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Heyming T, Knudsen-Robbins C, Schomberg J, Hayakawa J, Lara B, Bacon K, Valdez B, Wickens M, Shelton SK, Romain J, Wallace E, Taraman S, Loudon W, Pearson R. Evaluation of Quantitative Pupillometry in Acute Postinjury Pediatric Concussion. Pediatr Neurol 2024; 153:103-112. [PMID: 38367484 DOI: 10.1016/j.pediatrneurol.2024.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 01/03/2024] [Accepted: 01/08/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Although millions of children sustain concussions each year, a rapid and objective test for concussion has remained elusive. The aim of this study was to investigate quantitative pupillometry in pediatric patients in the acute, postinjury setting. METHODS This was a prospective case-control study of concussed patients presenting to the emergency department within 72 hours of injury. Pupillary measurements were gathered using NeurOptics' PLR 3000; evaluation included a symptom checklist and neurocognitive assessment. Data were analyzed using descriptive statistics and regression models. RESULTS A total of 126 participants were enrolled. One significant difference in pupillometry between concussed and control participants was found: left minimum pupil diameter in 12- to 18 year-olds (P = 0.02). Models demonstrating odds of a concussion revealed significant associations for time to 75% recovery (T75) of the left pupil in five- to 11-year-olds and average dilation velocity of the left pupil in 12- to 18-year-olds (P = 0.03 and 0.02 respectively). Models predicting symptom improvement showed one significant association: percent change of the right pupil in five-to-11-year-olds (P = 0.02). Models predicting neurocognitive improvement in 12- to 18-year-olds demonstrated significant association in T75 in the left pupil for visual memory, visual motor processing speed, and reaction time (P = 0.002, P = 0.04, P = 0.04). CONCLUSIONS The limited statistically significant associations found in this study suggest that pupillometry may not be useful in pediatrics in the acute postinjury setting for either the diagnosis of concussion or to stratify risk for prolonged recovery.
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Affiliation(s)
- Theodore Heyming
- CHOC Children's Hospital, Orange, California; Department of Emergency Medicine, University of California, Irvine, California.
| | - Chloe Knudsen-Robbins
- Department of Emergency Medicine, University of Cincinnati Medical Center, Cincinnati, Ohio
| | | | | | - Bryan Lara
- CHOC Children's Hospital, Orange, California
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Heyming T, Knudsen-Robbins C, Sharma S, Thackeray J, Schomberg J, Lara B, Wickens M, Wong D. Child physical abuse screening in a pediatric ED; Does TRAIN(ing) Help? BMC Pediatr 2023; 23:117. [PMID: 36894913 PMCID: PMC9998251 DOI: 10.1186/s12887-023-03927-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/21/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Child maltreatment is distressingly prevalent yet remains under-recognized by healthcare providers. In 2015 the Ohio Children's Hospital Association developed the Timely Recognition of Abusive INjuries (TRAIN) collaborative in an effort to promote child physical abuse (CPA) screening. Our institution implemented the TRAIN initiative in 2019. The objective of this study was to examine the effects of the TRAIN initiative at this institution. METHODS In this retrospective chart review we recorded the incidence of sentinel injuries (SIS) in children presenting to the Emergency Department (ED) of an independent level 2 pediatric trauma center. SIS were defined and identified by a diagnosis of ecchymosis, contusion, fracture, head injury, intracranial hemorrhage, abdominal trauma, open wound, laceration, abrasion, oropharyngeal injury, genital injury, intoxication, or burn in a child < 6.01 months of age. Patients were stratified into pre-TRAIN (PRE), 1/2017-9/2018, or post-TRAIN (POST), 10/2019-7/2020, periods. Repeat injury was defined as a subsequent visit for any of the previously mentioned diagnoses within 12 months of the initial visit. Demographics/visit characteristics were analyzed using Chi square analysis, Fischer's exact test, and student's paired t-test. RESULTS In the PRE period, 12,812 ED visits were made by children < 6.01 months old; 2.8% of these visits were made by patients with SIS. In the POST period there were 5,372 ED visits, 2.6% involved SIS (p = .4). The rate of skeletal surveys performed on patients with SIS increased from 17.1% in the PRE period to 27.2% in the POST period (p = .01). The positivity rate of skeletal surveys in the PRE versus POST period was 18.9% and 26.3% respectively (p = .45). Repeat injury rates did not differ significantly in patients with SIS pre- versus post-TRAIN (p = .44). CONCLUSION Implementation of TRAIN at this institution appears to be associated with increased skeletal survey rates.
