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Pérez Lázaro C, López-Bravo A, Gómez-Escalonilla Escobar C, Aguirre C, de Felipe A, de la Riva P, Calleja S, Arjona A, Serrano Ponz M, Navarro-Pérez MP, Delgado-Mederos R, Bashir Viturro S, Llul L, Egido J, García Madrona S, Díez González N, Benavente-Fernández L, de la Torre-Colmenero JD, Tejada Meza H, Vesperinas-Castro A, Sánchez-Cirera L, Trillo S. Management of cerebral venous thrombosis in Spain: MOTIVATE descriptive study. Neurologia 2024; 39:226-234. [PMID: 37442428 DOI: 10.1016/j.nrleng.2023.07.006] [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] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/22/2021] [Indexed: 07/15/2023] Open
Abstract
INTRODUCTION Cerebral venous thrombosis (CVT) is an uncommon cause of stroke that mainly affects young adults. Early, accurate diagnosis can reduce the rate and severity of complications. OBJECTIVE The aim of this study was to analyse the clinical characteristics, management, and treatment of CVT in different centres in Spain. METHODS We conducted a multicentre, retrospective, descriptive study of patients hospitalised due to CVT between 2008 and 2017 at 10 Spanish centres. RESULTS We included 256 patients, with a mean age (SD) of 49.8 (18.7) years; 51% of patients were women. The most frequent symptoms were headache (73%), focal deficits (50%), epileptic seizures (33%), and encephalopathy (21%). The most frequent localisations were the superior sagittal sinus (12.5%), the transverse sinus (10.9%), and 2 or more sinuses or veins (66.4%). Thrombophilia was the most frequent known aetiology (24%), and was most commonly associated with the prothrombin G20210A mutation (19%). Forty-six percent of patients were treated with antithrombotics for 3 to 6 months, 21% for one year, and 22.6% required indefinite anticoagulation. Endovascular therapy was performed in 5% of cases, and 33% required neurosurgery. Regarding outcomes, 75% of patients were independent at 3 months (modified Rankin Scale [mRS] score ≤ 2), with papilloedema (P = .03), focal deficits (P = .001), and encephalopathy (P < .001) showing a statistically significant association with poor prognosis (mRS > 3). The in-hospital mortality rate was 4.3%, with a 3-month mortality rate of 6.3%. CONCLUSION The diverse risk factors and variable presentation of CVT represent a challenge in the diagnosis and treatment of this condition. To improve prognosis and reduce mortality, it is essential to establish management protocols for this entity.
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Affiliation(s)
- C Pérez Lázaro
- Hospital Clínico Universitario «Lozano Blesa», Instituto de Investigación Sanitaria Aragón (IIS-A), Zaragoza, Spain
| | - A López-Bravo
- Hospital Clínico Universitario «Lozano Blesa», Instituto de Investigación Sanitaria Aragón (IIS-A), Zaragoza, Spain.
| | | | | | | | - P de la Riva
- Hospital Universitario Donosti, San Sebastián, Spain
| | - S Calleja
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | - A Arjona
- Hospital Universitario Torrecárdenas, Almería, Spain
| | | | - M P Navarro-Pérez
- Hospital Clínico Universitario «Lozano Blesa», Instituto de Investigación Sanitaria Aragón (IIS-A), Zaragoza, Spain
| | | | | | - L Llul
- Hospital Clínic, Barcelona, Spain
| | - J Egido
- Hospital Clínico San Carlos, Madrid, Spain
| | | | | | | | | | - H Tejada Meza
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | | | - S Trillo
- Hospital La Princesa, Madrid, Spain
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Reategui M, Reategui D, Morales E, Reategui R, Aguirre C. Effect of Geographic Altitude on Carbon Stock in two Physiographic Units of the Reserved Forest of the Universidad Nacional Agraria de la Selva. Nat Env Poll Tech 2023. [DOI: 10.46488/nept.2023.v22i01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
The objective of the research was to evaluate the effect of geographic altitude on the carbon stock in two physiographic units of the Reserved Forest of the Universidad Nacional Agraria de la Selva, Tingo Maria-Huanuco. The methodology used was the field manual for the remeasurement and establishment of plots of the Amazon Forest Inventory Network (RAINFOR), for which 2 hectares were permanently established (one hectare in low and high hills) in which the diameter (greater than or equal to 10 cm) and the height of the trees were measured. Finally, the density of the wood was obtained from previous studies. The pantropical model formula was used to estimate the carbon stock. The results show that geographic altitude significantly affects carbon stock (p < 0.05) in low and high-hill forests, concluding that this may be due to differences in meteorological variables such as precipitation, temperature, and humidity.
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Vera Sainz A, Cecconi A, Ximenez Carrillo A, Ramos C, Martinez Vives P, Lopez Melgar B, Sanz Garcia A, Ortega G, Montes A, Aguirre C, Vivancos J, Alfonso F, Jimenez-Borreguero LJ. Advanced echocardiography with left atrial strain and indexed left atrial 3D volume for predicting underlying atrial fibrillation after cryptogenic stroke. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Cryptogenic stroke (CS) represents one-third of ischemic strokes. Atrial fibrillation (AF) can be detected in up to 30% of CS. Therefore, there is a clinical need for predicting AF to guide the optimal secondary prevention strategy. The evidence about the role of advanced echocardiography, including left atrial 3D index volume and left atrial strain (LAS) techniques, to predict underlying AF in this setting is lacking.
Methods
From April 2019 to November 2021 seventy-eight consecutive patients with ischemic stroke or transient ischemic attack with ABCD2 scale ≥4 of unknown etiology were prospectively recruited. Echocardiography was performed during admission. All patients underwent 15 days wearable Holter monitoring. The primary outcome measure was AF detection during follow-up.
Results
Twenty -two patients (28%) developed AF. Patients in the AF group were older (81±6.3 vs 76.5±7.8 years; p=0.012). Left atrial (LA) diastolic indexed volume was higher in AF group (37.2±12.8 vs 29.7±11 ml/m2 p=0.01). 3D LA indexed volume were also higher in patients with AF (41.4±14 vs 32.2±10 ml/m2 p=0.009). LAS reservoir, LAS conduct and LAS contraction (LASct) were significantly lower in patients with AF (19±5.6 vs 32±10.3%; 9±4.5 vs 15±7.6; 10±5.3 vs 17±6.4, respectively, all p<0.001). On multivariate analysis LASct <13.5% and LA 3D indexed volume >44.5 ml/m2 were independent predictors of AF (OR 10.9 [95% CI 1.09–108.2], p=0.042) (Table 1, Figure 1)
Conclusion
LASct <13.5% and LA 3D indexed volume >44.5 ml/m2 are independent predictors of underlying AF in patients with CS. Our results demonstrate the usefulness of advanced echocardiography in this challenging clinical setting.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): Spanish Society of Cardiology
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Affiliation(s)
- A Vera Sainz
- Navarra University Hospital, Pamplona , Navarra , Spain
| | - A Cecconi
- University Hospital of La Princesa , Madrid , Spain
| | | | - C Ramos
- University Hospital of La Princesa , Madrid , Spain
| | | | | | | | - G Ortega
- University Hospital of La Princesa , Madrid , Spain
| | - A Montes
- University Hospital of La Princesa , Madrid , Spain
| | - C Aguirre
- University Hospital of La Princesa , Madrid , Spain
| | - J Vivancos
- University Hospital of La Princesa , Madrid , Spain
| | - F Alfonso
- University Hospital of La Princesa , Madrid , Spain
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Vera Sainz A, Cecconi A, Ximenez-Carrillo A, Ramos C, Martinez-Vives P, Lopez Melgar B, Sanz A, Ortega G, Aguirre C, Gamarra A, Montes A, De Rueda C, Vivancos J, Alfonso F, Jimenez Borreguero LJ. CHA2DS2VASC score for predicting atrial fibrillation in patients with cryptogenic stroke. Eur Heart J Cardiovasc Imaging 2022. [DOI: 10.1093/ehjci/jeab289.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Spanish Society of Cardiology
Introduction
CHA2DS2-VASc Score is widely used to predict thromboembolic risk in patients with Atrial Fibrillation (AF). However the role of CHA2DS2-VASC score for predicting AF in patients with cryptogenic stroke (CS) remains unknown.
Methods
Sixty-three consecutive patients with ischemic stroke or transient ischemic attack with ABCD2 scale≥4 of unknown etiology, were prospectively recruited. They were classified according to
CHA2DS2-VASc Score: group 1 (score ≤ 5), and group 2 (score >5). The primary outcome measure was the occurrence of AF during clinical follow-up.
Results
Twenty-six (41%) patients had a CHA2DS2VASC score > 5 (group 2). Patients in this group were older (81 ± 5.5 vs 75 ± 8 years; p < 0.001) and more frequently female (73% vs 43% p = 0.019). Patients in group 2 present more often hypertension (84% vs 43% p = 0.001), diabetes (38% vs 11%, p = 0.009) , dyslipidemia 77% vs 49%, p = 0.024), and a prior history of coronary artery disease (27% vs 5%, p = 0.026). Notably, patients with higher CHA2DS2VASC showed worse left atrial ejection fraction (41.7 ± 13.1 vs 52.2 ± 15%, p = 0.009) and worse left atrial strain reservoir (21.5 ± 7.1 vs 33.8 ± 11%, p < 0.001), conduct (9.5 ± 4.8 vs 16.6 ± 8.4%;p < 0.001) and contraction (12 ± 4.6 vs 17.2 ± 7.3, p = 0.002). During follow-up AF was detected more often in group 2 (42% vs 11% p = 0.006). In multivariate analysis CHA2SD2VAS > 5 was an independent predictor of AF in patients with CS (HR 7.3 [95% CI 1.2-45.6] p = 0.032)
Conclusion
A CHA2DS2VASC score >5 is an independent predictor of AF in patients with CS. This score provides a new clinical tool to inform clinicians with regards to the optimal treatment of these challenging patients
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Affiliation(s)
- A Vera Sainz
- University Hospital De La Princesa, Madrid, Spain
| | - A Cecconi
- University Hospital De La Princesa, Madrid, Spain
| | | | - C Ramos
- University Hospital De La Princesa, Madrid, Spain
| | | | | | - A Sanz
- University Hospital De La Princesa, Madrid, Spain
| | - G Ortega
- University Hospital De La Princesa, Madrid, Spain
| | - C Aguirre
- University Hospital De La Princesa, Madrid, Spain
| | - A Gamarra
- University Hospital De La Princesa, Madrid, Spain
| | - A Montes
- University Hospital De La Princesa, Madrid, Spain
| | - C De Rueda
- University Hospital De La Princesa, Madrid, Spain
| | - J Vivancos
- University Hospital De La Princesa, Madrid, Spain
| | - F Alfonso
- University Hospital De La Princesa, Madrid, Spain
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Cecconi A, Vera A, Ximenez-Carrillo A, Ramos C, Martinez-Vives P, Lopez Melgar C, Roquero Gimenez P, Martinez-Avial Silva M, Sanz-Garcia A, Ortega G, Aguirre C, Vivancos J, Alfonso F, Jimenez-Borreguero L. A comprehensive model to estimate underlying atrial fibrillation in cryptogenic stroke: the decrypting score. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Cryptogenic stroke (CS) represents up to 30% of ischemic strokes. Since atrial fibrillation (AF) can be detected in up to one-third of CS, there is a clinical need for estimating the probability of underlying AF in CS to guide the optimal secondary prevention strategy.
Surrogate markers of left atrial dysfunction such as left atrial size, left atrial strain (LAS) and NTproBNP has been described as predictors of AF in patients with CS. However the evidence about AF markers in comprehensive and prospective studies in CS is still limited.
Purpose
The present study was designed to develop the first score to predict underlying AF in CS patients that includes markers of atrial dysfunction. To reach our aim we developed a comprehensive analysis including clinical, laboratory, electrocardiografic and advanced echocardiographic variables in patients with CS.
Methods
Sixty-three consecutive patients with ischemic stroke or transient ischemic attack with ABCD2 scale ≥4 of unknown etiology were prospectively recruited. Clinical, laboratory, electrocardiografic and echocardiographic variables were collected. All patients underwent 15 days wearable Holter monitoring. Main objective was the Decryptoring score creation to predict AF in CS. Score variables were initially selected by a univariate logistic regression and, thereafter, the score points were derived according to a multivariant analysis.
Results
AF was detected in 15 patients (24%). Patients in the AF group were older (81.4±6.9 vs 76.5±7.8 years; p=0.035. There was no difference in sex between groups. Regarding cardiovascular risk factors patients who developed AF had more often hypertension (87% vs 52%; p=0.018) without differences in diabetes, dyslipidemia and tobacco consumption. T troponin and NTproBNP were higher in the AF group (47±55.9 vs 16.8±12.4 ng/L; p=0.018 and 1379±1650 vs 317±496 ng/ml; p=0.001 respectively). There were no differences in ECG parameters such as p wave voltage, interatrial block, PR interval or QRS.
LAS reservoir, LAS conduct and LAS contraction were lower in patients with AF (18.6±4.6 vs 32.1±10.9%; 8±4.3 vs 15.6±8%; 10.5±3.4 vs 16.6±7 respectively, all p<0.001).
