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Villodre C, Taccogna L, Zapater P, Cantó M, Mena L, Ramia JM, Lluís F, Afonso N, Aguilella V, Aguiló J, Alados JC, Alberich M, Apio AB, Balongo R, Bra E, Bravo-Gutiérrez A, Briceño FJ, Cabañas J, Cánovas G, Caravaca I, Carbonell S, Carrera-Dacosta E, Castro EE, Caula C, Choolani-Bhojwani E, Codina A, Corral S, Cuenca C, Curbelo-Peña Y, Delgado-Morales MM, Delgado-Plasencia L, Doménech E, Estévez AM, Feria AM, Gascón-Domínguez MA, Gianchandani R, González C, Hevia RJ, González MA, Hidalgo JM, Lainez M, Lluís N, López F, López-Fernández J, López-Ruíz JA, Lora-Cumplido P, Madrazo Z, Marchena J, de la Cuadra MB, Martín S, Casas MI, Martínez P, Mena-Mateos A, Morales-García D, Mulas C, Muñoz-Forner E, Naranjo A, Navarro-Sánchez A, Oliver I, Ortega I, Ortega-Higueruelo R, Ortega-Ruiz S, Osorio J, Padín MH, Pamies JJ, Paredes M, Pareja-Ciuró F, Parra J, Pérez-Guarinós CV, Pérez-Saborido B, Pintor-Tortolero J, Plua-Muñiz K, Rey M, Rodríguez I, Ruiz C, Ruíz R, Ruiz S, Sánchez A, Sánchez D, Sánchez R, Sánchez-Cabezudo F, Sánchez-Santos R, Santos J, Serrano-Paz MP, Soria-Aledo V, Tallón-Aguilar L, Valdivia-Risco JH, Vallverdú-Cartié H, Varela C, Villar-Del-Moral J, Zambudio N. Simplified risk-prediction for benchmarking and quality improvement in emergency general surgery. Prospective, multicenter, observational cohort study. Int J Surg 2022; 97:106168. [PMID: 34785344 DOI: 10.1016/j.ijsu.2021.106168] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/24/2021] [Accepted: 11/03/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Emergency General Surgery (EGS) conditions account for millions of deaths worldwide, yet it is practiced without benchmarking-based quality improvement programs. The aim of this observational, prospective, multicenter, nationwide study was to determine the best benchmark cutoff points in EGS, as a reference to guide improvement measures. METHODS Over a 6-month period, 38 centers (5% of all public hospitals) attending EGS patients on a 24-h, 7-days a week basis, enrolled consecutive patients requiring an emergent/urgent surgical procedure. Patients were stratified into cohorts of low (i.e., expected morbidity risk <33%), middle and high risk using the novel m-LUCENTUM calculator. RESULTS A total of 7258 patients were included; age (mean ± SD) was 51.1 ± 21.5 years, 43.2% were female. Benchmark cutoffs in the low-risk cohort (5639 patients, 77.7% of total) were: use of laparoscopy ≥40.9%, length of hospital stays ≤3 days, any complication within 30 days ≤ 17.7%, and 30-day mortality ≤1.1%. The variables with the greatest impact were septicemia on length of hospital stay (21 days; adjusted beta coefficient 16.8; 95% CI: 15.3 to 18.3; P < .001), and respiratory failure on mortality (risk-adjusted population attributable fraction 44.6%, 95% CI 29.6 to 59.6, P < .001). Use of laparoscopy (odds ratio 0.764, 95% CI 0.678 to 0.861; P < .001), and intraoperative blood loss (101-500 mL: odds ratio 2.699, 95% CI 2.152 to 3.380; P < .001; and 500-1000 mL: odds ratio 2.875, 95% CI 1.403 to 5.858; P = .013) were associated with increased morbidity. CONCLUSIONS This study offers, for the first time, clinically-based benchmark values in EGS and identifies measures for improvement.
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Affiliation(s)
- C Villodre
- Hospital Gran Canaria Doctor Negrín, Las Palmas de Gran Canarias, Spain Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain Hospital Lluís Alcanyís de Xàtiva, Valencia, Spain Hospital Universitario de Badajoz, Badajoz, Spain Hospital Universitario de Bellvitge, Barcelona, Spain Hospital Marina Baixa, Alicante, Spain Hospital Juan Ramón Jiménez, Infanta Elena, Huelva, Spain Hospital Infanta Cristina, Parla, Madrid, Spain Hospital Universitario de Canarias, Tenerife, Spain Hospital Reina Sofía de Córdoba, Córdoba, Spain H. Ramón y Cajal, Madrid, Spain Hospital Parc Taulí de Sabadell, Barcelona, Spain Hospital General Universitario de Alicante, Alicante, Spain Complejo Hospitalario Universitario de Vigo, Hospital Pontevedra, Spain Hospital Trueta de Girona, Girona, Spain Hospital Universitario Rio Hortega, Valladolid, Spain Hospital Mutua Terrassa, Barcelona, Spain Consorci Hospitalari de Vic, Barcelona, Spain POVISA, Pontevedra, Spain Hospital Universitario Nuestra Señora de Candelaria, Tenerife, Spain Hospital Universitario Basurto, Bizkaia, Spain Hospital Universitario Marqués de Valdecilla, Santander, Spain Hospital de Viladecans, Barcelona, Spain Hospital Clínico de Valencia, Valencia, Spain Hospital Universitario Insular de Gran Canaria, Las Palmas, Spain Hospital Vírgen de la Macarena, Sevilla, Spain Hospital Cabueñes, Gijón, Spain Complejo Hospitalario de Jaén, Jaén, Spain Hospital Universitari Sant Joan de Reus, Tarragona, Spain Hospital Universitario Infanta Sofía, Madrid, Spain Complejo Hospitalario Torrecárdenas, Almería, Spain Hospital Sant Pau i Santa Tecla, Tarragona, Spain Hospital General Rafael Méndez de Lorca, Murcia, Spain Hospital Vírgen del Rocío, Sevilla, Spain Hospital Morales Meseguer, Murcia, Spain Hospital del Vinalopó, Alicante, Spain Hospital Universitario del Vinalopó, Alicante, Spain Hospital Universitario Virgen de las Nieves, Granada, Spain Department of Surgery, General University Hospital of Alicante, Alicante, Spain Department of Clinical Pharmacology, General University Hospital of Alicante, Alicante, Spain Computing, BomhardIP, Alicante, Spain Department of Clinical Documentation, General University Hospital of Alicante, Alicante, Spain Institute of Health and Biomedical Research of Alicante, ISABIAL, Alicante, Spain
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Williams BM, Purcell LN, Varela C, Gallaher J, Charles A. Non reducible inguinal hernias in Malawi: an occupational hazard. Hernia 2021; 25:1339-1344. [PMID: 33222030 PMCID: PMC8137715 DOI: 10.1007/s10029-020-02337-w] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Accepted: 11/04/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Inguinal hernias are one of the most common surgical conditions worldwide. Due to limited surgical access in low- and middle-income countries, many hernias present emergently; however, data on the resultant outcome disparities is limited. We, therefore, sought to describe the epidemiology, clinical features, and outcomes of incarcerated inguinal hernias at a tertiary center in Malawi. METHODS This is a retrospective analysis of the acute care surgery registry at Kamuzu Central Hospital in Lilongwe, Malawi. All patients > 13 years admitted with a non-reducible inguinal hernia from 2013 to 2019 were included. The primary outcome was in-hospital mortality. A Poisson multivariable regression determined factors associated with increased risk of mortality. RESULTS A total of 297 patients presented with non-reducible inguinal hernias, the majority of which were young (median age 38), male (93.6%), farmers (47.8%). Of the 81% who underwent surgery, 55% were delayed ≥ 24 h. 19.5% of hernias were strangulated. Overall mortality was 5.4%. Increased age (RR 1.06, 95% CI 1.01-1.12), shock index ≥ 1 (RR 4.82, 95% CI 1.45-16.09), and delay ≥ 24 h from presentation to operative intervention (RR 11.24, 95% CI 1.55-81.34) resulted in an increase in relative risk of mortality. CONCLUSION Non-reducible inguinal hernias largely affect young male farmers in Malawi. Delays to care can limit economic productivity for this rural population, as well as, yield considerable risk of mortality. While specific patient and institutional factors must be further elucidated, increased awareness, public health prioritization, and surgical capacity building is needed to reduce further hernia-related morbidity and mortality.
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Affiliation(s)
- B M Williams
- Department of Surgery, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - L N Purcell
- Department of Surgery, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - C Varela
- Department of Surgery, Kamuzu Central Hospital, Lilongwe, Malawi
| | - J Gallaher
- Department of Surgery, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - A Charles
- Department of Surgery, University of North Carolina, Chapel Hill, NC, 27599, USA.
- Department of Surgery, Kamuzu Central Hospital, Lilongwe, Malawi.
- UNC School of Medicine, 4008 Burnett Womack Building, CB 7228, Chapel Hill, USA.
