that might be useful to stratify seropositive and seronegative RA patients.Methods:A shotgun proteomic analysis was performed on 80 sera from the RA cohort of the Rheumatology Unit of the University Hospital of Santiago de Compostela (CHUS). Sera were classified as seropositive or seronegative according to their RF and ACPA values, and were then analyzed employing the iTRAQ labelling technique (Sciex) followed by LC-MALDI-MS/MS analysis (MALDI-TOF). A Multiple Reaction Monitoring (MRM) method was subsequently developed using the Skyline Software for the simultaneous quantification of 26 peptides belonging to ten putative protein biomarkers. The quantitative targeted analysis was performed using peptides with isotope labelled amino acids as internal standards. Serum levels of orosomucoid 1 (ORM1) and haptoglobin (HPT) were measured using commercially available ELISA Kits in the whole RA cohort (n=260) from the Rheumatology Unit of the University Hospital of A Coruña (HUAC).Results:For the initial screening, eighty sera were grouped according to the ACPA/RF status in 4 pools (20 patients/pool). Using an iTRAQ technology-based quantitative proteomic approach, the abundance of eleven proteins was altered in the sera from ACPApos/RFpos, 13 proteins in ACPAneg/RFpos and 12 proteins in ACPApos/RFneg, compared to ACPAneg/RFneg. Vitamin D binding protein (VTDB) was the unique protein that resulted increased in all the comparisons. For the biomarker verification phase, all the samples from the CHUS cohort were analyzed individually (n=80). Using the MRM technology, 26 peptides belonging to ten putative protein biomarkers associated with double positivity were simultaneously quantified. The statistical analysis showed a significant modulation of 9 peptides (belonging to 4 different proteins) in ACPApos/RFpos, 7 peptides (5 proteins) in ACPAneg/RFpos, and 9 peptides (6 proteins) in ACPApos/RFneg compared to ACPAneg/RFneg (p<0.05). Two acute phase reactants (ORM1 and HPT) displayed the same modulation in both screening and verification phases, thus confirming their association with the double positivity. Finally, in the biomarker validation phase, a total of 260 patients from CHUAC were included (Table 1). RA patients were classified as follows: (1) 112 patients (43.1%) were ACPApos/RFpos; (2) 73 patients (28.1%) were ACPAneg/RFneg; (3) 51 patients (19.6%) were ACPAneg/RFpos; and (4) 24 patients (9.2%) were ACPApos/RFneg. Serum levels of ORM1 and HPT (Figure 1), measured by commercial immunoassays, confirmed their increased values in double seropositive patients (p=0,0053 ORM1; p=0,0026 HPT). Finally, the increased level of ORM1 resulted associated with RF rather than ACPA status (p=0,0008 ACPAneg/RFpos); whereas HPT was associated with ACPA rather than RF status (p=0,0112 ACPApos/RFneg).Table 1.The different phases of RA biomarker development followed in this study.DISCOVERYPHASEVERIFICATIONPHASEVALIDATIONPHASESource centerCHUSCHUSCHUACN° ofsamplesn= 4n= 80n= 260ACPA+RF+Pool 1ACPA+RF+20ACPA+RF+112ACPA-RF-Pool 2ACPA-RF-20ACPA-RF-73ACPA-RF+Pool 3ACPA-RF+20ACPA-RF+51ACPA+RF-Pool 4ACPA+RF-20ACPA+RF-24N° ofbiomarkersORM1, ORM2, HPT, A2GL, AACT, RBP4, PLMN, IC1, VDBP, APOBORM1, HPT, A2GL, AACTORM1, HPTFigure 1.Conclusion:The determination of ORM1 and HPT in sera provides novel information useful for patient stratification, which might improve diagnostic and prognostic approaches and facilitate the development of personalized medicine strategies in RA.Acknowledgements:This work is supported by grants from Fondo de Investigación Sanitaria (RD16/0012/0002, PT17/0019/0014) integrated in the National Plan for Scientific Program, Development and Technological Innovation 2013–2016 and funded by the ISCIII-General Subdirection of Assessment and Promotion of Research-European Regional Development Fund (FEDER) “A way of making Europe”.Disclosure of Interests:None declared
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LeBlanc KA, Gonzalez A, Dickens E, Olsofka J, Ortiz-Ortiz C, Verdeja JC, Pierce R. Robotic-assisted, laparoscopic, and open incisional hernia repair: early outcomes from the Prospective Hernia Study. Hernia 2021; 25:1071-1082. [PMID: 34031762 DOI: 10.1007/s10029-021-02381-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 09/21/2020] [Accepted: 02/23/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To provide a comparative analysis of short-term outcomes after open, laparoscopic, and robotic-assisted (RAS) ventral incisional hernia (VIH) repairs that include subject-reported pain medication usage and hernia-related quality of life (QOL). METHODS Subjects were ≥ 18 years old and underwent elective open, laparoscopic or RAS VIH repair without myofascial release. Perioperative clinical outcomes through 30 days were analyzed as were prescription pain medication use and subject-reported responses to the HerQLes Abdominal QOL questionnaire. Observed differences in baseline characteristics were controlled using a weighted propensity score analysis to obviate potential selection bias (inverse probability of treatment weighting, IPTW). A p value < 0.05 was considered statistically significant. RESULTS Three hundred and seventy-one subjects (RAS, n = 159; open, n = 130; laparoscopic, n = 82) were enrolled in the study across 17 medical institutions within the United States. Operative times were significantly different between the RAS and laparoscopic groups (126.2 vs 57.2, respectively; p < 0.001). Mean length of stay was comparable for RAS vs laparoscopic (1.4 ± 1.0 vs 1.4 ± 1.1, respectively; p = 0.623) and differed for the RAS vs open groups (1.4 ± 1.0 vs 2.0 ± 1.9, respectively; p < 0.001). Conversion rates differed between RAS and laparoscopic groups (0.6% vs 4.9%; p = 0.004). The number of subjects reporting the need to take prescription pain medication through the 2-4 weeks visit differed between RAS vs open (65.2% vs 79.8%; p < 0.001) and RAS vs laparoscopic (65.2% vs 78.75%; p < 0.001). For those taking prescription pain medication, the mean number of pills taken was comparable for RAS vs open (23.3 vs 20.4; p = 0.079) and RAS vs laparoscopic (23.3 vs 23.3; p = 0.786). Times to return to normal activities and to work, complication rates and HerQLes QOL scores were comparable for the RAS vs open and RAS vs laparoscopic groups. The reoperation rate within 30 days post-procedure was comparable for RAS vs laparoscopic (0.6% vs 0%; p = 0.296) and differed for RAS vs open (0.6% vs 3.1%; p = 0.038). CONCLUSIONS Short-term outcomes indicate that open, laparoscopic, and robotic-assisted approaches are effective surgical approaches to VIH repair; however, each repair technique may demonstrate advantages in terms of clinical outcomes. Observed differences in the RAS vs laparoscopic comparison are longer operative time and lower conversion rate in the RAS group. Observed differences in the RAS vs open comparison are shorter LOS and lower reoperation rate through 30 days in the RAS group. The operative time in the RAS vs open comparison is similar. The number of subjects requiring the use of prescription pain medication favored the RAS group in both comparisons; however, among subjects reporting a need for pain medication, there was no difference in the number of prescription pain medication pills taken. While the study adds to the body of evidence evaluating the open, laparoscopic, and RAS approaches, future controlled studies are needed to better understand pain and QOL outcomes related to incisional hernia repair. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02715622.
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Affiliation(s)
- K A LeBlanc
- Our Lady of the Lake Regional Medical Center, 7777 Hennessy Blvd., Suite 612, Baton Rouge, LA, 70808, USA.
| | - A Gonzalez
- Baptist Health South Florida, Miami, FL, USA
| | - E Dickens
- Hillcrest Medical Center, Tulsa, OK, USA
| | - J Olsofka
- Louisville Surgical Associates, Louisville, KY, USA
| | | | - J-C Verdeja
- Baptist Health South Florida, Miami, FL, USA
| | - R Pierce
- Vanderbilt University Medical Center, Nashville, TN, USA
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Pérez-Segura P, Paz-Cabezas M, Núñez-Gil IJ, Arroyo-Espliguero R, Maroun Eid C, Romero R, Fernández Rozas I, Uribarri A, Becerra-Muñoz VM, García Aguado M, Huang J, Rondano E, Cerrato E, Rodríguez EA, Ortega-Armas ME, Raposeiras Roubin S, Pepe M, Feltes G, Gonzalez A, Cortese B, Buzón L, El-Battrawy I, Estrada V. Prognostic factors at admission on patients with cancer COVID-19: Analysis of hope registry data. Med Clin (Barc) 2021; 157:318-324. [PMID: 34154809 PMCID: PMC8101784 DOI: 10.1016/j.medcli.2021.02.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 02/08/2023]
Abstract
Background Previous works seem to agree in the higher mortality of cancer patients with COVID-19. Identifying potential prognostic factors upon admission could help identify patients with a poor prognosis. Methods We aimed to explore the characteristics and evolution of COVID-19 cancer patients admitted to hospital in a multicenter international registry (HOPE COVID-19). Our primary objective is to define those characteristics that allow us to identify cancer patients with a worse prognosis (mortality within 30 days after the diagnosis of COVID-19). Results 5838 patients have been collected in this registry, of whom 770 had cancer among their antecedents. In hospital mortality reached 258 patients (33.51%). The median was 75 years (65–82). Regarding the distribution by sex, 34.55% of the patients (266/770) were women. The distribution by type of cancer: genitourinary 238/745 (31.95%), digestive 124/745 (16.54%), hematologic 95/745 (12.75%). In multivariate regression analysis, factors that are independently associated with mortality at admission are: renal impairment (OR 3.45, CI 97.5% 1.85–6.58), heart disease (2.32, 1.47–3.66), liver disease (4.69, 1.94–11.62), partial dependence (2.41, 1.34–4.33), total dependence (7.21, 2.60–21.82), fatigue (1.84, 1.16–2.93), arthromialgias (0.45, 0.26–0.78), SatO2 < 92% (4.58, 2.97–7.17), elevated LDH (2.61, 1.51–4.69) and abnormal decreased Blood Pressure (3.57, 1.81–7.15). Analitical parameters are also significant altered. Conclusion In patients with cancer from the HOPE registry, 30-day mortality from any cause is high and is associated with easily identifiable clinical factors upon arrival at the hospital. Identifying these patients can help initiate more intensive treatments from the start and evaluate the prognosis of these patients.