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Affiliation(s)
- Theodore Heyming
- Children's Health of Orange County, CHOC Hospital, 1201 W. La Veta Ave, Orange, CA, 92868, USA. .,Department of Emergency Medicine, University of California, Irvine, 3800 W. Chapman Ave, Suite 3200, Orange, CA, 92868, USA.
| | - Chloe Knudsen-Robbins
- University of Pittsburgh School of Medicine, 3550 Terrace St, Pittsburgh, PA, 15213, USA
| | - Supriya Sharma
- Division of General Pediatrics, Harbor-UCLA Medical Center, 1000 W Carson St, Torrance, CA, 90502, USA
| | - Jonathan Thackeray
- Department of Pediatrics, Dayton Children's Hospital, 1 Childrens Plaza, Dayton, OH, 45404, USA
| | - John Schomberg
- Children's Health of Orange County, CHOC Hospital, 1201 W. La Veta Ave, Orange, CA, 92868, USA
| | - Bryan Lara
- Children's Health of Orange County, CHOC Hospital, 1201 W. La Veta Ave, Orange, CA, 92868, USA
| | - Maxwell Wickens
- Children's Health of Orange County, CHOC Hospital, 1201 W. La Veta Ave, Orange, CA, 92868, USA
| | - Daphne Wong
- Children's Health of Orange County, CHOC Hospital, 1201 W. La Veta Ave, Orange, CA, 92868, USA
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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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Srivastava A, Andersen MR, Alshehri AM, Lara B, Bashiri R, Li G, Chambers MS. Effectiveness of a Chairside Acrylic Adjustment Cabinet in Reducing Dental Acrylic Debris and Aerosols. J Prosthodont 2021; 31:488-495. [PMID: 34855263 DOI: 10.1111/jopr.13463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Chairside prosthesis adjustment procedures generate contaminated acrylic particle debris that include visible splatter (particles >50 μm) as well as invisible aerosols (<50 µm). The purpose of this study was to evaluate the effectiveness of a chairside acrylic adjustment cabinet (CAAC) in reducing airborne aerosol particles (<10 µm) and visible acrylic debris, time required for airborne aerosols to return to baseline levels after an acrylic adjustment procedure, and the effect on operatory turnover time. MATERIALS AND METHODS A total of 40 acrylic adjustment procedures were carried out in a simulated setting with (experiment) and without (control) a CAAC. Standardized acrylic samples of self-polymerized, and heat polymerized polymethylmethacrylate resins, Triad™ and Fastray™ custom tray materials were evaluated. Airborne aerosol measurements were done using a handheld Lase.r Particle Counter for absolute particle counts of sizes 0.3, 0.5, 1.0, 2.5, 5.0, and 10.0 μm before, during, and immediately after adjustment and 10 minutes postadjustment. Spread of aerosols was assessed at three distinct locations within the dental operatory specific to the provider, the patient, and the caregiver/guest. Visible acrylic debris and operatory turnover time were evaluated immediately postadjustments by a blinded investigator. Repeated measures ANOVA was used to estimate group effect, time effect and interaction between group and time for air particle analysis. Independent samples T-tests were used for group differences between operatory turnover time, and time for aerosols to return to baseline. Chi-square test was used for visible surface analysis. RESULTS In the control group, total aerosol particle counts increased from 6542.7 ± 162.6 particles at baseline to 598378.7 ± 586363.2 and 367569.9 ± 432220.8 particles during and immediately postadjustment, respectively. Adjustments made in the experiment group led to significantly reduced aerosol counts during (97738.9 ± 97866.5) and immediately postadjustment (19786.5 ± 14004.9; F = 17.8, p = 0.006). Similar trends were noted for the patient and guest positions. Time for aerosol particles to return to baseline was significantly lower in the experiment group (20.56 ± 14.5 minutes) compared to the control group (37.9 ± 31.96 minutes; p = 0.03). Visible acrylic debris analysis showed a significant decrease of 78% in the experiment group (p < 0.001). No significant differences were noted in operatory turnover time between the two groups (p = 0.61). CONCLUSIONS Acrylic adjustment procedures generated aerosols of particle sizes less than 10 µm and were measured in significant quantities throughout the dental operatory for up to 115 minutes. Chairside acrylic adjustment cabinets significantly decreased airborne aerosols, visible acrylic particle debris, and reduced the time for airborne aerosols to return to baseline levels.