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Verdugo J, Mena A, Cavada G, Silva C, Ramos C, Varela C, Diaz J, Alegria J. Correlation Between Non-contrast Chest CT Findings And Clinical Outcomes In Hospitalized Patients With Covid-19 Pneumonia With Positive PCR For SARS-Cov-2 During The First Wave. J Cardiovasc Comput Tomogr 2021. [PMCID: PMC8280283 DOI: 10.1016/j.jcct.2021.06.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Martinuzzi A, Cascaron M, Maldonado N, Schulz J, Roel P, Ocampo R, Traverso M, Carcamo C, Nuñez M, Varela C, Betancurt C, Leiva S, Bogado M. Intestinal rehabilitation in type iii intestinal failure. The patagonian experiences. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Porte L, Valdivieso F, Wilmes D, Gaete P, Díaz MC, Thompson L, Munita JM, Alliende R, Varela C, Rickerts V, Weitzel T. Laboratory exposure to Coccidioides: lessons learnt in a non-endemic country. J Hosp Infect 2019; 102:461-464. [PMID: 30885815 DOI: 10.1016/j.jhin.2019.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 03/11/2019] [Indexed: 01/27/2023]
Abstract
Coccidioides is a primary pathogenic fungus, which infects humans through highly infectious arthroconidia, causing substantial morbidity including life-threatening disseminated infections. Due to the low infectious dose, laboratory personnel might become infected during diagnostic procedures. Accordingly, coccidioidomycosis is reported as the most frequent laboratory-acquired systemic mycosis worldwide. This risk is aggravated in non-endemic countries, where the diagnosis may not be suspected. We report on an inadvertent exposure of 44 persons to Coccidioides posadasii in a clinical microbiology laboratory in Chile, the measures of containment after rapid diagnosis with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, and the lessons learnt in a non-endemic setting.
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Affiliation(s)
- L Porte
- Laboratorio Clínico, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile.
| | - F Valdivieso
- Programa Medicina del Viajero, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile; Laboratorio de Microbiología, Hospital Luis Calvo Mackenna, Santiago, Chile
| | - D Wilmes
- Mycology Section, FG 16, Robert-Koch Institute, Berlin, Germany
| | - P Gaete
- Comite IAAS, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago
| | - M C Díaz
- Programa de Microbiologia y Micologia, ICBM, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - L Thompson
- Servicio de Infectología, Departamento de Medicina Interna, Clínica Alemana, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - J M Munita
- Servicio de Infectología, Departamento de Medicina Interna, Clínica Alemana, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile; Genómica & Resistencia Microbiana, Instituto de Ciencias e Innovación en Medicina (ICIM), Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Chile; Millennium Initiative for Collaborative Research on Bacterial Resistance (MICROB-R)
| | - R Alliende
- Laboratorio Clínico, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - C Varela
- Laboratorio Clínico, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
| | - V Rickerts
- Mycology Section, FG 16, Robert-Koch Institute, Berlin, Germany
| | - T Weitzel
- Laboratorio Clínico, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile; Programa Medicina del Viajero, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana, Universidad del Desarrollo, Santiago, Chile
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Baran E, Godoy A, Merino E, Benigni L, Gonzalez J, Pierini N, Copparoni G, Farah A, Zubillaga M, Rivera A, Ferranti S, Bocanegra R, Lorenzin A, Barrena E, Varela C, Gatti L, Goñi S. P159 Usefulness of extended oral glucose tolerance test in patients with cystic fibrosis older than 16 years. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30454-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Varela C, Barker A, Tran T, Borneman A, Curtin C. Sensory profile and volatile aroma composition of reduced alcohol Merlot wines fermented with Metschnikowia pulcherrima and Saccharomyces uvarum. Int J Food Microbiol 2017; 252:1-9. [PMID: 28436828 DOI: 10.1016/j.ijfoodmicro.2017.04.002] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/11/2017] [Accepted: 04/11/2017] [Indexed: 12/23/2022]
Abstract
Strategies for production of wines containing lower alcohol concentrations are in strong demand, for reasons of quality, health, and taxation. Development and application of wine yeasts that are less efficient at transforming grape sugars into ethanol has the potential to allow winemakers the freedom to make lower alcohol wines from grapes harvested at optimal ripeness, without the need for post-fermentation processes aimed at removing ethanol. We have recently shown that two non-conventional wine yeast species Metschnikowia pulcherrima and Saccharomyces uvarum were both able to produce wine with reduced alcohol concentration. Both species produced laboratory-scale wines with markedly different volatile aroma compound composition relative to Saccharomyces cerevisiae. This work describes the volatile composition and sensory profiles of reduced-alcohol pilot-scale Merlot wines produced with M. pulcherrima and S. uvarum. Wines fermented with M. pulcherrima contained 1.0% v/v less ethanol than S. cerevisiae fermented wines, while those fermented with S. uvarum showed a 1.7% v/v reduction in ethanol. Compared to S. cerevisiae ferments, wines produced with M. pulcherrima showed higher concentrations of ethyl acetate, total esters, total higher alcohols and total sulfur compounds, while wines fermented with S. uvarum were characterised by the highest total concentration of higher alcohols. Sensorially, M. pulcherrima wines received relatively high scores for sensory descriptors such as red fruit and fruit flavour and overall exhibited a sensory profile similar to that of wine made with S. cerevisiae, whereas the main sensory descriptors associated with wines fermented with S. uvarum were barnyard and meat. This work demonstrates the successful application of M. pulcherrima AWRI3050 for the production of pilot-scale red wines with reduced alcohol concentration and highlights the need for rigorous evaluation of non-conventional yeasts with regard to their sensory impacts.
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Affiliation(s)
- C Varela
- The Australian Wine Research Institute, PO Box 197, Glen Osmond, Adelaide, South Australia 5064, Australia.
| | - A Barker
- The Australian Wine Research Institute, PO Box 197, Glen Osmond, Adelaide, South Australia 5064, Australia
| | - T Tran
- The Australian Wine Research Institute, PO Box 197, Glen Osmond, Adelaide, South Australia 5064, Australia
| | - A Borneman
- The Australian Wine Research Institute, PO Box 197, Glen Osmond, Adelaide, South Australia 5064, Australia
| | - C Curtin
- The Australian Wine Research Institute, PO Box 197, Glen Osmond, Adelaide, South Australia 5064, Australia
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De Haro J, Bleda S, Varela C, Cañibano C, Acin F. Meta-analysis and adjusted indirect comparison of direct oral anticoagulants in prevention of acute limb ischemia in patients with atrial fibrillation. Curr Med Res Opin 2016; 32:1167-73. [PMID: 26949899 DOI: 10.1185/03007995.2016.1163256] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [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: 11/23/2022]
Abstract
BACKGROUND Direct oral anticoagulants are being presented as alternatives to warfarin for preventing stroke in patients with atrial fibrillation. Yet direct comparative trials between these agents in prevention of acute limb ischemia (ALI) are unavailable so far. OBJECTIVE To conduct an adjusted indirect comparison meta-analysis between direct oral agents for prevention of acute limb ischemia in atrial fibrillation. METHODS We conducted a systematic literature review searching electronic databases (MEDLINE and Embase) and the Cochrane Library from January 1990 through November 2014. Two blinded investigators reviewed all potentially relevant articles in a parallel manner by using a priori defined criteria. To assess the long-term efficacy and safety of these agents, only randomized clinical trials (RCTs) with follow-up durations of >1 year were included. The primary efficacy outcome was the end point of acute limb ischemia and/or extremity embolism. RESULTS A total of 44,563 patients from three RCTs met criteria for inclusion. Patients randomized to direct oral anticoagulants had a non-significant decreased risk for acute limb ischemia (risk ratio [RR]: 0.57, 95% confidence interval [CI]: 0.26-1.2). In the analysis between agents, however, rivaroxaban significantly lowered the risk of ALI compared to warfarin (RR: 0.23, 95% CI: 0.064-0.82), apixaban (RR: 0.26, 95% CI: 0.081-0.83), and dabigatran (RR: 0.24, 95% CI: 0.077-0.83). CONCLUSIONS Significant differences in prevention of acute limb ischemia may exist between oral anticoagulant agents in patients with atrial fibrillation. Rivaroxaban lowers the risk of limb embolism versus warfarin, apixaban and dabigatran.
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Affiliation(s)
- J De Haro
- a Angiology and Vascular Surgery Department , Getafe University Hospital , Getafe , Madrid , Spain
| | - S Bleda
- a Angiology and Vascular Surgery Department , Getafe University Hospital , Getafe , Madrid , Spain
| | - C Varela
- a Angiology and Vascular Surgery Department , Getafe University Hospital , Getafe , Madrid , Spain
| | - C Cañibano
- a Angiology and Vascular Surgery Department , Getafe University Hospital , Getafe , Madrid , Spain
| | - F Acin
- a Angiology and Vascular Surgery Department , Getafe University Hospital , Getafe , Madrid , Spain
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Matos MJ, Vilar S, Kachler S, Vazquez-Rodriguez S, Varela C, Delogu G, Hripcsak G, Santana L, Uriarte E, Klotz KN, Borges F. Progress in the development of small molecules as new human A3 adenosine receptor ligands based on the 3-thiophenylcoumarin core. Med Chem Commun 2016. [DOI: 10.1039/c5md00573f] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
3-Thiophenylcoumarins are described as adenosine receptor ligands. Synthesis, in vitro pharmacological assays and docking studies were performed.