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Affiliation(s)
| | - M Paz-Cabezas
- Medical Oncology Dpt. Hospital Clinico San Carlos, Madrid, Spain
| | | | | | - C Maroun Eid
- Hospital Universitario La Paz. Instituto de Investigación Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - R Romero
- Hospital Universitario Getafe, Madrid, Spain
| | | | - A Uribarri
- Hospital Clinico Universitario de Valladolid, Valladolid, Spain
| | | | - M García Aguado
- Hospital Puerta de Hierro de Majadahonda. Majadahonda, Madrid, Spain
| | - J Huang
- The Second Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - E Rondano
- Sant'Andrea Hospital, Vercelli, Italy
| | - E Cerrato
- San Luigi Gonzaga University Hospital, Orbassano and Rivoli Infermi Hospital, Rivoli, Turin, Italy
| | | | - M E Ortega-Armas
- Hospital General del Norte de Guayaquil IESS Los Ceibos, Guayaquil, Ecuador
| | | | - M Pepe
- Azienda ospedaliero-universitaria consorziale policlinico di Bari, Bari, Italy
| | - G Feltes
- Nuestra Señora de América, Madrid, Spain
| | - A Gonzalez
- Hospital Universitario Infanta Sofia. San Sebastian de los Reyes, Madrid, Spain
| | | | - L Buzón
- Hospital Universitario de Burgos, Burgos, Spain
| | - I El-Battrawy
- First Department of Medicine, Medical Faculty Mannheim, University Heidelberg, Mannheim, 68167, Germany, DZHK (German Center for Cardiovascular Research), Partner Site, Heidelberg-Mannheim, Mannheim, Germany
| | - V Estrada
- Hospital Clinico San Carlos, Madrid, Spain
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Deosaran AP, Zeglam A, Wilson MK, Gonzalez A, Gray MJ. A 57-year-old man with leukocytosis and sphenoid sinus disease. Digit J Ophthalmol 2021; 26:17-20. [PMID: 33867877 DOI: 10.5693/djo.03.2019.09.003] [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: 11/20/2022]
Affiliation(s)
- Ansuya P Deosaran
- Department of Ophthalmology, Louisiana State University, New Orleans
| | - Ahmaida Zeglam
- Department of Ophthalmology, University of Florida, Gainesville
| | - Mary K Wilson
- College of Medicine, University of Florida, Gainesville
| | - Andres Gonzalez
- Department of Ophthalmology, University of Florida, Gainesville
| | - Matthew J Gray
- Department of Ophthalmology, University of Florida, Gainesville
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Martínez Y, Gonzalez A, Botello A, Perez K. Effect of a Combination of Propionic-Acetic Acid on Body Weight, Relative Weight of Some Organs, Lactic Acid Bacteria and Intestinal pH of Neonatal Broilers. Braz J Poult Sci 2021. [DOI: 10.1590/1806-9061-2020-1252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Y Martínez
- Escuela Agrícola Panamericana Zamorano, Honduras
| | - A Gonzalez
- Escuela Agrícola Panamericana Zamorano, Honduras
| | - A Botello
- Universidad Técnica “Luis Vargas Torres” de Esmeraldas, Ecuador
| | - K Perez
- Universidad Técnica “Luis Vargas Torres” de Esmeraldas, Ecuador
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Ritz M, Gonzalez A, Fries AS, Scheu T, Blad-Stahl N, Kotarski F, Schuler G, Koch C, Wrenzycki C. 38 Developmental competence of bovine cumulus–oocyte complexes collected from cows fed rumen-protected methionine and lysine. Reprod Fertil Dev 2021. [DOI: 10.1071/rdv33n2ab38] [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
Supplementation of rumen-protected amino acids (RPAA) has proven to be an effective tool to supply limiting AA in dairy diets. Methionine and lysine are the two most limiting AA for lactating dairy cows. Recently, it has been shown that methionine supplementation seems to affect pre-implantation embryos collected from superovulated cows enhancing their developmental competence because there is strong evidence that endogenous lipid reserves serve as an energy substrate (Acosta et al. 2016 Theriogenology 85, 1669–1679). Moreover, higher concentrations of methionine were determined in the follicular fluid of the first dominant follicle postpartum in cows supplemented with rumen-protected methionine and rumen-protected choline from 21 days before calving to 30 days postpartum and it was assumed that higher methionine concentrations in the follicular fluid could affect oocyte quality (Acosta et al. 2017 Theriogenology 96, 1–9). There is no information available so far regarding the effect of a combined methionine and lysine supplementation (each rumen-protected) on oocyte quality. Therefore, the objective of this study was to evaluate the effect of a combined methionine and lysine supplementation during early to mid-lactation on the developmental competence of oocytes collected from lactating dairy cows (days 0 to 100 p.p.). Thirty pregnant multiparous German Holstein dairy cows were grouped 3 weeks before their expected calving date, receiving identical diets. After calving, they were randomly allocated to 2 groups fed a total mixed ration supplemented with (N=14 cows; RPAA) or without (N=16 cows; CON) LysiGEMTM (encapsulated lysine; Kemin Industries) and Metasmart DryTM (isopropyl ester of the hydroxylated analogue of methionine adsorbed onto a silicon dioxide carrier; Adisseo). Starting from 45 days p.p., animals from both groups were submitted to an ovum pickup (OPU) session once a week for at least 8 weeks. Collected cumulus–oocyte complexes (COC) were subjected to a standard invitro production (IVP) protocol (Stinshoff et al. 2014 Reprod. Fertil. Dev. 26, 502–10) including IVM, IVF, and invitro culture (IVC). Cleavage and developmental rates up to the morula/blastocyst stage were recorded on Days 3, 7, and 8. In total, 1211 follicles have been aspirated from RPAA animals compared with 1413 from CON animals, from which 742 and 885 COC were collected, respectively. The calculated recovery rate based on the number of aspirated follicles and collected COC was similar for both groups (61.3±29.4% vs. 62.6±33.5%). Cleavage and developmental rates based on 240 (RPAA group) and 299 (CON group) COC also showed similar results [RPAA: 84.1±5.9% (202/240), 18.3±4.4% (44/240), 18.8±4.7% (45/240); CON: 81.9±8.6% (245/299), 15.4±8.9% (46/299), 16.7±8.4% (50/299)]. In conclusion, supplementation of RPAA (methionine and lysine) had no beneficial effect on the developmental competence of COC obtained from these animals compared with those collected from cows fed the diet without RPAA supplementation.
