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Justo I, Marcacuzco A, Caso Ó, Manrique A, García-Sesma Á, Calvo J, Fernández C, Vega V, Rivas C, Jiménez-Romero C. Modified Chevrel technique for abdominal closure in critically ill patients with abdominal hypertension and limited options for closure. Hernia 2023; 27:677-685. [PMID: 37138139 DOI: 10.1007/s10029-023-02797-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/19/2023] [Indexed: 05/05/2023]
Abstract
Abdominal compartment syndrome is a potentially life-threatening condition seen in critically ill patients, and most often caused by acute pancreatitis, postoperative abdominal vascular thrombosis or mesenteric ischemia. A decompressive laparotomy is sometimes required, often resulting in hernias, and subsequent definitive wall closure is challenging. AIM This study aims to describe short term results after a modified Chevrel technique for midline laparotomies in patients witch abdominal hypertension. MATERIALS AND METHODS We performed a modified Chevrel as an abdominal closure technique in 9 patients between January 2016 and January 2022. All patients presented varying degrees of abdominal hypertension. RESULTS Nine patients were treated with new technique (6 male and 3 female), all of whom had conditions that precluded unfolding the contralateral side as a means for closure. The reasons for this were diverse, including presence of ileostomies, intraabdominal drainages, Kher tubes or an inverted T scar from previous transplant. The use of mesh was initially dismissed in 8 of the patients (88,9%) because they required subsequent abdominal surgeries or active infection. None of the patients developed a hernia, although two died 6 months after the procedure. Only one patient developed bulging. A decrease in intrabdominal pressure was achieved in all patients. CONCLUSION The modified Chevrel technique can be used as a closure option for midline laparotomies in cases where the entire abdominal wall cannot be used.
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Affiliation(s)
- I Justo
- Unit of HPB Surgery and Abdominal Organ Transplantation, Department of Surgery, Faculty of Medicine, Instituto de Investigación (imas12), Complutense University, Madrid, Spain.
| | - A Marcacuzco
- Unit of HPB Surgery and Abdominal Organ Transplantation, Department of Surgery, Faculty of Medicine, Instituto de Investigación (imas12), Complutense University, Madrid, Spain
| | - Ó Caso
- Unit of HPB Surgery and Abdominal Organ Transplantation, Department of Surgery, Faculty of Medicine, Instituto de Investigación (imas12), Complutense University, Madrid, Spain
| | - A Manrique
- Unit of HPB Surgery and Abdominal Organ Transplantation, Department of Surgery, Faculty of Medicine, Instituto de Investigación (imas12), Complutense University, Madrid, Spain
| | - Á García-Sesma
- Unit of HPB Surgery and Abdominal Organ Transplantation, Department of Surgery, Faculty of Medicine, Instituto de Investigación (imas12), Complutense University, Madrid, Spain
| | - J Calvo
- Unit of HPB Surgery and Abdominal Organ Transplantation, Department of Surgery, Faculty of Medicine, Instituto de Investigación (imas12), Complutense University, Madrid, Spain
| | - C Fernández
- Unit of HPB Surgery and Abdominal Organ Transplantation, Department of Surgery, Faculty of Medicine, Instituto de Investigación (imas12), Complutense University, Madrid, Spain
| | - V Vega
- Unit of HPB Surgery and Abdominal Organ Transplantation, Department of Surgery, Faculty of Medicine, Instituto de Investigación (imas12), Complutense University, Madrid, Spain
| | - C Rivas
- Service of Thoracic Surgery and Lung Transplantation, Salamanca University Hospital, Salamanca, Spain
| | - C Jiménez-Romero
- Unit of HPB Surgery and Abdominal Organ Transplantation, Department of Surgery, Faculty of Medicine, Instituto de Investigación (imas12), Complutense University, Madrid, Spain
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Odriozola A, Santos-Laso A, Del Barrio M, Cabezas J, Iruzubieta P, Arias-Loste MT, Rivas C, Duque JCR, Antón Á, Fábrega E, Crespo J. Fatty Liver Disease, Metabolism and Alcohol Interplay: A Comprehensive Review. Int J Mol Sci 2023; 24:ijms24097791. [PMID: 37175497 PMCID: PMC10178387 DOI: 10.3390/ijms24097791] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/05/2023] [Accepted: 04/07/2023] [Indexed: 05/15/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide, and its incidence has been increasing in recent years because of the high prevalence of obesity and metabolic syndrome in the Western population. Alcohol-related liver disease (ArLD) is the most common cause of cirrhosis and constitutes the leading cause of cirrhosis-related deaths worldwide. Both NAFLD and ArLD constitute well-known causes of liver damage, with some similarities in their pathophysiology. For this reason, they can lead to the progression of liver disease, being responsible for a high proportion of liver-related events and liver-related deaths. Whether ArLD impacts the prognosis and progression of liver damage in patients with NAFLD is still a matter of debate. Nowadays, the synergistic deleterious effect of obesity and diabetes is clearly established in patients with ArLD and heavy alcohol consumption. However, it is still unknown whether low to moderate amounts of alcohol are good or bad for liver health. The measurement and identification of the possible synergistic deleterious effect of alcohol consumption in the assessment of patients with NAFLD is crucial for clinicians, since early intervention, advising abstinence and controlling cardiovascular risk factors would improve the prognosis of patients with both comorbidities. This article seeks to perform a comprehensive review of the pathophysiology of both disorders and measure the impact of alcohol consumption in patients with NAFLD.
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Affiliation(s)
- Aitor Odriozola
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla Universitary Hospital, Av. Valdecilla 25, 39008 Santander, Cantabria, Spain
| | - Alvaro Santos-Laso
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla Universitary Hospital, Av. Valdecilla 25, 39008 Santander, Cantabria, Spain
| | - María Del Barrio
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla Universitary Hospital, Av. Valdecilla 25, 39008 Santander, Cantabria, Spain
| | - Joaquín Cabezas
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla Universitary Hospital, Av. Valdecilla 25, 39008 Santander, Cantabria, Spain
| | - Paula Iruzubieta
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla Universitary Hospital, Av. Valdecilla 25, 39008 Santander, Cantabria, Spain
| | - María Teresa Arias-Loste
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla Universitary Hospital, Av. Valdecilla 25, 39008 Santander, Cantabria, Spain
| | - Coral Rivas
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla Universitary Hospital, Av. Valdecilla 25, 39008 Santander, Cantabria, Spain
| | - Juan Carlos Rodríguez Duque
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla Universitary Hospital, Av. Valdecilla 25, 39008 Santander, Cantabria, Spain
| | - Ángela Antón
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla Universitary Hospital, Av. Valdecilla 25, 39008 Santander, Cantabria, Spain
| | - Emilio Fábrega
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla Universitary Hospital, Av. Valdecilla 25, 39008 Santander, Cantabria, Spain
| | - Javier Crespo
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla Universitary Hospital, Av. Valdecilla 25, 39008 Santander, Cantabria, Spain
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Del Barrio M, Lavín L, Santos-Laso Á, Arias-Loste MT, Odriozola A, Rodriguez-Duque JC, Rivas C, Iruzubieta P, Crespo J. Faecal Microbiota Transplantation, Paving the Way to Treat Non-Alcoholic Fatty Liver Disease. Int J Mol Sci 2023; 24:ijms24076123. [PMID: 37047094 PMCID: PMC10094628 DOI: 10.3390/ijms24076123] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/12/2023] [Accepted: 03/21/2023] [Indexed: 04/14/2023] Open
Abstract
Non-alcoholic fatty liver disease (NAFLD) is currently the most prevalent cause of chronic liver disease (CLD). Currently, the only therapeutic recommendation available is a lifestyle change. However, adherence to this approach is often difficult to guarantee. Alteration of the microbiota and an increase in intestinal permeability seem to be key in the development and progression of NAFLD. Therefore, the manipulation of microbiota seems to provide a promising therapeutic strategy. One way to do so is through faecal microbiota transplantation (FMT). Here, we summarize the key aspects of FMT, detail its current indications and highlight the most recent advances in NAFLD.
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Affiliation(s)
- María Del Barrio
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Av. Valdecilla 25, 39008 Santander, Cantabria, Spain
| | - Lucía Lavín
- Clinical Trial Agency Valdecilla-IDIVAL, Marqués de Valdecilla University Hospital, Av. Valdecilla, 25, 39008 Santander, Cantabria, Spain
| | - Álvaro Santos-Laso
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Av. Valdecilla 25, 39008 Santander, Cantabria, Spain
| | - Maria Teresa Arias-Loste
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Av. Valdecilla 25, 39008 Santander, Cantabria, Spain
| | - Aitor Odriozola
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Av. Valdecilla 25, 39008 Santander, Cantabria, Spain
| | - Juan Carlos Rodriguez-Duque
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Av. Valdecilla 25, 39008 Santander, Cantabria, Spain
| | - Coral Rivas
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Av. Valdecilla 25, 39008 Santander, Cantabria, Spain
| | - Paula Iruzubieta
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Av. Valdecilla 25, 39008 Santander, Cantabria, Spain
| | - Javier Crespo
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Av. Valdecilla 25, 39008 Santander, Cantabria, Spain
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Odriozola A, Puente Á, Cuadrado A, Iruzubieta P, Arias-Loste MT, Redondo C, Rivas C, Fábrega E, Crespo J, Fortea JI. High accuracy of spleen stiffness measurement in diagnosing clinically significant portal hypertension in metabolic-associated fatty liver disease. Liver Int 2023. [PMID: 36912787 DOI: 10.1111/liv.15561] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND AND AIMS Spleen stiffness measurement (SSM) by vibration-controlled transient elastography (VCTE) has been tested in a limited number of studies versus hepatic venous pressure gradient (HVPG), especially with the 100 Hz spleen-specific module. The current study aims to evaluate the diagnostic performance of this novel module for detecting clinically significant portal hypertension (CSPH) in a cohort of compensated patients with metabolic-associated fatty liver disease (MAFLD) as the main aetiology and to improve the performance of the Baveno VII criteria for CSPH diagnosis by including SSM. METHODS This is a retrospective single-centre study including patients with available measurements of HVPG, Liver stiffness measurement (LSM) and SSM by VCTE with the 100 Hz module. Area under the receiver operating characteristic (AUROC) curve analysis was conducted to identify dual cut-offs (rule-out and rule-in) associated with the absence/presence of CSPH. The diagnostic algorithms were adequate if negative predictive value (NPV) and positive predictive values (PPV) were >90%. RESULTS A total of 85 patients were included, 60 MAFLD and 25 non-MAFLD. SSM showed a good correlation with HVPG (MAFLD: r = .74; p < .0001; non-MAFLD: r = .62; p < .0011). In MAFLD patients, SSM had a high accuracy in discarding/diagnosing CSPH (cut-off values of <40.9 and >49.9 kPa, AUC 0.95). The addition of these cut-offs in a sequential or combined approach to the Baveno VII criteria significantly reduced the grey zone (60% vs. 15%-20%), while maintaining adequate NPV and PPV. CONCLUSIONS Our findings support the utility of SSM for diagnosing CSPH in MAFLD patients and demonstrate that the addition of SSM to the Baveno VII criteria increases accuracy.