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Contreras A, Hidalgo C, Schmidt S, Henschke PA, Curtin C, Varela C. The application of non-Saccharomyces yeast in fermentations with limited aeration as a strategy for the production of wine with reduced alcohol content. Int J Food Microbiol 2015; 205:7-15. [PMID: 25866906 DOI: 10.1016/j.ijfoodmicro.2015.03.027] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [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: 11/27/2014] [Revised: 03/10/2015] [Accepted: 03/24/2015] [Indexed: 10/23/2022]
Abstract
High alcohol concentrations reduce the complexity of wine sensory properties. In addition, health and economic drivers have the wine industry actively seeking technologies that facilitate the production of wines with lower alcohol content. One of the simplest approaches to achieve this aim would be the use of wine yeast strains which are less efficient at transforming grape sugars into ethanol, however commercially available wine yeasts produce very similar ethanol yields. Non-conventional yeast, in particular non-Saccharomyces species, have shown potential for producing wines with lower alcohol content. These yeasts are naturally present in the early stages of fermentation but in general are not capable of completing alcoholic fermentation. We have evaluated 48 non-Saccharomyces isolates to identify strains that, with limited aeration and in sequential inoculation regimes with S. cerevisiae, could be used for the production of wine with lower ethanol concentration. Two of these, Torulaspora delbrueckii AWRI1152 and Zygosaccharomyces bailii AWRI1578, enabled the production of wine with reduced ethanol concentration under limited aerobic conditions. Depending on the aeration regime T. delbrueckii AWRI1152 and Z. bailii AWRI1578 showed a reduction in ethanol concentration of 1.5% (v/v) and 2.0% (v/v) respectively, compared to the S. cerevisiae anaerobic control.
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Affiliation(s)
- A Contreras
- The Australian Wine Research Institute, PO Box 197, Glen Osmond, Adelaide, South Australia, 5064, Australia; Department of Chemical and Bioprocess Engineering, College of Engineering, Pontificia Universidad Católica de Chile, Casilla 306 Correo 22, Santiago, Chile
| | - C Hidalgo
- The Australian Wine Research Institute, PO Box 197, Glen Osmond, Adelaide, South Australia, 5064, Australia; Instituto de Investigaciones Agropecuarias, La Platina Research Station, Avenida Santa Rosa 11610, La Pintana, 8831314, Santiago, Chile
| | - S Schmidt
- The Australian Wine Research Institute, PO Box 197, Glen Osmond, Adelaide, South Australia, 5064, Australia
| | - P A Henschke
- The Australian Wine Research Institute, PO Box 197, Glen Osmond, Adelaide, South Australia, 5064, Australia; School of Agriculture, Food and Wine, The University of Adelaide, PMB 1, Glen Osmond, SA 5064, Australia
| | - C Curtin
- The Australian Wine Research Institute, PO Box 197, Glen Osmond, Adelaide, South Australia, 5064, Australia
| | - C Varela
- The Australian Wine Research Institute, PO Box 197, Glen Osmond, Adelaide, South Australia, 5064, Australia.
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Matos MJ, Varela C, Vilar S, Hripcsak G, Borges F, Santana L, Uriarte E, Fais A, Di Petrillo A, Pintus F, Era B. Design and discovery of tyrosinase inhibitors based on a coumarin scaffold. RSC Adv 2015. [DOI: 10.1039/c5ra14465e] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A novel series of 3-aryl and 3-heteroarylcoumarins displaying tyrosinase inhibitory activity.
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Varela C, Kumar S, Yang JY, Wilson MA. Anatomical substrates for direct interactions between hippocampus, medial prefrontal cortex, and the thalamic nucleus reuniens. Brain Struct Funct 2014; 219:911-29. [PMID: 23571778 PMCID: PMC4179252 DOI: 10.1007/s00429-013-0543-5] [Citation(s) in RCA: 171] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Accepted: 03/13/2013] [Indexed: 12/18/2022]
Abstract
The reuniens nucleus in the midline thalamus projects to the medial prefrontal cortex (mPFC) and the hippocampus, and has been suggested to modulate interactions between these regions, such as spindle-ripple correlations during sleep and theta band coherence during exploratory behavior. Feedback from the hippocampus to the nucleus reuniens has received less attention but has the potential to influence thalamocortical networks as a function of hippocampal activation. We used the retrograde tracer cholera toxin B conjugated to two fluorophores to study thalamic projections to the dorsal and ventral hippocampus and to the prelimbic and infralimbic subregions of mPFC. We also examined the feedback connections from the hippocampus to reuniens. The goal was to evaluate the anatomical basis for direct coordination between reuniens, mPFC, and hippocampus by looking for double-labeled cells in reuniens and hippocampus. In confirmation of previous reports, the nucleus reuniens was the origin of most thalamic afferents to the dorsal hippocampus, whereas both reuniens and the lateral dorsal nucleus projected to ventral hippocampus. Feedback from hippocampus to reuniens originated primarily in the dorsal and ventral subiculum. Thalamic cells with collaterals to mPFC and hippocampus were found in reuniens, across its anteroposterior axis, and represented, on average, about 8 % of the labeled cells in reuniens. Hippocampal cells with collaterals to mPFC and reuniens were less common (~1 % of the labeled subicular cells), and located in the molecular layer of the subiculum. The results indicate that a subset of reuniens cells can directly coordinate activity in mPFC and hippocampus. Cells with collaterals in the hippocampus-reuniens-mPFC network may be important for the systems consolidation of memory traces and for theta synchronization during exploratory behavior.
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Affiliation(s)
- C Varela
- Department of Brain and Cognitive Sciences, Picower Institute for Learning and Memory, Massachusetts Institute of Technology, 77 Massachusetts Avenue, 46-5233, Cambridge, MA, 02139, USA,
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Arevalo G, Varela C, Gijon L, Rosas M, Arevalo F. Modifiable risk factors and lumbar disc herniation: Results of a case control study in 652 patients. Ann Phys Rehabil Med 2014. [DOI: 10.1016/j.rehab.2014.03.718] [Citation(s) in RCA: 2] [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: 11/17/2022]
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Rosado C, Fierro C, Cossio F, Rodriguez A, Candas MA, Varela C, Miranda G, Plano AI, Martínez-Múgica C, Gomez de Segura L. GM-018 Survey to assess outpatient satisfaction as a quality measure tool in a Hospital Pharmacy. Eur J Hosp Pharm 2014. [DOI: 10.1136/ejhpharm-2013-000436.296] [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: 11/04/2022] Open
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Samuel JC, Ludzu EK, Cairns BA, Varela C, Charles AG. A patient with severe peritonitis. Malawi Med J 2013; 25:86-87. [PMID: 24358426 PMCID: PMC3859995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Affiliation(s)
- J C Samuel
- Department of Surgery, University of North Carolina, Chapel Hill NC USA
| | - E K Ludzu
- Department of Surgery, Kamuzu Central Hospital, Lilongwe Malawi
| | - B A Cairns
- Department of Surgery, University of North Carolina, Chapel Hill NC USA
| | - C Varela
- Department of Surgery, Kamuzu Central Hospital, Lilongwe Malawi
| | - A G Charles
- Department of Surgery, University of North Carolina, Chapel Hill NC USA
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Diaz-Garcia CM, Fuentes-Silva D, Sanchez-Soto C, Domínguez-Pérez D, García-Delgado N, Varela C, Mendoza-Hernández G, Rodriguez-Romero A, Castaneda O, Hiriart M. Toxins from Physalia physalis (Cnidaria) raise the intracellular Ca(2+) of beta-cells and promote insulin secretion. Curr Med Chem 2013; 19:5414-23. [PMID: 22830340 DOI: 10.2174/092986712803833308] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Revised: 07/04/2012] [Accepted: 07/19/2012] [Indexed: 11/22/2022]
Abstract
Physalia physalis is a marine cnidarian from which high molecular weight toxins with hemolytic and neurotoxic effects have been isolated. In the present work, two novel toxins, PpV9.4 and PpV19.3 were purified from P. physalis by bioactive guideline isolation. It involved two steps of column chromatography, gel filtration and RP-HPLC. The molecular weights were 550.7 and 4720.9 Da for PpV9.4 and PpV19.3, respectively. In the light of the Edman sequencing results, the structure of these toxins included the presence of modified amino acids. Both toxins increased the percentage of insulin secreting beta-cells and induced cytosolic Ca2+ elevation. To date, this is the first report of low molecular weight toxins increasing insulin secretion purified from cnidarians, by constituting a new approach to the study of beta-cells physiology.
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Affiliation(s)
- C M Diaz-Garcia
- Department of Neural Development and Physiology, Instituto de Fisiologia Celular, Universidad Nacional Autonoma de Mexico/Circuito Ext. SN, UNAM, Coyoacan, Mexico DF. CP 04510, Mexico
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Abstract
Thalamic input to the neocortex is crucial for sensory perception and constitutes the basis of complex awake behavior. Connections within the neocortex play an important role in internally generated neural activity, which is considered critical for memory retrieval and for the generation of imagery in our dreams. Modulatory neurotransmitters, such as noradrenaline and acetylcholine, gate information transmission in the brain. Favero et al. (J Neurophysiol 108: 1010-1024, 2012) show that modulators differentially facilitate thalamocortical relative to intracortical transmission in the input layers of cortex.
