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Merech F, Gori S, Calo G, Hauk V, Paparini D, Rios D, Lara B, Doga L, D'Eramo L, Squassi A, Ramhorst R, Argüello RJ, Pérez Leirós C, Vota D. Monocyte immunometabolic reprogramming in human pregnancy: contribution of trophoblast cells. Am J Physiol Endocrinol Metab 2024; 326:E215-E225. [PMID: 38117266 DOI: 10.1152/ajpendo.00357.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/04/2023] [Accepted: 12/18/2023] [Indexed: 12/21/2023]
Abstract
Immunometabolism research is uncovering the relationship between metabolic features and immune cell functions in physiological and pathological conditions. Normal pregnancy entails a fine immune and metabolic regulation of the maternal-fetal interaction to assist the energetic demands of the fetus with immune homeostasis maintenance. Here, we determined the immunometabolic status of monocytes of pregnant women compared with nonpregnant controls and its impact on monocyte anti-inflammatory functions such as efferocytosis. Monocytes from pregnant women (16-20 wk) and nonpregnant age-matched controls were studied. Single cell-based metabolic assays using freshly isolated monocytes from both groups were carried out in parallel with functional assays ex vivo to evaluate monocyte efferocytic capacity. On the other hand, various in vitro metabolic assays with human monocytes or monocyte-derived macrophages were designed to explore the effect of trophoblast cells in the profiles observed. We found that pregnancy alters monocyte metabolism and function. An increased glucose dependency and enhanced efferocytosis were detected in monocytes from pregnant women at resting states, compared with nonpregnant controls. Furthermore, monocytes display a reduced glycolytic response when stimulated with lipopolysaccharide (LPS). The metabolic profiling of monocytes at this stage of pregnancy was comparable with the immunometabolic phenotypes of human monocytes treated in vitro with human first trimester trophoblast cell conditioned media. These findings suggest that immunometabolic mechanisms are involved in the functional shaping of monocytes during pregnancy with a contribution of trophoblast cells. Results provide new clues for future hypotheses regarding pregnancies complicated by metabolic disorders.NEW & NOTEWORTHY Immunometabolism stands as a novel perspective to understand the complex regulation of the immune response and to provide small molecule-based therapies. By applying this approach to study monocytes during pregnancy, we found that these cells have a unique activation pattern. They rely more on glycolysis and show increased efferocytosis/IL-10 production, but they do not have the typical proinflammatory responses. We also present evidence that trophoblast cells can shape monocytes into this distinct immunometabolic profile.
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Affiliation(s)
- Fátima Merech
- Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Universidad de Buenos Aires (UBA)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Soledad Gori
- Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Universidad de Buenos Aires (UBA)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Guillermina Calo
- Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Universidad de Buenos Aires (UBA)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Vanesa Hauk
- Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Universidad de Buenos Aires (UBA)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Daniel Paparini
- Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Universidad de Buenos Aires (UBA)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Daiana Rios
- Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Universidad de Buenos Aires (UBA)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Brenda Lara
- Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Universidad de Buenos Aires (UBA)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Luciana Doga
- Facultad de Odontología, Cátedra de Odontología Preventiva y Comunitaria, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
| | - Luciana D'Eramo
- Facultad de Odontología, Cátedra de Odontología Preventiva y Comunitaria, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
| | - Aldo Squassi
- Facultad de Odontología, Cátedra de Odontología Preventiva y Comunitaria, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
| | - Rosanna Ramhorst
- Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Universidad de Buenos Aires (UBA)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Rafael J Argüello
- Centre d'Immunologie de Marseille-Luminy, Aix Marseille University, CNRS, INSERM, Marseille, France
| | - Claudia Pérez Leirós
- Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Universidad de Buenos Aires (UBA)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Daiana Vota
- Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Universidad de Buenos Aires (UBA)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
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Lara B, Loureiro I, Gliosca L, Castagnola L, Merech F, Gallino L, Calo G, Sassot M, Ramhorst R, Vota D, Pérez Leirós C, Hauk V. Porphyromonas gingivalis outer membrane vesicles shape trophoblast cell metabolism impairing functions associated to adverse pregnancy outcome. J Cell Physiol 2023; 238:2679-2691. [PMID: 37842869 DOI: 10.1002/jcp.31138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/23/2023] [Accepted: 08/30/2023] [Indexed: 10/17/2023]
Abstract
Periodontitis is proposed as a risk factor for preterm delivery, fetal growth restriction, and preeclampsia with severe consequences for maternal and neonatal health, but the biological mechanisms involved are elusive. Porphyromonas gingivalis gain access to the placental bed and impair trophoblast cell function, as assessed in murine and human pregnancy, suggesting a pathogenic role in adverse pregnancy and neonatal outcomes. P. gingivalis releases outer membrane vesicles (P. gingivalis OMV) during growth that spread to distant tissues and are internalized in host cells as described in metabolic, neurological, and vascular systemic diseases. Here we tested the hypothesis that P. gingivalis OMV internalized in trophoblast cells disrupt their metabolism leading to trophoblast and placenta dysfunction and adverse pregnancy outcomes. An in vitro design with human trophoblast cells incubated with P. gingivalis OMV was used together with ex vivo and in vivo approaches in pregnant mice treated with P. gingivalis OMV. P. gingivalis OMV modulated human trophoblast cell metabolism by reducing glycolytic pathways and decreasing total reactive oxygen species with sustained mitochondrial activity. Metabolic changes induced by P. gingivalis OMV did not compromise cell viability; instead, it turned trophoblast cells into a metabolic resting state where central functions such as migration and invasion were reduced. The effects of P. gingivalis OMV on human trophoblast cells were corroborated ex vivo in mouse whole placenta and in vivo in pregnant mice: P. gingivalis OMV reduced glycolytic pathways in the placenta and led to lower placental and fetal weight gain in vivo with reduced placental expression of the glucose transporter GLUT1. The present results point to OMV as a key component of P. gingivalis involved in adverse pregnancy outcomes, and even more, unveil a metabolic cue in the deleterious effect of P. gingivalis OMV on trophoblast cells and mouse pregnancy, providing new clues to understand pathogenic mechanisms in pregnancy complications and other systemic diseases.
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Affiliation(s)
- Brenda Lara
- Universidad de Buenos Aires - CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Laboratorio de Inmunofarmacología, Buenos Aires, Argentina
| | - Iñaki Loureiro
- Universidad de Buenos Aires - CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Laboratorio de Inmunofarmacología, Buenos Aires, Argentina
| | - Laura Gliosca
- Universidad de Buenos Aires - Facultad de Odontología, Cátedra de Microbiología, Buenos Aires, Argentina
| | - Lara Castagnola
- Universidad de Buenos Aires - CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Laboratorio de Inmunofarmacología, Buenos Aires, Argentina
| | - Fátima Merech
- Universidad de Buenos Aires - CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Laboratorio de Inmunofarmacología, Buenos Aires, Argentina
| | - Lucila Gallino
- Universidad de Buenos Aires - CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Laboratorio de Inmunofarmacología, Buenos Aires, Argentina
| | - Guillermina Calo
- Universidad de Buenos Aires - CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Laboratorio de Inmunofarmacología, Buenos Aires, Argentina
| | - Matías Sassot
- Universidad de Buenos Aires - CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Laboratorio de Inmunofarmacología, Buenos Aires, Argentina
| | - Rosanna Ramhorst
- Universidad de Buenos Aires - CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Laboratorio de Inmunofarmacología, Buenos Aires, Argentina
| | - Daiana Vota
- Universidad de Buenos Aires - CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Laboratorio de Inmunofarmacología, Buenos Aires, Argentina
| | - Claudia Pérez Leirós
- Universidad de Buenos Aires - CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Laboratorio de Inmunofarmacología, Buenos Aires, Argentina
| | - Vanesa Hauk
- Universidad de Buenos Aires - CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Laboratorio de Inmunofarmacología, Buenos Aires, Argentina
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Lara B, Sassot M, Calo G, Paparini D, Gliosca L, Chaufan G, Loureiro I, Vota D, Ramhorst R, Pérez Leirós C, Hauk V. Extracellular Vesicles of Porphyromonas gingivalis Disrupt Trophoblast Cell Interaction with Vascular and Immune Cells in an In Vitro Model of Early Placentation. Life (Basel) 2023; 13:1971. [PMID: 37895353 PMCID: PMC10608595 DOI: 10.3390/life13101971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/21/2023] [Accepted: 09/22/2023] [Indexed: 10/29/2023] Open
Abstract
Extracellular vesicles released by the primary pathogen of periodontal disease Porphyromonas gingivalis (Pg), referred to as outer membrane vesicles (OMVs), have been associated with the pathogenesis of systemic diseases like cardiovascular disease, rheumatoid arthritis, and Alzheimer's disease. A pathogenic role for Pg by disrupting placental homeostasis was proposed in the association between periodontal disease and adverse pregnancy outcomes. On the basis that trophoblast-derived factors modulate endothelial and immune cell profiles in normal pregnancy and the scarce presence of Pg in placenta, we hypothesized that OMVs from Pg affect trophoblast cell phenotype, impairing trophoblast-endothelium and trophoblast-neutrophil interactions. By means of in vitro designs with first-trimester human trophoblast cells, endothelial cells, and freshly isolated neutrophils, we showed that Pg OMVs are internalized by trophoblast cells and modulate the activity and expression of functional markers. Trophoblast cells primed with Pg OMVs enhanced neutrophil chemoattraction and lost their anti-inflammatory effect. In addition, reduced migration with enhanced adhesion of monocytes was found in endothelial cells upon incubation with the media from trophoblast cells pretreated with Pg OMVs. Taken together, the results support a pathogenic role of Pg OMVs at early stages of pregnancy and placentation through disruption of trophoblast contribution to vascular transformation and immune homeostasis maintenance.
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Affiliation(s)
- Brenda Lara
- Universidad de Buenos Aires—CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Buenos Aires C1428EGA, Argentina; (B.L.); (M.S.); (G.C.); (D.P.); (L.G.); (G.C.); (I.L.); (D.V.); (R.R.)
| | - Matías Sassot
- Universidad de Buenos Aires—CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Buenos Aires C1428EGA, Argentina; (B.L.); (M.S.); (G.C.); (D.P.); (L.G.); (G.C.); (I.L.); (D.V.); (R.R.)
| | - Guillermina Calo
- Universidad de Buenos Aires—CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Buenos Aires C1428EGA, Argentina; (B.L.); (M.S.); (G.C.); (D.P.); (L.G.); (G.C.); (I.L.); (D.V.); (R.R.)
| | - Daniel Paparini
- Universidad de Buenos Aires—CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Buenos Aires C1428EGA, Argentina; (B.L.); (M.S.); (G.C.); (D.P.); (L.G.); (G.C.); (I.L.); (D.V.); (R.R.)
| | - Laura Gliosca
- Universidad de Buenos Aires—CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Buenos Aires C1428EGA, Argentina; (B.L.); (M.S.); (G.C.); (D.P.); (L.G.); (G.C.); (I.L.); (D.V.); (R.R.)
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Microbiología, Buenos Aires C1122AAH, Argentina
| | - Gabriela Chaufan
- Universidad de Buenos Aires—CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Buenos Aires C1428EGA, Argentina; (B.L.); (M.S.); (G.C.); (D.P.); (L.G.); (G.C.); (I.L.); (D.V.); (R.R.)
| | - Iñaki Loureiro
- Universidad de Buenos Aires—CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Buenos Aires C1428EGA, Argentina; (B.L.); (M.S.); (G.C.); (D.P.); (L.G.); (G.C.); (I.L.); (D.V.); (R.R.)
| | - Daiana Vota
- Universidad de Buenos Aires—CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Buenos Aires C1428EGA, Argentina; (B.L.); (M.S.); (G.C.); (D.P.); (L.G.); (G.C.); (I.L.); (D.V.); (R.R.)
| | - Rosanna Ramhorst
- Universidad de Buenos Aires—CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Buenos Aires C1428EGA, Argentina; (B.L.); (M.S.); (G.C.); (D.P.); (L.G.); (G.C.); (I.L.); (D.V.); (R.R.)
| | - Claudia Pérez Leirós
- Universidad de Buenos Aires—CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Buenos Aires C1428EGA, Argentina; (B.L.); (M.S.); (G.C.); (D.P.); (L.G.); (G.C.); (I.L.); (D.V.); (R.R.)
| | - Vanesa Hauk
- Universidad de Buenos Aires—CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Buenos Aires C1428EGA, Argentina; (B.L.); (M.S.); (G.C.); (D.P.); (L.G.); (G.C.); (I.L.); (D.V.); (R.R.)
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Hauk V, D'Eramo L, Calo G, Merech F, Doga L, Lara B, Gliosca L, Massone C, Molgatini S, Ramhorst R, Squassi A, Pérez Leirós C. Gingival crevicular fluid from pregnant women impairs trophoblast cell function and trophoblast-neutrophil interaction. Am J Reprod Immunol 2022; 88:e13558. [PMID: 35511077 DOI: 10.1111/aji.13558] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/10/2022] [Accepted: 04/19/2022] [Indexed: 12/15/2022] Open
Abstract
PROBLEM A strong association between periodontitis and higher susceptibility to pregnancy complications like preeclampsia has been reported although the mechanisms remain elusive. Trophoblast cells modulate the recruitment and functional shaping of maternal leukocytes at early stages to sustain an antiinflammatory microenvironment and fetal growth. Neutrophil activation with reactive oxygen species (ROS) release is associated with preeclampsia. Our aim was to study the effect of the gingival crevicular fluid (GCF) from pregnant women on trophoblast cell function and trophoblast-neutrophil interaction. METHOD OF STUDY Pregnant women at 16-20 weeks of gestation (n = 27) and non-pregnant women (n = 8) as the control group were studied for gingivoperiodontal clinical score evaluation and GCF collection. Total bacteria and common periodontal pathogens were analyzed in GCF samples. The effect of each GCF sample was tested on first trimester trophoblast-derived cells to assess cell migration, cytokine expression and glucose uptake. Also, the effect of GCF on human peripheral neutrophil chemoattraction by trophoblast cells and ROS formation was assessed. RESULTS Gingival crevicular fluid from pregnant women reduced trophoblast cell migration, increased proinflammatory marker expression and glucose uptake. A significant correlation between gingivoperiodontal score and trophoblast dysfunction was observed. Upon conditioning of trophoblast cells with GCF, only the GCF from pregnant women stimulated neutrophil chemoattraction. Similarly, GCF from pregnant but not from non-pregnant controls stimulated ROS formation in neutrophils. CONCLUSIONS Gingival crevicular fluid from pregnant women is deleterious for first trimester trophoblast cell function. These effects could lead to placental homeostasis disruption underlying a pathogenic mechanism of pregnancy complications associated to periodontal disease.
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Affiliation(s)
- Vanesa Hauk
- Universidad de Buenos Aires - CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Laboratorio de Inmunofarmacología, Buenos Aires, Argentina
| | - Luciana D'Eramo
- Universidad de Buenos Aires - Facultad de Odontología, Cátedra de Odontología Preventiva y Comunitaria, Buenos Aires, Argentina
| | - Guillermina Calo
- Universidad de Buenos Aires - CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Laboratorio de Inmunofarmacología, Buenos Aires, Argentina
| | - Fátima Merech
- Universidad de Buenos Aires - CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Laboratorio de Inmunofarmacología, Buenos Aires, Argentina
| | - Luciana Doga
- Universidad de Buenos Aires - Facultad de Odontología, Cátedra de Odontología Preventiva y Comunitaria, Buenos Aires, Argentina
| | - Brenda Lara
- Universidad de Buenos Aires - CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Laboratorio de Inmunofarmacología, Buenos Aires, Argentina
| | - Laura Gliosca
- Universidad de Buenos Aires - Facultad de Odontología, Cátedra de Microbiología, Buenos Aires, Argentina
| | - Carla Massone
- Universidad de Buenos Aires - Facultad de Odontología, Cátedra de Microbiología, Buenos Aires, Argentina
| | - Susana Molgatini
- Universidad de Buenos Aires - Facultad de Odontología, Cátedra de Microbiología, Buenos Aires, Argentina
| | - Rosanna Ramhorst
- Universidad de Buenos Aires - CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Laboratorio de Inmunofarmacología, Buenos Aires, Argentina
| | - Aldo Squassi
- Universidad de Buenos Aires - Facultad de Odontología, Cátedra de Odontología Preventiva y Comunitaria, Buenos Aires, Argentina
| | - Claudia Pérez Leirós
- Universidad de Buenos Aires - CONICET, Instituto de Química Biológica de la Facultad de Ciencias Exactas y Naturales (IQUIBICEN), Laboratorio de Inmunofarmacología, Buenos Aires, Argentina
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Lara B, Merech F, Calo G, Gliosca L, Vota D, Ramhorst R, Leirós CP, Hauk V. Oral infections and pregnancy outcome: Outer membrane vesicles from porphyromonas gingivalis impair trophoblast cell function. Placenta 2022. [DOI: 10.1016/j.placenta.2022.03.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Paparini DE, Grasso EN, Vota D, Hauk V, Merech F, Lara B, Izbizky G, Abasolo JI, Ramhorst R, Leirós CP. Extracellular vesicles of first trimester trophoblast cell line overexpressing VPAC2 induce anti-inflammatory signals in HB cell and maternal monocytes. Placenta 2022. [DOI: 10.1016/j.placenta.2022.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Pandey S, Anderson N, Lara B, Parr D, Grammatopoulos D D. W128 Discrepancy between molecular genotyping and phenotyping of alpha-1-antitrypsin results due to a novel null mutation. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lara B, Kottler J, Olsen A, Best A, Conkright J, Larimer K. Home Monitoring Programs for Patients Testing Positive for SARS-CoV-2: An Integrative Literature Review. Appl Clin Inform 2022; 13:203-217. [PMID: 35172373 PMCID: PMC8850013 DOI: 10.1055/s-0042-1742370] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) pandemic threatened to oversaturate hospitals worldwide, necessitating rapid patient discharge to preserve capacity for the most severe cases. This need, as well as the high risk of SARS-CoV-2 transmission, led many hospitals to implement remote patient monitoring (RPM) programs for SARS-CoV-2 positive patients in an effort to provide care that was safe and preserve scarce resources. OBJECTIVE The aim of this study is to provide an integrative review of peer-reviewed literature on different RPM programs that were implemented for SARS-CoV-2 positive patients including their strengths and challenges. METHODS A search was conducted for peer reviewed literature using PubMed, CINAHL, OVID, and Google Scholar. Peer-reviewed studies written in English or Spanish and published between 2019 and 2021 on RPM of SARS-CoV-2-positive patients were considered. Information was extracted according to a qualitative content analysis method, informed by the Comparison of Mobile Patient Monitoring Systems Framework. RESULTS Of 57 retrieved articles, 10 publications were included. The sample sizes ranged from 75 to 48,290 and the monitoring length ranged from 7 to 30 days. Information regarding the comparison framework was summarized. Main strengths of using RPM for SARS-CoV-2 positive patients was participant acceptance, feasibility, safety, and resource conservation. Main limitations were the lack of information on patient data security measures, robust outcomes testing, and identification of the most effective biomarkers to track SARS-CoV-2 decompensation. CONCLUSION Different RPM programs for SARS-CoV-2 were implemented, from sending home participants with a pulse oximeter and collecting readings via call to modifying existing mobile applications and sending holistic health questionnaires to participants. This review determined that RPM is beneficial to SARS-CoV-2 positive patients; however, its effectiveness can be improved by further research. Mainly, identifying what patient data are most effective at tracking SARS-CoV-2 decompensation by utilizing advanced technology already in the market.
