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Kshatriya M, Wang KW, Hildebrand J, Crawford R, Nadarajah A, Youssef M, Rivas A, Kaushal A, Banfield LE, Thabane L, Samaan MC. The Effectiveness of Indigenous Knowledge-Based Lifestyle Interventions in Preventing Obesity and Type 2 Diabetes Mellitus in Indigenous Children in Canada: A Systematic Review. Adolesc Health Med Ther 2023; 14:175-193. [PMID: 37790916 PMCID: PMC10544169 DOI: 10.2147/ahmt.s405814] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 09/20/2023] [Indexed: 10/05/2023] Open
Abstract
Background Indigenous children in Canada have high rates of obesity and type 2 diabetes mellitus (T2DM). Culturally appropriate interventions, guided by an Indigenous knowledge-based view of health, are crucial to target these conditions. The objective of this systematic review was to assess the impact of indigenous Knowledge-based lifestyle interventions on the prevention of obesity and T2DM in Indigenous children in Canada. Methods Database searches were conducted from inception until February 22, 2022. The main outcomes were changes in Body Mass Index (BMI) z-score and the development of T2DM. The other outcomes included adiposity, metabolic, and lifestyle determinants of health. The GRADE approach was used to assess confidence in the evidence. Results Four non-randomized controlled trials (non-RCTs) and six uncontrolled studies were identified. Peer-led interventions led to a reduction in BMI z-score and waist circumference. GRADE assessment revealed very low quality of evidence due to a lack of randomization and small sample sizes. There were no diabetes-specific reported programs. Conclusion Limited evidence from non-randomized studies suggest that peer-led indigenous Knowledge-based lifestyle interventions improve BMI z-score and central adiposity. There is a need for community-owned and adequately powered randomized studies for interventions that aim to treat and prevent obesity and T2DM in Indigenous children in Canada. Systematic Review Registration PROSPERO CRD42017072781.
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Affiliation(s)
- Maya Kshatriya
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Global Health Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Kuan-Wen Wang
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Julia Hildebrand
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Rebecca Crawford
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Indigenous Undergraduate Summer Research Program, McMaster University, Hamilton, Ontario, Canada
| | - Ajantha Nadarajah
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Global Health Graduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Michael Youssef
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Angelica Rivas
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Ashleen Kaushal
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Laura E Banfield
- Health Sciences Library, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Biostatistics Unit, St. Joseph’s Healthcare-Hamilton, Hamilton, Ontario, Canada
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Centre for Evaluation of Medicines, St. Joseph’s Health Care, Hamilton, Ontario, Canada
| | - M Constantine Samaan
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Global Health Graduate Program, McMaster University, Hamilton, Ontario, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
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Rivas A, Pherwani S, Mohamed R, Smith ZL, Elmunzer BJ, Forbes N. ERCP-related adverse events: incidence, mechanisms, risk factors, prevention, and management. Expert Rev Gastroenterol Hepatol 2023; 17:1101-1116. [PMID: 37899490 DOI: 10.1080/17474124.2023.2277776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/27/2023] [Indexed: 10/31/2023]
Abstract
INTRODUCTION Endoscopic retrograde cholangiopancreatography (ERCP) is a commonly performed procedure for pancreaticobiliary disease. While ERCP is highly effective, it is also associated with the highest adverse event (AE) rates of all commonly performed endoscopic procedures. Thus, it is critical that endoscopists and caregivers of patients undergoing ERCP have clear understandings of ERCP-related AEs. AREAS COVERED This narrative review provides a comprehensive overview of the available evidence on ERCP-related AEs. For the purposes of this review, we subdivide the presentation of each ERCP-related AE according to the following clinically relevant domains: definitions and incidence, proposed mechanisms, risk factors, prevention, and recognition and management. The evidence informing this review was derived in part from a search of the electronic databases PubMed, Embase, and Cochrane, performed on 1 May 20231 May 2023. EXPERT OPINION Knowledge of ERCP-related AEs is critical not only given potential improvements in peri-procedural quality and related care that can ensue but also given the importance of reviewing these considerations with patients during informed consent. The ERCP community and researchers should aim to apply standardized definitions of AEs. Evidence-based knowledge of ERCP risk factors should inform patient care decisions during training and beyond.
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Affiliation(s)
- Angelica Rivas
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Simran Pherwani
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Rachid Mohamed
- Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada
| | - Zachary L Smith
- Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - B Joseph Elmunzer
- Division of Gastroenterology and Hepatology, Medical University of South Carolina, Charleston, SC, USA
| | - Nauzer Forbes
- Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Rivas A, Barkle G, Sarris T, Park J, Kenny A, Maxwell B, Stenger R, Moorhead B, Schipper L, Clague J. Improving accuracy of quantifying nitrate removal performance and enhancing understanding of processes in woodchip bioreactors using high-frequency data. Sci Total Environ 2023; 880:163289. [PMID: 37023810 DOI: 10.1016/j.scitotenv.2023.163289] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 03/15/2023] [Accepted: 03/31/2023] [Indexed: 05/27/2023]
Abstract
Woodchip bioreactors have gained popularity in many countries as a conservation practice for reducing nitrate load to freshwater. However, current methods for assessing their performance may be inadequate when nitrate removal rates (RR) are determined from low-frequency (e.g., weekly) concurrent sampling at the inlet and outlet. We hypothesised that high-frequency monitoring data at multiple locations can help improve the accuracy of quantifying nitrate removal performance, enhance the understanding of processes occurring within a bioreactor, and therefore improve the design practice for bioreactors. Accordingly, the objectives of this study were to compare RRs calculated using high- and low-frequency sampling and assess the spatiotemporal variability of the nitrate removal within a bioreactor to unravel the processes occurring within a bioreactor. For two drainage seasons, we monitored nitrate concentrations at 21 locations on an hourly or two-hourly basis within a pilot-scale woodchip bioreactor in Tatuanui, New Zealand. A novel method was developed to account for the variable lag time between entry and exit of a parcel of sampled drainage water. Our results showed that this method not only enabled lag time to be accounted for but also helped quantify volumetric inefficiencies (e.g., dead zone) within the bioreactor. The average RR calculated using this method was significantly higher than the average RR calculated using conventional low-frequency methods. The average RRs of each of the quarter sections within the bioreactor were found to be different. 1-D transport modelling confirmed the effect of nitrate loading on the removal process as nitrate reduction followed Michaelis-Menten (MM) kinetics. These results demonstrate that high-frequency temporal and spatial monitoring of nitrate concentrations in the field allows improved description of bioreactor performance and better understanding of processes occurring within woodchip bioreactors. Thus, insights gained from this study can be used to optimise the design of future field bioreactors.
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Affiliation(s)
- A Rivas
- Lincoln Agritech Ltd., Private Bag 3062, Hamilton 3240, New Zealand.
| | - G Barkle
- Land and Water Research Ltd., PO Box 27046, Garnett Ave., Hamilton 3257, New Zealand
| | - T Sarris
- Institute of Environmental Science and Research, PO Box 29-181, Christchurch 8540, New Zealand
| | - J Park
- Lincoln Agritech Ltd., Private Bag 3062, Hamilton 3240, New Zealand
| | - A Kenny
- Institute of Environmental Science and Research, PO Box 29-181, Christchurch 8540, New Zealand
| | - B Maxwell
- Department of Crop Sciences, University of Illinois Urbana-Champaign, Urbana, IL 61801-4730, USA
| | - R Stenger
- Lincoln Agritech Ltd., Private Bag 3062, Hamilton 3240, New Zealand
| | - B Moorhead
- Lincoln Agritech Ltd., Private Bag 3062, Hamilton 3240, New Zealand
| | - L Schipper
- University of Waikato, Private Bag 3105, Hamilton 3240, New Zealand
| | - J Clague
- Lincoln Agritech Ltd., Private Bag 3062, Hamilton 3240, New Zealand
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Cioana M, Deng J, Nadarajah A, Hou M, Qiu Y, Chen SSJ, Rivas A, Toor PP, Banfield L, Thabane L, Chaudhary V, Samaan MC. Global Prevalence of Diabetic Retinopathy in Pediatric Type 2 Diabetes: A Systematic Review and Meta-analysis. JAMA Netw Open 2023; 6:e231887. [PMID: 36930156 PMCID: PMC10024209 DOI: 10.1001/jamanetworkopen.2023.1887] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023] Open
Abstract
IMPORTANCE Type 2 diabetes (T2D) is increasing globally. Diabetic retinopathy (DR) is a leading cause of blindness in adults with T2D; however, the global burden of DR in pediatric T2D is unknown. This knowledge can inform retinopathy screening and treatments to preserve vision in this population. OBJECTIVE To estimate the global prevalence of DR in pediatric T2D. DATA SOURCES MEDLINE, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Library, the Web of Science, and the gray literature (ie, literature containing information that is not available through traditional publishing and distribution channels) were searched for relevant records from the date of database inception to April 4, 2021, with updated searches conducted on May 17, 2022. Searches were limited to human studies. No language restrictions were applied. Search terms included diabetic retinopathy; diabetes mellitus, type 2; prevalence studies; and child, adolescent, teenage, youth, and pediatric. STUDY SELECTION Three teams, each with 2 reviewers, independently screened for observational studies with 10 or more participants that reported the prevalence of DR. Among 1989 screened articles, 27 studies met the inclusion criteria for the pooled analysis. DATA EXTRACTION AND SYNTHESIS This systematic review and meta-analysis followed the Meta-analysis of Observational Studies in Epidemiology (MOOSE) and the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines for systematic reviews and meta-analyses. Two independent reviewers performed the risk of bias and level of evidence analyses. The results were pooled using a random-effects model, and heterogeneity was reported using χ2 and I2 statistics. MAIN OUTCOMES AND MEASURES The main outcome was the estimated pooled global prevalence of DR in pediatric T2D. Other outcomes included DR severity and current DR assessment methods. The association of diabetes duration, sex, race, age, and obesity with DR prevalence was also assessed. RESULTS Among the 27 studies included in the pooled analysis (5924 unique patients; age range at T2D diagnosis, 6.5-21.0 years), the global prevalence of DR in pediatric T2D was 6.99% (95% CI, 3.75%-11.00%; I2 = 95%; 615 patients). Fundoscopy was less sensitive than 7-field stereoscopic fundus photography in detecting retinopathy (0.47% [95% CI, 0%-3.30%; I2 = 0%] vs 13.55% [95% CI, 5.43%-24.29%; I2 = 92%]). The prevalence of DR increased over time and was 1.11% (95% CI, 0.04%-3.06%; I2 = 5%) at less than 2.5 years after T2D diagnosis, 9.04% (95% CI, 2.24%-19.55%; I2 = 88%) at 2.5 to 5.0 years after T2D diagnosis, and 28.14% (95% CI, 12.84%-46.45%; I2 = 96%) at more than 5 years after T2D diagnosis. The prevalence of DR increased with age, and no differences were noted based on sex, race, or obesity. Heterogeneity was high among studies. CONCLUSIONS AND RELEVANCE In this study, DR prevalence in pediatric T2D increased significantly at more than 5 years after diagnosis. These findings suggest that retinal microvasculature is an early target of T2D in children and adolescents, and annual screening with fundus photography beginning at diagnosis offers the best assessment method for early detection of DR in pediatric patients.
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Affiliation(s)
- Milena Cioana
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Jiawen Deng
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Ajantha Nadarajah
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Maggie Hou
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Yuan Qiu
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Sondra Song Jie Chen
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Angelica Rivas
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Parm Pal Toor
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Laura Banfield
- Health Sciences Library, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Centre for Evaluation of Medicines, St Joseph’s Health Care, Hamilton, Ontario, Canada
- Biostatistics Unit, St Joseph's Healthcare, Hamilton, Ontario, Canada
| | - Varun Chaudhary
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Division of Ophthalmology, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - M. Constantine Samaan
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children's Hospital, Hamilton, Ontario, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
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Cioana M, Deng J, Nadarajah A, Hou M, Qiu Y, Chen SSJ, Rivas A, Banfield L, Toor PP, Zhou F, Guven A, Alfaraidi H, Alotaibi A, Thabane L, Samaan MC. The Prevalence of Obesity Among Children With Type 2 Diabetes: A Systematic Review and Meta-analysis. JAMA Netw Open 2022; 5:e2247186. [PMID: 36520430 PMCID: PMC9856349 DOI: 10.1001/jamanetworkopen.2022.47186] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 10/30/2022] [Indexed: 12/16/2022] Open
Abstract
Importance The childhood obesity epidemic is presumed to drive pediatric type 2 diabetes (T2D); however, the global scale of obesity in children with T2D is unknown. Objectives To evaluate the global prevalence of obesity in pediatric T2D, examine the association of sex and race with obesity risk, and assess the association of obesity with glycemic control and dyslipidemia. Data Sources MEDLINE, Embase, CINAHL, Cochrane Library, and Web of Science were searched from database inception to June 16, 2022. Study Selection Observational studies with at least 10 participants reporting the prevalence of obesity in patients with pediatric T2D were included. Data Extraction and Synthesis Following the Meta-analysis of Observational Studies in Epidemiology reporting guideline, 2 independent reviewers in teams performed data extraction and risk of bias and level of evidence analyses. The meta-analysis was conducted using a random-effects model. Main Outcomes and Measures The primary outcomes included the pooled prevalence rates of obesity in children with T2D. The secondary outcomes assessed pooled prevalence rates by sex and race and associations between obesity and glycemic control and dyslipidemia. Results Of 57 articles included in the systematic review, 53 articles, with 8942 participants, were included in the meta-analysis. The overall prevalence of obesity among pediatric patients with T2D was 75.27% (95% CI, 70.47%-79.78%), and the prevalence of obesity at diabetes diagnosis among 4688 participants was 77.24% (95% CI, 70.55%-83.34%). While male participants had higher odds of obesity than female participants (odds ratio, 2.10; 95% CI, 1.33-3.31), Asian participants had the lowest prevalence of obesity (64.50%; 95% CI, 53.28%-74.99%), and White participants had the highest prevalence of obesity (89.86%; 95% CI, 71.50%-99.74%) compared with other racial groups. High heterogeneity across studies and varying degrees of glycemic control and dyslipidemia were noted. Conclusions and Relevance The findings of this systematic review and meta-analysis suggest that obesity is not a universal phenotype in children with T2D. Further studies are needed to consider the role of obesity and other mechanisms in diabetes genesis in this population.