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Affiliation(s)
- C Varela
- The Picower Institute for Learning and Memory, Dept. of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
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Varela C, Torrea D, Schmidt SA, Ancin-Azpilicueta C, Henschke PA. Effect of oxygen and lipid supplementation on the volatile composition of chemically defined medium and Chardonnay wine fermented with Saccharomyces cerevisiae. Food Chem 2012; 135:2863-71. [PMID: 22980883 DOI: 10.1016/j.foodchem.2012.06.127] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Revised: 06/08/2012] [Accepted: 06/27/2012] [Indexed: 11/28/2022]
Abstract
Oxygen or lipids are required to complete stressful alcoholic fermentation. Lack of these nutrients can inhibit sugar uptake and growth, which leads to incomplete or 'stuck' fermentation. Oxygen or lipids supplementation not only restores yeast fermentative activity and also affects formation of yeast volatile metabolites. To clarify the effect of oxygen and lipid supplementation on the formation of flavour active metabolites during wine fermentation, we evaluated the addition of these two nutrients to chemically defined grape juice and filter clarified Chardonnay must. Lipid addition increased the concentration of esters, higher alcohols and volatile acids, whereas oxygen increased the concentration of higher alcohols and altered the proportion of acetate to ethyl esters and the proportion of branch-chain acids to medium-chain fatty acids. Combined addition of lipids and oxygen showed an additive effect on concentration of higher alcohols whereas oxygen suppressed the enhancing effect of lipids on formation of esters and volatile acids. Our results demonstrate the potential of lipid and oxygen supplementation for the manipulation of wine aroma in white wine fermentation.
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Affiliation(s)
- C Varela
- Australian Wine Research Institute, P.O. Box 197, Glen Osmond (Adelaide), SA 5064, Australia
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Susla O, Shin HS, Jung YS, Rim H, Speer T, Owala FO, Razawi M, Holy E, Ferdinand B, Danilo F, Luscher TF, Tanner FC, Markaki A, Kyriazis J, Petrakis I, Mavroeidi V, Perakis K, Fragkiadakis GA, Venyhaki M, Tzanakakis M, Vardaki E, Maraki K, Doskas T, Daphnis E, Bregman R, Vale B, Lemos C, Kawakami L, Silva MI, Zhu F, Kaysen G, Kotanko P, Abbas SR, Dou Y, Heymsfield S, Levin NW, Turkmen K, Kayikcioglu H, Guney I, Altintepe L, Ozbek O, Tonbul HZ, Kaysen GA, Kaysen GA, Usvyat LA, Thijssen S, Levin NW, Kotanko P, Mutluay R, Konca Degertekin C, Derici U, Yilmaz MI, Akkiyal F, Gultekin S, Gonen S, Deger SM, Arinsoy T, Sindel S, Hueso M, Torras J, Carrera M, Vidal A, Navarro E, Rivas I, Rama I, Bolanos N, Varela C, Martinez-Castelao A, Grinyo JM, Harving F, Svensson M, Schmidt EB, Jorgensen KA, Christensen JH, Park JH, Koo EH, Kim HK, Kim MS, Cho AJ, Lee JE, Jang HR, Huh W, Kim DJ, Kim YG, Oh HY, Zawiasa A, Nowak D, Nowicki M, Nathalie N, Griet G, Eva S, Raymond V, Ng KP, Stringer S, Jesky M, Dutton M, Ferro C, Cockwell P, Jia T, Gama Axelsson T, Lindholm B, Heimburger O, Barany P, Stenvinkel P, Qureshi AR, Quiroga B, Goicoechea M, Garcia de Vinuesa S, Verdalles U, Reque J, Panizo N, Arroyo D, Santos A, Macias N, Luno J, Honda H, Hirano T, Ueda M, Kojima S, Mashiba S, Hayase Y, Michihata T, Akizawa T, Gungor O, Sezis Demirci M, Kircelli F, Tatar E, Hur E, Sen S, Toz H, Basci A, Ok E, Sepe V, Albrizio P, Gnecchi M, Cervio E, Esposito P, Rampino T, Libetta C, Dal Canton A, Faria MS, Faria MS, Ribeiro S, Silva G, Nascimento H, Rocha-Pereira P, Miranda V, Vieira E, Santos R, Mendonca D, Quintanilha A, Costa E, Belo L, Santos-Silva A, Pruijm M, Pruijm M, Hofmann L, Heuvelin E, Forni V, Coristine A, Stuber M, Vogt B, Burnier M, Chiappini MG, Ammann T, Muzzi L, Grosso A, Sabry A, Bansal V, Hoppensteadt D, Jeske W, Fareed J. Nutrition, inflammation and oxidative stress - CKD 1-5. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs238] [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: 11/13/2022] Open
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Lopes R, Silva A, Costa M, Baeta C, Varela C. Cardiac monitoring of the administration of trastuzumab at the Portuguese Institute of Oncology of Coimbra Francisco Gentil, EPE. Eur J Hosp Pharm 2012. [DOI: 10.1136/ejhpharm-2012-000074.252] [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: 11/03/2022] Open
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Flórez A, De Haro J, Bleda S, Varela C, Esparza L, Acin F. Analysis of vascular endothelial growth factor gene expression in the tissues of patients with chronic venous insufficiency. Phlebology 2012; 28:32-7. [PMID: 22368191 DOI: 10.1258/phleb.2011.011102] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Immunohistochemical techniques have revealed the presence of vascular endothelial growth factor (VEGF) in the epidermis of patients with chronic venous disease (CVD). Our objective was to perform a quantitative analysis of the VEGF gene transcription in tissues that are potential sources of this factor (skin, varicose veins [VV] and great saphenous vein [GSV]) in patients with CVD. METHODS In all, 212 skin and venous tissue samples were collected from patients diagnosed with CVD and controls. The VEGF gene expression was analysed using quantitative realtime polymerase chain reaction (PCR). RESULTS The skin VEGF expression was lower in the CVD group than in the control group (P = 0.04). There were no significant differences between the insufficient GSV of the CVD group and the control healthy vein (P = 0.22). There was a greater expression of VEGF in the VV of the CVD group than in the control healthy vein (P = 0.03). Comparison of the VEGF expression between the different tissue types in the CVD group revealed significant differences between the skin and GSV (P = 0.02) and between the skin and the VV (P = 0.004), and between the VV and the GSV (P = 0.02). CONCLUSIONS The results of the present study show an over-expression of VEGF gene in the VV tissue of patients with CVD. Based on the data in patients with C2 disease, the VVs appear to be the source of increased VEGF expression.
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Affiliation(s)
- A Flórez
- Vascular Surgery and Angiology Department, Hospital Central de la Cruz Roja, Madrid, Spain
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Varela C, Acin F, De Haro J, March J, Florez A, Lopez-Quintana A. Influence of surgical or endovascular distal revascularization of the lower limbs on ischemic ulcer healing. J Cardiovasc Surg (Torino) 2011; 52:381-9. [PMID: 21577193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/28/2022]
Abstract
AIM Our aim is to analyze the ability of distal endovascular procedures, performed as first treatment option, to promote ischemic ulcer healing. METHODS Retrospective analysis of 91 primary distal procedures, 49 (53.8%) surgical and 42 (46.2%) endovascular, performed consecutively between January 2005 and December 2007 in patients with critical limb ischemia (CLI) and ischemic ulcers. Patient comorbidities, intervention duration time, postoperative hospital stay and complications were recorded. Ischemic ulcer healing time, patency, limb salvage and survival rates were compared between both groups. Data were included in a Cox regression model to determine predictive factors for healing RESULTS Endovascular therapy was associated with shorter intervention time (128±53 versus 301±91 min; P=0.001) and postoperative hospital stay (13±13 versus 19±14 days; P=0.05). Surgical procedures were associated with more local complications (28.6% versus 7.1% P=0.01), more readmissions for surgical wound complications (12.2% versus 0% P=0.03) and more early major amputations (16.3% versus 0% P=0.007). Ischemic ulcer healing in endovascular and surgical procedures was 80% versus 83% at 12 months (P=NS). Overall patency, limb salvage, survival and amputation-free survival with healed ulcers at 24 months in endovascular and surgical groups were 82% versus 82% (P=NS), 83% versus 72% (P=NS), 81% versus 79% (P=NS) and 63% versus 56% (P=NS). Diabetes mellitus (HR: 2.86 95% CI [1.44-5.68]), free ambulatory status (HR: 0.57 95% CI [0.33-0.98]) and the presence of severe wounds (HR: 2.73 95% CI [1.40-5.30]) were predictors for ulcer healing. CONCLUSION Endovascular and surgical distal procedures had a similar ulcer healing rate and limb salvage. Our experience supports endovascular-first strategy for CLI with tissue loss.
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Affiliation(s)
- C Varela
- Department of Angiology and Vascular Surgery, Getafe University Hospital, Madrid, Spain.