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Meler E, Mazarico E, Eixarch E, Gonzalez A, Peguero A, Martinez J, Boada D, Vellvé K, Gomez-Roig MD, Gratacós E, Figueras F. Ten-year experience of protocol-based management of small-for-gestational-age fetuses: perinatal outcome in late-pregnancy cases diagnosed after 32 weeks. Ultrasound Obstet Gynecol 2021; 57:62-69. [PMID: 33159370 DOI: 10.1002/uog.23537] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/17/2020] [Accepted: 10/20/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To report our 10-year experience of protocol-based management of small-for-gestational-age (SGA) fetuses, based on standardized clinical and Doppler criteria, in late-pregnancy cases. METHODS A retrospective cohort was constructed of consecutive singleton pregnancies referred for late-onset (> 32 weeks) SGA (defined as estimated fetal weight (EFW) < 10th centile) that were classified as fetal growth restriction (FGR) or low-risk SGA, based on the severity of smallness (EFW < 3rd centile) and the presence of Doppler abnormalities (uterine artery pulsatility index (UtA-PI) ≥ 95th centile or cerebroplacental ratio (CPR) < 5th centile). Low-risk SGA pregnancies were followed at 2-week intervals and delivered electively at 40 weeks. FGR pregnancies were followed at 1-week intervals, or more frequently if there were signs of fetal deterioration, and were delivered electively after 37 + 0 weeks' gestation. The occurrence of stillbirth and composite adverse outcome (CAO; defined as neonatal death, metabolic acidosis, need for endotracheal intubation or need for admission to the neonatal intensive care unit) was analyzed in low-risk SGA and FGR pregnancies. RESULTS A total of 1197 pregnancies with EFW < 10th centile were identified and classified at diagnosis as low-risk SGA (n = 619; 51.7%) or FGR (n = 578; 48.3%). Of these, 160 were delivered before 37 weeks' gestation; for obstetric reasons in 93 (58.1%) cases, severe pre-eclampsia in 33 (20.6%), FGR with severe hypoxia in 47 (29.4%) and stillbirth in four (2.5%) (indications are non-exclusive). During follow-up, 52/574 (9.1%) low-risk SGA pregnancies were reclassified as FGR, whereas 22/463 (4.8%) FGR pregnancies were reclassified as low-risk SGA. Overall, there were no stillbirths in the low-risk SGA group and four in the FGR group, all of which occurred before 37 weeks. There were no instances of neonatal death in pregnancies delivered ≥ 37 weeks. The risk of CAO was higher in those meeting antenatal criteria for FGR at 37 weeks than in those classified as low-risk SGA (32/493 (6.5%) vs 15/544 (2.8%); odds ratio, 2.5 (95% CI, 1.3-4.6)). In FGR pregnancies, the adjusted odds ratio (95% CI) for CAO was 6.3 (1.8-21.1) in those with EFW < 3rd centile, while it was 3.2 (1.5-6.8) and 4.2 (1.9-8.9) in those with UtA-PI ≥ 95th centile and CPR < 5th centile, respectively, as compared to FGR pregnancies without each of these criteria. CONCLUSION Protocol-based risk stratification with different management and monitoring schemes for late pregnancy with a suspected SGA baby, based on clinical and Doppler criteria, enables identification and tailored assessment of high-risk FGR, while allowing expectant management with safe perinatal outcome for low-risk SGA fetuses. Copyright © 2020 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- E Meler
- Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, IDIBAPS, University of Barcelona, Barcelona, Spain
- Center for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - E Mazarico
- Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, IDIBAPS, University of Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu (IR-SJD), Barcelona, Spain
- Maternal and Child Health Development Network, RETICS, Research Institute Carlos III, Spanish Ministry of Economy and Competitiveness, Madrid, Spain
| | - E Eixarch
- Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, IDIBAPS, University of Barcelona, Barcelona, Spain
- Center for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - A Gonzalez
- Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, IDIBAPS, University of Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu (IR-SJD), Barcelona, Spain
| | - A Peguero
- Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, IDIBAPS, University of Barcelona, Barcelona, Spain
- Center for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - J Martinez
- Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, IDIBAPS, University of Barcelona, Barcelona, Spain
- Center for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - D Boada
- Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, IDIBAPS, University of Barcelona, Barcelona, Spain
- Center for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - K Vellvé
- Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, IDIBAPS, University of Barcelona, Barcelona, Spain
- Center for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - M D Gomez-Roig
- Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, IDIBAPS, University of Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu (IR-SJD), Barcelona, Spain
- Maternal and Child Health Development Network, RETICS, Research Institute Carlos III, Spanish Ministry of Economy and Competitiveness, Madrid, Spain
| | - E Gratacós
- Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, IDIBAPS, University of Barcelona, Barcelona, Spain
- Center for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
| | - F Figueras
- Barcelona Center for Maternal-Fetal and Neonatal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, IDIBAPS, University of Barcelona, Barcelona, Spain
- Center for Biomedical Research on Rare Diseases (CIBER-ER), Madrid, Spain
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Gordon B, Buendia Fuentes F, Dos L, Miranda B, Osa A, Gonzalez A, Gallego P, Meras P, Adsuar A, Rodriguez M, Montserrat S, Carbonell B, Oliver J, Rueda J. Clinical features and outcomes of adult patients with single ventricle physiology not undergoing Fontan repair. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2179] [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: 11/14/2022] Open
Abstract
Abstract
Background
Adult patients with single ventricle (SV) physiology who had not undergone Fontan palliation are uncommon. Little is known about their clinical features and outcomes.
Objective
This study aims to describe the clinical features, cardiovascular outcomes and long-term survival of patients with SV physiology without Fontan palliation.
Methods
Data were collected retrospectively from SV physiology patients followed in adult congenital heart disease (ACHD) units of five tertiary referral centers. None of them had Fontan palliation. Baseline data were recorded on the first visit at ACHD unit. Death was considered as main endpoint. Other outcomes such as atrial or ventricular arrhythmias, endocarditis, ICD or pacemaker implantation, admission for heart failure and heart transplant were also collected and analyzed. Association between clinical/analytical baseline variables and death was also evaluated by univariate Cox regression.
Results
128 patients were included. On the first visit, mean age was 32.3±10.9 years, being the most common defect double inlet left ventricle (63p, 49.2%). The single ventricle had left morphology in 106 cases (82.8%). At baseline mean heaemglobin was 19.1±2.8 g/dl, mean O2 Sat 83±6.9% and 46 patients (36%) had a NYHA status III or IV. 4 different groups were found: a) Unrestricted pulmonary flow with Eisenmenger physiology (24p, 18.8%); b) Restricted forward pulmonary flow with or without pulmonary banding (46p, 35.9%); c) Aortopulmonary shunts as a source of pulmonary flow (20p, 15.5%) and d) cavopulmonary shunt (Glenn) as a definitive palliation (38p, 29.7%). After 7.3±4.1 years follow-up, mortality was 22.7% (29 patients), being sudden death (9p, 7%) the most frequent cause. Survival rate at 5 and 10 years of follow-up were 85% and 76% respectively (Figure 1). About of the rest of the outcomes, highlighting a high rate of atrial tachycardia (38.3%), admission for heart failure (23.4%), stroke (17.2%), endocarditis (9.4%), pacemaker/ICD implantation (11.8%). Baseline variables associated with higher mortality were: older age (HR=1.1 [1.004–1–087]); NYHA III or IV (HR=5.5 [2.4–12.4]); thrombocytopenia (HR=1.01 [1.001–1.003]); anticoagulant treatment (HR=2.6 [1.7–3.9]); glomerular filtration rate below 60 ml/min (HR=3.77 [1.5–9.6]); QRS width (HR=1.03 [1.01–1.05]); atrial arrhythmias (HR=3.1 [1.5–6.5]); moderate or severe AV valve regurgitation (HR=1.5 [1.15–1.97]) and ventricular ejection fraction (HR=0.94 [0.91-0.97]).
Conclusions
Adults survivors with SV physiology without Fontan palliation have a high mortality and frequently suffer from serious cardiovascular events. Several clinical (NYHA status, previous atrial arrhythmias, anticoagulant treatment), analytical (renal function, thrombocytopenia), ECG (QRS width) and echocardiography (AV valve regurgitation and EF) factors can identify patients at higher risk of death.
Figure 1. Survival curve
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- B Gordon
- University Hospital Vall d'Hebron, Barcelona, Spain
| | | | - L Dos
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - B Miranda
- University Hospital Vall d'Hebron, Barcelona, Spain
| | - A Osa
- Hospital Universitario y Politecnico La Fe, Valencia, Spain
| | - A Gonzalez
- University Hospital La Paz, Madrid, Spain
| | - P Gallego
- Complex Public Hospital Virgen del Rocio Regional, Sevilla, Spain, Spain
| | - P Meras
- University Hospital La Paz, Madrid, Spain
| | - A Adsuar
- Complex Public Hospital Virgen del Rocio Regional, Sevilla, Spain, Spain
| | - M.J Rodriguez
- Complex Public Hospital Virgen del Rocio Regional, Sevilla, Spain, Spain
| | | | | | - J.M Oliver
- University Hospital Gregorio Maranon, Madrid, Spain
| | - J Rueda
- Hospital Universitario y Politecnico La Fe, Valencia, Spain
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Abellas Sequeiros M, Garcia Martin A, Gonzalez A, Hinojar Baydes R, Rincon Diaz L, Vieitez Florez J, Lorente Ros A, Pardo Sanz A, Manjon Rubio H, Pascual Izco M, Moya Mur J, Casas E, Jimenez Nacher J, Zamorano J, Fernandez Golfin C. Asymptomatic aortic regurgitation: diastolic function and type-B natriuretic peptide as prognostic factors. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0055] [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
Introduction
The indication of valve replacement surgery in patients with severe aortic regurgitation (AR) is mainly based on the presence of symptoms or dilatation/dysfunction of the left ventricle (LV). However, diastolic function and natriuretic peptides have not been related to adverse outcomes in these patients. The aim of this study was to evaluate the prognosis impact of different diastolic function parameters as well as type-B natriuretic peptide (BNP).
Methods
Patients with moderate to severe or severe AR evaluated in the Heart Valve Clinic between 2013–2019 were evaluated. Those patients with classical indications for surgical aortic valve replacement (SAVR) at the moment of inclusion were excluded, as well as those patients with atrial fibrillation. Echocardiographic and analytical data were obtained from the medical history. End-point included cardiovascular mortality, SAVR and heart failure.
Results
A total of 126 patients were included. Median age was 65.0±17.7 years. Among them, 75 (59.5%) were men, 78 (62.4%) hypertensive, 44 (35.3%) suffered from dyslipidemia and 11 (9,6%) had ischaemic cardiomyopathy. During a median follow up of 31±17 months, 24.6% of the patients reached the combined end-point (n=5 developed heart failure, n=28 underwent SAVR, and n=4 died).
Among the diastolic parameters [E wave, A wave, E/A, E/e', left atrial volume and diameter, tricuspid regurgitation (TR) degree and pulmonary systolic pressure (PSP)], only TR degree and PSP were associated with a higher incidence of the combined endpoint: TR degree HR=2,08, p=0,039 and PSP HR= 1,1, p=0,007. BNP also showed prognostic impact for the combined endpoint (HR= 1,002, p=0,011).