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Affiliation(s)
- Akanksha Srivastava
- Department of Surgery, College of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Michael R Andersen
- Department of Hospital Dentistry, Naval Medical Center, San Diego, CA, USA
| | - Abdulkareem M Alshehri
- Maxillofacial Prosthodontics Surgical Dentistry, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Bryan Lara
- Private practice, Inwood, West Virginia, USA
| | - Rafiullah Bashiri
- Division of Comprehensive Oral Health, Adams School of Dentistry, The University of North Carolina, Chapel Hill, NC, USA
| | - Guojun Li
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Mark S Chambers
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
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Heyming TW, Nugent D, Tongol A, Knudsen-Robbins C, Hoang J, Schomberg J, Bacon K, Lara B, Sanger T. Rapid antibody testing for SARS-CoV-2 vaccine response in pediatric healthcare workers. Int J Infect Dis 2021; 113:1-6. [PMID: 34601142 PMCID: PMC8482557 DOI: 10.1016/j.ijid.2021.09.065] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The durability of the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination remains unknown. The objective of this study was to evaluate a rapid SARS-CoV-2 IgM/IgG antibody detection kit as a qualitative screen for the humoral response to vaccination. METHODS Study participants (n = 125) included pediatric healthcare workers (HCWs) who had received two doses of BNT162b2 or mRNA-1273. Participants were tested on study entry (March 12, 2021 to April 9, 2021). The mean number of days post second dose was 22 (range 17-36). Participants were tested for IgM/IgG antibodies to the SARS-CoV-2 spike protein with the RightSign COVID-19 IgG/IgM Rapid Test Cassette. ELISA/competitive inhibition ELISA (CI-ELISA) were subsequently run to assess for the neutralization effect and SARS-CoV-2 anti-nucleocapsid IgM/IgG antibodies. RESULTS Overall, 98.4% of participants were IgG-positive and 0.8% were IgM-positive on rapid RightSign testing. Of those with IgG-positive results, 100% were anti-spike protein IgG-positive on CI-ELISA; none of those who tested IgG-negative via the rapid test were IgG-positive on CI-ELISA. All HCWs who tested RightSign positive demonstrated neutralizing capability on CI-ELISA. Overall, 1.6% demonstrated anti-nucleocapsid IgM antibodies and 5.6% demonstrated anti-nucleocapsid IgG antibodies. CONCLUSIONS The strong agreement between the rapid RightSign IgG results and confirmatory CI-ELISA testing suggests that this test may be used to assess for positive, and neutralizing, antibody responses to SARS-CoV-2 mRNA vaccination.
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Affiliation(s)
- Theodore W Heyming
- Department of Emergency Medicine, Children's Hospital of Orange County, Orange, California, USA; Department of Emergency Medicine, University of California, Irvine, California, USA.
| | - Diane Nugent
- Department of Hematology, Children's Hospital of Orange County, Orange, California, USA
| | - Aprille Tongol
- Research Institute, Children's Hospital of Orange County, Orange, California, USA
| | | | - Janet Hoang
- Department of Hematology, Children's Hospital of Orange County, Orange, California, USA
| | - John Schomberg
- Research Institute, Children's Hospital of Orange County, Orange, California, USA
| | - Kellie Bacon
- Research Institute, Children's Hospital of Orange County, Orange, California, USA
| | - Bryan Lara
- Research Institute, Children's Hospital of Orange County, Orange, California, USA
| | - Terence Sanger
- Research Institute, Children's Hospital of Orange County, Orange, California, USA; Department of Electrical Engineering and Computer Science, University of California, Irvine, California, USA
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Heyming T, Bacon K, Lara B, Knudsen-Robbins C, Tongol A, Sanger T. SARS-CoV-2 Serology Testing in an Asymptomatic, At-Risk Population: Methods, Results, Pitfalls. Infect Dis Rep 2021; 13:910-916. [PMID: 34698190 PMCID: PMC8544562 DOI: 10.3390/idr13040082] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/05/2021] [Accepted: 10/14/2021] [Indexed: 11/30/2022] Open
Abstract
The primary aim of this study was to determine the seroprevalence of SARS-CoV-2 antibodies in a population of pediatric healthcare workers (HCWs). This study was conducted 14 May-13 July 2020. Study participants included pediatric HCWs at a pediatric hospital with either direct patient contact or close proximity to patient-care areas. SARS-CoV-2 antibodies were assessed via the Wytcote Superbio SARS-CoV-2 IgM/IgG Antibody Fast Detection Kit and the Abbott Architect SARS-CoV-2 IgG assay. Participants underwent RT-PCR testing upon entry to the study and following rapid IgM+/IgG+ results; respiratory panel PCR (RP-PCR) was performed following IgM+ results. A total of 57 of 289 (19.7%) of participants demonstrated positive serology as assessed by the Wytcote rapid kit (12 on Day 1 and 45 throughout the study). However, only one of these participants demonstrated IgG+ serology via the Abbott assay. Two participants tested SARS-CoV-2+ via RT-PCR testing. One individual was adenovirus+ and enterovirus/rhinovirus+. In our study population, we observed a seroprevalence of SARS-CoV-2 antibodies of 0.35%. The lack of concordance between antibody tests suggests that the Wytcote rapid test kit may not be of use as a screening tool. However, the feasibility of the overall process indicates that a similar methodology may have potential for future epidemiologic surveillance.
