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Salmerón P, Buckley C, Arando M, Alcoceba E, Romero B, Clavo P, Whiley D, Serra-Pladevall J. Genome-based epidemiology and antimicrobial resistance of Neisseria gonorrhoeae in Spain: A prospective multicentre study. J Eur Acad Dermatol Venereol 2023; 37:2575-2582. [PMID: 37620291 DOI: 10.1111/jdv.19458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 08/02/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Whole-genome sequencing (WGS) of Neisseria gonorrhoeae isolates combined with epidemiological and phenotypic data provides better understanding of population dynamics. AIM The objective of this study was to investigate the molecular epidemiology of N. gonorrhoeae isolates from three centres in Spain and determine associations of antimicrobial resistance. METHODS Genetic characterization was performed in 170 N. gonorrhoeae isolates. WGS was carried out with the HiSeq platform (Illumina). Genome assemblies were submitted to the PubMLST Neisseria database website to determine NG-MAST, MLST and NG-STAR. Antimicrobial resistance genes and point mutations were identified with PubMLST. Phylogenomic comparison was based on whole-genome single nucleotide polymorphism analysis. RESULTS Twenty-six MLST, 49 NG-MAST and 41 NG-STAR sequence types were detected, the most prevalent being MLST-ST9363 (27.1%), NG-MAST ST569 (12.4%) and NG-STAR ST193 (14.7%). Phylogenetic analysis identified 13 clusters comprising 69% of the isolates, with two of note: one involved cefixime-resistant isolates from Barcelona presenting a mosaic penA X and belonging to MLST-ST7363 and the other involved azithromycin-resistant isolates from Mallorca that possessed the C2611T mutation in the four 23S rRNA alleles belonging to MLST-ST1901. CONCLUSION The population of N. gonorrhoeae is quite heterogeneous in Spain. Our results agree with previous data published in Europe, albeit with some differences in distribution between regions. This study describes the circulation of two gonococcal populations with a specific resistance profile and sequence type in a specific geographic area. WGS is an effective tool for epidemiological surveillance of gonococcal infection and detection of resistance genes.
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Affiliation(s)
- P Salmerón
- Microbiology Department, Vall d'Hebron Hospital Universitari, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
- Sexually Transmitted Infections Study Group (GEITS), Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC), Madrid, Spain
- Department of Genetics and Microbiology, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - C Buckley
- University of Queensland, UQ Centre for Clinical Research (UQCCR), Herston, Queensland, Australia
| | - M Arando
- Sexually Transmitted Infections Study Group (GEITS), Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC), Madrid, Spain
- Drassanes-Vall d'Hebron Sexually Transmitted Infections Unit, Vall d'Hebron Hospital Universitari, Barcelona, Spain
| | - E Alcoceba
- Microbiology Department, Son Espases Hospital Universitari, Mallorca, Spain
| | - B Romero
- Microbiology Department, Ramón y Cajal Hospital Universitario, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - P Clavo
- Sandoval Health Centre, San Carlos Hospital Clínico, Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - D Whiley
- University of Queensland, UQ Centre for Clinical Research (UQCCR), Herston, Queensland, Australia
| | - J Serra-Pladevall
- Sexually Transmitted Infections Study Group (GEITS), Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica (SEIMC), Madrid, Spain
- Clinical Laboratory, Hospital Universitari de Vic, Catalonia, Spain
- Faculty of Health Sciences, Universitat de Vic - Universitat Central de Catalunya (UVIC -UCC), Vic, Spain
- Multidisciplinary Inflammation Research Group (MIRG), Fundació Institut de Recerca i Innovació en Ciències de la Vida i de la Salut de la Catalunya Central, Vic, Spain
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Molina N, Sola-Leyva A, Vargas E, Canha-Gouveia A, Sáez-Lara M, Romero B, Sánchez R, Fontes J, Mozas-Moreno J, Martínez L, Castilla J, Aguilera C, Altmäe S. P-423 Metabolomic profiles of receptive-phase endometrium in women with different infertility diagnosis. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
What is the entire metabolomic profile of receptive-phase human endometrium and does the metabolic composition differ between women with different infertility diagnosis?
Summary answer
Human endometrium contains 925 different metabolites from diverse chemical classes, and the metabolomic signature varies between women with different infertility diagnosis.
What is known already
Different metabolites have been identified in human endometrium, including amino acids, nucleosides/nucleotides, organic acids, lipids, and sugars, with main focus on lipid profiles in endometriosis. Metabolic dysregulation in the uterus has been shown to provoke complex effects in the endometrium, leading to a low rate of embryo implantation and endometriosis. These are the first studies highlighting the importance of metabolites (metabolic routes) in endometrial functions and more research in the field is warranted. Further, the previous studies have focussed on specific metabolite classes, and we lack the knowledge of the whole metabolome composition in human uterus.
Study design, size, duration
This cross-sectional study included in total 47 women (age= 34.7±3.8 years, BMI= 24.5±4.2 kg/m²) who attended the Reproduction Unit at the University Hospital Granada from March 2019 to April 2021. Women with endometriosis (n = 13), unexplained infertility (n = 10), recurrent implantation failure (RIF) (n = 15) and male factor infertility (n = 9) were included. The study was approved by the Ethics Committee of Investigación Biomédica de Andalucia.
Participants/materials, setting, methods
Endometrial biopsies were collected at the mid-secretory phase (LH + 7) of a natural cycle using Pipelle curette. The complete metabolome from endometrial samples was analysed by Ultrahigh Performance Liquid Chromatography-Tandem Mass Spectroscopy (UPLC-MS/MS). Raw data were extracted, peak-identified and quality control processed using Metabolon’s hardware and software (metabolon.com). Multiple regression models controlling for age and BMI were applied using R software.
Main results and the role of chance
We provide the whole metabolome profile of endometrium, where 925 different metabolites were identified. Among these metabolites, lipid metabolites comprised the largest percentage (44%), where long chain fatty acids such as myristate (14:0), palmitoleate (16:1n7), nonadecanoate (19:0), arachidate (20:0), and dihomo-linolenate (20:3n3 or n6) prevailed. The endometrial metabolomic profiles differed significantly between women with different infertility diagnosis (p <0.05). Overall, the metabolites of the lipid and protein metabolism were less present, while carbohydrates, nucleotides, and xenobiotics were predominant in the uterus of women with unexplained infertility, endometriosis, and RIF when compared to women with male factor infertility. Specifically, the metabolites linoleate (18:2n6), linolenate (18:3n3 or n6), and dihomo-linolenate (20:3n3 or n6) were less abundant in women with indication of dysfunctional endometrium (endometriosis and RIF) (FDR p -value<0.05).
Limitations, reasons for caution
This is the first study presenting the complete metabolome of human endometrium on a limited sample size, which might have been underpowered to detect all differences in metabolite composition between groups.
Wider implications of the findings
This study identifies a metabolomic profiles associated with infertility diagnoses where altered endometrial functions are suspected (RIF and endometriosis). Our study findings could help to understand the molecular background of female infertility and lead to identification of potential molecular biomarkers of endometrial functions involved in embryo implantation and infertility.
Trial registration number
not applicable
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Affiliation(s)
- N.M Molina
- University of Granada, Department of Biochemistry and Molecular Biology- Faculty of Sciences , Granada, Spain
- ibs.GRANADA, Instituto de Investigación Biosanitaria , Granada, Spain
| | - A Sola-Leyva
- University of Granada, Department of Biochemistry and Molecular Biology- Faculty of Sciences , Granada, Spain
- ibs.GRANADA, Instituto de Investigación Biosanitaria , Granada, Spain
| | - E Vargas
- University of Granada, Department of Biochemistry and Molecular Biology- Faculty of Sciences , Granada, Spain
- ibs.GRANADA, Instituto de Investigación Biosanitaria , Granada, Spain
- University of Jaen, Department of Experimental Biology- Faculty of Experimental Sciences , Jaen, Spain
| | - A Canha-Gouveia
- University of Granada, Department of Biochemistry and Molecular Biology- Faculty of Sciences , Granada, Spain
| | - M.J Sáez-Lara
- University of Granada, Department of Biochemistry and Molecular Biology- Faculty of Sciences , Granada, Spain
- ibs.GRANADA, Instituto de Investigación Biosanitaria , Granada, Spain
- University of Granada, Institute of Nutrition and Food Technology “José Mataix”- Centre of Biomedical Research , Granada, Spain
| | - B Romero
- ibs.GRANADA, Instituto de Investigación Biosanitaria , Granada, Spain
- HU Virgen de las Nieves, Unidad Reproducción- UGC Laboratorio clínico y UGC Obstetricia y Ginecología , Granada, Spain
| | - R Sánchez
- HU Virgen de las Nieves, Unidad Reproducción- UGC Laboratorio clínico y UGC Obstetricia y Ginecología , Granada, Spain
| | - J Fontes
- ibs.GRANADA, Instituto de Investigación Biosanitaria , Granada, Spain
- HU Virgen de las Nieves, Unidad Reproducción- UGC Laboratorio clínico y UGC Obstetricia y Ginecología , Granada, Spain
| | - J Mozas-Moreno
- ibs.GRANADA, Instituto de Investigación Biosanitaria , Granada, Spain
- HU Virgen de las Nieves, Unidad Reproducción- UGC Laboratorio clínico y UGC Obstetricia y Ginecología , Granada, Spain
| | - L Martínez
- ibs.GRANADA, Instituto de Investigación Biosanitaria , Granada, Spain
- HU Virgen de las Nieves, Unidad Reproducción- UGC Laboratorio clínico y UGC Obstetricia y Ginecología , Granada, Spain
| | - J.A Castilla
- ibs.GRANADA, Instituto de Investigación Biosanitaria , Granada, Spain
- HU Virgen de las Nieves, Unidad Reproducción- UGC Laboratorio clínico y UGC Obstetricia y Ginecología , Granada, Spain
- CEIFER, Nextclinics , Granada, Spain
| | - C.M Aguilera
- ibs.GRANADA, Instituto de Investigación Biosanitaria , Granada, Spain
- University of Granada, Institute of Nutrition and Food Technology “José Mataix”- Centre of Biomedical Research , Granada, Spain
- University of Granada, Department of Biochemistry and Molecular Biology- Faculty of Pharmacy , Granada, Spain
- Instituto de Salud Carlos III, CIBEROBN CIBER Physiopathology of Obesity and Nutrition , Madrid, Spain
| | - S Altmäe
- University of Granada, Department of Biochemistry and Molecular Biology- Faculty of Sciences , Granada, Spain
- Karolinska Institute, Division of Obstetrics and Gynaecology- CLINTEC , Stockholm, Sweden
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Nag A, Romero B. Development and content validation of patient-reported outcomes tools for ulcerative colitis and Crohn's disease in adults with moderate-to-severe disease. Health Qual Life Outcomes 2022; 20:75. [PMID: 35525935 PMCID: PMC9078017 DOI: 10.1186/s12955-022-01975-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 04/14/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Ulcerative colitis (UC) and Crohn's disease (CD) are associated with a range of symptoms that adversely affect health-related quality of life. This research aimed to develop and validate two patient-reported outcome (PRO) tools to assess signs and symptoms in patients with moderate-to-severe UC or CD. METHODS PRO-UC and PRO-CD Diaries were developed in accordance with US Food and Drug Administration (FDA) recommendations. Data were collected from concept elicitation interviews (in which patients described their symptoms and experience of the disease) and further refined through cognitive interviews (in which patients assessed the relevance and clarity of questions in the tools). RESULTS Interviews were conducted with 12 patients for each indication. Five symptoms (urgent bowel movements, abdominal pain, frequent bowel movements, bloody stools, diarrhea/watery stools) were reported by 83-100% of participants with UC and were included in the final 6-item PRO-UC Diary: stool frequency, rectal bleeding (2 items), diarrhea, rectal urgency, and abdominal pain. For CD, seven symptoms (abdominal pain, diarrhea/loose stools, urgent bowel movements, fatigue/tiredness/weakness, frequent bowel movements, bloody stools, nausea) were reported by 50-100% of participants. These, together with vomiting and incontinence (reported by 42% and 33% of participants, respectively), were included in the final 10-item PRO-CD Diary, covering abdominal pain (2 items), stool frequency, liquid/very soft stool frequency, rectal bleeding, rectal urgency, nausea, vomiting, bowel incontinence, and general well-being. Symptoms were consistently cited across both indications to have an impact on quality of life, with frequent complaints being the need to always be near a toilet and inability to leave home, as well as general pain, discomfort, and nausea. For both tools, questions were accurately interpreted, with at least 67% of participants in both indications stating that items were easy to answer/relevant to their condition and symptoms were easy to recall over the last 24 h. CONCLUSIONS Both the PRO-UC and PRO-CD Diaries were developed and validated in accordance with FDA recommendations, providing two new tools for use in clinical trials to assess response to treatment in patients with UC or CD. Psychometric analyses are warranted to fully evaluate their properties and value for use in clinical trials.