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Affiliation(s)
- Aitor Odriozola
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Santander, Spain
| | - Ángela Puente
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Santander, Spain
| | - Antonio Cuadrado
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Santander, Spain
| | - Paula Iruzubieta
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Santander, Spain
| | - María T Arias-Loste
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Santander, Spain
| | - Carlos Redondo
- Statistical and Bioinformatic Unit, Valdecilla Research Institute (IDIVAL), Santander, Spain
| | - Coral Rivas
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Santander, Spain
| | - Emilio Fábrega
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Santander, Spain
| | - Javier Crespo
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Santander, Spain
| | - José I Fortea
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, Santander, Spain
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Odriozola A, Puente Á, Cuadrado A, Rivas C, Anton Á, González FJ, Pellón R, Fábrega E, Crespo J, Fortea JI. Portal Vein Thrombosis in the Setting of Cirrhosis: A Comprehensive Review. J Clin Med 2022; 11:6435. [PMID: 36362663 PMCID: PMC9655000 DOI: 10.3390/jcm11216435] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 08/06/2023] Open
Abstract
Portal vein thrombosis constitutes the most common thrombotic event in patients with cirrhosis, with increased rates in the setting of advanced liver disease. Despite being a well-known complication of cirrhosis, the contribution of portal vein thrombosis to hepatic decompensation and overall mortality is still a matter of debate. The incorporation of direct oral anticoagulants and new radiological techniques for portal vein recanalization have expanded our therapeutic arsenal. However, the lack of large prospective observational studies and randomized trials explain the heterogenous diagnostic and therapeutic recommendations of current guidelines. This article seeks to make a comprehensive review of the pathophysiology, clinical features, diagnosis, and treatment of portal vein thrombosis in patients with cirrhosis.
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Affiliation(s)
- Aitor Odriozola
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, 39008 Santander, Spain
| | - Ángela Puente
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, 39008 Santander, Spain
| | - Antonio Cuadrado
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, 39008 Santander, Spain
| | - Coral Rivas
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, 39008 Santander, Spain
| | - Ángela Anton
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, 39008 Santander, Spain
| | | | - Raúl Pellón
- Radiology Department, Marqués de Valdecilla University Hospital, 39008 Santander, Spain
| | - Emilio Fábrega
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, 39008 Santander, Spain
| | - Javier Crespo
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, 39008 Santander, Spain
| | - José Ignacio Fortea
- Gastroenterology and Hepatology Department, Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Marqués de Valdecilla University Hospital, 39008 Santander, Spain
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Cediel Calderon G, Lopez H, Domingo M, Codina P, Santiago E, Borrellas A, Gonzalez B, Rivas C, Crespo E, Pulido A, Velayos P, Barcelo E, Lupon J, Bayes-Genis A. Alcohol abstinence vs. persistent alcohol consumption in alcoholic cardiomyopathy: impact on long-term prognosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.946] [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
Background
Alcoholic Cardiomyopathy (ACM) remains a prevalent form of toxic-induced heart damage. Whether ACM prognosis depends on the persistence of alcohol consumption is a matter of debate.
Purpose
We sought to determine predictors of adverse events during long-term follow-up and left ventricular ejection fraction (LVEF) changes between abstainers and non-abstainers.
Methods
Consecutive patients admitted to a HF clinic from 2001 to 2020 with ACM were included. The primary endpoint was the composite of all-cause death or HF hospitalization. HF hospitalization was analyzed as a secondary outcome. Changes in LVEF at 1- and 3-years follow-up according to discontinuation of alcohol consumption was also analyzed. Multivariable Cox regression analyses were performed using the competing risk strategy for the secondary endpoint.
Results
A total of 122 patients were included with a mean age of 57.8±10.0 years and 95.1% (n=116) of males. The mean LVEF was 27.5% ± 10.6 and 11.5% (n=14) exhibited NYHA functional class 3. A total of 92 (75.4%) patients remained abstinent during follow-up; the rest continued with at least moderate alcohol intake. After a median follow-up of 6.8 years (interquartile range: 3.2 to 11.3 years), 59 (48.4%) presented the primary endpoint (45 [36.9%] died and 34 [27.9%] experienced HF readmission). Independent predictors of the primary outcome were age (hazard ratio [HR]: 1.03; 95% confidence interval [CI]: 1.00–1.06; p=0.042), hemoglobin (HR: 0.68; 95% CI: 0.56–0.82; p<0.001) and alcohol abstinence (HR: 0.35; 95% CI: 0.20–0.61; p<0.001). Predictors of HF readmission were hemoglobin (HR: 0.65; 95% CI: 0.50–0.83; p=0.001) and alcohol abstinence (HR: 0.39; 95% CI: 0.17–0.92; p=0.032). Improvement in LVEF was higher in abstainers (27.5±10.6% from baseline to 46.7±13.1% and 49.1±14.3% at 1- and 3-years respectively) than in non-abstainers (27.8±10.3% to 40.3±14.0% and 39.2±16.3% at 1- and 3-years respectively), being these changes in LVEF significantly different between both groups (p=0.004).
Conclusions
Patients with ACM and who remain abstainers during follow-up exhibit better outcomes and higher LVEF improvement in comparison to non-abstainers. These findings should help to inform lifestyle modification for patients with ACM.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- G Cediel Calderon
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - H Lopez
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - M Domingo
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - P Codina
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - E Santiago
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - A Borrellas
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - B Gonzalez
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - C Rivas
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - E Crespo
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - A Pulido
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - P Velayos
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - E Barcelo
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - J Lupon
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - A Bayes-Genis
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
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Gonzalez B, Zamora E, Rivas C, Pulido A, Crespo E, Velayos P, Diaz V, Altabella M, Bares D, Codina P, Domingo M, Santiago-Vacas E, Cediel G, Lupon J, Bayes-Genis A. Quality of life in patients with heart failure and improved ejection fraction: one year changes and prognostic implication. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2734] [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: 11/14/2022] Open
Abstract
Abstract
Background
Inconsistent and controversial results have been reported about the association of quality of life (QoL) and left ventricular ejection fraction (LVEF) in patients with heart failure (HF). The 2021 universal definition of HF specifically describes the criteria for the patients with HF and improved LVEF (HFimpEF): HF with a baseline LVEF ≤40%, a ≥10 point increase from baseline LVEF, and a second measurement of LVEF >40%.
Purpose
1) To assess whether patients with HF and reduced LVEF (HFrEF) at first visit in an outpatient HF Clinic that fulfil the HFimpEF criteria one year later presented a higher improvement in QoL assessed by the Minnesota Living With Heart Failure Questionnaire (MLWHFQ) than those patients that did not fulfil HFimpEF criteria. 2) To assess the prognostic role of QoL on outcomes in HFimpEF patients.
Methods
In a prospective registry of real-life HF outpatients LVEF and QoL evaluated by MLWHFQ were assessed at first visit at the HF Clinic and at one year of follow-up.
Results
From August 2001 to August 2021, baseline and one year LVEF and MLWFQ scores were available in 1040 patients with an initial LVEF ≤40%. Table 1 shows baseline demographic and clinical characteristics of patients. In summary, mean age was 65.2±11.7 years, 75.9% of the patients were men, the main aetiology was ischaemic heart disease (52.9%) and patients were mostly in New York heart Association (NHYA) class II (71.1%) and III (21.6%). Baseline LVEF was 28.5% ± 7.3 and baseline MLWHFQ score was 30.2±19.5. At one year, mean LVEF increased to 38.0±12.2 while MLWHFQ scores improved to 17.4±16.0. There were 361 patients that fulfilled the HFimpEF criteria (34.7%). These patients significantly and markedly improved both LVEF (from 28.7±6.6 to 50.9±7.6, p<0.001) and QoL (from 32.9±20.6 to 16.9±16.0, p<0.001). Although in patients that did not fulfil the criteria of HFimpEF both LVEF (from 28.4±7.6 to 31.1±7.9, p<0.001) and QoL (from 28.7±18.8 to 17.6±15.9, p<0.001) also significantly improved, the improvement in QoL was significantly higher in HFimpEF patients (−16.0±23.8 vs. −11.1±20.3, p=0.001), taking into account that baseline MLWHFQ score was worse in HFimpEF patients (p=0.001). However, at one year QoL was similar when both groups were compared (p=0.50). MLWHFQ score at one year proved to be superior to QoL improvement (using a cut-off of at least 5 points) from the prognostic point of view.