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Affiliation(s)
- Theodore Heyming
- Children’s Hospital of Orange County, Orange, CA 92868, USA; (T.H.); (K.B.); (B.L.); (A.T.)
- Department of Emergency Medicine, University of California, Irvine, CA 92868, USA
| | - Kellie Bacon
- Children’s Hospital of Orange County, Orange, CA 92868, USA; (T.H.); (K.B.); (B.L.); (A.T.)
| | - Bryan Lara
- Children’s Hospital of Orange County, Orange, CA 92868, USA; (T.H.); (K.B.); (B.L.); (A.T.)
| | | | - Aprille Tongol
- Children’s Hospital of Orange County, Orange, CA 92868, USA; (T.H.); (K.B.); (B.L.); (A.T.)
| | - Terence Sanger
- Children’s Hospital of Orange County, Orange, CA 92868, USA; (T.H.); (K.B.); (B.L.); (A.T.)
- Department of Electrical Engineering and Computer Science, University of California, Irvine, CA 92697, USA
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Heyming TW, Fortier MA, Martin SR, Lara B, Bacon K, Kain ZN. Predictors for COVID-19-related new-onset maladaptive behaviours in children presenting to a paediatric emergency department. J Paediatr Child Health 2021; 57:1634-1639. [PMID: 34042245 PMCID: PMC8242733 DOI: 10.1111/jpc.15579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/08/2021] [Accepted: 05/06/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE The goal of the present study was to determine the incidence of new onset maladaptive behaviours in paediatric emergency department (PED) patients during the COVID-19 pandemic and to examine whether child and parent anxiety and parental health status were predictors for the new-onset of maladaptive behaviours. METHODS Participants included child-parent dyads seen in a PED following the state's issuance of mandatory stay-at-home orders on 19 March 2020. A total of 351 children age 0-25 years and 335 parents enrolled in the study. Parents provided baseline demographic data and completed standardised surveys that assessed aspects of parental and child anxiety and parental health, as well as child new-onset maladaptive behaviours. Children ≥8 years of age completed surveys that assessed child anxiety. FINDINGS Parents reported the new onset of maladaptive behaviours in children during the pandemic with frequencies up to 43%. Bivariate analysis identified predictors such as child anxiety (t(96) = -2.04, P = 0.044) as well as parental variables such as state anxiety (t(190) = -4.91, P < 0.001) and parental sensitivity to anxiety (t(243) = -3.19, P = 0.002). A logistic regression model identified parent mental health and COVID-19 anxiety as predictors of new onset maladaptive behaviours in children (X2 (6) = 42.514, P < 0.001). Specifically, every unit change in parental anxiety of COVID-19 was associated with a unit increase in maladaptive behaviours in children. CONCLUSIONS We identified distinct parent and child-related factors that predicted new onset child maladaptive behaviours during the COVID-19 pandemic. The identification of such predictors may help clinicians to prevent maladaptive responses to the pandemic quarantine.