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Affiliation(s)
- Arpita Nag
- Takeda Development Center Americas, Lexington, MA, USA
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4
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Ortega J, Infantes-Lorenzo J, Roy A, de Juan L, Romero B, Moreno I, Domínguez M, Domínguez L, Bezos J. Factors affecting the performance of P22 ELISA for the diagnosis of caprine tuberculosis in milk samples. Res Vet Sci 2022; 145:40-45. [DOI: 10.1016/j.rvsc.2022.02.008] [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] [Received: 10/21/2021] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 10/19/2022]
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Ortega J, Roy A, Díaz-Castillo A, de Juan L, Romero B, Sáez-Llorente JL, Domínguez L, Regal P, Infantes-Lorenzo JA, Álvarez J, Bezos J. Effect of the topical administration of corticosteroids and tuberculin pre-sensitisation on the diagnosis of tuberculosis in goats. BMC Vet Res 2022; 18:58. [PMID: 35086534 PMCID: PMC8793155 DOI: 10.1186/s12917-022-03156-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/17/2022] [Indexed: 12/05/2022] Open
Abstract
Background Caprine tuberculosis (TB) is a zoonosis caused by members of the Mycobacterium tuberculosis complex (MTBC). Caprine TB control and eradication programmes have traditionally been based on intradermal tuberculin tests and slaughterhouse surveillance. However, this strategy has limitations in terms of sensitivity and specificity. Different factors may affect the performance of the TB diagnostic tests used in goats and, subsequently, the detection of TB-infected animals. In the present study, the effect of two of the factors that may affect the performance of the techniques used to diagnose TB in goats, the topical administration of corticosteroids and a recent pre-sensitisation with tuberculin, was analysed. Methods The animals (n = 151) were distributed into three groups: (1) a group topically treated with corticosteroids 48 h after intradermal tuberculin tests (n = 53); (2) a group pre-sensitised with bovine and avian purified protein derivatives (PPDs) 3 days before the intradermal tuberculin test used for TB diagnosis (n = 48); and (3) a control group (n = 50). All the animals were tested using single and comparative intradermal tuberculin (SIT and CIT, respectively) tests, an interferon-gamma release assay (IGRA) and a P22 ELISA. Results The number of SIT test reactors was significantly lower in the group treated with corticosteroids when compared to the pre-sensitised (p < 0.001) and control (p = 0.036) groups. In contrast, pre-sensitisation with bovine and avian PPDs did not cause a significant reduction in the number of SIT and CIT test reactors compared with the control group. In fact, a higher number of reactors was observed after the prior tuberculin injection in the pre-sensitised group (p > 0.05). No significant effect was observed on IGRA and P22 ELISA due to corticosteroids administration. Nevertheless, a previous PPD injection affected the IGRA performance in some groups. Conclusions The application of topical corticosteroid 24 h before reading the SIT and CIT tests can reduce the increase in skin fold thickness and subsequently significantly decrease the number of positive reactors. Corticosteroids used can be detected in hair samples. A previous pre-sensitisation with bovine and avian PPDs does not lead to a significant reduction in the number of intradermal tests reactors. These results are valuable in order to improve diagnosis of caprine TB and detect fraudulent activities in the context of eradication programs.
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Affiliation(s)
- J Ortega
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain.,Centro de Vigilancia Sanitaria Veterinaria VISAVET, Universidad Complutense de Madrid, Madrid, Spain
| | - A Roy
- Centro de Vigilancia Sanitaria Veterinaria VISAVET, Universidad Complutense de Madrid, Madrid, Spain
| | - A Díaz-Castillo
- Centro de Vigilancia Sanitaria Veterinaria VISAVET, Universidad Complutense de Madrid, Madrid, Spain
| | - L de Juan
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain.,Centro de Vigilancia Sanitaria Veterinaria VISAVET, Universidad Complutense de Madrid, Madrid, Spain
| | - B Romero
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain.,Centro de Vigilancia Sanitaria Veterinaria VISAVET, Universidad Complutense de Madrid, Madrid, Spain
| | | | - L Domínguez
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain.,Centro de Vigilancia Sanitaria Veterinaria VISAVET, Universidad Complutense de Madrid, Madrid, Spain
| | - P Regal
- Laboratorio de Higiene, Inspección y Control de Alimentos (LHICA), Departamento de Química Analítica, Nutrición y Bromatología, Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
| | - J A Infantes-Lorenzo
- Unidad de Inmunología Microbiana, Centro Nacional de Microbiología, Instituto de Investigación Carlos III, Majadahonda, Madrid, Spain
| | - J Álvarez
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain.,Centro de Vigilancia Sanitaria Veterinaria VISAVET, Universidad Complutense de Madrid, Madrid, Spain
| | - J Bezos
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain. .,Centro de Vigilancia Sanitaria Veterinaria VISAVET, Universidad Complutense de Madrid, Madrid, Spain.
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Smith H, Romero B, Flood E, Boney A. The patient journey to diagnosis and treatment of congenital sucrase-isomaltase deficiency. Qual Life Res 2021; 30:2329-2338. [PMID: 33772704 PMCID: PMC8298246 DOI: 10.1007/s11136-021-02819-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2021] [Indexed: 11/12/2022]
Abstract
Purpose Congenital sucrase-isomaltase deficiency (CSID) is a rare genetic disorder characterized by a deficiency of the sucrase-isomaltase (SI) enzyme complex within the brush border membrane of the small intestine. Mutations in the SI gene result in abnormal synthesis and/or incorrect transport of the SI enzyme. Patients with CSID generally have reduced sucrase activity, but levels of isomaltase activity range from absent to almost normal. This study sought to better understand the experience of patients with CSID prior to, during, and after their diagnosis and its subsequent treatment with sacrosidase. Methods This was a cross-sectional interview study conducted in conjunction with a longitudinal, observational study of US patients prescribed and taking sacrosidase for at least three consecutive months as treatment for CSID. The observational study included both children and adults. Results This qualitative interview study explored the experiences of 43 adult and pediatric patients (n = 8 adults and n = 35 children/adolescents) with CSID pre-, during, and post-diagnosis. Findings suggest that a CSID diagnosis is particularly problematic given the disparate range of more commonly understood gastrointestinal (GI) disorders. After diagnosis and treatment with sacrosidase, participants reported considerable improvement in symptoms and health-related quality of life (HRQL), yet symptoms persist that continue to affect daily life, indicating areas of potential unmet need. Conclusion Educating clinicians about CSID may help improve the overall diagnosis experience. As this research is the first of its kind in CSID, additional research, qualitative and quantitative, will be important to furthering the understanding of HRQL impact and unmet need experienced by this population and identifying ways to best meet those needs.
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Infantes-Lorenzo JA, Romero B, Rodríguez-Bertos A, Roy A, Ortega J, de Juan L, Moreno I, Domínguez M, Domínguez L, Bezos J. Tuberculosis caused by Mycobacterium caprae in a camel (Camelus dromedarius). BMC Vet Res 2020; 16:435. [PMID: 33172453 PMCID: PMC7653750 DOI: 10.1186/s12917-020-02665-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 11/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Animal tuberculosis (TB) is distributed worldwide and has a wide range of wild and domestic reservoirs. Few studies concerning TB in camelids have been published in the last decade, particularly as regards Old World Camelids (OWC), but the increase in reports of TB outbreaks in these species in recent years suggests a high susceptibility to the infection. CASE PRESENTATION We studied a dromedary camel (Camelus dromedarius) herd (n = 24) in which a Mycobacterium caprae infection was detected. The TB infection was confirmed in one animal at necropsy through the detection of TB lesions, mainly in the abdominal organs, and the subsequent isolation of M. caprae (SB0157 spoligotype). The whole herd was additionally tested using cellular and humoral based diagnostic techniques. The intradermal tuberculin test results were compared with those obtained using P22 ELISA for the detection of specific antibodies against the M. tuberculosis complex. The TB infected animal was a positive reactor to both the intradermal tuberculin tests and P22 ELISA, while the others were negative to all the diagnostic tests. CONCLUSION The present study found M. caprae infection in OWC. This is the first report of M. caprae infection in an OWC not living in a zoo. Since the animal was born in the herd and fed with goat's milk, this practice was suspected to be the potential source of TB infection, which was not confirmed in the other animals present in the herd. Moreover, our results highlight that the intradermal tuberculin test and the P22 ELISA could be valuable tools for the diagnosis of TB in OWC.
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Affiliation(s)
- J A Infantes-Lorenzo
- Servicio de Inmunología Microbiana, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - B Romero
- VISAVET Health Surveillance Centre, Complutense University of Madrid, Madrid, Spain
| | - A Rodríguez-Bertos
- VISAVET Health Surveillance Centre, Complutense University of Madrid, Madrid, Spain.,Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, Complutense University of Madrid, 28040, Madrid, Spain
| | - A Roy
- BIOFABRI S.L., Porriño, Pontevedra, Spain
| | - J Ortega
- VISAVET Health Surveillance Centre, Complutense University of Madrid, Madrid, Spain.,Department of Animal Health, Faculty of Veterinary Medicine, Complutense University of Madrid, 28040, Madrid, Spain
| | - L de Juan
- VISAVET Health Surveillance Centre, Complutense University of Madrid, Madrid, Spain.,Department of Animal Health, Faculty of Veterinary Medicine, Complutense University of Madrid, 28040, Madrid, Spain
| | - I Moreno
- Servicio de Inmunología Microbiana, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - M Domínguez
- Servicio de Inmunología Microbiana, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - L Domínguez
- VISAVET Health Surveillance Centre, Complutense University of Madrid, Madrid, Spain.,Department of Animal Health, Faculty of Veterinary Medicine, Complutense University of Madrid, 28040, Madrid, Spain
| | - J Bezos
- VISAVET Health Surveillance Centre, Complutense University of Madrid, Madrid, Spain. .,Department of Animal Health, Faculty of Veterinary Medicine, Complutense University of Madrid, 28040, Madrid, Spain.
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Ogdie A, Nowell WB, Applegate E, Gavigan K, Venkatachalam S, de la Cruz M, Flood E, Schwartz EJ, Romero B, Hur P. Patient perspectives on the pathway to psoriatic arthritis diagnosis: results from a web-based survey of patients in the United States. BMC Rheumatol 2020; 4:2. [PMID: 31938764 PMCID: PMC6953285 DOI: 10.1186/s41927-019-0102-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 05/28/2019] [Accepted: 10/30/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND There are limited real-world data on the diagnostic experiences of patients with psoriatic arthritis (PsA), including medical care sought and potential barriers to diagnosis. We aim to describe patient experiences related to receiving a PsA diagnosis. METHODS Ours was a mixed-method, 2-phase study. Phase 1 comprised concept elicitation and cognitive interviews with clinical experts and adults diagnosed with PsA to develop a cross sectional, web-based survey. US adults with a self-reported PsA diagnosis were recruited through a patient support community (CreakyJoints), an online patient research registry (ArthritisPower), and social media outreach. In Phase 2, the online survey collected data on sociodemographics, clinical symptoms, disease burden, and diagnosis history of survey respondents with PsA. RESULTS Of the 203 respondents included, 172 (84.7%) were female, and the mean (SD) age was 51.6 (10.8) years. The time between seeking medical attention and receiving a diagnosis was < 6 months for 69 respondents, 6 months to 4 years for 68 respondents, and ≥ 5 years for 66 respondents. Most respondents sought care from general practitioners (79.8%) and rheumatologists (66.5%). Common initial symptoms that led respondents to seek medical attention were joint pain (70.0%) and stiffness (53.7%). Among the initial symptoms that led respondents to seek care, joint pain, swollen joints, and sausage-like fingers or toes (indicating dactylitis) were more common among respondents with shorter time to diagnosis, whereas stiffness, fatigue, enthesitis (indicated by foot problems, tendon and ligament pain), and back pain were more common among respondents with longer time to diagnosis. Common misdiagnoses were psychosomatic issues (26.6%) and osteoarthritis (21.7%). Respondents with shorter times to diagnosis had lower frequencies of misdiagnosis. CONCLUSIONS Respondents with PsA reported delays in diagnosis and misdiagnoses on their journey to a PsA diagnosis. Symptom differences, such as enthesitis and stiffness, were noted among respondents with shorter vs longer time to diagnosis. Increased understanding of diagnostic barriers may lead to earlier diagnosis and appropriate management to improve outcomes.