Conclusions
QoL improved both in patients with and without HFimpEF criteria, and QoL perception at one year was similar in both groups, suggesting the influence of other factors other than LVEF in QoL perception. QoL at one year revealed to be superior to QoL changes from baseline from the prognostic point of view.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- B Gonzalez
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - E Zamora
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - C Rivas
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - A Pulido
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - E Crespo
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - P Velayos
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - V Diaz
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - M Altabella
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - D Bares
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - P Codina
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - M Domingo
- Germans Trias i Pujol Hospital , Badalona , Spain
| | | | - G Cediel
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - J Lupon
- Germans Trias i Pujol Hospital , Badalona , Spain
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8
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Roig T, Gonzalez B, Lopez Y, Rivas C, Arderiu A, Pulido A, Crespo E, Velayos P, Diaz V, Altabella M, Bares D, Barcelo E, Domingo M, Lupon J, Bayes-Genis A. How to screen frailty in outpatients with heart failure: multimodality assessment vs. the Vulnerable Elderly Survey 13 (VES-13) scale. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2735] [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
Background
During two decades we have been screening fragility in outpatients with heart failure (HF) with a multimodality assessment using several geriatric scales, showing that frailty or fragility is frequent in HF patients, even in young patients, and we demonstrated that this identified fragility played an important prognostic role. Frailty is a medical syndrome with multiple causes and contributors that increases outpatients' vulnerability so a minimal stress can cause functional impairment, with a major risk of dependency, even death. Frailty can be reversible or attenuated by interventions. Nowadays several specific scales for fragility or frailty detection are widely available. One of them, the Vulnerable Elderly Survey 13 (VES-13) has scarcely been used in HF.
Purpose
To assess the prevalence of fragility in an outpatient HF Clinic at first visit using both the VES-13 scale and a multimodality assessment that includes Barthel index, OARS scale, Pfeiffer test, and abbreviated Yesavage Geriatric Depression Scale of 4 items (GDS), and compare the two approaches
Methods
Nurses fulfilled the scales with the patients at their first visit. An scoring ≥3 in the VES-13 scale and the presence of one of the predefined criteria in the multimodality assessment (Barthel <90; OARS score <10 in women and <6 in men; Pfeiffer Test score >3±1, depending on educational level; one positive depression response in abbreviated GDS; and age >85 years or nobody to turn to for help) were considered to have fragility for the purpose of the study.
Results
From March 2021 to December 2021, 136 patients were evaluated with the two fragility screening modalities (mean age 68.8±10.8 years, 64% men, 46% from ischaemic aetiology, 65.4%/27.9% in NYHA class II/III, LVEF 39.5% ± 13.4). VES-13 identified 51 (37.5%) patients with fragility, while the multimodality assessment detected 45 (33.6%) patients. Barthel index and depressive symptoms in the GDS were the most altered items (19 and 20 patients respectively) in the multimodality assessment. Concordance between VES-13 and multimodality assessment was 83.8%, but Cohen's Kappa was 0.65, not reaching the suitable level of 0.70.
Conclusions
VES-13 was capable of identifying a higher number of patients with fragility at first visit in the routine screening performed in an outpatient HF clinic, than the multimodality assessment used in the last decades. Follow-up of patients and further analysis will allow evaluating which of these two approaches adds more value for outcomes prediction.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Roig
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - B Gonzalez
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - Y Lopez
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - C Rivas
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - A Arderiu
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - A Pulido
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - E Crespo
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - P Velayos
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - V Diaz
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - M Altabella
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - D Bares
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - E Barcelo
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - M Domingo
- Germans Trias i Pujol Hospital , Badalona , Spain
| | - J Lupon
- Germans Trias i Pujol Hospital , Badalona , Spain
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9
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Paulauskaite L, Rivas C, Paris A, Totsika V. A systematic review of relationships and sex education outcomes for students with intellectual disability reported in the international literature. J Intellect Disabil Res 2022; 66:577-616. [PMID: 35698311 PMCID: PMC9328360 DOI: 10.1111/jir.12952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 03/23/2022] [Accepted: 05/16/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Little is known about how to evaluate relationships and sex education (RSE) delivered to students with intellectual disability and what stakeholders perceive are important outcomes. The present study aimed to systematically review existing studies on outcomes of RSE, as the first step in the development of a core outcome set (COS) for students with intellectual disability. METHOD A systematic literature process included two stages: (1) searching for studies reporting on RSE outcomes for students with intellectual disability and (2) studies reporting on measurement properties (e.g. validity, reliability and responsiveness) of standardised instruments identified in stage 1. RESULTS A total of 135 RSE outcomes were extracted from 42 studies: 43 outcomes for students in secondary education and 92 outcomes for students in further education. No RSE outcomes were reported for primary education. Outcomes referred to the human body, hygiene, relationships, sexuality, sex and its consequences, inappropriate and appropriate social and sexual behaviour, keeping safe, emotional vocabulary and positive self-esteem. Outcomes were predominantly knowledge-based, rather than relating to skills and attitudes development. Students with intellectual disability, parents and teachers perceive different RSE outcomes meaningful. Five instruments were used to measure the outcomes, but none have established psychometric properties with this population. CONCLUSIONS The comprehensive list of RSE outcomes for students with intellectual disability will be used to inform the next steps of a Core Outcome Set needed for RSE evaluations in research and education settings. There is an urgent need to develop standardised instruments validated for students with intellectual disability.
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Affiliation(s)
| | - C. Rivas
- Social Research InstituteUniversity College LondonLondonUK
| | - A. Paris
- Centre for Educational Development Appraisal and ResearchUniversity of WarwickCoventryUK
| | - V. Totsika
- Centre for Educational Development Appraisal and ResearchUniversity of WarwickCoventryUK
- Division of PsychiatryUniversity College LondonLondonUK
- Department of PsychiatryMonash UniversityMelbourneVictoriaAustralia
- Tavistock and Portman NHS Foundation TrustLondonUK
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10
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García MJ, Rodríguez-Duque JC, Pascual M, Rivas C, Castro B, Raso S, López-Hoyos M, Arias-Loste MT, Rivero M. Prevalence of antinuclear antibodies in inflammatory bowel disease and seroconversion after biological therapy. Therap Adv Gastroenterol 2022; 15:17562848221077837. [PMID: 35251307 PMCID: PMC8894967 DOI: 10.1177/17562848221077837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 01/13/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Estimates of detectable antinuclear antibodies (ANA) prevalence vary widely, from 6% in healthy populations to 50-80% in patients with autoimmune disease. However, there is a lack of evidence about the overall prevalence in inflammatory bowel disease (IBD) and ANA seroconversion after the beginning of biological therapy. OBJECTIVES The aim of the study was to investigate the overall prevalence of ANA in IBD patients, their relationship with different treatments, clinical outcomes and the seroconversion rate of ANA in patients treated with biological therapy. METHODS Ambispective observational study including all consecutive IBD patients was carried out. Information about the presence of ANA, disease phenotype, duration, activity, complications, and past and current treatments were transversally collected. Retrospectively, in patients with detectable ANA, data regarding previous ANA detection and the diagnosis of lupus-like syndrome (LLS) was gathered. RESULTS A total of 879 IBD patients were included. We observed a detectable ANA prevalence of 13.6%. The presence of ANA was frequently associated with biological therapy (36/118) and decreased when immunomodulators were combined to this therapy (7/32). Of 78 patients with ANA prior to the beginning of biological therapy, a seroconversion rate of 28.8% was observed after a mean of 3.14 years. Only 1 patient suffered LLS. CONCLUSION Our study showed a prevalence of detectable ANA higher than the expected in healthy population. The presence of ANA was lower when immunomodulator therapy is associated. The ANA seroconversion rate is relevant after the initiation of biological treatment nevertheless, the risk of LLS appeared to be marginal.
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Affiliation(s)
| | | | - Marta Pascual
- Gastroenterology and Hepatology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain,Group of Clinical and Translational Research in Digestive Diseases Infection, Immunity and Digestive Pathology Group, Instituto de Investigación Sanitaria de Valdecilla (IDIVAL), Santander, Spain
| | - Coral Rivas
- Gastroenterology and Hepatology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain,Group of Clinical and Translational Research in Digestive Diseases Infection, Immunity and Digestive Pathology Group, Instituto de Investigación Sanitaria de Valdecilla (IDIVAL), Santander, Spain
| | - Beatriz Castro
- Gastroenterology and Hepatology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain,Group of Clinical and Translational Research in Digestive Diseases Infection, Immunity and Digestive Pathology Group, Instituto de Investigación Sanitaria de Valdecilla (IDIVAL), Santander, Spain
| | - Sandra Raso
- Immunology Department, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Sanitaria de Valdecilla (IDIVAL), Santander, Spain
| | - Marcos López-Hoyos
- Immunology Department, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Sanitaria de Valdecilla (IDIVAL), Santander, Spain
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11
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Lavín-Alconero L, Fernández-Lanas T, Iruzubieta-Coz P, Arias-Loste MT, Rodriguez-Duque JC, Rivas C, Cagigal ML, Montalbán C, Useros AL, Álvarez-Cancelo A, García-Saiz M, Crespo-García J. Efficacy and safety of endoscopic sleeve gastroplasty versus laparoscopic sleeve gastrectomy in obese subjects with Non-Alcoholic SteatoHepatitis (NASH): study protocol for a randomized controlled trial (TESLA-NASH study). Trials 2021; 22:756. [PMID: 34717726 PMCID: PMC8556907 DOI: 10.1186/s13063-021-05695-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 10/07/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Non-alcoholic steatohepatitis (NASH) is frequently associated with obesity, and its standard treatment is weight loss with diet and exercise; a dy% weight reduction has been associated with improvement in liver histological and analytical abnormalities. However, less than 25% of subjects achieve this goal. Laparoscopic sleeve gastrectomy (LSG) represents the most common procedure of bariatric surgery, providing effective weight loss and improvement in comorbidities such as NASH, but it is associated with several postoperative complications. Endoscopic bariatric techniques are currently on the rise as a new tool in the fight against obesity, offering patients an alternative to more invasive surgery. However, their efficacy and safety compared with LSG is unclear. METHODS The TESLA-NASH study is a randomized, controlled, open-label, unicentric clinical trial with a medical device. The aim of this study is to evaluate and compare the efficacy and safety of endoscopic sleeve gastroplasty (ESG) versus laparoscopic sleeve gastrectomy (LSG) in liver histology improvement of patients with obesity +/- metabolic syndrome and NASH. A total of 30 patients will be randomized 1:1 to the experimental or control group. DISCUSSION LSG is an effective treatment for weight reduction and for the remission of hepatic alterations. However, LSG is associated with acute and chronic postoperative complications. Bariatric endoscopic techniques promise less invasive and more cost-effective approaches to the treatment of obesity and metabolic comorbidities. ESG represents one of the most promising novel endoscopic interventions and it is mainly proposed for patients with mild-to-moderate obesity, but there are still no guidelines that specify its applicability criteria. This clinical trial will help us apply different tactics to the treatment of obesity and NASH. TRIAL REGISTRATION ClinicalTrials.gov NCT04060368. Registered on Nov 15, 2019.