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Affiliation(s)
- Brenda Lara
- Department of Emergency Medicine, University of Illinois, Chicago, Illinois, United States,Address for correspondence Brenda Lara, MA Department of Emergency Medicine, University of Illinois at Chicago808 South Wood Street, Suite 471, Chicago, IL 60607-7101United States
| | - Janey Kottler
- Department of Emergency Medicine, University of Illinois, Chicago, Illinois, United States
| | - Abigail Olsen
- Department of Emergency Medicine, University of Illinois, Chicago, Illinois, United States
| | - Andrew Best
- Department of Emergency Medicine, University of Illinois, Chicago, Illinois, United States
| | | | - Karen Larimer
- Clinical Development, PhysIQ, Chicago, Illinois, United States
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Picornell A, Oteros J, Ruiz-Mata R, Recio M, Trigo MM, Martínez-Bracero M, Lara B, Serrano-García A, Galán C, García-Mozo H, Alcázar P, Pérez-Badia R, Cabezudo B, Romero-Morte J, Rojo J. Methods for interpolating missing data in aerobiological databases. Environ Res 2021; 200:111391. [PMID: 34058184 DOI: 10.1016/j.envres.2021.111391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/15/2021] [Accepted: 05/21/2021] [Indexed: 06/12/2023]
Abstract
Missing data is a common problem in scientific research. The availability of extensive environmental time series is usually laborious and difficult, and sometimes unexpected failures are not detected until samples are processed. Consequently, environmental databases frequently have some gaps with missing data in it. Applying an interpolation method before starting the data analysis can be a good solution in order to complete this missing information. Nevertheless, there are several different approaches whose accuracy should be considered and compared. In this study, data from 6 aerobiological sampling stations were used as an example of environmental data series to assess the accuracy of different interpolation methods. For that, observed daily pollen/spore concentration data series were randomly removed, interpolated by using different methods and then, compared with the observed data to measure the errors produced. Different periods, gap sizes, interpolation methods and bioaerosols were considered in order to check their influence in the interpolation accuracy. The moving mean interpolation method obtained the highest success rate as average. By using this method, a success rate of the 70% was obtained when the risk classes used in the alert systems of the pollen information platforms were taken into account. In general, errors were mostly greater when there were high oscillations in the concentrations of biotic particles during consecutive days. That is the reason why the pre-peak and peak periods showed the highest interpolation errors. The errors were also higher when gaps longer than 5 days were considered. So, for completing long periods of missing data, it would be advisable to test other methodological approaches. A new Variation Index based on the behaviour of the pollen/spore season (measurement of the variability of the concentrations every 2 consecutive days) was elaborated, which allows to estimate the potential error before the interpolation is applied.
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Affiliation(s)
- A Picornell
- Department of Botany and Plant Physiology, University of Malaga, Campus de Teatinos s/n, E-29071, Malaga, Spain.
| | - J Oteros
- Department of Botany, Ecology and Plant Physiology, Agrifood Campus of International Excellence CeiA3, University of Cordoba, Cordoba, Spain; Andalusian Inter-University Institute for Earth System IISTA, University of Cordoba, Spain
| | - R Ruiz-Mata
- Department of Botany and Plant Physiology, University of Malaga, Campus de Teatinos s/n, E-29071, Malaga, Spain
| | - M Recio
- Department of Botany and Plant Physiology, University of Malaga, Campus de Teatinos s/n, E-29071, Malaga, Spain
| | - M M Trigo
- Department of Botany and Plant Physiology, University of Malaga, Campus de Teatinos s/n, E-29071, Malaga, Spain
| | - M Martínez-Bracero
- Department of Botany, Ecology and Plant Physiology, Agrifood Campus of International Excellence CeiA3, University of Cordoba, Cordoba, Spain; Andalusian Inter-University Institute for Earth System IISTA, University of Cordoba, Spain; School of Chemical and Pharmaceutical Sciences, Technological University Dublin, Dublin, Ireland
| | - B Lara
- University of Castilla-La Mancha, Institute of Environmental Sciences (Botany), Toledo, Spain
| | - A Serrano-García
- University of Castilla-La Mancha, Institute of Environmental Sciences (Botany), Toledo, Spain
| | - C Galán
- Department of Botany, Ecology and Plant Physiology, Agrifood Campus of International Excellence CeiA3, University of Cordoba, Cordoba, Spain; Andalusian Inter-University Institute for Earth System IISTA, University of Cordoba, Spain
| | - H García-Mozo
- Department of Botany, Ecology and Plant Physiology, Agrifood Campus of International Excellence CeiA3, University of Cordoba, Cordoba, Spain; Andalusian Inter-University Institute for Earth System IISTA, University of Cordoba, Spain
| | - P Alcázar
- Department of Botany, Ecology and Plant Physiology, Agrifood Campus of International Excellence CeiA3, University of Cordoba, Cordoba, Spain; Andalusian Inter-University Institute for Earth System IISTA, University of Cordoba, Spain
| | - R Pérez-Badia
- University of Castilla-La Mancha, Institute of Environmental Sciences (Botany), Toledo, Spain
| | - B Cabezudo
- Department of Botany and Plant Physiology, University of Malaga, Campus de Teatinos s/n, E-29071, Malaga, Spain
| | - J Romero-Morte
- University of Castilla-La Mancha, Institute of Environmental Sciences (Botany), Toledo, Spain
| | - J Rojo
- University of Castilla-La Mancha, Institute of Environmental Sciences (Botany), Toledo, Spain; Department of Pharmacology, Pharmacognosy and Botany, Complutense University, Madrid, Spain
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Gutiérrez E, Sánchez I, Díaz O, Valles A, Balderrama R, Fuentes J, Lara B, Olimón C, Ruiz V, Rodríguez J, Bayardo LH, Chan M, Villafuerte CJ, Padayachee J, Sun A. Current Evidence for Stereotactic Body Radiotherapy in Lung Metastases. ACTA ACUST UNITED AC 2021; 28:2560-2578. [PMID: 34287274 PMCID: PMC8293144 DOI: 10.3390/curroncol28040233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 12/25/2022]
Abstract
Lung metastases are the second most common malignant neoplasms of the lung. It is estimated that 20–54% of cancer patients have lung metastases at some point during their disease course, and at least 50% of cancer-related deaths occur at this stage. Lung metastases are widely accepted to be oligometastatic when five lesions or less occur separately in up to three organs. Stereotactic body radiation therapy (SBRT) is a noninvasive, safe, and effective treatment for metastatic lung disease in carefully selected patients. There is no current consensus on the ideal dose and fractionation for SBRT in lung metastases, and it is the subject of study in ongoing clinical trials, which examines different locations in the lung (central and peripheral). This review discusses current indications, fractionations, challenges, and technical requirements for lung SBRT.
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Affiliation(s)
- Enrique Gutiérrez
- Princess Margaret Cancer Centre, Radiation Medicine Program, University Health Network, Toronto, ON M5G2M9, Canada; (E.G.); (M.C.); (C.J.V.); (J.P.)
- Department of Radiation Oncology, University of Toronto, Toronto, ON M5G2M9, Canada
| | - Irving Sánchez
- Western National Medical Center, Department of Radiation Oncology, Mexican Institute of Social Security (IMSS), Belisario Domínguez 1000, Guadalajara 44340, Jalisco, Mexico; (I.S.); (O.D.); (A.V.); (R.B.); (J.F.); (B.L.); (C.O.); (V.R.); (J.R.); (L.H.B.)
| | - Omar Díaz
- Western National Medical Center, Department of Radiation Oncology, Mexican Institute of Social Security (IMSS), Belisario Domínguez 1000, Guadalajara 44340, Jalisco, Mexico; (I.S.); (O.D.); (A.V.); (R.B.); (J.F.); (B.L.); (C.O.); (V.R.); (J.R.); (L.H.B.)
| | - Adrián Valles
- Western National Medical Center, Department of Radiation Oncology, Mexican Institute of Social Security (IMSS), Belisario Domínguez 1000, Guadalajara 44340, Jalisco, Mexico; (I.S.); (O.D.); (A.V.); (R.B.); (J.F.); (B.L.); (C.O.); (V.R.); (J.R.); (L.H.B.)
| | - Ricardo Balderrama
- Western National Medical Center, Department of Radiation Oncology, Mexican Institute of Social Security (IMSS), Belisario Domínguez 1000, Guadalajara 44340, Jalisco, Mexico; (I.S.); (O.D.); (A.V.); (R.B.); (J.F.); (B.L.); (C.O.); (V.R.); (J.R.); (L.H.B.)
| | - Jesús Fuentes
- Western National Medical Center, Department of Radiation Oncology, Mexican Institute of Social Security (IMSS), Belisario Domínguez 1000, Guadalajara 44340, Jalisco, Mexico; (I.S.); (O.D.); (A.V.); (R.B.); (J.F.); (B.L.); (C.O.); (V.R.); (J.R.); (L.H.B.)
| | - Brenda Lara
- Western National Medical Center, Department of Radiation Oncology, Mexican Institute of Social Security (IMSS), Belisario Domínguez 1000, Guadalajara 44340, Jalisco, Mexico; (I.S.); (O.D.); (A.V.); (R.B.); (J.F.); (B.L.); (C.O.); (V.R.); (J.R.); (L.H.B.)
| | - Cipatli Olimón
- Western National Medical Center, Department of Radiation Oncology, Mexican Institute of Social Security (IMSS), Belisario Domínguez 1000, Guadalajara 44340, Jalisco, Mexico; (I.S.); (O.D.); (A.V.); (R.B.); (J.F.); (B.L.); (C.O.); (V.R.); (J.R.); (L.H.B.)
| | - Víctor Ruiz
- Western National Medical Center, Department of Radiation Oncology, Mexican Institute of Social Security (IMSS), Belisario Domínguez 1000, Guadalajara 44340, Jalisco, Mexico; (I.S.); (O.D.); (A.V.); (R.B.); (J.F.); (B.L.); (C.O.); (V.R.); (J.R.); (L.H.B.)
| | - José Rodríguez
- Western National Medical Center, Department of Radiation Oncology, Mexican Institute of Social Security (IMSS), Belisario Domínguez 1000, Guadalajara 44340, Jalisco, Mexico; (I.S.); (O.D.); (A.V.); (R.B.); (J.F.); (B.L.); (C.O.); (V.R.); (J.R.); (L.H.B.)
| | - Luis H. Bayardo
- Western National Medical Center, Department of Radiation Oncology, Mexican Institute of Social Security (IMSS), Belisario Domínguez 1000, Guadalajara 44340, Jalisco, Mexico; (I.S.); (O.D.); (A.V.); (R.B.); (J.F.); (B.L.); (C.O.); (V.R.); (J.R.); (L.H.B.)
| | - Matthew Chan
- Princess Margaret Cancer Centre, Radiation Medicine Program, University Health Network, Toronto, ON M5G2M9, Canada; (E.G.); (M.C.); (C.J.V.); (J.P.)
- Department of Radiation Oncology, University of Toronto, Toronto, ON M5G2M9, Canada
| | - Conrad J. Villafuerte
- Princess Margaret Cancer Centre, Radiation Medicine Program, University Health Network, Toronto, ON M5G2M9, Canada; (E.G.); (M.C.); (C.J.V.); (J.P.)
- Department of Radiation Oncology, University of Toronto, Toronto, ON M5G2M9, Canada
| | - Jerusha Padayachee
- Princess Margaret Cancer Centre, Radiation Medicine Program, University Health Network, Toronto, ON M5G2M9, Canada; (E.G.); (M.C.); (C.J.V.); (J.P.)
- Department of Radiation Oncology, University of Toronto, Toronto, ON M5G2M9, Canada
| | - Alexander Sun
- Princess Margaret Cancer Centre, Radiation Medicine Program, University Health Network, Toronto, ON M5G2M9, Canada; (E.G.); (M.C.); (C.J.V.); (J.P.)
- Department of Radiation Oncology, University of Toronto, Toronto, ON M5G2M9, Canada
- Correspondence: ; Tel.: +1-41-6946-2853
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11
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Carnes A, Barallat-Gimeno E, Galvan A, Lara B, Lladó A, Contador-Muñana J, Vega-Rodriguez A, Escobar MA, Piñol-Ripoll G. Spanish-dementia knowledge assessment scale (DKAS-S): psychometric properties and validation. BMC Geriatr 2021; 21:302. [PMID: 33971836 PMCID: PMC8111921 DOI: 10.1186/s12877-021-02230-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 06/22/2020] [Accepted: 04/19/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Alzheimer's disease (AD) is the most frequent cause of cognitive impairment. Community knowledge of the disease has proven to be a very important aspect of the development of interventions and the evaluation of their effectiveness. However, it is necessary to have standardized and recognized tools in different languages. The aim of the current study was to develop a cross-cultural adaptation of the Spanish Dementia Knowledge Assessment Scale (DKAS-S) and to assess their psychometric properties with cohorts of health students and professional and non-professional caregivers of AD patients from several regions of Spain. METHODS We developed and translated the DKAS into Spanish following the forward-back-forward translation procedure. Then, we performed a cross-sectional study to assess the validity, reliability and feasibility of the DKAS-S. We also performed an analysis to obtain test-retest reliability measures. The study was performed in four medical centres across three regions in Spain. From May to September 2019, we administered the scale to students, professional and non-professional caregivers; including a subgroup of non-professional caregivers of patients with early-onset AD (< 65 years). RESULTS Eight hundred forty-six volunteer participants completed the DKAS-S: 233 students (mean age 26.3 ± 9.2 years), 270 professional caregivers (mean age 42.5 ± 11.7 years) and 343 non-professional caregivers of AD patients. (mean age was 56.4 ± 13.16). The DKAS-S showed good internal consistency (Cronbach's α = 0.819) and good test-retest reliability (time 1: 28.1 ± 8.09 vs time 2: 28.8 ± 7.96; t = - 1.379; p = 0.173). Sensitivity to change was also significant in a subgroup of 31 students who received education related to AD and dementias between each administration (time 1: 25.6 ± 6.03) to (time 2: 32.5 ± 7.12; t = - 5.252, p = 0.000). The validity of the construct was verified by confirmatory factor analysis, although there were challenges in the inclusion of some items in the original 4 factors. CONCLUSIONS The 25-item DKAS-S showed good psychometric properties for validity and reliability and the factorial analysis when it was administered to a population of students and professional and non-professional caregivers. It was a useful instrument for measuring levels of knowledge about dementia in Spanish population.
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Affiliation(s)
- A. Carnes
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, Santa Maria University Hospital, Rovira Roure n 44. 25198. IRBLleida, Lleida, Spain
| | - E. Barallat-Gimeno
- Faculty of Nursing and Phisiotherapy, Universitat de Lleida, IRBLleida, Lleida, Spain
| | - A. Galvan
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, Santa Maria University Hospital, Rovira Roure n 44. 25198. IRBLleida, Lleida, Spain
| | - B. Lara
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, Santa Maria University Hospital, Rovira Roure n 44. 25198. IRBLleida, Lleida, Spain
| | - A. Lladó
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Department of Neurology, Hospital Clínic, Institut d’Investigació Biomèdica August Pi I Sunyer, Barcelona, Spain
| | - J. Contador-Muñana
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Department of Neurology, Hospital Clínic, Institut d’Investigació Biomèdica August Pi I Sunyer, Barcelona, Spain
| | | | - M. A. Escobar
- Faculty of Nursing and Phisiotherapy, Universitat de Lleida, IRBLleida, Lleida, Spain
| | - G. Piñol-Ripoll
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, Santa Maria University Hospital, Rovira Roure n 44. 25198. IRBLleida, Lleida, Spain
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12
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Alemany M, Nuñez A, Falip M, Lara B, Paipa A, Quesada H, Mora P, De Miquel MA, Barranco R, Pedro J, Cardona P. Acute symptomatic seizures and epilepsy after mechanical thrombectomy. A prospective long-term follow-up study. Seizure 2021; 89:5-9. [PMID: 33933947 DOI: 10.1016/j.seizure.2021.04.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/05/2021] [Accepted: 04/09/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION New treatments for acute ischaemic stroke, such as mechanical thrombectomy, can achieve reperfusion of large ischaemic tissue. Some studies have suggested that reperfusion therapies can increase the risk of suffering acute symptomatic seizure (ASS) and poststroke epilepsy (PSE). The aim of the study was to determine the incidence of ASS and PSE in patients undergoing thrombectomy, and related factors. PATIENTS AND METHODS This was a retrospective single-centre study including patients with ischaemic stroke and NIHSS> 8 treated with thrombectomy with a follow-up ≥5 years. We evaluated several epidemiological, radiological, clinical and electroencephalographic variables. RESULTS Of the 344 included patients, 21 (6.1%) presented ASS, 53 (15.40%) died in the acute phase, and 13 (4.46%) died during the first year. The degree of reperfusion (p 0.029), advanced age (p 0.035), and haemorrhagic transformation (p 0.038) increased the risk of suffering ASS, with degree of reperfusion being an independent factor, OR 2.02 (1.21-4.64). The incidence of PSE was 4.12% in the first year, 3.72% in the second, and 1.61% in the fifth. The accumulated incidence at 5 years was 8.93%. Related risk factor for suffering PSE was ASS (p < 0.001), yielding an OR value of 2.00 (1.28-3.145). CONCLUSIONS Thrombectomy doesn´t increase the risk of ASS. A higher percentage of reperfusion, advanced age, and haemorrhagic transformation are associated with an increased risk of ASS. ASS is a risk factor for suffering PSE. In terms of mortality, having suffered ASS and/or PSE does not increase acute or long-term mortality.
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Affiliation(s)
- M Alemany
- Neuro-Oncology Unit, Neurology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - A Nuñez
- Stroke Unit, Neurology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - M Falip
- Epilepsy Unit, Neurology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - B Lara
- Stroke Unit, Neurology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - A Paipa
- Stroke Unit, Neurology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - H Quesada
- Stroke Unit, Neurology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - P Mora
- Neuroradiology Department, Hospital Universitari Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - M A De Miquel
- Neuroradiology Department, Hospital Universitari Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - R Barranco
- Neuroradiology Department, Hospital Universitari Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - J Pedro
- Neurophysiology Unit, Neurology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - P Cardona
- Stroke Unit, Neurology Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain..
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Prendergast H, Del Rios M, Durazo‐Arvizu R, Escobar‐Schulz S, Heinert S, Jackson M, Gimbar RP, Daviglus M, Lara B, Khosla S. Effect of an emergency department education and empowerment intervention on uncontrolled hypertension in a predominately minority population: The AHEAD2 randomized clinical pilot trial. J Am Coll Emerg Physicians Open 2021; 2:e12386. [PMID: 33718921 PMCID: PMC7926004 DOI: 10.1002/emp2.12386] [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: 08/27/2020] [Revised: 01/08/2021] [Accepted: 01/22/2021] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE To determine whether an emergency department (ED) education and empowerment intervention coupled with early risk assessment can help improve blood pressure (BP) in a high-risk population. METHODS A hypertension emergency department intervention aimed at decreasing disparities (AHEAD2) is a 3-arm, single-site randomized pilot trial for feasibility in an urban academic ED. A total of 150 predominantly ethnic minorities with no primary care provider and severely elevated blood pressure (BP) (≥160/100 mm Hg) were enrolled over 10 months. Participants were randomized into 1 of 3 study arms: (1) enhanced usual care (EUC), (2) ED-initiated screening, brief intervention, and referral for treatment (ED-SBIRT), or (3) ED- SBIRT plus a 48-72 hours post-acute care hypertension transition clinic (ED-SBIRT+PACHT-c). Primary outcomes were change in systolic and diastolic BP (SBP and DBP) from baseline to 9 months. Secondary outcomes were BP control (BP <140/90 mm Hg), changes in hypertension knowledge, medication adherence, and limited bedside echocardiogram (LBE) findings. RESULTS SBP reduction from baseline to month 9 was -26.8 (95% confidence interval [CI]: -32.8, -20.7) mm Hg for ED-SBIRT, -23.4 (95% CI: -29.5, -17.3) mm Hg for ED-SBIRT+PACHT-c, and -18.9 (95% CI: -24.9, -12.9) mm Hg for EUC. DBP decreased by -12.5 (95% CI: -16.1, -9.0) mm Hg for ED-SBIRT, -11.3 (95% CI: -14.8, -7.7) mm Hg for ED-SBIRT+PACHT-c, and -8.4 (95% CI: -11.9, -4.9) mm Hg for EUC. A multicomponent intervention compared with EUC resulted in SBP decrease of -7.9 mm Hg (95% CI: -16.4, 0.6). At 9 months, hypertension was controlled for 29.3% (95% CI: 20.3, 38.3) of intervention and 23.5% (95% CI: 11.9, 35.2) of EUC participants. All groups saw improvements in hypertension knowledge, medication adherence, and LBEs, with greater improvements in intervention groups. CONCLUSIONS The study findings suggest that a multicomponent intervention comprising of ED education and empowerment coupled with early risk assessment may help improve BP in a high-risk population.