Age >75 (9 points), hypertension (1 point), Troponin T >40 ng/L (8.5 points), NTproBNP >200 pg/ml (0.5 points), LAS reservoir <25.3% (24.5 points) and LAS conduct <10.4% (0.5 points) were included in the score. The rate of AF detection was 0% among patients with a score of <10 and 80% among patients with a score >35.
Conclusion
The proposed score offers an accurate AF prediction in patients with CS providing a new clinical tool to orient the optimal treatment in these patients.
Funding Acknowledgement
Type of funding sources: Other. Main funding source(s): Spanish Society of Cardiology
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Affiliation(s)
- A Cecconi
- Hospital Universitario La Princesa, Madrid, Spain
| | - A Vera
- Hospital Universitario La Princesa, Madrid, Spain
| | | | - C Ramos
- Hospital Universitario La Princesa, Madrid, Spain
| | | | | | | | | | | | - G Ortega
- Hospital Universitario La Princesa, Madrid, Spain
| | - C Aguirre
- Hospital Universitario La Princesa, Madrid, Spain
| | - J Vivancos
- Hospital Universitario La Princesa, Madrid, Spain
| | - F Alfonso
- Hospital Universitario La Princesa, Madrid, Spain
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6
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Pérez Lázaro C, López-Bravo A, Gómez-Escalonilla Escobar C, Aguirre C, de Felipe A, de la Riva P, Calleja S, Arjona A, Serrano Ponz M, Navarro-Pérez MP, Delgado-Mederos R, Bashir Viturro S, Llul L, Egido J, García Madrona S, Díez González N, Benavente Fernández L, de la Torre Colmenero JD, Tejada Meza H, Vesperinas Castro A, Sánchez Cirera L, Trillo S. Management of cerebral venous thrombosis in Spain: MOTIVATE descriptive study. Neurologia 2021:S0213-4853(21)00116-X. [PMID: 34511275 DOI: 10.1016/j.nrl.2021.05.016] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/29/2021] [Accepted: 05/22/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Cerebral venous thrombosis (CVT) is an uncommon cause of stroke that mainly affects young adults. Early, accurate diagnosis can reduce the rate and severity of complications. OBJECTIVE The aim of this study was to analyse the clinical characteristics, management, and treatment of CVT in different centres in Spain. METHODS We conducted a multicentre, retrospective, descriptive study of patients hospitalised due to CVT between 2008 and 2017 at 11 Spanish centres. RESULTS We included 256 patients, with a mean age (SD) of 49.8 (18.7) years; 51% of patients were women. The most frequent symptoms were headache (73%), focal deficits (50%), epileptic seizures (33%), and encephalopathy (21%). The most frequent localisations were the superior sagittal sinus (12.5%), the transverse sinus (10.9%), and 2 or more sinuses or veins (66.4%). Thrombophilia was the most frequent known aetiology (24%), and was most commonly associated with the prothrombin G20210A mutation (19%). Forty-six percent of patients were treated with antithrombotics for 3-6 months, 21% for one year, and 22.6% required indefinite anticoagulation. Endovascular therapy was performed in 5% of cases, and 33% required neurosurgery. Regarding outcomes, 75% of patients were independent at 3 months (modified Rankin Scale [mRS] score ≤ 2), with papilloedema (P=.03), focal deficits (P=.001), and encephalopathy (P <.001) showing a statistically significant association with poor prognosis (mRS> 3). The in-hospital mortality rate was 4.3%, with a 3-month mortality rate of 6.3%. CONCLUSION The diverse risk factors and variable presentation of CVT represent a challenge in the diagnosis and treatment of this condition. To improve prognosis and reduce mortality, it is essential to establish management protocols for this entity.
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Affiliation(s)
- C Pérez Lázaro
- Hospital Clínico Universitario «Lozano Blesa», Instituto de Investigación Sanitaria Aragón (IIS-A), Zaragoza, España
| | - A López-Bravo
- Hospital Clínico Universitario «Lozano Blesa», Instituto de Investigación Sanitaria Aragón (IIS-A), Zaragoza, España.
| | | | - C Aguirre
- Hospital La Princesa, Madrid, España
| | | | - P de la Riva
- Hospital Universitario Donosti, San Sebastián, España
| | - S Calleja
- Hospital Universitario Central de Asturias, Oviedo, España
| | - A Arjona
- Hospital Universitario Torrecárdenas, Almería, España
| | | | - M P Navarro-Pérez
- Hospital Clínico Universitario «Lozano Blesa», Instituto de Investigación Sanitaria Aragón (IIS-A), Zaragoza, España
| | | | | | - L Llul
- Hospital Clínic, Barcelona, España
| | - J Egido
- Hospital Clínico San Carlos, Madrid, España
| | | | | | | | | | - H Tejada Meza
- Hospital Universitario Miguel Servet, Zaragoza, España
| | | | | | - S Trillo
- Hospital La Princesa, Madrid, España
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7
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Catho H, Guigard S, Toffart AC, Frey G, Chollier T, Brichon PY, Roux JF, Sakhri L, Bertrand D, Aguirre C, Gorain S, Wuyam B, Arbib F, Borel JC. What are the barriers to the completion of a home-based rehabilitation programme for patients awaiting surgery for lung cancer: a prospective observational study. BMJ Open 2021; 11:e041907. [PMID: 33568371 PMCID: PMC7878140 DOI: 10.1136/bmjopen-2020-041907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES Home-based rehabilitation programmes (H-RPs) could facilitate the implementation of pulmonary rehabilitation prior to resection for non-small cell lung cancer (NSCLC), but their feasibility has not been evaluated. The aim of this study was to identify determinants of non-completion of an H-RP and the factors associated with medical events occurring 30 days after hospital discharge. DESIGN A prospective observational study. INTERVENTION All patients with confirmed or suspected NSCLC were enrolled in a four-component H-RP prior to surgery: (i) smoking cessation, (ii) nutritional support, (iii) physiotherapy (at least one session/week) and (iv) home cycle-ergometry (at least three times/week). OUTCOMES The H-RP was defined as 'completed' if the four components were performed before surgery. RESULTS Out of 50 patients included, 42 underwent surgery (80% men; median age: 69 (IQR 25%-75%; 60-74) years; 64% Chronic Obstructive Pulmonary Disease (COPD); 29% type 2 diabetes). Twenty patients (48%) completed 100% of the programme. The median (IQR) duration of the H-RP was 32 (19; 46) days. Multivariate analysis showed polypharmacy (n=24) OR=12.2 (95% CI 2.0 to 74.2), living alone (n=8) (single vs couple) OR=21.5 (95% CI 1.4 to >100) and a long delay before starting the H-RP (n=18) OR=6.24 (95% CI 1.1 to 36.6) were independently associated with a risk of non-completion. In univariate analyses, factors associated with medical events at 30 days were H-RP non-completion, diabetes, polypharmacy, social precariousness and female sex. CONCLUSION Facing multiple comorbidities, living alone and a long delay before starting the rehabilitation increase the risk of not completing preoperative H-RP. TRIAL REGISTRATION NUMBER NCT03530059.
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Affiliation(s)
- Heloise Catho
- Department of Pneumology, University Hospital of Grenoble, Grenoble, France
| | - Sebastien Guigard
- Department of Thoracic surgery, Clinique Belledonne, Grenoble, France
| | - Anne-Claire Toffart
- Department of Pneumo-oncology, University Hospital of Grenoble, Grenoble, France
| | - Gil Frey
- Department of Thoracic surgery, University Hospital of Grenoble, Grenoble, France
| | - Thibaut Chollier
- Department of Thoracic surgery, University Hospital of Grenoble, Grenoble, France
| | - Pierre-Yves Brichon
- Department of Thoracic surgery, University Hospital of Grenoble, Grenoble, France
| | | | - Linda Sakhri
- Department of Oncology, Institut Daniel Hollard, groupe hospitalier mutualiste, Grenoble, France
| | | | | | - Sandy Gorain
- Research and Development, Agir à Dom, Association, Meylan, France
| | - Bernard Wuyam
- Clinical Research, HP2, INSERM U1042, Université Grenoble Alpes, Grenoble, France
- Sleep Laboratory and Exercise Physiology, Thorax and Vessels Division, Grenoble Alps University Hospital, Grenoble, France
| | - François Arbib
- Department of Pneumology, University Hospital of Grenoble, Grenoble, France
| | - Jean Christian Borel
- Research and Development, Agir à Dom, Association, Meylan, France
- Clinical Research, HP2, INSERM U1042, Université Grenoble Alpes, Grenoble, France
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Vera Sainz A, Cecconi A, Martinez Vives P, Ximenez Carrillo A, Aguirre C, Ramos C, Benedicto A, Diego G, Dominguez L, Lopez B, Rojas A, Gamarra A, Vivancos J, Jimenez Borreguero LJ, Alfonso F. Predictors of atrial fibrillation in patients with cryptogenic stroke and fifteen-days electrocardiographic monitoring. Preliminary results of the DECRYPTORING study. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
onbehalf
DECRYPTORING study
Introduction
Cryptogenic stroke (CS) represents up to 30% of all stroke types. In one third of CS, atrial fibrillation (AF) is identified as the underlying cause. Predictors of AF in the setting of CS have been described, however these findings were based on retrospective studies and with maximum ECG monitoring of 72 hours. To overcome these limitations, we designed the prospective Decryptoring study whose objective is to create a comprehensive predictive model for AF in patients with CS.
Methods
From April 2019, 41 consecutive patients with a CS and age > 60 years were included. On admission, a transthoracic echocardiogram with 3D volume and left atrial (LA) strain was performed. All patients were monitored with a 15-day ECG-Holter after discharge. Patients were classified according to AF detection.
Results
AF was detected in 9 patients (22%). Patients with AF were older (75.9 ± 8 vs. 81.9 ± 4.3 years, p = 0.041). There was no difference in T-troponin levels. NTproBNP was higher in the group with AF (350 ± 586 pg / ml vs. 1084 ± 1416 pg / ml, p = 0.018). Regarding LA strain, patients with AF presented reservoir LA strain (25.5 ± 8.2% vs 17.4 ± 4.3%; p = 0.006) and conduct LA strain (12 ± 5.2% vs 7.2 ± 1.5%; p = 0.01) lower than patients without AF. There were no differences in contraction LA strain or other echocardiographic variables. The risk of developing AF was higher in patients with NTproBNP> 165 pg / ml (OR 11.3 [95% CI 1.2-102.9] p = 0.031), LA reservoir strain <19.1% (OR 7.7 [IC 95 % 1.5-40.0] p = 0.016) and LA conduct strain <9.1% (OR 7.8 [95% CI 1.3-45.0] p = 0.022) (Table).
Conclusions
This prospective study, demonstrates that high NTproBNP, low reservoir LA strain and low conduct LA strain are associated with underlying AF in patients with cryptogenic stroke.