Conclusions
In patients with asymptomatic significant AR, severity of TR, PSP and BNP levels are associated with worst prognosis. However, classical echocardiographic diastolic parameters do not show prognosis impact, probably due to the limitations of such parameters to identify diastolic dysfunction and high filling pressures in this population. Our findings support the use of PSP and TR over diastolic function parameters to better stratify left valvular patient risk in clinical practice.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | | | - A Gonzalez
- University Hospital Ramon y Cajal de Madrid, Madrid, Spain
| | | | | | | | - A Lorente Ros
- University Hospital Ramon y Cajal de Madrid, Madrid, Spain
| | - A Pardo Sanz
- University Hospital Ramon y Cajal de Madrid, Madrid, Spain
| | - H Manjon Rubio
- University Hospital Ramon y Cajal de Madrid, Madrid, Spain
| | - M Pascual Izco
- University Hospital Ramon y Cajal de Madrid, Madrid, Spain
| | - J.L Moya Mur
- University Hospital Ramon y Cajal de Madrid, Madrid, Spain
| | - E Casas
- University Hospital Ramon y Cajal de Madrid, Madrid, Spain
| | | | - J.L Zamorano
- University Hospital Ramon y Cajal de Madrid, Madrid, Spain
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Gomez-Iturriaga A, Büchser D, Miguel IS, Marban M, Urresola A, Ezquerro A, Gil A, Suarez F, Gonzalez A, Mairata E, Martinez-Indart L, Cacicedo J, Couñago F, Mínguez P, Casquero F. MRI detected extaprostatic extension (EPE) in prostate cancer: Do all T3a patients have the same outcomes? Clin Transl Radiat Oncol 2020; 24:135-139. [PMID: 32875127 PMCID: PMC7451735 DOI: 10.1016/j.ctro.2020.08.002] [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: 07/30/2020] [Accepted: 08/11/2020] [Indexed: 10/31/2022] Open
Abstract
MRI-detected T3a prostate cancer is a heterogeneous disease. This post-hoc analysis of a prospective trial found that patients with T3a disease presenting obliteration of the recto-prostatic angle, contact-asymmetry of neuro-vascular bundle and periprostatic fat invasion, may be at higher risk of biochemical failure and metastases.
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Affiliation(s)
- A Gomez-Iturriaga
- Hospital Universitario Cruces/Biocruces Bizkaia Health Research Institute, Radiation Oncology, Barakaldo, Spain
| | - D Büchser
- Hospital Universitario Cruces/Biocruces Bizkaia Health Research Institute, Radiation Oncology, Barakaldo, Spain
| | - I San Miguel
- Hospital Universitario Cruces/Biocruces Bizkaia Health Research Institute, Radiation Oncology, Barakaldo, Spain
| | - M Marban
- Hospital Universitario Cruces/Biocruces Bizkaia Health Research Institute, Radiation Oncology, Barakaldo, Spain.,Hospital Universitario Cruces/Biocruces Bizkaia Health Research Institute, Radiation Oncology, Barakaldo, Spain
| | - A Urresola
- Hospital Universitario Cruces/Biocruces Bizkaia Health Research Institute, Radiation Oncology, Barakaldo, Spain
| | - A Ezquerro
- Hospital Universitario Cruces/Biocruces Bizkaia Health Research Institute, Radiation Oncology, Barakaldo, Spain
| | - A Gil
- Hospital Universitario Cruces/Biocruces Bizkaia Health Research Institute, Radiation Oncology, Barakaldo, Spain
| | - F Suarez
- Hospital Universitario Cruces/Biocruces Bizkaia Health Research Institute, Radiation Oncology, Barakaldo, Spain
| | - A Gonzalez
- Hospital Universitario Cruces/Biocruces Bizkaia Health Research Institute, Radiation Oncology, Barakaldo, Spain
| | - E Mairata
- Hospital Universitario Cruces/Biocruces Bizkaia Health Research Institute, Radiation Oncology, Barakaldo, Spain
| | - L Martinez-Indart
- Hospital Universitario Cruces/Biocruces Health Research Institute, Clinical Epidemiology Unit, Barakaldo, Spain
| | - J Cacicedo
- Hospital Universitario Cruces/Biocruces Bizkaia Health Research Institute, Radiation Oncology, Barakaldo, Spain
| | - F Couñago
- Department of Radiation Oncology, Hospital Universitario Quirón salud Madrid, 28223 Pozuelo de Alarcón, Madrid, Spain
| | - P Mínguez
- Hospital Universitario Cruces/Biocruces Bizkaia Health Research Institute, Radiation Oncology, Barakaldo, Spain
| | - F Casquero
- Hospital Universitario Cruces/Biocruces Bizkaia Health Research Institute, Radiation Oncology, Barakaldo, Spain
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40
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Gonzalez A, Agarwal-Sinha S. Fluorescein angiographic features post-intravitreal bevacizumab for retinopathy of prematurity: can they support rescue laser photocoagulation to the avascular retina. Can J Ophthalmol 2020; 55:373-381. [PMID: 32835673 DOI: 10.1016/j.jcjo.2020.05.017] [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] [Received: 02/02/2020] [Revised: 03/30/2020] [Accepted: 05/21/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To study the fluorescein angiography (FA) features post-intravitreal bevacizumab (post-IVB) monotherapy for retinopathy of prematurity (ROP) that may pose risk for late sight-threatening ROP and support rescue laser to the avascular retina. METHODS A retrospective review of 26 infants (47 eyes) with type 1 ROP treated with IVB monotherapy. RESULTS All infants had RetCam and FA performed at an average of 68 weeks postmenstrual age (PMA), 19 at an average 98 weeks PMA, and 10 at an average of 120 weeks PMA. Average gestational age at birth and birth weight were 24.8 weeks (standard deviation [SD] 1.91 weeks) and 683 g (SD 158.85 g), respectively. Average PMA at first IVB was 37 weeks. Eight eyes of 6 infants received repeat IVB for recurrent stage 3 at an average of 46.6 weeks PMA. All infants had inhibited retinal vasculature in zone 2, and 25 of 26 had conventional FA features, which included peripheral leakage, shunts, abnormal branching, and tangles with no late reactivation of ROP until age 3 years. Only 1 infant showed diffuse hyperfluorescence along the regressed proliferation site with a late proliferation necessitating laser to preserve vision. CONCLUSIONS Conventional FA features seen in 98% post-IVB monotherapy showed no late complications without rescue laser photocoagulation to the avascular retina.
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Affiliation(s)
- Andres Gonzalez
- Department of Ophthalmology, University of Florida, Gainesville, FL
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41
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Angelopoulos V, Tsai E, Bingley L, Shaffer C, Turner DL, Runov A, Li W, Liu J, Artemyev AV, Zhang XJ, Strangeway RJ, Wirz RE, Shprits YY, Sergeev VA, Caron RP, Chung M, Cruce P, Greer W, Grimes E, Hector K, Lawson MJ, Leneman D, Masongsong EV, Russell CL, Wilkins C, Hinkley D, Blake JB, Adair N, Allen M, Anderson M, Arreola-Zamora M, Artinger J, Asher J, Branchevsky D, Capitelli MR, Castro R, Chao G, Chung N, Cliffe M, Colton K, Costello C, Depe D, Domae BW, Eldin S, Fitzgibbon L, Flemming A, Fox I, Frederick DM, Gilbert A, Gildemeister A, Gonzalez A, Hesford B, Jha S, Kang N, King J, Krieger R, Lian K, Mao J, McKinney E, Miller JP, Norris A, Nuesca M, Palla A, Park ESY, Pedersen CE, Qu Z, Rozario R, Rye E, Seaton R, Subramanian A, Sundin SR, Tan A, Turner W, Villegas AJ, Wasden M, Wing G, Wong C, Xie E, Yamamoto S, Yap R, Zarifian A, Zhang GY. The ELFIN Mission. Space Sci Rev 2020; 216:103. [PMID: 32831412 PMCID: PMC7413588 DOI: 10.1007/s11214-020-00721-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/09/2020] [Indexed: 06/11/2023]
Abstract
The Electron Loss and Fields Investigation with a Spatio-Temporal Ambiguity-Resolving option (ELFIN-STAR, or heretoforth simply: ELFIN) mission comprises two identical 3-Unit (3U) CubeSats on a polar (∼93∘ inclination), nearly circular, low-Earth (∼450 km altitude) orbit. Launched on September 15, 2018, ELFIN is expected to have a >2.5 year lifetime. Its primary science objective is to resolve the mechanism of storm-time relativistic electron precipitation, for which electromagnetic ion cyclotron (EMIC) waves are a prime candidate. From its ionospheric vantage point, ELFIN uses its unique pitch-angle-resolving capability to determine whether measured relativistic electron pitch-angle and energy spectra within the loss cone bear the characteristic signatures of scattering by EMIC waves or whether such scattering may be due to other processes. Pairing identical ELFIN satellites with slowly-variable along-track separation allows disambiguation of spatial and temporal evolution of the precipitation over minutes-to-tens-of-minutes timescales, faster than the orbit period of a single low-altitude satellite (Torbit ∼ 90 min). Each satellite carries an energetic particle detector for electrons (EPDE) that measures 50 keV to 5 MeV electrons with Δ E/E < 40% and a fluxgate magnetometer (FGM) on a ∼72 cm boom that measures magnetic field waves (e.g., EMIC waves) in the range from DC to 5 Hz Nyquist (nominally) with <0.3 nT/sqrt(Hz) noise at 1 Hz. The spinning satellites (Tspin ∼ 3 s) are equipped with magnetorquers (air coils) that permit spin-up or -down and reorientation maneuvers. Using those, the spin axis is placed normal to the orbit plane (nominally), allowing full pitch-angle resolution twice per spin. An energetic particle detector for ions (EPDI) measures 250 keV - 5 MeV ions, addressing secondary science. Funded initially by CalSpace and the University Nanosat Program, ELFIN was selected for flight with joint support from NSF and NASA between 2014 and 2018 and launched by the ELaNa XVIII program on a Delta II rocket (with IceSatII as the primary). Mission operations are currently funded by NASA. Working under experienced UCLA mentors, with advice from The Aerospace Corporation and NASA personnel, more than 250 undergraduates have matured the ELFIN implementation strategy; developed the instruments, satellite, and ground systems and operate the two satellites. ELFIN's already high potential for cutting-edge science return is compounded by concurrent equatorial Heliophysics missions (THEMIS, Arase, Van Allen Probes, MMS) and ground stations. ELFIN's integrated data analysis approach, rapid dissemination strategies via the SPace Environment Data Analysis System (SPEDAS), and data coordination with the Heliophysics/Geospace System Observatory (H/GSO) optimize science yield, enabling the widest community benefits. Several storm-time events have already been captured and are presented herein to demonstrate ELFIN's data analysis methods and potential. These form the basis of on-going studies to resolve the primary mission science objective. Broad energy precipitation events, precipitation bands, and microbursts, clearly seen both at dawn and dusk, extend from tens of keV to >1 MeV. This broad energy range of precipitation indicates that multiple waves are providing scattering concurrently. Many observed events show significant backscattered fluxes, which in the past were hard to resolve by equatorial spacecraft or non-pitch-angle-resolving ionospheric missions. These observations suggest that the ionosphere plays a significant role in modifying magnetospheric electron fluxes and wave-particle interactions. Routine data captures starting in February 2020 and lasting for at least another year, approximately the remainder of the mission lifetime, are expected to provide a very rich dataset to address questions even beyond the primary mission science objective.