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Affiliation(s)
- Heather Prendergast
- Department of Emergency MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Marina Del Rios
- Department of Emergency MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | | | | | - Sara Heinert
- Department of Emergency MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Maya Jackson
- Department of Emergency MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | | | - Martha Daviglus
- Institute for Minority Health ResearchUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Brenda Lara
- Department of Emergency MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
| | - Shaveta Khosla
- Department of Emergency MedicineUniversity of Illinois at ChicagoChicagoIllinoisUSA
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D'Evelyn SM, Vogel C, Bein KJ, Lara B, Laing EA, Abarca RA, Zhang Q, Li L, Li J, Nguyen TB, Pinkerton KE. Differential inflammatory potential of particulate matter (PM) size fractions from Imperial Valley, CA. Atmos Environ (1994) 2021; 244:117992. [PMID: 33184556 PMCID: PMC7654835 DOI: 10.1016/j.atmosenv.2020.117992] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Particulate matter (PM) in Imperial Valley originates from a variety of sources such as agriculture, traffic at the border crossing, emissions from the cross-border city of Mexicali, and the drying lakebed of the Salton Sea. Dust storms in Imperial Valley, California regularly lead to exceedances of the federal air quality standards for PM10 (diameter less than 10 microns). To determine if there are differences in the composition and biological response to Imperial County PM by size, ambient PM samples were collected from a sampling unit stationed in the northern-most part of the valley, South of the Salton Sea. Ultrafine, fine, and coarse PM samples were collected and extracted separately. Chemical composition of each size fraction was obtained after extraction by using several analytical techniques, and biological response was measured by exposing a cell line of macrophages to particles and quantifying subsequent gene expression. Biological measurements demonstrated coarse PM induced an inflammatory response in macrophages measured in increases of inflammatory markers IL-1β, IL-6, IL-8 and CXCL2 expression, whereas ultrafine and fine PM only demonstrated significant increases in expression of CYP1a1. These differential responses were due not only to particle size, but to the distinct chemical profiles of each size faction as well. Community groups in Imperial Valley have already completed several projects to learn more about local air quality, giving residents access to data that provides real-time levels of PM2.5 and PM10 as well as recommendations on health-based practices dependent on the current AQI (air quality index). However, to date there is no information on the composition or toxicity of ambient PM from the region. The data presented here could provide more definitive information on the toxicity of PM by size, and further inform the community on local air quality.
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Affiliation(s)
- S M D'Evelyn
- Center for Health and the Environment, University of California, Davis
| | - Cfa Vogel
- Center for Health and the Environment, University of California, Davis
- Department of Environmental Toxicology, University of California, Davis
| | - K J Bein
- Center for Health and the Environment, University of California, Davis
| | | | - E A Laing
- Center for Health and the Environment, University of California, Davis
| | - R A Abarca
- Center for Health and the Environment, University of California, Davis
| | - Q Zhang
- Department of Environmental Toxicology, University of California, Davis
| | - L Li
- Department of Environmental Toxicology, University of California, Davis
| | - J Li
- Department of Environmental Toxicology, University of California, Davis
| | - T B Nguyen
- Department of Environmental Toxicology, University of California, Davis
| | - K E Pinkerton
- Center for Health and the Environment, University of California, Davis
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15
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Lara B, Carnes A, Dakterzada F, Benitez I, Piñol-Ripoll G. Neuropsychiatric symptoms and quality of life in Spanish patients with Alzheimer's disease during the COVID-19 lockdown. Eur J Neurol 2020; 27:1744-1747. [PMID: 32449791 PMCID: PMC7283827 DOI: 10.1111/ene.14339] [Citation(s) in RCA: 116] [Impact Index Per Article: 29.0] [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] [Received: 04/27/2020] [Accepted: 05/14/2020] [Indexed: 01/10/2023]
Abstract
Background and purpose The COVID‐19 epidemic is affecting almost all individuals worldwide, and patients with Alzheimer’s disease (AD) and amnesic mild cognitive impairment (MCI) are particularly at risk due to their characteristics and age. We analysed the impact of the pandemic on these patients’ neuropsychiatric symptoms and their quality of life after 5 weeks of lockdown in Spain. Methods A total of 40 patients with a diagnosis of MCI (n = 20) or mild AD (n = 20) from the Cognitive Stimulation Program of the Cognitive Disorders Unit were evaluated. All patients had undergone a previous evaluation during the month before the lockdown, and were re‐evaluated after 5 weeks of lockdown. The Neuropsychiatric Inventory (NPI) and EuroQol‐5D questionnaire (EQ‐5D) were used to assess neuropsychiatric symptoms in patients and the quality of life in patients as well in caregivers. Results The mean (SD) total baseline NPI score was 33.75 (22.28), compared with 39.05 (27.96) after confinement (P = 0.028). The most frequently affected neuropsychiatric symptoms were apathy [4.15 (3.78) vs. 5.75 (4.02); P = 0.002] and anxiety [3.95 (3.73) vs. 5.30 (4.01); P = 0.006] in patients with MCI, and apathy [2.35 (2.70) vs. 3.75 (3.78); P = 0.036], agitation [0.45 (1.14) vs. 1.50 (2.66); P = 0.029] and aberrant motor behaviour [1.25 (2.86) vs. 2.00 (2.93); P = 0.044] in patients with AD. We did not observe differences in EQ‐5D scores during the re‐evaluation. The 30% of patients and 40% of caregivers reported a worsening of the patients' health status during confinement. Conclusions The results of this study show the worsening of neuropsychiatric symptoms in patients with AD and MCI during 5 weeks of lockdown, with agitation, apathy and aberrant motor activity being the most affected symptoms.
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Affiliation(s)
- B Lara
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, IRBLleida, Santa Maria University Hospital, Lleida, Spain
| | - A Carnes
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, IRBLleida, Santa Maria University Hospital, Lleida, Spain
| | - F Dakterzada
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, IRBLleida, Santa Maria University Hospital, Lleida, Spain
| | - I Benitez
- Translational Research in Respiratory Medicine, IRBLleida, Hospital Universitari Arnau de Vilanova-Santa Maria, Lleida, Spain
| | - G Piñol-Ripoll
- Unitat Trastorns Cognitius, Clinical Neuroscience Research, IRBLleida, Santa Maria University Hospital, Lleida, Spain
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Pink G, Mapfunde I, Lara B. Neuroendocrine cells in the lung: physiology and pathology. Lung Cancer 2019. [DOI: 10.1016/s0169-5002(19)30267-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Román LS, Menon BK, Blasco J, Hernández-Pérez M, Dávalos A, Majoie CBLM, Campbell BCV, Guillemin F, Lingsma H, Anxionnat R, Epstein J, Saver JL, Marquering H, Wong JH, Lopes D, Reimann G, Desal H, Dippel DWJ, Coutts S, du Mesnil de Rochemont R, Yavagal D, Ferre JC, Roos YBWEM, Liebeskind DS, Lenthall R, Molina C, Al Ajlan FS, Reddy V, Dowlatshahi D, Sourour NA, Oppenheim C, Mitha AP, Davis SM, Weimar C, van Oostenbrugge RJ, Cobo E, Kleinig TJ, Donnan GA, van der Lugt A, Demchuk AM, Berkhemer OA, Boers AMM, Ford GA, Muir KW, Brown BS, Jovin T, van Zwam WH, Mitchell PJ, Hill MD, White P, Bracard S, Goyal M, Berkhemer OA, Fransen PSS, Beumer D, van den Berg LA, Lingsma HF, Yoo AJ, Schonewille WJ, Vos JA, Nederkoorn PJ, Wermer MJH, van Walderveen MAA, Staals J, Hofmeijer J, van Oostayen JA, Lycklama à Nijeholt GJ, Boiten J, Brouwer PA, Emmer BJ, de Bruijn SF, van Dijk LC, Kappelle J, Lo RH, van Dijk EJ, de Vries J, de Kort PL, van Rooij WJJ, van den Berg JS, van Hasselt BA, Aerden LA, Dallinga RJ, Visser MC, Bot JC, Vroomen PC, Eshghi O, Schreuder TH, Heijboer RJ, Keizer K, Tielbeek AV, den Hertog HM, Gerrits DG, van den Berg-Vos RM, Karas GB, Steyerberg EW, Flach Z, Marquering HA, Sprengers ME, Jenniskens SF, Beenen LF, Zech M, Kowarik M, Seifert C, Schwaiger B, Puri A, Hou S, Wakhloo A, Moonis M, Henniger N, Goddeau R, van den Berg R, Massari F, Minaeian A, Lozano JD, Ramzan M, Stout C, Patel A, Tunguturi A, Onteddu S, Carandang R, Howk M, Koudstaal PJ, Ribó M, Sanjuan E, Rubiera M, Pagola J, Flores A, Muchada M, Meler P, Huerga E, Gelabert S, Coscojuela P, van Zwam WH, Tomasello A, Rodriguez D, Santamarina E, Maisterra O, Boned S, Seró L, Rovira A, Molina CA, Millán M, Muñoz L, Roos YB, Pérez de la Ossa N, Gomis M, Dorado L, López-Cancio E, Palomeras E, Munuera J, García Bermejo P, Remollo S, Castaño C, García-Sort R, van der Lugt A, Cuadras P, Puyalto P, Hernández-Pérez M, Jiménez M, Martínez-Piñeiro A, Lucente G, Dávalos A, Chamorro A, Urra X, Obach V, van 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VA, Lanthier S, Odier C, Durocher A, Raymond J, Weill A, Daneault N, Deschaintre Y, Jankowitz B, Baxendell L, Massaro L, Jackson-Graves C, Decesare S, Porter P, Armbruster K, Adams A, Billigan J, Oakley J, Ducruet A, Jadhav A, Giurgiutiu DV, Aghaebrahim A, Reddy V, Hammer M, Starr M, Totoraitis V, Wechsler L, Streib S, Rangaraju S, Campbell D, Rocha M, Gulati D, Silver FL, Krings T, Kalman L, Cayley A, Williams J, Stewart T, Wiegner R, Casaubon LK, Jaigobin C, del Campo JM, Elamin E, Schaafsma JD, Willinsky RA, Agid R, Farb R, ter Brugge K, Sapkoda BL, Baxter BW, Barton K, Knox A, Porter A, Sirelkhatim A, Devlin T, Dellinger C, Pitiyanuvath N, Patterson J, Nichols J, Quarfordt S, Calvert J, Hawk H, Fanale C, Frei DF, Bitner A, Novak A, Huddle D, Bellon R, Loy D, Wagner J, Chang I, Lampe E, Spencer B, Pratt R, Bartt R, Shine S, Dooley G, Nguyen T, Whaley M, McCarthy K, Teitelbaum J, Tampieri D, Poon W, Campbell N, Cortes M, Dowlatshahi D, Lum C, Shamloul R, Robert S, Stotts G, Shamy M, 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Kim BM, Kim YD, Song D, Lee KJ, Yoo J, Bang OY, Rho S, Lee J, Jeon P, Kim KH, Cha J, Kim SJ, Ryoo S, Lee MJ, Sohn SI, Kim CH, Ryu HG, Hong JH, Chang HW, Lee CY, Rha J, Davis SM, Donnan GA, Campbell BCV, Mitchell PJ, Churilov L, Yan B, Dowling R, Yassi N, Oxley TJ, Wu TY, Silver G, McDonald A, McCoy R, Kleinig TJ, Scroop R, Dewey HM, Simpson M, Brooks M, Coulton B, Krause M, Harrington TJ, Steinfort B, Faulder K, Priglinger M, Day S, Phan T, Chong W, Holt M, Chandra RV, Ma H, Young D, Wong K, Wijeratne T, Tu H, Mackay E, Celestino S, Bladin CF, Loh PS, Gilligan A, Ross Z, Coote S, Frost T, Parsons MW, Miteff F, Levi CR, Ang T, Spratt N, Kaauwai L, Badve M, Rice H, de Villiers L, Barber PA, McGuinness B, Hope A, Moriarty M, Bennett P, Wong A, Coulthard A, Lee A, Jannes J, Field D, Sharma G, Salinas S, Cowley E, Snow B, Kolbe J, Stark R, King J, Macdonnell R, Attia J, D'Este C, Saver JL, Goyal M, Diener HC, Levy EI, Bonafé A, Mendes Pereira V, Jahan R, Albers GW, Cognard C, Cohen DJ, Hacke W, Jansen O, Jovin TG, Mattle HP, Nogueira RG, Siddiqui AH, Yavagal DR, von Kummer R, Smith W, Turjman F, Hamilton S, Chiacchierini R, Amar A, Sanossian N, Loh Y, Devlin T, Baxter B, Hawk H, Sapkota B, Quarfordt S, Sirelkhatim A, Dellinger C, Barton K, Reddy VK, Ducruet A, Jadhav A, Horev A, Giurgiutiu DV, Totoraitis V, Hammer M, Jankowitz B, Wechsler L, Rocha M, Gulati D, Campbell D, Star M, Baxendell L, Oakley J, Siddiqui A, Hopkins LN, Snyder K, Sawyer R, Hall S, Costalat V, Riquelme C, Machi P, Omer E, Arquizan C, Mourand I, Charif M, Ayrignac X, Menjot de Champfleur N, Leboucq N, Gascou G, Moynier M, du Mesnil de Rochemont R, Singer O, Berkefeld J, Foerch C, Lorenz M, Pfeilschifer W, Hattingen E, Wagner M, You SJ, Lescher S, Braun H, Dehkharghani S, Belagaje SR, Anderson A, Lima A, Obideen M, Haussen D, Dharia R, Frankel M, Patel V, Owada K, Saad A, Amerson L, Horn C, Doppelheuer S, Schindler K, Lopes DK, Chen M, Moftakhar R, Anton C, Smreczak M, Carpenter JS, Boo S, Rai A, 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M, Belden J, Baker C, Connolly LS, Papanagiotou P, Roth C, Kastrup A, Politi M, Brunner F, Alexandrou M, Merdivan H, Ramsey C, Given II C, Renfrow S, Deshmukh V, Sasadeusz K, Vincent F, Thiesing JT, Putnam J, Bhatt A, Kansara A, Caceves D, Lowenkopf T, Yanase L, Zurasky J, Dancer S, Freeman B, Scheibe-Mirek T, Robison J, Rontal A, Roll J, Clark D, Rodriguez M, Fitzsimmons BFM, Zaidat O, Lynch JR, Lazzaro M, Larson T, Padmore L, Das E, Farrow-Schmidt A, Hassan A, Tekle W, Cate C, Jansen O, Cnyrim C, Wodarg F, Wiese C, Binder A, Riedel C, Rohr A, Lang N, Laufs H, Krieter S, Remonda L, Diepers M, Añon J, Nedeltchev K, Kahles T, Biethahn S, Lindner M, Chang V, Gächter C, Esperon C, Guglielmetti M, Arenillas Lara JF, Martínez Galdámez M, Calleja Sanz AI, Cortijo Garcia E, Garcia Bermejo P, Perez S, Mulero Carrillo P, Crespo Vallejo E, Ruiz Piñero M, Lopez Mesonero L, Reyes Muñoz FJ, Brekenfeld C, Buhk JH, Krützelmann A, Thomalla G, Cheng B, Beck C, Hoppe J, Goebell E, Holst B, Grzyska U, Wortmann G, Starkman S, Duckwiler G, Jahan R, Rao N, Sheth S, Ng K, Noorian A, Szeder V, Nour M, McManus M, Huang J, Tarpley J, Tateshima S, Gonzalez N, Ali L, Liebeskind D, Hinman J, Calderon-Arnulphi M, Liang C, Guzy J, Koch S, DeSousa K, Gordon-Perue G, Haussen D, Elhammady M, Peterson E, Pandey V, Dharmadhikari S, Khandelwal P, Malik A, Pafford R, Gonzalez P, Ramdas K, Andersen G, Damgaard D, Von Weitzel-Mudersbach P, Simonsen C, Ruiz de Morales Ayudarte N, Poulsen M, Sørensen L, Karabegovich S, Hjørringgaard M, Hjort N, Harbo T, Sørensen K, Deshaies E, Padalino D, Swarnkar A, Latorre JG, Elnour E, El-Zammar Z, Villwock M, Farid H, Balgude A, Cross L, Hansen K, Holtmannspötter M, Kondziella D, Hoejgaard J, Taudorf S, Soendergaard H, Wagner A, Cronquist M, Stavngaard T, Cortsen M, Krarup LH, Hyldal T, Haring HP, Guggenberger S, Hamberger M, Trenkler J, Sonnberger M, Nussbaumer K, Dominger C, Bach E, Jagadeesan BD, Taylor R, Kim J, Shea K, Tummala R, Zacharatos H, Sandhu D, Ezzeddine M, Grande A, Hildebrandt D, Miller K, Scherber J, Hendrickson A, Jumaa M, Zaidi S, Hendrickson T, Snyder V, Killer-Oberpfalzer M, Mutzenbach J, Weymayr F, Broussalis E, Stadler K, Jedlitschka A, Malek A, Mueller-Kronast N, Beck P, Martin C, Summers D, Day J, Bettinger I, Holloway W, Olds K, Arkin S, Akhtar N, Boutwell C, Crandall S, Schwartzman M, Weinstein C, Brion B, Prothmann S, Kleine J, Kreiser K, Boeckh-Behrens T, Poppert H, Wunderlich S, Koch ML, Biberacher V, Huberle A, Gora-Stahlberg G, Knier B, Meindl T, Utpadel-Fischler D. Imaging features and safety and efficacy of endovascular stroke treatment: a meta-analysis of individual patient-level data. Lancet Neurol 2018; 17:895-904. [DOI: 10.1016/s1474-4422(18)30242-4] [Citation(s) in RCA: 213] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 06/11/2018] [Accepted: 06/12/2018] [Indexed: 11/29/2022]
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Villalva M, Jaime L, Villanueva-Bermejo D, Lara B, Fornari T, Reglero G, Santoyo S. Supercritical anti-solvent fractionation for improving antioxidant and anti-inflammatory activities of an Achillea millefolium L. extract. Food Res Int 2018; 115:128-134. [PMID: 30599924 DOI: 10.1016/j.foodres.2018.08.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/17/2018] [Accepted: 08/10/2018] [Indexed: 12/15/2022]
Abstract
Achillea millefolium L. is a plant widely used in traditional medicine. Nowadays, there is a growing concern about the study of its bioactive properties in order to develop food and nutraceutical formulations. Supercritical anti-solvent fractionation (SAF) of an A. millefollium extract was carried out to improve its antioxidant and anti-inflammatory activities. A selective precipitation of phenolic compounds was achieved in the precipitation vessel fractions, which presented an antioxidant activity twice than original extract, especially when fractionation was carried out at 10 MPa. The main phenolic components identified in this fraction were luteolin-7-O-glucoside, 3,5-dicaffeoylquinic acid, 6-hidroxyluteolin-7-O-glucoside and apigenin-7-O-glucoside. However, separator fractions presented higher anti-inflammatory activity than precipitation vessel ones, particularly at 15 MPa. This fact could be related to separator fractions enrichment in anti-inflammatory compounds, mainly camphor, artemisia ketone and borneol. Therefore, SAF produced a concentration of antioxidant and anti-inflammatory compounds that could be used as high-added valued ingredients.