No AF (n = 32) AF (n = 9) P value Age (years) 75.9 ± 8 81.9 ± 4.3 p = 0.041 NTPROBNP (pg/ml) 350 ± 586 1084 ± 1416 P = 0.018 LA indexed diastolic volume (ml/m2) 30 ± 11.8 33.8 ± 9.8 P = 0.35 LA EF (%) 45 ± 16.7 45 ± 12.8 P = 1 Reservoir LA strain (%) 25.5± 8.2 17.4± 4.3 P = 0.006 Conduct LA strain (%) 12 ± 5.2 7.2 ± 1.5 P = 0.01 Contraction LA strain (%) 13.5 ±5.3 10.2± 3.9 P = 0.10 NTPROBNP > 165 pg/ml 12 (41%) 8 (89%) OR 11.3 [IC 95% 1.2-102.9]; p = 0.031 Reservoir LA strain <19.1% 6 (20%) 6 (67%) OR 7.7 [IC 95% 1.5-40.0]; p = 0.016 Conduct LA strain <9.1% 9 (31%) 7 (78%) OR 7.8 [IC 95% 1.3-45.1]; p = 0.022
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Affiliation(s)
- A Vera Sainz
- University Hospital De La Princesa, Madrid, Spain
| | - A Cecconi
- University Hospital De La Princesa, Madrid, Spain
| | | | | | - C Aguirre
- University Hospital De La Princesa, Madrid, Spain
| | - C Ramos
- University Hospital De La Princesa, Madrid, Spain
| | - A Benedicto
- University Hospital De La Princesa, Madrid, Spain
| | - G Diego
- University Hospital De La Princesa, Madrid, Spain
| | - L Dominguez
- University Hospital De La Princesa, Madrid, Spain
| | - B Lopez
- University Hospital De La Princesa, Madrid, Spain
| | - A Rojas
- University Hospital De La Princesa, Madrid, Spain
| | - A Gamarra
- University Hospital De La Princesa, Madrid, Spain
| | - J Vivancos
- University Hospital De La Princesa, Madrid, Spain
| | | | - F Alfonso
- University Hospital De La Princesa, Madrid, Spain
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Muro I, Ximénez-Carrillo A, Carreras MT, de la Fuente E, Aizpún A, Orts M, Ramasco F, Barbosa A, Vivancos J, Aguirre C. [Multiple cerebral haemorrhages secondary to disseminated intravascular coagulation in a patient with COVID-19]. Rev Neurol 2021; 72:33-34. [PMID: 33378077 DOI: 10.33588/rn.7201.2020448] [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: 11/24/2022]
Affiliation(s)
- I Muro
- Hospital Universitario La Princesa. Instituto de Investigación Sanitaria Princesa, Madrid, España
| | - A Ximénez-Carrillo
- Hospital Universitario La Princesa. Instituto de Investigación Sanitaria Princesa, Madrid, España
| | - M T Carreras
- Hospital Universitario La Princesa. Instituto de Investigación Sanitaria Princesa, Madrid, España
| | - E de la Fuente
- Hospital Universitario La Princesa. Instituto de Investigación Sanitaria Princesa, Madrid, España
| | - A Aizpún
- Hospital Universitario La Princesa. Instituto de Investigación Sanitaria Princesa, Madrid, España
| | - M Orts
- Hospital Universitario La Princesa. Instituto de Investigación Sanitaria Princesa, Madrid, España
| | - F Ramasco
- Hospital Universitario La Princesa. Instituto de Investigación Sanitaria Princesa, Madrid, España
| | - A Barbosa
- Hospital Universitario La Princesa. Instituto de Investigación Sanitaria Princesa, Madrid, España
| | - J Vivancos
- Hospital Universitario La Princesa. Instituto de Investigación Sanitaria Princesa, Madrid, España
| | - C Aguirre
- Hospital Universitario La Princesa. Instituto de Investigación Sanitaria Princesa, Madrid, España
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Ikenaka K, Aguirre C, Araki K, So M, Kakuda K, Nagano S, Hideki M. Structural variations in αSyn fibrils of Parkinson’s disease and related disorders. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.995] [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: 11/29/2022]
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Lertxundi U, Marquínez AC, Domingo-Echaburu S, Solinís MÁ, Calvo B, Del Pozo-Rodríguez A, García M, Aguirre C, Isla A. Hiccups in Parkinson's disease: an analysis of cases reported in the European pharmacovigilance database and a review of the literature. Eur J Clin Pharmacol 2017; 73:1159-1164. [PMID: 28600702 DOI: 10.1007/s00228-017-2275-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 05/26/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Some reports have suggested an association between dopamine agonists and hiccups, involuntary contractions that merit full clinical attention because they can be very debilitating. Many drugs frequently used to treat hiccups are formally contraindicated in Parkinson's disease due to their liability to worsen motor symptoms, making the treatment of hiccups problematic in this disease. The objective of the present study was to analyze all spontaneous reports of hiccups from the European Pharmacovigilance Database in patients with Parkinson's disease and/or on dopaminergic drugs. Finally, we sought to identify evidence-based recommendations on the management of hiccups in Parkinson's disease. METHODS We searched for all reports of hiccups in the European Pharmacovigilance Database (EudraVigilance) and calculated proportional reporting ratios for dopamine agonists and hiccups. We reviewed the literature on Parkinson's disease, dopamine agonists, and hiccups, searching for specific treatment recommendations for hiccups in this disease. RESULTS Both rotigotine and pramipexole fulfilled the criteria to generate a safety signal. We found 32 and 13 cases of hiccups associated with dopamine agonists in EudraVigilance and the literature, respectively. There were no specific recommendations for the management of hiccups in Parkinson's disease in the clinical guidelines consulted. CONCLUSIONS We have found evidence that rotigotine and pramipexole are associated with the appearance of hiccups and that this adverse reaction occurs predominantly in males. Given the scarce information available, specific recommendations are needed in clinical guidelines for the adequate management of hiccups in Parkinson's disease.
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Affiliation(s)
- U Lertxundi
- Pharmacy Service, Araba Mental Health Network, C/Alava 43, 01006, Vitoria-Gasteiz, Alava, Spain.
| | - A C Marquínez
- Pharmacokinetic, Nanotechnology and Gene Therapy Group (PharmaNanoGene), Faculty of Pharmacy, Lascaray Research Center, University of the Basque Country UPV/EHU, Paseo de la Universidad, 7, 01006, Vitoria-Gasteiz, Spain
| | - S Domingo-Echaburu
- Pharmacy Service, Alto Deba Integrated Health Organization, Avda. Nafarroa 16, 20500, Arrasate Gipuzkoa, Spain
| | - M Á Solinís
- Pharmacokinetic, Nanotechnology and Gene Therapy Group (PharmaNanoGene), Faculty of Pharmacy, Lascaray Research Center, University of the Basque Country UPV/EHU, Paseo de la Universidad, 7, 01006, Vitoria-Gasteiz, Spain
| | - B Calvo
- Pharmacokinetic, Nanotechnology and Gene Therapy Group (PharmaNanoGene), Faculty of Pharmacy, Lascaray Research Center, University of the Basque Country UPV/EHU, Paseo de la Universidad, 7, 01006, Vitoria-Gasteiz, Spain
| | - A Del Pozo-Rodríguez
- Pharmacokinetic, Nanotechnology and Gene Therapy Group (PharmaNanoGene), Faculty of Pharmacy, Lascaray Research Center, University of the Basque Country UPV/EHU, Paseo de la Universidad, 7, 01006, Vitoria-Gasteiz, Spain
| | - M García
- Basque Pharmacovigilance Unit, Hospital de Galdakao-Usansolo, Galdakao, Spain
| | - C Aguirre
- Basque Pharmacovigilance Unit, Hospital de Galdakao-Usansolo, Galdakao, Spain
| | - A Isla
- Pharmacokinetic, Nanotechnology and Gene Therapy Group (PharmaNanoGene), Faculty of Pharmacy, Lascaray Research Center, University of the Basque Country UPV/EHU, Paseo de la Universidad, 7, 01006, Vitoria-Gasteiz, Spain
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Palomino W, Aguirre C, Argandoña F, Ventureira M, Kohen P, Devoto L. Abnormal endometrial expression of complement regulatory protein decay accelerating factor in women with recurrent implantation failure in cycles of assisted reproduction. Placenta 2017. [DOI: 10.1016/j.placenta.2017.01.076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Landin-Romero R, McKenna PJ, Romaguera A, Álvarez-Moya E, Sarró S, Aguirre C, Sarri C, Compte A, Bosque C, Salvador R, Pomarol-Clotet E. Examining the continuum of psychosis: Frequency and characteristics of psychotic-like symptoms in relatives and non-relatives of patients with schizophrenia. Schizophr Res 2016; 178:6-11. [PMID: 27632907 DOI: 10.1016/j.schres.2016.07.015] [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] [Received: 05/04/2016] [Revised: 07/07/2016] [Accepted: 07/15/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND A key finding underlying the continuum of psychosis concept is the presence of psychotic-like experiences (PLEs) in healthy subjects. However, it remains uncertain to what extent these experiences are related to the genetic risk for schizophrenia and how far they actually resemble attenuated forms of psychotic symptoms. METHODS Forty-nine adults with no history of mental illness in first-degree relatives and 59 siblings of patients with schizophrenia were rated on the psychosis section of the Computerized Diagnostic Interview Schedule IV (C DIS-IV) and the Rust Inventory of Schizotypal Cognitions (RISC). Those who rated positive on the CDIS-IV were re-interviewed using the lifetime version of the Present State Examination 9th edition (PSE-9) and the Structured interview for Schizotypy (SIS). RESULTS Seventeen (34.69%) of the non-relatives and 22 (37.29%) of the relatives responded positively to one or more of the psychosis questions on the DIS. This difference was not significant. RISC scores were also similar between the groups. At follow-up interview with the PSE-9, 13/40 PLEs (32.50%) in the non-relatives were classified as possible or probable psychotic symptoms compared to 11/46 (23.91%) in the relatives. Using liberal symptom thresholds, 5 of those who attended the follow-up interview (2 non-relatives and 3 relatives) met SIS criteria for schizotypal personality disorder. CONCLUSIONS Rates of PLEs, however considered, do not differ substantially between relatives and non-relatives of patients with schizophrenia. Only a minority of PLEs picked up by screening interviews resemble attenuated forms of psychotic symptoms.
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Affiliation(s)
- R Landin-Romero
- FIDMAG Germanes Hospitalàries, Barcelona, Spain; Neuroscience Research Australia, Sydney, Australia
| | - P J McKenna
- FIDMAG Germanes Hospitalàries, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
| | - A Romaguera
- FIDMAG Germanes Hospitalàries, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - E Álvarez-Moya
- Benito Menni Complex Assistencial en Salut Mental, Barcelona, Spain
| | - S Sarró
- FIDMAG Germanes Hospitalàries, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - C Aguirre
- FIDMAG Germanes Hospitalàries, Barcelona, Spain; Benito Menni Complex Assistencial en Salut Mental, Barcelona, Spain
| | - C Sarri
- FIDMAG Germanes Hospitalàries, Barcelona, Spain; Benito Menni Complex Assistencial en Salut Mental, Barcelona, Spain
| | - A Compte
- FIDMAG Germanes Hospitalàries, Barcelona, Spain; Benito Menni Complex Assistencial en Salut Mental, Barcelona, Spain
| | - C Bosque
- FIDMAG Germanes Hospitalàries, Barcelona, Spain; Benito Menni Complex Assistencial en Salut Mental, Barcelona, Spain
| | - R Salvador
- FIDMAG Germanes Hospitalàries, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - E Pomarol-Clotet
- FIDMAG Germanes Hospitalàries, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
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Ruiz-Irastorza G, Egurbide MV, Martinez-Berriotxoa A, Ugalde J, Aguirre C. Antiphospholipid antibodies predict early damage in patients with systemic lupus erythematosus. Lupus 2016; 13:900-5. [PMID: 15645743 DOI: 10.1191/0961203304lu2030oa] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [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 aim of this study was to determine whether the different autoantibodies predict early damage in patients with systemic lupus erythematosus (SLE). The patients comprised a prospective inception cohort of 205 patients with SLE, 154 on follow-up for at least five years after diagnosis. Eight patients who died before the fifth year of disease course were included in analyses comprising survival. Organ damage was measured using the Systemic Lupus International Collaborating Clinics - American College of Rheumatology damage index (SDI). Endpoints were the development of some (SDI ≥1) or severe (SDI > 2) damage at five years after diagnosis or the combined outcome ‘SDI ≥1 or death at five years’. Autoantibodies [anti-DNA, anti-Ro, anti-La, anti-Sm, anti-U1 RNP, any anti-ENA and antiphospholipid (aPL)] were included in univariate and multivariate analysis. ‘Age at diagnosis’ was also included as an independent variable in multivariant analyses. Sapporo criteria were used to define aPL positivity. Eighty-four patients (54.5%) had accrued damage at five years, 17 patients (11.0%) having severe damage. Patients with aPL had damage in a higher proportion (63.2% any damage, 17.6% severe damage). Only aPL were related to damage in univariate analysis ( P = 0.03). In logistic regression models, aPL were the only independent predictors of damage at five years (OR 1.94, 95% CI 1.01-3.73), severe damage at five years (OR 3.34, 95% CI 1.11-10.03) and increasing damage since diagnosis (OR 2.46, 95% CI 1.24-4.87). No autoantibody was a predictor of the outcome ‘SDI ≥1 or death at five years’. The conclusion was that aPL predict early damage in patients with SLE.
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Affiliation(s)
- G Ruiz-Irastorza
- Service and Department of Internal Medicine, Hospital de Cruces, Universidad del Pais Vasco/ Euskal Herriko Unibertsitatea, Bizkaia, The Basque Country, Spain.
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Abstract
The incidence and severity of tuberculosis (TB) in patients with systemic lupus erythematosus (SLE) varies greatly among different series. In addition, prospective data are scarce. The aim of this study is to analyse the frequency and severity of TB in our cohort of lupus patients. We analysed data from a prospective database of a single center cohort of 232 patients with SLE (ACR criteria). Prophylaxis with isoniazid was not regularly administered. We identified all cases of TB diagnosed during 10 years (January 1994 to December 2003). The following variables were analysed: annual incidence of TB, location of infection and response to therapy. Data from published series reporting on the incidence of TB among SLE patients were extracted. Three patients (1.3%) suffered clinically manifest TB in 1603 patient-years of follow-up, resulting in an incidence of 187 cases/100 000 patient-years (95% CI 39-547). The pooled annual incidence of TB infection in our area during this period was 30/100 000 individuals. We recorded two cases of pulmonary TB and one case of tuberculous pleurisy. All patients had good response to therapy. The annual incidence of TB among SLE patients in other series, most of them from developing countries, varied between 150/100 000 patients in Turkey and 2450/100 000 patients in India. Of note, high prevalence of extrapulmonary forms as well as elevated TB-associated mortality was reported in most series. TB was more frequent in SLE patients than expected in the general population. We did not see any cases of disseminated infection and all patients had good response to treatment. Our data compare favourably in terms of incidence, severity and outcome with those from highly endemic areas.