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Affiliation(s)
- Lucía Lavín-Alconero
- Marqués de Valdecilla Research Institute (IDIVAL), s/n, Calle Cardenal Herrera Oria, 39011, Santander, Cantabria, Spain. .,Department of Clinical Pharmacology, Marqués de Valdecilla University Hospital, Av. Valdecilla, 25, 39008, Santander, Cantabria, Spain. .,Clinical Trial Agency Valdecilla-IDIVAL, Marqués de Valdecilla University Hospital, Av. Valdecilla, 25, 39008, Santander, Cantabria, Spain.
| | - Tatiana Fernández-Lanas
- Marqués de Valdecilla Research Institute (IDIVAL), s/n, Calle Cardenal Herrera Oria, 39011, Santander, Cantabria, Spain.,Department of Clinical Pharmacology, Marqués de Valdecilla University Hospital, Av. Valdecilla, 25, 39008, Santander, Cantabria, Spain
| | - Paula Iruzubieta-Coz
- Marqués de Valdecilla Research Institute (IDIVAL), s/n, Calle Cardenal Herrera Oria, 39011, Santander, Cantabria, Spain.,Department of Gastroenterology and Hepatology, Marqués de Valdecilla University Hospital, School of Medicine, University of Cantabria, Av. Valdecilla, 25, 39008, Santander, Cantabria, Spain
| | - Maria Teresa Arias-Loste
- Marqués de Valdecilla Research Institute (IDIVAL), s/n, Calle Cardenal Herrera Oria, 39011, Santander, Cantabria, Spain.,Department of Clinical Pharmacology, Marqués de Valdecilla University Hospital, Av. Valdecilla, 25, 39008, Santander, Cantabria, Spain
| | - Juan Carlos Rodriguez-Duque
- Marqués de Valdecilla Research Institute (IDIVAL), s/n, Calle Cardenal Herrera Oria, 39011, Santander, Cantabria, Spain.,Department of Gastroenterology and Hepatology, Marqués de Valdecilla University Hospital, School of Medicine, University of Cantabria, Av. Valdecilla, 25, 39008, Santander, Cantabria, Spain
| | - Coral Rivas
- Marqués de Valdecilla Research Institute (IDIVAL), s/n, Calle Cardenal Herrera Oria, 39011, Santander, Cantabria, Spain.,Department of Clinical Pharmacology, Marqués de Valdecilla University Hospital, Av. Valdecilla, 25, 39008, Santander, Cantabria, Spain
| | - Maria Luisa Cagigal
- Department of Pathological Anatomy, Marques de Valdecilla University Hospital, Av. Valdecilla 25, 39008, Santander, Cantabria, Spain
| | - Coral Montalbán
- Department of Endocrinology, Diabetes and Nutricion, Marques de Valdecilla University Hospital, Av. Valdecilla 25, 39008, Santander, Cantabria, Spain
| | - Antonio Lopez Useros
- Departament of General and Digestive Surgery, Marques de Valdecilla University Hospital, Av. Valdecilla 25, 39008, Santander, Cantabria, Spain
| | - Ana Álvarez-Cancelo
- Marqués de Valdecilla Research Institute (IDIVAL), s/n, Calle Cardenal Herrera Oria, 39011, Santander, Cantabria, Spain.,Department of Gastroenterology and Hepatology, Marqués de Valdecilla University Hospital, School of Medicine, University of Cantabria, Av. Valdecilla, 25, 39008, Santander, Cantabria, Spain
| | - Mar García-Saiz
- Marqués de Valdecilla Research Institute (IDIVAL), s/n, Calle Cardenal Herrera Oria, 39011, Santander, Cantabria, Spain.,Department of Clinical Pharmacology, Marqués de Valdecilla University Hospital, Av. Valdecilla, 25, 39008, Santander, Cantabria, Spain.,Clinical Trial Agency Valdecilla-IDIVAL, Marqués de Valdecilla University Hospital, Av. Valdecilla, 25, 39008, Santander, Cantabria, Spain
| | - Javier Crespo-García
- Marqués de Valdecilla Research Institute (IDIVAL), s/n, Calle Cardenal Herrera Oria, 39011, Santander, Cantabria, Spain.,Department of Gastroenterology and Hepatology, Marqués de Valdecilla University Hospital, School of Medicine, University of Cantabria, Av. Valdecilla, 25, 39008, Santander, Cantabria, Spain
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12
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Spitaleri G, Cediel G, Santiago-Vacas E, Codina P, Domingo M, Zamora E, Santesmases J, Diez-Quevedo C, Troya M, Boldo M, Altimir S, Alonso N, Rivas C, Lupon J, Bayes-Genis A. Differences in long-term all-cause and cardiovascular mortality according to heart failure aetiology in ambulatory patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0805] [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: 11/14/2022] Open
Abstract
Abstract
Background
Heart failure (HF) is the final stage of many cardiac disorders. Mortality in heart HF remains challenging despite improvement in outcomes proved in clinical trials in HF with reduced ejection fraction and it can be influenced by the aetiology of HF.
Purpose
To assess differences in long-term mortality (up to 18 years) in a real-life cohort of HF outpatients according to the aetiology of HF.
Methods
Consecutive patients with HF admitted at the HF Clinic from August 2001 to September 2019 were included. Follow-up was closed at 30.9.2020. HF aetiology was divided into ischemic heart disease (IHD), dilated cardiomyopathy (CM) –including non-compaction CM–, hypertensive CM, alcohol-derived CM, drug-derived CM, valvular disease, hypertrophic CM and others. For the present analysis, this latter group was excluded due to the big heterogeneity and limited number of patients in each subtype of aetiology. All-cause death and cardiovascular death were the primary end-points. Fine & Gray method for competing risk was used for cardiovascular mortality analysis.
Results
Out of 2387 patients included (age 66.5±12.5 years, 71.3% men, LVEF 35.4%±14.2, mainly in NYHA class II [65.5%] and III [26.5%]), 1317 deaths were recorded (731 from cardiovascular cause) during a maximum follow-up of 18 years (median 4.1 years [IQR 2–7.8] for the total cohort, 5.3 years [IQR 2.6–9.7] for survivors). Figure 1 shows Cox regression multivariable analysis for all-cause death and cardiovascular mortality. Considering IHD aetiology as reference, only dilated CM showed significantly lower risk of all-cause death, and only drug-induced CM showed higher risk of all-cause death. However, when cardiovascular mortality was considered almost all aetiologies showed significant lower risk of cardiovascular death than IHD. Figure 2 shows adjusted survival curves (A) and adjusted incidence curves of cardiovascular death (B) based on HF aetiology.
Conclusions
After adjusting for multiple prognostic factors among the studied HF aetiologies, dilated CM and drug-related CM showed the lowest and the highest risk of all-cause death, respectively. Patients with IHD showed the highest adjusted risk of cardiovascular death.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- G Spitaleri
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - G Cediel
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - E Santiago-Vacas
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - P Codina
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - M Domingo
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - E Zamora
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - J Santesmases
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - C Diez-Quevedo
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - M Troya
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - M Boldo
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - S Altimir
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - N Alonso
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - C Rivas
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - J Lupon
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - A Bayes-Genis
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
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13
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Casquete D, Codina P, Domingo M, Santiago E, Cediel G, Spitaleri G, Zamora E, Santesmases J, Boldo M, Rivas C, Gonzalez B, Velayos P, Pulido A, Lupon J, Bayes-Genis A. Natriuretic peptide dynamics with remote pulmonary artery pressure monitoring. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1031] [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: 11/14/2022] Open
Abstract
Abstract
Background
Real-life clinical practice has confirmed the value of pulmonary artery (PA) pressure-guided therapy in patients with heart failure (HF) and history of repeated HF hospitalizations (HFH), to greater extent to that reported in the pivotal clinical trial CHAMPION-HF. The value of hemodynamic monitoring in a population of patients with HF and elevated natriuretic peptides, but without recent HFH, is unknown.
Objective
To assess N-terminal-pro-brain natriuretic peptide (NTproBNP) dynamics before and 6 months after PA pressure sensor implantation.
Methods
Ten patients managed in a multidisciplinary HF clinic implanted with the CardioMEMS PA pressure sensor were consecutively included from June 2019 to July 2020. Mean age was 63.1±23.5 years, 30% were women, 40% had HF with reduced EF (EF <40%). NTproBNP was measured at baseline and six months after sensor implantation. Wilcoxon matched-pairs signed-rank test was used to compare NTproBNP values at baseline and at 6 months. Fractional polynomial fit plot was used to represent changes in mean PA pressure over time. Linear regression was used to predict the change in NTproBNP based on the change in PA pressures.