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Bleda S, De Haro J, Florez A, Varela C, Esparza L, Acin F. Long-term pleiotropic effect of statins upon nitric oxide and C-reactive protein levels in patients with peripheral arterial disease. Heart Asia 2011; 3:130-4. [PMID: 27326011 DOI: 10.1136/heartasia-2011-010045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 09/06/2011] [Indexed: 01/14/2023]
Abstract
OBJECTIVES Peripheral arterial disease can be regarded as a systemic inflammatory disorder affecting the entire vascular system. In the early clinical stages, it is characterised by the deterioration of endothelial function, which does not progress with the development of the disease. This study analyses the pleiotropic effects upon the plasma nitrite and C-reactive protein (CRP) levels in claudicating patients after 12 months of treatment with statins. STUDY DESIGN A prospective randomised controlled translational study was made in patients with Fontaine grade II ischaemia, treated with the best medical treatment with or without statins for 12 months from the time of diagnosis for assessing the pleiotropic effects of those statins. METHODS Measurements of plasma high-sensitivity CRP (hsCRP), lipid profile and nitrites were made at baseline and after 1 month and 1 year of treatment with atorvastatin 40 mg/day. RESULTS A significant reduction in nitrite levels was observed after 1 month of treatment (11.8±7.8 μM vs 5.7±1.8 μM, p=0.0001), but this effect did not persist after 1 year (11.8±7.8 μM vs 9.4±8.9 μM, p=0.27). HsCRP underwent a significant reduction after both 1 month (7 (2.2-12) vs 3.4 (1.6-5.5), p<0.01) and 1 year of treatment with atorvastatin (7 (2.2-12) vs 2.25 (1.67-6.7), p=0.02). Statin treatment reduced hsCRP levels in 9.64 (95% CI (1.60 to 17.68)) after 1 month and in 9.14 (95% CI (0.18 to 18.47)) after 1 year. CONCLUSIONS The long-term biological pleiotropic effects of statins provide information on the role of endothelial function and systemic inflammation in the aetiopathogenesis of peripheral arterial disease. Statins slow endothelial degradation at the start of the disease, with no effects over the long term. These drug substances reduce progressive inflammation throughout the treatment period. This supports the novel hypothesis that endothelial dysfunction is only a disease-triggering phenomenon, while systemic inflammation would be responsible for both the origin and the maintenance of peripheral arterial disease.
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Affiliation(s)
- S Bleda
- Department of Vascular Surgery and Angiology, Getafe University Hospital, Getafe, Madrid, Spain
| | - J De Haro
- Department of Vascular Surgery and Angiology, Getafe University Hospital, Getafe, Madrid, Spain
| | - A Florez
- Department of Vascular Surgery and Angiology, Getafe University Hospital, Getafe, Madrid, Spain
| | - C Varela
- Department of Vascular Surgery and Angiology, Getafe University Hospital, Getafe, Madrid, Spain
| | - L Esparza
- Department of Vascular Surgery and Angiology, Getafe University Hospital, Getafe, Madrid, Spain
| | - F Acin
- Department of Vascular Surgery and Angiology, Getafe University Hospital, Getafe, Madrid, Spain
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Pastor J, Martínez S, Álvarez R, Varela C, Hernández A, Rodríguez S, Oyarzábal J, Albarrán M, Link W, Bischoff J. 183 Amino-alkyl substituted fused imidazoles: potent, selective and orally bioavailable inhibitors of PI3K. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)71888-7] [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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de Haro J, Bleda S, Florez A, Varela C, Esparza L, Acin F. MS481 LONG-TERM PLEIOTROPIC EFFECT OF STATINS UPON NITRIC OXIDE AND C-REACTIVE PROTEIN LEVELS IN PATIENTS WITH PERIPHERAL ARTERIAL DISEASE. ATHEROSCLEROSIS SUPP 2010. [DOI: 10.1016/s1567-5688(10)70982-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Luque-Ramírez M, Portoles GR, Varela C, Albero R, Halperin I, Moreiro J, Soto A, Casamitjana R. The efficacy of octreotide LAR as firstline therapy for patients with newly diagnosed acromegaly is independent of tumor extension: predictive factors of tumor and biochemical response. Horm Metab Res 2010; 42:38-44. [PMID: 19798622 DOI: 10.1055/s-0029-1239506] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Surgical outcome of acromegaly depends on the preoperatory tumor size and extension. Somatostatin analogues are also a highly effective treatment for acromegalic patients. Nevertheless, the response of GH-secreting adenomas to primary medical therapy is variable. The aim of the present study was to evaluate the efficacy of octreotide LAR as primary therapy for acromegalic patients as a function of initial tumor extension. We performed a multicentre, prospective, observational and analytical study recruiting 19 "naive" acromegalic patients (5 microadenomas, 10 intrasellar, and 4 extrasellar macroadenomas). All of them were treated with octreotide LAR for 12 months. Basal GH and fasting IGF-I concentrations, and tumor volume were measured at baseline and after 6 and 12 months of treatment. Six patients withdrew the study. The patients who completed the protocol showed a significant reduction of tumor volume (25+/-23%, Wilk's lambda=0.506, F=4.400, p=0.046) independently of tumor extension at study entry (Wilk's lambda=0.826, F=0.452, p=0.769). A shrinkage >25% of baseline tumor volume was achieved in 8 (42%) patients with no differences between tumor extension subgroups. Basal GH levels (76+/-18%) and fasting IGF-I (52+/-31%) decreased throughout the study. Six (46%) patients normalized their IGF-I levels. Octreotide LAR is an effective first-line treatment for a large group of acromegalic patients independent of initial tumor extension.
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Affiliation(s)
- M Luque-Ramírez
- Department of Endocrinology, Hospital Universitario de La Princesa, Diego de León 62, 28006 Madrid, Spain.
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Esperón A, Kamaid E, Diamant M, Campos HP, Del Carmen Saldías M, Icasuriaga A, Varela C, Delgado D, Alvarez I. Uruguayan experience with cryopreserved arterial homografts. Transplant Proc 2009; 41:3500-4. [PMID: 19857780 DOI: 10.1016/j.transproceed.2009.09.006] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We analyzed the Uruguayan experience with cryopreserved arterial homografts. We studied 55 medical records in the period from June 9, 2000 to April 7, 2007, including 41 from males and 14 from females, ranging from 36-78 years of age. The clinical indications were as follows: Group 1, revascularization of infrainguinal atherosclerotic occlusive disease by bypass due to the lack of availability of a suitable vein (n = 35); Group 2, substitution of an infected prosthetic grafts (n = 15); and Group 3, arteriovenous fistula (AVF) after failure of previous prosthetic loops by repeated thrombosis and/or infection in the absence of a vein (n = 5). RESULTS Among Group 1, primary and secondary patency rates were 61% and 71%, respectively at 1 year with 15 complications, 3 infections, 8 thromboses, 2 aneurysms, 1 homograft degradation, and 1 death related to surgery. Among Group 2, the primary and secondary patency rates were 71% and 79%, respectively, at 1 year with 6 patients experiencing complications. Group 3 did not have complications with a primary patency rate of 67% at 1 year. CONCLUSIONS The use of cryopreserved arterial homografts is a valid, accessible, and safe alternative in complicated vascular situations. In our country, it is a technology to consider for patients with critical limb ischemia, when the risk of a major amputation is high and it is not possible to have a suitable vein or prosthetic bypass. It can be an excellent alternative for the substitution of infected synthetic bypasses, especially to substitute in situ for an infected aortic graft.
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Affiliation(s)
- A Esperón
- Area de Cirugía Vascular Periférica, Hospital de Clínicas, Instituto Nacional de Donación y Transplante, Ministerio de Salud Pública, Clinica Quirúrgica 1, Hospital Pasteur.
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Jaramillo E, Stotz W, Bertrán C, Navarro J, Román C, Varela C. Actividad locomotriz deOrchestoidea tuberculata(Amphipoda, Talitridae) sobre la superficie de una playa arenosa del Sur de Chile (Mehuín, Provincia de Valdivia). Studies on Neotropical Fauna and Environment 2008. [DOI: 10.1080/01650528009360561] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
Two types of thalamic nuclei have been recognized: first order, which relay information from subcortical sources, and higher order, which may relay information from one cortical area to another. We have recently shown that muscarinic agonists depolarize all first order and most higher order relay cells but hyperpolarize a significant proportion of higher order relay cells. We now extend this result to serotonergic agonists, using rat thalamic brain slices and whole-cell, current- and voltage-clamp recordings from relay cells in various first order (the lateral geniculate nucleus, the ventral posterior nucleus, and the ventral portion of the medial geniculate body) and higher order nuclei (the lateral posterior, the posterior medial nucleus, and the dorsal portion of the medial geniculate body). Similar to the effects of muscarinic agonists, we found that first and most higher order relay cells were depolarized by serotonergic agonists, but 15% of higher order relay cells responded with hyperpolarization. Thus different subsets of higher order relay cells are hyperpolarized by these modulatory systems, which could have implications for the transfer of information between cortical areas.