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Affiliation(s)
- M Villalva
- Institute of Food Science Research (CIAL), Universidad Autónoma de Madrid (CEI UAM+CSIC), 28049 Madrid, Spain
| | - L Jaime
- Institute of Food Science Research (CIAL), Universidad Autónoma de Madrid (CEI UAM+CSIC), 28049 Madrid, Spain
| | - D Villanueva-Bermejo
- Institute of Food Science Research (CIAL), Universidad Autónoma de Madrid (CEI UAM+CSIC), 28049 Madrid, Spain
| | - B Lara
- Institute of Food Science Research (CIAL), Universidad Autónoma de Madrid (CEI UAM+CSIC), 28049 Madrid, Spain
| | - T Fornari
- Institute of Food Science Research (CIAL), Universidad Autónoma de Madrid (CEI UAM+CSIC), 28049 Madrid, Spain
| | - G Reglero
- Institute of Food Science Research (CIAL), Universidad Autónoma de Madrid (CEI UAM+CSIC), 28049 Madrid, Spain; Imdea-Food Institute, 28049 Madrid, Spain
| | - S Santoyo
- Institute of Food Science Research (CIAL), Universidad Autónoma de Madrid (CEI UAM+CSIC), 28049 Madrid, Spain.
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H, Aceituno A, Rudilosso S, Renu A, Macho JM, San Roman L, Blasco J, López A, Macías N, Cardona P, Mattle H, Quesada H, Rubio F, Cano L, Lara B, de Miquel MA, Aja L, Serena J, Cobo E, Albers GW, Lees KR, Wahlgren N, Arenillas J, Roberts R, Minhas P, Al-Ajlan F, Salluzzi M, Zimmel L, Patel S, Eesa M, Martí-Fàbregas J, Jankowitz B, van der Heijden E, Serena J, Salvat-Plana M, López-Cancio E, Bracard S, Ducrocq X, Anxionnat R, Baillot PA, Barbier C, Derelle AL, Lacour JC, Ghannouti N, Richard S, Samson Y, Sourour N, Baronnet-Chauvet F, Clarencon F, Crozier S, Deltour S, Di Maria F, Le Bouc R, Leger A, Fleitour N, Mutlu G, Rosso C, Szatmary Z, Yger M, Zavanone C, Bakchine S, Pierot L, Caucheteux N, Estrade L, Kadziolka K, Hooijenga I, Leautaud A, Renkes C, Serre I, Desal H, Guillon B, Boutoleau-Bretonniere C, Daumas-Duport B, De Gaalon S, Derkinderen P, Evain S, Puppels C, Herisson F, Laplaud DA, Lebouvier T, Lintia-Gaultier A, Pouclet-Courtemanche H, Rouaud T, Rouaud Jaffrenou V, Schunck 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Morrish WF, Eesa M, Newcommon NJ, Shuaib A, Schwindt B, Butcher KS, Jeerakathil T, Buck B, Khan K, Naik SS, Emery DJ, Owen RJ, Kotylak TB, Ashforth RA, Yeo TA, McNally D, Siddiqui M, Saqqur M, Hussain D, Kalashyan H, Manosalva A, Kate M, Gioia L, Hasan S, Mohammad A, Muratoglu M, Williams D, Thornton J, Cullen A, Brennan P, O'Hare A, Looby S, Hyland D, Duff S, McCusker M, Hallinan B, Lee S, McCormack J, Moore A, O'Connor M, Donegan C, Brewer L, Martin A, Murphy S, O'Rourke K, Smyth S, Kelly P, Lynch T, Daly T, O'Brien P, O'Driscoll A, Martin M, Daly T, Collins R, Coughlan T, McCabe D, Murphy S, O'Neill D, Mulroy M, Lynch O, Walsh T, O'Donnell M, Galvin T, Harbison J, McElwaine P, Mulpeter K, McLoughlin C, Reardon M, Harkin E, Dolan E, Watts M, Cunningham N, Fallon C, Gallagher S, Cotter P, Crowe M, Doyle R, Noone I, Lapierre M, Coté VA, Lanthier S, Odier C, Durocher A, Raymond J, Weill A, Daneault N, Deschaintre Y, Jankowitz B, Baxendell L, Massaro L, Jackson-Graves C, Decesare S, Porter P, Armbruster K, Adams A, Billigan J, Oakley J, Ducruet A, Jadhav A, Giurgiutiu DV, Aghaebrahim A, Reddy V, Hammer M, Starr M, Totoraitis V, Wechsler L, Streib S, Rangaraju S, Campbell D, Rocha M, Gulati D, Silver FL, Krings T, Kalman L, Cayley A, Williams J, Stewart T, Wiegner R, Casaubon LK, Jaigobin C, del Campo JM, Elamin E, Schaafsma JD, Willinsky RA, Agid R, Farb R, ter Brugge K, Sapkoda BL, Baxter BW, Barton K, Knox A, Porter A, Sirelkhatim A, Devlin T, Dellinger C, Pitiyanuvath N, Patterson J, Nichols J, Quarfordt S, Calvert J, Hawk H, Fanale C, Frei DF, Bitner A, Novak A, Huddle D, Bellon R, Loy D, Wagner J, Chang I, Lampe E, Spencer B, Pratt R, Bartt R, Shine S, Dooley G, Nguyen T, Whaley M, McCarthy K, Teitelbaum J, Tampieri D, Poon W, Campbell N, Cortes M, Dowlatshahi D, Lum C, Shamloul R, Robert S, Stotts G, Shamy M, Steffenhagen N, Blacquiere D, Hogan M, AlHazzaa M, Basir G, Lesiuk H, Iancu D, Santos M, Choe H, Weisman DC, Jonczak K, Blue-Schaller A, Shah Q, MacKenzie L, Klein B, Kulandaivel K, Kozak O, Gzesh DJ, Harris LJ, Khoury JS, Mandzia J, Pelz D, Crann S, Fleming L, Hesser K, Beauchamp B, Amato-Marzialli B, Boulton M, Lopez- Ojeda P, Sharma M, Lownie S, Chan R, Swartz R, Howard P, Golob D, Gladstone D, Boyle K, Boulos M, Hopyan J, Yang V, Da Costa L, Holmstedt CA, Turk AS, Navarro R, Jauch E, Ozark S, Turner R, Phillips S, Shankar J, Jarrett J, Gubitz G, Maloney W, Vandorpe R, Schmidt M, Heidenreich J, Hunter G, Kelly M, Whelan R, Peeling L, Burns PA, Hunter A, Wiggam I, Kerr E, Watt M, Fulton A, Gordon P, Rennie I, Flynn P, Smyth G, O'Leary S, Gentile N, Linares G, McNelis P, Erkmen K, Katz P, Azizi A, Weaver M, Jungreis C, Faro S, Shah P, Reimer H, Kalugdan V, Saposnik G, Bharatha A, Li Y, Kostyrko P, Santos M, Marotta T, Montanera W, Sarma D, Selchen D, Spears J, Heo JH, Jeong K, Kim DJ, Kim BM, Kim YD, Song D, Lee KJ, Yoo J, Bang OY, Rho S, Lee J, Jeon P, Kim KH, Cha J, Kim SJ, Ryoo S, Lee MJ, Sohn SI, Kim CH, Ryu HG, Hong JH, Chang HW, Lee CY, Rha J, Davis SM, Donnan GA, Campbell BCV, Mitchell PJ, Churilov L, Yan B, Dowling R, Yassi N, Oxley TJ, Wu TY, Silver G, McDonald A, McCoy R, Kleinig TJ, Scroop R, Dewey HM, Simpson M, Brooks M, Coulton B, Krause M, Harrington TJ, Steinfort B, Faulder K, Priglinger M, Day S, Phan T, Chong W, Holt M, Chandra RV, Ma H, Young D, Wong K, Wijeratne T, Tu H, Mackay E, Celestino S, Bladin CF, Loh PS, Gilligan A, Ross Z, Coote S, Frost T, Parsons MW, Miteff F, Levi CR, Ang T, Spratt N, Kaauwai L, Badve M, Rice H, de Villiers L, Barber PA, McGuinness B, Hope A, Moriarty M, Bennett P, Wong A, Coulthard A, Lee A, Jannes J, Field D, Sharma G, Salinas S, Cowley E, Snow B, Kolbe J, Stark R, King J, Macdonnell R, Attia J, D'Este C, Saver JL, Goyal M, Diener HC, Levy EI, Bonafé A, Mendes Pereira V, Jahan R, Albers GW, Cognard C, Cohen DJ, Hacke W, Jansen O, Jovin TG, Mattle HP, Nogueira RG, Siddiqui AH, Yavagal DR, von Kummer R, Smith W, Turjman F, Hamilton S, Chiacchierini R, Amar A, Sanossian N, Loh Y, Devlin T, Baxter B, Hawk H, Sapkota B, Quarfordt S, Sirelkhatim A, Dellinger C, Barton K, Reddy VK, Ducruet A, Jadhav A, Horev A, Giurgiutiu DV, Totoraitis V, Hammer M, Jankowitz B, Wechsler L, Rocha M, Gulati D, Campbell D, Star M, Baxendell L, Oakley J, Siddiqui A, Hopkins LN, Snyder K, Sawyer R, Hall S, Costalat V, Riquelme C, Machi P, Omer E, Arquizan C, Mourand I, Charif M, Ayrignac X, Menjot de Champfleur N, Leboucq N, Gascou G, Moynier M, du Mesnil de Rochemont R, Singer O, Berkefeld J, Foerch C, Lorenz M, Pfeilschifer W, Hattingen E, Wagner M, You SJ, Lescher S, Braun H, Dehkharghani S, Belagaje SR, Anderson A, Lima A, Obideen M, Haussen D, Dharia R, Frankel M, Patel V, Owada K, Saad A, Amerson L, Horn C, Doppelheuer S, Schindler K, Lopes DK, Chen M, Moftakhar R, Anton C, Smreczak M, Carpenter JS, Boo S, Rai A, Roberts T, Tarabishy A, Gutmann L, Brooks C, Brick J, Domico J, Reimann G, Hinrichs K, Becker M, Heiss E, Selle C, Witteler A, Al-Boutros S, Danch 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S, Deshmukh V, Sasadeusz K, Vincent F, Thiesing JT, Putnam J, Bhatt A, Kansara A, Caceves D, Lowenkopf T, Yanase L, Zurasky J, Dancer S, Freeman B, Scheibe-Mirek T, Robison J, Rontal A, Roll J, Clark D, Rodriguez M, Fitzsimmons BFM, Zaidat O, Lynch JR, Lazzaro M, Larson T, Padmore L, Das E, Farrow-Schmidt A, Hassan A, Tekle W, Cate C, Jansen O, Cnyrim C, Wodarg F, Wiese C, Binder A, Riedel C, Rohr A, Lang N, Laufs H, Krieter S, Remonda L, Diepers M, Añon J, Nedeltchev K, Kahles T, Biethahn S, Lindner M, Chang V, Gächter C, Esperon C, Guglielmetti M, Arenillas Lara JF, Martínez Galdámez M, Calleja Sanz AI, Cortijo Garcia E, Garcia Bermejo P, Perez S, Mulero Carrillo P, Crespo Vallejo E, Ruiz Piñero M, Lopez Mesonero L, Reyes Muñoz FJ, Brekenfeld C, Buhk JH, Krützelmann A, Thomalla G, Cheng B, Beck C, Hoppe J, Goebell E, Holst B, Grzyska U, Wortmann G, Starkman S, Duckwiler G, Jahan R, Rao N, Sheth S, Ng K, Noorian A, Szeder V, Nour M, McManus M, Huang J, Tarpley J, Tateshima S, Gonzalez N, Ali L, Liebeskind D, Hinman J, Calderon-Arnulphi M, Liang C, Guzy J, Koch S, DeSousa K, Gordon-Perue G, Haussen D, Elhammady M, Peterson E, Pandey V, Dharmadhikari S, Khandelwal P, Malik A, Pafford R, Gonzalez P, Ramdas K, Andersen G, Damgaard D, Von Weitzel-Mudersbach P, Simonsen C, Ruiz de Morales Ayudarte N, Poulsen M, Sørensen L, Karabegovich S, Hjørringgaard M, Hjort N, Harbo T, Sørensen K, Deshaies E, Padalino D, Swarnkar A, Latorre JG, Elnour E, El-Zammar Z, Villwock M, Farid H, Balgude A, Cross L, Hansen K, Holtmannspötter M, Kondziella D, Hoejgaard J, Taudorf S, Soendergaard H, Wagner A, Cronquist M, Stavngaard T, Cortsen M, Krarup LH, Hyldal T, Haring HP, Guggenberger S, Hamberger M, Trenkler J, Sonnberger M, Nussbaumer K, Dominger C, Bach E, Jagadeesan BD, Taylor R, Kim J, Shea K, Tummala R, Zacharatos H, Sandhu D, Ezzeddine M, Grande A, Hildebrandt D, Miller K, Scherber J, Hendrickson A, Jumaa M, Zaidi S, Hendrickson T, Snyder V, Killer-Oberpfalzer M, Mutzenbach J, Weymayr F, Broussalis E, Stadler K, Jedlitschka A, Malek A, Mueller-Kronast N, Beck P, Martin C, Summers D, Day J, Bettinger I, Holloway W, Olds K, Arkin S, Akhtar N, Boutwell C, Crandall S, Schwartzman M, Weinstein C, Brion B, Prothmann S, Kleine J, Kreiser K, Boeckh-Behrens T, Poppert H, Wunderlich S, Koch ML, Biberacher V, Huberle A, Gora-Stahlberg G, Knier B, Meindl T, Utpadel-Fischler D, Zech M, Kowarik M, Seifert C, Schwaiger B, Puri A, Hou S. Effect of general anaesthesia on functional outcome in patients with anterior circulation ischaemic stroke having endovascular thrombectomy versus standard care: a meta-analysis of individual patient data. Lancet Neurol 2018; 17:47-53. [DOI: 10.1016/s1474-4422(17)30407-6] [Citation(s) in RCA: 129] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/05/2017] [Accepted: 10/11/2017] [Indexed: 10/18/2022]
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Abilleira S, Ribera A, Cardona P, Rubiera M, López-Cancio E, Amaro S, Rodríguez-Campello A, Camps-Renom P, Cánovas D, de Miquel MA, Tomasello A, Remollo S, López-Rueda A, Vivas E, Perendreu J, Gallofré M, Martí-Fàbregas J, Delgado-Mederos R, Martínez-Domeño A, Marín R, Roquer J, Ois Á, Jiménez-Conde J, Guimaraens L, Chamorro Á, Obach V, Urra X, Macho J, Blasco J, San Roman L, Martínez-Yélamos A, Quesada H, Lara B, Cayuela N, Aja L, Mora P, Molina C, Ribó M, Pagola J, Rodríguez-Luna D, Muchada M, Coscojuela P, Dávalos A, Millán M, Pérez de la Ossa N, Gomis M, Dorado L, Castaño C, Garcia M, Estela J, Krupinski J, Huertas-Folch S, Nicolás-Herrerias M, Gómez-Choco M, García S, Martínez R, Sanahuja J, Purroy F, Serena J, Castellanos M, Silva Y, Marés R, Pellisé A, Ustrell X, Baiges J, Garcés M, Saura J, Soler-Insa J, Aragonés J, Cocho D, Palomeras E. Outcomes After Direct Thrombectomy or Combined Intravenous and Endovascular Treatment Are Not Different. Stroke 2017; 48:375-378. [DOI: 10.1161/strokeaha.116.015857] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 10/24/2016] [Accepted: 11/15/2016] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
Whether intravenous thrombolysis adds a further benefit when given before endovascular thrombectomy (EVT) is unknown. Furthermore, intravenous thrombolysis delays time to groin puncture, mainly among drip and ship patients.
Methods—
Using region-wide registry data, we selected cases that received direct EVT or combined intravenous thrombolysis+EVT for anterior circulation strokes between January 2011 and October 2015. Treatment effect was estimated by stratification on a propensity score. The average odds ratios for the association of treatment with good outcome and death at 3 months and symptomatic bleedings at 24 hours were calculated with the Mantel–Haenszel test statistic.
Results—
We included 599 direct EVT patients and 567 patients with combined treatment. Stratification through propensity score achieved balance of baseline characteristics across treatment groups. There was no association between treatment modality and good outcome (odds ratio, 0.97; 95% confidence interval, 0.74–1.27), death (odds ratio, 1.07; 95% confidence interval, 0.74–1.54), or symptomatic bleedings (odds ratio, 0.56; 95% confidence interval, 0.25–1.27).
Conclusions—
This observational study suggests that outcomes after direct EVT or combined intravenous thrombolysis+EVT are not different. If confirmed by a randomized controlled trial, it may have a significant impact on organization of stroke systems of care.