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Affiliation(s)
- J G Erdozain
- Department of Internal Medicine, Hospital de Cruces, University of the Basque Country, Bizkaia, Spain
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Ruiz-Irastorza G, Egurbide MV, Pijoan JI, Garmendia M, Villar I, Martinez-Berriotxoa A, Erdozain JG, Aguirre C. Effect of antimalarials on thrombosis and survival in patients with systemic lupus erythematosus. Lupus 2016; 15:577-83. [PMID: 17080912 DOI: 10.1177/0961203306071872] [Citation(s) in RCA: 279] [Impact Index Per Article: 34.9] [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: 11/16/2022]
Abstract
Antimalarials have shown beneficial effects on systemic lupus erythematosus (SLE) activity. Our aim was to investigate whether antimalarials protect against thrombosis and influence survival in SLE patients. A prospective cohort including 232 patients with SLE were included in the study at the time of lupus diagnosis. End points were documented thrombosis and death due to any cause. A Cox regression-multiple-failure time survival analysis model was fitted to establish the effect of antimalarials on the development of thrombosis. Kaplan-Meier survival curves and propensity score adjusted-Cox regression analysis were performed to investigate the effect of antimalarials use on survival. Of our subjects, 204 patients (88%) were women. 230 patients (99%) were white. 150 patients (64%) had ever received antimalarials. Median time on antimalarials was 52 months (range three to 228 months). The Cox multiple-failure time survival analysis showed that taking antimalarials was protective against thrombosis (HR 0.28, 95%CI 0.08-0.90), while aPL-positivity (HR 3.16, 95%CI 1.45-6.88) and previous thrombosis (HR 3.85, 95%CI 1.50-9.91) increased the risk of thrombotic events. Twenty-three patients died, 19 of whom (83%) had never received antimalarials. No patient treated with antimalarials died of cardiovascular complications. Cumulative 15-year survival rates were 0.68 for never versus 0.95 for ever treated patients ( P < 0.001). Age at diagnosis and propensity score-adjusted HR for antimalarials ever versus never users was 0.14 (95%CI 0.04-0.48). Our study shows a protective effect of antimalarials against thrombosis and an increased survival of SLE patients taking these drugs. These data support the routine use of antimalarials in all patients with SLE.
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Affiliation(s)
- G Ruiz-Irastorza
- Department of Internal Medicine, Hospital de Cruces, University of the Basque Country, Bizkaia, Spain.
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Martínez-Berriotxoa A, Ruiz-Irastorza G, Egurbide MV, Rueda M, Aguirre C. Homocysteine, antiphospholipid antibodies and risk of thrombosis in patients with systemic lupus erythematosus. Lupus 2016; 13:927-33. [PMID: 15645748 DOI: 10.1191/0961203304lu2035oa] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Cardiovascular disease is a major cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Antiphospholipid syndrome (APS) is one of the most important causes of thrombosis in SLE. In addition, an association between hyperhomocysteinemia and increased cardiovascular risk has also been reported. Our aim is to analyse the association of thrombosis with plasma total homocysteine (ptHcy), antiphospholipid antibodies (aPL) and other vascular risk factors in SLE patients. Fasting plasma levels of ptHcy, vitamin B12, folate, total cholesterol and creatinine were measured in 117 SLE patients. Clinical and immunological data were obtained from our prospective computerized database. aPL-positivity was defined according to Sapporo criteria. There was no association between aPL and ptHcy. ptHcy was higher in patients with arterial (median 13.02 versus 10.16 mmol/L, P = 0.010) but not venous thrombosis. In the subgroup analysis, this association was only seen in aPL-negative patients. In logistic regression, aPL (OR 6.60, 95% CI 1.86-23.34) and ptHcy (OR 1.10, 95% CI 1.01-1.19) were independently associated with arterial thrombosis. However, when hypertension, smoking and plasma total cholesterol were added to the model, only aPL (OR 7.38, 95% CI 2.02-26.91) and hypertension (OR 7.70, 95% CI 2.33-25.39), but not ptHcy, remained independently related to arterial events. aPL was the only variable independently related to venous thrombosis (OR 7.68, 95% CI 1.60-36.86). ptHcy concentrations are higher in SLE patients with arterial thrombosis. No interaction between homocysteine and aPL was found. Raised ptHcy may be a marker of increased vascular risk in aPL-negative SLE patients. The role of homocysteine as a marker of vascular risk may depend on the presence of traditional risk factors, although a modest intrinsic effect cannot be entirely excluded.
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Affiliation(s)
- A Martínez-Berriotxoa
- Service of Internal Medicine, Hospital de Cruces Universidad del Pais Vasco/Euskal Herriko Unibertsitatea, Bizkaia, The Basque Country, Spain
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Abstract
Hypercalcemia is a common electrolyte abnormality with a wide differential diagnosis. Primary hyperparathyroidismand malignancy are the most frequent causes, accounting for more than 90% of cases. We report the case of a woman presenting with symptomatic severe hypercalcemia, who was subsequently diagnosed with systemic lupus erythematosus (SLE) due to the presence of arthritis, lymphopenia, antinuclear antibodies (ANA), anti-DNA and anti-Ro antibodies and low C3 levels. After acute treatment with intravenous fluids, steroids, diuretics and pamidronate, calcium levels corrected and have remained normal on low-dose prednisone.Five similar cases have been reported in the literature. Thus, SLE is an uncommon cause of hypercalcemia, which can also be the presenting feature of lupus.
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Affiliation(s)
- J G Erdozain
- Service of Internal Medicine, Hospital de Cruces, Universidad del Pais Vasco/Euskal Herriko Unibertsitatea, Bizkaia, Spain
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García M, Aranburu MA, Palacios-Zabalza I, Lertxundi U, Aguirre C. Dipeptidyl peptidase-IV inhibitors induced bullous pemphigoid: a case report and analysis of cases reported in the European pharmacovigilance database. J Clin Pharm Ther 2016; 41:368-370. [PMID: 27191539 DOI: 10.1111/jcpt.12397] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [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: 03/01/2016] [Accepted: 04/08/2016] [Indexed: 01/21/2023]
Abstract
WHAT IS KNOWN AND OBJECTIVE Bullous pemphigoid has been reported in association with gliptins. We describe a case, review the literature and analyse all cases of bullous pemphigoid recorded in the European pharmacovigilance database, EudraVigilance. CASE SUMMARY A 74-year-old woman, treated with vildagliptin/metformin for 12 months, developed bullous pemphigoid, confirmed by skin biopsy. The symptoms resolved within 7 months after vildagliptin/metformin withdrawal. WHAT IS NEW AND CONCLUSION A search in EudraVigilance showed a disproportionality for bullous pemphigoid and gliptins, except alogliptin. These findings extend the evidence associating gliptins with this potentially serious disease.
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Affiliation(s)
- M García
- Basque Country Pharmacovigilance Unit, Galdakao-Usansolo Hospital, Galdakao, Spain
| | | | | | - U Lertxundi
- Pharmacy Service, Araba's Mental Health Network, Vitoria-Gasteiz, Spain
| | - C Aguirre
- Basque Country Pharmacovigilance Unit, Galdakao-Usansolo Hospital, Galdakao, Spain.,Department of Pharmacology, Faculty of Medicine, University of Basque Country, Leioa, Spain
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Autie-Castro G, Autie M, Rodríguez-Castellón E, Aguirre C, Reguera E. Cu-BTC and Fe-BTC metal-organic frameworks: Role of the materials structural features on their performance for volatile hydrocarbons separation. Colloids Surf A Physicochem Eng Asp 2015. [DOI: 10.1016/j.colsurfa.2015.05.044] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Landin-Romero R, McKenna PJ, Salgado-Pineda P, Sarró S, Aguirre C, Sarri C, Compte A, Bosque C, Blanch J, Salvador R, Pomarol-Clotet E. Failure of deactivation in the default mode network: a trait marker for schizophrenia? Psychol Med 2015; 45:1315-1325. [PMID: 25331916 DOI: 10.1017/s0033291714002426] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [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] [Indexed: 12/18/2022]
Abstract
BACKGROUND Functional imaging studies in relatives of schizophrenic patients have had inconsistent findings, particularly with respect to altered dorsolateral prefrontal cortex activation. Some recent studies have also suggested that failure of deactivation may be seen. METHOD A total of 28 patients with schizophrenia, 28 of their siblings and 56 healthy controls underwent functional magnetic resonance imaging during performance of the n-back working memory task. An analysis of variance was fitted to individual whole-brain maps from each set of patient-relative-matched pair of controls. Clusters of significant difference among the groups were then used as regions of interest to compare mean activations and deactivations among the groups. RESULTS In all, five clusters of significant differences were found. The schizophrenic patients, but not the relatives, showed reduced activation compared with the controls in the lateral frontal cortex bilaterally, the left basal ganglia and the cerebellum. In contrast, both the patients and the relatives showed significant failure of deactivation compared with the healthy controls in the medial frontal cortex, with the relatives also showing less failure than the patients. Failure of deactivation was not associated with schizotypy scores or presence of psychotic-like experiences in the relatives. CONCLUSIONS Both schizophrenic patients and their relatives show altered task-related deactivation in the medial frontal cortex. This in turn suggests that default mode network dysfunction may function as a trait marker for schizophrenia.
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Affiliation(s)
| | - P J McKenna
- FIDMAG Germanes Hospitalàries,Barcelona,Spain
| | | | - S Sarró
- FIDMAG Germanes Hospitalàries,Barcelona,Spain
| | - C Aguirre
- FIDMAG Germanes Hospitalàries,Barcelona,Spain
| | - C Sarri
- FIDMAG Germanes Hospitalàries,Barcelona,Spain
| | - A Compte
- FIDMAG Germanes Hospitalàries,Barcelona,Spain
| | - C Bosque
- FIDMAG Germanes Hospitalàries,Barcelona,Spain
| | - J Blanch
- Hospital Sant Joan de Déu Infantil,Barcelona,Spain
| | - R Salvador
- FIDMAG Germanes Hospitalàries,Barcelona,Spain
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Aguirre C, Olivares N, Luppichini P, Hinrichsen P. A PCR-Based Diagnostic System for Differentiating Two Weevil Species (Coleoptera: Curculionidae) of Economic Importance to the Chilean Citrus Industry. J Econ Entomol 2015; 108:107-113. [PMID: 26470110 DOI: 10.1093/jee/tou041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 10/18/2013] [Accepted: 11/14/2014] [Indexed: 06/05/2023]
Abstract
A PCR-based method was developed to identify Naupactus cervinus (Boheman) and Naupactus xanthographus (Germar), two curculionids affecting the citrus industry in Chile. The quarantine status of these two species depends on the country to which fruits are exported. This identification method was developed because it is not possible to discriminate between these two species at the egg stage. The method is based on the species-specific amplification of sequences of internal transcribed spacers, for which we cloned and sequenced these genome fragments from each species. We designed an identification system based on two duplex-PCR reactions. Each one contains the species-specific primer set and a second generic primer set that amplify a short 18S region common to coleopterans, to avoid false negatives. The marker system is able to differentiate each Naupactus species at any life stage, and with a diagnostic sensitivity to 0.045 ng of genomic DNA. This PCR kit was validated by samples collected from different citrus production areas throughout Chile and showed 100% accuracy in differentiating the two Naupactus species.
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Affiliation(s)
- C Aguirre
- Biotechnology Lab, La Platina Experimental Center, Instituto de Investigaciones Agropecuarias (INIA), Santa Rosa 11,610, Santiago, 8820000, Chile. Doctoral Program in Agricultural and Veterinary Sciences, Universidad de Chile, Santa Rosa 11,315, Santiago, 8820000, Chile
| | - N Olivares
- La Cruz Experimental Center, Instituto de Investigaciones Agropecuarias (INIA), Chorrillos 86, La Cruz, Quillota, 2260000, Chile
| | - P Luppichini
- La Cruz Experimental Center, Instituto de Investigaciones Agropecuarias (INIA), Chorrillos 86, La Cruz, Quillota, 2260000, Chile
| | - P Hinrichsen
- Biotechnology Lab, La Platina Experimental Center, Instituto de Investigaciones Agropecuarias (INIA), Santa Rosa 11,610, Santiago, 8820000, Chile.
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García M, Aguirre U, Martinez A, Ruiz B, Lertxundi U, Aguirre C. Acute adverse reactions to iopromide vs iomeprol: a retrospective analysis of spontaneous reporting from a radiology department. Br J Radiol 2014; 87:20130511. [PMID: 24191124 PMCID: PMC4612218 DOI: 10.1259/bjr.20130511] [Citation(s) in RCA: 8] [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] [Received: 08/13/2013] [Revised: 10/29/2013] [Accepted: 10/30/2013] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To compare the safety of iopromide and iomeprol use in a hospital that switched from the former to the latter and found an apparent increase in the number (and a different profile) of adverse reactions reported for iomeprol, putting the safety of its use into question. METHODS This was a retrospective study of cases of acute reactions to iopromide and iomeprol reported in two successive time periods. Data from examinations using iopromide (62539 CT scans and 10348 urography scans) and iomeprol (34308 CT scans and 2846 urography scans) were obtained from the computer system of the hospital. RESULTS For each period, 154 cases of reactions were reported for iopromide and 86 for iomeprol, being severe in 10 (6.5%) patients for iopromide vs 17 (19.8%) patients for iomeprol; a statistically significant difference of p<0.003 was recorded. The most frequent adverse reactions (%/%) for iopromide/iomeprol were urticaria (29.1/17.2), pruritus (22.6/15.6), upper respiratory tract signs and symptoms (12.1/16.7), oedema (4.3/0), erythemas (3.4/5.0), nausea or vomiting (1.2/11.7) and chest pain (0/3.9) (p<0.0001 for the global comparison). The distribution of the reactions (%/%) by System Organ Class for iopromide/iomeprol was skin (56.7/41.1), respiratory (19.2/26.7), vascular (6.8/2.2), general (5.3/7.2), gastrointestinal (4.6/15.0) and others (7.4/7.9) (p<0.0002 for the global comparison). CONCLUSION Adverse reactions were more severe for iomeprol. Skin and vascular reactions with no chest pain were more frequent for iopromide, whereas gastrointestinal reactions were more frequent for iomeprol. ADVANCES IN KNOWLEDGE Comparative studies of media contrast safety are scarce and summary information on product characteristics is insufficient. This study showed the differences in severity and profile of adverse reactions between iopromide and iomeprol.