Results
Mean daily pressure transmission rate was 92.4±5.1%. During the six-month study period 90% of patients had a change in medication related to PA pressure, with an average of 0.21 [0.17–0.66] changes per patient per month. Mean PA pressure at baseline was 28.5±9.5 mmHg, and decreased by 5.5 mmHg at 6 months (p=0.01) (Figure 1). NTproBNP was also significantly lower six months post CardioMEMS implantation; decreasing from 1696 pg/ml [976–2930] at baseline to 1046 pg/ml [616–2076] after six months (p=0.04) (Figure 2). There was a weak correlation between the change in NTproBNP and the change in mean PA pressure (R2=0.22, p=0.17).
Conclusions
NTproBNP values were significantly lower 6-months following implantation of a PA pressure sensor to guide HF management. Mean PA pressures were also significantly reduced.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): Hospital Universitari Germans Trias i Pujol Figure 1. Change in mean PA pressure over time.Figure 2. Change in NTproBNP after PAP monitoring.
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Affiliation(s)
- D Casquete
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - P Codina
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - M Domingo
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - E Santiago
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - G Cediel
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - G Spitaleri
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - E Zamora
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - J Santesmases
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - M Boldo
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - C Rivas
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - B Gonzalez
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - P Velayos
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - A Pulido
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - J Lupon
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
| | - A Bayes-Genis
- Germans Trias i Pujol Hospital, Cardiology, Badalona, Spain
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14
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Codina Verdaguer P, Buchaca D, Spitaleri G, Domingo M, Santiago-Vacas E, Cediel G, Zamora E, Santesmases J, Troya M, Escabia C, Gonzalez B, Rivas C, Nunez J, Lupon J, Bayes-Genis A. Long-term evolution of estimated glomerular filtration rate in heart failure. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0988] [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
Background
Limited data are available on the very long-term trajectory of glomerular filtration rate (GFR) in patients with chronic heart failure (HF).
Purpose
To assess the GFR dynamics estimated by CKD-EPI in a real-life cohort of HF patients over a 14-year follow-up.
Methods
In a prospective observational registry of real-life HF outpatients, estimated GFR (eGFR) was calculated by CKD-EPI at baseline and on a structured schedule every 3 months up to 14 years. We included in the analysis only eGFR values that were assessed at scheduled visits, discarding urgent renal function assessments. Loess (locally weighted error sum of squares) curves were plotted for the whole cohort and subgroups according to vital status up to 14 years of follow-up. Loess curves are useful to observe a trend or relationship on nonlinear data observed over time.
Results
2423 patients were consecutively included from August 2001 to December 2018. Mean age was 67.0±12.7 years, 28,8% were women and 71.1% had HF with reduced ejection fraction (EF<40%). Out of 37360 eGFR values, 25458 were included in the analysis with a median of 8 values per patient [IQR 4–15] and a range between 1 and 47.
Significant changes occurred along the whole trajectory. An initial decline in eGFR was observed during the first three years of follow-up. Subsequently, there was an upward trend during the following five years and after that period a progressive decline was seen until the end of follow-up (Figure 1). In the sub-group of patients who died during follow-up the eGFR slope showed a persistent decline over time of ∼1ml/min/1.73m2 per year. On the contrary, patients who survived to follow-up maintained a stable eGFR (Figure 2).
Conclusions
The eGFR long-term trajectory in patients with chronic HF showed a snaky pattern with an early decrease, mid-term improvement and late progressive decline. Patients who died during follow-up presented a progressive decline from the beginning.
Funding Acknowledgement
Type of funding sources: None. Figure 1. Long-term evolution of eGFRFigure 2. eGFR evolution according to vital status
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Affiliation(s)
| | - D Buchaca
- Barcelona Supercomputing Center, Barcelona, Spain
| | - G Spitaleri
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - M Domingo
- Germans Trias i Pujol Hospital, Badalona, Spain
| | | | - G Cediel
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - E Zamora
- Germans Trias i Pujol Hospital, Badalona, Spain
| | | | - M.I Troya
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - C Escabia
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - B Gonzalez
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - C Rivas
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - J Nunez
- INCLIVA Foundation, Valencia, Spain
| | - J Lupon
- Germans Trias i Pujol Hospital, Badalona, Spain
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15
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Burel C, Direur G, Rivas C, Purevdorj-Gage L. Colorimetric detection of residual quaternary ammonium compounds on dry surfaces and prediction of antimicrobial activity using bromophenol blue. Lett Appl Microbiol 2020; 72:358-365. [PMID: 33191523 DOI: 10.1111/lam.13429] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 01/22/2023]
Abstract
Controlling and monitoring the residual activity of quaternary ammonium compounds (QACs) are critical for maintaining safe yet effective levels of these agents in the environment. This study investigates the utility of bromophenol blue (BPB) as a safe, rapid and user-friendly indicator to detect in situ residual QACs dried on hard, non-porous surfaces, as well a means to assess their antimicrobial efficacy. At pH 7, BPB has a purple colour which turns blue upon its complexation with QACs such as didecyldimethylammonium chloride (DDAC). BPB itself has no antimicrobial properties up to 400 ppm. Within the range of 0-400 ppm, BPB colour change was tied to specific DDAC antimicrobial performances with a detection threshold of 100 ppm. BPB concentration and application volume could be adjusted such that a colour shift from purple to blue correlated with a set percent reduction (>99·9%) in test bacteria (Staphylococcus aureus and Klebsiella aerogenes). The BPB solutions developed in this study yielded similar colour shifts on polycarbonate and stainless steel surfaces and did not cross-react with chemical ingredients commonly found in sanitizers and disinfectant products. Overall, this study suggests that BPB provides a simple solution to safely monitor the post-application level and biocidal activity of residual dried QACs on surfaces.
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Affiliation(s)
- C Burel
- Complex Assemblies of Soft Matter Laboratory (COMPASS), UMI 3254, CNRS-Solvay-University of Pennsylvania, CRTB, Bristol, PA, USA
| | - G Direur
- Complex Assemblies of Soft Matter Laboratory (COMPASS), UMI 3254, CNRS-Solvay-University of Pennsylvania, CRTB, Bristol, PA, USA
| | - C Rivas
- Solvay, CRTB, Bristol, PA, USA
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16
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Codina P, De Antonio M, Domingo M, Santiago-Vacas E, Zamora E, Santesmases J, Subirana I, Buchaca D, Diez-Quevedo C, Boldo M, Rivas C, Velayos P, Nunez J, Lupon J, Bayes-Genis A. Head-to-head comparison of MAGGIC-HF, SHFM and BCN-Bio HF scores. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0958] [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
Background
Three heart failure (HF) web-based risk scores are currently used in clinical practice. Two only include clinical variables; one adds biomarkers, known to refine pathophysiological pathways in HF and to improve mortality prediction.
Objective
To assess inter-score agreement and to compare mortality prediction discrimination between MAGGIC-HF risk score, Seattle HF Model (SHFM) and Barcelona Bio-HF Risk Calculator (BCN Bio-HF), which includes both clinical and biomarker variables (NTproBNP).
Methods
Out of 1745 consecutive patients with HF from different etiologies admitted at our Unit from May 2006 to November 2018, 1689 with NTproBNP measurement at first visit were included. Absolute and consistency intraclass correlation coefficient (ICC) at individual level among the three risk estimation tools was assessed. Bland Altman graphics were used to illustrate the differences between scores across the broad spectrum of mortality risk. Discrimination of the three prediction tools was compared by AUC of the ROC curves for 1-, 3- and 5-year all-cause mortality. Patients used previously to derivate the BCN Bio-HF were excluded.
Results
Patients age 66.3±13.3 years, 70.4% men, LVEF 36.4%±14.4, ischemic etiology 43.7%. Absolute ICC was poor for the three tools (from 0.18 [–0.006 to 0.35] to 0.53 [0.42 to 0.62], while consistency ICC was slightly better (from 0.28 [0.24 to 0.33] to 0.57 [0.53 to 0.60], being highest the ICC of MAGGIC-HF and BCN Bio-HF. Correlation was better among scores in low-mortality risk profile patients but clinical scores tended to infraestimate the risk in comparison with the BCN Bio-HF in high-risk patients (Figure). Discrimination was numerically better with the BCN Bio-HF at every time risk (Table), significantly better when compared with SHFM.
Conclusions
In comparison with other clinical scores, the BCN Bio-HF calculator predicted better higher mortality risk. Correlation was globally poor for the three tools at individual level, although improved in the low risk patients. Discrimination tended to be numerically better with the BCN Bio-HF calculator, reaching statistical significance when compared with the SHFM.
Bland Altman agreement among tools
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- P Codina
- Germans Trias i Pujol Hospital, Badalona, Spain
| | | | - M Domingo
- Germans Trias i Pujol Hospital, Badalona, Spain
| | | | - E Zamora
- Germans Trias i Pujol Hospital, Badalona, Spain
| | | | - I Subirana
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - D Buchaca
- Barcelona Supercomputing Center, Barcelona, Spain
| | | | - M Boldo
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - C Rivas
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - P Velayos
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - J Nunez
- University General Hospital of Valencia, Valencia, Spain
| | - J Lupon
- Germans Trias i Pujol Hospital, Badalona, Spain
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17
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Zamora E, De Antonio M, Domingo M, Santiago-Vacas E, Codina P, Santesmases J, Troya M, Diez-Quevedo C, Boldo M, Alonso N, Gonzalez B, Rivas C, Nunez J, Lupon J, Bayes-Genis A. Heart failure hospitalization trends during a very long-term follow-up up to 18 years. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0959] [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: 11/14/2022] Open
Abstract
Abstract
Background
Heart Failure (HF) is the first cause of hospitalizations in people older than 65 years. Often patients suffer recurrent hospital admissions.