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Affiliation(s)
- Milena Cioana
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Jiawen Deng
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Ajantha Nadarajah
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Maggie Hou
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Yuan Qiu
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Sondra Song Jie Chen
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Angelica Rivas
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Laura Banfield
- Health Sciences Library, McMaster University, Hamilton, Ontario, Canada
| | - Parm Pal Toor
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Fangwen Zhou
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Ayla Guven
- Health Science University, Zeynep Kamil Maternity and Children Hospital, Pediatric Endocrinology Clinic, Istanbul, Turkey
| | - Haifa Alfaraidi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Division of Endocrinology, Department of Pediatrics, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Ahlam Alotaibi
- Division of Pediatric Endocrinology, Department of Pediatrics, King Abdullah bin Abdulaziz University Hospital, Princess Noura University, Riyadh, Saudi Arabia
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Centre for Evaluation of Medicines, St Joseph’s Healthcare, Hamilton, Ontario, Canada
- Biostatistics Unit, St Joseph’s Healthcare, Hamilton, Ontario, Canada
| | - M. Constantine Samaan
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
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Cioana M, Deng J, Nadarajah A, Hou M, Qiu Y, Chen SSJ, Rivas A, Toor PP, Banfield L, Thabane L, Chaudhary V, Constantine Samaan M. ODP185 Diabetic Retinopathy Prevalence in Pediatric Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. J Endocr Soc 2022. [PMCID: PMC9629227 DOI: 10.1210/jendso/bvac150.637] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is on the rise in children and adolescents. Diabetic retinopathy (DR) is a leading cause of blindness in adult patients with diabetes. However, the exact prevalence of DR and its determinants in pediatric patients with T2DM are unknown. Understanding the burden of DR in pediatric T2DM can help inform screening and management clinical practice guidelines. This systematic review and meta-analysis aimed to determine the prevalence and determinants of DR in pediatric T2DM. The main outcome was the pooled prevalence of DR in pediatric T2DM. Other important outcomes included the assessment of the impact of diabetes duration, method of retinopathy diagnosis, sex, race, and obesity on prevalence. We searched MEDLINE, Embase, CINAHL, Cochrane Library, Web of Science, and the grey literature from inception until April 4, 2021 for relevant data. No language restrictions were applied, and searches were limited to human studies. Two reviewers independently screened for studies of T2DM patients diagnosed <21 years of age with observational study design and ≥10 participants. Risk of bias evaluation was performed and level of evidence analysis was conducted using the Oxford Centre for Evidence-Based Medicine criteria. A random-effects meta-analysis was used to pool the results. Out of 1849 screened studies, 24 studies met the inclusion criteria. The overall prevalence of DR in pediatric T2DM was 6.58% (95%CI 3.46-10.46, I 2 =96%,n=9026). Most cases were classified as minimal or mild non-proliferative DR. Six cases were sight-threatening. Prevalence was higher in studies using fundoscopy than fundus photography to evaluate DR (0.47% [95%CI 0. 00-3.30, I 2 =0%,n=135] vs. 18.20% [95%CI 7.92-31.28, I 2 =89%,n=718]), suggesting that fundus photography was more sensitive in detecting DR than fundoscopy. The risk of DR rose progressively post-diagnosis; while1.25% (95%CI 0. 00-4. 01, I 2 =13%,n=213) of patients had DR <3 years post T2DM diagnosis, this figure rose to33. 03% (95%CI 25.79-40.66, I 2 =0%,n=162) >5 years after diagnosis. Obesity and sex did not impact DR prevalence. White/Middle Eastern patients had a DR prevalence of 7.43% (95%CI 0. 00-31.37; I 2 =97%,P <0. 001, n=4419),while Asians had a higher prevalence of 14.85% (95%CI 0.91-39.16; I 2 =93%,P <0. 001, n=501). In conclusion, DR is a frequent complication in children and adolescents in the early years post T2DM diagnosis. Screening for DR at diagnosis and annually thereafter using fundus photography is critical to allow early detection and management to prevent visual impairment in these patients. Presentation: No date and time listed
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Stecca L, Moscoso‐Ruiz I, Gálvez‐Ontiveros Y, Rivas A. Association between dietary exposure to bisphenols and body mass index in Spanish schoolchildren. EFSA J 2022; 20:e200421. [PMID: 35634546 PMCID: PMC9131603 DOI: 10.2903/j.efsa.2022.e200421] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The increase in children obesity worldwide has been of particular concern in recent decades. Environmental factors have been proposed as contributors to obesity, and there is a growing concern over obesogens, environmental chemicals with potential obesity‐related endocrine‐disrupting properties. In this regard, bisphenol A (BPA) and its analogues are suspected to have obesogenic properties. Current document report on the activities of the fellow, undertaken during the fourth, 2020–2021 cycle of the EU‐FORA programme at the University of Granada, Institute of Nutrition and Food Science, in Spain. The work programme offered by the hosting site was related to the extrapolation of bisphenols exposure following the determination of these compounds in food frequently consumed by children and in their biological samples. The fellow has participated in the recruitment of the study population in the health centres. In addition, she has participated in the collection of the children biological samples, anthropometric measurements and dietary surveys and in the optimisation of the laboratory methodology for the extraction of bisphenols in biological samples. All these activities also provided the fellow an opportunity to develop her data science related skills, which will benefit her professional development. In addition, the fellow gained an overview of various topics related to food safety risk assessment by attending the EU‐FORA dedicated training modules.
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Cioana M, Deng J, Nadarajah A, Hou M, Qiu Y, Chen SSJ, Rivas A, Banfield L, Alfaraidi H, Alotaibi A, Thabane L, Samaan MC. Prevalence of Polycystic Ovary Syndrome in Patients With Pediatric Type 2 Diabetes: A Systematic Review and Meta-analysis. JAMA Netw Open 2022; 5:e2147454. [PMID: 35166782 PMCID: PMC8848210 DOI: 10.1001/jamanetworkopen.2021.47454] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
IMPORTANCE The prevalence of pediatric type 2 diabetes (T2D) is increasing globally. Girls with T2D are at risk of developing polycystic ovary syndrome (PCOS), but the prevalence of PCOS among girls with T2D is unknown. OBJECTIVE To determine the prevalence of PCOS in girls with T2D and to assess the association of obesity and race with this prevalence. DATA SOURCES In this systematic review and meta-analysis, MEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Web of Science: Conference Proceedings Citation Index-Science, and the gray literature were searched from inception to April 4, 2021. STUDY SELECTION Two reviewers independently screened for studies with observational study design that recruited 10 or more participants and reported the prevalence of PCOS in girls with T2D. DATA EXTRACTION AND SYNTHESIS Risk of bias was evaluated using a validated tool, and level of evidence was assessed using the Oxford Centre for Evidence-Based Medicine criteria. A random-effects meta-analysis was performed. This study follows the Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guideline. MAIN OUTCOMES AND MEASURES The main outcome of this systematic review was the prevalence of PCOS in girls with T2D. Secondary outcomes included assessing the associations of obesity and race with PCOS prevalence. RESULTS Of 722 screened studies, 6 studies involving 470 girls with T2D (mean age at diagnosis, 12.9-16.1 years) met the inclusion criteria. The prevalence (weighted percentage) of PCOS was 19.58% (95% CI, 12.02%-27.14%; I2 = 74%; P = .002). Heterogeneity was moderate to high; however, it was significantly reduced after excluding studies that did not report PCOS diagnostic criteria, leading to a calculated prevalence (weighted percentage) of 24.04% (95% CI, 15.07%-33.01%; I2 = 0%; P = .92). Associations with obesity and race could not be determined because of data paucity. CONCLUSIONS AND RELEVANCE In this meta-analysis, approximately 1 in 5 girls with T2D had PCOS, but the results of this meta-analysis should be considered with caution because studies including the larger numbers of girls did not report the criteria used to diagnose PCOS, which is a challenge during adolescence. The associations of obesity and race with PCOS prevalence among girls with T2D need further evaluation to help define at-risk subgroups and implement early assessment and treatment strategies to improve management of this T2D-related comorbidity.
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Affiliation(s)
- Milena Cioana
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Jiawen Deng
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Ajantha Nadarajah
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Maggie Hou
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Yuan Qiu
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Sondra Song Jie Chen
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Angelica Rivas
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Laura Banfield
- Health Sciences Library, McMaster University, Hamilton, Ontario, Canada
| | - Haifa Alfaraidi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Division of Endocrinology, Department of Pediatrics, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Ahlam Alotaibi
- Department of Pediatrics, Division of Pediatric Endocrinology, King Abdullah bin Abdulaziz University Hospital, Princess Noura University, Riyadh, Saudi Arabia
| | - Lehana Thabane
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Centre for Evaluation of Medicines, St Joseph’s Health Care, Hamilton, Ontario, Canada
- Biostatistics Unit, St Joseph’s Healthcare, Hamilton, Ontario, Canada
| | - M. Constantine Samaan
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
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Rivas A, Lauw MN, Bonin-Schnabel R, Crowther M, Van Spall H. Stroke and Thromboembolism in Patients with Heart Failure and Sinus Rhythm: A Matter of Risk Stratification? Thromb Haemost 2022; 122:871-878. [PMID: 35045579 DOI: 10.1055/a-1745-2083] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Patients with heart failure (HF) in sinus rhythm (SR) experience an increased incidence of thromboembolic events including stroke. Among patients with HF, high-quality evidence supports the use of oral anticoagulation when atrial fibrillation (AF) is present, but the benefit of anticoagulation in SR in absence of other known indications for anticoagulation is unclear. In four randomized controlled trials (RCTs), warfarin did not improve a composite of clinical outcomes compared with aspirin or placebo in patients with HF with reduced ejection fraction (HFrEF) and SR. A recent RCT assessed the efficacy of the direct oral anticoagulant rivaroxaban versus placebo in patients with HFrEF (including mildly reduced ejection fraction), SR and coronary artery disease. While rivaroxaban had a neutral effect on the primary composite outcome of MI, stroke, or all-cause mortality, exploratory analyses revealed a significant reduction in strokes. It is thus possible that a subgroup of patients with HFrEF who are at high risk of stroke may benefit from anticoagulation. The challenge is to adequately identify this subgroup and to balance the potential benefit of anticoagulation with the risk of major bleeding. There is also an unmet need for evidence around anticoagulation in HF with preserved ejection fraction (HFpEF) and SR. This review explores the current evidence around anticoagulation in patients with HF and SR, identifies challenges regarding outcome definitions and patient selection, and offers suggestions for future research.
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Affiliation(s)
| | - Mandy N Lauw
- Hematology, Erasmus Medical Center, Rotterdam, Netherlands
| | - Renate Bonin-Schnabel
- Cardiology, Universitätsklinikum Hamburg Eppendorf Universitäres Herzzentrum Hamburg GmbH, Hamburg, Germany
| | | | - Harriette Van Spall
- Medicine, McMaster University, Hamilton, Canada.,Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada.,Population Health Research Institute, McMaster University, Hamilton, Canada
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Cioana M, Deng J, Nadarajah A, Hou M, Qiu Y, Chen SSJ, Rivas A, Samaan Z, Banfield L, Thabane L, Samaan MC. Psychiatric Comorbidities in Children and Youth With Type 2 Diabetes: A Systematic Review and Meta-Analysis. Can J Diabetes 2021. [DOI: 10.1016/j.jcjd.2021.09.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Franch‐Sarto M, Garcia‐Calduch O, Rivas A, Lopez A, Gonzalez‐Barca E, Sureda A, Baile M, Martin A, Salar A, Gutierrez A, Bastos M, Rodriguez M, Gonzalez S, Queizán J, Cordoba R, Montalbán C, Luzardo HD, Abrisqueta P, Garcia D, Hong A, Peñalver F, Moreno M, Sancho J. CENTRAL NERVOUS SYSTEM RELAPSE IN PATIENTS WITH DIFFUSE LARGE B‐CELL LYMPHOMA TREATED WITH R‐CHOP: STUDY OF THE SPANISH LYMPHOMA GROUP GELTAMO. Hematol Oncol 2021. [DOI: 10.1002/hon.91_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- M. Franch‐Sarto
- Hospital Universitari Germans Trias i Pujol Hematology Badalona Spain
| | - O. Garcia‐Calduch
- Hospital Universitari Germans Trias i Pujol Hematology Badalona Spain
| | - A. Rivas
- Hospital Universitari Clinic Hematology Barcelona Spain
| | - A. Lopez
- Hospital Universitari Clinic Hematology Barcelona Spain
| | | | - A. Sureda
- Hospital Duran i Reynalds Hematology Bellvitge Spain
| | - M. Baile
- Hospital Universitario de Salamanca and IBSAL. Hematology Salamanca Spain
| | - A. Martin
- Hospital Universitario de Salamanca and IBSAL. Hematology Salamanca Spain
| | - A. Salar
- Hospital del Mar Hematology Barcelona Spain
| | | | - M. Bastos
- Hospital Universitario Gregorio Marañón Hematology Madrid Spain
| | - M.‐J. Rodriguez
- Hospital Universitario de Canarias Hematology Canarias Spain
| | - S. Gonzalez
- Hospital Universitario Marqués de Valdecilla Hematology Santander Spain
| | - J.‐A. Queizán
- Hospital General de Segovia Hematology Segovia Spain
| | - R. Cordoba
- Fundación Jiméndez Díaz Hematology Madrid Spain
| | - C. Montalbán
- MD Anderson Cancer Center Hematology Madrid Spain
| | - H. D. Luzardo
- Hospital Universitario de Gran Canarias Dr Negrín Hematology Las Palmas de Gran Canaria Spain
| | - P. Abrisqueta
- Hospital Universitari Vall d'Hebron Hematology Barcelona Spain
| | - D. Garcia
- Hospital La Zarzuela Hematology Madrid Spain
| | - A. Hong
- Hospital de Lanzarote Hematology Lanzarote Spain
| | | | - M. Moreno
- Hospital Universitari Germans Trias i Pujol Hematology Badalona Spain
| | - J.‐M. Sancho
- Hospital Universitari Germans Trias i Pujol Hematology Badalona Spain
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Cioana M, Deng J, Hou M, Nadarajah A, Qiu Y, Chen SSJ, Rivas A, Banfield L, Chanchlani R, Dart A, Wicklow B, Alfaraidi H, Alotaibi A, Thabane L, Samaan MC. Prevalence of Hypertension and Albuminuria in Pediatric Type 2 Diabetes: A Systematic Review and Meta-analysis. JAMA Netw Open 2021; 4:e216069. [PMID: 33929524 PMCID: PMC8087958 DOI: 10.1001/jamanetworkopen.2021.6069] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 02/24/2021] [Indexed: 12/11/2022] Open
Abstract
Importance Hypertension and albuminuria are markers of diabetes-related nephropathy and important factors associated with kidney outcomes in pediatric type 2 diabetes. However, their prevalence in these patients is unknown. Objective To measure the prevalence of hypertension and albuminuria in pediatric patients with type 2 diabetes and to evaluate the association of sex and race/ethnicity with these conditions. Data Sources MEDLINE, Embase, CINAHL, Cochrane Library, Web of Science, the gray literature, and references of the screened articles were searched for human studies from date of database inception to February 20, 2020. Study Selection Observational studies with at least 10 participants reporting the prevalence of hypertension and/or albuminuria in pediatric patients with type 2 diabetes were included. Three teams of 2 independent reviewers screened 7614 papers, of which 60 fulfilled the eligibility criteria. Data Extraction and Synthesis Three teams of 2 independent reviewers performed data extraction, risk of bias analysis, and level of evidence analyses. The meta-analysis was conducted using a random-effects model and followed the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Main Outcomes and Measures The primary outcomes included the pooled prevalence rates (percentages with 95% CI) for hypertension and albuminuria. The secondary outcomes assessed pooled prevalence rates by sex and racial/ethnic group. Results Sixty studies were included in the systematic review. Diabetes duration varied from inclusion at diagnosis to 15.0 years after diagnosis, and the reported mean age at diagnosis ranged from 6.5 to 21.0 years. Hypertension prevalence among 3463 participants was 25.33% (95% CI, 19.57%-31.53%). Male participants had higher hypertension risk than female participants (odds ratio [OR], 1.42 [95% CI, 1.10-1.83]), with Pacific Islander and Indigenous youth having the highest prevalence of all racial/ethnic groups (Pacific Islander youth: 26.71% [95% CI, 14.54%-40.72%]; Indigenous youth: 26.48% [95% CI, 17.34%-36.74%]; White youth: 20.95% [95% CI, 12.65%-30.57%]; African American youth: 19.04% [95% CI, 12.01%-27.23%]; Hispanic/Latino youth: 15.11% [95% CI, 6.56%-26.30%]; Asian youth: 18.37% [95% CI, 9.49%-29.23%]). Albuminuria prevalence among 2250 participants was 22.17% (95% CI, 17.34%-27.38%). Pacific Islander youth, Indigenous youth, and Asian youth had higher prevalence rates than White youth (Pacific Islander youth: 31.84% [95% CI, 11.90%-55.47%]; Indigenous youth: 24.27% [95% CI, 14.39%-35.73%]; Asian youth: 23.00% [95% CI, 18.85%-27.41%]; White youth: 12.59% [95% CI, 7.75%-18.33%]), with no sex differences (OR for male vs female participants, 0.68 [95% CI, 0.46-1.01]). Heterogeneity was high among studies, with a low to moderate risk of bias. Conclusions and Relevance In this study, markers of diabetes-related nephropathy were commonly detected in pediatric patients with type 2 diabetes, with a disproportionate burden noted among Pacific Islander and Indigenous youth. Personalized management strategies to target kidney outcomes are urgently needed in pediatric patients with type 2 diabetes to alleviate the burden of this condition on the kidneys.