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Affiliation(s)
- Alexis Ogdie
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA USA
- Hospital of the University of Pennsylvania, 3400 Spruce Street, 5 White Building, Philadelphia, PA 19104-4283 USA
| | | | | | - Kelly Gavigan
- Global Healthy Living Foundation, Upper Nyack, NY USA
| | | | | | | | | | | | - Peter Hur
- Novartis Pharmaceuticals Corporation, East Hanover, NJ USA
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Adler LA, Farahbakhshian S, Romero B, Flood E, Doll H. Healthcare provider perspectives on diagnosing and treating adults with attention-deficit/hyperactivity disorder. Postgrad Med 2019; 131:461-472. [PMID: 31340712 DOI: 10.1080/00325481.2019.1647080] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective: This study examined adult attention-deficit/hyperactivity disorder (ADHD) screening and management patterns among healthcare provider (HCP) subgroups. Methods: An online survey of US-based HCPs (neurologists, n = 200; nurse practitioners [NPs], n = 100; psychiatrists, n = 201; primary care physicians [PCPs], n = 201) was conducted from May to June 2017. The survey assessed issues relating to adult ADHD screening and management and HCP perceptions of factors influencing patient choice of pharmacotherapy. Participants were required to be experienced in diagnosing and/or treating ADHD in adults (≥5 patients/month for neurologists and NPs; ≥10 patients/month for psychiatrists and PCPs). Results: Significantly greater percentages of psychiatrists than non-psychiatrists were confident in diagnosing ADHD (P < 0.001) and screened/evaluated for ADHD in patients with depression/anxiety disorders (P < 0.001). Significantly greater percentages of psychiatrists versus non-psychiatrists prescribed once-daily long-acting (LA) stimulants (71.6% vs 62.2%; P = 0.023) or short-acting (SA) stimulants more than once daily (40.3% vs 29.7%; P = 0.009) as first-line therapy. In contrast, a significantly greater percentage of non-psychiatrists than psychiatrists prescribed once-daily SA stimulants (32.9% vs 17.4%; P < 0.001). Psychiatrist and non-psychiatrist HCPs viewed insurance coverage/treatment costs (79.9%), perceived duration of effect (72.2%), and side effects (66.5%) as important factors to patients when choosing treatment. HCPs reported that the greatest mean ± SD percentages of patients changed their treatment regimen in the past 6 months because of perceptions of insufficient duration of effect (35.4% ± 22.1%) and lack of efficacy (30.3% ± 21.0%). Conclusion: Compared with psychiatrists, non-psychiatrists exhibited less confidence in diagnosing adult ADHD and experienced greater difficulty determining optimal treatment regimens.
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Affiliation(s)
- Lenard A Adler
- Department of Psychiatry and Child and Adolescent Psychiatry, New York University Langone Medical Center , New York , NY , USA
| | - Sepehr Farahbakhshian
- Health Economics and Outcomes, Shire, a member of the Takeda group of companies , Lexington , MA , USA
| | - Beverly Romero
- Patient Centered Outcomes, ICON , Gaithersburg , MD , USA
| | - Emuella Flood
- Formerly of Patient Centered Outcomes, ICON , Gaithersburg , MD , USA
| | - Helen Doll
- Formerly of Patient Centered Outcomes, ICON , London , UK
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Brown TE, Romero B, Sarocco P, Atkins N, Schwartz EJ, Rhoten S. The Patient Perspective. Prim Care Companion CNS Disord 2019; 21. [DOI: 10.4088/pcc.18m02397] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 02/15/2019] [Indexed: 10/26/2022] Open
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Ogdie A, Benjamin Nowell W, Reynolds R, Gavigan K, Venkatachalam S, de la Cruz M, Flood E, Schwartz EJ, Romero B, Park Y. Real-World Patient Experience on the Path to Diagnosis of Ankylosing Spondylitis. Rheumatol Ther 2019; 6:255-267. [PMID: 31041666 PMCID: PMC6513959 DOI: 10.1007/s40744-019-0153-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Indexed: 12/17/2022] Open
Abstract
Introduction We describe the journey to diagnosis of ankylosing spondylitis (AS) from the patient perspective and examine differences in this journey by sex. Methods US adults aged ≥ 18 years with a self-reported AS diagnosis were recruited online through CreakyJoints, a patient support community, and ArthritisPower, a patient research registry. Respondents completed a web-based survey on sociodemographics, disease burden, and diagnosis history. Results were stratified by sex and time to diagnosis using two-sample t tests and χ2 tests, respectively, to observe differences across the groups; P < 0.05 was considered statistically significant. Results Among 235 respondents, 174 (74.0%) were female. Mean (SD) ages of female and male respondents were 48.6 (10.6) and 53.1 (10.3) years, respectively. From the time respondents began seeking medical attention, 87 were diagnosed within ≤ 1 year, 71 in 2–9 years, and 77 after ≥ 10 years. Symptoms that led respondents to seek treatment were back pain (73.2%) and joint pain (63.8%); fatigue and difficulty sleeping were more common among respondents with longer times to diagnosis. During the diagnosis process, men with AS tended to receive quicker AS diagnosis compared with women. Overall, commonly reported initial diagnoses among respondents with longer time to AS diagnosis included back problems and psychosomatic disorders. Significantly more women reported misdiagnoses of fibromyalgia (20.7 vs. 6.6%) and psychosomatic disorders (40.8 vs. 23.0%) compared with men. Conclusions Diagnosis delays and misdiagnoses were common among respondents with AS. Increasing awareness about AS among referring providers may minimize diagnosis delay. Funding Novartis Pharmaceuticals Corporation. Plain Language Summary Plain language summary available for this article. Electronic Supplementary Material The online version of this article (10.1007/s40744-019-0153-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alexis Ogdie
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | | | | | - Kelly Gavigan
- Global Healthy Living Foundation, Upper Nyack, NY, USA
| | | | | | | | | | | | - Yujin Park
- Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA
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Infantes-Lorenzo JA, Moreno I, Roy A, Risalde MA, Balseiro A, de Juan L, Romero B, Bezos J, Puentes E, Åkerstedt J, Tessema GT, Gortázar C, Domínguez L, Domínguez M. Specificity of serological test for detection of tuberculosis in cattle, goats, sheep and pigs under different epidemiological situations. BMC Vet Res 2019; 15:70. [PMID: 30823881 PMCID: PMC6397464 DOI: 10.1186/s12917-019-1814-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 02/20/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Serum antibody detection has potential as a complementary diagnostic tool in animal tuberculosis (TB) control, particularly in multi-host systems. The objective of the present study was to assess the specificity (Sp) of an enzyme-linked immunosorbent assay (ELISA) based on the new multiprotein complex P22 for the detection of specific antibodies against the Mycobacterium tuberculosis complex (MTC) in the four most relevant domestic animals acting as MTC hosts: cattle, goat, sheep and pig. We used sera from an officially TB-free (OTF) country, Norway, and from a non-OTF one, Spain. The samples included sera from goats that had been vaccinated against M. avium subsp. paratuberculosis (MAP) and sheep from a herd in which Corynebacterium pseudotuberculosis had been isolated. RESULTS In cattle, the Sp ranged from 92.5 (IC95% 90.7-94) to 99.4% (IC95% 98.3-99.8) depending on the cut-off used and the origin of the samples (Spain or Norway). Sp in cattle (cut-off point 100) was significantly higher (P < 0.05) for Norwegian samples. By contrast, Sp in goats was consistently low at the 100 cut-off [30.9 (CI95%23.4-39.5)-78% (CI95% 68.9-85)]. A higher cut-off of 150 improved Sp in Norwegian goats [97% (CI95% 91.6-99)], but still yielded a poor Sp of 56.1% (CI95% 47.3-64.6) in Spanish goats. In Norway at the 100 cut-off the Sp was 58.3 (CI95% 42.2-72.9) and 90.6% (CI95% 81-95.6) in MAP vaccinated and non-vaccinated goats, respectively, indicating interference due to MAP vaccination. Sp in sheep was between 94.4 (CI95% 91.7-96.3) and 100% (CI95% 96.3-100) depending on the cut-off and country, and no diagnostic interference due to infection with C. pseudotuberculosis was recorded. Sp in pigs was 100%, regardless the cut-off point applied, and no significant differences were observed between pigs from Norway and from Spain. CONCLUSIONS Due to its excellent Sp in pigs and acceptable Sp in cattle and sheep, this ELISA may constitute a suitable option for TB screening at herd level, particularly in OTF-countries.
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Affiliation(s)
- J. A. Infantes-Lorenzo
- VISAVET Health Surveillance Centre, Universidad Complutense de Madrid, Madrid, Spain
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - I. Moreno
- Unidad de Inmunología Microbiana, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - A. Roy
- CZ Veterinaria S.A., Porriño, Pontevedra, Spain
| | - M. A. Risalde
- SaBio (Health and Biotechnology), Instituto de Investigación en Recursos Cinegéticos IREC (CSIC-UCLM-JCCM), Ciudad Real, Spain
- Dpto. de Anatomía y Anatomía Patológica Comparadas, Agrifood Campus of International Excellence (ceia3), Universidad de Córdoba, Córdoba, Spain
| | - A. Balseiro
- SERIDA, Servicio Regional de Investigación y Desarrollo Agroalimentario, Centro de Biotecnología Animal, Deva-Gijón, Asturias Spain
| | - L. de Juan
- VISAVET Health Surveillance Centre, Universidad Complutense de Madrid, Madrid, Spain
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - B. Romero
- VISAVET Health Surveillance Centre, Universidad Complutense de Madrid, Madrid, Spain
| | - J. Bezos
- VISAVET Health Surveillance Centre, Universidad Complutense de Madrid, Madrid, Spain
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - E. Puentes
- CZ Veterinaria S.A., Porriño, Pontevedra, Spain
| | - J. Åkerstedt
- Norwegian Veterinary Institute, Sentrum, Oslo Norway
| | - G. T. Tessema
- Norwegian Veterinary Institute, Sentrum, Oslo Norway
| | - C. Gortázar
- SaBio (Health and Biotechnology), Instituto de Investigación en Recursos Cinegéticos IREC (CSIC-UCLM-JCCM), Ciudad Real, Spain
| | - L. Domínguez
- VISAVET Health Surveillance Centre, Universidad Complutense de Madrid, Madrid, Spain
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Madrid, Spain
| | - M. Domínguez
- Unidad de Inmunología Microbiana, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
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Thomas J, Infantes-Lorenzo JA, Moreno I, Romero B, Garrido JM, Juste R, Domínguez M, Domínguez L, Gortazar C, Risalde MA. A new test to detect antibodies against Mycobacterium tuberculosis complex in red deer serum. Vet J 2018; 244:98-103. [PMID: 30825903 DOI: 10.1016/j.tvjl.2018.12.021] [Citation(s) in RCA: 11] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 12/16/2018] [Accepted: 12/17/2018] [Indexed: 02/06/2023]
Abstract
Red deer (Cervus elaphus) farming is a growing economic activity worldwide. However, the capacity of this species to act as reservoir of animal tuberculosis (TB) poses a threat to other wildlife and to livestock. Diagnostic assay accuracy in this species is therefore highly relevant for prevention and control measures. Our aim was to evaluate the diagnostic performance of the protein complex P22, obtained from Mycobacterium bovis derived purified protein derivative (bPPD), as a candidate antigen for the detection of antibodies against Mycobacterium tuberculosis complex (MTC). We assessed the performance of this new antigen in indirect enzyme-linked immunosorbent assays (ELISA) in TB-positive and TB-negative red deer, in comparison with a bPPD-based ELISA. The P22 ELISA achieved a higher specificity (Sp) and similar sensitivity (Se) in comparison with the bPPD ELISA at all the cut-off points considered. The P22 ELISA yielded optimal Sp (99.02%; 95% confidence intervals [CI95%]: 96.5-99.8) and appropriate Se (70.1%; CI95%: 63.6-76) at the selected cut-off point of 100%. These results suggest that P22 can be used as an alternative antigen in the immunodiagnosis of animal TB through the use of an ELISA-type detection of antibodies against MTC in red deer, thus contributing to the diagnosis of animal TB in this species as a measure for further disease prevention and control programs.