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Affiliation(s)
- Theodore W Heyming
- Children's Hospital of Orange CountyOrangeCaliforniaUSA,Department of Emergency MedicineUniversity of CaliforniaIrvineCaliforniaUSA,Center on Stress & HealthUniversity of CaliforniaIrvineCaliforniaUSA
| | - Michelle A Fortier
- Children's Hospital of Orange CountyOrangeCaliforniaUSA,Center on Stress & HealthUniversity of CaliforniaIrvineCaliforniaUSA,Sue & Bill Gross School of NursingUniversity of CaliforniaIrvineCaliforniaUSA,Department of Anesthesiology and Perioperative CareUniversity of CaliforniaIrvineCaliforniaUSA
| | - Sarah R Martin
- Children's Hospital of Orange CountyOrangeCaliforniaUSA,Center on Stress & HealthUniversity of CaliforniaIrvineCaliforniaUSA,Department of Anesthesiology and Perioperative CareUniversity of CaliforniaIrvineCaliforniaUSA
| | - Bryan Lara
- Children's Hospital of Orange CountyOrangeCaliforniaUSA
| | - Kellie Bacon
- Children's Hospital of Orange CountyOrangeCaliforniaUSA
| | - Zeev N Kain
- Children's Hospital of Orange CountyOrangeCaliforniaUSA,Center on Stress & HealthUniversity of CaliforniaIrvineCaliforniaUSA,Department of Anesthesiology and Perioperative CareUniversity of CaliforniaIrvineCaliforniaUSA
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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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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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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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11
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Heyming TW, Sanger T, Tongol A, Schomberg J, Bacon K, Lara B. Provider Antibody Serology Study of Virus in the Emergency Room (PASSOVER) Study: Special Population COVID-19 Seroprevalence. West J Emerg Med 2021; 22:565-571. [PMID: 34125028 PMCID: PMC8203005 DOI: 10.5811/westjem.2021.1.50058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 01/23/2021] [Indexed: 01/10/2023] Open
Abstract
Introduction Limited data on the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among healthcare workers (HCW) are publicly available. In this study we sought to determine the seroprevalence of SARS-CoV-2 in a population of HCWs in a pediatric emergency department (ED). Methods We conducted this observational cohort study from April 14–May 13, 2020 in a pediatric ED in Orange County, CA. Asymptomatic HCW ≥18 years of age were included in the study. Blood samples were obtained by fingerstick at the start of each shift. The inter-sampling interval was ≤96 hours. The primary outcome was positive seroprevalence of SARS-CoV-2 as determined with an antibody fast detection kit (Colloidal Gold, Superbio, Timisoara, Romania) for the SARS-CoV-2 immunoglobulin M/immunoglobulin G (IgM/IgG) antibody. Results A total of 143 HCWs participated in the study. Overall SARS-CoV-2 seroprevalence was 10.5% (n = 15). Positive seroprevalence was classified as IgG only (4.9%), IgM+IgG (3.5%), or IgM only (2.1%). SARS-CoV-2 was detected by reverse transcription polymerase chain reaction RT-PCR in 0.7% of the overall study population (n = 1). Samples obtained on Day 1 indicated seropositivity in 4.2% of the study population (n = 6). Subsequent seroconversion occurred in 6.3% of participants (n = 9). The rate of seroconversion was linear with a rate of approximately one new case every two days, starting at Day 9 of the study. Conclusion We observed a linear rate of seroconversion to SARS-CoV-2–positive status among asymptomatic HCWs who underwent daily symptom surveys and temperature screens in an environment with universal source control. Rapid antibody testing may be useful for screening for SARS-CoV-2 seropositivity in high-risk populations, such as HCWs in the ED.