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Affiliation(s)
- M García
- Basque Country Pharmacovigilance Unit, Galdakao-Usansolo Hospital, Galdakao, Spain
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Landin-Romero R, McKenna P, Salgado-Pineda P, Sarrò S, Aguirre C, Sarri C, Compte A, Bosque C, Blanch J, Salvador R, Pomarol-Clotet E. EPA-0448 – Failure of de-activation in the default mode network: a trait marker for schizophrenia? Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)77867-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Baudry M, Bi X, Aguirre C. Progesterone-estrogen interactions in synaptic plasticity and neuroprotection. Neuroscience 2013; 239:280-94. [PMID: 23142339 PMCID: PMC3628409 DOI: 10.1016/j.neuroscience.2012.10.051] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.6] [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: 07/10/2012] [Revised: 10/23/2012] [Accepted: 10/26/2012] [Indexed: 01/01/2023]
Abstract
17ß-Estradiol and progesterone exert a number of physiological effects throughout the brain due to interactions with several types of receptors belonging to the traditional family of intracellular hormonal receptors as well as to membrane-bound receptors. In particular, both hormones elicit rapid modifications of neuronal excitability that have been postulated to underlie their effects on synaptic plasticity and learning and memory. Likewise, both hormones have been shown to be neuroprotective under certain conditions, possibly due to the activation of pro-survival pathways and the inhibition of pro-apoptotic cascades. Because of the similarities in their cellular effects, there have been a number of questions raised by numerous observations that progesterone inhibits the effects of estrogen. In this manuscript, we first review the interactions between 17ß-estradiol (E2) and progesterone (P4) in synaptic plasticity, and conclude that, while E2 exerts a clear and important role in long-term potentiation of synaptic transmission in hippocampal neurons, the role of P4 is much less clear, and could be accounted by the direct or indirect regulation of GABAA receptors. We then discuss the neuroprotective roles of both hormones, in particular against excitotoxicity. In this case, the neuroprotective effects of these hormones are very similar to those of the neurotrophic factor BDNF. Interestingly, P4 antagonizes the effects of E2, possibly through the regulation of estrogen receptors or of proteins associated with the receptors or interactions with signaling pathways activated by E2. Overall, this review emphasizes the existence of common molecules and pathways that participate in the regulation of both synaptic plasticity and neurodegeneration.
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Affiliation(s)
- M Baudry
- GCBS and COMP, Western University of Health Sciences, Pomona, CA, USA.
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Collado M, Gomez G, Gargiulo M, Colaianni I, Suarez L, Dorado E, Zazzetti F, Chaparro del moral R, Martinez A, Ortiz A, Galván I, Juarez V, Moreno C, Paira S, Rillo O, Barreira J, Aguirre C, Sarano J. FRI0283 Clinical course of mesangial lupus nephritis in a cohort of argentinian patients. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1410] [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]
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Lange C, Hennig D, Hurtado A, Schuster R, Lukas B, Aguirre C. Remarks on boiling water reactor stability analysis – part 2: stability monitoring. KERNTECHNIK 2013. [DOI: 10.3139/124.110275] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
In part 1 of this article we explained the partly relative complex solution manifold of the differential equations describing the stability behaviour of a BWR, in particular the coexistence of different types of solutions, such as the coexistence of unstable limit cycles and stable fixed points are of interest from the operational safety point of view. The part 2 is devoted to the surveillance of the stability behaviour. We summarize some stability monitoring methods and suggest to support stability tests by RAM-ROM analyses in order to reveal in advance the stability “landscape” of the BWR in a parameter region high sensitive for appearing of linear unstable states. The analysis of an especial stability test, performed at NPP Leibstadt (KKL), makes it clear that the measurement results can only be interpreted by application of bifurcation analysis.
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Affiliation(s)
| | | | - A. Hurtado
- Technische Universität Dresden, Institute of Power Engineering, Chair of Hydrogen and Nuclear Energy, 01062 Dresden, Germany
| | - R. Schuster
- Kernkraftwerk Brunsbüttel GmbH & Co. oHG, Otto-Hahn-Straße, 25541 Brunsbüttel, Germany, E-mail:
| | - B. Lukas
- EnBW Kernkraft GmbH, Kernkraftwerk Philippsburg, Rheinschanzinsel, 76661 Philippsburg, Germany, E-mail:
| | - C. Aguirre
- Kernkraftwerk Leibstadt AG, Leibstadt, Aargau, Switzerland, E-mail:
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Lange C, Hennig D, Hurtado A, Schuster R, Lukas B, Aguirre C. Remarks on boiling water reactor stability analysis – part 1: theory and application of bifurcation analysis. KERNTECHNIK 2013. [DOI: 10.3139/124.110274] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Modern theoretical methods for analysing the stability behaviour of Boiling Water Reactors (BWRs) are relatively reliable. The analysis is performed by comprehensive validated system codes comprising 3D core models and one-dimensional thermal-hydraulic parallel channel models in the frequency (linearized models) or time domain. Nevertheless the spontaneous emergence of stable or unstable periodic orbits as solutions of the coupled nonlinear differential equations determining the stability properties of the coupled thermal-hydraulic and neutron kinetic (highly) nonlinear BWR system is a surprising phenomenon, and it is worth thinking about the mathematical background controlling such behaviour. In particular the coexistence of different types of solutions, such as the coexistence of unstable limit cycles and stable fixed points, are states of stability, not all nuclear engineers are familiar with. Hence the part I of this paper is devoted to the mathematical background of linear and nonlinear stability analysis and introduces a novel efficient approach to treat the nonlinear BWR stability behaviour with both system codes and so-called (advanced) reduced order models (ROMs). The efficiency of this approach, called the RAM-ROM method, will be demonstrated by some results of stability analyses for different power plants.
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Affiliation(s)
- C. Lange
- Carsten Lange (corresponding author), E-mail:
| | | | - A. Hurtado
- Technische Universität Dresden, Institute of Power Engineering, Chair of Hydrogen and Nuclear Energy, 01062 Dresden, Germany
| | - R. Schuster
- Kernkraftwerk Brunsbüttel GmbH & Co. oHG, Otto-Hahn-Straße, 25541 Brunsbüttel, Germany, E-mail:
| | - B. Lukas
- EnBW Kernkraft GmbH, Kernkraftwerk Philippsburg, Rheinschanzinsel, 76661 Philippsburg, Germany, E-mail:
| | - C. Aguirre
- Kernkraftwerk Leibstadt AG, Leibstadt, Aargau, Switzerland, E-mail:
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Cabrera S, Merce J, de Castro R, Aguirre C, Carmona A, Pinedo M, Salmeron M, Bardaji A. Pacemaker clinic: an opportunity to detect silent atrial fibrillation and improve antithrombotic treatment: Response. Europace 2012. [DOI: 10.1093/europace/eus067] [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: 11/12/2022] Open
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Cabrera S, Merce J, de Castro R, Aguirre C, Carmona A, Pinedo M, Salmeron M, Bardaji A. Pacemaker clinic: an opportunity to detect silent atrial fibrillation and improve antithrombotic treatment. Europace 2011; 13:1574-9. [DOI: 10.1093/europace/eur160] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bussmann RW, Malca-García G, Glenn A, Sharon D, Chait G, Díaz D, Pourmand K, Jonat B, Somogy S, Guardado G, Aguirre C, Chan R, Meyer K, Kuhlman A, Townesmith A, Effio-Carbajal J, Frías-Fernandez F, Benito M. Minimum inhibitory concentrations of medicinal plants used in Northern Peru as antibacterial remedies. J Ethnopharmacol 2010; 132:101-8. [PMID: 20678568 PMCID: PMC2956840 DOI: 10.1016/j.jep.2010.07.048] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Revised: 07/22/2010] [Accepted: 07/26/2010] [Indexed: 05/18/2023]
Abstract
AIM The plant species reported here are traditionally used in Northern Peru to treat bacterial infections, often addressed by the local healers as "inflammation". The aim of this study was to evaluate the minimum inhibitory concentration (MIC) of their antibacterial properties against gram-positive and gram-negative bacteria. MATERIALS AND METHODS The antimicrobial activity of ethanolic and water extracts of 141 plant species was determined using a deep-well broth microdilution method on commercially available bacterial strains. RESULTS The ethanolic extracts of 51 species inhibited Escherichia coli, and 114 ethanolic extracts inhibited Staphylococcus aureus. In contrast, only 30 aqueous extracts showed activity against Escherichia coli and 38 extracts against Staphylococcus aureus. The MIC concentrations were mostly very high and ranged from 0.008 to 256 mg/ml, with only 36 species showing inhibitory concentrations of <4 mg/ml. The ethanolic extracts exhibited stronger activity and a much broader spectrum of action than the aqueous extracts. Hypericum laricifolium, Hura crepitans, Caesalpinia paipai, Cassia fistula, Hyptis sidifolia, Salvia sp., Banisteriopsis caapi, Miconia salicifolia and Polygonum hydropiperoides showed the lowest MIC values and would be interesting candidates for future research. CONCLUSIONS The presence of antibacterial activity could be confirmed in most species used in traditional medicine in Peru which were assayed in this study. However, the MIC for the species employed showed a very large range, and were mostly very high. Nevertheless, traditional knowledge might provide some leads to elucidate potential candidates for future development of new antibiotic agents.
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Affiliation(s)
- R W Bussmann
- William L. Brown Center, Missouri Botanical Garden, P.O. Box 299, St. Louis, MO 63166-0299, USA.
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Pomarol-Clotet E, Fatjó-Vilas M, McKenna PJ, Monté GC, Sarró S, Ortiz-Gil J, Aguirre C, Gomar JJ, Guerrero A, Landin R, Capdevila A, Fañanás L, Salvador R. COMT Val158Met polymorphism in relation to activation and de-activation in the prefrontal cortex: A study in patients with schizophrenia and healthy subjects. Neuroimage 2010; 53:899-907. [PMID: 20398774 DOI: 10.1016/j.neuroimage.2010.04.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2009] [Revised: 04/06/2010] [Accepted: 04/07/2010] [Indexed: 11/18/2022] Open
Abstract
The Val158Met polymorphism in the COMT gene has been found to be associated with differences in brain activation in both healthy subjects and patients with schizophrenia. The predominant finding has been increased prefrontal activation associated with the Val allele; however, genotype-related de-activations have not been studied. In this study 42 schizophrenia patients and 31 controls underwent fMRI while performing the n-back task. Brain differences related to presence/absence of disease and presence/absence of the Val/Val genotype were examined. Both disease and Val/Val genotype were associated with failure of de-activation in a cluster centred in the medial prefrontal cortex. There was no interaction between disease and genotype at this location, but clusters where there were significant interactions emerged in the right prefrontal cortex and left temporal/parietal cortex. These findings suggest that Val158Met polymorphism influences task-related de-activations in the default mode network in both healthy subjects and schizophrenia patients to an equivalent extent. However the Val158Met polymorphism also has disease-specific effects on DLPFC activation in schizophrenia.
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Affiliation(s)
- E Pomarol-Clotet
- Benito Menni Complex Assistencial Salut Mental and CIBERSAM, Spain.