Objective
To assess recurrent HF-related hospitalizations during very long-term follow-up in a cohort of HF outpatients managed in an ambulatory structured HF Unit.
Methods
End of follow-up was 31.8.2019 (at least 1-year follow-up for alive patients, up to 18 years). Heart failure hospitalizations were defined as unplanned hospitalizations of at least 24 hours due to worsening heart failure and were identified from clinic records, hospital wards, or electronic Catalan history record. Death was recorded from the same sources and Spanish Health System and Spanish Death Registry. Lost information during follow-up was adequately censored (1 patient for survival status and 37 for HF-related hospitalizations).
Results
A total of 2355 patients were included. Follow-up span a total of 12,472 patients-years. 1682 HF-related hospitalizations were recorded in 725 patients (13.5 per 100 patients-years). Number of admissions ranged from 0 in 1630 patients to 22 in 1 patient (patients with hospitalizations, median 2 [Q1-Q3, 1–3]; 118 patients had 4 or more hospitalizations). HF hospitalization density incidence was higher during the 10 first years in patients with HF hospitalizations in the precedent year before HF Clinic baseline visit (table). By contrast, if only patients who died during follow-up were considered (N=1299), hospitalization trends significantly increased in their last period of life: 11.7%, 8.9%, 13.6%, 20.8% and 44.9% from the first to the last period (quintile) of their trajectory, respectively.
Conclusions
HF hospitalizations occur during the whole HF trajectory, with an increasing trend at the end of the every patient trajectory.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- E Zamora
- Germans Trias i Pujol Hospital, Badalona, Spain
| | | | - M Domingo
- Germans Trias i Pujol Hospital, Badalona, Spain
| | | | - P Codina
- Germans Trias i Pujol Hospital, Badalona, Spain
| | | | - M.I Troya
- Germans Trias i Pujol Hospital, Badalona, Spain
| | | | - M Boldo
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - N Alonso
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - B Gonzalez
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - C Rivas
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - J Nunez
- University General Hospital of Valencia, Valencia, Spain
| | - J Lupon
- Germans Trias i Pujol Hospital, Badalona, Spain
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18
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Duncan AD, Peters BS, Rivas C, Goff LM. Reducing risk of Type 2 diabetes in HIV: a mixed-methods investigation of the STOP-Diabetes diet and physical activity intervention. Diabet Med 2020; 37:1705-1714. [PMID: 30734352 DOI: 10.1111/dme.13927] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/05/2019] [Indexed: 12/14/2022]
Abstract
AIM To conduct a mixed-methods feasibility study of the effectiveness and acceptability of an individualized diet and physical activity intervention designed to reduce the risk of Type 2 diabetes experienced by people living with HIV. METHODS Participants with impaired fasting glucose and HIV were invited to take part in a 6-month diet and physical activity intervention. Individualized advice to achieve 10 lifestyle goals was delivered monthly. Diabetes risk was assessed pre- and post-intervention by measurement of the glucose and insulin response to a 3-h meal tolerance test. Six-month change was analysed using paired t-tests. Research interviews exploring the acceptability of the intervention and factors influencing behaviour change were conducted with those who participated in the intervention, and those who declined participation. RESULTS The intervention (n=28) significantly reduced the following: glucose and insulin, both fasting and postprandial incremental area under the curve (glucose 7.9% and 17.6%; insulin 22.7% and 31.4%, respectively); weight (4.6%); waist circumference (6.2%); systolic blood pressure (7.4%); and triglycerides (36.7%). Interview data demonstrated the acceptability of the intervention. However, participants expressed concern that deliberate weight loss might lead to disclosure of HIV status or association with AIDS-related illness. The belief that antiretroviral medications drove diabetes risk was associated with declining study participation or achieving fewer goals. CONCLUSIONS We have demonstrated the beneficial effects of a lifestyle intervention in mitigating the increased risk of Type 2 diabetes associated with HIV. Future interventions should be designed to further reduce the unique barriers that prevent successful outcomes in this cohort.
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Affiliation(s)
- A D Duncan
- Department of Immunology, Infection and Inflammatory Diseases, King's College, London
- Department of Diabetes and Nutrition, King's College, London
- Department of HIV Medicine, Guy's and St. Thomas' Hospital NHS Foundation Trust
| | - B S Peters
- Department of Immunology, Infection and Inflammatory Diseases, King's College, London
- Department of HIV Medicine, Guy's and St. Thomas' Hospital NHS Foundation Trust
| | - C Rivas
- Institute of Education, University College Hospital, London, UK
| | - L M Goff
- Department of Diabetes and Nutrition, King's College, London
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19
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Doussoulin A, Rivas C, Bacco J, Sepúlveda P, Carvallo G, Gajardo C, Soto A, Rivas R. Prevalence of Spasticity and Postural Patterns in the Upper Extremity Post Stroke. J Stroke Cerebrovasc Dis 2020; 29:105253. [PMID: 33066909 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105253] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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: 07/31/2020] [Accepted: 08/15/2020] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION A high number of patients with stroke develop upper extremity spasticity, causing abnormal postures and patterns. These alterations limit the use of arm in functional activities and affect social participation. AIM To determine the prevalence of spasticity and postural patterns of the upper extremity post stroke. MATERIALS AND METHODS A cross-sectional descriptive design was used with a prospective follow-up. The sample included 136 patients. The study included 3 measuring times; at 10 days (T1), applying a record with sociodemographic-clinical data, the evaluation of muscle tone in the elbow and wrist and the postural patterns of the UE, and at 3 months (T2) and 12 months (T3) post stroke, re-evaluating tone and patterns. Prevalence was calculated through the one-sample chi-squared (χ2) test followed by inspection of the standardized residuals (z) in each cell. The Kappa coefficient evaluated the degree of agreement in elbow and wrist tone. RESULTS The prevalence of spasticity in the elbow was 37.5% at T1, 57.4% at T2, and 57.4% at T3. At each time there was a high degree of agreement between elbow and wrist tone. Patients developed increased elbow tone between T1 and T2, with maintained tone between T2 and T3. Postural pattern III was the most prevalent according to Hefter's classification. CONCLUSION The prevalence of spasticity in the elbow and wrist increases between 10 days and 3 months post stroke, and is maintained between 3 and 12 months. The onset of spasticity occurs in almost half of patients during the first 10 days post stroke. Postural pattern III according to Hefter's classification presented the greatest prevalence in the spastic UE.
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Affiliation(s)
- A Doussoulin
- Physiotherapist, Associate Professor, Departamento de Pediatría y Cirugía Infantil - Universidad de La Frontera Temuco, Hochstetter 405, Temuco, Chile.
| | - C Rivas
- Physiotherapist MV Clinical Temuco, Chile
| | - J Bacco
- Rehabilitation Physician, Instituto Teletón - Valparaíso
| | - P Sepúlveda
- Physiotherapist, Departamento Ciencias Preclínicas - Universidad de La Frontera, Temuco
| | - G Carvallo
- Physiotherapist, Hospital Dr. Hernán Henríquez Aravena, Temuco, Chile
| | - C Gajardo
- Physiotherapist, Centro Habilidades Clínicas, Universidad de La Frontera, Temuco, Chile
| | - A Soto
- Neurologist, Hospital Dr. Hernán Henríquez Aravena, Temuco, Chile; Departamento de Especialidades Médicas, Universidad de La Frontera, Temuco, Chile
| | - R Rivas
- Departamento de Especialidades Médicas, Universidad de La Frontera, Temuco, Chile; Neurologist, Clínica Alemana de Temuco, Chile
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20
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Domingo M, Conangla L, Lupon J, De Antonio M, Moliner P, Santiago-Vacas E, Zamora E, Gonzalez B, Diaz V, Rivas C, Velayos P, Santesmases J, Altimir S, Boldo M, Bayes-Genis A. 4307Lung ultrasound in stable ambulatory chronic heart failure patients. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0152] [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: 11/14/2022] Open
Abstract
Abstract
Background
The role of lung ultrasound (LUS) in diagnosis and response to diuretic treatment of patients with acute HF has been widely studied, but less is known about its value in chronic HF.
Purpose
To assess the prognostic value of LUS in a cohort of chronic HF stable ambulatory patients and to explore the relationship of LUS findings with clinical data, such as NYHA functional class, left ventricular ejection fraction (LVEF) and NTproBNP.
Methods
Consecutive stable ambulatory patients who attended a scheduled follow-up visit in a HF clinic were included. LUS were performed with a pocket device and examined 4 chest areas per side (two anterior and two lateral). Scans were analysed offline by two investigators blinded to clinical data, who evaluated the number of B-lines of each area. The addition number of B-lines of each area and the quartiles of such addition were used for the analyses. The primary outcome end-point was the composite of all-cause death or hospitalization due to HF at one year. Linear regression and Cox regression analyses were performed.
Results
Five-hundred seventy-seven patients were included between July 2016 and July 2017 (age 69±12 years, 72% men). The main HF aetiology was ischemic heart disease (43%) followed by dilated cardiomyopathy (20%). Median HF duration was 79 months (Q1-Q3 38–144). Mean LVEF was 45%±13 (mean LVEF when admitted at the Unit 34%±13). Most patients were in NYHA functional class II (70%), 13% were in class I and 17% in class III. Median NTproBNP was 722 ng/L (Q1-Q3 262–1760). Mean number of B-lines was 5±6 (Q1, 0; Q2, 1–3; Q3, 4–7; Q4, ≥8). The number of B-lines was associated with age (beta-coefficient 0.11, p<0.001), NYHA functional class (beta-coefficient 1.75, p<0.001), and logNTproBNP (beta-coefficient 1.40, p<0.001). Mean number of B-lines according to NYHA functional class was: class I, 3.5±6; class II, 4.9±6; and class III, 7.1±7. During the one year follow-up 47 patients suffered the primary end-point. In total there were 24 HF related hospitalizations and 26 deaths. In Cox regression analysis, Q4 of B-lines showed a double risk of suffering the primary end-point (HR 2.13 [95% CI 1.18–3.84], p=0.01). However, statistically significance was not maintained for LUS results in the multivariable analysis when age, NYHA functional class and logNTproBNP were included in the model, although a 38% increase in the risk of suffering the primary end-point for Q4 was observed (HR 1.38 [95% CI 0.75–2.54], p=0.31).