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Affiliation(s)
- J Thomas
- SaBio (Health and Biotechnology), Instituto de Investigación en Recursos Cinegéticos IREC (CSIC-UCLM), Ciudad Real, Spain; Indian Council of Agricultural Research (ICAR), New Delhi, India
| | - J A Infantes-Lorenzo
- VISAVET Health Surveillance Centre, Complutense University of Madrid, Madrid, Spain; Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense, Madrid, Spain
| | - I Moreno
- Unidad de Inmunología Microbiana, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - B Romero
- VISAVET Health Surveillance Centre, Complutense University of Madrid, Madrid, Spain
| | - J M Garrido
- NEIKER-Tecnalia, Animal Health Department, Derio, Bizkaia, Spain
| | - R Juste
- Servicio Regional de Investigación y Desarrollo Agrario (SERIDA), Villaviciosa, Asturias, Spain
| | - M Domínguez
- Unidad de Inmunología Microbiana, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - L Domínguez
- VISAVET Health Surveillance Centre, Complutense University of Madrid, Madrid, Spain; Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense, Madrid, Spain
| | - C Gortazar
- SaBio (Health and Biotechnology), Instituto de Investigación en Recursos Cinegéticos IREC (CSIC-UCLM), Ciudad Real, Spain.
| | - M A Risalde
- Dpto. de Anatomía y Anatomía Patológica Comparadas, Facultad de Veterinaria, Universidad de Córdoba (UCO), Agrifood Excellence International Campus (ceiA3), Córdoba, Spain; Infectious Diseases Unit, Instituto Maimonides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía de Córdoba, Universidad de Córdoba, Cordoba, Spain
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Díez-Guerrier A, Roy A, de la Cruz M, Sáez J, Sanz C, Boschiroli M, Romero B, de Juan L, Domínguez L, Bezos J. Evaluation of the use of a needle-free injection syringe as a cause of non-specific reactions in the intradermal tuberculin test used for the diagnosis of bovine tuberculosis. Res Vet Sci 2018; 119:56-60. [DOI: 10.1016/j.rvsc.2018.05.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/10/2018] [Accepted: 05/23/2018] [Indexed: 11/16/2022]
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Bezos J, Casal C, Álvarez J, Roy A, Romero B, Rodríguez-Bertos A, Bárcena C, Díez A, Juste R, Gortázar C, Puentes E, Aguiló N, Martín C, de Juan L, Domínguez L. Evaluation of the Mycobacterium tuberculosis SO 2 vaccine using a natural tuberculosis infection model in goats. Vet J 2017; 223:60-67. [PMID: 28671074 DOI: 10.1016/j.tvjl.2017.04.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [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: 08/24/2016] [Revised: 04/06/2017] [Accepted: 04/13/2017] [Indexed: 11/27/2022]
Abstract
The development of new vaccines against animal tuberculosis (TB) is a priority for improving the control and eradication of this disease, particularly in those species not subjected to compulsory eradication programmes. In this study, the protection conferred by the Mycobacterium tuberculosis SO2 experimental vaccine was evaluated using a natural infection model in goats. Twenty-six goats were distributed in three groups: (1) 10 goats served as a control group; (2) six goats were subcutaneously vaccinated with BCG; and (3) 10 goats were subcutaneously vaccinated with SO2. Four months after vaccination, all groups were merged with goats infected with Mycobacterium bovis or Mycobacterium caprae, and tested over a 40 week period using a tuberculin intradermal test and an interferon-γ assay for mycobacterial reactivity. The severity of lesions was determined at post-mortem examination and the bacterial load in tissues were evaluated by culture. The two vaccinated groups had significantly lower lesion and bacterial culture scores than the control group (P<0.05); at the end of the study, the SO2 vaccinated goats had the lowest lesion and culture scores. These results suggest that the SO2 vaccine provides some protection against TB infection acquired from natural exposure.
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Affiliation(s)
- J Bezos
- MAEVA SERVET SL, Alameda del Valle, Madrid, Spain; Centro de Vigilancia Sanitaria Veterinaria (VISAVET), Universidad Complutense, Madrid, Spain.
| | - C Casal
- Centro de Vigilancia Sanitaria Veterinaria (VISAVET), Universidad Complutense, Madrid, Spain
| | - J Álvarez
- Department of Veterinary Population Medicine, University of Minnesota, St. Paul, MN, USA
| | - A Roy
- Centro de Vigilancia Sanitaria Veterinaria (VISAVET), Universidad Complutense, Madrid, Spain
| | - B Romero
- Centro de Vigilancia Sanitaria Veterinaria (VISAVET), Universidad Complutense, Madrid, Spain
| | - A Rodríguez-Bertos
- Centro de Vigilancia Sanitaria Veterinaria (VISAVET), Universidad Complutense, Madrid, Spain
| | - C Bárcena
- Centro de Vigilancia Sanitaria Veterinaria (VISAVET), Universidad Complutense, Madrid, Spain
| | - A Díez
- MAEVA SERVET SL, Alameda del Valle, Madrid, Spain
| | - R Juste
- Servicio Regional de Investigación y Desarrollo Agrario (SERIDA), Carretera Oviedo, Villaviciosa, Asturias, Spain
| | - C Gortázar
- SaBio, Instituto de Investigación en Recursos Cinegéticos IREC-CSIC-UCLM-JCCM, Ciudad Real, Spain
| | - E Puentes
- BIOFABRI SL, Porriño, Pontevedra, Spain
| | - N Aguiló
- Departamento de Microbiología, Universidad de Zaragoza, ISS Aragón, CIBER de Enfermedades Respiratorias, Spain
| | - C Martín
- Departamento de Microbiología, Universidad de Zaragoza, ISS Aragón, CIBER de Enfermedades Respiratorias, Spain
| | - L de Juan
- Centro de Vigilancia Sanitaria Veterinaria (VISAVET), Universidad Complutense, Madrid, Spain
| | - L Domínguez
- Centro de Vigilancia Sanitaria Veterinaria (VISAVET), Universidad Complutense, Madrid, Spain
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Qin L, Chen S, Flood E, Shaunik A, Romero B, de la Cruz M, Alvarez C, Grandy S. Glucagon-like Peptide-1 Receptor Agonist Treatment Attributes Important to Injection-Naïve Patients with Type 2 Diabetes Mellitus: A Multinational Preference Study. Diabetes Ther 2017; 8:321-334. [PMID: 28155131 PMCID: PMC5380493 DOI: 10.1007/s13300-017-0230-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION Glucagon-like peptide-1 receptor agonists (GLP-1RAs) differ in efficacy, side effects, dosing frequency, and device-related attributes. This study assessed the relative importance of treatment-related attributes in influencing preferences for GLP-1RAs among injection-naïve patients with type 2 diabetes mellitus (T2DM). METHODS Injection-naïve T2DM patients from five countries completed a Web-based discrete choice experiment (DCE) survey. Patients chose between hypothetical treatment profiles reflecting important and differentiating attributes of GLP-1RAs. Eight attributes were included: efficacy, side effects, device size, needle size, titration, preparation, evidence of long-term efficacy/safety, and dosing frequency. Odds ratios (ORs) and 95% confidence intervals were calculated using a conditional logit model to indicate the likelihood of choosing a treatment with a given attribute level versus a reference attribute level. The influence of individual attributes when considering full treatment profiles was examined using exenatide once weekly (QW) and liraglutide once daily (QD) as case examples. RESULTS A total of 1482 patients with T2DM completed the DCE survey. Side effects, efficacy, and dosing frequency were the three most important attributes influencing preferences; needle size, device size, and required preparation were least important. Total sample analysis indicated that a profile of GLP-1RA approximating exenatide QW (single pen) was preferred over a profile approximating liraglutide QD (OR 3.36; p < 0.001), when efficacy was assumed to be equal. CONCLUSION The most influential drivers of treatment preferences for a hypothetical GLP-RA profile were side effects, efficacy, and dosing frequency among injection-naïve T2DM patients. Preference elicitation can promote patient-centered care and inform new generations of T2DM treatments, which can lead to improved adherence and health outcomes.
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Affiliation(s)
- Lei Qin
- AstraZeneca, Gaithersburg, MD, USA.
| | | | - Emuella Flood
- ICON plc, Clinical Outcomes Assessments, Gaithersburg, MD, USA
| | | | - Beverly Romero
- ICON plc, Clinical Outcomes Assessments, Gaithersburg, MD, USA
| | | | - Cynthia Alvarez
- ICON plc, Medical Affairs Statistical Analysis, San Diego, CA, USA
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Qin L, Chen S, Flood E, Shaunik A, Romero B, de la Cruz M, Alvarez C, Grandy S. Glucagon-Like Peptide-1 Receptor Agonist Treatment Attributes Important to Injection-Experienced Patients with Type 2 Diabetes Mellitus: A Preference Study in Germany and the United Kingdom. Diabetes Ther 2017; 8:335-353. [PMID: 28236271 PMCID: PMC5380499 DOI: 10.1007/s13300-017-0237-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION This study assessed the relative importance of treatment-related attributes in influencing patient preferences for glucagon-like peptide-1 receptor agonists (GLP-1RAs) among injection-experienced type 2 diabetes mellitus (T2DM) patients in Germany and the United Kingdom. METHODS T2DM patients experienced with injecting once-weekly (QW) exenatide or once-daily (QD) liraglutide completed an online discrete-choice experiment (DCE) survey. Patients chose between hypothetical blinded treatment profiles reflecting attributes of GLP-1RAs. The DCE survey included eight attributes: efficacy, side effects, device size, needle size, titration, injection preparation, long-term efficacy/safety, and dosing frequency. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a conditional logit model indicating the likelihood of choosing a treatment with a given attribute level versus a reference attribute level. RESULTS 510 GLP-1RA injection-experienced patients completed the survey; 45.3% respondents were being treated with exenatide QW and 54.7% respondents were being treated with liraglutide QD. In terms of GLP-1RA attributes, patients indicated a preference for a treatment with greater efficacy (i.e., a 1.5-point improvement in HbA1c) (OR 2.58; 95% CI 2.37, 2.80; p < 0.001), fewer side effects (OR 2.67; 95% CI 2.52, 2.82; p < 0.001), once-weekly rather than once-daily administration (OR 2.26; 95% CI 2.13, 2.39; p < 0.001), and the preparation required for a multi-use pen (OR 1.71; 95% CI 1.55, 1.88; p < 0.001). Needle size, device size, and titration were not significant drivers of patient preference. CONCLUSIONS Among GLP-1RA injection-experienced patients, key drivers of treatment preference for a hypothetical GLP-RA profile were side effects, efficacy, dosing frequency, and required preparation. Understanding patient preferences is important for optimizing treatment decision-making and improving treatment adherence. FUNDING AstraZeneca.
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Affiliation(s)
- Lei Qin
- AstraZeneca, Gaithersburg, MD, USA.
| | | | - Emuella Flood
- ICON plc, Clinical Outcomes Assessment, Gaithersburg, MD, USA
| | | | - Beverly Romero
- ICON plc, Clinical Outcomes Assessment, Gaithersburg, MD, USA
| | | | - Cynthia Alvarez
- ICON plc, Medical Affairs Statistical Analysis, San Diego, CA, USA
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Che'Amat A, Armenteros JA, González-Barrio D, Lima JF, Díez-Delgado I, Barasona JA, Romero B, Lyashchenko KP, Ortiz JA, Gortázar C. Is targeted removal a suitable means for tuberculosis control in wild boar? Prev Vet Med 2016; 135:132-135. [PMID: 27843020 DOI: 10.1016/j.prevetmed.2016.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 10/28/2016] [Accepted: 11/03/2016] [Indexed: 11/16/2022]
Abstract
We assessed the suitability of targeted removal as a means for tuberculosis (TB) control on an intensely managed Eurasian wild boar (Sus scrofa) hunting estate. The 60km2 large study area included one capture (treatment) site, one control site, and one release site. Each site was fenced. In the summers of 2012, 2013 and 2014, 929 wild boar were live-captured on the treatment site. All wild boar were micro-chipped and tested using an animal side lateral flow test immediately after capture in order to detect antibodies to the Mycobacterium tuberculosis complex (MTC). The wild boar were released according to their TB status: Seropositive individuals onto the release site (hunted after summer), and seronegative individuals back onto the treatment site. The annual summer seroprevalence of antibodies to the MTC declined significantly in live-captured wild boar piglets from the treatment site, from 44% in 2012 to 27% in 2013 (a reduction of 39%). However, no significant further reduction was recorded in 2014, during the third capture season. Fall-winter MTC infection prevalence was calculated on the basis of the culture results obtained for hunter-harvested wild boar. No significant changes between hunting seasons were recorded on either the treatment site or the control site, and prevalence trends over time were similar on both sites. The fall-winter MTC infection prevalence on the release site increased significantly from 40% in 2011-2012 to 64% in 2012-2013 and 2013-2014 (60% increase). Recaptures indicated a persistently high infection pressure. This experiment, the first attempt to control TB in wild boar through targeted removal, failed to reduce TB prevalence when compared to the control site. However, it generated valuable knowledge on infection pressure and on the consequences of translocating TB-infected wild boar.