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Affiliation(s)
- Milena Cioana
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Jiawen Deng
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Maggie Hou
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Ajantha Nadarajah
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Yuan Qiu
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Sondra Song Jie Chen
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Angelica Rivas
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Laura Banfield
- Health Sciences Library, McMaster University, Hamilton, Ontario, Canada
| | - Rahul Chanchlani
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Nephrology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
| | - Allison Dart
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
- Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Brandy Wicklow
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
- Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Haifa Alfaraidi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Division of Endocrinology, Department of Pediatrics, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Ahlam Alotaibi
- Department of Pediatrics, Division of Pediatric Endocrinology, King Abdullah bin Abdulaziz University Hospital, Princess Noura University, Riyadh, Saudi Arabia
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Centre for Evaluation of Medicines, St Joseph’s Health Care, Hamilton, Ontario, Canada
- Biostatistics Unit, St Joseph’s Healthcare, Hamilton, Ontario, Canada
| | - M. Constantine Samaan
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Michael G. De Groote School of Medicine, McMaster University, Hamilton, Ontario, Canada
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Blondon M, Jimenez D, Robert‐Ebadi H, Del Toro J, Lopez‐Jimenez L, Falga C, Skride A, Font L, Vazquez FJ, Bounameaux H, Monreal M, Prandoni P, Brenner, B, Farge‐Bancel D, Barba R, Di Micco P, Bertoletti L, Schellong S, Tzoran I, Reis A, Bosevski M, Malý R, Verhamme P, Caprini JA, My Bui H, Adarraga MD, Agud M, Aibar J, Aibar MA, Alfonso J, Amado C, Arcelus JI, Baeza C, Ballaz A, Barba R, Barbagelata C, Barrón M, Barrón‐Andrés B, Blanco‐Molina A, Botella E, Camon AM, Castro J, Caudevilla MA, Cerdà P, Chasco L, Criado J, de Ancos C, de Miguel J, Demelo‐Rodríguez P, Díaz‐Peromingo JA, Díez‐Sierra J, Díaz‐Simón R, Domínguez IM, Encabo M, Escribano JC, Falgá C, Farfán AI, Fernández‐Capitán C, Fernández‐Reyes JL, Fidalgo MA, Flores K, Font C, Francisco I, Gabara C, Galeano‐Valle F, García MA, García‐Bragado F, García‐Mullor MM, Gavín‐Blanco O, Gavín‐Sebastián O, Gil‐Díaz A, Gómez‐Cuervo C, González‐Martínez J, Grau E, Guirado L, Gutiérrez J, Hernández‐Blasco L, Jara‐Palomares L, Jaras MJ, Jiménez D, Joya MD, Jou I, Lacruz B, Lecumberri R, Lima J, Lobo JL, López‐Brull H, López‐Jiménez L, López‐Miguel P, López‐Núñez JJ, López‐Reyes R, López‐Sáez JB, Lorente MA, Lorenzo A, Loring M, Madridano O, Maestre A, Marchena PJ, Martín del Pozo M, Martín‐Martos F, Martínez‐Baquerizo C, Mella C, Mellado M, Mercado MI, Moisés J, Morales MV, Muñoz‐Blanco A, Muñoz‐Guglielmetti D, Muñoz‐Rivas N, Nart E, Nieto JA, Núñez MJ, Olivares MC, Ortega‐Michel C, Ortega‐Recio MD, Osorio J, Otalora S, Otero R, Parra P, Parra V, Pedrajas JM, Pellejero G, Pérez‐Jacoiste A, Peris ML, Pesántez D, Porras JA, Portillo J, Reig L, Riera‐Mestre A, Rivas A, Rodríguez‐Cobo A, Rodríguez‐Matute C, Rogado J, Rosa V, Rubio CM, Ruiz‐Artacho P, Ruiz‐Giménez N, Ruiz‐Ruiz J, Ruiz‐Sada P, Sahuquillo JC, Salgueiro G, Sampériz A, Sánchez‐Muñoz‐Torrero JF, Sancho T, Sigüenza P, Sirisi M, Soler S, Suárez S, Suriñach JM, Tiberio G, Torres MI, Tolosa C, Trujillo‐Santos J, Uresandi F, Usandizaga E, Valle R, Vela JR, Vidal G, Vilar C, Villares P, Zamora C, Gutiérrez P, Vázquez FJ, Vanassche T, Vandenbriele C, Verhamme P, Hirmerova J, Malý R, Salgado E, Benzidia I, Bertoletti L, Bura‐Riviere A, Crichi B, Debourdeau P, Espitia O, Farge‐Bancel D, Helfer H, Mahé I, Moustafa F, Poenou G, Schellong S, Braester A, Brenner B, Tzoran I, Amitrano M, Bilora F, Bortoluzzi C, Brandolin B, Ciammaichella M, Colaizzo D, Dentali F, Di Micco P, Giammarino E, Grandone E, Mangiacapra S, Mastroiacovo D, Maida R, Mumoli N, Pace F, Pesavento R, Pomero F, Prandoni P, Quintavalla R, Rocci A, Siniscalchi C, Tufano A, Visonà A, Vo Hong N, Zalunardo B, Kalejs RV, Maķe K, Ferreira M, Fonseca S, Martins F, Meireles J, Bosevski M, Zdraveska M, Mazzolai L, Caprini JA, Tafur AJ, Weinberg I, Wilkins H, Bui HM. Comparative clinical prognosis of massive and non-massive pulmonary embolism: A registry-based cohort study. J Thromb Haemost 2021; 19:408-416. [PMID: 33119949 DOI: 10.1111/jth.15146] [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: 06/02/2020] [Revised: 09/29/2020] [Accepted: 10/21/2020] [Indexed: 01/16/2023]
Abstract
AIMS Little is known about the prognosis of patients with massive pulmonary embolism (PE) and its risk of recurrent venous thromboembolism (VTE) compared with non-massive PE, which may inform clinical decisions. Our aim was to compare the risk of recurrent VTE, bleeding, and mortality after massive and non-massive PE during anticoagulation and after its discontinuation. METHODS AND RESULTS We included all participants in the RIETE registry who suffered a symptomatic, objectively confirmed segmental or more central PE. Massive PE was defined by a systolic hypotension at clinical presentation (<90 mm Hg). We compared the risks of recurrent VTE, major bleeding, and mortality using time-to-event multivariable competing risk modeling. There were 3.5% of massive PE among 38 996 patients with PE. During the anticoagulation period, massive PE was associated with a greater risk of major bleeding (subhazard ratio [sHR] 1.72, 95% confidence interval [CI] 1.28-2.32), but not of recurrent VTE (sHR 1.15, 95% CI 0.75-1.74) than non-massive PE. An increased risk of mortality was only observed in the first month after PE. After discontinuation of anticoagulation, among 11 579 patients, massive PE and non-massive PE had similar risks of mortality, bleeding, and recurrent VTE (sHR 0.85, 95% CI 0.51-1.40), but with different case fatality of recurrent PE (11.1% versus 2.4%, P = .03) and possibly different risk of recurrent fatal PE (sHR 3.65, 95% CI 0.82-16.24). CONCLUSION In this large prospective registry, the baseline hemodynamic status of the incident PE did not influence the risk of recurrent VTE, during and after the anticoagulation periods, but was possibly associated with recurrent PE of greater severity.
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Affiliation(s)
- Marc Blondon
- Division of Angiology and Hemostasis Geneva University Hospitals and Faculty of Medicine Geneva Switzerland
| | - David Jimenez
- Respiratory Department Hospital Ramón y Cajal and Medicine Department Universidad de Alcalá (IRYCIS) Madrid Spain
| | - Helia Robert‐Ebadi
- Division of Angiology and Hemostasis Geneva University Hospitals and Faculty of Medicine Geneva Switzerland
| | - Jorge Del Toro
- Department of Internal Medicine Hospital General Universitario Gregorio Marañón Madrid Spain
| | | | - Conxita Falga
- Department of Internal Medicine Hospital de Mataro Barcelona Spain
| | - Andris Skride
- Department of Cardiology Ospedale Pauls Stradins Clinical University Hospital Riga Latvia
| | - Llorenç Font
- Department of Haematology Hospital de Tortosa Verge de la Cinta Tarragona Spain
| | | | - Henri Bounameaux
- Division of Angiology and Hemostasis Geneva University Hospitals and Faculty of Medicine Geneva Switzerland
| | - Manuel Monreal
- Department of Internal Medicine Hospital Germans Trias i Pujol Badalona Spain
- Universidad Catolica de Murcia Murcia Spain
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Avnery O, Martin M, Bura-Riviere A, Barillari G, Mazzolai L, Mahé I, Marchena PJ, Verhamme P, Monreal M, Ellis MH, Aibar MA, Aibar J, Amado C, Arcelus JI, Ballaz A, Barba R, Barrón M, Barrón‐Andrés B, Bascuñana J, ina A, Camon AM, Cañas I, Carrasco C, Castro J, Ancos C, Toro J, Demelo P, Díaz‐Peromingo JA, Falgá C, Farfán AI, Fernández‐Capitán C, Fernández‐Criado MC, Fernández‐Núñez S, Fidalgo MA, Font C, Font L, Freire M, Gallego M, García MA, García‐Bragado F, García‐Morillo M, García‐Raso A, Gavín O, Gayol MC, Gil‐Díaz A, Gómez V, Gómez‐Cuervo C, González‐Martínez J, Grau E, Gutiérrez J, Hernández‐Blasco LM, Iglesias M, Jara‐Palomares L, Jaras MJ, Jiménez R, Jiménez‐Castro D, Jiménez‐López J, Joya MD, Lima J, Llamas P, Lobo JL, López‐Jiménez L, López‐Miguel P, López‐Núñez JJ, López‐Reyes R, López‐Sáez JB, Lorente MA, Lorenzo A, Loring M, Madridano O, Maestre A, Martín del Pozo M, Martín‐Guerra JM, Martín‐Romero M, Mellado M, Morales MV, Muñoz N, Nieto‐Cabrera MA, Nieto‐Rodríguez JA, Núñez‐Ares A, Núñez MJ, Olivares MC, Otalora S, Otero R, Pedrajas JM, Pellejero G, Pérez‐Rus G, Peris ML, Porras JA, Rivas A, Rodríguez‐Dávila MA, Rodríguez‐Hernández A, Rubio CM, Ruiz‐Artacho P, Ruiz‐Ruiz J, Ruiz‐Torregrosa P, Ruiz‐Sada P, Sahuquillo JC, Salazar V, Sampériz A, Sánchez‐Muñoz‐Torrero JF, Sancho T, Soler S, Sopeña B, Suriñach JM, Tolosa C, Torres MI, Trujillo‐Santos J, Uresandi F, Valle R, Vidal G, Villares P, Gutiérrez P, Vázquez FJ, Vilaseca A, Vanassche T, Vandenbriele C, Hirmerova J, Malý R, Salgado E, Benzidia I, Bertoletti L, Debourdeau P, Farge‐Bancel D, Hij A, Moustafa F, Schellong S, Braester A, Brenner B, Tzoran I, Sharif‐Kashani B, Bilora F, Bortoluzzi C, Bucherini E, Ciammaichella M, Dentali F, Di Micco P, Di Pangrazio M, Maida R, Mastroiacovo D, Pace F, Pallotti G, Parisi R, Pesavento R, Prandoni P, Quintavalla R, Rocci A, Siniscalchi C, Tufano A, Visonà A, Vo Hong N, Gibietis V, Skride A, Strautmane S, Bosevski M, Zdraveska M, Bounameaux H, Fresa M, Ney B, Caprini J, Bui HM, Pham KQ. D-dimer levels and risk of recurrence following provoked venous thromboembolism: findings from the RIETE registry. J Intern Med 2020; 287:32-41. [PMID: 31394000 DOI: 10.1111/joim.12969] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Patients with venous thromboembolism (VTE) secondary to transient risk factors may develop VTE recurrences after discontinuing anticoagulation. Identifying at-risk patients could help to guide the duration of therapy. METHODS We used the RIETE database to assess the prognostic value of d-dimer testing after discontinuing anticoagulation to identify patients at increased risk for recurrences. Transient risk factors were classified as major (postoperative) or minor (pregnancy, oestrogen use, immobilization or recent travel). RESULTS In December 2018, 1655 VTE patients with transient risk factors (major 460, minor 1195) underwent d-dimer measurements after discontinuing anticoagulation. Amongst patients with major risk factors, the recurrence rate was 5.74 (95% CI: 3.19-9.57) events per 100 patient-years in those with raised d-dimer levels and 2.68 (95% CI: 1.45-4.56) in those with normal levels. Amongst patients with minor risk factors, the rates were 7.79 (95% CI: 5.71-10.4) and 3.34 (95% CI: 2.39-4.53), respectively. Patients with major risk factors and raised d-dimer levels (n = 171) had a nonsignificantly higher rate of recurrences (hazard ratio [HR]: 2.14; 95% CI: 0.96-4.79) than those with normal levels. Patients with minor risk factors and raised d-dimer levels (n = 382) had a higher rate of recurrences (HR: 2.34; 95% CI: 1.51-3.63) than those with normal levels. On multivariate analysis, raised d-dimers (HR: 1.74; 95% CI: 1.09-2.77) were associated with an increased risk for recurrences in patients with minor risk factors, not in those with major risk factors. CONCLUSIONS Patients with raised d-dimer levels after discontinuing anticoagulant therapy for VTE provoked by a minor transient risk factor were at an increased risk for recurrences.