Conclusion
In outpatients with stable chronic HF, the number of B-lines detected in LUS was associated with age, NYHA functional class and NTproBNP. Patients having ≥8 B-lines had a significant double risk of HF related hospitalization or all-cause death at one year. However, when strongly powerful prognostic variables such as NYHA class and NTproBNP were included in the model LUS did not retain an independent prognostic role.
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Affiliation(s)
- M Domingo
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - L Conangla
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - J Lupon
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - M De Antonio
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - P Moliner
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | | | - E Zamora
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - B Gonzalez
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - V Diaz
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - C Rivas
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - P Velayos
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - J Santesmases
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - S Altimir
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - M Boldo
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - A Bayes-Genis
- Germans Trias i Pujol University Hospital, Barcelona, Spain
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21
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Zamora E, Gonzalez B, Rivas C, Diaz V, Velayos P, Lupon J, De Antonio M, Domingo M, Moliner P, Santiago-Vacas E, Cachero M, Joaquim C, Alonso N, Santesmases J, Bayes-Genis A. P2607Quick nutritional assessment and prognosis in outpatients with heart failure with mid-range ejection fraction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0931] [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
Background
Nutritional status is an important prognostic factor in patients with heart failure (HF) beyond body mass index, although its prognostic value in patients with mid-range left ventricular ejection fraction (HFmrEF) is not completely elucidated. In a pilot study we observed that the Mini Nutritional Assessment Short Form (MNA-SF) was the best approach for the screening of nutritional status in HF outpatients over others screening tools.
Purpose
To assess the prognostic role of malnutrition or risk of malnutrition in HFmrEF outpatients after the implementation of the MNA-SF screening tool in a routine way in a multidisciplinary HF.
Methods
The MNA-SF screening tool was administered during the global nurse evaluation of patients. The scoring ranges from 0 to 14, being 0 to7 as malnutrition status, 8 to 11 as at risk of malnutrition and 12 to 14 as normal nutritional status. For the present study those patients with malnutrition and at risk of malnutrition were merged and considered abnormal nutritional status. All-cause death was the primary end-point. Univariate and multivariate (backward conditional stepwise) Cox regression analyses were performed.
Results
Since October 2016 to November 2017, 153 HFmrEF patients were studied (mean age 68.8±11.7 years, 72.5% men, body mass index 28.4±4.4, LVEF 44% ± 3, NYHA class I 5.9%, II 86.3%, and III 7.8%). According to the MNA-SF 25 patients were (16.3%) fulfilled criteria of malnutrition (4) or where at risk of malnutrition (21). During a mean follow-up of 17.4±6.1 months, 23 patients died (15%). In the univariate analysis, nutritional abnormal status was significantly associated with all-cause death (HR 2.93 [1.23–7], p=0.02). In the multivariate analysis which included age, sex, NYHA functional class, body mass index, ischemic aetiology of HF and years of duration of HF, abnormal nutritional status remained significantly associated with all-cause mortality (HR 3.64 [1.39–9.54], p=0.009), together with NYHA functional class (HR 7.93 [2.69–23.4], p<0.001) and years of HF duration (HR 1.10 [1.04–1.16], p=0.001).
Conclusions
Nutritional status assessed with the screening MNA-SF was an independent predictor of all-cause death in ambulatory patients with HFmrEF – beyond BMI – together with NYHA functional class and HF duration.
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Affiliation(s)
- E Zamora
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - B Gonzalez
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - C Rivas
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - V Diaz
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - P Velayos
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - J Lupon
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - M De Antonio
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - M Domingo
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - P Moliner
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | | | - M Cachero
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - C Joaquim
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - N Alonso
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - J Santesmases
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - A Bayes-Genis
- Germans Trias i Pujol University Hospital, Barcelona, Spain
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22
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Zamora E, Lupon J, De Antonio M, Domingo M, Moliner P, Santiago-Vacas E, Santesmases J, Boldo M, Diez-Quevedo C, Troya MI, Rivas C, Gonzalez B, Diaz V, Velayos P, Bayes-Genis A. P6330Obesity paradox in heart failure with mid-range ejection fraction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0927] [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: 11/14/2022] Open
Abstract
Abstract
Background
Obesity is identified as an independent risk factor for developing congestive heart failure (HF). Paradoxically it has been reported that obesity is associated with improved survival in different cohorts of HF patients. Nevertheless, the presence of obesity paradox in HF with mid-range ejection fraction (HFmrEF) is not completely elucidated.
Objective
To analyse the relationship between body mass index (BMI) and mortality in a HFmrEF ambulatory cohort of different aetiologies followed in a HF unit, with especial focus on the role of obesity in prognosis.
Methods
Baseline BMI was analysed as continuous variable and categorized in 4 groups based on 2009 WHO classification: low weight (BMI <20.5 kg/m2), normal weight (BMI 20.5 to <25.5 kg/m2), overweight (BMI 25.5 to <30 kg/m2) and obesity (BMI ≥30 kg/m2). All-cause mortality was the primary end-point of the study. Cox regression analyses adjusted by age, sex and NYHA functional class were performed and survival curves plotted.
Results
Three-hundred thirty patients were included in the study (age 65.9±13.2 years, 68% men). The main aetiology was ischemic heart disease (52%, followed by dilated cardiomyopathy (11%) and hypertensive cardiomyopathy (11%). The majority of patients were in NYHA class II (65%) and III (26%). Mean ejection fraction was 43.2% ± 2.7. During a mean follow-up of 5.3±4.6 years 142 patients (42%) died. BMI showed a protective effect on survival in Cox regression analysis (HR 0.96 [95% CI 0.92–0.99], p=0.01). When categorized groups of BMI were analysed, obese patients showed a trend towards lower mortality than normal weight patients (reference): adjusted HR 0.65 [95% CI 0.40–1.03], p=0.07. Survival curves adjusted by age, sex and NYHA functional class according to BMI category are depicted in the figure. As a significant interaction (p=0.02) was found between BMI and ischemic aetiology of HF, separate analyses were performed for BMI categories for ischemic and non-ischemic patients, with remarkably different results: ischemic aetiology: HR 0.97 [95% CI 0.52–1.79], p=0.91; non-ischemic aetiology HR 0.28 [95% CI 0.13–0.64], p=0.003.
Conclusions
A greater BMI was associated with lower mortality rates in patients with HFmrEF during a mean follow-up of five years. Obesity showed a protective effect in HFmrEF patients, which remarkable in patients from non-ischemic aetiology and was absent in patients from ischemic aetiology.