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Affiliation(s)
- A Che'Amat
- SaBio Instituto de Investigación en Recursos Cinegéticos IREC (CSIC-UCLM-JCCM), Ronda de Toledo s.n. 13005 Ciudad Real, Spain; Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
| | - J A Armenteros
- SaBio Instituto de Investigación en Recursos Cinegéticos IREC (CSIC-UCLM-JCCM), Ronda de Toledo s.n. 13005 Ciudad Real, Spain
| | - D González-Barrio
- SaBio Instituto de Investigación en Recursos Cinegéticos IREC (CSIC-UCLM-JCCM), Ronda de Toledo s.n. 13005 Ciudad Real, Spain
| | - J F Lima
- SaBio Instituto de Investigación en Recursos Cinegéticos IREC (CSIC-UCLM-JCCM), Ronda de Toledo s.n. 13005 Ciudad Real, Spain; Sabiotec, Camino de Moledores s.n., Campus Universitario, 13005 Ciudad Real, Spain
| | - I Díez-Delgado
- SaBio Instituto de Investigación en Recursos Cinegéticos IREC (CSIC-UCLM-JCCM), Ronda de Toledo s.n. 13005 Ciudad Real, Spain; Departamento de Sanidad Animal, Universidad Complutense, 28040 Madrid, Spain
| | - J A Barasona
- SaBio Instituto de Investigación en Recursos Cinegéticos IREC (CSIC-UCLM-JCCM), Ronda de Toledo s.n. 13005 Ciudad Real, Spain
| | - B Romero
- Centro de Vigilancia Sanitaria Veterinaria VISAVET, Avenida de Puerta de Hierro, s.n. 28040 Madrid, Spain
| | | | - J A Ortiz
- Medianilla Red Deer Genetics, Benalup, Cádiz, Spain
| | - C Gortázar
- SaBio Instituto de Investigación en Recursos Cinegéticos IREC (CSIC-UCLM-JCCM), Ronda de Toledo s.n. 13005 Ciudad Real, Spain.
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Flood E, Gajria K, Sikirica V, Dietrich CN, Romero B, Harpin V, Banaschewski T, Quintero J, Erder MH, Fridman M, Chen K. The Caregiver Perspective on Paediatric ADHD (CAPPA) survey: Understanding sociodemographic and clinical characteristics, treatment use and impact of ADHD in Europe. J Affect Disord 2016; 200:222-34. [PMID: 27137089 DOI: 10.1016/j.jad.2016.04.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 03/16/2016] [Accepted: 04/11/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that affects the lives of patients and their families. The Caregiver Perspective on Paediatric ADHD (CAPPA) survey was conducted to evaluate the burden associated with ADHD in Europe and to identify unmet needs. Here, we describe sociodemographic and clinical characteristics, treatment use and impact of ADHD. METHODS The cross-sectional web-based CAPPA survey was fielded in 10 European countries among caregivers of children/adolescents (aged 6-17 years) with ADHD who were currently receiving or had received pharmacotherapy in the previous 6 months. RESULTS Data on 3688 completed CAPPA surveys were evaluated. Children/adolescents were diagnosed with ADHD at a mean age of 6.9 years; 80% were male. Most children/adolescents (56%) had undergone behavioural therapy. Overall, 78% of children/adolescents currently received ADHD pharmacotherapy; high rates of atypical antipsychotic use were reported in some countries. Overall, 23% of children/adolescents had repeated a school year and 4% had been expelled recently. Most caregivers (68-88%) reported difficulty with schoolwork, social interactions/activities and family relationships, even when the child/adolescent was receiving ADHD medication. Almost one third (31%) of caregivers felt the need to change employment status despite their child/adolescent receiving ADHD medication in 53% of these cases. LIMITATIONS Information was reported by caregivers recruited through market research panels; reporting, recall and selection biases may be present. CONCLUSION Variation across Europe was observed in characteristics of caregivers and children/adolescents with ADHD, and treatment use. Even with medication, ADHD compromised or negatively impacted caregivers' work and children/adolescents' schoolwork, their social interactions and family relationships.
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Affiliation(s)
| | - Kavita Gajria
- Global Health Economics Outcomes Research and Epidemiology, Shire, Wayne, PA, USA
| | - Vanja Sikirica
- Global Health Economics Outcomes Research and Epidemiology, Shire, Wayne, PA, USA
| | | | | | - Valerie Harpin
- Ryegate Children's Centre, Sheffield, South Yorkshire, UK
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany
| | - Javier Quintero
- Psychiatry Department, Hospital Universitario Infanta Leonor, Complutense University, Madrid, Spain
| | - M Haim Erder
- Global Health Economics Outcomes Research and Epidemiology, Shire, Wayne, PA, USA
| | | | - Kristina Chen
- Global Health Economics Outcomes Research and Epidemiology, Shire, Lexington, MA, USA
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Che’ Amat A, González-Barrio D, Ortiz J, Díez-Delgado I, Boadella M, Barasona J, Bezos J, Romero B, Armenteros J, Lyashchenko K, Venteo A, Rueda P, Gortázar C. Testing Eurasian wild boar piglets for serum antibodies against Mycobacterium bovis. Prev Vet Med 2015; 121:93-8. [DOI: 10.1016/j.prevetmed.2015.05.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 05/19/2015] [Accepted: 05/28/2015] [Indexed: 12/17/2022]
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Muñoz-Mendoza M, Romero B, del Cerro A, Gortázar C, García-Marín JF, Menéndez S, Mourelo J, de Juan L, Sáez JL, Delahay RJ, Balseiro A. Sheep as a Potential Source of Bovine TB: Epidemiology, Pathology and Evaluation of Diagnostic Techniques. Transbound Emerg Dis 2015; 63:635-646. [DOI: 10.1111/tbed.12325] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Indexed: 11/28/2022]
Affiliation(s)
- M. Muñoz-Mendoza
- Subdirección de Ganadería; Consellería do Medio Rural; Xunta de Galicia; Edificio Administrativo San Caetano; Santiago de Compostela A Coruña Spain
| | - B. Romero
- Centro de Vigilancia Sanitaria Veterinaria (VISAVET) y Departamento de Sanidad Animal (Facultad de Veterinaria); Universidad Complutense; Madrid Spain
| | - A. del Cerro
- Centro de Biotecnología Animal; SERIDA; Servicio Regional de Investigación y Desarrollo Agroalimentario; Gijón Spain
| | - C. Gortázar
- SaBio IREC (CSIC - UCLM - JCCM); Ciudad Real Spain
| | | | - S. Menéndez
- Departamento de Biología Molecular del Laboratorio de Sanidad y Producción Animal de Galicia; Xunta de Galicia; Lugo Spain
| | - J. Mourelo
- Subdirección de Ganadería; Consellería do Medio Rural; Xunta de Galicia; Edificio Administrativo San Caetano; Santiago de Compostela A Coruña Spain
| | - L. de Juan
- Centro de Vigilancia Sanitaria Veterinaria (VISAVET) y Departamento de Sanidad Animal (Facultad de Veterinaria); Universidad Complutense; Madrid Spain
| | - J. L. Sáez
- Subdirección General de Sanidad e Higiene Animal y Trazabilidad; Dirección General de Sanidad de la Producción Agraria; Ministerio de Agricultura, Alimentación y Medio Ambiente; Madrid Spain
| | - R. J. Delahay
- National Wildlife Management Centre; Animal and Plant Health Agency (APHA); Gloucestershire UK
| | - A. Balseiro
- Centro de Biotecnología Animal; SERIDA; Servicio Regional de Investigación y Desarrollo Agroalimentario; Gijón Spain
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Gajria K, Flood E, Dietrich C, Romero B, Paillé S, Sikirica V. Carer perspective on treatment, comorbidities and diagnosis of Paediatric ADHD in France. Eur Psychiatry 2014. [DOI: 10.1016/j.eurpsy.2014.09.187] [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: 11/29/2022] Open
Abstract
ObjectivesTo examine treatment, comorbidity status and diagnosis among the French sample of the Caregiver Perspective of Pediatric ADHD (CAPPA) survey.MethodsCarers in 10 EU countries, including France, completed an Internet survey regarding ADHD diagnosis, treatment and comorbidities. Descriptive statistics were calculated for categorical [n (%)] and continuous variables [mean, standard deviation (SD), median, range].ResultsEU carers representing 3688 children/adolescents (6–17 years) with ADHD completed the survey; 486 were from France (median age 10 years, 84% male). Most (77%) French children/adolescents were currently receiving pharmacological treatment(s): 74% stimulant, 15% non-stimulant and 22% antipsychotic. Across countries, stimulant use ranged from 60% (Italy) to 93% (Germany/Netherlands), non-stimulant use from 1% (Germany) to 18% (Sweden) and antipsychotic use from 8% (Germany) to 46% (Italy). Many French children/adolescents received behaviour therapy (BT) after ADHD diagnosis (59%). Among those receiving BT, 52% began prior to starting medication. BT was often discontinued within 6 months (44%) or 6–12 (30%) months. 52% of carers reported ≥ 1 comorbidity; they reported the highest rates of conduct (24%), sleep (11%), eating (6%) and motor-coordination (6%) disorders, and the second-highest rates of anxiety (22%), learning difficulties (15%), oppositional defiant disorder (5%), bipolar disorder (4%) and epilepsy (2%). Time to diagnosis from first doctor's visit averaged 7 months (SD 11, median 3). 81% received a specialist referral. French carers reported the highest perceived difficulty (‘great deal’/’a lot’ of difficulty) obtaining a diagnosis (43%) and a specialist referral (53%).ConclusionsThis sample of French children/adolescents with ADHD had higher non-stimulant and antipsychotic use than most other countries and higher reports of certain comorbid conditions. Carers perceived greater difficulty in obtaining a diagnosis and seeing a specialist, although time to diagnosis was lower compared with a number of other countries.