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Affiliation(s)
- V Angelopoulos
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - E Tsai
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - L Bingley
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - C Shaffer
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Tyvak Nano-Satellite Systems, Inc., Irvine, CA 92618 USA
| | - D L Turner
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723 USA
| | - A Runov
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - W Li
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Department of Astronomy and Center for Space Physics, Boston University, Boston, MA 02215 USA
| | - J Liu
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - A V Artemyev
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - X-J Zhang
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - R J Strangeway
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - R E Wirz
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - Y Y Shprits
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- GFZ German Research Centre for Geosciences, Potsdam, 14473 Germany
| | - V A Sergeev
- Saint Petersburg State University, St. Petersburg, 199034 Russia
| | - R P Caron
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - M Chung
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723 USA
| | - P Cruce
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - W Greer
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - E Grimes
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - K Hector
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Raytheon Space and Airborne Systems, El Segundo, CA 90245 USA
| | - M J Lawson
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - D Leneman
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - E V Masongsong
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - C L Russell
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - C Wilkins
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - D Hinkley
- The Aerospace Corporation, El Segundo, CA 90245 USA
| | - J B Blake
- The Aerospace Corporation, El Segundo, CA 90245 USA
| | - N Adair
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Millenium Space Systems, El Segundo, CA 90245 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - M Allen
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - M Anderson
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Aptiv, Agoura Hills, CA 91301 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - M Arreola-Zamora
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - J Artinger
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
| | - J Asher
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Johns Hopkins University Applied Physics Laboratory, Laurel, MD 20723 USA
| | - D Branchevsky
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- The Aerospace Corporation, El Segundo, CA 90245 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - M R Capitelli
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Millenium Space Systems, El Segundo, CA 90245 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - R Castro
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Raytheon Space and Airborne Systems, El Segundo, CA 90245 USA
| | - G Chao
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: The Boeing Company, Long Beach, CA 90808 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - N Chung
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: SF Motors, Santa Clara, CA 95054 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - M Cliffe
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: SpaceX, Hawthorne, CA 90250 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - K Colton
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Planet Labs, Inc., San Francisco, CA 94107 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - C Costello
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - D Depe
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - B W Domae
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - S Eldin
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - L Fitzgibbon
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Tyvak Nano-Satellite Systems, Inc., Irvine, CA 92618 USA
| | - A Flemming
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - I Fox
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - D M Frederick
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Millenium Space Systems, El Segundo, CA 90245 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - A Gilbert
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - A Gildemeister
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - A Gonzalez
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: SpaceX, Hawthorne, CA 90250 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - B Hesford
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Jet Propulsion Laboratory, Pasadena, CA 91109 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - S Jha
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - N Kang
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Millenium Space Systems, El Segundo, CA 90245 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - J King
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - R Krieger
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Mercedes-Benz Research and Development North America, Long Beach, CA 90810 USA
| | - K Lian
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - J Mao
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Verona, WI 53593 USA
| | - E McKinney
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: California State Polytechnic University, Pomona, CA 91768 USA
| | - J P Miller
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - A Norris
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
| | - M Nuesca
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - A Palla
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - E S Y Park
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Economics Department, University of California, Los Angeles, CA 90095 USA
| | - C E Pedersen
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - Z Qu
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - R Rozario
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: SpaceX, Hawthorne, CA 90250 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - E Rye
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - R Seaton
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - A Subramanian
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - S R Sundin
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Tyvak Nano-Satellite Systems, Inc., Irvine, CA 92618 USA
| | - A Tan
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Experior Laboratories, Oxnard, CA 93033 USA
| | - W Turner
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
| | - A J Villegas
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
| | - M Wasden
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - G Wing
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - C Wong
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
| | - E Xie
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - S Yamamoto
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - R Yap
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Mathematics Department, University of California, Los Angeles, CA 90095 USA
| | - A Zarifian
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Jet Propulsion Laboratory, Pasadena, CA 91109 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
| | - G Y Zhang
- Earth, Planetary, and Space Sciences Department, University of California, Los Angeles, CA 90095 USA
- Institute of Geophysics and Planetary Physics, University of California, San Diego, CA USA
- Present Address: Qualcomm, San Diego, CA 92121 USA
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Peguero A, Fernandez-Blanco L, Mazarico E, Benitez L, Gonzalez A, Youssef L, Crispi F, Hernandez S, Figueras F. Added prognostic value of longitudinal changes of angiogenic factors in early-onset severe pre-eclampsia: a prospective cohort study. BJOG 2020; 128:158-165. [PMID: 32593222 DOI: 10.1111/1471-0528.16383] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 06/04/2020] [Accepted: 06/11/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To assess in women with early-onset severe pre-eclampsia whether longitudinal changes in angiogenic factors improve the prediction of adverse outcome. DESIGN Prospective cohort study. SETTING Maternity units in two Spanish hospitals. POPULATION Women with diagnosis of early-onset severe pre-eclampsia. METHODS Levels of placental growth factor (PlGF), soluble fms-like tyrosine kinase (sFlt-) and sFlt-1/PlGF ratio were measured at admission and before delivery, and average daily change calculated. The association of longitudinal changes of angiogenic factors with the time interval to delivery and with complications was evaluated by logistic and Cox regression. MAIN OUTCOME MEASURES Interval to delivery and composite of adverse outcomes. RESULTS We included 63 women, of which 26 (41.3%) had a complication. Longitudinal changes of sFlt-1 were more pronounced in complicated pregnancies (median: 1047 versus 342 pg/ml/day; P = 0.04). On the multivariate analysis, the clinical risk score and sFlt-1 at admission explained 6.2% of the uncertainty for complication; the addition of sFlt-1 longitudinal changes improved this to 25.3% (P = 0.002). The median time from admission to delivery was 4 days (95% CI 1.6-6.04) in those in the highest quartile of sFlt-1 longitudinal changes versus 16 days (95% CI 12.4-19.6) in the remaining women (Log-rank test P < 0.001). CONCLUSIONS Longitudinal changes in sFlt-1 maternal levels from admission for confirmed early-onset severe pre-eclampsia add to baseline characteristics in the prediction of adverse outcome and interval to delivery. TWEETABLE ABSTRACT In early-onset severe pre-eclampsia, longitudinal changes in sFlt-1 levels improve the prediction of complications and interval to delivery.