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Affiliation(s)
- Theodore W Heyming
- Children's Hospital of Orange County, Department of Emergency Medicine, Orange, California.,University of California, Irvine, Department of Emergency Medicine, Irvine, California
| | - Terence Sanger
- University of California, Irvine, Department of Electrical Engineering and Computer Science, Irvine, California.,Children's Hospital of Orange County, Research Institute, Orange, California
| | - Aprille Tongol
- Children's Hospital of Orange County, Research Institute, Orange, California
| | - John Schomberg
- Children's Hospital of Orange County, Department of Nursing, Orange, California
| | - Kellie Bacon
- Children's Hospital of Orange County, Research Institute, Orange, California
| | - Bryan Lara
- Children's Hospital of Orange County, Research Institute, Orange, California
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12
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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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13
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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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14
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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 Oostenbrugge RJ, Cervera A, Amaro S, Llull L, Codas J, Balasa M, Navarro J, Ariño H, Aceituno A, Rudilosso S, Renu A, Majoie CB, Macho JM, San Roman L, Blasco J, López A, Macías N, Cardona P, Quesada H, Rubio F, Cano L, Lara B, Dippel DW, de Miquel MA, Aja L, Serena J, Cobo E, Albers GW, Lees KR, Arenillas J, Roberts R, Minhas P, Al-Ajlan F, Brown MM, Salluzzi M, Zimmel L, Patel S, Eesa M, Martí-Fàbregas J, Jankowitz B, Serena J, Salvat-Plana M, López-Cancio E, Bracard S, Liebig T, Ducrocq X, Anxionnat R, Baillot PA, Barbier C, Derelle AL, Lacour JC, Richard S, Samson Y, Sourour N, Baronnet-Chauvet F, Stijnen T, Clarencon F, Crozier S, Deltour S, Di Maria F, Le Bouc R, Leger A, Mutlu G, Rosso C, Szatmary Z, Yger M, Andersson T, Zavanone C, Bakchine S, Pierot L, Caucheteux N, Estrade L, Kadziolka K, Leautaud A, Renkes C, Serre I, Desal H, Mattle H, Guillon B, Boutoleau-Bretonniere C, Daumas-Duport B, De Gaalon S, Derkinderen P, Evain S, Herisson F, Laplaud DA, Lebouvier T, Lintia-Gaultier A, Wahlgren N, Pouclet-Courtemanche H, Rouaud T, Rouaud Jaffrenou V, Schunck A, Sevin-Allouet M, Toulgoat F, Wiertlewski S, Gauvrit JY, Ronziere T, Cahagne V, van der Heijden E, Ferre JC, Pinel JF, Raoult H, Mas JL, Meder JF, Al Najjar-Carpentier AA, Birchenall J, Bodiguel E, Calvet D, Domigo V, Ghannouti N, Godon-Hardy S, Guiraud V, Lamy C, Majhadi L, Morin L, Naggara O, Trystram D, Turc G, Berge J, Sibon I, Fleitour N, Menegon P, Barreau X, Rouanet F, Debruxelles S, Kazadi A, Renou P, Fleury O, Pasco-Papon A, Dubas F, Caroff J, Hooijenga I, Godard Ducceschi S, Hamon MA, Lecluse A, Marc G, Giroud M, Ricolfi F, Bejot Y, Chavent A, Gentil A, Kazemi A, Puppels C, Osseby GV, Voguet C, Mahagne MH, Sedat J, Chau Y, Suissa L, Lachaud S, Houdart E, Stapf C, Buffon Porcher F, Pellikaan W, Chabriat H, Guedin P, Herve D, Jouvent E, Mawet J, Saint-Maurice JP, Schneble HM, Turjman F, Nighoghossian N, Berhoune NN, Geerling A, Bouhour F, Cho TH, Derex L, Felix S, Gervais-Bernard H, Gory B, Manera L, Mechtouff L, Ritzenthaler T, Riva R, Lindl-Velema A, Salaris Silvio F, Tilikete C, Blanc R, Obadia M, Bartolini MB, Gueguen A, Piotin M, Pistocchi S, Redjem H, Drouineau J, van Vemde G, Neau JP, Godeneche G, Lamy M, Marsac E, Velasco S, Clavelou P, Chabert E, Bourgois N, Cornut-Chauvinc C, Ferrier A, de Ridder A, Gabrillargues J, Jean B, Marques AR, Vitello N, Detante O, Barbieux M, Boubagra K, Favre Wiki I, Garambois K, Tahon F, Greebe P, Ashok V, Voguet C, Coskun O, Guedin P, Rodesch G, Lapergue B, Bourdain F, Evrard S, Graveleau P, Decroix JP, de Bont-Stikkelbroeck J, Wang A, Sellal F, Ahle G, Carelli G, Dugay MH, Gaultier C, Lebedinsky AP, Lita L, Musacchio RM, Renglewicz-Destuynder C, de Meris J, Tournade A, Vuillemet F, Montoro FM, Mounayer C, Faugeras F, Gimenez L, Labach C, Lautrette G, Denier C, Saliou G, Janssen K, Chassin O, Dussaule C, Melki E, Ozanne A, Puccinelli F, Sachet M, Sarov M, Bonneville JF, Moulin T, Biondi A, Struijk W, De Bustos