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Affiliation(s)
- Sònia Abilleira
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Aida Ribera
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Pedro Cardona
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Marta Rubiera
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Elena López-Cancio
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Sergi Amaro
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Ana Rodríguez-Campello
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Pol Camps-Renom
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - David Cánovas
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Maria Angels de Miquel
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Alejandro Tomasello
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Sebastian Remollo
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Antonio López-Rueda
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Elio Vivas
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Joan Perendreu
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
| | - Miquel Gallofré
- From the Stroke Program, Agency for Health Quality and Assessment of Catalonia, Barcelona, Spain (S. Abilleira, M.G.); CIBER Epidemiología y Salud Pública (CIBERESP) (S. Abilleira, M.G.); Cardiovascular Epidemiology Unit, Cardiology Department, Hospital Vall d’Hebron, Barcelona, Spain (A.R.); Neurology Department, Hospital de Bellvitge, Hospitalet de Llobregat, Spain (P.C.); Stroke Unit, Neurology Department, Hospital Vall d’Hebron, Barcelona, Spain (M.R.); Department of Neurosciences, Hospital
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Mena N, Ayala F, Elicer B, Donoso F, Diaz R, Kripper C, Lara B. 86 Accuracy of Three Pre-endoscopic Risk Scores in Patients With Upper Gastrointestinal Bleeding at a University Hospital in Chile: A Retrospective Study. Ann Emerg Med 2016. [DOI: 10.1016/j.annemergmed.2016.08.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Stanworth SJ, Jensen JF, Overgaard D, Bestle MH, Christensen DF, Egerod I, Pivkina A, Gusarov V, Zhivotneva I, Pasko N, Zamyatin M, Jensen JF, Egerod I, Bestle MH, Christensen DF, Alklit A, Hansen RL, Knudsen H, Grode LB, Overgaard D, Hravnak M, Chen L, Dubrawski A, Clermont G, Pinsky MR, Parry SM, Knight LD, Connolly BC, Baldwin CE, Puthucheary ZA, Denehy L, Hart N, Morris PE, Mortimore J, Granger CL, Jensen HI, Piers R, Van den Bulcke B, Malmgren J, Metaxa V, Reyners AK, Darmon M, Rusinova K, Talmor D, Meert AP, Cancelliere L, Zubek L, Maia P, Michalsen A, Decruyenaere J, Kompanje E, Vanheule S, Azoulay E, Vansteelandt S, Benoit D, Van den Bulcke B, Piers R, Jensen HI, Malmgren J, Metaxa V, Reyners AK, Darmon M, Rusinova K, Talmor D, Meert AP, Cancelliere L, Zubek L, Maia P, Michalsen A, Decruyenaere J, Kompanje E, Vanheule S, Azoulay E, Vansteelandt S, Benoit D, Ryan C, Dawson D, Ball J, Noone K, Aisling B, Prudden S, Ntantana A, Matamis D, Savvidou S, Giannakou M, Gouva M, Nakos G, Koulouras V, Aron J, Lumley G, Milliken D, Dhadwal K, McGrath BA, Lynch SJ, Bovento B, Sharpe G, Grainger E, Pieri-Davies S, Wallace S, McGrath B, Lynch SJ, Bovento B, Grainger E, Pieri-Davies S, Sharpe G, Wallace S, Jung M, Cho J, Park H, Suh G, Kousha O, Paddle J, Gripenberg LG, Rehal MS, Wernerman J, Rooyackers O, de Grooth HJ, Choo WP, Spoelstra-de Man AM, Swart EL, Oudemans-van Straaten HM, Talan L, Güven G, Altıntas ND, Padar M, Uusvel G, Starkopf L, Starkopf J, Blaser AR, Kalaiselvan MS, Arunkumar AS, Renuka MK, Shivkumar RL, Volbeda M, ten Kate D, Hoekstra M, van der Maaten JM, Nijsten MW, Komaromi A, Rooyackers O, Wernerman J, Norberg Å, Smedberg M, Mori M, Pettersson L, Norberg Å, Rooyackers O, Wernerman J, Theodorakopoulou M, Christodoulopoulou T, Diamantakis A, Frantzeskaki F, Kontogiorgi M, Chrysanthopoulou E, Lygnos M, Diakaki C, Armaganidis A, Gundogan K, Dogan E, Coskun R, Muhtaroglu S, Sungur M, Ziegler T, Guven M, Kleyman A, Khaliq W, Andreas D, Singer M, Meierhans R, Schuepbach R, De Brito-Ashurst I, Zand F, Sabetian G, Nikandish R, Hagar F, Masjedi M, Maghsudi B, Vazin A, Ghorbani M, Asadpour E, Kao KC, Chiu LC, Hung CY, Chang CH, Li SH, Hu HC, El Maraghi S, Ali M, Rageb D, Helmy M, Marin-Corral J, Vilà C, Masclans JR, Vàzquez A, Martín-Loeches I, Díaz E, Yébenes JC, Rodriguez A, Álvarez-Lerma F, Varga N, Cortina-Gutiérrez A, Dono L, Martínez-Martínez M, Maldonado C, Papiol E, Pérez-Carrasco M, Ferrer R, Nweze K, Morton B, Welters I, Houard M, Voisin B, Ledoux G, Six S, Jaillette E, Nseir S, Romdhani S, Bouneb R, Loghmari D, Aicha NB, Ayachi J, Meddeb K, Chouchène I, Khedher A, Boussarsar M, Chan KS, Yu WL, Marin-Corral J, Vilà C, Masclans JR, Nolla J, Vidaur L, Bonastre J, Suberbiola B, Guerrero JE, Rodriguez A, Coll NR, Jiménez GJ, Brugger SC, Calero JC, Garrido BB, García M, Martínez MP, Vidal MV, de la Torre MC, Vendrell E, Palomera E, Güell E, Yébenes JC, Serra-Prat M, Bermejo-Martín JF, Almirall J, Tomas E, Escoval A, Froe F, Pereira MHV, Velez N, Viegas E, Filipe E, Groves C, Reay M, Chiu LC, Hu HC, Hung CY, Chang CH, Li SH, Kao KC, Ballin A, Facchin F, Sartori G, Zarantonello F, Campello E, Radu CM, Rossi S, Ori C, Simioni P, Umei N, Shingo I, Santos AC, Candeias C, Moniz I, Marçal R, e Silva ZC, Ribeiro JM, Georger JF, Ponthus JP, Tchir M, Amilien V, Ayoub M, Barsam E, Martucci G, Panarello G, Tuzzolino F, Capitanio G, Ferrazza V, Carollo T, Giovanni L, Arcadipane A, Sánchez ML, González-Gay MA, Díaz FJL, López MIR, Zogheib E, Villeret L, Nader J, Bernasinski M, Besserve P, Caus T, Dupont H, Morimont P, Habran S, Hubert R, Desaive T, Blaffart F, Janssen N, Guiot J, Pironet A, Dauby P, Lambermont B, Zarantonello F, Ballin A, Facchin F, Sartori G, Campello E, Pettenuzzo T, Citton G, Rossi S, Simioni P, Ori C, Kirakli C, Ediboglu O, Ataman S, Yarici M, Tuksavul F, Keating S, Gibson A, Gilles M, Dunn M, Price G, Young N, Remeta P, Bishop P, Zamora MDF, Muñoz-Bono J, Curiel-Balsera E, Aguilar-Alonso E, Hinojosa R, Gordillo-Brenes A, Arboleda-Sánchez JA, Skorniakov I, Vikulova D, Whiteley C, Shaikh O, Jones A, Ostermann M, Forni L, Scott M, Sahatjian J, Linde-Zwirble W, Hansell D, Laoveeravat P, Srisawat N, Kongwibulwut M, Peerapornrattana S, Suwachittanont N, Wirotwan TO, Chatkaew P, Saeyub P, Latthaprecha K, Tiranathanagul K, Eiam-ong S, Kellum JA, Berthelsen RE, Perner A, Jensen AEK, Jensen JU, Bestle MH, Gebhard DJ, Price J, Kennedy CE, Akcan-Arikan A, Liberatore AMA, Souza RB, Martins AMCRPF, Vieira JCF, Kang YR, Nakamae MN, Koh IHJ, Hamed K, Khaled MM, Soliman RA, Mokhtar MS, Seller-Pérez G, Arias-Verdú D, Llopar-Valdor E, De-Diós-Chacón I, Quesada-García G, Herrera-Gutierrez ME, Hafes R, Carroll G, Doherty P, Wright C, Vera IGG, Ralston M, Gemmell ML, MacKay A, Black E, Wright C, Docking RI, Appleton R, Ralston MR, Gemmell L, Appleton R, Wright C, Docking RI, Black E, Mackay A, Rozemeijer S, Mulier JLGH, Röttgering JG, Elbers PWG, Spoelstra-de Man AME, Tuinman PR, de Waard MC, Oudemans-van Straaten HM, Mejeni N, Nsiala J, Kilembe A, Akilimali P, Thomas G, Egerod I, Andersson AE, Fagerdahl AM, Knudsen V, Meddeb K, Cheikh AB, Hamdaoui Y, Ayachi J, Guiga A, Fraj N, Romdhani S, Sma N, Bouneb R, Chouchene I, Khedher A, Bouafia N, Boussarsar M, Amirian A, Ziaian B, Masjedi M, Fleischmann C, Thomas-Rueddel DO, Schettler A, Schwarzkopf D, Stacke A, Reinhart K, Filipe E, Escoval A, Martins A, Sousa P, Velez N, Viegas E, Tomas E, Snell G, Matsa R, Paary TTS, Kalaiselvan MS, Cavalheiro AM, Rocha LL, Vallone CS, Tonilo A, Lobato MDS, Malheiro DT, Sussumo G, Lucino NM, Zand F, Rosenthal VD, Masjedi M, Sabetian G, Maghsudi B, Ghorbani M, Dashti AS, Yousefipour A, Goodall JR, Williamson M, Tant E, Thomas N, Balci C, Gonen C, Haftacı E, Gurarda H, Karaca E, Paldusová B, Zýková I, Šímová D, Houston S, D’Antona L, Lloyd J, Garnelo-Rey V, Sosic M, Sotosek-Tokmazic V, Kuharic J, Antoncic I, Dunatov S, Sustic A, Chong CT, Sim M, Lyovarin T, Díaz FMA, Galdó SN, Garach MM, Romero OM, Bailón AMP, Pinel AC, Colmenero M, Gritsan A, Gazenkampf A, Korchagin E, Dovbish N, Lee RM, Lim MPP, Chong CT, Lim BCL, See JJ, Assis R, Filipe F, Lopes N, Pessoa L, Pereira T, Catorze N, Aydogan MS, Aldasoro C, Marchio P, Jorda A, Mauricio MD, Guerra-Ojeda S, Gimeno-Raga M, Colque-Cano M, Bertomeu-Artecero A, Aldasoro M, Valles SL, Tonon D, Triglia T, Martin JC, Alessi MC, Bruder N, Garrigue P, Velly L, Spina S, Scaravilli V, Marzorati C, Colombo E, Savo D, Vargiolu A, Cavenaghi G, Citerio G, Andrade AHV, Bulgarelli P, Araujo JAP, Gonzalez V, Souza VA, Costa A, Massant C, Filho CACA, Morbeck RA, Burgo LE, van Groenendael R, van Eijk LT, Leijte GP, Koeneman B, Kox M, Pickkers P, García-de la Torre A, de la Torre-Prados M, Fernández-Porcel A, Rueda-Molina C, Nuevo-Ortega P, Tsvetanova-Spasova T, Cámara-Sola E, García-Alcántara A, Salido-Díaz L, Liao X, Feng T, Zhang J, Cao X, Wu Q, Xie Z, Li H, Kang Y, Winkler MS, Nierhaus A, Mudersbach E, Bauer A, Robbe L, Zahrte C, Schwedhelm E, Kluge S, Zöllner C, Morton B, Mitsi E, Pennington SH, Reine J, Wright AD, Parker R, Welters ID, Blakey JD, Rajam G, Ades EW, Ferreira DM, Wang D, Kadioglu A, Gordon SB, Koch R, Kox M, Rahamat-Langedoen J, Schloesser J, de Jonge M, Pickkers P, Bringue J, Guillamat-Prats R, Torrents E, Martinez ML, Camprubí-Rimblas M, Artigas A, Blanch L, Park SY, Park YB, Song DK, Shrestha S, Park SH, Koh Y, Park MJ, Hong CW, Lesur O, Coquerel D, Sainsily X, Cote J, Söllradl T, Murza A, Dumont L, Dumaine R, Grandbois M, Sarret P, Marsault E, Salvail D, Auger-Messier M, Chagnon F, Lauretta MP, Greco E, Dyson A, Singer M, Preau S, Ambler M, Sigurta A, Saeed S, Singer M, Sarıca LT, Zibandeh N, Genc D, Gul F, Akkoc T, Kombak E, Cinel L, Akkoc T, Cinel I, Pollen SJ, Arulkumaran N, Singer M, Torrance HD, Longbottom ER, Warnes G, Hinds CJ, Pennington DJ, Brohi K, O’Dwyer MJ, Kim HY, Na S, Kim J, Chang YF, Chao A, Shih PY, Lee CT, Yeh YC, Chen LW, Adriaanse M, Trogrlic Z, Ista E, Lingsma H, Rietdijk W, Ponssen HH, Schoonderbeek JF, Schreiner F, Verbrugge SJ, Duran S, Gommers DAMPJ, van der Jagt M, Funcke S, Sauerlaender S, Saugel B, Pinnschmidt H, Reuter DA, Nitzschke R, Perbet S, Biboulet C, Lenoire A, Bourdeaux D, Pereira B, Plaud B, Bazin JE, Sautou V, Mebazaa A, Constantin JM, Legrand M, Boyko Y, Jennum P, Nikolic M. ESICM LIVES 2016: part one. Intensive Care Med Exp 2016. [PMCID: PMC5042924 DOI: 10.1186/s40635-016-0098-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Blanco I, Lipsker D, Lara B, Janciauskiene S. Neutrophilic panniculitis and autoinflammation: what's the link?: reply from authors. Br J Dermatol 2016; 175:647-8. [PMID: 27463611 DOI: 10.1111/bjd.14614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- I Blanco
- Board of Directors of the Alpha1-Antitrypsin Deficiency Spanish Registry, Lung Foundation Breathe, Spanish Society of Pneumology (SEPAR), Barcelona, Spain.
| | - D Lipsker
- Faculté de Medecine, Université de Strasbourg et Clinique Dermatologique, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - B Lara
- Respiratory Medicine Department, Royal Exeter and Devon Hospital, Exeter, U.K
| | - S Janciauskiene
- Department of Respiratory Medicine, Hannover Medical School, Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Member of the German Center for Lung Research (DZL), Hanover, Germany
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Cano L, Cardona P, Quesada H, Lara B, Rubio F. Ischaemic stroke in patients treated with oral anticoagulants. Neurología (English Edition) 2016. [DOI: 10.1016/j.nrleng.2014.09.002] [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: 11/25/2022] Open
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García-Palenzuela R, Timiraos Carrasco R, Gómez-Besteiro MI, Lavia G, Lago Pose M, Lara B. [Detection of alpha-1 antitrypsin deficiency: A study on patients diagnosed with chronic obstructive pulmonary disease in primary health care]. Semergen 2016; 43:289-294. [PMID: 27353138 DOI: 10.1016/j.semerg.2016.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 05/08/2016] [Accepted: 05/11/2016] [Indexed: 10/21/2022]
Abstract
The prevalence of chronic obstructive pulmonary disease (COPD) in Spain is 10.2%. Although tobacco is the main aetiological factor, biomass smoke exposure and alpha-1 antitrypsin deficiency (AATD) have also been related to its development. AATD is a genetic condition which could be causing 2-3% of COPD cases. The aim of this cross-sectional descriptive study was to exclude the existence of AATD in a population of COPD patients from CS Culleredo, A Coruña. The thick blood drop test on blotting paper, as well as the analysis of the mutations PI*S and PI*Z of the gene SERPINA 1 by the analysis of denaturing gradients after simultaneous amplification related to PCR (polymerase chain reaction). The study population included 80 patients between 40-80 years old, of whom 30% were carriers of a deficient allele (heterozygous), and 80% of them were the allele PiS. Only one PiSZ (1.25%) individual and no PiZZ was detected. This represents an allelic frequency of 3.1% (PiZ), and 13.1% (PiS). The detected allelic frequencies are higher than previously reported in the Spanish population. Severe AATD has been excluded in 98.75% of the study population. The Pi*SZ patient has been diagnosed in an early stage of the disease. We have also achieved one of the quality indicators recommended by GesEPOC. Our area has shown a high PiS and PiZ frequency, thus our study could be used as a reference for further research in the Galician population.
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Affiliation(s)
| | | | | | - G Lavia
- CS de Acea da Ma, Culleredo, A Coruña, España
| | - M Lago Pose
- CS de Acea da Ma, Culleredo, A Coruña, España
| | - B Lara
- Coventry and Warwickshire University Hospitals, Reino Unido.
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Pérez de la Ossa N, Abilleira S, Dorado L, Urra X, Ribó M, Cardona P, Giralt E, Martí-Fàbregas J, Purroy F, Serena J, Cánovas D, Garcés M, Krupinski J, Pellisé A, Saura J, Molina C, Dávalos A, Gallofré M, Delgado Mederos R, Martínez Domeño A, Marín Bueno R, Roquer J, Rodríguez-Campello A, Ois Á, Jiménez-Conde J, Cuadrado-Godia E, Guimaraens L, Chamorro A, Obach V, Amaro S, Macho JM, Blasco J, San Roman Manzanera L, López A, Martínez-Yélamos A, Quesada H, Lara B, Cayuela N, Aja L, de Miquel MA, Mora P, Rubiera M, Pagola J, Rodríguez-Luna D, Muchada M, Tomasello A, Coscojuela P, Millán M, Gomis M, López-Cancio E, Castaño C, Remollo S, Del Carmen Garcia M, Estela J, Perendreu J, Huertas S, Nicolás MC, Gómez-Choco M, García S, Martínez R, Sanahuja J, Castellanos M, Silva Y, van Eendenburg C, Marés R, Ustrell X, Baiges J, Soler Insa JM, Aragonés JM, Cocho Calderón L, Otermin P, Palomeras E. Access to Endovascular Treatment in Remote Areas. Stroke 2016; 47:1381-4. [DOI: 10.1161/strokeaha.116.013069] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 02/24/2016] [Indexed: 01/19/2023]
Abstract
Background and Purpose—
Since demonstration of the benefit of endovascular treatment (EVT) in acute ischemic stroke patients with proximal arterial occlusion, stroke care systems need to be reorganized to deliver EVT in a timely and equitable way. We analyzed differences in the access to EVT by geographical areas in Catalonia, a territory with a highly decentralized stroke model.
Methods—
We studied 965 patients treated with EVT from a prospective multicenter population-based registry of stroke patients treated with reperfusion therapies in Catalonia, Spain (SONIIA). Three different areas were defined: (A) health areas primarily covered by Comprehensive Stroke Centers, (B) areas primarily covered by local stroke centers located less than hour away from a Comprehensive Stroke Center, and (C) areas primarily covered by local stroke centers located more than hour away from a Comprehensive Stroke Center. We compared the number of EVT×100 000 inhabitants/year and time from stroke onset to groin puncture between groups.
Results—
Baseline characteristics were similar between groups. Throughout the study period, there were significant differences in the population rates of EVT across geographical areas. EVT rates by 100 000 in 2015 were 10.5 in A area, 3.7 in B, and 2.7 in C. Time from symptom onset to groin puncture was 82 minutes longer in group B (312 minutes [245–435]) and 120 minutes longer in group C (350 minutes [284–408]) compared with group A (230 minutes [160–407];
P
<0.001).
Conclusions—
Accessibility to EVT from remote areas is hampered by lower rate and longer time to treatment compared with areas covered directly by Comprehensive Stroke Centers.