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Romero B, Gajria K, Dietrich CN, Flood E, Gustafsson PA, Ahnemark E, Sikirica V. The Impact on Work and Social Activities Among Carers of Children with Adhd in Sweden Relative to Other Nordic Countries. Value Health 2014; 17:A461. [PMID: 27201294 DOI: 10.1016/j.jval.2014.08.1278] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- B Romero
- ICON Commercialisation and Outcomes, Bethesda, MD, USA
| | | | - C N Dietrich
- ICON Commercialisation and Outcomes, Bethesda, MD, USA
| | - E Flood
- ICON Commercialisation and Outcomes, Bethesda, MD, USA
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Martín E, Hornero F, Rodríguez R, Castellà M, Porras C, Romero B, Maroto L, Pérez de la Sota E, Echevarría M, Dalmau M, Díez L, Buendía J, Enríquez F, Castaño M, Reyes G, Ginel A, Pérez M, García R, Barquero J, Heredero A, Jiménez A, Castedo E, Lugo J, Pradas G, Gómez M, Rieta J. Estudio multicéntrico español para la predicción del riesgo perioperatorio de accidente cerebrovascular tras cirugía de bypass coronario aislada: el modelo PACK2. Cirugía Cardiovascular 2014. [DOI: 10.1016/j.circv.2014.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Ortega J, Noguera A, García-Quirós A, Viana D, Selva L, de Juan L, Romero B, García-Parraga D, Crespo JL, Corpa JM. Lesional patterns associated with mycobacteriosis in an Atlantic horse mackerel, Trachurus trachurus (L.), aquarium population. J Fish Dis 2014; 37:591-595. [PMID: 23802507 DOI: 10.1111/jfd.12145] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 05/17/2013] [Accepted: 05/17/2013] [Indexed: 06/02/2023]
Affiliation(s)
- J Ortega
- Faculty of Veterinary Medicine, Biomedical Sciences Research Institute, PASACTA (Histología y AnatomíaPatológica), Universidad CEU Cardenal Herrera, Moncada, Valencia, Spain
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26
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Bezos J, Romero B, Delgado A, Alvarez J, Casal C, Venteo A, González I, Domínguez L, de Juan L. Evaluation of the specificity of intradermal tuberculin and serological tests for diagnosis of tuberculosis in alpaca (Vicugna pacos) and llama (Lama glama) herds under field conditions in Peru. Vet Rec 2014; 174:532. [PMID: 24789853 DOI: 10.1136/vr.102463] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- J Bezos
- MAEVA SERVET SL., C/ de la Fragua 3, Alameda del Valle, Madrid 28749, Spain Centro de Vigilancia Sanitaria Veterinaria (VISAVET). Universidad Complutense, Avda. Puerta de Hierro s/n, Madrid 28040, Spain
| | - B Romero
- Centro de Vigilancia Sanitaria Veterinaria (VISAVET). Universidad Complutense, Avda. Puerta de Hierro s/n, Madrid 28040, Spain
| | - A Delgado
- Clínica de Animales Mayores, Facultad de Medicina Veterinaria, Universidad Nacional de San Marcos, Lima, Perú
| | - J Alvarez
- Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Ctra. Colmenar Viejo, Km. 9.100, Madrid 28034, Spain
| | - C Casal
- Centro de Vigilancia Sanitaria Veterinaria (VISAVET). Universidad Complutense, Avda. Puerta de Hierro s/n, Madrid 28040, Spain
| | - A Venteo
- INGENASA, C/ Hermanos García Noblejas 39, Madrid 28037, Spain
| | - I González
- INGENASA, C/ Hermanos García Noblejas 39, Madrid 28037, Spain
| | - L Domínguez
- Centro de Vigilancia Sanitaria Veterinaria (VISAVET). Universidad Complutense, Avda. Puerta de Hierro s/n, Madrid 28040, Spain Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense, Avda. Puerta de Hierro s/n, Madrid 28040, Spain
| | - L de Juan
- Centro de Vigilancia Sanitaria Veterinaria (VISAVET). Universidad Complutense, Avda. Puerta de Hierro s/n, Madrid 28040, Spain Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense, Avda. Puerta de Hierro s/n, Madrid 28040, Spain
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Morencos E, Romero B, Peinado AB, González-Gross M, Fernández C, Gómez-Candela C, Benito PJ. Effects of dietary restriction combined with different exercise programs or physical activity recommendations on blood lipids in overweight adults. NUTR HOSP 2013; 27:1916-27. [PMID: 23588439 DOI: 10.3305/nh.2012.27.6.6057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2012] [Accepted: 09/28/2012] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND AND AIM Many exercise studies, although generally showing the beneficial effects of supervised aerobic, resistance or combined exercise on blood lipids, have sometimes reached equivocal conclusions. The aim of this study is to evaluate the impact of different programs that combined exercise and dietary restriction on blood lipids versus a clinical practice intervention for weight loss, in overweight adults. METHODS For this study 66 subjects participated in a supervised 22 weeks training program, composed of three sessions per week and they were randomized in three groups: strength training (S; n = 19), endurance training (E; n = 25), a combination of E and S (SE; n = 22). Eighteen subjects served as physical activity group (PA) that followed a clinical intervention consisted of physical activity recommendations. All groups followed the same dietary treatment, and blood samples were obtained for lipids measurements, at the beginning and end of the study. RESULTS Lipid profile improved in all groups. No significant differences for baseline and post-training values were observed between groups. In general, SE and PA decreased low-density lipoprotein cholesterol (LDL-C) values (p < 0.01). S decreased triglyceride levels (p < 0.01) and E, SE, and PA decreased total cholesterol levels (p < 0.05, p < 0.01 and p < 0.01, respectively). CONCLUSIONS These results suggest that an intervention program of supervised exercise combined with diet restriction did not achieved further improvements in blood lipid profile than diet restriction and physical activity recommendations, in overweight adults. (Clinical Trials gov number: NCT01116856).
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Affiliation(s)
- E Morencos
- Department of Health and Human Performance, School of Physical Activity and Sport Sciences, Technical University of Madrid, Madrid, Spain
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Hornero F, Martín E, Mena-Durán AV, Rodríguez R, Castellà M, Porras C, Romero B, Maroto L, de la Sota E P, Echevarría M, Dalmau MJ, Díez L, Buendía J, Enríquez F, Castaño M, Reyes G, Ginel A, Pérez M, Barquero J, Jiménez A, Castedo E, Pradas G, Gómez M. Atrial Fibrillation and Stroke Risk After Coronary Artery Bypass Grafting Surgery. J Atr Fibrillation 2013; 6:909. [PMID: 28496894 DOI: 10.4022/jafib.909] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 09/11/2013] [Accepted: 09/13/2013] [Indexed: 11/10/2022]
Abstract
Background: The present multicentre study was aimed at determining the effect of preoperative atrial fibrillation (preop-AF) as stroke risk factor in coronary artery bypass graft surgery (CABG) during the perioperative period. Methods: Patients undergoing isolated CABG surgery were enrolled from 21 Spanish centers. Baseline variables related with perioperative stroke risk were recorded and analysed. The Northern New England Cardiovascular Disease Study Group (NNECVDSG) stroke risk schema was used to stratify stroke risk and compare predicted vs observed neurologic outcomes in this study. Results: 26347 patients were enrolled in the study. Prevalence of preop-AF was 4.2%, and was associated significantly with major cardiovascular comorbidities. The stroke rate was 1.38% (365 strokes), and it was slightly higher for patients with preop-AF vs non preop-AF, 1.82% vs 1.36%, p = 0.2. NNECVDSG schema showed good predictive ability calculating the area under the receiver operating characteristic curve (c-statistic 0.696; 95% CI 0.668 to 0.723). To investigate the associations of baseline preoperative variables with perioperative CABG-stroke a logistic regression model was performed. Preop-AF impact on perioperative stroke was lower that other variables. Preop-AF did not show an adverse impact in the quartiles groups according to NNECVDSG Stroke Risk Index. Conclusion: Risk of perioperative stroke in isolated CABG surgery patients is not significantly increased by preop-AF.
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Affiliation(s)
- F Hornero
- Instituto Cardiovascular. Heart Surgery Dept. Hospital General Universitario. Avda. Tres Cruces, s/n Valencia (Spain)
| | - E Martín
- Instituto Cardiovascular. Heart Surgery Dept. Hospital General Universitario. Avda. Tres Cruces, s/n Valencia (Spain)
| | - A V Mena-Durán
- Instituto Cardiovascular. Heart Surgery Dept. Hospital General Universitario. Avda. Tres Cruces, s/n Valencia (Spain)
| | - R Rodríguez
- Heart Surgery Dept. Hospital Vall d'Hebrón. Barcelona. Passeig de la Vall d'Hebron, 119. Barcelona (Spain)
| | - M Castellà
- Heart Surgery Dept. Hospital Clinic I Provincial. Carrer Villarroel, 170. Barcelona (Spain)
| | - C Porras
- Heart Surgery Dept. Hospital Clínico Universitario Virgen de la Victoria. Avda. Cervantes,2. Málaga (Spain)
| | - B Romero
- Heart Surgery Dept. Hospital Germans Trias i Pujol. Ctra. Canyet, S/N. Badalona (Spain)
| | - L Maroto
- Heart Surgery Dept. Hospital Clínico San Carlos. Calle Profesor Martín Lagos, s/n. Madrid (Spain)
| | - Pérez de la Sota E
- Heart Surgery Dept. Hospital Doce de Octubre. Avda. de Córdoba, s/n. Madrid (Spain)
| | - Mª Echevarría
- Heart Surgery Dept. Hospital Clínico Universitario. Avda. Ramón y Cajal s/n. Valladolid (Spain)
| | - M J Dalmau
- Heart Surgery Dept. Hospital Universitario. Calle San Vicente, 58. Salamanca (Spain)
| | - L Díez
- Heart Surgery Dept. Hospital Marqués de Valdecilla. Avenida Valdecilla, s/n Santander (Spain)
| | - J Buendía
- Heart Surgery Dept. Complejo Hospitalario. Av. de Barber, 30. Toledo (Spain)
| | - F Enríquez
- Heart Surgery Dept. Hospital Son Espases. Carretera de Valldemossa, 79. Palma de Mallorca (Spain)
| | - M Castaño
- Heart Surgery Dept. Complejo Asistencial Hospital of León. Altos de Nava s/n. León (Spain)
| | - G Reyes
- Heart Surgery Dept. Hospital de La Princesa. C/ Diego de León, 62. Madrid (Spain
| | - A Ginel
- Heart Surgery Dept. Hospital de la Santa Creu i Sant Pau. C/ Sant Quintí, 89. Barcelona (Spain)
| | - M Pérez
- Heart Surgery Dept. Hospital Universitari i Politècnic La Fe. Bulevar Sur, s/n. Valencia (Spain)
| | - J Barquero
- Heart Surgery Dept. Hospital Universitario Virgen Macarena. Av. Dr. Fedriani, 3. Sevilla (Spain)
| | - A Jiménez
- Heart Surgery Dept. Hospital Fundación Jiménez Díaz. Avda. Reyes Católicos, 2 Madrid (Spain)
| | - E Castedo
- Heart Surgery Dept. Hospital Universitario Puerta de Hierro. Calle Joaquin Rodrigo, 2 Majadahonda (Spain)
| | - G Pradas
- Heart Surgery Dept. Hospital Xeral. C/ Pizarro, 22.Vigo (Spain)
| | - M Gómez
- Heart Surgery Dept. Hospital Universitario Puerta del Mar. Avda. Ana de Viya, 21. Cádiz (Spain)
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Napp S, Allepuz A, Mercader I, Nofrarías M, López-Soria S, Domingo M, Romero B, Bezos J, Pérez de Val B. Evidence of goats acting as domestic reservoirs of bovine tuberculosis. Vet Rec 2013; 172:663. [DOI: 10.1136/vr.101347] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- S. Napp
- Centre de Recerca en Sanitat Animal (CReSA); UAB-IRTA; Campus de la Universitat Autònoma de Barcelona; Bellaterra (Cerdanyola del Vallès); Barcelona 08193 Spain
| | - A. Allepuz
- Centre de Recerca en Sanitat Animal (CReSA); UAB-IRTA; Campus de la Universitat Autònoma de Barcelona; Bellaterra (Cerdanyola del Vallès); Barcelona 08193 Spain
| | - I. Mercader
- Departament d'Agricultura, Ramaderia, Pesca; Alimentació i Medi Natural de la; Generalitat de Catalunya; Barcelona 08007 Spain
| | - M. Nofrarías
- Centre de Recerca en Sanitat Animal (CReSA); UAB-IRTA; Campus de la Universitat Autònoma de Barcelona; Bellaterra (Cerdanyola del Vallès); Barcelona 08193 Spain
| | - S. López-Soria
- Centre de Recerca en Sanitat Animal (CReSA); UAB-IRTA; Campus de la Universitat Autònoma de Barcelona; Bellaterra (Cerdanyola del Vallès); Barcelona 08193 Spain
| | - M. Domingo
- Departament de Sanitat i d'Anatomia Animals; Universitat Autònoma de Barcelona; Bellaterra Barcelona 08193 Spain
| | - B. Romero
- Centro de Vigilancia Sanitaria Veterinaria (VISAVET); Universidad Complutense de Madrid; Madrid 28040 Spain
| | - J. Bezos
- Centro de Vigilancia Sanitaria Veterinaria (VISAVET); Universidad Complutense de Madrid; Madrid 28040 Spain
| | - B. Pérez de Val
- Centre de Recerca en Sanitat Animal (CReSA); UAB-IRTA; Campus de la Universitat Autònoma de Barcelona; Bellaterra (Cerdanyola del Vallès); Barcelona 08193 Spain
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Hornero F, Martin E, Rodriguez R, Castella M, Porras C, Romero B, Maroto L, Perez de la Sota E. Off-pump surgery in preventing perioperative stroke after coronary artery bypass grafting: a retrospective multicentre study. Eur J Cardiothorac Surg 2013; 44:725-31. [DOI: 10.1093/ejcts/ezt067] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Berastegui E, Cámara M, Delgado L, Romero B, Fernández C, Flores J, Ruyra X. 258. Ausencia de deterioro estructural acelerado en la prótesis aórtica mitroflow a 10 años. Experiencia en el hospital germans trias i pujol. Cirugía Cardiovascular 2012. [DOI: 10.1016/s1134-0096(12)70400-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Cámara M, Delgado L, Romero B, Fernández C, Berastegui E, Flores J, Ruyra X. 259. Prótesis mecánica on-x conform 25–33 mm: válvula de elección para reemplazo valvular mitral. Cirugía Cardiovascular 2012. [DOI: 10.1016/s1134-0096(12)70523-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Casal C, Bezos J, Díez-Guerrier A, Álvarez J, Romero B, de Juan L, Rodriguez-Campos S, Vordermeier M, Whelan A, Hewinson RG, Mateos A, Domínguez L, Aranaz A. Evaluation of two cocktails containing ESAT-6, CFP-10 and Rv-3615c in the intradermal test and the interferon-γ assay for diagnosis of bovine tuberculosis. Prev Vet Med 2012; 105:149-54. [PMID: 22391021 DOI: 10.1016/j.prevetmed.2012.02.007] [Citation(s) in RCA: 36] [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] [Received: 12/01/2011] [Revised: 02/02/2012] [Accepted: 02/07/2012] [Indexed: 12/01/2022]
Abstract
The intradermal tuberculin tests and the interferon-gamma (IFN-γ) assay are the principal tests used worldwide for the ante-mortem diagnosis of bovine tuberculosis. The conventional reagent currently in use in these tests is purified protein derivative (PPD) tuberculin obtained from Mycobacterium bovis culture. The components of PPD are poorly characterized and difficult to standardize. To overcome this issue, antigens specific to the Mycobacterium tuberculosis complex are being studied. Here we have assessed the biological potency of ESAT-6, CFP-10 and Rv-3615c presented as peptide or recombinant protein cocktails in comparison with the standard bovine PPD used routinely in Spanish eradication campaigns. The study was performed in cattle (n=23) from a herd with natural M. bovis infection. Animals were simultaneously injected with PPD and the peptide and protein cocktails. The percentages of cattle reacting positively to single intradermal test were 60.9% (bovine PPD), 47.8% (peptide cocktail) and 60.9% (protein cocktail), with no significant difference between the actual skin fold thickness increases (p>0.05). The IFN-γ assay detected 60.9% of animals when stimulation was performed with bovine PPD, but decreased to 52.2% when stimulation was performed with the peptide cocktail and to 47.8% when stimulation was performed with the protein cocktail. However, no significant differences were found between IFN-γ responder frequencies (p>0.05). These results show a potential use of these defined reagents for in vivo tuberculosis diagnosis.