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Abraham J, Abreu P, Aglietta M, Aguirre C, Allard D, Allekotte I, Allen J, Allison P, Alvarez-Muñiz J, Ambrosio M, Anchordoqui L, Andringa S, Anzalone A, Aramo C, Argirò S, Arisaka K, Armengaud E, Arneodo F, Arqueros F, Asch T, Asorey H, Assis P, Atulugama BS, Aublin J, Ave M, Avila G, Bäcker T, Badagnani D, Barbosa AF, Barnhill D, Barroso SLC, Baughman B, Bauleo P, Beatty JJ, Beau T, Becker BR, Becker KH, Bellido JA, Benzvi S, Berat C, Bergmann T, Bernardini P, Bertou X, Biermann PL, Billoir P, Blanch-Bigas O, Blanco F, Blasi P, Bleve C, Blümer H, Bohácová M, Bonifazi C, Bonino R, Brack J, Brogueira P, Brown WC, Buchholz P, Bueno A, Burton RE, Busca NG, Caballero-Mora KS, Cai B, Camin DV, Caramete L, Caruso R, Carvalho W, Castellina A, Catalano O, Cataldi G, Cazon L, Cester R, Chauvin J, Chiavassa A, Chinellato JA, Chou A, Chudoba J, Chye J, Clark PDJ, Clay RW, Colombo E, Conceição R, Connolly B, Contreras F, Coppens J, Cordier A, Cotti U, Coutu S, Covault CE, Creusot A, Criss A, Cronin J, Curutiu A, Dagoret-Campagne S, Daumiller K, Dawson BR, de Almeida RM, De Donato C, de Jong SJ, De La Vega G, Junior WJMDM, Neto JRTDM, De Mitri I, de Souza V, Del Peral L, Deligny O, Della Selva A, Fratte CD, Dembinski H, Di Giulio C, Diaz JC, Diep PN, Dobrigkeit C, D'Olivo JC, Dong PN, Dornic D, Dorofeev A, Dos Anjos JC, Dova MT, D'Urso D, Dutan I, Duvernois MA, Engel R, Epele L, Erdmann M, Escobar CO, Etchegoyen A, Luis PFS, Falcke H, Farrar G, Fauth AC, Fazzini N, Ferrer F, Ferrero A, Fick B, Filevich A, Filipcic A, Fleck I, Fracchiolla CE, Fulgione W, García B, Gámez DG, Garcia-Pinto D, Garrido X, Geenen H, Gelmini G, Gemmeke H, Ghia PL, Giller M, Glass H, Gold MS, Golup G, Albarracin FG, Berisso MG, Gonçalves P, do Amaral MG, Gonzalez D, Gonzalez JG, González M, Góra D, Gorgi A, Gouffon P, Grassi V, Grillo AF, Grunfeld C, Guardincerri Y, Guarino F, Guedes GP, Gutiérrez J, Hague JD, Halenka V, Hamilton JC, Hansen P, Harari D, Harmsma S, Harton JL, Haungs A, Hauschildt T, Healy MD, Hebbeker T, Hebrero G, Heck D, Hojvat C, Holmes VC, Homola P, Hörandel JR, Horneffer A, Hrabovský M, Huege T, Hussain M, Iarlori M, Insolia A, Ionita F, Italiano A, Kaducak M, Kampert KH, Karova T, Kasper P, Kégl B, Keilhauer B, Kemp E, Kieckhafer RM, Klages HO, Kleifges M, Kleinfeller J, Knapik R, Knapp J, Koang DH, Krieger A, Krömer O, Kuempel D, Kunka N, Kusenko A, La Rosa G, Lachaud C, Lago BL, Lebrun D, Lebrun P, Lee J, de Oliveira MAL, Letessier-Selvon A, Leuthold M, Lhenry-Yvon I, López R, Agüera AL, Bahilo JL, Lucero A, García RL, Maccarone MC, Macolino C, Maldera S, Mancarella G, Manceñido ME, Mandat D, Mantsch P, Mariazzi AG, Maris IC, Falcon HRM, Martello D, Martínez J, Bravo OM, Mathes HJ, Matthews J, Matthews JAJ, Matthiae G, Maurizio D, Mazur PO, McCauley T, McEwen M, McNeil RR, Medina MC, Medina-Tanco G, Melo D, Menichetti E, Menschikov A, Meurer C, Meyhandan R, Micheletti MI, Miele G, Miller W, Mollerach S, Monasor M, Ragaigne DM, Montanet F, Morales B, Morello C, Moreno JC, Morris C, Mostafá M, Muller MA, Mussa R, Navarra G, Navarro JL, Navas S, Necesal P, Nellen L, Newman-Holmes C, Newton D, Nhung PT, Nierstenhoefer N, Nitz D, Nosek D, Nozka L, Oehlschläger J, Ohnuki T, Olinto A, Olmos-Gilbaja VM, Ortiz M, Ortolani F, Ostapchenko S, Otero L, Pacheco N, Selmi-Dei DP, Palatka M, Pallotta J, Parente G, Parizot E, Parlati S, Pastor S, Patel M, Paul T, Pavlidou V, Payet K, Pech M, Pekala J, Pelayo R, Pepe IM, Perrone L, Pesce R, Petrera S, Petrinca P, Petrov Y, Pichel A, Piegaia R, Pierog T, Pimenta M, Pinto T, Pirronello V, Pisanti O, Platino M, Pochon J, Privitera P, Prouza M, Quel EJ, Rautenberg J, Redondo A, Reucroft S, Revenu B, Rezende FAS, Ridky J, Riggi S, Risse M, Rivière C, Rizi V, Roberts M, Robledo C, Rodriguez G, Martino JR, Rojo JR, Rodriguez-Cabo I, Rodríguez-Frías MD, Ros G, Rosado J, Roth M, Rouillé-d'Orfeuil B, Roulet E, Rovero AC, Salamida F, Salazar H, Salina G, Sánchez F, Santander M, Santo CE, Santos EM, Sarazin F, Sarkar S, Sato R, Scherini V, Schieler H, Schmidt A, Schmidt F, Schmidt T, Scholten O, Schovánek P, Schroeder F, Schulte S, Schüssler F, Sciutto SJ, Scuderi M, Segreto A, Semikoz D, Settimo M, Shellard RC, Sidelnik I, Siffert BB, Sigl G, Grande NSD, Smiałkowski A, Smída R, Smith AGK, Smith BE, Snow GR, Sokolsky P, Sommers P, Sorokin J, Spinka H, Squartini R, Strazzeri E, Stutz A, Suarez F, Suomijärvi T, Supanitsky AD, Sutherland MS, Swain J, Szadkowski Z, Takahashi J, Tamashiro A, Tamburro A, Tarutina T, Taşcău O, Tcaciuc R, Thao NT, Thomas D, Ticona R, Tiffenberg J, Timmermans C, Tkaczyk W, Peixoto CJT, Tomé B, Tonachini A, Torres I, Travnicek P, Tripathi A, Tristram G, Tscherniakhovski D, Tuci V, Tueros M, Tunnicliffe V, Ulrich R, Unger M, Urban M, Galicia JFV, Valiño I, Valore L, van den Berg AM, van Elewyck V, Vázquez RA, Veberic D, Veiga A, Velarde A, Venters T, Verzi V, Videla M, Villaseñor L, Vorobiov S, Voyvodic L, Wahlberg H, Wahrlich P, Wainberg O, Walker P, Warner D, Watson AA, Westerhoff S, Wieczorek G, Wiencke L, Wilczyńska B, Wilczyński H, Wileman C, Winnick MG, Wu H, Wundheiler B, Yamamoto T, Younk P, Zas E, Zavrtanik D, Zavrtanik M, Zaw I, Zepeda A, Ziolkowski M. Observation of the suppression of the flux of cosmic rays above 4 x 10 (19) eV. Phys Rev Lett 2008; 101:061101. [PMID: 18764444 DOI: 10.1103/physrevlett.101.061101] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2008] [Indexed: 05/26/2023]
Abstract
The energy spectrum of cosmic rays above 2.5 x 10;{18} eV, derived from 20,000 events recorded at the Pierre Auger Observatory, is described. The spectral index gamma of the particle flux, J proportional, variantE;{-gamma}, at energies between 4 x 10;{18} eV and 4 x 10;{19} eV is 2.69+/-0.02(stat)+/-0.06(syst), steepening to 4.2+/-0.4(stat)+/-0.06(syst) at higher energies. The hypothesis of a single power law is rejected with a significance greater than 6 standard deviations. The data are consistent with the prediction by Greisen and by Zatsepin and Kuz'min.
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Affiliation(s)
- J Abraham
- Universidad Tecnológica Nacional, FR-Mendoza, Argentina
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Abraham J, Abreu P, Aglietta M, Aguirre C, Allard D, Allekotte I, Allen J, Allison P, Alvarez-Muñiz J, Ambrosio M, Anchordoqui L, Andringa S, Anzalone A, Aramo C, Argirò S, Arisaka K, Armengaud E, Arneodo F, Arqueros F, Asch T, Asorey H, Assis P, Atulugama BS, Aublin J, Ave M, Avila G, Bäcker T, Badagnani D, Barbosa AF, Barnhill D, Barroso SLC, Bauleo P, Beatty JJ, Beau T, Becker BR, Becker KH, Bellido JA, BenZvi S, Berat C, Bergmann T, Bernardini P, Bertou X, Biermann PL, Billoir P, Blanch-Bigas O, Blanco F, Blasi P, Bleve C, Blümer H, Bohácová M, Bonifazi C, Bonino R, Boratav M, Brack J, Brogueira P, Brown WC, Buchholz P, Bueno A, Burton RE, Busca NG, Caballero-Mora KS, Cai B, Camin DV, Caramete L, Caruso R, Carvalho W, Castellina A, Catalano O, Cataldi G, Cazon L, Cester R, Chauvin J, Chiavassa A, Chinellato JA, Chou A, Chye J, Clark PDJ, Clay RW, Colombo E, Conceição R, Connolly B, Contreras F, Coppens J, Cordier A, Cotti U, Coutu S, Covault CE, Creusot A, Criss A, Cronin J, Curutiu A, Dagoret-Campagne S, Daumiller K, Dawson BR, de Almeida RM, De Donato C, de Jong SJ, De La Vega G, de Mello Junior WJM, de Mello Neto JRT, DeMitri I, de Souza V, del Peral L, Deligny O, Della Selva A, Delle Fratte C, Dembinski H, Di Giulio C, Diaz JC, Dobrigkeit C, D'Olivo JC, Dornic D, Dorofeev A, dos Anjos JC, Dova MT, D'Urso D, Dutan I, DuVernois MA, Engel R, Epele L, Erdmann M, Escobar CO, Etchegoyen A, Facal San Luis P, Falcke H, Farrar G, Fauth AC, Fazzini N, Ferrer F, Ferry S, Fick B, Filevich A, Filipcic A, Fleck I, Fonte R, Fracchiolla CE, Fulgione W, García B, García Gámez D, Garcia-Pinto D, Garrido X, Geenen H, Gelmini G, Gemmeke H, Ghia PL, Giller M, Glass H, Gold MS, Golup G, Gomez Albarracin F, Gómez Berisso M, Gómez Herrero R, Gonçalves P, Gonçalves do Amaral M, Gonzalez D, Gonzalez JG, González M, Góra D, Gorgi A, Gouffon P, Grassi V, Grillo AF, Grunfeld C, Guardincerri Y, Guarino F, Guedes GP, Gutiérrez J, Hague JD, Hamilton JC, Hansen P, Harari D, Harmsma S, Harton JL, Haungs A, Hauschildt T, Healy MD, Hebbeker T, Hebrero G, Heck D, Hojvat C, Holmes VC, Homola P, Hörandel J, Horneffer A, Horvat M, Hrabovský M, Huege T, Hussain M, Iarlori M, Insolia A, Ionita F, Italiano A, Kaducak M, Kampert KH, Karova T, Kégl B, Keilhauer B, Kemp E, Kieckhafer RM, Klages HO, Kleifges M, Kleinfeller J, Knapik R, Knapp J, Koang DH, Krieger A, Krömer O, Kuempel D, Kunka N, Kusenko A, La Rosa G, Lachaud C, Lago BL, Lebrun D, Lebrun P, Lee J, Leigui de Oliveira MA, Letessier-Selvon A, Leuthold M, Lhenry-Yvon I, López R, Lopez Agüera A, Lozano Bahilo J, Luna García R, Maccarone MC, Macolino C, Maldera S, Mancarella G, Manceñido ME, Mandat D, Mantsch P, Mariazzi AG, Maris IC, Marquez Falcon HR, Martello D, Martínez J, Martínez Bravo O, Mathes HJ, Matthews J, Matthews JAJ, Matthiae G, Maurizio D, Mazur PO, McCauley T, McEwen M, McNeil RR, Medina MC, Medina-Tanco G, Meli A, Melo D, Menichetti E, Menschikov A, Meurer C, Meyhandan R, Micheletti MI, Miele G, Miller W, Mollerach S, Monasor M, Monnier Ragaigne D, Montanet F, Morales B, Morello C, Moreno JC, Morris C, Mostafá M, Muller MA, Mussa R, Navarra G, Navarro JL, Navas S, Necesal P, Nellen L, Newman-Holmes C, Newton D, Nguyen Thi T, Nierstenhoefer N, Nitz D, Nosek D, Nozka L, Oehlschläger J, Ohnuki T, Olinto A, Olmos-Gilbaja VM, Ortiz M, Ortolani F, Ostapchenko S, Otero L, Pacheco N, Pakk Selmi-Dei D, Palatka M, Pallotta J, Parente G, Parizot E, Parlati S, Pastor S, Patel M, Paul T, Pavlidou V, Payet K, Pech M, Pekala J, Pelayo R, Pepe IM, Perrone L, Petrera S, Petrinca P, Petrov Y, Pham Ngoc D, Pham Ngoc D, Pham Thi TN, Pichel A, Piegaia R, Pierog T, Pimenta M, Pinto T, Pirronello V, Pisanti O, Platino M, Pochon J, Privitera P, Prouza M, Quel EJ, Rautenberg J, Redondo A, Reucroft S, Revenu B, Rezende FAS, Ridky J, Riggi S, Risse M, Rivière C, Rizi V, Roberts M, Robledo C, Rodriguez G, Rodríguez Frías D, Rodriguez Martino J, Rodriguez Rojo J, Rodriguez-Cabo I, Ros G, Rosado J, Roth M, Rouillé-d'Orfeuil B, Roulet E, Rovero AC, Salamida F, Salazar H, Salina G, Sánchez F, Santander M, Santo CE, Santos EM, Sarazin F, Sarkar S, Sato R, Scherini V, Schieler H, Schmidt A, Schmidt F, Schmidt T, Scholten O, Schovánek P, Schüssler F, Sciutto SJ, Scuderi M, Segreto A, Semikoz D, Settimo M, Shellard RC, Sidelnik I, Siffert BB, Sigl G, Smetniansky De Grande N, Smiałkowski A, Smída R, Smith AGK, Smith BE, Snow GR, Sokolsky P, Sommers P, Sorokin J, Spinka H, Squartini R, Strazzeri E, Stutz A, Suarez F, Suomijärvi T, Supanitsky AD, Sutherland MS, Swain J, Szadkowski Z, Takahashi J, Tamashiro A, Tamburro A, Taşcău O, Tcaciuc R, Thomas D, Ticona R, Tiffenberg J, Timmermans C, Tkaczyk W, Todero Peixoto CJ, Tomé B, Tonachini A, Torres I, Torresi D, Travnicek P, Tripathi A, Tristram G, Tscherniakhovski D, Tueros M, Tunnicliffe V, Ulrich R, Unger M, Urban M, Valdés Galicia JF, Valiño I, Valore L, van den Berg AM, van Elewyck V, Vázquez RA, Veberic D, Veiga A, Velarde A, Venters T, Verzi V, Videla M, Villaseñor L, Vorobiov S, Voyvodic L, Wahlberg H, Wainberg O, Walker P, Warner D, Watson AA, Westerhoff S, Wieczorek G, Wiencke L, Wilczyńska B, Wilczyński H, Wileman C, Winnick MG, Wu H, Wundheiler B, Yamamoto T, Younk P, Zas E, Zavrtanik D, Zavrtanik M, Zech A, Zepeda A, Ziolkowski M. Upper limit on the diffuse flux of ultrahigh energy tau neutrinos from the Pierre Auger Observatory. Phys Rev Lett 2008; 100:211101. [PMID: 18518595 DOI: 10.1103/physrevlett.100.211101] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2007] [Indexed: 05/26/2023]
Abstract
The surface detector array of the Pierre Auger Observatory is sensitive to Earth-skimming tau neutrinos that interact in Earth's crust. Tau leptons from nu(tau) charged-current interactions can emerge and decay in the atmosphere to produce a nearly horizontal shower with a significant electromagnetic component. The data collected between 1 January 2004 and 31 August 2007 are used to place an upper limit on the diffuse flux of nu(tau) at EeV energies. Assuming an E(nu)(-2) differential energy spectrum the limit set at 90% C.L. is E(nu)(2)dN(nu)(tau)/dE(nu)<1.3 x 10(-7) GeV cm(-2) s(-1) sr(-1) in the energy range 2 x 10(17) eV< E(nu)< 2 x 10(19) eV.