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Affiliation(s)
- Natalia Pérez de la Ossa
- From the Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (N.P.d.l.O.); Stroke Program/Agency for Health Quality and Assessment of Catalonia (CIBER Epidemiología y Salud Pública, CIBERESP) (S.A.); Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (L.D.); Hospital Clínic, Barcelona, Spain (X.U.); Hospital Vall d’Hebrón, Barcelona, Spain (M.R.); Hospital Bellvitge, Barcelona, Spain (P.C.); Hospital del Mar, Barcelona, Spain (E.G.); Hospital Santa Creu i Sant Pau, Barcelona, Spain (J
| | - Sònia Abilleira
- From the Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (N.P.d.l.O.); Stroke Program/Agency for Health Quality and Assessment of Catalonia (CIBER Epidemiología y Salud Pública, CIBERESP) (S.A.); Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (L.D.); Hospital Clínic, Barcelona, Spain (X.U.); Hospital Vall d’Hebrón, Barcelona, Spain (M.R.); Hospital Bellvitge, Barcelona, Spain (P.C.); Hospital del Mar, Barcelona, Spain (E.G.); Hospital Santa Creu i Sant Pau, Barcelona, Spain (J
| | - Laura Dorado
- From the Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (N.P.d.l.O.); Stroke Program/Agency for Health Quality and Assessment of Catalonia (CIBER Epidemiología y Salud Pública, CIBERESP) (S.A.); Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (L.D.); Hospital Clínic, Barcelona, Spain (X.U.); Hospital Vall d’Hebrón, Barcelona, Spain (M.R.); Hospital Bellvitge, Barcelona, Spain (P.C.); Hospital del Mar, Barcelona, Spain (E.G.); Hospital Santa Creu i Sant Pau, Barcelona, Spain (J
| | - Xabier Urra
- From the Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (N.P.d.l.O.); Stroke Program/Agency for Health Quality and Assessment of Catalonia (CIBER Epidemiología y Salud Pública, CIBERESP) (S.A.); Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (L.D.); Hospital Clínic, Barcelona, Spain (X.U.); Hospital Vall d’Hebrón, Barcelona, Spain (M.R.); Hospital Bellvitge, Barcelona, Spain (P.C.); Hospital del Mar, Barcelona, Spain (E.G.); Hospital Santa Creu i Sant Pau, Barcelona, Spain (J
| | - Marc Ribó
- From the Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (N.P.d.l.O.); Stroke Program/Agency for Health Quality and Assessment of Catalonia (CIBER Epidemiología y Salud Pública, CIBERESP) (S.A.); Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (L.D.); Hospital Clínic, Barcelona, Spain (X.U.); Hospital Vall d’Hebrón, Barcelona, Spain (M.R.); Hospital Bellvitge, Barcelona, Spain (P.C.); Hospital del Mar, Barcelona, Spain (E.G.); Hospital Santa Creu i Sant Pau, Barcelona, Spain (J
| | - Pere Cardona
- From the Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (N.P.d.l.O.); Stroke Program/Agency for Health Quality and Assessment of Catalonia (CIBER Epidemiología y Salud Pública, CIBERESP) (S.A.); Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (L.D.); Hospital Clínic, Barcelona, Spain (X.U.); Hospital Vall d’Hebrón, Barcelona, Spain (M.R.); Hospital Bellvitge, Barcelona, Spain (P.C.); Hospital del Mar, Barcelona, Spain (E.G.); Hospital Santa Creu i Sant Pau, Barcelona, Spain (J
| | - Eva Giralt
- From the Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (N.P.d.l.O.); Stroke Program/Agency for Health Quality and Assessment of Catalonia (CIBER Epidemiología y Salud Pública, CIBERESP) (S.A.); Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (L.D.); Hospital Clínic, Barcelona, Spain (X.U.); Hospital Vall d’Hebrón, Barcelona, Spain (M.R.); Hospital Bellvitge, Barcelona, Spain (P.C.); Hospital del Mar, Barcelona, Spain (E.G.); Hospital Santa Creu i Sant Pau, Barcelona, Spain (J
| | - Joan Martí-Fàbregas
- From the Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (N.P.d.l.O.); Stroke Program/Agency for Health Quality and Assessment of Catalonia (CIBER Epidemiología y Salud Pública, CIBERESP) (S.A.); Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (L.D.); Hospital Clínic, Barcelona, Spain (X.U.); Hospital Vall d’Hebrón, Barcelona, Spain (M.R.); Hospital Bellvitge, Barcelona, Spain (P.C.); Hospital del Mar, Barcelona, Spain (E.G.); Hospital Santa Creu i Sant Pau, Barcelona, Spain (J
| | - Francisco Purroy
- From the Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (N.P.d.l.O.); Stroke Program/Agency for Health Quality and Assessment of Catalonia (CIBER Epidemiología y Salud Pública, CIBERESP) (S.A.); Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (L.D.); Hospital Clínic, Barcelona, Spain (X.U.); Hospital Vall d’Hebrón, Barcelona, Spain (M.R.); Hospital Bellvitge, Barcelona, Spain (P.C.); Hospital del Mar, Barcelona, Spain (E.G.); Hospital Santa Creu i Sant Pau, Barcelona, Spain (J
| | - Joaquín Serena
- From the Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (N.P.d.l.O.); Stroke Program/Agency for Health Quality and Assessment of Catalonia (CIBER Epidemiología y Salud Pública, CIBERESP) (S.A.); Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (L.D.); Hospital Clínic, Barcelona, Spain (X.U.); Hospital Vall d’Hebrón, Barcelona, Spain (M.R.); Hospital Bellvitge, Barcelona, Spain (P.C.); Hospital del Mar, Barcelona, Spain (E.G.); Hospital Santa Creu i Sant Pau, Barcelona, Spain (J
| | - David Cánovas
- From the Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (N.P.d.l.O.); Stroke Program/Agency for Health Quality and Assessment of Catalonia (CIBER Epidemiología y Salud Pública, CIBERESP) (S.A.); Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (L.D.); Hospital Clínic, Barcelona, Spain (X.U.); Hospital Vall d’Hebrón, Barcelona, Spain (M.R.); Hospital Bellvitge, Barcelona, Spain (P.C.); Hospital del Mar, Barcelona, Spain (E.G.); Hospital Santa Creu i Sant Pau, Barcelona, Spain (J
| | - Moisés Garcés
- From the Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (N.P.d.l.O.); Stroke Program/Agency for Health Quality and Assessment of Catalonia (CIBER Epidemiología y Salud Pública, CIBERESP) (S.A.); Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (L.D.); Hospital Clínic, Barcelona, Spain (X.U.); Hospital Vall d’Hebrón, Barcelona, Spain (M.R.); Hospital Bellvitge, Barcelona, Spain (P.C.); Hospital del Mar, Barcelona, Spain (E.G.); Hospital Santa Creu i Sant Pau, Barcelona, Spain (J
| | - Jurek Krupinski
- From the Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (N.P.d.l.O.); Stroke Program/Agency for Health Quality and Assessment of Catalonia (CIBER Epidemiología y Salud Pública, CIBERESP) (S.A.); Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (L.D.); Hospital Clínic, Barcelona, Spain (X.U.); Hospital Vall d’Hebrón, Barcelona, Spain (M.R.); Hospital Bellvitge, Barcelona, Spain (P.C.); Hospital del Mar, Barcelona, Spain (E.G.); Hospital Santa Creu i Sant Pau, Barcelona, Spain (J
| | - Anna Pellisé
- From the Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (N.P.d.l.O.); Stroke Program/Agency for Health Quality and Assessment of Catalonia (CIBER Epidemiología y Salud Pública, CIBERESP) (S.A.); Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (L.D.); Hospital Clínic, Barcelona, Spain (X.U.); Hospital Vall d’Hebrón, Barcelona, Spain (M.R.); Hospital Bellvitge, Barcelona, Spain (P.C.); Hospital del Mar, Barcelona, Spain (E.G.); Hospital Santa Creu i Sant Pau, Barcelona, Spain (J
| | - Júlia Saura
- From the Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (N.P.d.l.O.); Stroke Program/Agency for Health Quality and Assessment of Catalonia (CIBER Epidemiología y Salud Pública, CIBERESP) (S.A.); Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (L.D.); Hospital Clínic, Barcelona, Spain (X.U.); Hospital Vall d’Hebrón, Barcelona, Spain (M.R.); Hospital Bellvitge, Barcelona, Spain (P.C.); Hospital del Mar, Barcelona, Spain (E.G.); Hospital Santa Creu i Sant Pau, Barcelona, Spain (J
| | - Carlos Molina
- From the Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (N.P.d.l.O.); Stroke Program/Agency for Health Quality and Assessment of Catalonia (CIBER Epidemiología y Salud Pública, CIBERESP) (S.A.); Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (L.D.); Hospital Clínic, Barcelona, Spain (X.U.); Hospital Vall d’Hebrón, Barcelona, Spain (M.R.); Hospital Bellvitge, Barcelona, Spain (P.C.); Hospital del Mar, Barcelona, Spain (E.G.); Hospital Santa Creu i Sant Pau, Barcelona, Spain (J
| | - Antoni Dávalos
- From the Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (N.P.d.l.O.); Stroke Program/Agency for Health Quality and Assessment of Catalonia (CIBER Epidemiología y Salud Pública, CIBERESP) (S.A.); Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (L.D.); Hospital Clínic, Barcelona, Spain (X.U.); Hospital Vall d’Hebrón, Barcelona, Spain (M.R.); Hospital Bellvitge, Barcelona, Spain (P.C.); Hospital del Mar, Barcelona, Spain (E.G.); Hospital Santa Creu i Sant Pau, Barcelona, Spain (J
| | - Miquel Gallofré
- From the Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (N.P.d.l.O.); Stroke Program/Agency for Health Quality and Assessment of Catalonia (CIBER Epidemiología y Salud Pública, CIBERESP) (S.A.); Hospital Germans Trias i Pujol, Badalona, Barcelona, Spain (L.D.); Hospital Clínic, Barcelona, Spain (X.U.); Hospital Vall d’Hebrón, Barcelona, Spain (M.R.); Hospital Bellvitge, Barcelona, Spain (P.C.); Hospital del Mar, Barcelona, Spain (E.G.); Hospital Santa Creu i Sant Pau, Barcelona, Spain (J
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27
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Lara B, Castillo Carullón S, Martínez Martínez M, García Reymundo M, Miravitlles M. Profiles of cases included in the Spanish registry of patients with alpha-1 antitrypsin deficiency. Anales de Pediatría (English Edition) 2016. [DOI: 10.1016/j.anpede.2015.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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28
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Ribo M, Molina CA, Cobo E, Cerdà N, Tomasello A, Quesada H, De Miquel MA, Millan M, Castaño C, Urra X, Sanroman L, Dàvalos A, Jovin T, Sanjuan E, Rubiera M, Pagola J, Flores A, Muchada M, Meler P, Huerga E, Gelabert S, Coscojuela P, Rodriguez D, Santamarina E, Maisterra O, Boned S, Seró L, Rovira A, Muñoz L, Pérez de la Ossa N, Gomis M, Dorado L, López-Cancio E, Palomeras E, Munuera J, García Bermejo P, Remollo S, García-Sort R, Cuadras P, Puyalto P, Hernández-Pérez M, Jiménez M, Martínez-Piñeiro A, Lucente G, Chamorro A, Obach V, Cervera A, Amaro S, Llull L, Codas J, Balasa M, Navarro J, Ariño H, Aceituno A, Rudilosso S, Renu A, Macho JM, Blasco J, López A, Macías N, Cardona P, Rubio F, Cano L, Lara B, Aja L, Chamorro A, Serena J, Rovira A, Albers G, Lees K, Arenillas J, Roberts R, Goyal M, Demchuk A, Minhas P, Al-Ajlan F, Salluzzi M, Zimmel L, Patel S, Eesa M, von Kummer R, Martí-Fàbregas J, Jankowitz B, Serena J, Salvat-Plana M, López-Cancio E, Hernandez-Pérez M. Association Between Time to Reperfusion and Outcome Is Primarily Driven by the Time From Imaging to Reperfusion. Stroke 2016; 47:999-1004. [DOI: 10.1161/strokeaha.115.011721] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 02/04/2016] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
A progressive decline in the odds of favorable outcome as time to reperfusion increases is well known. However, the impact of specific workflow intervals is not clear.
Methods—
We studied the mechanical thrombectomy group (n=103) of the prospective, randomized REVASCAT (Randomized Trial of Revascularization With Solitaire FR Device Versus Best Medical Therapy in the Treatment of Acute Stroke due to Anterior Circulation Large Vessel Occlusion Presenting Within Eight Hours of Symptom Onset) trial. We defined 3 workflow metrics: time from symptom onset to reperfusion (OTR), time from symptom onset to computed tomography, and time from computed tomography (CT) to reperfusion. Clinical characteristics, core laboratory-evaluated Alberta Stroke Program Early CT Scores (ASPECTS) and 90-day outcome data were analyzed. The effect of time on favorable outcome (modified Rankin scale, 0–2) was described via adjusted odds ratios (ORs) for every 30-minute delay.
Results—
Median admission National Institutes of Health Stroke Scale was 17.0 (14.0–20.0), reperfusion rate was 66%, and rate of favorable outcome was 43.7%. Mean (SD) workflow times were as follows: OTR: 342 (107) minute, onset to CT: 204 (93) minute, and CT to reperfusion: 138 (56) minute. Longer OTR time was associated with a reduced likelihood of good outcome (OR for 30-minute delay, 0.74; 95% confidence interval [CI], 0.59–0.93). The onset to CT time did not show a significant association with clinical outcome (OR, 0.87; 95% CI, 0.67–1.12), whereas the CT to reperfusion interval showed a negative association with favorable outcome (OR, 0.72; 95% CI, 0.54–0.95). A similar subgroup analysis according to admission ASPECTS showed this relationship for OTR time in ASPECTS<8 patients (OR, 0.56; 95% CI, 0.35–0.9) but not in ASPECTS≥8 (OR, 0.99; 95% CI, 0.68–1.44).
Conclusions—
Time to reperfusion is negatively associated with favorable outcome, being CT to reperfusion, as opposed to onset to CT, the main determinant of this association. In addition, OTR was strongly associated to outcome in patients with low ASPECTS scores but not in patients with high ASPECTS scores.
Clinical Trial Registration—
URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT01692379.
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Affiliation(s)
- Marc Ribo
- From the Stroke Unit, Department of Neurology, Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (M.R., C.A.M.); Statistics and Operations Research, Barcelona-Tech, Universitat Politecnica de Catalunya, Barcelona, Spain (E.C.); Bioclever, Barcelona, Spain (N.C.); Department of Radiology, Hospital Vall d’Hebron, Barcelona, Spain (A.T.); Stroke Unit, Departments of Neurology (H.Q.) and Radiology (M.A.D.M.), Hospital de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Carlos A. Molina
- From the Stroke Unit, Department of Neurology, Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (M.R., C.A.M.); Statistics and Operations Research, Barcelona-Tech, Universitat Politecnica de Catalunya, Barcelona, Spain (E.C.); Bioclever, Barcelona, Spain (N.C.); Department of Radiology, Hospital Vall d’Hebron, Barcelona, Spain (A.T.); Stroke Unit, Departments of Neurology (H.Q.) and Radiology (M.A.D.M.), Hospital de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Erik Cobo
- From the Stroke Unit, Department of Neurology, Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (M.R., C.A.M.); Statistics and Operations Research, Barcelona-Tech, Universitat Politecnica de Catalunya, Barcelona, Spain (E.C.); Bioclever, Barcelona, Spain (N.C.); Department of Radiology, Hospital Vall d’Hebron, Barcelona, Spain (A.T.); Stroke Unit, Departments of Neurology (H.Q.) and Radiology (M.A.D.M.), Hospital de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Neus Cerdà
- From the Stroke Unit, Department of Neurology, Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (M.R., C.A.M.); Statistics and Operations Research, Barcelona-Tech, Universitat Politecnica de Catalunya, Barcelona, Spain (E.C.); Bioclever, Barcelona, Spain (N.C.); Department of Radiology, Hospital Vall d’Hebron, Barcelona, Spain (A.T.); Stroke Unit, Departments of Neurology (H.Q.) and Radiology (M.A.D.M.), Hospital de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Alejandro Tomasello
- From the Stroke Unit, Department of Neurology, Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (M.R., C.A.M.); Statistics and Operations Research, Barcelona-Tech, Universitat Politecnica de Catalunya, Barcelona, Spain (E.C.); Bioclever, Barcelona, Spain (N.C.); Department of Radiology, Hospital Vall d’Hebron, Barcelona, Spain (A.T.); Stroke Unit, Departments of Neurology (H.Q.) and Radiology (M.A.D.M.), Hospital de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Helena Quesada
- From the Stroke Unit, Department of Neurology, Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (M.R., C.A.M.); Statistics and Operations Research, Barcelona-Tech, Universitat Politecnica de Catalunya, Barcelona, Spain (E.C.); Bioclever, Barcelona, Spain (N.C.); Department of Radiology, Hospital Vall d’Hebron, Barcelona, Spain (A.T.); Stroke Unit, Departments of Neurology (H.Q.) and Radiology (M.A.D.M.), Hospital de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Maria Angeles De Miquel
- From the Stroke Unit, Department of Neurology, Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (M.R., C.A.M.); Statistics and Operations Research, Barcelona-Tech, Universitat Politecnica de Catalunya, Barcelona, Spain (E.C.); Bioclever, Barcelona, Spain (N.C.); Department of Radiology, Hospital Vall d’Hebron, Barcelona, Spain (A.T.); Stroke Unit, Departments of Neurology (H.Q.) and Radiology (M.A.D.M.), Hospital de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Mónica Millan
- From the Stroke Unit, Department of Neurology, Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (M.R., C.A.M.); Statistics and Operations Research, Barcelona-Tech, Universitat Politecnica de Catalunya, Barcelona, Spain (E.C.); Bioclever, Barcelona, Spain (N.C.); Department of Radiology, Hospital Vall d’Hebron, Barcelona, Spain (A.T.); Stroke Unit, Departments of Neurology (H.Q.) and Radiology (M.A.D.M.), Hospital de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Carlos Castaño
- From the Stroke Unit, Department of Neurology, Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (M.R., C.A.M.); Statistics and Operations Research, Barcelona-Tech, Universitat Politecnica de Catalunya, Barcelona, Spain (E.C.); Bioclever, Barcelona, Spain (N.C.); Department of Radiology, Hospital Vall d’Hebron, Barcelona, Spain (A.T.); Stroke Unit, Departments of Neurology (H.Q.) and Radiology (M.A.D.M.), Hospital de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Xabier Urra
- From the Stroke Unit, Department of Neurology, Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (M.R., C.A.M.); Statistics and Operations Research, Barcelona-Tech, Universitat Politecnica de Catalunya, Barcelona, Spain (E.C.); Bioclever, Barcelona, Spain (N.C.); Department of Radiology, Hospital Vall d’Hebron, Barcelona, Spain (A.T.); Stroke Unit, Departments of Neurology (H.Q.) and Radiology (M.A.D.M.), Hospital de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Luis Sanroman
- From the Stroke Unit, Department of Neurology, Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (M.R., C.A.M.); Statistics and Operations Research, Barcelona-Tech, Universitat Politecnica de Catalunya, Barcelona, Spain (E.C.); Bioclever, Barcelona, Spain (N.C.); Department of Radiology, Hospital Vall d’Hebron, Barcelona, Spain (A.T.); Stroke Unit, Departments of Neurology (H.Q.) and Radiology (M.A.D.M.), Hospital de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Antoni Dàvalos
- From the Stroke Unit, Department of Neurology, Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (M.R., C.A.M.); Statistics and Operations Research, Barcelona-Tech, Universitat Politecnica de Catalunya, Barcelona, Spain (E.C.); Bioclever, Barcelona, Spain (N.C.); Department of Radiology, Hospital Vall d’Hebron, Barcelona, Spain (A.T.); Stroke Unit, Departments of Neurology (H.Q.) and Radiology (M.A.D.M.), Hospital de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
| | - Tudor Jovin
- From the Stroke Unit, Department of Neurology, Hospital Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (M.R., C.A.M.); Statistics and Operations Research, Barcelona-Tech, Universitat Politecnica de Catalunya, Barcelona, Spain (E.C.); Bioclever, Barcelona, Spain (N.C.); Department of Radiology, Hospital Vall d’Hebron, Barcelona, Spain (A.T.); Stroke Unit, Departments of Neurology (H.Q.) and Radiology (M.A.D.M.), Hospital de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
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- Data and Safety Monitoring Board
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- Central blinded evaluation of Modified Rankin Scale
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Blanco I, Lipsker D, Lara B, Janciauskiene S. Neutrophilic panniculitis associated with alpha-1-antitrypsin deficiency: an update. Br J Dermatol 2016; 174:753-62. [DOI: 10.1111/bjd.14309] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2015] [Indexed: 12/13/2022]
Affiliation(s)
- I. Blanco
- Board of Directors of the Alpha1-Antitrypsin Deficiency Spanish Registry; Lung Foundation Breathe; Spanish Society of Pneumology (SEPAR), Provenza; 108 Bajo 08029 Barcelona Spain
| | - D. Lipsker
- Faculté de Médecine; Université de Strasbourg et Clinique Dermatologique; Hôpitaux Universitaires de Strasbourg; 1 Place de l'Hôpital 67091 Strasbourg CEDEX France
| | - B. Lara
- Respiratory Medicine Department; Royal Exeter and Devon Hospital; Exeter U.K
| | - S. Janciauskiene
- Department of Respiratory Medicine; Hannover Medical School; Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH); Member of the German Center for Lung Research (DZL); 30626 Hanover Germany
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Lara B, Salinero JJ, Areces F, Ruiz-Vicente D, Gallo-Salazar C, Abián-Vicén J, Del Coso J. Sweat sodium loss influences serum sodium concentration in a marathon. Scand J Med Sci Sports 2015; 27:152-160. [PMID: 26661748 DOI: 10.1111/sms.12637] [Citation(s) in RCA: 13] [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] [Accepted: 11/15/2015] [Indexed: 11/26/2022]
Abstract
The aim of this investigation was to determine the influence of sweat electrolyte concentration on body water and electrolyte homeostasis during a marathon. Fifty-one runners completed a marathon race in a warm and dry environment (24.4 ± 3.6 °C). Runners were classified as low-salt sweaters (n = 21; <30 mmol/L of sweat Na+ concentration), typical sweaters (n = 20; ≥30 and <60 mmol/L of sweat Na+ concentration), and salty sweaters (n = 10; ≥60 mmol/L of sweat Na+ concentration). Before and after the race, body mass and a sample of venous blood were obtained. During the race, sweat samples were collected by using sweat patches, and fluid and electrolyte intake were recorded by using self-reported questionnaires. Low-salt, typical and salty sweaters presented similar sweat rates (0.93 ± 0.2, 0.92 ± 0.29, 0.99 ± 0.21 L/h, respectively), body mass changes (-3.0 ± 1.0, -3.3 ± 1.0, -3.2 ± 0.8%), total Na+ intake (12.7 ± 8.1, 11.5 ± 9.7, 14.5 ± 16.6 mmol), and fluid intake (1.3 ± 0.8, 1.2 ± 0.8, 1.2 ± 0.6 L) during the race. However, salty sweaters presented lower post-race serum Na+ concentration (140.8 ± 1.3 vs 142.5 ± 1.1, 142.4 ± 1.4 mmol/L; P < 0.01) and serum osmolality (297 ± 6 vs 299 ± 5, 301 ± 6 mOsm/kg; P < 0.05) than low-salt and typical sweaters. Sweat electrolyte concentration could influence post-race serum electrolyte concentration in the marathon. However, even the saltiest sweaters did not develop exercise-associated hyponatremia or associated symptoms.