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Affiliation(s)
- C Varela
- Department of Neurobiology, The University of Chicago, 947 E. 58th Street, Chicago, IL 60637, USA
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Varela C. Anfípodos de las playas de arena del sur de Chile (Bahía de Maiquillahue, Valdivia). Studies on Neotropical Fauna and Environment 2008. [DOI: 10.1080/01650528309360617] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Coulombier D, Ciotti M, Freitas G, Frota A, Varela C, Vasconcelos P, Fernandes T. Strengthening Europe's epidemic intelligence capacity: the first collaboration between a European Union Member State and the European Centre for Disease Prevention and Control. Euro Surveill 2008; 13:8034. [PMID: 18445423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Affiliation(s)
- D Coulombier
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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Coulombier D, Ciotti M, Freitas G, Frota A, Varela C, Vasconcelos P, Fernandes T. Strengthening Europe's epidemic intelligence capacity: the first collaboration between a European Union Member State and the European Centre for Disease Prevention and Control. Euro Surveill 2008. [DOI: 10.2807/ese.13.06.08034-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Binary file ES_Abstracts_Final_ECDC.txt matches
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Affiliation(s)
- D Coulombier
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - M Ciotti
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - G Freitas
- Directorate-General of Health, Ministry of Health, Lisbon, Portugal
| | - A Frota
- Directorate-General of Health, Ministry of Health, Lisbon, Portugal
| | - C Varela
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - P Vasconcelos
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - T Fernandes
- Directorate-General of Health, Ministry of Health, Lisbon, Portugal
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Denny J, Threlfall J, Takkinen J, Lofdahl S, Westrell T, Varela C, Adak B, Boxall N, Ethelberg S, Torpdahl M, Straetemans M, van Pelt W. Multinational Salmonella Paratyphi B variant Java (Salmonella Java) outbreak, August - December 2007. ACTA ACUST UNITED AC 2007; 12:E071220.2. [PMID: 18179762 DOI: 10.2807/esw.12.51.03332-en] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- J Denny
- European Centre for Disease Prevention and Control, Stockholm, Sweden.
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Varela C, Sherman SM. Differences in Response to Muscarinic Activation Between First and Higher Order Thalamic Relays. J Neurophysiol 2007; 98:3538-47. [DOI: 10.1152/jn.00578.2007] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The mammalian thalamus is composed of two types of thalamocortical relay. First order relays receive information from subcortical sources and relay it to cortex, whereas higher order relays receive information from layer 5 of one cortical area and relay it to another. Recent reports suggest that modulatory inputs to first and higher order relays may differ. We used rat thalamic brain slices and whole cell recordings from relay cells in various first order (the lateral geniculate nucleus, the ventral posterior nucleus, and the ventral portion of the medial geniculate body) and higher order (the lateral posterior, the posterior medial nucleus, and the dorsal portion of the medial geniculate body) relays to explore their responses to activation of muscarinic receptors. We found that, whereas all first order relay cells show a depolarizing response to muscarinic activation, ∼20% of higher order relay cells respond with hyperpolarization. The depolarization is accompanied by an overall increase in input resistance, whereas the hyperpolarization correlates with a decrease in resistance. Because activation of cholinergic brain stem afferents to thalamus increases with increasing behavioral vigilance, the findings suggest that increased vigilance will depolarize all first order and most higher order relay cells but will hyperpolarize a significant subset of higher order relay cells. Such hyperpolarization is expected to bias these relay cells to the burst firing mode, and so these results are consistent with evidence of more bursting among higher order than first order relay cells.
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Nicoll A, Ciancio B, de la Hoz KF, Kreidl P, Needham H, Varela C, Vasconcelos P, Webber JT, Wurz A. Public Health Measures in an Influenza Pandemic - the importance of surveillance. Euro Surveill 2007; 12:E071101.4. [PMID: 17997909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Affiliation(s)
- A Nicoll
- European Centre for Disease Prevention and Control, Stockholm, Sweden.
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Vilanova M, Ugliano M, Varela C, Siebert T, Pretorius IS, Henschke PA. Assimilable nitrogen utilisation and production of volatile and non-volatile compounds in chemically defined medium by Saccharomyces cerevisiae wine yeasts. Appl Microbiol Biotechnol 2007; 77:145-57. [PMID: 17846763 DOI: 10.1007/s00253-007-1145-z] [Citation(s) in RCA: 133] [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] [Received: 04/05/2007] [Revised: 06/30/2007] [Accepted: 07/20/2007] [Indexed: 10/22/2022]
Abstract
Surveys conducted worldwide have shown that a significant proportion of grape musts are suboptimal for yeast nutrients, especially assimilable nitrogen. Nitrogen deficiencies are linked to slow and stuck fermentations and sulphidic off-flavour formation. Nitrogen supplementation of grape musts has become common practice; however, almost no information is available on the effects of nitrogen supplementation on wine flavour. In this study, the effect of ammonium supplementation of a synthetic medium over a wide range of nitrogen values on the production of volatile and non-volatile compounds by two high-nitrogen-demand wine fermentation strains of Saccharomyces cerevisiae was determined. To facilitate this investigation, a simplified chemically defined medium that resembles the nutrient composition of grape juice was used. Analysis of variance revealed that ammonium supplementation had significant effects on the concentration of residual sugar, L-malic acid, acetic acid and glycerol but not the ethanol concentration. While choice of yeast strain significantly affected half of the aroma compounds measured, nitrogen concentrations affected 23 compounds, including medium-chain alcohols and fatty acids and their esters. Principal component analysis showed that branched-chain fatty acids and their esters were associated with low nitrogen concentrations, whereas medium-chain fatty esters and acetic acid were associated with high nitrogen concentrations.
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Affiliation(s)
- M Vilanova
- Misión Biológica de Galicia, Consejo Superior de Investigaciones Cientificas, Pontevedra, Galicia, Spain
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Varela C, Coulombier D. Defining core competencies for epidemiologists working in communicable disease surveillance and response in the public health administrations of the European Union. Euro Surveill 2007; 12:E070802.2. [PMID: 17880886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Affiliation(s)
- C Varela
- European Centre for Disease Prevention and Control, Stockholm, Sweden
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Gómez Codina J, Provencio M, Rueda A, Capote F, Carbonell F, Conde E, Fernandez Rañada J, Giraldo P, Rios E, Varela C. Cost-effectiveness of rituximab maintenance therapy for patients with follicular lymphoma: The Spanish perspective. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.8092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
8092 Background: In patients with relapsed or refractory follicular lymphoma (FL) who attain a response with either cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) alone or Rituximab + CHOP, maintenance treatment with Rituximab has shown to significantly improve overall survival (OS) (85% at 3 years vs. 77%, p=0.011) and progression free survival (PFS) (51,5 vs. 14.9 months, p<0.001) as compared to observation alone (OA). We analyzed the cost-effectiveness, from a Spanish perspective, of Rituximab maintenance therapy (375mg/m2 every 3 months until progression or for 2 years) versus OA according to the population and data described for the European Organization for Research Treatment of Cancer (EORTC) 20981 study (van Oers MHJ Blood 2006). Methods: Incremental cost-effectiveness was assessed through a deterministic, three health states model (disease-free, progression and death) transition model. Base case model: PFS and OS were extrapolated from EORTC 20981 data using a Weibull distribution, Rituximab maintenance benefit was assumed to last 5 years, 10 years time horizon, 3.5% discount rate on costs and benefits, and Spanish National Health Service perspective (direct costs only). Resource use was estimated from a Spanish expert panel and EORTC 20981 study. Unit costs were obtained from local databases (May 2006 €). Health states utility values were derived from an ad hoc study. Sensitivity analyses were performed for all mentioned variables. Results: For the base case, more quality-adjusted life years (QALY), life-years (LY) and progression-free survival years per patient on maintenance therapy were obtained versus OA (incremental values of 0.85, 0.94 and 1.46, respectively). Total cost per patient was higher with Rituximab than with OA (+8,026€). Incremental cost per QALY gained was 9,358€, with a cost per LY gained of 8.493€ and a cost per PFS year gained of 5,485€. In the sensitivity analysis, values ranged between 7.263€ and 22.160€ per QALY gained. Conclusions: This study confirms that in patients with relapsed /refractory FL who attain a response with further therapy, maintenance treatment with Rituximab compared to observation alone is cost-effective. No significant financial relationships to disclose.