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Affiliation(s)
- J Abraham
- Centro de Investigaciones en Laseres y Aplicaciones, CITEFA and CONICET, Argentina
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Ruiz-Irastorza G, Egurbide MV, Olivares N, Martinez-Berriotxoa A, Aguirre C. Vitamin D deficiency in systemic lupus erythematosus: prevalence, predictors and clinical consequences. Rheumatology (Oxford) 2008; 47:920-3. [PMID: 18411213 DOI: 10.1093/rheumatology/ken121] [Citation(s) in RCA: 225] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES We aimed to establish the prevalence, predictors and clinical consequences of vitamin D deficiency in patients with SLE. METHODS Cross-sectional study including patients fulfilling ACR criteria for the classification of SLE. Serum 25(OH)D levels at 30 and 10 ng/ml were the cut-off values for vitamin D insufficiency and vitamin D deficiency, respectively. SLE activity was measured by SLEDAI and irreversible organ damage by the SLICC-ACR index. Fatigue was quantified using a 0-10 visual analogue scale (VAS). RESULTS Ninety-two patients (90% women, 98% white) were included in the study. Sixty-nine (75%) and 14 (15%) patients presented with vitamin D insufficiency and deficiency, respectively. Female sex (P = 0.001), treatment with HCQ (P = 0.014) and treatment with calcium and vitamin D (P = 0.049) predicted higher levels of 25(OH)D. Photosensitivity [odds ratio (OR) 3.5] and photoprotection (OR 5.7) predicted vitamin D insufficiency and deficiency, respectively. Higher age (OR 0.95) and HCQ use (OR 0.29) protected against vitamin D deficiency. Patients with vitamin D deficiency had a higher degree of fatigue as quantified by a 0-10 VAS (mean 5.32 vs 4.03, P = 0.08). No relation was seen between vitamin D insufficiency or deficiency and disease duration, SLEDAI or SLICC-ACR indexes. CONCLUSIONS Vitamin D insufficiency and deficiency are common in patients with SLE and are associated with sun avoidance. HCQ prevented vitamin D deficiency. Vitamin D deficiency was related to a higher degree of fatigue. Vitamin D levels had no relation with SLE severity.
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Affiliation(s)
- G Ruiz-Irastorza
- Servicio de Medicina Interna, Hospital de Cruces, 48903-Bizkaia, Spain.
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Arango J, Arbelaez M, Henao J, Mejia G, Arroyave I, Carvajal J, Garcia A, Gutierrez J, Velásquez A, Garcia L, Aguirre C. Kidney graft survival in patients with hepatitis C: a single center experience. Clin Transplant 2008; 22:16-9. [PMID: 18217900 DOI: 10.1111/j.1399-0012.2007.00679.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Hepatitis C virus (HCV) infection is highly prevalent in renal transplant candidates; however, its effect on the transplant outcome is still controversial. The aim of the present study was to determine the effect of HCV infection in the outcome of kidney transplantation in a single transplant center. The study population 144 HCV- randomized selected patients and 64 HCV+ patients transplanted from 1973 to 2000, followed for up to 60 months post-transplantation. This retrospective study included the following variables: type of dialysis, time on renal replacement therapy, number of transfusions before and after transplantation, number of transplants, type of donor, immunosuppression, and rejection episodes. The Kaplan-Meier method was used to estimate graft and patient survival. Log-rank test was used to assess the difference in survival between HCV+ and HCV-. A multivariate Cox proportional hazards model was used to analyze the relation between graft and patient survival. HCV+ and HCV- patients had similar demographic and clinical characteristics; however, a higher number of HCV+ patients received blood transfusions after transplantation. Patient survival was not significantly different in 39 HCV+ and 96 HCV- patients transplanted with living-related donors (71% and 77% at five yr, respectively). Similarly, there was not significant difference in 25 HCV+ and 48 HCV- patients transplanted with kidneys from deceased donors, although there was a tendency to better outcome in HCV- patients (55% and 72% at five yr respectively). Regarding graft survival, there was also no differences in HCV+ and HCV- recipients of living-related grafts (61% and 66% at five yr post-transplant, respectively) and recipients of kidneys from deceased donors (44% and 41%, respectively). The results show that HCV+ patients can be transplanted with the same success than HCV- patients.
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Affiliation(s)
- J Arango
- Grupo de Transplantes, Universidad de Antioquia, Hospital San Vicente de Paúl, Medellín, Colombia.
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Abraham J, Abreu P, Aglietta M, Aguirre C, Allard D, Allekotte I, Allen J, Allison P, Alvarez C, Alvarez-Muñiz J, Ambrosio M, Anchordoqui L, Andringa S, Anzalone A, Aramo C, Argirò S, Arisaka K, Armengaud E, Arneodo F, Arqueros F, Asch T, Asorey H, Assis P, Atulugama BS, Aublin J, Ave M, Avila G, Bäcker T, Badagnani D, Barbosa AF, Barnhill D, Barroso SLC, Bauleo P, Beatty J, Beau T, Becker BR, Becker KH, Bellido JA, BenZvi S, Berat C, Bergmann T, Bernardini P, Bertou X, Biermann PL, Billoir P, Blanch-Bigas O, Blanco F, Blasi P, Bleve C, Blümer H, Boháčová M, Bonifazi C, Bonino R, Boratav M, Brack J, Brogueira P, Brown WC, Buchholz P, Bueno A, Busca NG, Caballero-Mora KS, Cai B, Camin DV, Caruso R, Carvalho W, Castellina A, Catalano O, Cataldi G, Cazón-Boado L, Cester R, Chauvin J, Chiavassa A, Chinellato JA, Chou A, Chye J, Clark PDJ, Clay RW, Colombo E, Conceição R, Connolly B, Contreras F, Coppens J, Cordier A, Cotti U, Coutu S, Covault CE, Creusot A, Cronin J, Dagoret-Campagne S, Daumiller K, Dawson BR, de Almeida RM, De Donato C, de Jong SJ, De La Vega G, de Mello Junior WJM, de Mello Neto JRT, De Mitri I, de Souza V, del Peral L, Deligny O, Selva AD, Fratte CD, Dembinski H, Di Giulio C, Diaz JC, Dobrigkeit C, D'Olivo JC, Dornic D, Dorofeev A, Anjos JCD, Dova MT, D'Urso D, DuVernois MA, Engel R, Epele L, Erdmann M, Escobar CO, Etchegoyen A, Luis PFS, Falcke H, Farrar G, Fauth AC, Fazzini N, Fernández A, Ferrer F, Ferry S, Fick B, Filevich A, Filipčič A, Fleck I, Fonte R, Fracchiolla CE, Fulgione W, García B, García Gámez D, Garcia-Pinto D, Garrido X, Geenen H, Gelmini G, Gemmeke H, Ghia PL, Giller M, Glass H, Gold MS, Golup G, Albarracin FG, Berisso MG, Herrero RG, Gonçalves P, do Amaral MG, Gonzalez D, Gonzalez JG, González M, Góra D, Gorgi A, Gouffon P, Grassi V, Grillo A, Grunfeld C, Guardincerri Y, Guarino F, Guedes GP, Gutiérrez J, Hague JD, Hamilton JC, Hansen P, Harari D, Harmsma S, Harton JL, Haungs A, Hauschildt T, Healy MD, Hebbeker T, Heck D, Hojvat C, Holmes VC, Homola P, Hörandel J, Horneffer A, Horvat M, Hrabovský M, Huege T, Iarlori M, Insolia A, Ionita F, Italiano A, Kaducak M, Kampert KH, Keilhauer B, Kemp E, Kieckhafer RM, Klages HO, Kleifges M, Kleinfeller J, Knapik R, Knapp J, Koang DH, Kopmann A, Krieger A, Krömer O, Kümpel D, Kunka N, Kusenko A, La Rosa G, Lachaud C, Lago BL, Lebrun D, LeBrun P, Lee J, de Oliveira MAL, Letessier-Selvon A, Leuthold M, Lhenry-Yvon I, López R, Lopez Agüera A, Bahilo JL, Maccarone MC, Macolino C, Maldera S, Malek M, Mancarella G, Manceñido ME, Mandat D, Mantsch P, Mariazzi AG, Maris IC, Martello D, Martínez J, Bravo OM, Mathes HJ, Matthews J, Matthews JAJ, Matthiae G, Maurizio D, Mazur PO, McCauley T, McEwen M, McNeil RR, Medina MC, Medina-Tanco G, Meli A, Melo D, Menichetti E, Menschikov A, Meurer C, Meyhandan R, Micheletti MI, Miele G, Miller W, Mollerach S, Monasor M, Ragaigne DM, Montanet F, Morales B, Morello C, Moreno E, Moreno JC, Morris C, Mostafá M, Muller MA, Mussa R, Navarra G, Navarro JL, Navas S, Nellen L, Newman-Holmes C, Newton D, Thi TN, Nierstenhöfer N, Nitz D, Nosek D, Nožka L, Oehlschläger J, Ohnuki T, Olinto A, Olmos-Gilbaja VM, Ortiz M, Ostapchenko S, Otero L, Selmi-Dei DP, Palatka M, Pallotta J, Parente G, Parizot E, Parlati S, Pastor S, Patel M, Paul T, Pavlidou V, Payet K, Pech M, Pȩkala J, Pelayo R, Pepe IM, Perrone L, Petrera S, Petrinca P, Petrov Y, Ngoc D, Ngoc D, Thi TNP, Pichel A, Piegaia R, Pierog T, Pimenta M, Pinto T, Pirronello V, Pisanti O, Platino M, Pochon J, Porter TA, Privitera P, Prouza M, Quel EJ, Rautenberg J, Reucroft S, Revenu B, Rezende FAS, Řídký J, Riggi S, Risse M, Rivière C, Rizi V, Roberts M, Robledo C, Rodriguez G, Frías DR, Martino JR, Rojo JR, Rodriguez-Cabo I, Ros G, Rosado J, Roth M, Rouillé-d'Orfeuil B, Roulet E, Rovero AC, Salamida F, Salazar H, Salina G, Sánchez F, Santander M, Santo CE, Santos EM, Sarazin F, Sarkar S, Sato R, Scherini V, Schieler H, Schmidt F, Schmidt T, Scholten O, Schovánek P, Schüssler F, Sciutto SJ, Scuderi M, Segreto A, Semikoz D, Settimo M, Shellard RC, Sidelnik I, Siffert BB, Sigl G, De Grande NS, Smiałkowski A, šmída R, Smith AGK, Smith BE, Snow GR, Sokolsky P, Sommers P, Sorokin J, Spinka H, Squartini R, Strazzeri E, Stutz A, Suarez F, Suomijärvi T, Supanitsky AD, Sutherland MS, Swain J, Szadkowski Z, Takahashi J, Tamashiro A, Tamburro A, Taşcău O, Tcaciuc R, Thomas D, Ticona R, Tiffenberg J, Timmermans C, Tkaczyk W, Peixoto CJT, Tomé B, Tonachini A, Torresi D, Travnicek P, Tripathi A, Tristram G, Tscherniakhovski D, Tueros M, Tunnicliffe V, Ulrich R, Unger M, Urban M, Galicia JFV, Valiño I, Valore L, van den Berg AM, van Elewyck V, Vázquez RA, Veberič D, Veiga A, Velarde A, Venters T, Verzi V, Videla M, Villaseñor L, Vorobiov S, Voyvodic L, Wahlberg H, Wainberg O, Waldenmaier T, Walker P, Warner D, Watson AA, Westerhoff S, Wieczorek G, Wiencke L, Wilczyńska B, Wilczyński H, Wileman C, Winnick MG, Wu H, Wundheiler B, Xu J, Yamamoto T, Younk P, Zas E, Zavrtanik D, Zavrtanik M, Zech A, Zepeda A, Ziolkowski M. Correlation of the Highest-Energy Cosmic Rays with Nearby Extragalactic Objects. Science 2007; 318:938-43. [DOI: 10.1126/science.1151124] [Citation(s) in RCA: 560] [Impact Index Per Article: 32.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Ruiz-Irastorza G, Ugarte A, Egurbide MV, Garmendia M, Pijoan JI, Martinez-Berriotxoa A, Aguirre C. Antimalarials may influence the risk of malignancy in systemic lupus erythematosus. Ann Rheum Dis 2007; 66:815-7. [PMID: 17204564 PMCID: PMC1954667 DOI: 10.1136/ard.2006.067777] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [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: 11/03/2022]
Abstract
BACKGROUND Recent studies suggest that antimalarials have antineoplastic properties. OBJECTIVE To investigate whether antimalarials decrease the risk of cancer in systemic lupus erythematosus (SLE). METHODS An observational prospective cohort study was carried out. 235 patients were included in the study at the time of diagnosis (American College of Rheumatology criteria). The end point was the diagnosis of cancer. Kaplan-Meier cancer-free survival curves for patients treated and not treated with antimalarials were compared. A Cox proportional hazards model was fitted, with cancer as the dependent variable. Age at diagnosis, gender, treatment with azathioprine, cyclophosphamide and methotrexate, smoking, Systemic Lupus International Collaborating Clinics (SLICC) Damage Index 6 months after diagnosis, year of diagnosis and treatment with antimalarials were entered as independent variables. RESULTS 209 (89%) patients were women. 233 (99%) patients were white. Mean (SD) age at diagnosis was 37 (16) years. Median (range) follow-up was 10 (1-31) years. 156 (66%) patients had ever received antimalarials. 2/156 (1.3%) ever-treated patients compared with 11/79 (13%) never-treated patients had cancer (p<0.001). Cumulative cancer-free survival in treated and not treated patients was 0.98 and 0.73, respectively (p<0.001). Adjusted hazard ratio for cancer among malaria drug users compared with non-users was 0.15 (95% CI 0.02 to 0.99). CONCLUSIONS This study launches the hypothesis of a protective action of antimalarials against cancer in patients with SLE. This effect should be confirmed in larger multicentre studies.