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Affiliation(s)
- O Avnery
- Meir Medical Center, Hematology Institute and Blood Bank, Kfar Saba, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - M Martin
- Hospital Infanta Sofia San Sebastian de los Reyes and Universidad Europea de Madrid, Madrid, Spain
| | - A Bura-Riviere
- Department of Vascular Medicine, Hôpital de Rangueil, Toulouse, France
| | - G Barillari
- Department of Internal Medicine, Ospedale S. Maria della Misericordia, Udine, Italy
| | - L Mazzolai
- Department of Angiology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - I Mahé
- Department of Internal Medicine, Hôpital Louis Mourier, Colombes (APHP), University Paris 7, Colombes, France
| | - P J Marchena
- Department of Internal Medicine and Emergency, Parc Sanitari Sant Joan de Deu-Hospital General, Barcelona, Spain
| | - P Verhamme
- Vascular Medicine and Haemostasis, University of Leuven, Leuven, Belgium
| | - M Monreal
- Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - M H Ellis
- Meir Medical Center, Hematology Institute and Blood Bank, Kfar Saba, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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15
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Pascual-Geler M, Robles-Fernandez I, Monteagudo C, Lopez-Guarnido O, Rodrigo L, Gálvez-Ontiveros Y, Cozar JM, Rivas A, Alvarez-Cubero MJ. Impact of oxidative stress SNPs and dietary antioxidant quality score on prostate cancer. Int J Food Sci Nutr 2019; 71:500-508. [PMID: 31647334 DOI: 10.1080/09637486.2019.1680958] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Purpose: To analyse the relation between antioxidant genotypes and Dietary Antioxidant Quality score (DAQs) effect on prostate cancer (PCa) risk and aggressiveness in a Spanish population.Methods: Men (N = 155 patients and 152 controls) with PSA values >4 ng/ml were enrolled in the project. DAQs were used considering the daily recommended intake for Spanish people (DRI). Genotyping of 5 SNPs rs662 (PON1), rs10432782 (SOD1), rs4880 (SOD2), rs17650792 (GPX1) and rs1001179 (CAT) were included for the analysis.Results: rs17650792 was statistically significant between case and controls subjects. When comparing D´Amico risk, we found that rs662 (CC), rs10432782 (G allele) and rs17650792 (GG) confer a protection. When testing SNP-antioxidant nutrients interactions, we found an intake of vitamin A and rs100179 (T carriers) and selenium and rs17650792 (G carriers) confers a protection of being in low risk classification.Conclusions: We reported by the first time a correlation between rs662 (PON1) and PCa aggressiveness.
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Affiliation(s)
- M Pascual-Geler
- Urology Department, University Hospital Virgen de las Nieves, Granada, Spain
| | - I Robles-Fernandez
- GENYO (Pfizer-University of Granada-Andalusian Government Centre for Genomics and Oncological Research), Granada, Spain
| | - C Monteagudo
- Department of Nutrition and Food Science, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria (ibs. GRANADA), Granada, Spain
| | - O Lopez-Guarnido
- Legal Medicine and Toxicology Department, University of Granada, Granada, Spain
| | - L Rodrigo
- Legal Medicine and Toxicology Department, University of Granada, Granada, Spain
| | - Y Gálvez-Ontiveros
- Department of Nutrition and Food Science, University of Granada, Granada, Spain
| | - J M Cozar
- Urology Department, University Hospital Virgen de las Nieves, Granada, Spain
| | - A Rivas
- Department of Nutrition and Food Science, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria (ibs. GRANADA), Granada, Spain
| | - M J Alvarez-Cubero
- GENYO (Pfizer-University of Granada-Andalusian Government Centre for Genomics and Oncological Research), Granada, Spain.,Department of Biochemistry & Molecular Biology III - Faculty of Medicine - PTS, University of Granada, Granada, Spain
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16
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Franchi F, Rollini F, Kairouz V, Rivas J, Rivas A, Agarwal M, Briceno M, Wali M, Nawaz A, Silva G, Shaikh Z, Soffer D, Zenni MM, Bass TA, Angiolillo DJ. P1930Pharmacodynamic effects of vorapaxar as an add-on antiplatelet therapy in patients with and without diabetes mellitus: the optimizing anti-platelet therapy in diabetes mellitus (OPTIMUS)-5 study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0677] [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
Vorapaxar (Vora) is a protease-activated receptor (PAR)-1 inhibitor which when added to dual antiplatelet therapy (DAPT) in patients with a history of myocardial infarction (MI) or with peripheral arterial (PAD) reduces thrombotic cardiovascular events at the expense of increased bleeding. The efficacy of Vora is enhanced in patients with diabetes mellitus (DM) compared to non-DM. However, the differential pharmacodynamic (PD) effects of Vora in DM vs non-DM patients are unknown. Moreover, although withdrawal of aspirin has emerged as a strategy to reduce bleeding when adjunctive antithrombotic therapies are used, the PD effects of Vora after stopping aspirin in DAPT treated patients is unknown.
Purpose
To assess the PD effects of Vora in addition to standard DAPT as well as in combination with clopidogrel following aspirin withdrawal in patients with and without DM.
Methods
This was a prospective parallel-design PD study conducted in post-MI or PAD patients with and without DM. Patients on DAPT with aspirin (81mg/qd) and clopidogrel (75mg/qd) were divided in two groups according to DM status. Each cohort was treated with Vora (2.5mg/qd) in addition to DAPT (i.e., triple therapy) for 30 days and afterwards stopped aspirin and maintained treatment with Vora plus clopidogrel (i.e., dual therapy) for other 30 days. PD testing using 5 different assays was conducted at 3 time-points: baseline (while on DAPT); after 30 days of triple therapy; after 30 days of dual therapy. The primary endpoint was the non-inferiority of CAT (Collagen-ADP-TRAP)-induced aggregation, a marker of global platelet reactivity, of Vora plus clopidogrel (dual therapy) vs Vora plus DAPT (triple therapy).
Results
The PD population was composed of a total of 64 patients (DM, n=30; non-DM, n=34). Although adding Vora to DAPT significantly reduced CAT-induced aggregation, stopping aspirin was associated with an increase in CAT-induced aggregation in both DM (mean difference=12; 95% CI: 3 to 21; p=0.010) and non-DM (mean difference=10; 95% CI: 4 to 16; p=0.003), thus not meeting the primary endpoint of non-inferiority (Figure). The magnitude of such increase was higher in DM compared with non-DM (p=0.036). Although Vora abolished TRAP-induced aggregation in both DM and non-DM patients, it did not affect markers of clot kinetics including speed of thrombin generation. Aspirin withdrawal was associated with a marked increase in makers sensitive to cyclooxygenase-1 (COX-1) blockade; markers of P2Y12 signaling were higher in DM compared to not DM after aspirin withdrawal.
CAT-induced aggregation
Conclusion
Adjunctive treatment with Vora reduces platelet-mediated thrombogenicity without affecting clot kinetics in both DM and non-DM patients while on DAPT. However, platelet-mediated thrombogenicity is increased after aspirin withdrawal, a phenomenon which is enhanced in DM patients underscoring the pivotal contribution of the COX-1 signaling pathway in these high risk patients.
Acknowledgement/Funding
The study was supported in part by an investigator initiated study grant from Merck
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Affiliation(s)
- F Franchi
- University of Florida College of Medicine, Jacksonville, United States of America
| | - F Rollini
- University of Florida College of Medicine, Jacksonville, United States of America
| | - V Kairouz
- University of Florida College of Medicine, Jacksonville, United States of America
| | - J Rivas
- University of Florida College of Medicine, Jacksonville, United States of America
| | - A Rivas
- University of Florida College of Medicine, Jacksonville, United States of America
| | - M Agarwal
- University of Florida College of Medicine, Jacksonville, United States of America
| | - M Briceno
- University of Florida College of Medicine, Jacksonville, United States of America
| | - M Wali
- University of Florida College of Medicine, Jacksonville, United States of America
| | - A Nawaz
- University of Florida College of Medicine, Jacksonville, United States of America
| | - G Silva
- University of Florida College of Medicine, Jacksonville, United States of America
| | - Z Shaikh
- University of Florida College of Medicine, Jacksonville, United States of America
| | - D Soffer
- University of Florida College of Medicine, Jacksonville, United States of America
| | - M M Zenni
- University of Florida College of Medicine, Jacksonville, United States of America
| | - T A Bass
- University of Florida College of Medicine, Jacksonville, United States of America
| | - D J Angiolillo
- University of Florida College of Medicine, Jacksonville, United States of America
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17
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Franchi F, Rollini F, Rivas J, Rivas A, Agarwal M, Briecno M, Wali M, Nawaz A, Silva G, Shaikh Z, Pineda A, Soffer D, Zenni MM, Bass TA, Angiolillo DJ. P1934Platelet inhibitory profiles of prasugrel versus ticagrelor in patients with CYP2C19 loss-of-function genotypes undergoing percutaneous coronary intervention: results of a randomized feasibility study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0681] [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
Although clopidogrel is the most widely used P2Y12 inhibitor, loss-of-function (LOF) allelic variants located within the hepatic cytochrome P450 (CYP) 2C19 gene lead to attenuated bioactivation, increased rates of high platelet reactivity (HPR), and worse outcomes in patients undergoing percutaneous coronary intervention (PCI). Drug regulating authorities have suggested using alternative P2Y12 inhibitors (i.e., prasugrel or ticagrelor) in these patients. However, tailoring antiplatelet therapy in clinical practice according to results of genetic testing has been limited due to lack of access to promptly available results. Moreover, there are no head-to-head pharmacodynamic (PD) comparisons of prasugrel vs ticagrelor among patients with CYP2C19 LOF alleles.
Purpose
The aim of this study was to evaluate the feasibility of using rapid genetic testing in clinical practice and to compare the PD effects of prasugrel vs ticagrelor in patients undergoing PCI with CYP2C19 LOF alleles.
Methods
This was a prospective, randomized study conducted in patients with stable coronary artery disease and non-ST elevation acute coronary syndrome scheduled for left heart catheterization (LHC) with the intent to undergo PCI. Patients underwent rapid genetic testing using the Spartan RX assay, which defines CYP2C19 genetic status within 1 hour, allowing patients to be genotyped the same day of their LHC. Patients who were carriers of at least one LOF (*2 or *3) allele were randomized to receive either prasugrel [60mg loading dose (LD) - 10mg/day maintenance dose (MD)] or ticagrelor (180mg LD - 90mg b.i.d MD). Blood samples for PD analysis by VerifyNow were collected at 5 time points: baseline (prior to PCI), 30 minutes, 2 hours, 24 hours (or at hospital discharge whichever came first), and 1–4 weeks post-LD. All patients were treated with aspirin. The primary endpoint of our study was the non-inferiority in platelet reactivity, measured as PRU, at 24 hours of prasugrel vs ticagrelor in LOF allele carriers.
Results
A total of 781 consecutive patients scheduled for LHC were genotyped, of whom 223 (28.5%) were carriers of at least one LOF. Of these, 65 patients underwent PCI and randomized to prasugrel (n=32) vs ticagrelor (n=33). PRU levels at 24 hours were 33 vs 36 (prasugrel vs ticagrelor; mean difference = −3; 95% CI: −28 to 22; p=0.814) meeting the primary endpoint of non-inferiority. Both prasugrel and ticagrelor significantly reduced PRU to a similar extent with no differences between groups at all other time points (Figure). Accordingly, HPR rates were low and similar between groups.
PRU by VerifyNow
Conclusion
Rapid genetic testing using the Spartan assay is feasible providing results in a timely fashion in a real-world clinical practice of patients undergoing PCI. Among patients with CYP2C19 LOF carrier status, prasugrel and ticagrelor are associated with similar levels of platelet inhibition.