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Affiliation(s)
- A Peguero
- BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut Clínic de Ginecologia, Obstetrícia i Neonatologia Fetal i+D Fetal Medicine Research Center, Barcelona, Spain
| | - L Fernandez-Blanco
- BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut Clínic de Ginecologia, Obstetrícia i Neonatologia Fetal i+D Fetal Medicine Research Center, Barcelona, Spain
| | - E Mazarico
- BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut Clínic de Ginecologia, Obstetrícia i Neonatologia Fetal i+D Fetal Medicine Research Center, Barcelona, Spain
| | - L Benitez
- BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut Clínic de Ginecologia, Obstetrícia i Neonatologia Fetal i+D Fetal Medicine Research Center, Barcelona, Spain
| | - A Gonzalez
- BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut Clínic de Ginecologia, Obstetrícia i Neonatologia Fetal i+D Fetal Medicine Research Center, Barcelona, Spain
| | - L Youssef
- BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut Clínic de Ginecologia, Obstetrícia i Neonatologia Fetal i+D Fetal Medicine Research Center, Barcelona, Spain
| | - F Crispi
- BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut Clínic de Ginecologia, Obstetrícia i Neonatologia Fetal i+D Fetal Medicine Research Center, Barcelona, Spain
| | - S Hernandez
- BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut Clínic de Ginecologia, Obstetrícia i Neonatologia Fetal i+D Fetal Medicine Research Center, Barcelona, Spain
| | - F Figueras
- BCNatal, Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Déu), Institut Clínic de Ginecologia, Obstetrícia i Neonatologia Fetal i+D Fetal Medicine Research Center, Barcelona, Spain
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Fayne R, Castillo D, Sanchez N, Burroway B, Nanda S, De Bedout V, Stratman S, Rosen J, Darwin E, Nagrani N, Gonzalez A, Paul S, Maderal A, Elgart G, Kirsner R, Nichols A. Dermatology consultation service at a large metropolitan hospital system serving minority populations. J Eur Acad Dermatol Venereol 2020; 34:2120-2126. [DOI: 10.1111/jdv.16565] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 04/03/2020] [Indexed: 11/30/2022]
Affiliation(s)
- R. Fayne
- Dr. Philip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - D.E. Castillo
- Dr. Philip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - N. Sanchez
- Dr. Philip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - B. Burroway
- Dr. Philip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - S. Nanda
- Dr. Philip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - V. De Bedout
- Dr. Philip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - S. Stratman
- Dr. Philip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - J. Rosen
- Dr. Philip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - E. Darwin
- Dr. Philip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - N. Nagrani
- Dr. Philip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - A. Gonzalez
- Dr. Philip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - S. Paul
- Dr. Philip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - A. Maderal
- Dr. Philip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - G. Elgart
- Dr. Philip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - R. Kirsner
- Dr. Philip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
| | - A. Nichols
- Dr. Philip Frost Department of Dermatology and Cutaneous Surgery University of Miami Miller School of Medicine Miami FL USA
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Amin SM, Gonzalez A, Guevara J, Bolch C, Andersen L, Smith WC, Agarwal-Sinha S. Efficacy of Aflibercept Treatment and Its Effect on the Retinal Perfusion in the Oxygen-Induced Retinopathy Mouse Model of Retinopathy of Prematurity. Ophthalmic Res 2020; 64:91-98. [PMID: 32535604 DOI: 10.1159/000509380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 06/12/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Bevacizumab and ranibizumab, which are anti-vascular endothelial growth factor (VEGF) medications, are used frequently in the treatment for retinopathy of prematurity (ROP) in infants. Aflibercept, or VEGF Trap, has been used anecdotally, but translation and clinical studies are lacking. OBJECTIVE This study investigates the efficacy of aflibercept at reducing areas of non-perfused retina and studies its effect on normal angiogenesis in the oxygen-induced retinopathy mouse model of ROP. METHODS C57BL/6 J mice were assigned to room air control (n = 21 eyes) or hyperoxia with 75% oxygen (n = 84 eyes). The hyperoxic mice were assigned to 1 of 3 groups: 0 ng (n = 14 eyes), 100 ng (n = 35 eyes), or 1,000 ng (n = 35 eyes) of intravitreal aflibercept administered on postnatal day 14. Eyes were enucleated at PN17 and PN25 postinjection. Retinas were stained with anti-collagen IV antibody and photographed with microscopy. Areas of perfused and non-perfused retina were quantified using ImageJ software. Statistical comparisons were made using ANOVA with Tukey post hoc comparisons. RESULTS At PN17, there was no significant difference in the area of non-perfused retina between the hyperoxic control and the 100 and 1,000 ng aflibercept groups. At PN25, the 100 ng (p < 0.05) and 1,000 ng (p = 0.008) treatment groups displayed less non-perfusion compared to hyperoxic controls. At the 1,000 ng dose, there was increased non-perfusion compared to the 100 ng dose (p = 0.02). There was reduced non-perfusion by PN25 compared to PN17 for the 100 ng group (p < 0.05), with no difference in the 1,000 ng group. CONCLUSIONS The study shows that the area of non-perfused retina decreases effectively with aflibercept at PN25 with 100 ng dosage. With the 1,000 ng dosage, there is an inhibition of the physiologic angiogenesis with a higher area of non-perfused retina.
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Affiliation(s)
- Sarina M Amin
- Department of Ophthalmology, University of Florida College of Medicine, Gainesville, Illinois, USA
| | - Andres Gonzalez
- Department of Ophthalmology, University of Florida College of Medicine, Gainesville, Illinois, USA
| | - Jade Guevara
- Department of Ophthalmology, University of Florida College of Medicine, Gainesville, Illinois, USA
| | - Charlotte Bolch
- Department of Ophthalmology, University of Florida College of Medicine, Gainesville, Illinois, USA
| | - Lorick Andersen
- Department of Ophthalmology, University of Florida College of Medicine, Gainesville, Illinois, USA
| | - W Clay Smith
- Department of Ophthalmology, University of Florida College of Medicine, Gainesville, Illinois, USA
| | - Swati Agarwal-Sinha
- Department of Ophthalmology, University of Florida College of Medicine, Gainesville, Illinois, USA,
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Lopez F, Charbonnier G, Kermezli Y, Belhocine M, Ferré Q, Zweig N, Aribi M, Gonzalez A, Spicuglia S, Puthier D. Explore, edit and leverage genomic annotations using Python GTF toolkit. Bioinformatics 2020; 35:3487-3488. [PMID: 30768152 DOI: 10.1093/bioinformatics/btz116] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/15/2019] [Accepted: 02/13/2019] [Indexed: 11/12/2022] Open
Abstract
MOTIVATION While Python has become very popular in bioinformatics, a limited number of libraries exist for fast manipulation of gene coordinates in Ensembl GTF format. RESULTS We have developed the GTF toolkit Python package (pygtftk), which aims at providing easy and powerful manipulation of gene coordinates in GTF format. For optimal performances, the core engine of pygtftk is a C dynamic library (libgtftk) while the Python API provides usability and readability for developing scripts. Based on this Python package, we have developed the gtftk command line interface that contains 57 sub-commands (v0.9.10) to ease handling of GTF files. These commands may be used to (i) perform basic tasks (e.g. selections, insertions, updates or deletions of features/keys), (ii) select genes/transcripts based on various criteria (e.g. size, exon number, transcription start site location, intron length, GO terms) or (iii) carry out more advanced operations such as coverage analyses of genomic features using bigWig files to create faceted read-coverage diagrams. In conclusion, the pygtftk package greatly simplifies the annotation of GTF files with external information while providing advance tools to perform gene analyses. AVAILABILITY AND IMPLEMENTATION pygtftk and gtftk have been tested on Linux and MacOSX and are available from https://github.com/dputhier/pygtftk under the MIT license. The libgtftk dynamic library written in C is available from https://github.com/dputhier/libgtftk.