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Affiliation(s)
- C Casal
- Centro VISAVET, Universidad Complutense de Madrid, Avda. Puerta de Hierro s/n, 28040 Madrid, Spain
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Bezos J, Álvarez J, Juan LD, Romero B, Rodríguez S, Castellanos E, Saéz-Llorente J, Mateos A, Domínguez L, Aranaz A. Factors influencing the performance of an interferon-γ assay for the diagnosis of tuberculosis in goats. Vet J 2011; 190:131-5. [DOI: 10.1016/j.tvjl.2010.09.026] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Revised: 09/07/2010] [Accepted: 09/10/2010] [Indexed: 11/24/2022]
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Robles NR, Romero B, Garcia de Vinuesa E, Sánchez-Casado E, Cubero JJ. Treatment of proteinuria with lercanidipine associated with reninangiotensin axis-blocking drugs. Cardiovasc Ther Prev 2011. [DOI: 10.15829/1728-8800-2011-3-83-88] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim. Most calcium antagonists do not seem to reduce microalbuminuria or proteinuria. We have tried to assess the antiproteinuric effect of a calcium channel blocker, lercanidipine, in patients previously treated with ACE inhibitors or angiotensin receptor blockers.Design and methods. The study included 68 proteinuric (>500 mg/day) patients (age 63,1±12,9 years, 69,1 % males and 30,9 % females). All patients were receiving ACE inhibitors (51,4 %) or angiotensin II receptor blockers (48,6 %) therapy but had higher blood pressure (BP) than recommended for proteinuric patients (<130/80 mm Hg). Patients were clinically evaluated one, three, and six months after starting treatment with lercanidipine (20 mg/day). Samples for urine and blood examination were taken during the examination. When needed, a third drug was added to treatment. Creatinine clearance was measured using 24 h urine collection.Results. BP significantly decreased from 152±15/86±11 mm Hg to 135±12/77±10 mm Hg at six months of follow-up (p<0,001). After six months of treatment, the percentage of normalized patients (BP <130/80 mm Hg) was 42,5 %, and the proportion of patients whose BP was below 140/90 mm Hg was 58,8 %. Plasmatic creatinine did not change nor did creatinine clearance. Plasmatic cholesterol also decreased from 210±48 to 192±34 mg/dL (p<0,001), as did plasma triglycerides (from 151±77 to 134±72 mg/dL,p=0,022). Basal proteinuria was 1,63±1,34 g/day; it was significantly (p<0,001) reduced by 23 % at the first month, 37 % at three months, and 33 % at the last visit.Conclusion. Lercanidipine at 20 mg dose, associated with renin-angiotensin axis-blocking drugs, showed a high antihypertensive and antiproteinuric effect. This antiproteinuric effect seems to be dose-dependent as compared with previous reports and proportionally higher than blood pressure reduction.
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Affiliation(s)
- N. R. Robles
- Cátedra de Riesgo Cardiovascular, Universidad de Salamanca, Servicio de Nefrología, Hospital Infanta Cristina
| | - B. Romero
- Cátedra de Riesgo Cardiovascular, Universidad de Salamanca, Servicio de Nefrología, Hospital Infanta Cristina
| | - E. Garcia de Vinuesa
- Cátedra de Riesgo Cardiovascular, Universidad de Salamanca, Servicio de Nefrología, Hospital Infanta Cristina
| | - E. Sánchez-Casado
- Cátedra de Riesgo Cardiovascular, Universidad de Salamanca, Servicio de Nefrología, Hospital Infanta Cristina
| | - J. J. Cubero
- Cátedra de Riesgo Cardiovascular, Universidad de Salamanca, Servicio de Nefrología, Hospital Infanta Cristina
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Fritze O, Romero B, Schleicher M, Jacob MP, Oh DY, Schenke-Layland K, Bujan J, Stock U. Elastic ageing in the cardiovascular system. Thorac Cardiovasc Surg 2011. [DOI: 10.1055/s-0030-1268957] [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]
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Robles NR, Romero B, de Vinuesa EG, Sánchez-Casado E, Cubero JJ. Treatment of proteinuria with lercanidipine associated with renin-angiotensin axis-blocking drugs. Ren Fail 2010; 32:192-7. [PMID: 20199181 DOI: 10.3109/08860220903541135] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Most calcium antagonists do not seem to reduce microalbuminuria or proteinuria. We have tried to assess the antiproteinuric effect of a calcium channel blocker, lercanidipine, in patients previously treated with ACE inhibitors or angiotensin receptor blockers. DESIGN AND METHODS The study included 68 proteinuric (> 500 mg/day) patients (age 63.1 +/- 12.9 years, 69.1% males and 30.9 females). All patients were receiving ACE inhibitors (51.4%) or angiotensin II receptor blockers (48.6%) therapy but had higher blood pressure than recommended for proteinuric patients (<130/80 mmHg). Patients were clinically evaluated one, three, and six months after starting treatment with lercanidipine (20 mg/day). Samples for urine and blood examination were taken during the examination. When needed, a third drug was added to treatment. Creatinine clearance was measured using 24 h urine collection. RESULTS BP significantly decreases from 152 +/- 15/86 +/- 11 mmHg to 135 +/- 12/77 +/- 10 mmHg at six months of follow-up (p < 0.001). After six months of treatment, the percentage of normalized patients (BP < 130/80 mmHg) was 42.5%, and the proportion of patients whose BP was below 140/90 mmHg was 58.8%. Plasmatic creatinine did not change nor did creatinine clearance. Plasmatic cholesterol also decreased from 210 +/- 48 to 192 +/- 34 mg/dL (p < 0.001), as did plasma triglycerides (from 151 +/- 77 to 134 +/- 72 mg/dL, p = 0.022). Basal proteinuria was 1.63 +/- 1.34 g/day; it was significantly (p < 0.001) reduced by 23% at the first month, 37% at three months, and 33% at the last visit. CONCLUSIONS Lercanidipine at 20 mg dose, associated to renin-angiotensin axis-blocking drugs, showed a high antihypertensive and antiproteinuric effect. This antiproteinuric effect seems to be dose-dependent as compared with previous reports and proportionally higher than blood pressure reduction.
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Affiliation(s)
- N R Robles
- Cátedra de Riesgo Cardiovascular, Universidad de Salamanca, Servicio de Nefrología, Hospital Infanta Cristina, Badajoz, Spain.
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Garrido JM, Vicente J, Carrasco-García R, Galindo RC, Minguijón E, Ballesteros C, Aranaz A, Romero B, Sevilla I, Juste R, de la Fuente J, Gortazar C. Experimental infection of Eurasian wild boar with Mycobacterium avium subsp. avium. Vet Microbiol 2010; 144:240-5. [PMID: 20116184 DOI: 10.1016/j.vetmic.2009.12.041] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2009] [Revised: 12/23/2009] [Accepted: 12/24/2009] [Indexed: 10/20/2022]
Abstract
The Eurasian wild boar (Sus scrofa) is increasingly relevant as a host for several pathogenic mycobacteria. We aimed to characterize the first experimental Mycobacterium avium subsp. avium (MAA) infection in wild boar in order to describe the lesions and the immune response as compared to uninfected controls. Twelve 1-4-month-old wild boar piglets were housed in class III bio-containment facilities. Four concentrations of MAA suspension were used: 10, 10(2) and 10(4) mycobacteria (2 animals each, oropharyngeal route) and 2.5 x 10(6) mycobacteria (2 animals each by the oropharyngeal and nasal routes). No clinical signs were observed and pathology evidenced a low pathogenicity of this MAA strain for this particular host. Bacteriological and pathological evidence of successful infection after experimental inoculation was found for the group challenged with 2.5 x 10(6) mycobacteria. These four wild boar showed a positive IFN-gamma response to the avian PPD and the real-time RT-PCR data revealed that three genes, complement component C3, IFN-gamma and RANTES, were significantly down regulated in infected animals. These results were similar to those found in naturally and experimentally M. bovis-infected wild boar and may constitute biomarkers of mycobacterial infection in this species.
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Affiliation(s)
- J M Garrido
- NEIKER-Tecnalia, Animal Health Department, 48160 Derio, Bizkaia, Spain
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Cámara Rosell M, Delgado L, Romero B, Fernández C, Colli A, Ruyra X. 79. Cirugía valvular aórtica en octogenarios. ¿debemos dejar de operarles? Cirugía Cardiovascular 2010. [DOI: 10.1016/s1134-0096(10)70691-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Ballesteros C, Garrido JM, Vicente J, Romero B, Galindo RC, Minguijón E, Villar M, Martín-Hernando MP, Sevilla I, Juste R, Aranaz A, de la Fuente J, Gortázar C. First data on Eurasian wild boar response to oral immunization with BCG and challenge with a Mycobacterium bovis field strain. Vaccine 2009; 27:6662-8. [PMID: 19747578 DOI: 10.1016/j.vaccine.2009.08.095] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2009] [Revised: 08/19/2009] [Accepted: 08/26/2009] [Indexed: 10/20/2022]
Abstract
The Eurasian wild boar (Sus scrofa) is considered a reservoir for bovine tuberculosis (bTB) caused by Mycobacterium bovis and closely related members of the Mycobacterium tuberculosis complex in south-central Spain. The vaccination of wildlife with BCG offers an alternative to culling and to movement restriction for the control of bTB among wildlife reservoirs. In this study, we hypothesized that oral BCG immunization of wild boar would affect the expression of immunoregulatory genes and confer protection against M. bovis. Three groups were used to describe the infection, pathological findings and gene expression profiles in wild boar: BCG-vaccinated and M. bovis-challenged (vaccinated challenged group; N=6), non-vaccinated and M. bovis-challenged (non-vaccinated challenged group; N=4), and non-vaccinated and mock-infected (control group; N=2) animals. M. bovis was isolated from 50% (3/6) and 75% (3/4) of vaccinated challenged and non-vaccinated challenged animals, respectively. All four wild boar from the non-vaccinated challenged group developed bTB-compatible lesions 114 days after challenge. In contrast, only 50% of vaccinated challenged wild boar developed lesions. The PBMC mRNA levels of IL4, RANTES, C3, IFN-gamma and methylmalonyl-CoA mutase (MUT) were analyzed at several days post-vaccination (dpi). When vaccinated challenged animals were compared to controls, all five genes were significantly upregulated at the time of M. bovis infection at 186dpi but IFN-gamma levels were also upregulated at 11 and 46dpi. The C3 and MUT mRNA levels were higher at 46dpi, and 11 and 186dpi, respectively, in vaccinated protected wild boar when compared to non-vaccinated challenged animals. At the end of the experiment (300dpi), the mRNA levels of selected genes were lower in non-vaccinated challenged animals when compared to control wild boar. Exposing wild boar to a dose of 10(4)cfu of M. bovis by the oropharyngeal route is an adequate protocol to produce an infection model in this species. Our results suggested that oral BCG immunization of wild boar results in the upregulation of immunoregulatory genes that may be associated with protective response to M. bovis infection in this species. More studies on vaccine efficacy, delivery, and safety will be needed to confirm if oral vaccination with BCG could be used in bTB control programs for reducing M. bovis infection and clinical disease in wild boar.