Medeiros E, Vuillier F, Courtheoux P, Viader F, Apoil-Brissard M, Bataille M, Bonnet AL, Cogez J, Kazemi A, Touze E, Licher S, Leclerc X, Leys D, Aggour M, Aguettaz P, Bodenant M, Cordonnier C, Deplanque D, Girot M, Henon H, Kalsoum E, Boodt N, Lucas C, Pruvo JP, Zuniga P, Bonafé A, Arquizan C, Costalat V, Machi P, Mourand I, Riquelme C, Bounolleau P, Ros A, Arteaga C, Faivre A, Bintner M, Tournebize P, Charlin C, Darcel F, Gauthier-Lasalarie P, Jeremenko M, Mouton S, Zerlauth JB, Venema E, Lamy C, Hervé D, Hassan H, Gaston A, Barral FG, Garnier P, Beaujeux R, Wolff V, Herbreteau D, Debiais S, Slokkers I, Murray A, Ford G, Muir KW, White P, Brown MM, Clifton A, Freeman J, Ford I, Markus H, Wardlaw J, Ganpat RJ, Lees KR, Molyneux A, Robinson T, Lewis S, Norrie J, Robertson F, Perry R, Dixit A, Cloud G, Clifton A, Mulder M, Madigan J, Roffe C, Nayak S, Lobotesis K, Smith C, Herwadkar A, Kandasamy N, Goddard T, Bamford J, Subramanian G, Saiedie N, Lenthall R, Littleton E, Lamin S, Storey K, Ghatala R, Banaras A, Aeron-Thomas J, Hazel B, Maguire H, Veraque E, Heshmatollah A, Harrison L, Keshvara R, Cunningham J, Schipperen S, Vinken S, van Boxtel T, Koets J, Boers M, Santos E, Borst J, Jansen I, Kappelhof M, Lucas M, Geuskens R, Barros RS, Dobbe R, Csizmadia M, Hill MD, Goyal M, Demchuk AM, Menon BK, Eesa M, Ryckborst KJ, Wright MR, Kamal NR, Andersen L, Randhawa PA, Stewart T, Patil S, Minhas P, Almekhlafi M, Mishra S, Clement F, Sajobi T, Shuaib A, Montanera WJ, Roy D, Silver FL, Jovin TG, Frei DF, Sapkota B, Rempel JL, Thornton J, Williams D, Tampieri D, Poppe AY, Dowlatshahi D, Wong JH, Mitha AP, Subramaniam S, Hull G, Lowerison MW, Sajobi T, Salluzzi M, Wright MR, Maxwell M, Lacusta S, Drupals E, Armitage K, Barber PA, Smith EE, Morrish WF, Coutts SB, Derdeyn C, Demaerschalk B, Yavagal D, Martin R, Brant R, Yu Y, Willinsky RA, Montanera WJ, Weill A, Kenney C, Aram H, Stewart T, Stys PK, Watson TW, Klein G, Pearson D, Couillard P, Trivedi A, Singh D, Klourfeld E, Imoukhuede O, Nikneshan D, Blayney S, Reddy R, Choi P, Horton M, Musuka T, Dubuc V, Field TS, Desai J, Adatia S, Alseraya A, Nambiar V, van Dijk R, Wong JH, Mitha AP, 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, 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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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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 MJ, Ranft A, Rohde S, Burg K, Weimar C, Zegarac V, Hartmann C, Schlamann M, Göricke S, Ringlestein A, Wanke I, Mönninghoff C, Dietzold M, Budzik R, Davis T, Eubank G, Hicks WJ, Pema P, Vora N, Mejilla J, Taylor M, Clark W, Rontal A, Fields J, Peterson B, Nesbit G, Lutsep H, Bozorgchami H, Priest R, Ologuntoye O, Barnwell S, Dogan A, Herrick K, Takahasi C, Beadell N, Brown B, Jamieson S, Hussain MS, Russman A, Hui F, Wisco D, Uchino K, Khawaja Z, Katzan I, Toth G, Cheng-Ching E, Bain M, Man S, Farrag A, George P, John S, Shankar L, Drofa A, Dahlgren R, Bauer A, Itreat A, Taqui A, Cerejo R, Richmond A, Ringleb P, Bendszus M, Möhlenbruch M, Reiff T, Amiri H, Purrucker J, Herweh C, Pham M, Menn O, Ludwig I, Acosta I, Villar C, Morgan W, Sombutmai C, Hellinger F, Allen E, Bellew M, Gandhi R, Bonwit E, Aly J, Ecker RD, Seder D, Morris J, Skaletsky 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, 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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Martínez ÁF, Lai CH, Hsu YC, Yeh YC, Cheng YJ, Colella V, Zarrillo N, D’Amico M, Forfori F, Pezza B, Laddomada T, Aliaga SM, Beltramelli V, Pizzaballa ML, Doronzio A, Balicco B, Kiers D, van der Heijden W, Gerretsen J, de Mast Q, el Messaoudi S, Rongen G, Para LH, Gomes M, Kox M, Pickkers P, Riksen NP, Kashiwagi Y, Okada M, Hayashi K, Inagaki Y, Fujita S, Nakamae MN, Payá JM, Kang YR, Souza RB, Liberatore AMA, Koh IHJ, Blet A, Sadoune M, Lemarié J, Bihry N, Bern R, Polidano E, Mulero FR, Merval R, Launay JM, Lévy B, Samuel JL, Mebazaa A, Hartmann J, Harm S, Weber V, Guerci P, Ince Y, Heeman P, Ergin B, Ince C, Uz Z, Massey M, Ince Y, Papatella R, Bulent E, Guerci P, Toraman F, Ince C, Longbottom ER, Torrance HD, Owen HC, Hinds CJ, Pearse RM, O’Dywer MJ, Trogrlic Z, van der Jagt M, Lingsma H, Ponssen HH, Schoonderbeek JF, Schreiner F, Verbrugge SJ, Duran S, van Achterberg T, Bakker J, Gommers DAMPJ, Ista E, Krajčová A, Waldauf P, Duška F, Shah A, Roy N, McKechnie S, Doree C, Fisher S, 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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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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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