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Affiliation(s)
- F Lopez
- Aix Marseille Univ, INSERM, TAGC, UMR U1090, Marseille, France
| | - G Charbonnier
- Aix Marseille Univ, INSERM, TAGC, UMR U1090, Marseille, France
| | - Y Kermezli
- Aix Marseille Univ, INSERM, TAGC, UMR U1090, Marseille, France.,The Laboratory of Applied Molecular Biology and Immunology, Tlemcen University, Algeria
| | - M Belhocine
- Molecular Biology and Genetics Laboratory, Dubai, United Arab Emirates
| | - Q Ferré
- Aix Marseille Univ, INSERM, TAGC, UMR U1090, Marseille, France
| | | | - M Aribi
- The Laboratory of Applied Molecular Biology and Immunology, Tlemcen University, Algeria
| | - A Gonzalez
- Aix Marseille Univ, INSERM, TAGC, UMR U1090, Marseille, France
| | - S Spicuglia
- Aix Marseille Univ, INSERM, TAGC, UMR U1090, Marseille, France.,Equipe Labellisée LIGUE contre le Cancer
| | - D Puthier
- Aix Marseille Univ, INSERM, TAGC, UMR U1090, Marseille, France
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Lourido L, Ruiz-Romero C, Picchi F, Diz-Rosales N, Vilaboa-Galán S, Fernández-López C, Pinto Tasende JA, Perez-Pampin E, Regueiro Expósito C, Mera Varela A, Gonzalez A, Hambardzumyan K, Saevarsdottir S, Nilsson P, Blanco FJ. AB0206 CIRCULATING CENTROMERE PROTEIN F AUTOANTIBODIES FOR PREDICTING CLINICAL RESPONSE TO INFLIXIMAB IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4869] [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: 11/03/2022]
Abstract
Background:One third of patients with rheumatoid arthritis (RA) respond poorly to TNF inhibitors and related studies are inconsistent in predictive biomarkers. The identification of biomarkers that predict the treatment response prior to drug exposure is a current priority on the RA field. ACPA and RF are ubiquitously tested in RA patients, but other autoantibodies exist and may provide additional information on RA treatment response.Objectives:This study aimed to identify circulating autoantibodies for predicting response to infliximab (IFX) in RA.Methods:We profiled the autoantibody repertoire of baseline sera from 155 biologic naïve RA patients treated with IFX. The sera were provided by three independent clinical sources and distributed in one exploratory cohort (N=20) collected from Hospital Clínico Universitario of Santiago de Compostela (Spain), one replication cohort (N=61) collected from Hospital Universitario de A Coruña (Spain) and samples from the Swedish Farmacotherapy (SWEFOT) trial (Sweden) (N=74) for clinical validation. The presence of autoantibodies and their levels in serum were analysed in association with EULAR clinical response at 6 months follow-up: good response (GR, N=56), moderate (MR, N=55) and non-response (NR, N=44). A suspension bead array platform built on protein fragments within Human Protein Atlas and selected from an initial untargeted screening using an array containing 42000 antigens was employed to identify the IgG and IgA autoantibodies on the exploratory cohort. A replication and validation phases were carried out on the other two serum sample cohorts. Meta-analysis and Receiver Operating Curves were performed in order to assess the clinical relevance of the findings observed.Results:Meta-analysis revealed that the levels in serum of IgG autoantibodies against Centromere protein F (CENPF) are significantly increased in responders (good responders and moderate responders; N=111) to IFX compared to non-responders (N=44) (P=0.018). CENP-F is a proliferation-associated and cell cycle-dependent centromere autoantigen that might be involved in the increased or abnormal cell proliferation that occurs during RA process. The combination of the anti-CENPF antibodies with clinical variables (age, sex, DAS28-ESR) resulted in the best model to discriminate the patients that will respond to IFX, showing an AUC of 0.756 (95% CI [0.639-0.874], P=0.001).Conclusion:High serum levels of IgG anti-CENPF antibodies might be potentially useful to identify RA patients more likely to benefit from IFXDisclosure of Interests:Lucía Lourido: None declared, Cristina Ruiz-Romero: None declared, flor picchi: None declared, Naomi Diz-Rosales: None declared, Sergio Vilaboa-Galán: None declared, Carlos Fernández-López: None declared, Jose Antonio Pinto Tasende: None declared, Eva Perez-Pampin: None declared, Cristina Regueiro Expósito: None declared, ANTONIO MERA VARELA: None declared, Antonio Gonzalez: None declared, Karen Hambardzumyan: None declared, Saedis Saevarsdottir Employee of: Part-time at deCODE Genetics/Amgen Inc, working on genetic research unrelated to this project, Peter Nilsson: None declared, Francisco J. Blanco Grant/research support from: Sanofi-Aventis, Lilly, Bristol MS, Amgen, Pfizer, Abbvie, TRB Chemedica International, Glaxo SmithKline, Archigen Biotech Limited, Novartis, Nichi-iko pharmaceutical Co, Genentech, Jannsen Research & Development, UCB Biopharma, Centrexion Theurapeutics, Celgene, Roche, Regeneron Pharmaceuticals Inc, Biohope, Corbus Pharmaceutical, Tedec Meiji Pharma, Kiniksa Pharmaceuticals, Ltd, Gilead Sciences Inc, Consultant of: Lilly, Bristol MS, Pfizer
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Julià A, Blanco F, Fernandez B, Gonzalez A, D J, Maymó J, Alperi-López M, Olive A, Corominas H, Martinez Taboada V, González-Álvaro I, Fernandez-Nebro A, Erra A, Sánchez Fernandez S, Palau N, Lopez Lasanta M, Aterido A, Tornero J, Marsal S. THU0001 GENOME-WIDE ASSOCIATION STUDY ON JOINT EROSIONS IN RHEUMATOID ARTHRITIS SUPPORTS DIFFERENTIAL PATHOLOGICAL MECHANISMS ACCORDING TO ANTI-CCP STATUS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3133] [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: 11/03/2022]
Abstract
Background:Joint damage is the pathological hallmark of rheumatoid arthritis (RA). To identify the genetic variation associated with a higher level of erosions has proven elusive.Objectives:The objective of the present study was to perform a genome-wide association study on joint damage in a cohort of RA patients of the Spanish population. Our aims were to provide independent validation of previously reported variants and to identify new candidate risk loci. A stratified analysis was performed based on positivity to ACPA status.Methods:A total of 1,135 patients diagnosed with RA using the ACR-EULAR criteria recruited by the IMID Consortium were genotyped using a 550,000 single-nucleotide polymorphism array. Additional SNPs were imputed using the 1KG genome data. Joint damage was performed using the S-score, a simplified radiographic erosion score that has a high correlation with the Sharp-van der Hejde score (1). Association testing of SNPs with joint damage was performed via linear regression with the addition of the years of evolution as covariate. The two main components of genetic variation were also added to adjust for potential population stratification. A total of 50 SNPs representing previously reported loci associated with joint damage were selected. Genetic association was also performed at the pathway level using Pascal.Results:45 out of 50 SNPs representing 31 previously reported loci for joint damage could be satisfactorily imputed. Association testing of the whole patient cohort replicated the association withIL2RAandTRAF1. Of relevance, after stratifying for anti-CCP five new loci were replicated:KIF5AandSOSTin ACPA-positive RA andCD40, DKK1andTNFin ACPA-negative RA.IL2RAwas only significant in the ACPA-positive group andTRAF1was not significant in either strata. GWAS on the ACPA-positive cohort and on the ACPA-negative group identified n=7 and n=18 loci with P-values < 1x10-5, respectively. From these, however, only 1 SNP showed nominal significant association in the other patient group. Based on this evidence, we performed a pathway-based analysis to understand the biological mechanisms underlying this difference. Pathway analysis showed 52 biological processes associated with joint damage in ACPA-negative RA and 32 pathways in the ACPA-positive group, with only two shared biological processes between the two groups. Fc Gamma receptor mediated phagocytosis was the topmost biological process associated with erosions specifically in ACPA-negative RA and Signalling by Fibroblast Growth Factor mutants was the top process specific for ACPA-positive patients.Conclusion:The results from our study provide suggestive evidence that the genetic basis for joint damage is different according to the presence of ACPA. Replication of the new candidate loci in an independent patient cohort is underway.References:[1]Lopez-Lasanta, M., Julià, A., Maymó, J., Fernández-Gutierrez, B., Ureña-Garnica, I., Blanco, F. J., ... & Tornero, J. (2015). Variation at interleukin-6 receptor gene is associated to joint damage in rheumatoid arthritis.Arthritis research & therapy,17(1), 242.Disclosure of Interests:Antonio Julià: None declared, Francisco Blanco: None declared, Benjamin Fernandez: None declared, Antonio Gonzalez: None declared, Juan D: None declared, Joan Maymó: None declared, Mercedes Alperi-López: None declared, Alejandro Olive: None declared, Héctor Corominas Speakers bureau: Abbvie, Lilly, Pfizer, Roche, Victor Martinez Taboada: None declared, Isidoro González-Álvaro Grant/research support from: Roche Laboratories, Consultant of: Lilly, Sanofi, Paid instructor for: Lilly, Speakers bureau: Abbvie, MSD, Roche, Lilly, Antonio Fernandez-Nebro: None declared, Alba Erra: None declared, Simon Sánchez Fernandez: None declared, Núria Palau: None declared, Maria Lopez Lasanta: None declared, Adrià Aterido: None declared, Jesús Tornero: None declared, Sara Marsal: None declared
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Gonzalez A, Rodríguez-Martínez L, Perez-Pampín E, Mera Varela A, Herbello-Hermelo P, Moreda-Piñeiro A. THU0098 ANTIBODIES AGAINST THREE POST-TRANSLATIONAL PROTEIN MODIFICATIONS IN PATIENTS WITH RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6503] [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: 03/16/2023]
Abstract