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Affiliation(s)
- J. Gómez Codina
- Hospital Universitario La Fe, Valencia, Spain; Hospital Clínica Puerta de Hierro, Madrid, Spain; Hospital Clínico Virgen de la Victoria, Malaga, Spain; Hospital Puerta del Mar, Cadiz, Spain; Hospital General Universitario, Valencia, Spain; Hospital Universitario Marques de Valdecilla, Santander, Spain; Hospital Universitario de la Princesa, Madrid, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Roche farma, Madrid, Spain
| | - M. Provencio
- Hospital Universitario La Fe, Valencia, Spain; Hospital Clínica Puerta de Hierro, Madrid, Spain; Hospital Clínico Virgen de la Victoria, Malaga, Spain; Hospital Puerta del Mar, Cadiz, Spain; Hospital General Universitario, Valencia, Spain; Hospital Universitario Marques de Valdecilla, Santander, Spain; Hospital Universitario de la Princesa, Madrid, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Roche farma, Madrid, Spain
| | - A. Rueda
- Hospital Universitario La Fe, Valencia, Spain; Hospital Clínica Puerta de Hierro, Madrid, Spain; Hospital Clínico Virgen de la Victoria, Malaga, Spain; Hospital Puerta del Mar, Cadiz, Spain; Hospital General Universitario, Valencia, Spain; Hospital Universitario Marques de Valdecilla, Santander, Spain; Hospital Universitario de la Princesa, Madrid, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Roche farma, Madrid, Spain
| | - F. Capote
- Hospital Universitario La Fe, Valencia, Spain; Hospital Clínica Puerta de Hierro, Madrid, Spain; Hospital Clínico Virgen de la Victoria, Malaga, Spain; Hospital Puerta del Mar, Cadiz, Spain; Hospital General Universitario, Valencia, Spain; Hospital Universitario Marques de Valdecilla, Santander, Spain; Hospital Universitario de la Princesa, Madrid, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Roche farma, Madrid, Spain
| | - F. Carbonell
- Hospital Universitario La Fe, Valencia, Spain; Hospital Clínica Puerta de Hierro, Madrid, Spain; Hospital Clínico Virgen de la Victoria, Malaga, Spain; Hospital Puerta del Mar, Cadiz, Spain; Hospital General Universitario, Valencia, Spain; Hospital Universitario Marques de Valdecilla, Santander, Spain; Hospital Universitario de la Princesa, Madrid, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Roche farma, Madrid, Spain
| | - E. Conde
- Hospital Universitario La Fe, Valencia, Spain; Hospital Clínica Puerta de Hierro, Madrid, Spain; Hospital Clínico Virgen de la Victoria, Malaga, Spain; Hospital Puerta del Mar, Cadiz, Spain; Hospital General Universitario, Valencia, Spain; Hospital Universitario Marques de Valdecilla, Santander, Spain; Hospital Universitario de la Princesa, Madrid, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Roche farma, Madrid, Spain
| | - J. Fernandez Rañada
- Hospital Universitario La Fe, Valencia, Spain; Hospital Clínica Puerta de Hierro, Madrid, Spain; Hospital Clínico Virgen de la Victoria, Malaga, Spain; Hospital Puerta del Mar, Cadiz, Spain; Hospital General Universitario, Valencia, Spain; Hospital Universitario Marques de Valdecilla, Santander, Spain; Hospital Universitario de la Princesa, Madrid, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Roche farma, Madrid, Spain
| | - P. Giraldo
- Hospital Universitario La Fe, Valencia, Spain; Hospital Clínica Puerta de Hierro, Madrid, Spain; Hospital Clínico Virgen de la Victoria, Malaga, Spain; Hospital Puerta del Mar, Cadiz, Spain; Hospital General Universitario, Valencia, Spain; Hospital Universitario Marques de Valdecilla, Santander, Spain; Hospital Universitario de la Princesa, Madrid, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Roche farma, Madrid, Spain
| | - E. Rios
- Hospital Universitario La Fe, Valencia, Spain; Hospital Clínica Puerta de Hierro, Madrid, Spain; Hospital Clínico Virgen de la Victoria, Malaga, Spain; Hospital Puerta del Mar, Cadiz, Spain; Hospital General Universitario, Valencia, Spain; Hospital Universitario Marques de Valdecilla, Santander, Spain; Hospital Universitario de la Princesa, Madrid, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Roche farma, Madrid, Spain
| | - C. Varela
- Hospital Universitario La Fe, Valencia, Spain; Hospital Clínica Puerta de Hierro, Madrid, Spain; Hospital Clínico Virgen de la Victoria, Malaga, Spain; Hospital Puerta del Mar, Cadiz, Spain; Hospital General Universitario, Valencia, Spain; Hospital Universitario Marques de Valdecilla, Santander, Spain; Hospital Universitario de la Princesa, Madrid, Spain; Hospital Miguel Servet, Zaragoza, Spain; Hospital Virgen del Rocio, Sevilla, Spain; Roche farma, Madrid, Spain
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Varela C, Palacio F, Reina MA, López A, Benito-León J. [Horner's syndrome secondary to epidural anesthesia]. Neurologia 2007; 22:196-200. [PMID: 17364261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023] Open
Abstract
INTRODUCTION The Horner's syndrome in association with the anesthetic techniques is produced by a blockade of the stellate ganglion sympathetic fibers. This complication is produced by the local anesthetic non-expected migration when it is administered either in the epidural space while performing an epidural block or inside the aponeurosis vascular elements during the performance of a brachial plexus block. Its evolution is quick, with benign incident that disappears in a few hours, without leaving any sequels. It can occur in patients without any previous clinical condition. CLINICAL CASE We described the case of 28 years old pregnant woman, with a body mass index of 40.6, without any previous neurological background, who was admitted into hospital for labour. She had epidural analgesia and needed a caesarean section 2 hours later. Twenty minutes after the administration of an epidural dose of local anesthetic, the patient developed a completed left side Horner's Syndrome, as well as ipsi-lateral brachial paresis, that lasted for three hours, with complete recovery. CONCLUSIONS Several etiopathologenic options were considered at the time, such as a possible subdural or paravertebral migration of the local anesthetic, the influence of the patient's position (decubitus) and the possible existence of fibrotic compartments in the epidurals space.
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Affiliation(s)
- C Varela
- Servicio de Anestesiología y Reanimación, Hospital Madrid Montepríncipe, Madrid, Spain
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Baca Baldomero E, Leal Cercós C, Varela C, Riesgo Y, Roca M. [Diagnostic process and management of schizophrenia in Spain: the ACEE project]. Actas Esp Psiquiatr 2006; 34:224-30. [PMID: 16823682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
INTRODUCTION Although schizophrenia has a great impact on the health care, social and family levels, there is little epidemiological information on patients with schizophrenia, its diagnosis and treatment in Spain. The ACEE (Abordaje Clínico de la Esquizofrenia en España; Clinical Approach to Schizophrenia in Spain) study was designed with the primary objective of defining the management of schizophrenia in Spain from the perspective of current clinical practice. METHOD ACEE is a descriptive cross-sectional multicenter observational study with data collected in the setting of current clinical practice by means of a specifically designed questionnaire. RESULTS A total of 1,937 patients have been studied (83% pertaining to the public sector and 17% to private one). Most subjects had paranoid schizophrenia in the stabilization phase, and did not work because of their illness. Most (96%) were receiving antipsychotic treatment and 55% also received some non-drug treatment. Negative symptoms were more frequent than positive symptoms (88% versus 63%). Significant differences were observed for type of patients and diagnostic procedures involved between the public and private health care sectors. CONCLUSIONS The ACEE study shows that schizophrenic patients attending Spanish psychiatric centers are mainly single, non-working males who are living in their family setting. Treatment basically consists of antipsychotics combined with other drugs, and few complementary examinations are performed.
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Abstract
We are developing a new method to characterize the margin of a mammographic mass lesion to improve the classification of benign and malignant masses. Towards this goal, we designed features that measure the degree of sharpness and microlobulation of mass margins. We calculated these features in a border region of the mass defined as a thin band along the mass contour. The importance of these features in the classification of benign and malignant masses was studied in relation to existing features used for mammographic mass detection. Features were divided into three groups, each representing a different mass segment: the interior region of a mass, the border and the outer area. The interior and the outer area of a mass were characterized using contrast and spiculation measures. Classification was done in two steps. First, features representing each of the three mass segments were merged into a neural network classifier resulting in a single regional classification score for each segment. Secondly, a classifier combined the three single scores into a final output to discriminate between benign and malignant lesions. We compared the classification performance of each regional classifier and the combined classifier on a data set of 1076 biopsy proved masses (590 malignant and 486 benign) from 481 women included in the Digital Database for Screening Mammography. Receiver operating characteristic (ROC) analysis was used to evaluate the accuracy of the classifiers. The area under the ROC curve (A(z)) was 0.69 for the interior mass segment, 0.76 for the border segment and 0.75 for the outer mass segment. The performance of the combined classifier was 0.81 for image-based and 0.83 for case-based evaluation. These results show that the combination of information from different mass segments is an effective approach for computer-aided characterization of mammographic masses. An advantage of this approach is that it allows the assessment of the contribution of regions rather than individual features. Results suggest that the border and the outer areas contained the most valuable information for discrimination between benign and malignant masses.
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Affiliation(s)
- C Varela
- Department of Radiology, Radboud University, Nijmegen Medical Centre, The Netherlands
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Michea L, Kunstmann S, Vukusic A, Alliende I, Varela C, Gainza D, Bravo S, Sepulveda D, Marusic E. Mo-P5:361 Non diabetic end stage renal disease patients in chronic hemodialysis have high prevalence of cardiovascular damage. ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)80492-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Oropesa P, Hernández AT, Serra RA, Varela C, Woods MJ. Some results of a simulated test for administration of activity in nuclear medicine. Appl Radiat Isot 2005; 64:475-84. [PMID: 16303312 DOI: 10.1016/j.apradiso.2005.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2005] [Revised: 07/05/2005] [Accepted: 10/11/2005] [Indexed: 11/30/2022]
Abstract
This paper describes the results obtained using a simulated test for administration of activity in nuclear medicine between 2002 and 2004. Measurements in the radionuclide calibrator are made during the different stages of the procedure. The test attempts to obtain supplementary information on the quality of the measurement, with the aim of evaluating in a more complete way the accuracy of the administered activity value compared with the prescribed one. The participants' performance has been assessed by means of a statistical analysis of the reported data. Dependences between several attributes of the simulated administration tests results are discussed. Specifically, the proportion of satisfactory results in the 2003-2004 period was found to be higher than in 2002. It reveals an improvement of the activity administration in the Cuban nuclear medicine departments since 2003.
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Affiliation(s)
- P Oropesa
- Centro de Isótopos (CENTIS), San José de las Lajas, Habana, Cuba.