Acknowledgement/Funding
Genetic testing was provided by Spartan RX
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Affiliation(s)
- F Franchi
- University of Florida College of Medicine, Jacksonville, United States of America
| | - F Rollini
- University of Florida College of Medicine, Jacksonville, United States of America
| | - J Rivas
- University of Florida College of Medicine, Jacksonville, United States of America
| | - A Rivas
- University of Florida College of Medicine, Jacksonville, United States of America
| | - M Agarwal
- University of Florida College of Medicine, Jacksonville, United States of America
| | - M Briecno
- University of Florida College of Medicine, Jacksonville, United States of America
| | - M Wali
- University of Florida College of Medicine, Jacksonville, United States of America
| | - A Nawaz
- University of Florida College of Medicine, Jacksonville, United States of America
| | - G Silva
- University of Florida College of Medicine, Jacksonville, United States of America
| | - Z Shaikh
- University of Florida College of Medicine, Jacksonville, United States of America
| | - A Pineda
- University of Florida College of Medicine, Jacksonville, United States of America
| | - D Soffer
- University of Florida College of Medicine, Jacksonville, United States of America
| | - M M Zenni
- University of Florida College of Medicine, Jacksonville, United States of America
| | - T A Bass
- University of Florida College of Medicine, Jacksonville, United States of America
| | - D J Angiolillo
- University of Florida College of Medicine, Jacksonville, United States of America
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18
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Puig N, Benítez S, Miñambres I, Rivas A, Grau M, Sánchez J, Pérez A. Effect Of Lipid-Lowering Treatment In Composition And Functionality Of Lipoproteins In Patients With Familial Combined Hyperlipidemia. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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19
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Ouyang K, Rivas A, Baugh A, Qin M, Agak G, Kim J. 510 Distinguishing type II from type I cutibacterium acnes: an efficient method for studying c. acnes interaction. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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20
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Crawford R, Sims ED, Wang KW, Youssef M, Nadarajah A, Rivas A, Banfield L, Thabane L, Samaan MC. Traditional knowledge-based lifestyle interventions in the prevention of obesity and type 2 diabetes in Indigenous children in Canada: a systematic review protocol. Syst Rev 2019; 8:69. [PMID: 30841917 PMCID: PMC6402164 DOI: 10.1186/s13643-019-0961-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 01/23/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Approximately 50% of all youth-onset type 2 diabetes mellitus (T2DM) in Canada occurs in Indigenous children. In adults, cardiovascular disease is one of the leading causes of mortality in First Nations communities, and diabetes is a significant contributor to the risk of developing this disorder. The early onset of diabetes may predispose these children to premature cardiovascular disease and influence their longevity and quality of life. As a result, the implementation of culturally tailored obesity and T2DM primary prevention programs is vital. This systematic review aims to assess the effectiveness of existing traditional knowledge-based lifestyle intervention programs on preventing obesity and T2DM in Indigenous children in Canada. METHODS We will conduct database searches in MEDLINE, Embase, PsycINFO, SPORTDiscus, CINAHL, Web of Science, Cochrane Database of Systematic Reviews, and the Cochrane Controlled Register of Trials. We will also conduct grey literature searches of central repository of trials ( ClinicalTrials.gov ), ProQuest Dissertations, Theses A&I, and Indigenous studies portal research tools. Reviewers will independently review titles, abstracts, and full-text articles retrieved from databases to assess potentially eligible studies, and relevant articles will be assessed for risk of bias and quality. The primary outcomes include the change in body mass index z-scores or a diagnosis of diabetes. The secondary outcomes include the change in measures of adiposity as well as lifestyle and metabolic profiles. A meta-analysis will be performed if two or more studies have used similar study designs, comparable intervention techniques , similar populations and measured similar outcomes. DISCUSSION This review will provide a summary of current interventions to prevent obesity and T2DM in Indigenous children in Canada and help determine the gaps in the literature so that interventions can be developed to control the surge in pediatric T2DM in Indigenous communities. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017072781.
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Affiliation(s)
- Rebecca Crawford
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario L8S 4K1 Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario Canada
- Indigenous Undergraduate Summer Research Scholars Program, Hamilton, Ontario Canada
| | - E. Danielle Sims
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario L8S 4K1 Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario Canada
- Medical Sciences Graduate Program, McMaster University, Hamilton, Ontario Canada
| | - Kuan-Wen Wang
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario L8S 4K1 Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario Canada
- Medical Sciences Graduate Program, McMaster University, Hamilton, Ontario Canada
| | - Michael Youssef
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario L8S 4K1 Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario Canada
| | - Ajantha Nadarajah
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario L8S 4K1 Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario Canada
| | - Angelica Rivas
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario L8S 4K1 Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario Canada
| | - Laura Banfield
- Health Sciences Library, McMaster University, Hamilton, Ontario Canada
| | - Lehana Thabane
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario L8S 4K1 Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario Canada
- Department of Anesthesia, McMaster University, Hamilton, Ontario Canada
- Centre for Evaluation of Medicines, St. Joseph’s Health Care, Hamilton, Ontario Canada
- Biostatistics Unit, St. Joseph’s Healthcare, Hamilton, Ontario Canada
| | - M. Constantine Samaan
- Department of Pediatrics, McMaster University, 1280 Main Street West, HSC-3A57, Hamilton, Ontario L8S 4K1 Canada
- Division of Pediatric Endocrinology, McMaster Children’s Hospital, Hamilton, Ontario Canada
- Medical Sciences Graduate Program, McMaster University, Hamilton, Ontario Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario Canada
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21
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Salazar V, Castillo A, Rivas A, Valle R, Nieto J, Font C, Schellong S, Braester A, Fidalgo A, Monreal M. O004: Vena caval filter in pregnant women with acute venous thromboembolism: is it useful and safe? Thromb Res 2019. [DOI: 10.1016/s0049-3848(19)30084-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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22
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Pina-Pérez MC, Rivas A, Martínez A, Rodrigo D. Antimicrobial potential of macro and microalgae against pathogenic and spoilage microorganisms in food. Food Chem 2017; 235:34-44. [PMID: 28554644 PMCID: PMC7131516 DOI: 10.1016/j.foodchem.2017.05.033] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 05/01/2017] [Accepted: 05/06/2017] [Indexed: 11/16/2022]
Abstract
Algae are a valuable and never-failing source of bioactive compounds. The increasing efforts to use ingredients that are as natural as possible in the formulation of innovative products has given rise to the introduction of macro and microalgae in food industry. To date, scarce information has been published about algae ingredients as antimicrobials in food. The antimicrobial potential of algae is highly dependent on: (i) type, brown algae being the most effective against foodborne bacteria; (ii) the solvent used in the extraction of bioactive compounds, ethanolic and methanolic extracts being highly effective against Gram-positive and Gram-negative bacteria; and (iii) the concentration of the extract. The present paper reviews the main antimicrobial potential of algal species and their bioactive compounds in reference and real food matrices. The validation of the algae antimicrobial potential in real food matrices is still a research niche, being meat and bakery products the most studied substrates.
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Affiliation(s)
- M C Pina-Pérez
- Centro Avanzado de Microbiología de Alimentos (CAMA) - Universitat Politècnica de Valencia (UPV), Camino de Vera s/n, 46022 Valencia, Spain.
| | - A Rivas
- Instituto de Agroquímica y Tecnología de Alimentos (IATA-CSIC), Departamento Conservación y Calidad de los Alimentos, Avda. Agustin Escardino, 7, 46980 Paterna, Valencia, Spain
| | - A Martínez
- Instituto de Agroquímica y Tecnología de Alimentos (IATA-CSIC), Departamento Conservación y Calidad de los Alimentos, Avda. Agustin Escardino, 7, 46980 Paterna, Valencia, Spain
| | - D Rodrigo
- Instituto de Agroquímica y Tecnología de Alimentos (IATA-CSIC), Departamento Conservación y Calidad de los Alimentos, Avda. Agustin Escardino, 7, 46980 Paterna, Valencia, Spain
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Collins S, Singh R, Rivas A, Palmer A, Horne D, Manderson A, Roygard J, Matthews A. Transport and potential attenuation of nitrogen in shallow groundwaters in the lower Rangitikei catchment, New Zealand. J Contam Hydrol 2017; 206:55-66. [PMID: 29033220 DOI: 10.1016/j.jconhyd.2017.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 11/20/2016] [Revised: 10/02/2017] [Accepted: 10/02/2017] [Indexed: 06/07/2023]
Abstract
Intensive agricultural activities are generally associated with nitrogen leaching from agricultural soils, and this nitrogen has the potential to percolate and contaminate groundwater and surface waters. We assessed surface water and groundwater interactions, and nitrogen leaching and its potential attenuation in shallow groundwater in the lower Rangitikei River catchment (832km2), New Zealand. We combined regional- and local-scale field surveys and experiments, nutrient budget modelling, and hydraulic and geochemical methods, to gain an insight into leaching, transformation and transport of nitrogen via groundwaters to the river in the study area. Concurrent river flow gaugings (in January 2015) and a piezometric map, developed from measured depths to groundwater in 110 bores (in October 2014), suggest groundwater discharges to the Rangitikei River in the upper parts of the study area, while there is groundwater recharge near the coast. The groundwater redox characterisation, based on sampling and analysis of 15 mostly shallow bores (<30m below ground level (bgl)), suggests groundwater across the lower Rangitikei catchment in general is under anoxic/reduced conditions. The groundwater typically has low dissolved oxygen (DO) concentrations (<1mg/L), suggesting the subsurface environment is conducive to potential attenuation by 'denitrification' of NO3-N in groundwater. We further measured NO3-N attenuation in shallow groundwater piezometers (3-6mbgl) using single-well push-pull tests. We found generally low levels (<0.5mg/L) of NO3-N in shallow groundwater piezometers (>5mbgl), despite being installed under intensive land uses, such as dairying and cropping. Our in-field push-pull tests showed NO3-N reduction at four shallow groundwater piezometers, with the rates of reduction varying from 0.04mgNL-1h-1 to 1.57mgNL-1h-1. This highlights the importance of a sound understanding of not only the sources, but also transport and transformation, or fate, of nutrients leached from farms, to mitigate the likely impacts of land use on water quality and ecosystem health in agricultural catchments.
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Affiliation(s)
- S Collins
- Soil and Earth Sciences, Massey University, Palmerston North, New Zealand; Horizons Regional Council, Palmerston North, New Zealand
| | - R Singh
- Soil and Earth Sciences, Massey University, Palmerston North, New Zealand.
| | - A Rivas
- Soil and Earth Sciences, Massey University, Palmerston North, New Zealand
| | - A Palmer
- Soil and Earth Sciences, Massey University, Palmerston North, New Zealand
| | - D Horne
- Soil and Earth Sciences, Massey University, Palmerston North, New Zealand
| | - A Manderson
- Landcare Research Limited, Palmerston North, New Zealand
| | - J Roygard
- Horizons Regional Council, Palmerston North, New Zealand
| | - A Matthews
- Horizons Regional Council, Palmerston North, New Zealand
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García-Córcoles MT, Cipa M, Rodríguez-Gómez R, Rivas A, Olea-Serrano F, Vílchez JL, Zafra-Gómez A. Determination of bisphenols with estrogenic activity in plastic packaged baby food samples using solid-liquid extraction and clean-up with dispersive sorbents followed by gas chromatography tandem mass spectrometry analysis. Talanta 2017; 178:441-448. [PMID: 29136846 DOI: 10.1016/j.talanta.2017.09.067] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 09/19/2017] [Accepted: 09/22/2017] [Indexed: 11/26/2022]
Abstract
Bisphenols (BPs) are a family of chemicals with known endocrine disrupting activity. Bisphenol A (BPA) is the most representative prototype of this group of chemicals. Recently, the use of BPA, a prototype of endocrine disruptors, has been reduced and replaced with structural analogs due to its negative effects on both the environment and consumers. In this work, a new method is presented for the determination of seven BPs, with estrogenic activity in ready-to-eat plastic packaged baby foods. The procedure involves the isolation of the analytes using solid-liquid phase extraction with acetonitrile followed by a clean-up step with a mixture of dispersive-SPE sorbents (C18 and PSA) and magnesium sulphate, to reduce matrix effect from proteins, sugars and lipids. Extraction parameters were optimized using multivariate optimization methods. The compounds were detected and quantified by gas chromatography tandem mass spectrometry (GC-MS/MS). The limits of quantification were between 0.1 and 1.2ngg-1 for the studied analytes. The method was validated using matrix-matched calibration and recovery assays with spiked samples. Recovery rates were between 91% and 110% and % RSD was lower than 13% in all cases. The method has been successfully applied for the determination of these endocrine disrupting chemicals (EDCs) in samples of a novel type of food consumed by pre-schoolers. This is the first study to analyze EDCs in plastic packaged foods consumed by this target group.
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Affiliation(s)
- M T García-Córcoles
- Research Group of Analytical Chemistry and Life Sciences, Department of Analytical Chemistry, Campus of Fuentenueva, University of Granada, E-18071 Granada, Spain
| | - M Cipa
- Research Group of Analytical Chemistry and Life Sciences, Department of Analytical Chemistry, Campus of Fuentenueva, University of Granada, E-18071 Granada, Spain; Department of Chemistry, University of Tirana, St. Bulevardi "Zogu I", 1001 Tirana, Albania
| | - R Rodríguez-Gómez
- Research Group of Analytical Chemistry and Life Sciences, Department of Analytical Chemistry, Campus of Fuentenueva, University of Granada, E-18071 Granada, Spain
| | - A Rivas
- Research Group on Nutrition, Diet and Risk Assessment, Department of Nutrition and Food Science, University of Granada, Campus of Cartuja s/n, 18071 Granada, Spain
| | - F Olea-Serrano
- Research Group on Nutrition, Diet and Risk Assessment, Department of Nutrition and Food Science, University of Granada, Campus of Cartuja s/n, 18071 Granada, Spain
| | - J L Vílchez
- Research Group of Analytical Chemistry and Life Sciences, Department of Analytical Chemistry, Campus of Fuentenueva, University of Granada, E-18071 Granada, Spain
| | - A Zafra-Gómez
- Research Group of Analytical Chemistry and Life Sciences, Department of Analytical Chemistry, Campus of Fuentenueva, University of Granada, E-18071 Granada, Spain.