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - K. Lees
- Data and Safety Monitoring Board
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - J. Serena
- 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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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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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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Abstract
This study examines the effects of a 6-week exposure to 1% NaCl in tap water with and without desoxycorticosterone acetate (DOCA) on renal alpha adrenoceptors and systolic blood pressure (SBP) in spontaneously hypertensive adult rats (SHR) and normotensive Wistar-Kyoto (WKY) rats. On normal sodium intake, SHR had higher renal alpha 1- (p less than 0.05) and alpha 2-adrenoceptor densities (p less than 0.001) and SBP (p less than 0.001) than WKY rats. Although WKY rats given either 1% NaCl, DOCA, or DOCA plus 1% NaCl developed hypertension after 6 weeks of treatment, only 1% NaCl administration for the same period produced an increase in the alpha 1-adrenoceptor density when compared to the control (p less than 0.001). In SHR, ingestion of 1% NaCl or DOCA plus 1% NaCl increased the already elevated alpha 2-adrenoceptor density (p less than 0.001) and SBP even more in this strain after 6 weeks of treatment. Equilibrium dissociation constants (Kd), however, were similar for both classes of receptors in experimental and control rats. The results of this study indicate that only the combination of 1% NaCl in tap water and DOCA administration is effective in accelerating hypertension in adult SHR. On the other hand, in this form of genetic rat hypertension, exaggerated sodium intake with or without DOCA administration could presumably be correlated with the increased renal alpha 2 adrenoceptors observed in these animals.
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Affiliation(s)
- A Sánchez
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Córdoba, Spain
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Abstract
The effects of high sodium intake (drinking 1% NaCl), DOCA and DOCA + 1%NaCl for 6 weeks on renal alpha 1- and alpha 2-adrenoceptors and on systolic blood pressure (SBP) were examined in young spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto rats (WKY). On normal sodium intake, SHR rats had higher renal alpha 1 (p less than .001) and alpha 2-adrenoceptor densities (p less than .001) and SBP (p less than .001) than WKY rats. Although, WKY rats given either 1% NaCl, DOCA, and DOCA + 1% NaCl developed hypertension after 6 weeks of treatment, only 1% NaCl administration for the same period produced an increase in the alpha 1- and alpha 2-adrenoceptor densities when compared to the control (p less than .01 and p less than .001, respectively). In the SHR rats, to the contrary, ingestion of 1% NaCl and DOCA + 1% NaCl increased the already elevated alpha 2-adrenoceptor density (p less than .001) and SBP even more in this strain after 6 weeks of treatment. Equilibrium dissociation constants (KD), however, were similar for both classes of receptors in experimental and control rats. This study indicates that postweaning exposure of the WKY and SHR rats to a high salt treatment and DOCA can influence the renal alpha-adrenoceptor densities. Although the functional significance of the changes is unclear, it is reasonable to speculate that postweaning exposure to a hypertensinogenic stimuli such as a 1% NaCl and/or DOCA may ultimately interfere with the functional development of the kidney differently in rats genetically predisposed to hypertension (SHR) from normotensive (WKY) rats.
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Affiliation(s)
- J Sáiz
- Department of Pharmacology and Toxicology, Faculty of Medicine, University of Córdoba, Spain
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