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Oropesa P, Hernández AT, Serra R, Varela C. Comparisons of activity measurements with radionuclide calibrators—A tool for quality assessment and improvement in nuclear medicine. Appl Radiat Isot 2005; 63:493-503. [PMID: 16039865 DOI: 10.1016/j.apradiso.2005.05.051] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2005] [Revised: 05/11/2005] [Accepted: 05/12/2005] [Indexed: 10/25/2022]
Abstract
A national program of ongoing comparisons for assaying gamma-emitting radiopharmaceuticals for amount of radioactivity using radionuclide calibrators was begun in 2000. Nuclides of the most wide-spread use in Cuban nuclear medicine, 131I, 201Tl and (99m)Tc, as well as two measurement geometries, glass vials and plastic syringes, were employed. In this paper, the participants' performance is assessed by mean of a statistical analysis of the reported data. Performance tables have been obtained and a chi2 statistic is calculated from observed and expected frequencies, with the aim of testing the hypothesis about the independence of some characteristics of the comparison results, at a significance level alpha=0.05. The proportion of satisfactory results in the years 2002-2004 were found to be at the same level, but higher than in 2000. It reveals an improvement of the measurement quality since 2002. The causes of improvement were investigated using the statistical treatment of several data available as supplementary information.
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Affiliation(s)
- P Oropesa
- Centro de Isótopos (CENTIS), P.O. Box 3415, San José de las Lajas, Habana, Cuba.
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Jiménez M, Soler P, Venanzi JD, Canté P, Varela C, Martínez Navarro F. An outbreak of Campylobacter jejuni enteritis in a school of Madrid, Spain. Euro Surveill 2005; 10:118-21. [PMID: 15879642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
An outbreak of gastroenteritis caused by Campylobacter infection was identified in May 2003 in a school in Madrid, Spain. Eighty one cases were identified in a total of 253 people studied. A retrospective cohort study showed that a custard made with ultra high temperature (UHT) milk was associated with illness (RR: 3.15; 95% CI: 1.25-7.93). The custard was probably contaminated with Campylobacter jejuni from a raw chicken prepared a day previously in the same kitchen. Our recommendations were to periodically remind the school s authorities how to act if an outbreak should be suspected, to include the monitoring of a food handler s working day in each environmental investigation in order to detect any risk behaviour; to implement microbiological analysis from the surfaces and utensils of the collective kitchens and improve the sanitary education of food handlers.
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Affiliation(s)
- M Jiménez
- Epidemiology Training Program, Health Institute Carlos III, Madrid, Spain
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Jiménez M, Soler P, Venanzi JD, Canté P, Varela C, Martinez Navarro JF. An outbreak of Campylobacter jejuni enteritis in a school of Madrid, Spain. Euro Surveill 2005; 10:9-10. [DOI: 10.2807/esm.10.04.00533-en] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
An outbreak of gastroenteritis caused by Campylobacter infection was identified in May 2003 in a school in Madrid, Spain. Eighty one cases were identified in a total of 253 people studied. A retrospective cohort study showed that a custard made with ultra high temperature (UHT) milk was associated with illness (RR: 3.15; 95% CI: 1.25-7.93). The custard was probably contaminated with Campylobacter jejuni from a raw chicken prepared a day previously in the same kitchen. Our recommendations were to periodically remind the school’s authorities how to act if an outbreak should be suspected, to include the monitoring of a food handler’s working day in each environmental investigation in order to detect any risk behaviour; to implement microbiological analysis from the surfaces and utensils of the collective kitchens and improve the sanitary education of food handlers.
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Affiliation(s)
- M Jiménez
- Epidemiology Training Program. Health Institute Carlos III. Madrid. Spain
- Unit of Epidemiology. Public Health Institute of Madrid. Spain
| | - P Soler
- Epidemiology Training Program. Health Institute Carlos III. Madrid. Spain
| | - J D Venanzi
- Epidemiology Training Program. Health Institute Carlos III. Madrid. Spain
| | - P Canté
- Epidemiology Training Program. Health Institute Carlos III. Madrid. Spain
| | - C Varela
- Epidemiology Training Program. Health Institute Carlos III. Madrid. Spain
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Abstract
We used an in vitro slice preparation of the lateral geniculate nucleus in cats and rats to study morphological correlates of triadic circuitry in relay cells. The three triadic elements involve a retinal synapse onto a GABAergic dendritic terminal of an interneuron, a synapse from the same retinal terminal onto a relay cell dendrite, and a synapse from the same interneuron terminal onto the same relay cell dendrite. We made whole cell recordings and labeled cells with biocytin. Previous methods were used to identify triadic circuitry based on evidence that the retinal terminal activates a metabotropic glutamate receptor on the interneuronal terminal. Thus application of (+/-)-1-aminocyclopentane-trans-1,3-dicarboxylic acid (an agonist to that receptor) increases the rate of spontaneous inhibitory postsynaptic currents (sIPSCs) recorded in the relay cell, and if some of this increase remains with further addition of TTX (a TTX-insensitive response), a triad is indicated. We quantified the extent of the TTX-insensitive response and sought morphological correlates. In both rats and cats, this response correlated (negatively) with the number of primary dendrites and (positively) with polarity of the dendritic arbor. There was no correlation with cell size. Curiously, in cats, this response correlated with the presence of appendages at primary dendritic branches, but there was no such correlation in rats. These observations in cats map onto the X/Y classification, with X cells having triads, but it is not clear from our results if a comparable classification exists for rats.
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Affiliation(s)
- Y-W Lam
- Department of Neurobiology, State University of New York, Stony Brook, New York, USA
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Botella-Carretero JI, Escobar-Morreale HF, Martín I, Valero AM, Alvarez F, García G, Varela C, Cantarero M. Weight gain and cardiovascular risk factors during smoking cessation with bupropion or nicotine. Horm Metab Res 2004; 36:178-82. [PMID: 15057672 DOI: 10.1055/s-2004-814343] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Weight gain is frequent after smoking cessation, and may limit patient's will to quit and long-term success. Nicotine and bupropion are effective drugs for smoking withdrawal. However, their influence on weight gain, insulin resistance and other cardiovascular risk factors, as well as possible differences in obese and lean subjects, have not been fully evaluated. We randomised 25 lean and 25 obese smokers to receive either bupropion or nicotine patches. Clinical evaluation and lipid profile were performed at baseline and after treatment. Insulin resistance was also assessed at the end. Weight, BMI, waist-to-hip ratio, and diastolic blood pressure increased (p < 0.005), whereas lipid profile improved (p < 0.001) after smoking cessation independently of obesity at baseline or drug used. Obese patients had higher insulin resistance at the end (p < 0.05) regardless of drug used. Weight gain was inversely related to age (beta= - 0.125, R = 0.38, p = 0.046), and insulin resistance was related to obesity at baseline (beta = 0.85, R = 0.46, p = 0.02). In conclusion, weight gain after smoking cessation is not dependent on obesity or drug taken. A beneficial lipid profile is achieved after quitting smoking with either bupropion or nicotine patch in both obese and lean subjects.
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Montero-Odasso M, Schapira M, Varela C, Pitteri C, Soriano ER, Kaplan R, Camera LA, Mayorga LM. Gait velocity in senior people. An easy test for detecting mobility impairment in community elderly. J Nutr Health Aging 2004; 8:340-3. [PMID: 15359349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
BACKGROUND Functional assessment is an important part of the evaluation of elderly patients. Mobility problems detected by functional tests predict the development of more severe disability and injurious events such as falls and hip fractures. Several tests to evaluate mobility have been described, but most of them are difficult to perform by a primary care physicians or take much time in the ambulatory setting. PURPOSE To evaluate different mobility test to detect mobility impairment in community senior people. Select an easier test to perform on the ambulatory ward by a GP with the hypothesis that gait velocity could be an easier test to detect early mobility impairment. METHODS A cohort of 100 elderly subjects of 75 year and older were selected from our database and contacted by phone. The subjects were appointed and assessed by three geriatricians from January to May 2000. The measures including MMSE, Yesavage Test, ADL (Barhtel) and IADL (Lawton), the Get Up and Go test, the POMA, one leg balance test and the Gait Velocity (GV). A gait velocity of 0.8 m/s or lower was defined as a pathological gait velocity (PGV). RESULTS 95 subjects, mean age 79.63 (+/- 4) ranged form 75 to 95. Women in 71.3%. The ADLs were normal on 85% of the patients and the MMSE was normal on 78%. There was a significant association between pathological gait velocity (<0.8m/sec) and impairment on Get up and Go (OR 2.20; 95% CI 1.44-3.34), incapacity to perform the one leg balance test (OR 2.20; 95%CI: 1.43 - 4.71) and abnormal POMA test (OR 4.60; 95 %CI 1.5-14.7). Only 15% of the subjects with normal gait velocity reported recurrent falls in the previous 6 months while 35% of subjects with pathological gait velocity did. (OR 0.32 CI95% 010-099 p < 0.044). CONCLUSION The pathological gait velocity (<0.8m/sec) correlates with a pathologic performance of Get Up and Go test and POMA and with the incapacity to perform the One Leg Balance test. Also correlate with previous repeated falls in the last 6 (p <0.04). The gait velocity could be a test easy to perform, no time consuming, and an operative tool to apply in the ambulatory care to detect elderly patients with mobility impairment.
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Affiliation(s)
- M Montero-Odasso
- Geriatric Medicine Program and Internal Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires 1181(ACH), Argentina.
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