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Sansano S, Rivas A, Pina-Pérez M, Martinez A, Rodrigo D. Stevia rebaudiana Bertoni effect on the hemolytic potential of Listeria monocytogenes. Int J Food Microbiol 2017; 250:7-11. [DOI: 10.1016/j.ijfoodmicro.2017.03.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 03/07/2017] [Accepted: 03/10/2017] [Indexed: 01/13/2023]
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Tzoran I, Papadakis M, Brenner B, Fidalgo Á, Rivas A, Wells PS, Gavín O, Adarraga MD, Moustafa F, Monreal M, Prandoni P, Brenner B, Barba R, Di Micco P, Bertoletti L, Tzoran I, Reis A, Bosevski M, Bounameaux H, Malý R, Wells P, Papadakis M, Adarraga M, Aibar M, Alfonso M, Arcelus J, Barba R, Barrón M, Barrón-Andrés B, Bascuñana J, Blanco-Molina A, Bueso T, Cañada G, Cañas I, Chic N, del Pozo R, del Toro J, Díaz-Pedroche M, Díaz-Peromingo J, Falgá C, Fernández-Capitán C, Fidalgo M, Font C, Font L, Gallego P, García A, García M, García-Bragado F, García-Brotons P, Gavín O, Gómez C, Gómez V, González J, González-Marcano D, Grau E, Grimón A, Guijarro R, Gutiérrez J, Hernández-Comes G, Hernández-Blasco L, Hermosa-Los Arcos M, Jara-Palomares L, Jaras M, Jiménez D, Joya M, Llamas P, Lecumberri R, Lobo J, López P, López-Jiménez L, López-Reyes R, López-Sáez J, Lorente M, Lorenzo A, Maestre A, Marchena P, Martín-Martos F, Monreal M, Nieto J, Nieto S, Núñez A, Núñez M, Odriozola M, Otero R, Pedrajas J, Pérez G, Pérez-Ductor C, Peris M, Porras J, Reig O, Riera-Mestre A, Riesco D, Rivas A, Rodríguez C, Rodríguez-Dávila M, Rosa V, Ruiz-Giménez N, Sahuquillo J, Sala-Sainz M, Sampériz A, Sánchez-Martínez R, Sánchez Simón-Talero R, Sanz O, Soler S, Suriñach J, Torres M, Trujillo-Santos J, Uresandi F, Valero B, Valle R, Vela J, Vicente M, Villalobos A, Vanassche T, Verhamme P, Wells P, Hirmerova J, Malý R, Tomko T, del Pozo G, Salgado E, Sánchez G, Bertoletti L, Bura-Riviere A, Mahé I, Merah A, Moustafa F, Papadakis M, Braester A, Brenner B, Tzoran I, Antonucci G, Barillari G, Bilora F, Bortoluzzi C, Cattabiani C, Ciammaichella M, Di Biase J, Di Micco P, Duce R, Ferrazzi P, Giorgi-Pierfranceschi M, Grandone E, Imbalzano E, Lodigiani C, Maida R, Mastroiacovo D, Pace F, Pesavento R, Pinelli M, Poggio R, Prandoni P, Rota L, Tiraferri E, Tonello D, Tufano A, Visonà A, Zalunardo B, Gibietis V, Skride A, Vitola B, Monteiro P, Ribeiro J, Sousa M, Bosevski M, Zdraveska M, Bounameaux H, Calanca L, Erdmann A, Mazzolai L. Outcome of Patients with Venous Thromboembolism and Factor V Leiden or Prothrombin 20210 Carrier Mutations During the Course of Anticoagulation. Am J Med 2017; 130:482.e1-482.e9. [PMID: 27986523 DOI: 10.1016/j.amjmed.2016.11.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 11/03/2016] [Accepted: 11/04/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Individuals with factor V Leiden or prothrombin G20210A mutations are at a higher risk to develop venous thromboembolism. However, the influence of these polymorphisms on patient outcome during anticoagulant therapy has not been consistently explored. METHODS We used the Registro Informatizado de Enfermedad TromboEmbólica database to compare rates of venous thromboembolism recurrence and bleeding events occurring during the anticoagulation course in factor V Leiden carriers, prothrombin mutation carriers, and noncarriers. RESULTS Between March 2001 and December 2015, 10,139 patients underwent thrombophilia testing. Of these, 1384 were factor V Leiden carriers, 1115 were prothrombin mutation carriers, and 7640 were noncarriers. During the anticoagulation course, 160 patients developed recurrent deep vein thrombosis and 94 patients developed pulmonary embolism (16 died); 154 patients had major bleeding (10 died), and 291 patients had nonmajor bleeding. On multivariable analysis, factor V Leiden carriers had a similar rate of venous thromboembolism recurrence (adjusted hazard ratio [HR], 1.16; 95% confidence interval [CI], 0.82-1.64), half the rate of major bleeding (adjusted HR, 0.50; 95% CI, 0.25-0.99) and a nonsignificantly lower rate of nonmajor bleeding (adjusted HR, 0.66; 95% CI, 0.43-1.01) than noncarriers. Prothrombin mutation carriers and noncarriers had a comparable rate of venous thromboembolism recurrence (adjusted HR, 1.00; 95% CI, 0.68-1.48), major bleeding (adjusted HR, 0.75; 95% CI, 0.42-1.34), and nonmajor bleeding events (adjusted HR, 1.10; 95% CI, 0.77-1.57). CONCLUSIONS During the anticoagulation course, factor V Leiden carriers had a similar risk for venous thromboembolism recurrence and half the risk for major bleeding compared with noncarriers. This finding may contribute to decision-making regarding anticoagulation duration in selected factor V Leiden carriers with venous thromboembolism.
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Affiliation(s)
- Inna Tzoran
- Department of Haematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel.
| | - Manolis Papadakis
- Haematology and Hemostasis Unit, Hospital Papageorgiou, Saloniki, Greece
| | - Benjamin Brenner
- Department of Haematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel
| | - Ángeles Fidalgo
- Department of Internal Medicine, Hospital Universitario de Salamanca, Spain
| | - Agustina Rivas
- Department of Pneumonology, Hospital Universitario Araba, Álava, Spain
| | - Philip S Wells
- Department of Medicine, University of Ottawa, Ottawa Hospital Research Institute, Ontario, Canada
| | - Olga Gavín
- Department of Haematology, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | | | - Farès Moustafa
- Department of Emergency, Clermont-Ferrand University Hospital, France
| | - Manuel Monreal
- Department of Internal Medicine, Hospital Universitario Germans Trias i Pujol de Badalona, Universidad Católica de Murcia, Barcelona, Spain
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Mahé I, Chidiac J, Bertoletti L, Font C, Trujillo-Santos J, Peris M, Pérez Ductor C, Nieto S, Grandone E, Monreal M, Arcelus J, Ballaz A, Barba R, Barrón M, Barrón-Andrés B, Bascuñana J, Blanco-Molina A, Bueso T, Casado I, Culla A, de Miguel J, del Toro J, Díaz-Peromingo J, Falgá C, Fernández-Capitán C, Font C, Font L, Gallego P, García-Bragado F, García-Brotons P, Gómez V, González J, Grau E, Grimón A, Guirado L, Gutiérrez J, Hernández G, Hernández-Blasco L, Isern V, Jara-Palomares L, Jaras M, Jiménez D, Lacruz B, Lecumberri R, Lobo J, López-Jiménez L, López-Reyes R, López-Sáez J, Lorente M, Lorenzo A, Madridano O, Marchena P, Martín-Antorán J, Martín-Martos F, Monreal M, Morales M, Nauffal D, Nieto J, Nieto S, Núñez M, Otalora S, Otero R, Pagán B, Pedrajas J, Pérez C, Pérez G, Peris M, Porras J, Ramírez L, Reig O, Riera A, Rivas A, Rodríguez-Dávila M, Rosa V, Ruiz-Artacho P, Ruiz-Giménez N, Ruiz-Martínez C, Sampériz A, Sala C, Sanz O, Soler S, Sopeña B, Suarez I, Suriñach J, Tiberio G, Tolosa C, Trujillo-Santos J, Uresandi F, Valle R, Vela J, Villalta J, Malfante P, Verhamme P, Wells P, Hirmerova J, Malý R, Tomko T, Salgado E, Bertoletti L, Bura-Riviere A, Farge-Bancel D, Hij A, Mahé I, Merah A, Papadakis M, Braester A, Brenner B, Tzoran I, Apollonio A, Barillari G, Candeloro G, Ciammaichella M, Di Micco P, Ferrazzi P, Grandone E, Lessiani G, Lodigiani C, Mastroiacovo D, Pace F, Pinelli M, Prandoni P, Rota L, Tiraferri E, Tufano A, Visonà A, Belovs A, Skride A, Moreira M, Ribeiro J, Sousa M, Bosevski M, Zdraveska M, Alatri A, Bounameaux H, Calanca L, Mazzolai L, Serrano J, Decousus H, Reis A. The Clinical Course of Venous Thromboembolism May Differ According to Cancer Site. Am J Med 2017; 130:337-347. [PMID: 27884650 DOI: 10.1016/j.amjmed.2016.10.017] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 09/21/2016] [Accepted: 10/24/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND We hypothesized that the clinical course of venous thromboembolism in patients with active cancer may differ according to the specificities of primary tumor site. AIM AND METHODS We used data from RIETE (international registry of patients with venous thromboembolism) to compare the clinical venous thromboembolism-related outcomes during the course of anticoagulation in patients with one of the 4 more frequent cancers (breast, prostate, colorectal, or lung cancer). RESULTS As of September 2014, 3947 cancer patients were recruited, of whom 938 had breast, 629 prostate, 1189 colorectal, and 1191 lung cancer. Overall, 55% had metastatic disease (42%, 36%, 53%, and 72%, respectively). During the course of anticoagulant therapy (mean duration, 139 days), the rate of thromboembolic recurrences was similar to the rate of major bleeding in patients with breast (5.6 [95% confidence interval (CI), 3.8-8.1] vs 4.1 [95% CI, 2.7-5.9] events per 100 patient-years) or colorectal cancer (10 [95% CI, 7.6-13] vs 12 [95% CI, 9.4-15] per 100 patient-years). In contrast, in patients with prostate cancer, the rate of venous thromboembolic recurrences was half the rate of major bleeding (6.9 [95% CI, 4.4-10] vs 13 [95% CI, 9.2-17] events per 100 patient-years), whereas in those with lung cancer, the rate of thromboembolic recurrences was twofold higher than the rate of major bleeding (27 [95% CI, 22-23] vs 11 [95% CI, 8.6-15] per 100 patient-years). CONCLUSIONS Significant differences in the clinical profile of venous thromboembolic-related outcomes were observed according to the site of cancer. These findings suggest the development of cancer-specific anticoagulant strategies as an area for further research.
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Affiliation(s)
- Isabelle Mahé
- Department of Internal Medicine, Hôpital Louis Mourier, Investigation Network on Venous Thrombo-embolism (INNOVTE), Colombes (APHP), University Paris 7, EA REMES 7334 France.
| | - Jean Chidiac
- Department of Internal Medicine, Hôpital Louis Mourier, Investigation Network on Venous Thrombo-embolism (INNOVTE), Colombes (APHP), University Paris 7, EA REMES 7334 France
| | - Laurent Bertoletti
- Department of Vascular and Therapeutic Medicine, CHU Saint-Etienne, Hôpital Nord, French Clinical Research Infrastructure Network (F-CRIN), INNOVTE
| | - Carme Font
- Department of Medical Oncology, IDIBAPS/Translational Genomics and Targeted Therapeutics in Solid Tumors, Hospital Clinic de Barcelona, Spain
| | - Javier Trujillo-Santos
- Department of Internal Medicine, Complejo Hospitalario Universitario de Cartagena, Murcia, Spain
| | - Marisa Peris
- Department of Internal Medicine, Hospital Provincial Castellon; CEU Cardenal Herrero University, Spain
| | - Cristina Pérez Ductor
- Department of Emergency Medicine, Hospital Universitario Doctor Peset, Valencia, Spain
| | - Santiago Nieto
- Department of Haematology, Hospital de la Vega Lorenzo Guirao, Murcia, Spain
| | - Elvira Grandone
- Atherosclerosis and Thrombosis Unit, Casa Sollievo Della Sofferenza, Foggia, Italy
| | - Manuel Monreal
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Universidad Católica de Murcia, Spain
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Newton DH, Monreal Bosch M, Amendola M, Wolfe L, Perez Ductor C, Lecumberri R, Levy MM, Monreal M, Decousus H, Prandoni P, Brenner B, Barba R, Di Micco P, Bertoletti L, Tzoran I, Reis A, Bosevski M, Bounameaux H, Malý R, Wells P, Papadakis M, Agüero R, Aibar M, Alfonso M, Aranda R, Arcelus J, Barba R, Barrón M, Barrón-Andrés B, Bascuñana J, Binetti J, Blanco-Molina A, Bueso T, Cañas I, Carmona F, Chic N, Culla A, del Pozo R, del Toro J, Díaz-Pedroche M, Díaz-Peromingo J, Falgá C, Fernández-Aracil C, Fernández-Capitán C, Fidalgo M, Font C, Font L, Gallego P, García M, García-Bragado F, Gómez V, González J, Grau E, Grimón A, Guirado L, Gutiérrez J, Hernández-Comes G, Hernández-Blasco L, Jara-Palomares L, Jaras M, Jiménez D, Joya M, Lecumberri R, Lobo J, López-Jiménez L, López-Reyes R, López-Sáez J, Lorente M, Lorenzo A, Manrique-Abos I, Marchena P, Martín M, Martín-Antorán J, Martín-Martos F, Monreal M, Nieto J, Nieto S, Núñez A, Núñez M, Otalora S, Otero R, Pagán B, Pedrajas J, Pérez G, Pérez I, Pérez-Ductor C, Peris M, Porras J, Reig O, Riera-Mestre A, Riesco D, Rivas A, Rodríguez-Dávila M, Rosa V, Rosillo-Hernández E, Ruiz-Artacho P, Ruiz-Giménez N, Sahuquillo J, Sala-Sainz M, Sampériz A, Sánchez R, Sanz O, Soler S, Sopeña B, Suriñach J, Tolosa C, Trujillo-Santos J, Uresandi F, Valero B, Valle R, Vela J, Vidal G, Villalta J, Vanassche T, Verhamme P, Wells P, Hirmerova J, Malý R, Salgado E, Bertoletti L, Bura-Riviere A, Champion K, Farge-Bancel D, Hij A, Mahé I, Merah A, Papadakis M, Braester A, Brenner B, Tzoran I, Antonucci G, Barillari G, Bilora F, Ciammaichella M, Dentali F, Di Micco P, Duce R, Ferrazzi P, Grandone E, Lodigiani C, Maida R, Pace F, Pesavento R, Poggio R, Prandoni P, Rota L, Tiraferri E, Tonello D, Tufano A, Visonà A, Zalunardo B, Drucka E, Kigitovica D, Skride A, Ramos A, Ribeiro J, Sousa M, Bosevski M, Zdraveska M, Bounameaux H, Erdmann A, Mazzolai L, Ney B. Analysis of noncatheter-associated upper extremity deep venous thrombosis from the RIETE registry. J Vasc Surg Venous Lymphat Disord 2017; 5:18-24.e1. [DOI: 10.1016/j.jvsv.2016.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 08/12/2016] [Indexed: 11/25/2022]
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Velasco R, Gómez B, Hernández-Bou S, Olaciregui I, de la Torre M, González A, Rivas A, Durán I, Rubio A. Validation of a predictive model for identifying febrile young infants with altered urinalysis at low risk of invasive bacterial infection. Eur J Clin Microbiol Infect Dis 2016; 36:281-284. [DOI: 10.1007/s10096-016-2798-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 09/19/2016] [Indexed: 10/20/2022]
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Rull A, Jayaraman S, Rivas A, Pérez Cuellar M, Ordóñez Llanos J, Sánchez Quesada J, Gursky O. Thermal stability of human plasma LDL(−): A paradoxical behavior of LDL aggregation. Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Monteagudo C, Mariscal-Arcas M, Heras-Gonzalez L, Ibañez-Peinado D, Rivas A, Olea-Serrano F. Effects of maternal diet and environmental exposure to organochlorine pesticides on newborn weight in Southern Spain. Chemosphere 2016; 156:135-142. [PMID: 27174826 DOI: 10.1016/j.chemosphere.2016.04.103] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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: 04/21/2016] [Accepted: 04/25/2016] [Indexed: 06/05/2023]
Abstract
An appropriate eating pattern is essential during childbearing years and pregnancy to ensure a healthy pregnancy and newborn. Our group developed a Mediterranean Diet Score for Pregnancy (MDS-P) based on the MD and the specific need of pregnant women for Fe, Ca, and folic acid. Humans are daily exposed to endocrine disruptors, which may alter body weight and hormone system regulation. This study analyzed the relationship of maternal diet and in utero exposure to organochlorine pesticides (OCPs) with newborn weight in mothers and newborns from Southern Spain. Higher MDS-P score, folic acid supplementation, and greater in utero exposure to endosulfan-diol and endosulfan-1 were related to higher newborn weight. MDS-P score was not associated with maternal weight gain during pregnancy (above or below 12 Kg). Residues from one or more OCPs were detected in 96.5% of umbilical cord serum samples from 320 newborns. The most frequent residues were endosulfans (96.5%). The presence of endosulfan-diol, endosulfan-I, p-p´DDT, folic acid supplementation, and a higher MDS-P (>8) were predictive factors for newborn overweight (>3500 g). Conversely, smoking during pregnancy, shorter gestation time (32-36 vs. 37-39 weeks), and lesser maternal weight gain during pregnancy predicted lower newborn weight (<2500 g). These results indicate prenatal exposure to OCPs in Southern Spain and its possible impact on the weight of healthy full-term newborns. Further studies are warranted to interpret the consequences of this exposure and identify preventive measures. Adherence to the MD and folic acid supplementation during pregnancy emerged as predictive factors for overweight in newborns.