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Affiliation(s)
- C Ballesteros
- Instituto de Investigación en Recursos Cinegéticos IREC, Ronda de Toledo s.n., 13071 Ciudad Real, Spain
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Abstract
We evaluated the long-term changes on overt proteinuria induced by dual blockade of the renin-angiotensin system (RAS). Dual blockade was produced by adding an angiotensin II receptor blocker (ARB) to treatment with maximal recommended doses of an angiotensin converting enzyme (ACE) inhibitor in proteinuric patients. A total of 28 patients (19 men and 9 women) with proteinuria higher than 1 g/24 h were enrolled in this trial of treatment with the ARB candesartan (from 4 up to 32 mg daily) added to existing treatment with an ACE inhibitor. At 6, 12, 24, and 36 months, we evaluated proteinuria in 24-h urinary collections, office blood pressure (BP), plasmatic creatinine (Cr), serum potassium (K), and 24 h urine collection creatinine clearance (CrC). During monoblockade of the RAS by ACE inhibitor treatment, albuminuria was 2.94 +/- 1.92 mg/24 h; BP was 137/76 mmHg; K+ was 4.8 +/- 0.5 mmol/l, Cr was 1.76 +/- 0.67 mg/dL, and CrC was 62 +/- 31.9 mL/min. After 6 months, dual blockade of the RAS albuminuria was 2.18 +/- 2.29 mg/24 h (P < 0.01 vs. baseline) and BP was 133/75 mmHg (not significant). At 36 months, albuminuria was 2.21 +/- 2.20 mg/24 h (P < 0.05 vs. baseline); BP was 133/73 mmHg (not significant). CrC was not changed along the follow up. A small increment of Cr was detected at 24 months (2.11 +/- 1.06 mg/mL, P < 0.05). The antiproteinuric effect of dual renin-angiotensin system blockade combining candesartan and ACE inhibitors remain after 36 months without losing its initial effect. Blood pressure changes seem not to explain this long-term antiproteinuric effect.
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Affiliation(s)
- N R Robles
- Servicio de Nefrología, Hospital Infanta Cristina, Badajoz, Spain.
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Doege C, Kerskens C, Romero B, Brunecker P, v. Pannwitz W, Junge-Hülsing J, Müller B, Villringer A. Diffusions- und Perfusionsbildgebung in der Akutdiagnostik der zerebralen Ischämie. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1060069] [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: 10/21/2022]
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Johnsen-Soriano S, Genovés JM, Romero B, García-Delpech S, Muriach M, Sancho-Tello M, Bosch-Morell F, Romero FJ. [Chronic ethanol feeding induces oxidative stress in the rat retina: treatment with the antioxidant ebselen]. Arch Soc Esp Oftalmol 2007; 82:757-762. [PMID: 18040919 DOI: 10.4321/s0365-66912007001200008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
PURPOSE To assess the involvement of biochemical and functional changes to the retina after chronic ethanol intake in adult rats, and the capacity of the antioxidant ebselen to prevent these changes. METHODS Male Sprague-Dawley rats were used in the study. They were fed an ethanol-containing liquid diet, whereas a control group was given an ethanol-free isocaloric diet. After six weeks of experiment, the eyes were extracted and homogenized without the lens, and markers of oxidative stress were assayed, i.e., glutathione (GSH) and malondialdehyde (MDA) as an intracellular antioxidant and a lipid peroxidation product, respectively. Moreover, retinal function was assessed by electroretinogram (ERG). RESULTS The retinal MDA concentration was significantly increased in the ethanol-fed animals compared to controls, whereas the GSH content was significantly reduced in the ethanol-fed group compared to controls. Ethanol also induced a decrease in ERG b-wave amplitude. Ebselen treatment restored the MDA and GSH concentrations and ERG b-wave amplitude to control values. CONCLUSION These results indicate that chronic alcohol consumption alone and without the influence of nutritional factors alters the retinal redox status as well as its function (ERG). Further studies are required to better understand the protective mechanism of ebselen in this experimental model of chronic alcoholism.
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Castellanos E, Aranaz A, Romero B, de Juan L, Alvarez J, Bezos J, Rodríguez S, Stevenson K, Mateos A, Domínguez L. Polymorphisms in gyrA and gyrB genes among Mycobacterium avium subsp. paratuberculosis type I, II, and III isolates. J Clin Microbiol 2007; 45:3439-42. [PMID: 17670925 PMCID: PMC2045374 DOI: 10.1128/jcm.01411-07] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The analysis of the gyrA and gyrB genes of a panel of Mycobacterium avium subsp. paratuberculosis isolates from types I, II, and III detected type-specific single nucleotide polymorphisms. Based on these results, we developed a PCR and restriction enzyme analysis to discriminate type I and III isolates. The application of this technique would be the unique strategy to characterize these strains when there is not enough bacterial growth to perform pulsed-field gel electrophoresis and IS900 restriction fragment length polymorphism.
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Affiliation(s)
- E Castellanos
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Avda. Puerta de Hierro s/n, 28040 Madrid, Spain
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Delgado de la Cuesta J, Luna A, Chavez M, de la Rosa R, Fernandez Rivera J, Gomez S, Exposito S, Romero B. P1877 Control programme of an outbreak of pneumococcal pneumonia among residents of a rest home in southern Spain. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71716-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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de Juan L, Alvarez J, Aranaz A, Rodríguez A, Romero B, Bezos J, Mateos A, Domínguez L. Molecular epidemiology of Types I/III strains of Mycobacterium avium subspecies paratuberculosis isolated from goats and cattle. Vet Microbiol 2006; 115:102-10. [PMID: 16500045 DOI: 10.1016/j.vetmic.2006.01.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2005] [Revised: 12/29/2005] [Accepted: 01/05/2006] [Indexed: 10/25/2022]
Abstract
Molecular characterization of Mycobacterium avium subsp. paratuberculosis (M. a. paratuberculosis) isolates classifies them into three groups: cattle or Type II, sheep or Type I, and intermediate or Type III. To avoid problems associated with characterization of extremely slow growth strains, PCR-based techniques that divide the M. a. paratuberculosis strains in two main groups (cattle or Type II, and sheep or Types I/III) can be performed. The objectives of this study were to characterize the M. a. paratuberculosis isolates identified by different PCR-based tests (IS1311-PCR and restriction endonuclease analysis, PCR test based on a DNA sequence difference, and a PCR aimed at three Type I-specific loci), and to determine the clinical and epidemiological implications of Types I/III M. a. paratuberculosis strains in livestock. One hundred and fifty-eight M. a. paratuberculosis strains from domestic ruminants were analyzed. One hundred and six M. a. paratuberculosis isolates (61 from goats and 45 from cattle) were classified as Type II strains; and 52 (29 from cows, 20 from goats, and three from sheep) were included in the Types I/III. The Types I/III M. a. paratuberculosis strains were associated to Spanish native breeds. The majority of these animals had not been in direct or indirect contact with sheep flocks infected with M. a. paratuberculosis. This fact should be taken into account when implementing paratuberculosis control programs.
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Affiliation(s)
- L de Juan
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, Avda. Puerta de Hierro s/n, 28040 Madrid, Spain
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Singer M, Romero B, Koenig E, Förstl H, Brunner H. [Nightmares in patients with Alzheimer's disease caused by donepezil. Therapeutic effect depends on the time of intake]. Nervenarzt 2006; 76:1127-8, 1129. [PMID: 15630600 DOI: 10.1007/s00115-004-1856-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Dementia of the Alzheimer type (DAT) has been linked to losses of cholinergic function in the brain. The acetylcholinesterase inhibitors donepezil, rivastigmine and galantamine improve cognitive performance in manifest dementia. These substances, however, also influence the quality of sleep, and particularly the quality and amount of dreams. We therefore investigated the influence of the time point of donepezil intake on the occurrence of nightmares. We observed a clear-cut relationship between the occurrence of nightmares and an evening dose of donepezil in eight patients with DAT. None of these patients reported nightmares when donepezil was taken in the morning. We suggest that the activation of the visual association cortex during REM sleep is enhanced by donepezil, a mechanism most likely facilitating the development of nightmares in patients with DAT.
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Affiliation(s)
- M Singer
- Alzheimer Therapiezentrum der Neurologischen Klinik, Bad Aibling, Deutschland
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Alvarez J, De Juan L, Briones V, Romero B, Aranaz A, Fernández-Garayzábal JF, Mateos A. Mycobacterium avium subspecies paratuberculosis in fallow deer and wild boar in Spain. Vet Rec 2005; 156:212-3. [PMID: 15747660 DOI: 10.1136/vr.156.7.212] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- J Alvarez
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense de Madrid, 28040 Madrid, Spain
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Beck-Schimmer B, Romero B, Booy C, Joch H, Hallers U, Pasch T, Spahn DR. Release of inflammatory mediators in irradiated cell salvage blood and their biological consequences in human beings following transfusion. Eur J Anaesthesiol 2004; 21:46-52. [PMID: 14768923 DOI: 10.1017/s0265021504001085] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVE Irradiation of intraoperative cell salvage blood has recently been used to inactivate tumour cells before retransfusion, during cancer surgery. No information is available about a potential inflammatory response of the recipient to the retransfusion of irradiated intraoperative cell salvage blood. This pilot study was conducted to investigate the possible release of the pro-inflammatory mediators, tumour necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta), eotaxin and monocyte chemo-attractant protein-1 (MCP-1), in the serum of recipients by intraoperative retransfusion of irradiated intraoperative cell salvage blood. METHODS Nine patients undergoing gynaecological cancer surgery were included in this study. Intraoperative cell salvage blood was irradiated with 50 Gy and retransfused to the patient. Serum and intraoperative cell salvage blood concentrations of TNF-alpha, IL-1beta, eotaxin and MCP-1 were repeatedly analysed before and after retransfusion, respectively before and after irradiation. RESULTS Traces of mediators were detected in intraoperative cell salvage blood but no increase due to irradiation was observed. Following transfusion of intraoperative cell salvage blood, minute quantities (all < 30 pg mL(-1) of mediators were detected in the serum of patients. However, there was no significant upregulation compared to serum values before retransfusion. CONCLUSIONS These results provide evidence that retransfusion of irradiated intraoperative cell salvage blood might represent a blood-saving strategy in cancer surgery without an immunological inflammatory response as shown by a lack of upregulation of inflammatory mediators.
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Affiliation(s)
- B Beck-Schimmer
- University Hospital, Institute of Anaesthesiology, Zurich, Switzerland.
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Heinz A, Romero B, Gallinat J, Juckel G, Weinberger DR. Molecular brain imaging and the neurobiology and genetics of schizophrenia. Pharmacopsychiatry 2004; 36 Suppl 3:S152-7. [PMID: 14677072 DOI: 10.1055/s-2003-45123] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
It has been hypothesized that schizophrenia is related to dysfunction in temporolimbic-prefrontal neuronal networks, which is acquired early in an individual's development. After puberty, relatively reduced prefrontal control of striatal dopaminergic neurotransmission may lead to unmodulated striatal dopamine (DA) activity, and the positive symptoms of acute psychosis. Brain imaging studies support the notion of prefrontal dysfunction in schizophrenia and correlated upregulation of presynaptic striatal DA activity. Recent molecular brain imaging studies have combined genetic assessments with a multimodal neuroimaging approach to further refine our understanding of the pathophysiologic architecture of the disorder. We review the literature on functional brain imaging in schizophrenia and discuss genotype effects on core psychotic symptoms. A promising research strategy is the identification of genetic and environmental factors that contribute to intermediate phenotypes such as working memory deficits in schizophrenia. Molecular brain imaging can help to unravel the complex interactions between genes and environment and its association with neuronal network dysfunction in schizophrenia.
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Affiliation(s)
- A Heinz
- Department of Psychiatry and Psychotherapy, Charité - University Medicine Berlin, Campus Charité-Mitte (CCM), Berlin, Germany.
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