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Affiliation(s)
- G Ruiz-Irastorza
- Servicio de Medicina Interna, Hospital de Cruces, 48903-Bizkaia, Spain.
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Illanes A, Wilson L, Altamirano C, Cabrera Z, Alvarez L, Aguirre C. Production of cephalexin in organic medium at high substrate concentrations with CLEA of penicillin acylase and PGA-450. Enzyme Microb Technol 2007. [DOI: 10.1016/j.enzmictec.2006.03.041] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Dokhane A, Ferroukhi H, Zimmermann M, Aguirre C. Spatial and model-order based reactor signal analysis methodology for BWR core stability evaluation. ANN NUCL ENERGY 2006. [DOI: 10.1016/j.anucene.2006.08.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Gil F, Alemán M, Rivero MA, Latorre R, Carrión MA, Aguirre C, Ruíz I, Ayala I. Neuromuscular disease associated with glycogen storage in a Spanish-bred filly. Vet Rec 2006; 158:513-6. [PMID: 16617043 DOI: 10.1136/vr.158.15.513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- F Gil
- Department of Anatomy, Veterinary Faculty, Clinical Veterinary Hospital, University of Murcia, Spain
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Illanes A, Altamirano C, Fuentes M, Zamorano F, Aguirre C. Synthesis of cephalexin in organic medium at high substrate concentrations and low enzyme to substrate ratio. ACTA ACUST UNITED AC 2005. [DOI: 10.1016/j.molcatb.2005.04.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Aguirre C, Caruge D, Castrillo F, Dominicus G, Geutjes A, Saldo V, van der Hagen T, Hennig D, Huggenberger M, Ketelaar K, Manera A, Munoz-Cobo J, Prasser HM, Rohde U, Royer E, Yadigaroglu G. Natural circulation and stability performance of BWRs (NACUSP). Nuclear Engineering and Design 2005. [DOI: 10.1016/j.nucengdes.2004.08.048] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Erdozain JG, Ruiz-Irastorza G, Egurbide MV, Aguirre C. Sustained response to rituximab of autoimmune hemolytic anemia associated with antiphospholipid syndrome. Haematologica 2004; 89:ECR34. [PMID: 15377486] [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] Open
Abstract
Standard treatment for autoimmune hemolytic anemia (AIHA) due to warm antibodies includes combinations of glucocorticoids, immunosuppressive drugs (mainly azathioprine) and splenectomy. Patients who are refractory or intolerant to these therapies constitute an important therapeutic challenge. Rituximab, an anti-CD20 chimeric monoclonal antibody, can effectively deplete B-cells and is commonly used in B-cell non-Hodgkin lymphoma. In addition, it is being increasingly used in autoimmune disorders, such as idiopathic thrombocytopenic purpura, AIHA, systemic lupus erythematosus or vasculitis. We report a case of warm AIHA associated to primary antiphospholipid syndrome (APS). The patient was refractory to high-dose corticosteroids. Splenectomy was discarded in view of the high risk of thrombotic and/or hemorrhagic perioperative complications, due to the presence of APS. After treatment with four weekly doses of rituximab the patients had a rapid and sustained response which allowed progressive tapering of prednisone dose to 5 mg/d. In addition, IgM anticardiolipin titres decreased from > 600 MPL to < 100 MPL. Thirteen further cases of warm AIHA in adults treated with rituximab have been reviewed, showing excellent tolerance and high response rates. Rituximab may be considered prior to splenectomy in patients with refractory AIHA and high risk of complications following splenectomy.
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Affiliation(s)
- J G Erdozain
- Service of Internal Medicine, Hospital de Cruces, Universidad del Pais Vasco / Euskal Herriko Unibersitatea, 48903 Bizkaia, Spain
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Tirado V, Muñoz C, Aguirre C, Pineda DA, Lopera F. [Performance of carriers and non-carriers of the E280A mutation for familial Alzheimer's disease in a naming test]. Rev Neurol 2004; 39:322-6. [PMID: 15340889] [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
INTRODUCTION Early preclinical diagnosis is the greatest challenge faced by researchers into dementia. Cognitive, neuroanatomical, neurophysiological and genetic markers have been reported. One of the preclinical cognitive markers is anomia and it is often assessed using visual naming tests. AIMS The aim of this study was to analyse the type of mistakes made in a visual naming test in a group of carriers and non-carriers of the E280A PS1 mutation. PATIENTS AND METHODS The sample was made up of 91 participants who were genotyped for the E280A PS1 mutation and divided into three groups: non-carriers (n = 30), asymptomatic carriers (n = 39) and sick carriers (n = 22). Selection was performed using the Minimental and the Fast and EDG scales and mistakes in the CERAD naming test were classified. The types of mistakes taken into account were: no answer, visual, semantic, phonological, the whole for the part, and not related. RESULTS There is a significant difference in the number of semantic errors between non-carriers and asymptomatic carriers; on comparing the three groups, no statistically significant differences were found in visual mistakes. CONCLUSIONS Visual mistakes are a general characteristic, even in healthy subjects and, therefore, these errors did not provide any information that could be used to classify patients with or without dementia. Semantic mistakes can be considered as being a preclinical sign in familial Alzheimer's disease (FAD). Both visual and auditory naming tests must be applied when evaluating patients with FAD.
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Affiliation(s)
- V Tirado
- Grupo de Neurociencias, Universidad de Antioquia, Medellin, Colombia.
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Illanes A, Anjarı́ M, Altamirano C, Aguirre C. Optimization of cephalexin synthesis with immobilized penicillin acylase in ethylene glycol medium at low temperatures. ACTA ACUST UNITED AC 2004. [DOI: 10.1016/j.molcatb.2004.01.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Ayani I, Aguirre C, Gutiérrez G, Madariaga A, Rodríguez-Sasiaín JM, Martínez-Bengoechea MJ. A cost-analysis of suspected adverse drug reactions in a hospital emergency ward. Pharmacoepidemiol Drug Saf 2004; 8:529-34. [PMID: 15073897 DOI: 10.1002/(sici)1099-1557(199912)8:7<529::aid-pds460>3.0.co;2-j] [Citation(s) in RCA: 21] [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: 11/08/2022]
Abstract
The main objective of this study was to analyse the minimum direct cost to the Public Health System (PHS) of diagnosing and treating those patients attended to in the emergency ward (EW) for suspected adverse drug reaction (ADR). The cases were collected during March 1995 in the emergency ward of a 900-bed tertiary teaching hospital that covers 900,000 inhabitants. ADR was considered according to the WHO definition. The following EW costs were used: EW physician visit 78.5 ecus (1 ecu=156 pesetas), thorax or abdomen radiograph 21.5 ecus, computerized tomography 112.7 ecus, endoscopy 48 ecus, specialist physician visit 62 ecus. Three types of laboratory costs were considered: block of biochemical tests 16 ecus, biochemical tests with blood count 22.5 ecus, and biochemical tests with blood count and coagulation study 41.6 ecus. Pharmacotherapy of the ADR and changes in patient's usual drug therapy due to ADR were estimated. For patients admitted in the hospital, a per day cost of 391 ecus was considered. A mean ADR cost per organ or system affected (cutaneous, metabolic, gastrointestinal, nervous) was computed. The main conclusion of this study is that ADR, apart from inflicting damage on the patients, also incur PHS costs. The quantity of 42,732 ecus during the month of March, in a single hospital, can seem small when compared with the cost of some diseases such as AIDS or ischemic heart disease. But remembering that about 40% of all ADR attended to in hospitals is avoidable, a decrease of 40% could produce an annual saving of 205,216 ecus to the hospital, which is twice the annual budget of the Pharmacovigilance Centre of the Basque Country. Pharmacovigilance centres should include cost analysis of ADR among their objectives, to provide health systems managers with enough information to implement those measures that will result in a better utilization of the scarce resources of the Public Health System.
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Affiliation(s)
- I Ayani
- Pharmacovigilance Centre, Basque Country, Galdakao, Spain
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de Kruijf W, Ketelaar K, Avakian G, Gubernatis P, Caruge D, Manera A, Van der Hagen T, Yadigaroglu G, Dominicus G, Rohde U, Prasser HM, Castrillo F, Huggenberger M, Hennig D, Munoz-Cobo J, Aguirre C. Planned experimental studies on natural-circulation and stability performance of boiling water reactors in four experimental facilities and first results (NACUSP). Nuclear Engineering and Design 2003. [DOI: 10.1016/s0029-5493(02)00338-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sánchez JL, Aguirre C, Arcos-Burgos OM, Jiménez I, Jiménez M, León F, Pareja J, Pradilla G, Uribe B, Uribe CS, Villa A, Volcy M, Palacio LG. [Prevalence of multiple sclerosis in Colombia]. Rev Neurol 2000; 31:1101-3. [PMID: 11205538] [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: 02/19/2023]
Abstract
INTRODUCTION Multiple sclerosis (MS) is the commonest demyelinating condition of the nervous system. It is characterized by numerous demyelinating areas or plaques of demyelination which are found dispersed throughout the nervous system. It has been shown that MS is less frequent in tropical regions than in subtropical regions. In Latin America particularly, there are some studies which show this phenomenon. However, in Colombia no studies of prevalence of MS have been done. OBJECTIVE To determine the prevalence of multiple sclerosis in five provinces of Colombia (Antioquia, Caldas, Santander, Risaralda and Bolivar). PATIENTS AND METHODS The capture-recapture method was used for two sources to determine the number of cases defined on the criteria of Poser et al seen between July 1995 and June 2000. RESULTS The prevalence (cases of MS per 100,000 inhabitants) varied between 1.48 in Antioquia (95% CI 1.12; 1.78) and 4.98 in Risaralda (95% CI 3.52; 6.43). Seventy two percent were women. The regions included in this study represented 25% of the population of Colombia. CONCLUSIONS There is a low prevalence of MS which is as expected in tropical areas. Persons with MS in these regions may be very useful in the study of other factors involved in the aetiology of MS (genetic). The capture-recapture method is an excellent tool for carrying out prevalence studies since it is cheap and requires little time.
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Affiliation(s)
- J L Sánchez
- Instituto Neurológico de Antioquia, Colombian Committee for Treatment and Research on Multiple Sclerosis (COCTRIMS), Colombia.
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