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Affiliation(s)
- C Monteagudo
- Research Group Nutrition, Diet and Risk Assessment (AGR-255), Department of Nutrition and Food Science, University of Granada, Campus of Cartuja s/n, 18071, Granada, Spain; School of Hospitality, Culinary Arts and Meal Science, Örebro University, Grythyttan, Sweden
| | - M Mariscal-Arcas
- Research Group Nutrition, Diet and Risk Assessment (AGR-255), Department of Nutrition and Food Science, University of Granada, Campus of Cartuja s/n, 18071, Granada, Spain; School of Hospitality, Culinary Arts and Meal Science, Örebro University, Grythyttan, Sweden; Department of Food Technology, Nutrition and Food Science, University of Murcia, Campus de Lorca, 30800, Lorca, Spain
| | - L Heras-Gonzalez
- Research Group Nutrition, Diet and Risk Assessment (AGR-255), Department of Nutrition and Food Science, University of Granada, Campus of Cartuja s/n, 18071, Granada, Spain
| | - D Ibañez-Peinado
- Research Group Nutrition, Diet and Risk Assessment (AGR-255), Department of Nutrition and Food Science, University of Granada, Campus of Cartuja s/n, 18071, Granada, Spain
| | - A Rivas
- Research Group Nutrition, Diet and Risk Assessment (AGR-255), Department of Nutrition and Food Science, University of Granada, Campus of Cartuja s/n, 18071, Granada, Spain
| | - F Olea-Serrano
- Research Group Nutrition, Diet and Risk Assessment (AGR-255), Department of Nutrition and Food Science, University of Granada, Campus of Cartuja s/n, 18071, Granada, Spain.
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Román M, Ochoa D, Rivas A, Belmonte C, Abad-Santos F. Comparative Bioavailability of Aripiprazole Tablets and Orally Disintegrating Tablets In Young Healthy Volunteers. Clin Ther 2015. [DOI: 10.1016/j.clinthera.2015.05.410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Rivas A, Valdez S, González E, Abad F. Adverse Drug Reactions as A Cause of Hospital Admission Hospital Universitario De La Princesa – Madrid. Clin Ther 2015. [DOI: 10.1016/j.clinthera.2015.05.431] [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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Valdez S, Rivas A, Gonzalez E, Abad-Santos F, Ochoa D. Severe Dermatologic Reactions Associated With Drugs Identified In The Hospital Universitario De La Princesa. Clin Ther 2015. [DOI: 10.1016/j.clinthera.2015.05.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Affiliation(s)
- P Garcia-Huerta
- 1] Biomedical Neuroscience Institute, Faculty of Medicine, University of Chile, Santiago, Chile [2] Program of Cellular and Molecular Biology, Center for Molecular Studies of the Cell, Institute of Biomedical Sciences, University of Chile, Santiago, Chile
| | - A Rivas
- 1] Biomedical Neuroscience Institute, Faculty of Medicine, University of Chile, Santiago, Chile [2] Program of Cellular and Molecular Biology, Center for Molecular Studies of the Cell, Institute of Biomedical Sciences, University of Chile, Santiago, Chile
| | - C Hetz
- 1] Biomedical Neuroscience Institute, Faculty of Medicine, University of Chile, Santiago, Chile [2] Program of Cellular and Molecular Biology, Center for Molecular Studies of the Cell, Institute of Biomedical Sciences, University of Chile, Santiago, Chile [3] Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, MA, USA
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Trujillo-Santos J, Lozano F, Lorente MA, Adarraga D, Hirmerova J, Del Toro J, Mazzolai L, Barillari G, Barrón M, Monreal M, Alcalde M, Andújar V, Arcelus J, Barba R, Barrón M, Barrón-Andrés B, Bascuñana J, Blanco-Molina A, Bueso T, Casado I, Climent A, Conget F, del Molino F, del Toro J, Falgá C, Fernández-Capitán C, Font L, Gallego P, García-Bragado F, Gómez V, González J, González-Bachs E, Grau E, Guijarro R, Guil M, Gutiérrez J, Jara-Palomares L, Jaras M, Jiménez D, Jiménez R, Lecumberri R, Lobo J, López-Jiménez L, López-Montes L, López-Reyes R, López-Sáez J, Lorente M, Lorenzo A, Luque J, Madridano O, Marchena P, Martín-Antorán J, Mellado M, Monreal M, Morales M, Nauffal D, Nieto J, Núñez M, Ogea J, Otero R, Pagán B, Pedrajas J, Pérez-Rus G, Peris M, Porras J, Pons I, Riera-Mestre A, Rivas A, Rodríguez-Dávila M, Román P, Rosa V, Ruiz-Giménez N, Ruiz J, Sabio P, Samperiz A, Sánchez R, Soler S, Suriñach J, Tiberio G, Trujillo-Santos J, Uresandi F, Valero B, Valle R, Vela J, Villalobos A, Malfante P, Verhamme P, Peerlinck K, Wells P, Malý R, Hirmerova J, Kaletova M, Tomko T, Bertoletti L, Bura-Riviere A, Farès M, Grange C, Mahe I, Merah A, Quere I, Schellong S, Papadakis M, Braester A, Brenner B, Tzoran I, Zeltser D, Apollonio A, Barillari G, Ciammaichella M, Di Micco P, Duce R, Guida A, Maida R, Pace F, Pasca S, Piovella C, Pesavento R, Poggio R, Prandoni P, Rota L, Tiraferri E, Tonello D, Tufano A, Visonà A, Zalunardo B, Almeida S, Leal-Seabra F, Sousa M, Bosevski M, Alatri A, Bounameaux H, Calanca L, Mazzolai L, Serrano J. A prognostic score to identify low-risk outpatients with acute deep vein thrombosis in the lower limbs. Am J Med 2015; 128:90.e9-15. [PMID: 25242230 DOI: 10.1016/j.amjmed.2014.08.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 08/18/2014] [Accepted: 08/19/2014] [Indexed: 02/01/2023]
Abstract
BACKGROUND No prior studies have identified which patients with deep vein thrombosis in the lower limbs are at a low risk for adverse events within the first week of therapy. METHODS We used data from the Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) to identify patients at low risk for the composite outcome of pulmonary embolism, major bleeding, or death within the first week. We built a prognostic score and compared it with the decision to treat patients at home. RESULTS As of December 2013, 15,280 outpatients with deep vein thrombosis had been enrolled. Overall, 5164 patients (34%) were treated at home. Of these, 12 (0.23%) had pulmonary embolism, 8 (0.15%) bled, and 4 (0.08%) died. On multivariable analysis, chronic heart failure, recent immobility, recent bleeding, cancer, renal insufficiency, and abnormal platelet count independently predicted the risk for the composite outcome. Among 11,430 patients (75%) considered to be at low risk, 15 (0.13%) suffered pulmonary embolism, 22 (0.19%) bled, and 8 (0.07%) died. The C-statistic was 0.61 (95% confidence interval [CI], 0.57-0.65) for the decision to treat patients at home and 0.76 (95% CI, 0.72-0.79) for the score (P = .003). Net reclassification improvement was 41% (P < .001). Integrated discrimination improvement was 0.034 for the score and 0.015 for the clinical decision (P < .001). CONCLUSIONS Using 6 easily available variables, we identified outpatients with deep vein thrombosis at low risk for adverse events within the first week. These data may help to safely treat more patients at home. This score, however, should be validated.
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Affiliation(s)
- Javier Trujillo-Santos
- Department of Internal Medicine, Complejo Hospitalario Universitario de Cartagena, Murcia, Spain
| | - Francisco Lozano
- Department of Angiology and Vascular Surgery, Complejo Asistencial de Salamanca, Salamanca, Spain
| | - Manuel Alejandro Lorente
- Department of Internal Medicine, Hospital de la Agencia Valenciana de Salud Vega Baja, Alicante, Spain
| | - Dolores Adarraga
- Department of Internal Medicine, Hospital de Montilla, Córdoba, Spain
| | - Jana Hirmerova
- Department of Internal Medicine, University Hospital Plzen, Plzen, Czech Republic
| | - Jorge Del Toro
- Department of Internal Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Lucia Mazzolai
- Department of Angiology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Giovanni Barillari
- Department of Internal Medicine, Ospedale S. Maria della Misericordia, Udine, Italy
| | - Manuel Barrón
- Department of Pneumonology, Hospital San Pedro, Logroño, La Rioja, Spain
| | - Manuel Monreal
- Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
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Viyuela O, Rivas A, Martin-Delgado MA. Two-dimensional density-matrix topological fermionic phases: topological Uhlmann numbers. Phys Rev Lett 2014; 113:076408. [PMID: 25170721 DOI: 10.1103/physrevlett.113.076408] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Indexed: 05/05/2023]
Abstract
We construct a topological invariant that classifies density matrices of symmetry-protected topological orders in two-dimensional fermionic systems. As it is constructed out of the previously introduced Uhlmann phase, we refer to it as the topological Uhlmann number n_{U}. With it, we study thermal topological phases in several two-dimensional models of topological insulators and superconductors, computing phase diagrams where the temperature T is on an equal footing with the coupling constants in the Hamiltonian. Moreover, we find novel thermal-topological transitions between two nontrivial phases in a model with high Chern numbers. At small temperatures we recover the standard topological phases as the Uhlmann number approaches to the Chern number.
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Affiliation(s)
- O Viyuela
- Departamento de Física Teórica I, Universidad Complutense, 28040 Madrid, Spain
| | - A Rivas
- Departamento de Física Teórica I, Universidad Complutense, 28040 Madrid, Spain
| | - M A Martin-Delgado
- Departamento de Física Teórica I, Universidad Complutense, 28040 Madrid, Spain
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Rivas A, García-Martínez O, Mazzaglia G, Sánchez-Ortiz A, Ocaña-Peinado FM. Phenolic content of Sicilian virgin olive oils and their effect on MG-63 human osteoblastic cell proliferation. Grasas y Aceites 2014. [DOI: 10.3989/gya.0111141] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Viyuela O, Rivas A, Martin-Delgado MA. Uhlmann phase as a topological measure for one-dimensional fermion systems. Phys Rev Lett 2014; 112:130401. [PMID: 24745393 DOI: 10.1103/physrevlett.112.130401] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Indexed: 05/21/2023]
Abstract
We introduce the Uhlmann geometric phase as a tool to characterize symmetry-protected topological phases in one-dimensional fermion systems, such as topological insulators and superconductors. Since this phase is formulated for general mixed quantum states, it provides a way to extend topological properties to finite temperature situations. We illustrate these ideas with some paradigmatic models and find that there exists a critical temperature Tc at which the Uhlmann phase goes discontinuously and abruptly to zero. This stands as a borderline between two different topological phases as a function of the temperature. Furthermore, at small temperatures we recover the usual notion of topological phase in fermion systems.
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Affiliation(s)
- O Viyuela
- Departamento de Física Teórica I, Universidad Complutense, 28040 Madrid, Spain
| | - A Rivas
- Departamento de Física Teórica I, Universidad Complutense, 28040 Madrid, Spain
| | - M A Martin-Delgado
- Departamento de Física Teórica I, Universidad Complutense, 28040 Madrid, Spain
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Skarzynski H, van de Heyning P, Agrawal S, Arauz SL, Atlas M, Baumgartner W, Caversaccio M, de Bodt M, Gavilan J, Godey B, Green K, Gstoettner W, Hagen R, Han DM, Kameswaran M, Karltorp E, Kompis M, Kuzovkov V, Lassaletta L, Levevre F, Li Y, Manikoth M, Martin J, Mlynski R, Mueller J, O'Driscoll M, Parnes L, Prentiss S, Pulibalathingal S, Raine CH, Rajan G, Rajeswaran R, Rivas JA, Rivas A, Skarzynski PH, Sprinzl G, Staecker H, Stephan K, Usami S, Yanov Y, Zernotti ME, Zimmermann K, Lorens A, Mertens G. Towards a consensus on a hearing preservation classification system. Acta Otolaryngol 2013:3-13. [PMID: 24328756 DOI: 10.3109/00016489.2013.869059] [Citation(s) in RCA: 122] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION The comprehensive Hearing Preservation classification system presented in this paper is suitable for use for all cochlear implant users with measurable pre-operative residual hearing. If adopted as a universal reporting standard, as it was designed to be, it should prove highly beneficial by enabling future studies to quickly and easily compare the results of previous studies and meta-analyze their data. OBJECTIVES To develop a comprehensive Hearing Preservation classification system suitable for use for all cochlear implant users with measurable pre-operative residual hearing. METHODS The HEARRING group discussed and reviewed a number of different propositions of a HP classification systems and reviewed critical appraisals to develop a qualitative system in accordance with the prerequisites. RESULTS The Hearing Preservation Classification System proposed herein fulfills the following necessary criteria: 1) classification is independent from users' initial hearing, 2) it is appropriate for all cochlear implant users with measurable pre-operative residual hearing, 3) it covers the whole range of pure tone average from 0 to 120 dB; 4) it is easy to use and easy to understand.