Background:Autoantibodies to some post-translational modifications (PTMs) of proteins have a relevant role in rheumatoid arthritis (RA). Antibodies to other PMTs such as carbonylation (aCarbo) [1], nitration (aNitra) [2] and homocysteinylation (aHCis) [3] have also been described but they have been scarcely studied.Objectives:We aimed to evaluate the presence of antibodies against three poorly studied PTMs in patients with RA and explore their value as biomarkers.Methods:Serum samples from 196 healthy controls and RA patients meeting the 1987 ACR classification criteria that had either early RA (< 2 years from symptom onset) (n=182) or established RA (n=143) were analyzed. The antibodies were evaluated by indirect ELISA following the described protocols [1-3]. They include as antigens: HOCl- or ribose- carbonylated bovine type II collagen (HOCl-CII and GLI-CII, respectively) for aCarbo antibodies; homocysteinylated human serum albumin (Hcy-HSA) for aHCis antibodies; andin vitronitrated synovial proteins and synthetic nitrated peptides (3-NT-PS and 3-NT-pep, respectively) for aNitra antibodies. The efficiency of the reactions to produce these PTMs was verified. The study was approved by the CEIC of Galicia. The results were analyzed as differences between the optical densities (OD) obtained without correction, or the specific OD after subtracting reactivity to the native protein.Results:The aCarbo antibodies were studied in patients with early RA, as reported [1]. Despite this, uncorrected ODs against the two carbonylated forms of CII were not greater in the patients than in the controls (Table 1). Consequently, the corrected reactivity to GLI-CII that was significantly higher in patients than controls did not reflect aCarbo antibodies but differences in reactivity to native bovine CII.The other antibodies were analyzed in patients with established RA as previously done [2,3]. However, none of them showed specific reactivity (Table 1). In effect, although an excess of uncorrected reactivity to 3-NT-pep was observed in the patients with RA, it disappeared when corrected (Table 1). Also, the vast majority of patients and controls showed no reactivity to 3-NT-SP (not shown). In turn, the aHCis antibodies were significantly elevated in patients, but only in the uncorrected analysis because the difference disappeared when corrected for reactivity against native HSA (Table 1).Table 1.Antibodies against three post-translational protein modifications in RA patients and controlsRAControlsAntigenCorrectionMedian DOIQRMedian DOIQRPHOCl-CIIno0.1410.127/0.1730.1600.141/0.1880.0001HOCl-CIIyes-0.003-0.011/0.008-0.004-0.020/0.0050.02GLI-CIIno0.2340.171/0.2850.2220.163/0.3050.5GLI-CIIyes0.0720.016/0.1150.028-0.010/0.1000.00053-NT-pepno0.2500.201/0.3290.2090.190/0.2300.023-NT-pepyes0.1370.097/0.1850.1130.100/0.1330.1Hcy-HSAno0.1600.145/0.1780.1450.130/0.1550.00011Hcy-HSAyes-0.041-0.074/-0.015-0.038-0.069/-0.200.5Conclusion:The presence in RA patients of specific antibodies against the three PTMs has not been replicated. None of the observed reactivities were attributable to the PTMs. If confirmed, these results would indicate that only particular PTMs are relevant for RA and that carbonylation, nitration or homocysteinylation are not among them.References:[1]Strollo R, et al. Arthritis Rheum. 2013; 65:1702[2]Khan F, et al. Clin Chim Acta. 2006; 370:100[3]Nowakowska-Plaza A, et al. Scand J Rheumatol. 2014; 43:17Acknowledgments:Funded by the Instituto de Salud Carlos III projects PI17/01606 and RD16/0012/0014, which are partially co-funded by FEDERDisclosure of Interests:None declared
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Welling J, Roennow A, Sauvé M, Brown E, Galetti I, Gonzalez A, Portales Guiraud AP, Kennedy A, Leite C, Riggs RJ, Zheng A, Perkovic Popovic M, Gilbert A, Moros L, Sroka-Saidi K, Schindler T, Finnern H. PARE0009 COMMUNITY ADVISORY BOARD INPUT CAN MAKE LAY SUMMARIES OF CLINICAL TRIAL RESULTS MORE UNDERSTANDABLE. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4340] [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: 11/03/2022]
Abstract
Background:Under European Union (EU) Clinical Trial regulations,1clinical research sponsors (CRSs) must ensure all studies performed in the EU are accompanied by a trial summary for laypersons, published within 1 year of study completion. These lay summaries should disseminate clinical trial results in an easy-to-understand way for trial participants, patient and caregiver communities, and the general public. The European Patients Forum (EPF)2and European Patients’ Academy on Therapeutic Innovation (EUPATI)3encourage CRSs to engage with patient organisations (POs) in the development of lay summaries. This recognises the patients’ contribution to clinical research and supports the development of patient-focused material.Objectives:We share learnings from a collaboration between scleroderma POs and a CRS to create the SENSCIS® trial (NCT02597933) written and video lay summaries.Methods:A community advisory board (CAB), comprising representatives from 11 scleroderma POs covering a range of countries/regions, was formed based on the EURORDIS charter for collaboration in clinical research.4Through three structured meetings, over a seven-month period, the CAB provided advice on lay summary materials (written and video) drafted by the CRS’ Lay Summary Group (Fig. 1). At each review cycle, the CAB advice was addressed to make content more understandable and more relevant for patients and the general public.Results:The CAB advised that the existence of lay summaries is not well known in the patient community and also recommended the development of trial-specific lay summary videos to further improve understandability of the clinical trial results for the general public. Videos are a key channel of communication, enabling access to information for people with specific health needs and lower literacy levels. Following CAB advice, the CRS developed a stand-alone video entitled“What are lay summaries?”and a trial-specific lay summary video. Revisions to lay summary content (written and video) included colour schemes, iconography and language changes to make content more understandable. For videos, adjustments to animation speed, script and voiceover were implemented to improve clarity and flow of information (Fig. 2). Approved final versions of lay summary materials are publicly available on the CRS website. Translation into languages representing trial-site countries is in progress to widen access to non-English speakers and, where possible, local versions are being reviewed by the patient community.Conclusion:Structured collection and implementation of CAB advice can make lay summary materials more understandable for the patient community and wider general public.References:[1]EU. Summaries of clinical trial results for laypersons. 2018[2]EPF. EPF position: clinical trial results – communication of the lay summary. 2015[3]EUPATI. Guidance for patient involvement in ethical review of clinical trials. 2018[4]EURORDIS. Charter for Collaboration in Clinical Research in Rare Diseases. 2009Disclosure of Interests:Joep Welling Speakers bureau: Four times as a patient advocate for employees of BII and BI MIDI with a fixed amount of € 150,00 per occasion., Annelise Roennow: None declared, Maureen Sauvé Grant/research support from: Educational grants from Boehringer Ingelheim and Janssen., EDITH BROWN: None declared, Ilaria Galetti: None declared, Alex Gonzalez Consultant of: Payment made to the patient organisation (Scleroderma Research Foundation) for participation in advisory boards, Alexandra Paula Portales Guiraud: None declared, Ann Kennedy Grant/research support from: AS FESCA aisbl, Catarina Leite: None declared, Robert J. Riggs: None declared, Alison Zheng Grant/research support from: We get grants from Lorem Vascular; BI China,; Jianke Pharmaceutical Co., Ltd.; Kangjing Biological Co., Ltd.; COFCO Coca-Cola to organize national scleroderma meetings, offer patients service, holding academic meetings and other public activities, there is also a small part of the grants used to pay the workers in our organization., Consultant of: I worked as a paid consultant for BI. Pay-per-job., Speakers bureau: I was invited once to be a speaker at BI China’s internal meeting and they paid me., Matea Perkovic Popovic: None declared, Annie Gilbert Consultant of: I have worked as a paid consultant with BI International for over 3 years, since Sept 2016., Lizette Moros Employee of: Lizette Moros is an employee of Boehringer Ingelheim, Kamila Sroka-Saidi Employee of: Paid employee of Boehringer Ingelheim., Thomas Schindler Employee of: Employee of Boehringer Ingelheim Pharma, Henrik Finnern Employee of: Paid employee of Boehringer Ingelheim.
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Rodríguez-Trillo A, Mosquera Garrote N, Pena Pena CM, Mera Varela A, Gonzalez A, Conde C. SAT0015 ROCK INHIBITION REDUCES THE SEVERITY OF K/BXN SERUM-TRANSFER INDUCED ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5284] [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: 11/03/2022]
Abstract
Background:Fibroblast-like synoviocytes (FLS) are pivotal in inflammation and joint damage of rheumatoid arthritis (RA). These cells acquire an aggressive and invasive phenotype and secrete inflammatory mediators, metalloproteases and cathepsins that perpetuate inflammation and lead to cartilage and bone damage. We have previously shown that non-canonical Wnt5a pathway is involved in the aggressive phenotype of FLS by increasing their migration and invasion ability, and by stimulating the inflammatory response. The non-canonical Wnt signaling pathway included the planar cell polarity (PCP), with the activation of Rho and Rac GTPases, and the Wnt/Ca2+ pathways. We have also shown that Wnt5a contributes to the aggressive phenotype of RA FLS by binding to RYK receptor, through Rho-ROCK pathway and the activation of MAPKs, ERK and P38, as well as the activation of AKT and GSK3β.Objectives:To elucidate the therapeutic potential of the ROCK inhibitor (Y-27632) in the K/BxN serum transfer arthritis model.Methods:Two groups of C57BL/6J mice were used, in the control group, mice were treated with physiological serum and in the experimental group with a ROCK inhibitor (Y-27632). Arthritis was induced by intraperitoneal injection of 100 µl of K/BxN serum on days 0 and 2. In the experimental group, mice were treated with intraperitoneal injections of 10 mg/kg from day 0 until sacrifice, on day 10. Control mice were treated with the same volume of physiological serum. Arthritis was assessed by two observers using a semiquantitative clinical score. For histological analysis, it was decided to obtain the right ankle joints and foot. Joints were fixed in formalin for 6h and were decalcified and embedded in paraffin. Sections were stained with hematoxylin and eosin (H&E) and toluidine. Finally, total RNA was obtained from wrist and ankle joints of mice and the expression of inflammatory mediators and metalloproteases was analyzed by real-time PCR.Results:Arthritis was induced in C57BL/6J mice, which were treated with Y-27632 (ROCK inhibitor) or with physiological serum. The incidence of arthritis was 100% in both groups of mice and there were no differences in the course of the disease. Clinical score was significantly lower in the Y-27632-treated mice, all along the follow-up, compared with controls. Similar results were observed in the histological analysis. We also analyzed the effect of ROCK inhibitor on the inflammatory response of K/BxN serum-transfer induced arthritis. This analysis revealed that expression of IL6, IL1β, CXCL1, MMP3, MMP9 and MMP13 were significantly decreased in Y-27632-treated mice compared with control mice. In addition, TNF and NOS2 expression was reduced in Y-27632-treated mice to reach the same levels that observed in C57BL/6J mice without arthritis.Conclusion:These results indicate that the inhibition of the Rho-ROCK pathway decreases the severity of arthritis in the K/BxN serum transfer model, and point to ROCK as potential therapeutic target for RA. Supported: ISCIII / PI17 / 01660 / RETICS Program, RD16 / 0012/0014 / Cofinanced FEDER.Disclosure of Interests:None declared
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