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Affiliation(s)
- B Lara
- Exercise Physiology Laboratory, Sport Science Institute, Camilo José Cela University, Madrid, Spain
| | - J J Salinero
- Exercise Physiology Laboratory, Sport Science Institute, Camilo José Cela University, Madrid, Spain
| | - F Areces
- Exercise Physiology Laboratory, Sport Science Institute, Camilo José Cela University, Madrid, Spain
| | - D Ruiz-Vicente
- Exercise Physiology Laboratory, Sport Science Institute, Camilo José Cela University, Madrid, Spain
| | - C Gallo-Salazar
- Exercise Physiology Laboratory, Sport Science Institute, Camilo José Cela University, Madrid, Spain
| | - J Abián-Vicén
- Exercise Physiology Laboratory, Sport Science Institute, Camilo José Cela University, Madrid, Spain
| | - J Del Coso
- Exercise Physiology Laboratory, Sport Science Institute, Camilo José Cela University, Madrid, Spain
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Del Coso J, Lara B, Salinero JJ, Areces F, Ruiz-Vicente D, Gallo-Salazar C, Abián-Vicén J, Cacabelos R. CFTR genotype-related body water and electrolyte balance during a marathon. Scand J Med Sci Sports 2015; 26:1036-44. [PMID: 26282188 DOI: 10.1111/sms.12542] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2015] [Indexed: 11/26/2022]
Abstract
The aim of this investigation was to determine the influence of CFTR genotype on body water and electrolyte balance during a marathon. Fifty-one experienced runners completed a marathon race. Before and after the race, body mass and a sample of venous blood were obtained. During the race, sweat samples were collected using sweat patches, and fluid and electrolyte intake were obtained using self-reported questionnaires. Thirty-eight participants (74.5% of the total) were 7T/7T homozygotes, 11 (21.6%) were 7T/9T heterozygotes, and one participant presented the rare genotype 5T/7T. Another participant with 9T/9T presented the mutation p.L206W. Participants with 7T/7T showed higher sweat sodium concentrations (42.2 ± 21.6 mmol/L) than 7T/9T (29.0 ± 24.7 mmol/L; P = 0.04). The runner with the 5T/7T genotype (10.2 mmol/L) and the participant with the p.L206W mutation (20.5 mmol/L) exhibited low-range sweat sodium concentrations. However, post-race serum sodium concentration was similar in 7T/7T and 7T/9T (142.1 ± 1.3 and 142.4 ± 1.6 mmol/L, respectively; P = 0.27) and did not show abnormalities in participants with the 5T/7T genotype (140.0 mmol/L) and the p.L206W mutation (143.0 mmol/L). Runners with the CFTR-7T/7T genotype exhibited increased sweat sodium concentrations during a marathon. However, this phenotype was not related with increased likelihood of suffering body water and electrolyte imbalances during real competitions.
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Affiliation(s)
- J Del Coso
- Exercise Physiology Laboratory, Camilo José Cela University, Madrid, Spain
| | - B Lara
- Exercise Physiology Laboratory, Camilo José Cela University, Madrid, Spain
| | - J J Salinero
- Exercise Physiology Laboratory, Camilo José Cela University, Madrid, Spain
| | - F Areces
- Exercise Physiology Laboratory, Camilo José Cela University, Madrid, Spain
| | - D Ruiz-Vicente
- Exercise Physiology Laboratory, Camilo José Cela University, Madrid, Spain
| | - C Gallo-Salazar
- Exercise Physiology Laboratory, Camilo José Cela University, Madrid, Spain
| | - J Abián-Vicén
- Exercise Physiology Laboratory, Camilo José Cela University, Madrid, Spain
| | - R Cacabelos
- Chair of Genomic Medicine, Camilo José Cela University, Madrid, Spain
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Del Coso J, González-Millán C, Salinero JJ, Abián-Vicén J, Areces F, Lledó M, Lara B, Gallo-Salazar C, Ruiz-Vicente D. Effects of oral salt supplementation on physical performance during a half-ironman: A randomized controlled trial. Scand J Med Sci Sports 2015; 26:156-64. [DOI: 10.1111/sms.12427] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2015] [Indexed: 12/17/2022]
Affiliation(s)
- J. Del Coso
- Exercise Physiology Laboratory; Sports Science Institute; Camilo José Cela University; Madrid Spain
| | - C. González-Millán
- Exercise Physiology Laboratory; Sports Science Institute; Camilo José Cela University; Madrid Spain
| | - J. J. Salinero
- Exercise Physiology Laboratory; Sports Science Institute; Camilo José Cela University; Madrid Spain
| | - J. Abián-Vicén
- Exercise Physiology Laboratory; Sports Science Institute; Camilo José Cela University; Madrid Spain
| | - F. Areces
- Exercise Physiology Laboratory; Sports Science Institute; Camilo José Cela University; Madrid Spain
| | - M. Lledó
- Exercise Physiology Laboratory; Sports Science Institute; Camilo José Cela University; Madrid Spain
| | - B. Lara
- Exercise Physiology Laboratory; Sports Science Institute; Camilo José Cela University; Madrid Spain
| | - C. Gallo-Salazar
- Exercise Physiology Laboratory; Sports Science Institute; Camilo José Cela University; Madrid Spain
| | - D. Ruiz-Vicente
- Exercise Physiology Laboratory; Sports Science Institute; Camilo José Cela University; Madrid Spain
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Cano LM, Cardona P, Quesada H, Lara B, Rubio F. Ischaemic stroke in patients treated with oral anticoagulants. Neurologia 2014; 31:395-400. [PMID: 25529172 DOI: 10.1016/j.nrl.2014.09.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 09/19/2014] [Accepted: 09/25/2014] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Cardioembolic stroke is associated with poorer outcomes. Prevention is based on oral anticoagulant (OAC) therapy. Haemorrhage is the main complication of OACs, which are sometimes ineffective. PATIENTS AND METHODS We retrospectively reviewed 1014 consecutive patients who suffered an ischaemic stroke between 2011 and 2013, analysing those who were receiving OAC treatment at stroke onset (107 patients in total) with special attention to aetiology, outcomes, and INR value in the acute phase. RESULTS The mean age (SD) was 71.9 (10) years. Patients had been treated with OACs for 5.9 (5.5) years; 98.1% of them were being treated for heart disease. INR was <2 in 77 patients (72%), and 30 patients (28%) had an INR≥2. Nine patients (8.4%) had INR values within the therapeutic range. According to TOAST classification criteria, 88.8% of strokes were cardioembolic and 1.9% were atherothrombotic. Anticoagulation therapy was discontinued in 48 patients (44.9%) due to haemorrhagic transformation (24 patients), extensive infarction (23), or endarterectomy (1). Therapy was resumed in 24 patients (50%) after a mean lapse of 36 days. This was not possible in the remaining patients because of death or severe sequelae. New OACs (NOACs) were prescribed to 9 patients (18.7% of all potential candidates). At 3 months, patients with INR>1.7 in the acute phase exhibited better outcomes than patients with INR≤1.7 (mRS 0-2 in 62% vs 30.8%; death in 10% vs 38.4%; P=.0004). CONCLUSIONS Some patients taking OACs suffer ischaemic strokes that are usually cardioembolic, especially if INR is below the therapeutic range. OACs can be resumed without complications, and NOACs are still underused. Despite cases in which treatment is ineffective, outcomes are better when INR is above 1.7 at stroke onset.
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Affiliation(s)
- L M Cano
- Servicio de Neurología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, España.
| | - P Cardona
- Servicio de Neurología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, España
| | - H Quesada
- Servicio de Neurología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, España
| | - B Lara
- Servicio de Neurología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, España
| | - F Rubio
- Servicio de Neurología, Hospital Universitari de Bellvitge, IDIBELL, L'Hospitalet de Llobregat, Barcelona, España
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Soy D, de la Roza C, Lara B, Esquinas C, Torres A, Miravitlles M. Alpha-1-antitrypsin deficiency: optimal therapeutic regimen based on population pharmacokinetics. Thorax 2006; 61:1059-64. [PMID: 16928711 PMCID: PMC2117047 DOI: 10.1136/thx.2005.057943] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Exogenous doses of 60 mg/kg alpha(1)-antitrypsin (AAT) every 7 days are recommended in patients with severe AAT deficiency. However, long term administration of weekly doses is not well accepted by patients. Using pharmacokinetic simulations, we evaluated whether steady state minimum concentrations of total AAT can be maintained above the threshold of 0.5 g/l with longer intervals between doses. METHODS Several sets of exogenous AAT versus time simulations were studied using a non-linear mixed effect approach with dosage regimens every 7, 14, 21, and 28 days. For each regimen the mean exogenous AAT trough concentrations and 5/95th percentiles were determined. The results obtained were applied to estimate the individual optimal dose at 7, 14, and 21 days in six patients using Bayesian analysis. RESULTS The simulations showed that a dose of 50 mg/kg AAT every 7 days was sufficient to obtain nadir concentrations. Doses of 120 and 100 mg/kg every 14 days were also adequate, but 180 mg/kg given every 21 days required total AAT monitoring to avoid underdosage. Longer intervals were inappropriate. Dosage individualisation confirmed that AAT infusions given every 14 days maintained the nadir level of 0.5 g/l without a significant dose increase compared with current practice. When the time span between doses was fixed at 21 days, a mean relative AAT dose enhancement of 91% and 13%, respectively, was required to achieve sustained total AAT concentrations above the target level for 100% and 85% of the interval between doses. CONCLUSIONS It is feasible to extend the interval between doses of AAT to 14 or 21 days to achieve adequate trough total AAT concentrations. This study might be used as a starting point for clinical evaluation of the regimens described.
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Affiliation(s)
- D Soy
- Pharmacy Service, Hospital Clínic, (IDIBAPS), Barcelona, Spain
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Blanco I, de Serres FJ, Fernandez-Bustillo E, Lara B, Miravitlles M. Estimated numbers and prevalence of PI*S and PI*Z alleles of 1-antitrypsin deficiency in European countries. Eur Respir J 2006; 27:77-84. [PMID: 16387939 DOI: 10.1183/09031936.06.00062305] [Citation(s) in RCA: 141] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The current study focuses on developing estimates of the numbers of individuals carrying the two most common deficiency alleles, PI*S and PI*Z, for alpha1-antitrypsin deficiency (AT-D) in Europe. Criteria for selection of epidemiological studies were: 1) AT phenotyping performed by isoelectrofocusing or antigen-antibody crossed electrophoresis; 2) rejection of "screening studies"; 3) statistical precision factor score of > or = 5 for Southwest, Western and Northern Europe, > or = 4 for Central Europe, > or = 3 for Eastern Europe; and 4) samples representative of the general population. A total of 75,390 individuals were selected from 21 European countries (one each from Austria, Belgium, Latvia, Hungary, Serbia-Montenegro, Sweden and Switzerland; two each from Denmark, Estonia and Lithuania; three each from Portugal and the UK; four each from Finland, The Netherlands, Norway and Spain; five each from Russia and Germany; six from Poland; eight from Italy; and nine from France). The total AT-D populations of a particular phenotype in the countries selected were: 124,594 ZZ; 560,515 SZ; 16,323,226 MZ; 630,401 SS; and 36,716,819 MS. The largest number of ZZ (5,000-15,000) were in Italy, Spain, Germany, France, the UK, Latvia, Sweden and Denmark, followed by Belgium, Portugal, Serbia-Montenegro, Russia, The Netherlands, Norway and Austria (1,000-2,000), with < 1,000 in each of the remaining countries. A remarkable lack in number of reliable epidemiological studies and marked differences among these European countries and regions within a given country was also found.
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Affiliation(s)
- I Blanco
- Div of Internal Medicine, Respiratory Diseases Branch, Hospital Valle del Nalón, 33920 Langreo, Principado de Asturias, Spain.
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de la Roza C, Rodríguez-Frías F, Lara B, Vidal R, Jardí R, Miravitlles M. Results of a case-detection programme for 1-antitrypsin deficiency in COPD patients. Eur Respir J 2005; 26:616-22. [PMID: 16204591 DOI: 10.1183/09031936.05.00007305] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Alpha1-antitrypsin (alpha1-AT) deficiency is an underdiagnosed condition in patients with chronic obstructive pulmonary disease (COPD). The present authors have conducted a nationwide case detection programme of alpha1-AT deficiency in unselected patients with COPD using dried blood spots. The first phase analysed samples from 971 patients by determining alpha1-AT concentrations and identifying the deficient Z allele by genotyping using rapid real-time PCR. The second phase analysed 1,166 samples with alpha1-AT concentrations and identified both the S and the Z allele, but only in samples with low alpha1-AT concentrations. A total of eight (0.37%) individuals with the severe deficiency PiZZ were detected. In addition, three patients were identified with the PiSZ genotype in the second phase (0.3%). The global cost of the programme was 41,512, which represents 19.42 per sample and 5,189 per PiZZ detected. A sensitivity analysis demonstrated that performing Z genotype to all samples would have resulted in increased costs of 28 per sample and 7,479.5 per PiZZ case identified. In conclusion, a case detection programme of alpha1-antitrypsin deficiency in patients with chronic obstructive pulmonary disease using dried blood spots is feasible and at a reasonable cost per case detected. Diagnostic yield and costs depend largely on inclusion criteria and the protocol for processing of samples.
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Affiliation(s)
- C de la Roza
- Dept of Pneumology, Institut Clínic del Tòrax, Hospital Clínic, Red Respira, Barcelona 08036, Spain
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Lara B, Miravitlles M. [Travelling with oxygen. Thoughts on the first international meeting of patients with alpha 1-antitrypsin deficiency]. Arch Bronconeumol 2004; 40:144. [PMID: 14998480 DOI: 10.1016/s1579-2129(06)70081-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
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Lara B, Miravitlles M. Viajar con oxígeno. Reflexiones a propósito de la primera reunión internacional de pacientes con déficit de alfa-1-antitripsina. Arch Bronconeumol 2004. [DOI: 10.1157/13057897] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Rodés-Cabau J, Domingo E, Román A, Majó J, Lara B, Padilla F, Anívarro I, Angel J, Tardif JC, Soler-Soler J. Intravascular ultrasound of the elastic pulmonary arteries: a new approach for the evaluation of primary pulmonary hypertension. Heart 2003; 89:311-5. [PMID: 12591838 PMCID: PMC1767613 DOI: 10.1136/heart.89.3.311] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To assess the structural and functional characteristics of pulmonary arteries by intravascular ultrasound (IVUS) in the setting of primary pulmonary hypertension, and to correlate the ultrasound findings with haemodynamic variables and mortality at follow up. DESIGN Prospective observational study. SETTING University hospital (tertiary referral centre). PATIENTS 20 consecutive patients with primary pulmonary hypertension (16 female; mean (SD) age, 39 (14) years). METHODS Cardiac catheterisation and simultaneous IVUS of pulmonary artery branches at baseline and after infusion of epoprostenol. RESULTS 33 pulmonary arteries with a mean diameter of 3.91 (0.80) mm were imaged, and wall thickening was observed in all cases, 64% being eccentric. Mean wall thickness was 0.37 (0.13) mm, percentage wall area 31.0 (9.3)%, pulsatility 14.6 (4.8)%, and pulmonary/elastic strain index 449 (174) mm Hg. No correlation was observed between IVUS findings and haemodynamic variables. Epoprostenol infusion increased pulsatility by 53% and decreased the pulmonary/elastic strain index by 41% (p = 0.0001), irrespective of haemodynamic changes. At 18 (12) months follow up, nine patients had died. A reduced pulsatility and an increased pulmonary/elastic strain index were associated with increased mortality at follow up (12.0 (4.4)% v 16.4 (4.4)%, p = 0.03; 369 (67) v 546 (216) mm Hg, p = 0.02). CONCLUSIONS IVUS demonstrated pulmonary artery wall abnormalities in all patients with primary pulmonary hypertension, mostly eccentric. The severity of the changes did not correlate with haemodynamic variables, and epoprostenol improved pulmonary vessel stiffness. There was an association between impaired pulmonary artery functional state as determined by IVUS and mortality at follow up.
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Affiliation(s)
- J Rodés-Cabau
- Department of Cardiology, Hospital Universitari Vall d'Hebron, Barcelona, Spain.
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Abstract
Applying 10-s pulses of 10 mM Ba2+ to resting or K+-depolarized (70 mM) bovine adrenal chromaffin cells superfused with a nominal 0Ca2+ solution produced a large catecholamine secretory peak. In contrast, pulses of 10 mM Sr2+ or Ca2+ did not induce secretion from polarized resting cells, and induced smaller and narrower secretory peaks from depolarized cells; the areas of the secretory peaks from depolarized cells were 1.87, 3.06 and 27.4 nA s, respectively, for Ca2+, Sr2+ and Ba2+. Ca2+ channel currents in isolated cells or in cells surrounded by other unpatched cells (cell cluster) were studied with either the continuous-flow or the flow-stop method. When applied to an isolated cell, flow-stop reduced the amplitude of ICa by 19%, ISr by 31%, and IBa by 53%, compared with the current amplitude measured under continuous-flow conditions. This decrease in current amplitude was accompanied by a pronounced slowing down of current activation and could be largely relieved by applying strong depolarizing prepulses (facilitation). Under continuous-flow conditions, 10 microM exogenous ATP reduced (about 50%) ICa, ISr and IBa similarly. On the other hand, the use of Na+ as a charge carrier through Ca2+ channels, or intracellular dialysis with 1 mM BAPTA prevented the modulation of current by flow-stop. In cell clusters, activating secretion from unpatched cells, by either 10 mM Ba2+, 100 microM acetylcholine or 70 mM K+, caused a pronounced slowing down of current activation, as well as a decrease of its magnitude in the voltage-clamped cell immersed in the cluster. Such modulation of isolated cells was not observed. These data are compatible with the idea that the secretory activity of adrenal medullary chromaffin cells "in situ" controls the activity of their Ca2+ channels through autocrine/paracrine mechanisms.
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Affiliation(s)
- J M Hernández-Guijo
- Instituto de Farmacología Teófilo Hernando, Departamento de Farmacología, Facultad de Medicina, Universidad Autónoma de Madrid, Arzobispo Morcillo 4, E-28029 Madrid, Spain
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Lara B, Gandía L, Martínez-Sierra R, Torres A, García AG. Q-type Ca2+ channels are located closer to secretory sites than L-type channels: functional evidence in chromaffin cells. Pflugers Arch 1998; 435:472-8. [PMID: 9446693 DOI: 10.1007/s004240050541] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.8] [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: 02/05/2023]
Abstract
This study uses a new strategy to investigate the hypothesis that, of the various Ca2+ channels expressed by a neurosecretory cell, a given channel subtype is coupled more tightly to the exocytotic apparatus than others. The approach is based on the prediction that the degree of inhibition of the secretory response by various Ca2+ channel blockers will differ at low (0.5 mM) and high (5 mM) extracellular Ca2+ concentrations ([Ca2+]o). So, at low [Ca2+]o the K+-evoked catecholamine release from superfused bovine chromaffin cells was depressed 60-70% by 2 microM omega-agatoxin IVA (P/Q-type Ca2+ channel blockade), by 3 microM omega-conotoxin MVIIC (N/P/Q-type Ca2+ channel blockade), or by 3 microM lubeluzole (N/P/Q-type Ca2+ channel blockade); in high [Ca2+]o these blockers inhibited the responses by only 20-35%. At 1-3 microM omega-conotoxin GVIA (N-type Ca2+ channel blockade) or 3 microM furnidipine (L-type Ca2+ channel blockade), secretion was inhibited by 30 and 50%, respectively; such inhibitory effects were similar in low or high [Ca2+]o. Combined furnidipine plus omega-conotoxin MVIIC, omega-agatoxin IVA or omega-conotoxin GVIA exhibited additive blocking effects at both Ca2+ concentrations. The results suggest that Q-type Ca2+ channels are coupled more tightly to exocytotic active sites, as compared to L-type channels. This hypothesis if founded in the fact that external Ca2+ that enters the cell through a Ca2+ channel located near to chromaffin vesicles will saturate the K+ secretory response at both [Ca2+]o, i.e. 0.5 mM and 5 mM. In contrast, Ca2+ ions entering through more distant channels will be sequestered by intracellular buffers and, thus, will not saturate the secretory machinery at lower [Ca2+]o.