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Rivas A, Romero A, Mariscal-Arcas M, Monteagudo C, López G, Lorenzo ML, Ocaña-Peinado FM, Olea-Serrano F. Association between dietary antioxidant quality score (DAQs) and bone mineral density in Spanish women. NUTR HOSP 2013; 27:1886-93. [PMID: 23588435 DOI: 10.3305/nh.2012.27.6.6039] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Accepted: 07/13/2012] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Several lines of evidence suggest a tight association between oxidative stress and the pathogenesis of osteoporosis in humans. The intake of antioxidants may influence Bone Mineral Density by acting as free radical scavengers, preventing oxidation-induced damage to bone cells. OBJECTIVE The aim of this study was to assess the association between the Dietary Antioxidant Quality Score and bone mineral density in a sample of healthy women. METHODS A total of 280 women were grouped into three major groups: women aged ≤ 35 years; women aged 36-45, and finally women aged >45 years. Calcaneous Bone Mineral Density (g/cm²) was measured by dual energy X-ray absorptiometry. Data on the eating habits of each participant were collected with a structured 24-hour diet recall questionnaire. A Dietary Antioxidant Quality Score was used to calculate antioxidant-nutrient intake. RESULTS A significant and positive association was observed among Bone Mineral Density and dietary intake of vitamin C and selenium. Zinc intake was significantly related to Bone Mineral Density in the youngest group. Low antioxidant consumers were considered individuals whose Dietary Antioxidant Quality Score was lower or equal than the median (3.5), and high antioxidant consumers were those whose Dietary Antioxidant Quality Score were higher than 3.5. Bone Mineral Density was higher in the participants defined as high antioxidant consumers in all aged groups. CONCLUSION The study showed that there is an association between Bone Mineral Density and the Dietary Antioxidant Quality Score in all the women studied. Therefore, new therapies for osteoporosis based on higher dietary antioxidant intakes might be developed basing on the results obtained in this study.
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Affiliation(s)
- A Rivas
- Department of Nutrition and Food Science, Faculty of Pharmacy, University of Granada, Granada, Spain.
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Rivas A, Pina-Pérez M, Rodriguez-Vargas S, Zuñiga M, Martinez A, Rodrigo D. Sublethally damaged cells of Escherichia coli by Pulsed Electric Fields: The chance of transformation and proteomic assays. Food Res Int 2013. [DOI: 10.1016/j.foodres.2013.01.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Van de Heyning P, Adunka O, Arauz SL, Atlas M, Baumgartner WD, Brill S, Bruce I, Buchman C, Caversaccio M, Dillon M, Eikelboom R, Eskilsson G, Gavilan J, Godey B, Green K, Gstoettner W, Hagen R, Han D, Iwasaki S, Kameswaran M, Karltorp E, Kleine Punte A, Kompis M, Kuthubutheen J, Kuzovkov V, Lassaletta L, Li Y, Lorens A, Manikoth M, Martin J, Mlynski R, Mueller J, O'Driscoll M, Parnes L, Pillsbury H, Prentiss S, Pulibalathingal S, Raine CH, Rajan G, Rajeswaran R, Riechelmann H, Rivas A, Rivas JA, Senn P, Skarzynski PH, Sprinzl G, Staecker H, Stephan K, Sugarova S, Usami SI, Wolf-Magele A, Yanov Y, Zernotti ME, Zimmerman K, Zorowka P, Skarzynski H. Standards of practice in the field of hearing implants. Cochlear Implants Int 2013; 14 Suppl 2:S1-5. [DOI: 10.1179/1467010013z.00000000093] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Reverte-Vinaixa MM, Velez R, Alvarez S, Rivas A, Perez M. Percutaneous computed tomography-guided resection of non-spinal osteoid osteomas in 54 patients and review of the literature. Arch Orthop Trauma Surg 2013; 133:449-55. [PMID: 23354882 DOI: 10.1007/s00402-013-1686-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [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] [Received: 08/29/2012] [Indexed: 02/01/2023]
Abstract
BACKGROUND Osteoid osteoma is a benign osteoblastic tumor with a nidus of <20 mm in maximum diameter. There are several treatment options, all of them aiming either to resect or to eliminate the nidus. PURPOSE To report and to describe the benefits of treating non-spinal osteoid osteoma by percutaneous computed tomography-guided resection, according to our experience. STUDY DESIGN Retrospective case series METHODS Between 1992 and 2008, 54 patients with non-spinal osteoid osteoma underwent primary treatment with percutaneous CT-guided resection. In all cases, the materials obtained were processed for pathology and microbiology. RESULTS Fifty-four patients with a mean age of 22.7 years (range 10-47), of whom 46 were males (85.2 %) and 8 were females (14.8 %). The lesion size ranged between 5 and 15 mm with an average size of 6.9 mm. The resection was considered complete by the CT study in all 54 cases. Of all the specimens sent to pathology, the histological diagnosis was achieved in 41 (75.9 %). Cure was obtained in 50 patients (92.6 %) and the other four patients required a second surgery using the same technique, after which all of them achieved clinical and radiological improvement (100 %). CONCLUSION Percutaneous computed tomography-guided resection of non-spinal osteoid osteomas provides good results, similar to other surgical techniques, with the advantages of being a simple, mini invasive, safe and economic procedure without the need for specific materials. Level of evidence, IV.
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Affiliation(s)
- María Mercedes Reverte-Vinaixa
- Departament de Cirugia Ortopédica y Traumatologia, Hospital Universitari Vall d'Hebron, Passeig de la Vall d'Hebron 119-129, Barcelona, Spain.
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Gallego I, Muñoz J, Rivas A, Sánchez-Cambronero S. Vertical Track Stiffness as a New Parameter Involved in Designing High-Speed Railway Infrastructure. ACTA ACUST UNITED AC 2011. [DOI: 10.1061/(asce)te.1943-5436.0000288] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- I. Gallego
- Assistant Professor, Dept. of Civil Engineering, Univ. of Castilla-La Mancha, Spain (corresponding author)
- Ph.D. student, Dept. of Civil Engineering, Univ. of Castilla-La Mancha, Spain
- Assistant Professor, Dept. of Civil Engineering, Univ. of Castilla-La Mancha, Spain
- Assistant Professor, Dept. of Civil Engineering, Univ. of Castilla-La Mancha, Spain
| | - J. Muñoz
- Assistant Professor, Dept. of Civil Engineering, Univ. of Castilla-La Mancha, Spain (corresponding author)
- Ph.D. student, Dept. of Civil Engineering, Univ. of Castilla-La Mancha, Spain
- Assistant Professor, Dept. of Civil Engineering, Univ. of Castilla-La Mancha, Spain
- Assistant Professor, Dept. of Civil Engineering, Univ. of Castilla-La Mancha, Spain
| | - A. Rivas
- Assistant Professor, Dept. of Civil Engineering, Univ. of Castilla-La Mancha, Spain (corresponding author)
- Ph.D. student, Dept. of Civil Engineering, Univ. of Castilla-La Mancha, Spain
- Assistant Professor, Dept. of Civil Engineering, Univ. of Castilla-La Mancha, Spain
- Assistant Professor, Dept. of Civil Engineering, Univ. of Castilla-La Mancha, Spain
| | - S. Sánchez-Cambronero
- Assistant Professor, Dept. of Civil Engineering, Univ. of Castilla-La Mancha, Spain (corresponding author)
- Ph.D. student, Dept. of Civil Engineering, Univ. of Castilla-La Mancha, Spain
- Assistant Professor, Dept. of Civil Engineering, Univ. of Castilla-La Mancha, Spain
- Assistant Professor, Dept. of Civil Engineering, Univ. of Castilla-La Mancha, Spain
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Ackerman N, Aharmim B, Auger M, Auty DJ, Barbeau PS, Barry K, Bartoszek L, Beauchamp E, Belov V, Benitez-Medina C, Breidenbach M, Burenkov A, Cleveland B, Conley R, Conti E, Cook J, Cook S, Coppens A, Counts I, Craddock W, Daniels T, Danilov MV, Davis CG, Davis J, deVoe R, Djurcic Z, Dobi A, Dolgolenko AG, Dolinski MJ, Donato K, Dunford M, Fairbank W, Farine J, Fierlinger P, Franco D, Freytag D, Giroux G, Gornea R, Graham K, Gratta G, Green MP, Hägemann C, Hall C, Hall K, Haller G, Hargrove C, Herbst R, Herrin S, Hodgson J, Hughes M, Johnson A, Karelin A, Kaufman LJ, Koffas T, Kuchenkov A, Kumar A, Kumar KS, Leonard DS, Leonard F, LePort F, Mackay D, MacLellan R, Marino M, Martin Y, Mong B, Díez MM, Morgan P, Müller AR, Neilson R, Nelson R, Odian A, O'Sullivan K, Ouellet C, Piepke A, Pocar A, Prescott CY, Pushkin K, Rivas A, Rollin E, Rowson PC, Russell JJ, Sabourov A, Sinclair D, Skarpaas K, Slutsky S, Stekhanov V, Strickland V, Swift M, Tosi D, Twelker K, Vogel P, Vuilleumier JL, Vuilleumier JM, Waite A, Waldman S, Walton T, Wamba K, Weber M, Wichoski U, Wodin J, Wright JD, Yang L, Yen YR, Zeldovich OY. Observation of two-neutrino double-beta decay in 136Xe with the EXO-200 detector. Phys Rev Lett 2011; 107:212501. [PMID: 22181874 DOI: 10.1103/physrevlett.107.212501] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2011] [Indexed: 05/31/2023]
Abstract
We report the observation of two-neutrino double-beta decay in (136)Xe with T(1/2) = 2.11 ± 0.04(stat) ± 0.21(syst) × 10(21) yr. This second-order process, predicted by the standard model, has been observed for several nuclei but not for (136)Xe. The observed decay rate provides new input to matrix element calculations and to the search for the more interesting neutrinoless double-beta decay, the most sensitive probe for the existence of Majorana particles and the measurement of the neutrino mass scale.
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Affiliation(s)
- N Ackerman
- SLAC National Accelerator Laboratory, Stanford, California, USA
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LePort F, Neilson R, Barbeau PS, Barry K, Bartoszek L, Counts I, Davis J, deVoe R, Dolinski MJ, Gratta G, Green M, Montero Díez M, Müller AR, O'Sullivan K, Rivas A, Twelker K, Aharmim B, Auger M, Belov V, Benitez-Medina C, Breidenbach M, Burenkov A, Cleveland B, Conley R, Cook J, Cook S, Craddock W, Daniels T, Dixit M, Dobi A, Donato K, Fairbank W, Farine J, Fierlinger P, Franco D, Giroux G, Gornea R, Graham K, Green C, Hägemann C, Hall C, Hall K, Hallman D, Hargrove C, Herrin S, Hughes M, Hodgson J, Juget F, Kaufman LJ, Karelin A, Ku J, Kuchenkov A, Kumar K, Leonard DS, Lutter G, Mackay D, MacLellan R, Marino M, Mong B, Morgan P, Odian A, Piepke A, Pocar A, Prescott CY, Pushkin K, Rollin E, Rowson PC, Schmoll B, Sinclair D, Skarpaas K, Slutsky S, Stekhanov V, Strickland V, Swift M, Vuilleumier JL, Vuilleumier JM, Wichoski U, Wodin J, Yang L, Yen YR. A magnetically driven piston pump for ultra-clean applications. Rev Sci Instrum 2011; 82:105114. [PMID: 22047336 DOI: 10.1063/1.3653391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A magnetically driven piston pump for xenon gas recirculation is presented. The pump is designed to satisfy extreme purity and containment requirements, as is appropriate for the recirculation of isotopically enriched xenon through the purification system and large liquid xenon time projection chamber of EXO-200. The pump, using sprung polymer gaskets, is capable of pumping more than 16 standard liters per minute of xenon gas with 750 Torr differential pressure.
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Affiliation(s)
- F LePort
- Department of Physics, Stanford University, Stanford, California 94305, USA
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Rivas A, Barceló-Quintal I, Moeller GE. Pollutant removal in a multi-stage municipal wastewater treatment system comprised of constructed wetlands and a maturation pond, in a temperate climate. Water Sci Technol 2011; 64:980-987. [PMID: 22097088 DOI: 10.2166/wst.2011.731] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A multi-stage municipal wastewater treatment system is proposed to comply with Mexican standards for discharge into receiving water bodies. The system is located in Santa Fe de la Laguna, Mexico, an area with a temperate climate. It was designed for 2,700 people equivalent (259.2 m3/d) and consists of a preliminary treatment, a septic tank as well as two modules operating in parallel, each consisting of a horizontal subsurface-flow wetland, a maturation pond and a vertical flow polishing wetland. After two years of operation, on-site research was performed. An efficient biochemical oxygen demand (BOD5) (94-98%), chemical oxygen demand (91-93%), total suspended solids (93-97%), total Kjeldahl nitrogen (56-88%) and fecal coliform (4-5 logs) removal was obtained. Significant phosphorus removal was not accomplished in this study (25-52%). Evapotranspiration was measured in different treatment units. This study demonstrates that during the dry season wastewater treatment by this multi-stage system cannot comply with the limits established by Mexican standards for receiving water bodies type 'C'. However, it has demonstrated the system's potential for less restrictive uses such as agricultural irrigation, recreation and provides the opportunity for wastewater treatment in rural areas without electric energy.
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Affiliation(s)
- A Rivas
- Universidad Autónoma Metropolitana-Azcapotzalco, Posgrado en Ciencias e Ingeniería, Edificio K tercer piso, Av. San pablo 180 Col. Reynosa Tamaulipas, C. P. 02200, Mexico City.
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Rivas A, Landerer E, Burzio V, Gatica S, López C, Burzio L, Villegas J. 612 A single FISH procedure for the detection of tumor cells: Bladder cancer as model. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)72319-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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