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Affiliation(s)
- B Lara
- Departamento de Farmacología, Facultad de Medicina, Servicio de Farmacología Clínica, Hospital Reina Sofía, Universidad de Córdoba, Avda. Córdoba, Spain
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Gandía L, Lara B, Imperial JS, Villarroya M, Albillos A, Maroto R, García AG, Olivera BM. Analogies and differences between omega-conotoxins MVIIC and MVIID: binding sites and functions in bovine chromaffin cells. Pflugers Arch 1997; 435:55-64. [PMID: 9359903 DOI: 10.1007/s004240050483] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [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: 02/05/2023]
Abstract
The characteristics of the binding sites for the Conus magus toxins omega-conotoxin MVIIC and omega-conotoxin MVIID, as well as their effects on K+-evoked 45Ca2+ entry and whole-cell Ba2+ currents (IBa), and K+-evoked catecholamine secretion have been studied in bovine adrenal chromaffin cells. Binding of [125I] omega-conotoxin GVIA to bovine adrenal medullary membranes was displaced by omega-conotoxins GVIA, MVIIC and MVIID with IC50 values of around 0.1, 4 and 100 nM, respectively. The reverse was true for the binding of [125I] omega-conotoxin MVIIC, which was displaced by omega-conotoxins MVIIC, MVIID and GVIA with IC50 values of around 30, 80 and 1.200 nM, respectively. The sites recognized by omega-conotoxins MVIIC and MVIID in bovine brain exhibited higher affinities (IC50 values of around 1 nM). Both omega-conotoxin MVIIC and MVIID blocked IBa by 70-80%; the higher the [Ba2+]o of the extracellular solution the lower the blockade induced by omega-conotoxin MVIIC. This was not the case for omega-conotoxin MVIID; high Ba2+ (10 mM) slowed down the development of blockade but the maximum blockade achieved was similar to that obtained in 2 mM Ba2+. A further difference between the two toxins concerns their reversibility; washout of omega-conotoxin MVIIC did not reverse the blockade of IBa while in the case of omega-conotoxin MVIID a partial, quick recovery of current was produced. This component was irreversibly blocked by omega-conotoxin GVIA, suggesting that it is associated with N-type Ca2+ channels. Blockade of K+-evoked 45Ca2+ entry produced results which paralleled those obtained by measuring IBa. Thus, 1 microM of each of omega-conotoxin GVIA and MVIIA inhibited Ca2+ uptake by 25%, while 1 microM of each of omega-conotoxin MVIIC and MVIID caused a 70% blockade. K+-evoked catecholamine secretory responses were not reduced by omega-conotoxin GVIA (1 microM). In contrast, at 1 microM both omega-conotoxin MVIIC and MVIID reduced the exocytotic response by 70%. These data strengthen the previously established conclusion that Q-type Ca2+ channels that contribute to the regulation of secretion and are sensitive to omega-conotoxins MVIIC and MVIID are present in bovine chromaffin cells. These channels, however, seem to possess binding sites for omega-conotoxins MVIIC and MVIID whose characteristics differ considerably from those described to occur in the brain; they might represent a subset of Q-type Ca2+ channels or an entirely new subtype of voltage-dependent high-threshold Ca2+ channel.
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Affiliation(s)
- L Gandía
- Departamento de Farmacología, Facultad de Medicina, Universidad Autónoma de Madrid, Arzobispo Morcillo, 4, E-28029 Madrid, Spain
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Michelena P, de la Fuente MT, Vega T, Lara B, López MG, Gandía L, García AG. Drastic facilitation by alpha-latrotoxin of bovine chromaffin cell exocytosis without measurable enhancement of Ca2+ entry or [Ca2+]i. J Physiol 1997; 502 ( Pt 3):481-96. [PMID: 9279802 PMCID: PMC1159522 DOI: 10.1111/j.1469-7793.1997.481bj.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [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: 02/05/2023] Open
Abstract
1. Latrotoxin (LTX, 1-3 nM) caused a gradual increase of the spontaneous catecholamine release rate in bovine adrenal chromaffin cells superfused with normal Krebs-Hepes solution containing 2.5 mM Ca2+. Ca2+ removal abolished this effect. LTX enhanced also the secretory responses to high K+ (35 or 70 mM) and to acetylcholine (ACh, 30 microM). 2. The application of Ca2+ pulses to cells previously superfused with a 0 Ca2+ solution (Krebs-Hepes deprived of CaCl2) induced secretory responses that gradually reached 400-800 nA of catecholamines, provided that LTX was present. The responses to ACh or 35 mM K+ pulses (in the presence of Ca2+) were also enhanced by LTX, from around 100-200 nA to over 1000 nA. Though such enhancement remained in the presence of Ca2+ channel blockers, it disappeared upon the lowering of [Na+]o or in electroporated cells. 3. Using protocols similar to those of secretion, LTX did not enhance basal 45Ca2+ uptake, whole-cell Ca2+ currents or basal [Ca2+]i. In fact, LTX attenuated the K(+)- or ACh-evoked increases in 45Ca2+ uptake and [Ca2+]i. 4. It is proposed that the secretory response to brief periods of Ca2+ reintroductions is triggered by local subplasmalemmal Ca2+i transients, produced by the Na(+)-Ca2+ exchanger of the plasma membrane working in the reverse mode. This situation might be physiologically reproduced during ACh stimulation of chromaffin cells, which is followed by the firing of Na(+)-dependent action potentials.
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Affiliation(s)
- P Michelena
- Departamento de Farmacología, Facultad de Medicina, Universidad Autónoma de Madrid, Spain.
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Lara B, Gandía L, Torres A, Olivares R, Martínez-Sierra R, García AG, López MG. 'Wide-spectrum Ca2+ channel antagonists': lipophilicity, inhibition, and recovery of secretion in chromaffin cells. Eur J Pharmacol 1997; 325:109-19. [PMID: 9151946 DOI: 10.1016/s0014-2999(97)00108-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [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: 02/04/2023]
Abstract
Repetitive application of short depolarizing K+ pulses (70 mM K+, 2 mM Ca2+ Krebs-HEPES solution, for 10 s every 5 min) produced reproducible catecholamine secretory responses from superfused bovine chromaffin cells. At 10 microM for 15 min, the piperazine derivatives dotarizine, flunarizine and lidoflazine inhibited secretion by around 90%; cinnarizine halved the secretory response. Recovery of secretion after 30-min washout with Krebs-HEPES solution amounted to 75% in the case of dotarizine, 8% for flunarizine, 46% for lidoflazine and 21% for cinnarizine. The benzothiazol derivatives (10 microM) (+)-S-lubeluzole and R91154 (the (-)-R-enantiomer of lubeluzole) blocked the response by 75%; sabeluzole inhibited secretion by only 34% and R56865 (N-[1-(4-(4-fluorophenoxy)butyl]-4-piperidinyl-N-methyl-2-benzo-thiaz olamine) by 61%. Recoveries were around 70% in the case of these four benzothiazol derivatives. The diphenylbutyl-piperazine derivatives fluspirilene and penfluridol inhibited secretion by over 80%; no recovery was produced after 30-min washout. The inhibition of secretion was time dependent, as the recovery of the response was. Blockade of secretion by dotarizine and flunarizine occurred even in the absence of intermittent K+ stimulations of the cells. No obvious correlation was seen between the octanol/water partition coefficients of the ten compounds tested (that ranged between 6 and 4.61), the rate and extent of blockade of secretion, and the recovery of the secretory response upon washout. Rather than non-specific actions on ion channels (and secretion) due to their high lipophilicity, we believe that blockade of various Ca2+ channels relates to their binding properties to specific channel micro and macrodomains, as the case might be for 'narrow' (omega-conotoxin GVIA) and 'wide-spectrum' (omega-conotoxin MVIIC) peptide toxins.
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Affiliation(s)
- B Lara
- Departamento de Farmacología, Facultad de Medicina, Universidad Autónoma de Madrid, Spain
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Lara B, López MG, Villarroya M, Gandía L, Cleeman L, Morad M, García AG. A caffeine-sensitive Ca2+ store modulates K+-evoked secretion in chromaffin cells. Am J Physiol 1997; 272:C1211-21. [PMID: 9142846 DOI: 10.1152/ajpcell.1997.272.4.c1211] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Catecholamine release from bovine adrenal medulla chromaffin cells superfused with a Krebs-N-2-hydroxyethylpiperazine-N'-2-ethanesulfonic acid solution was monitored on-line with an electrochemical detector. Caffeine (10 mM) progressively depressed the magnitude of secretory responses to depolarizing pulses of 70 mM K+ and 2 mM Ca2+ (70 K+/2 Ca2+) in cells superfused with a Krebs-N-2-hydroxyethylpiperazine-N'-2-ethanesulfonic acid solution containing 0 mM Ca2+ + 0.5 mM EGTA; blockade reached 80% at the third 70 K+/2 Ca2+ challenge given in the presence of caffeine. A similar effect was obtained when, instead of continuous superfusion, prepulses of caffeine were applied (10 mM for 60 s). The blocking effects of caffeine on K+-induced secretion depended on the time of exposure to the drug: the longer the exposure time the greater the blockade. The recovery of the K+ secretory responses previously impaired by caffeine was always gradual and followed a staircase mode. This contrasts with the effects of caffeine on various parameters measuring Ca2+ entry through Ca2+ channels, which did not parallel its effects on K+-evoked secretion. The secretion data, however, are compatible with the disappearance and recovery of an intracellular Ca2+ concentration signal triggered by K+ in single chromaffin cells loaded with fura 2 and treated with 10 mM caffeine. Thus, contrary to previous views, the depression of secretion by caffeine does not seem to be associated with inhibition of extracellular Ca2+ entry through Ca2+ channels. These functional data are, rather, compatible with the view that the degree of filling of a caffeine-sensitive intracellular Ca2+ store might regulate the extent of exocytosis. When emptied, such a store might act as a sink for the external Ca2+ entering through Ca2+ channels during cell depolarization, thus decreasing the intracellular Ca2+ concentration available for exocytosis.
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Affiliation(s)
- B Lara
- Departamento de Farmacología y Terapéutica, Facultad de Medicina, Universidad Autónoma de Madrid, Spain
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Gandía L, Villarroya M, Lara B, Olmos V, Gilabert JA, López MG, Martínez-Sierra R, Borges R, García AG. Otilonium: a potent blocker of neuronal nicotinic ACh receptors in bovine chromaffin cells. Br J Pharmacol 1996; 117:463-470. [PMID: 8821535 PMCID: PMC1909307 DOI: 10.1111/j.1476-5381.1996.tb15213.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [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: 02/02/2023] Open
Abstract
1. Otilonium, a clinically useful spasmolytic, behaves as a potent blocker of neuronal nicotinic acetylcholine receptors (AChR) as well as a mild wide-spectrum Ca2+ channel blocker in bovine adrenal chromaffin cells. 2. 45Ca2+ uptake into chromaffin cells stimulated with high K+ (70 mM, 1 min) was blocked by otilonium with an IC50 of 7.6 microM. The drug inhibited the 45Ca2+ uptake stimulated by the nicotinic AChR agonist, dimethylphenylpiperazinium (DMPP) with a 79 fold higher potency (IC50 = 0.096 microM). 3. Whole-cell Ba2+ currents (IBa) through Ca2+ channels of voltage-clamped chromaffin cells were blocked by otilonium with an IC50 of 6.4 microM, very close to that of K(+)-evoked 45Ca2+ uptake. Blockade developed in 10-20 s, almost as a single step and was rapidly and almost fully reversible. 4. Whole-cell nicotinic AChR-mediated currents (250 ms pulses of 100 microM DMPP) applied at 30 s intervals were blocked by otilonium in a concentration-dependent manner, showing an IC50 of 0.36 microM. Blockade was induced in a step-wise manner. Wash out of otilonium allowed a slow recovery of the current, also in discrete steps. 5. In experiments with recordings in the same cells of whole-cell IDMPP, Na+ currents (INa) and Ca2+ currents (ICa), 1 microM otilonium blocked 87% IDMPP, 7% INa and 13% ICa. 6. Otilonium inhibited the K(+)-evoked catecholamine secretory response of superfused bovine chromaffin cells with an IC50 of 10 microM, very close to the IC50 for blockade of K(+)-induced 45Ca2+ uptake and IBa. 7. Otilonium inhibited the secretory responses induced by 10 s pulses of 50 microM DMPP with an IC50 of 7.4 nM. Hexamethonium blocked the DMPP-evoked responses with an IC50 of 29.8 microM, 4,000 fold higher than that of otilonium. 8. In conclusion, otilonium is a potent blocker of nicotinic AChR-mediated responses. The drugs also blocked various subtypes of neuronal voltage-dependent Ca2+ channels at a considerably lower potency. Na+ channels were unaffected by otilonium. This extraordinary potency of otilonium in blocking nicotinic AChR, unrecognised until now, might account in part for its well known spasmolytic effects.
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Affiliation(s)
- L Gandía
- Departamento de Farmacología, Universidad Autónoma de Madrid, Spain
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Lara B, Zapater P, Montiel C, de la Fuente MT, Martínez-Sierra R, Ballesta JJ, Gandía L, García AG. Density of apamin-sensitive Ca(2+)-dependent K+ channels in bovine chromaffin cells: relevance to secretion. Biochem Pharmacol 1995; 49:1459-68. [PMID: 7763289 DOI: 10.1016/0006-2952(94)00524-p] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Three objectives were defined when planning this study: (i) to identify binding sites for [125I]-apamin in intact bovine adrenal medulla chromaffin cells and to estimate their density and selectivity; (ii) to determine whether apamin modified the release of catecholamines evoked by brief pulses of dimethylphenylpiperazinium (DMPP, 1 or 5 microM for 10 sec), histamine (10 microM for 10 sec) or high K+ (20, 35 or 70 mM for 10 sec) applied to superfused cells; and (iii) to test whether apamin affected the profiles of the changes in cytosolic Ca2+ concentrations [Ca2+]i obtained in suspensions of cells loaded with fura-2 and stimulated with DMPP or histamine. At equilibrium, increasing concentrations of [125I]-apamin gave a saturation curve whose Scatchard transformation produced a Kd of 132 pM and a Bmax of 0.72 fmol/10(6) cells. Quinine, tetraethylammonium, charybdotoxin or glibenclamide (blockers of various subtypes of K+ channels) did not inhibit [125I]apamin binding. Binding was blocked by apamin and by d-tubocurarine, two blockers of small-conductance Ca(2+)-activated K+ channels (SK channels). The number of binding sites for [125I]apamin amounted to approx. 900 per single chromaffin cell, 0.72 sites per micron 2 surface area. Apamin (1 microM) enhanced the secretory response to histamine (10 microM), DMPP (1 or 5 microM) and high K+ (20 or 35 mM) by 2-3-fold. The response to 70 mM K+, however, was unaffected. Apamin also enhanced the peak [Ca2+]i increase produced by DMPP or histamine by approx. 30%. Overall, these results strongly support the hypothesis that under physiological conditions, SK channels control some of the electrical activity of chromaffin cells and indirectly, the opening of voltage-dependent Ca2+ channels, the access of Ca2+ to the secretory machinery and the rate of catecholamine release to the circulation from the intact adrenal gland.
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Affiliation(s)
- B Lara
- Departamento de Farmacología, Facultad de Medicina, Universidad Autónoma de Madrid, Spain
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48
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Abstract
1. Dotarizine is a novel piperazine derivative structurally related to flunarizine that is currently being evaluated in clinical trials for its antimigraine and antivertigo effects. This clinical profile may be related to its Ca2+ antagonist properties. Therefore, the actions of both compounds as calcium antagonists were compared in bovine chromaffin cells. 2. Dotarizine and flunarizine blocked 45Ca2+ uptake into K+ depolarized chromaffin cells (70 mM K+/0.5 mM Ca2+ for 60 s) in a concentration-dependent manner, with IC50s of 4.8 and 6.7 microM, respectively. 3. Dotarizine and flunarizine also inhibited the whole-cell Ca2+ and Ba2+ currents (ICa, IBa) in voltage-clamped chromaffin cells, induced by depolarizing test pulses to 0 mV, during 50 ms, from a holding potential of -80 mV. Blockade exhibited IC50s of 4 microM for dotarizine and 2.2 microM for flunarizine. Dotarizine increased the rate of inactivation of ICa and IBa; inhibition of whole-cell currents was use-dependent. 4. Transient increases of the cytosolic Ca2+ concentration, [Ca2+]i, produced by K+ stimulation (70 mM K+ for 5 s) of single fura-2-loaded chromaffin cells, were also inhibited by dotarizine and flunarizine with IC50s of 1.2 and 0.6 microM, respectively. Upon washout of dotarizine, the [Ca2+]i increases recovered fully after 5-10 min. In contrast, the responses remained largely inhibited 10 min after washing out flunarizine. 5. Catecholamine release induced by K+ stimulation (10-s pulses of 70 mM) was inhibited by dotarizine with an IC50 of 2.6 microM and by flunarizine with an IC50 of 1.2 microM. The blocking effects of both compounds developed slowly, and was fully established after 20-30 min of superfusion. While blockade by dotarizine quickly reversed upon its washout, that of flunarizine lasted even 25 min after washing out.6. Catecholamine release from electroporated chromaffin cells triggered by 10 micro M Ca2+ was not affected by 10 micro M dotarizine or flunarizine.7. Overall, the results suggest that dotarizine behaves as a Ca2+ antagonist in bovine chromaffin cells. It exhibits a potency similar to flunarizine in blocking Ca2+ entry, Ca2+ channels, Cai2+ signals and secretion. The dotarizine effects are readily reversible suggesting that in contrast to flunarizine, it does not accumulate in cells. Dotarizine is devoid of intracellular effects on the secretory machinery. All its blocking effects on Ca2+ entry, [Ca2+]i rise and secretion are probably due to blockade of various Ca2+channel subtypes in chromaffin cells. This blockade is use-dependent and seems to be due to the increase by dotarizine of the rate of Ca2+ channel inactivation.
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Affiliation(s)
- M Villarroya
- Departmento de Farmacología, Facultad de Medicina Universidad Autónoma de Madrid, Spain
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López MG, Villarroya M, Lara B, Martínez Sierra R, Albillos A, García AG, Gandía L. Q- and L-type Ca2+ channels dominate the control of secretion in bovine chromaffin cells. FEBS Lett 1994; 349:331-7. [PMID: 8050592 DOI: 10.1016/0014-5793(94)00696-2] [Citation(s) in RCA: 84] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Potassium-stimulated catecholamine release from superfused bovine adrenal chromaffin cells (70 mM K+ in the presence of 2 mM Ca2+ for 10 s, applied at 5-min intervals) was inhibited by the dihydropyridine furnidipine (3 microM) by 50%. omega-Conotoxin MVIIC (CTx-MVIIC, 3 microM) also reduced the secretory response by about half. Combined CTx-MVIIC plus furnidipine blocked 100% catecholamine release. 45Ca2+ uptake and cytosolic Ca2+ concentrations ([Ca2+]i) in K(+)-depolarized cells were partially blocked by furnidipine or CTx-MVIIC, and completely inhibited by both agents. The whole cell current through Ca2+ channels carried by Ba2+ (IBa) was partially blocked by CTx-MVIIC. Although omega-conotoxin GVIA (CTx-GVIA, 1 microM) and omega-agatoxin IVA (Aga-IVA, 0.2 microM) partially inhibited 45Ca2+ entry, IBa and the increase in [Ca2+]i, the combination of both toxins did not affect the K(+)-evoked secretory response. The results are compatible with the presence in bovine chromaffin cells of a Q-like Ca2+ channel which has a prominent role in controlling exocytosis. They also suggest that Q- and L-type Ca2+ channels, but not N- or P-types are localized near exocytotic active sites in the plasmalemma.
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Affiliation(s)
- M G López
- Departamento de Farmacología, Facultad de Medicina, Universidad Autónoma de Madrid, Spain
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50
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Abstract
A life-threatening intoxication, requiring ventilatory support, is reported from the ingestion of 3.05 g of buflomedil, a peripheral vasodilator. Buflomedil at a dosage of 50 mg/kg weight produces seizures. Hypotension is not a specific symptom of intoxication. Buflomedil poisoning can be easily confused with other drugs, especially tricyclic antidepressants.
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Affiliation(s)
- R Martínez-Sierra
- Clinical Pharmacology Unit, Faculty of Medicine, Hospital Regional Reina Sofía Córdoba, Spain
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