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Affiliation(s)
- E Zamora
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - J Lupon
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - M De Antonio
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - M Domingo
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - P Moliner
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | | | - J Santesmases
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - M Boldo
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - C Diez-Quevedo
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - M I Troya
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - C Rivas
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - B Gonzalez
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - V Diaz
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - P Velayos
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - A Bayes-Genis
- Germans Trias i Pujol University Hospital, Barcelona, Spain
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23
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Moliner P, Lupon J, Cediel G, De Antonio M, Domingo M, Zamora E, Nunez J, Santiago E, Gonzalez B, Rivas C, Diaz V, Santesmases J, Diez-Quevedo C, Boldo M, Bayes-Genis A. P1815Prediction of sudden death in outpatients with heart failure: a bio-clinical approach. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1815] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- P Moliner
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - J Lupon
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - G Cediel
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - M De Antonio
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - M Domingo
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - E Zamora
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - J Nunez
- University Hospital Clinic of Valencia, Valencia, Spain
| | - E Santiago
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - B Gonzalez
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - C Rivas
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - V Diaz
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - J Santesmases
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - C Diez-Quevedo
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - M Boldo
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - A Bayes-Genis
- Germans Trias i Pujol University Hospital, Badalona, Spain
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Diaz V, Agostinho J, Gonzalez B, Rivas C, Velayos P, Puertas M, Ros A, Benito N, Morales A, Cachero M, Lupon J, De Antonio M, Moliner P, Domingo M, Bayes-Genis A. 26Perception of symptoms, concerns and global disease experience in patients with heart failure. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.26] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- V Diaz
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - J Agostinho
- Cardiology Department, Santa Maria Hospital, CHLN, CCUL, Lisbon University, Lisbon, Portugal
| | - B Gonzalez
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - C Rivas
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - P Velayos
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - M Puertas
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - A Ros
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - N Benito
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - A Morales
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - M Cachero
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - J Lupon
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - M De Antonio
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - P Moliner
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - M Domingo
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - A Bayes-Genis
- Germans Trias i Pujol University Hospital, Badalona, Spain
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Gonzalez B, Cachero M, Rivas C, Diaz V, Ros A, Benito N, Puertas M, Morales A, Velayos P, Lupon J, De Antonio M, Moliner P, Domingo M, Zamora E, Bayes-Genis A. 411Mini nutritional assessment short form tool for nurse quick screening of nutritional status in an outpatient heart failure unit. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.411] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- B Gonzalez
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - M Cachero
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - C Rivas
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - V Diaz
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - A Ros
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - N Benito
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - M Puertas
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - A Morales
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - P Velayos
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - J Lupon
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - M De Antonio
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - P Moliner
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - M Domingo
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - E Zamora
- Germans Trias i Pujol University Hospital, Badalona, Spain
| | - A Bayes-Genis
- Germans Trias i Pujol University Hospital, Badalona, Spain
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26
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Xu B, Rivas C, Betancor J, Harb S, Menon V, Griffin B, Rodriguez LL. P6038Contemporary outcomes of conservatively managed sinus of valsalva aneurysms: a 20-year Cleveland clinic experience. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6038] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- B Xu
- Cleveland Clinic Foundation, Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland, United States of America
| | - C Rivas
- Cleveland Clinic Foundation, Department of Internal Medicine, Cleveland, United States of America
| | - J Betancor
- Cleveland Clinic Foundation, Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland, United States of America
| | - S Harb
- Cleveland Clinic Foundation, Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland, United States of America
| | - V Menon
- Cleveland Clinic Foundation, Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland, United States of America
| | - B Griffin
- Cleveland Clinic Foundation, Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland, United States of America
| | - L L Rodriguez
- Cleveland Clinic Foundation, Section of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland, United States of America
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Pacho C, Domingo M, Nunez R, Lupon J, Revuelta-Lopez E, Barallat J, Moliner P, Gonzalez B, Rodriguez M, Rivas C, Diaz V, Santesmases J, De Antonio M, Tor J, Bayes-Genis A. P2462Prediction of 30-day heart failure readmission and death with early post-discharge ST2 and NT-proBNP. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2462] [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: 11/12/2022] Open
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Gonzalez B, Gastelurrutia P, Lupon J, Rodriguez M, Moliner P, Rivas C, De Antonio M, Domingo M, Diaz V, Zamora E, Armesto T, Puertas M, Cachero M, Morales A, Bayes-Genis A. P2986Frailty and quality of life in heart failure patients with mid-range ejection fraction. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p2986] [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: 11/14/2022] Open
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De Antonio M, Lupon J, Barallat J, Domingo M, Nunez-Villota J, Moliner P, Zamora E, Rivas C, Gonzalez B, Diaz V, Rodriguez M, Santesmases J, Diez-Quevedo C, Pastor C, Bayes-Genis A. P590Prognostic value of a panel of biomarkers in heart failure with mid-range ejection fraction. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p590] [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: 11/13/2022] Open
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Lupon J, De Antonio M, Vila J, Subirana I, Galan A, Zamora E, Moliner P, Domingo M, Gonzalez B, Rodriguez M, Rivas C, Barallat J, Santesmases J, Diaz V, Bayes-Genis A. P2455The Barcelona-Bio-HF-calculator upgrade: heart failure hospitalization and all-cause death up to 5 years. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2455] [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: 11/13/2022] Open
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Moliner P, Gastelurrutia P, Lupon J, Yang X, De Antonio M, Domingo M, Altimir S, Gonzalez B, Rodriguez M, Rivas C, Fung E, Zamora E, Santesmases J, Woo J, Bayes-Genis A. P610Frailty, co-morbidities and survival in heart failure patients with mid-range ejection fraction. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p610] [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: 11/13/2022] Open
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Matheson L, Watson EK, Nayoan J, Wagland R, Glaser A, Gavin A, Wright P, Rivas C. A qualitative metasynthesis exploring the impact of prostate cancer and its management on younger, unpartnered and gay men. Eur J Cancer Care (Engl) 2017; 26. [PMID: 28382745 DOI: 10.1111/ecc.12676] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2017] [Indexed: 11/29/2022]
Abstract
Prostate cancer (PCa) can negatively impact on men's sexual, urinary and emotional functioning, affecting quality of life. Most men with PCa are older (≥65 years), married and heterosexual and little is known about the impact on men who are younger, unpartnered or gay. We aimed to synthesise existing qualitative research on these three groups of men. A systematic metasynthesis was undertaken that included data on the unique impacts of PCa on younger (<65 years) (n = 7 papers), unpartnered (n = 17 papers) or gay or bisexual men (n = 11 papers) using a modified meta-ethnographic approach. The three overarching constructs illustrated the magnified disruption to men's biographies, that included: marginalisation, isolation and stigma-relating to men's sense of being "out of sync"; the burden of emotional and embodied vulnerabilities and the assault on identity-illustrating the multiple threats to men's work, sexual and social identities; shifting into different communities of practice-such as the shift from being part of a sexually active community to celibacy. These findings suggest that PCa can have a particular impact on the quality of life of younger, unpartnered and gay men. This has implications for the provision of tailored support and information to these potentially marginalised groups.
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Affiliation(s)
- L Matheson
- Department of Applied Health and Professional Development, Oxford Brookes University, Oxford, UK
| | - E K Watson
- Department of Applied Health and Professional Development, Oxford Brookes University, Oxford, UK
| | - J Nayoan
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - R Wagland
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - A Glaser
- Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - A Gavin
- School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - P Wright
- Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - C Rivas
- Faculty of Health Sciences, University of Southampton, Southampton, UK
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Edwards EA, Lumsden J, Rivas C, Steed L, Edwards LA, Thiyagarajan A, Sohanpal R, Caton H, Griffiths CJ, Munafò MR, Taylor S, Walton RT. Gamification for health promotion: systematic review of behaviour change techniques in smartphone apps. BMJ Open 2016; 6:e012447. [PMID: 27707829 PMCID: PMC5073629 DOI: 10.1136/bmjopen-2016-012447] [Citation(s) in RCA: 187] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Smartphone games that aim to alter health behaviours are common, but there is uncertainty about how to achieve this. We systematically reviewed health apps containing gaming elements analysing their embedded behaviour change techniques. METHODS Two trained researchers independently coded apps for behaviour change techniques using a standard taxonomy. We explored associations with user ratings and price. DATA SOURCES We screened the National Health Service (NHS) Health Apps Library and all top-rated medical, health and wellness and health and fitness apps (defined by Apple and Google Play stores based on revenue and downloads). We included free and paid English language apps using 'gamification' (rewards, prizes, avatars, badges, leaderboards, competitions, levelling-up or health-related challenges). We excluded apps targeting health professionals. RESULTS 64 of 1680 (4%) health apps included gamification and met inclusion criteria; only 3 of these were in the NHS Library. Behaviour change categories used were: feedback and monitoring (n=60, 94% of apps), reward and threat (n=52, 81%), and goals and planning (n=52, 81%). Individual techniques were: self-monitoring of behaviour (n=55, 86%), non-specific reward (n=49, 82%), social support unspecified (n=48, 75%), non-specific incentive (n=49, 82%) and focus on past success (n=47, 73%). Median number of techniques per app was 14 (range: 5-22). Common combinations were: goal setting, self-monitoring, non-specific reward and non-specific incentive (n=35, 55%); goal setting, self-monitoring and focus on past success (n=33, 52%). There was no correlation between number of techniques and user ratings (p=0.07; rs=0.23) or price (p=0.45; rs=0.10). CONCLUSIONS Few health apps currently employ gamification and there is a wide variation in the use of behaviour change techniques, which may limit potential to improve health outcomes. We found no correlation between user rating (a possible proxy for health benefits) and game content or price. Further research is required to evaluate effective behaviour change techniques and to assess clinical outcomes. TRIAL REGISTRATION NUMBER CRD42015029841.
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Affiliation(s)
- E A Edwards
- Centre for Primary Care and Public Health, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - J Lumsden
- School of Experimental Psychology, University of Bristol, Bristol, UK MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - C Rivas
- Centre for Primary Care and Public Health, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - L Steed
- Centre for Primary Care and Public Health, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - L A Edwards
- Institute of Liver Studies, King's College Hospital, London, UK
| | - A Thiyagarajan
- Centre for Primary Care and Public Health, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - R Sohanpal
- Centre for Primary Care and Public Health, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - H Caton
- Department of Computing and Information Systems, Kingston University, London, UK
| | - C J Griffiths
- Centre for Primary Care and Public Health, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - M R Munafò
- School of Experimental Psychology, University of Bristol, Bristol, UK MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - S Taylor
- Centre for Primary Care and Public Health, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - R T Walton
- Centre for Primary Care and Public Health, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Cabo Fustaret M, Escobar A, Novo F, Illia R, Rivas C, Uranga Imaz M, Lobenstein G. PM321 NT-Pro-BNP Relevance in the Clinical Monitoring of Pregnant Patients. Glob Heart 2016. [DOI: 10.1016/j.gheart.2016.03.437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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35
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Rivas C, Navarro N, Huovinen P, Gómez I. Photosynthetic UV stress tolerance of the Antarctic snow alga Chlorella sp. modified by enhanced temperature? Rev Chil de Hist Nat 2016. [DOI: 10.1186/s40693-016-0050-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Coitinho C, Greif G, van Ingen J, Laserra P, Robello C, Rivas C. First case of Mycobacterium heckeshornense cavitary lung disease in the Latin America and Caribbean region. New Microbes New Infect 2016; 9:63-5. [PMID: 26909156 PMCID: PMC4735480 DOI: 10.1016/j.nmni.2015.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 12/09/2015] [Indexed: 11/24/2022] Open
Abstract
A case of cavitary pulmonary disease caused by Mycobacterium heckeshornense in Uruguay is described. This is the first case reported in the Latin America and Caribbean region, showing that this species is a worldwide opportunistic human pathogen.
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Affiliation(s)
- C Coitinho
- Comisión Honoraria de Lucha Anti-Tuberculosa y Enfermedades Prevalentes (CHLA-EP), Montevideo, Uruguay
| | - G Greif
- Institut Pasteur de Montevideo, Montevideo, Uruguay
| | - J van Ingen
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - P Laserra
- Comisión Honoraria de Lucha Anti-Tuberculosa y Enfermedades Prevalentes (CHLA-EP), Montevideo, Uruguay
| | - C Robello
- Institut Pasteur de Montevideo, Montevideo, Uruguay; Departamento de Bioquímica, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - C Rivas
- Comisión Honoraria de Lucha Anti-Tuberculosa y Enfermedades Prevalentes (CHLA-EP), Montevideo, Uruguay
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de la Cruz-Herrera CF, Baz-Martínez M, Lang V, El Motiam A, Barbazán J, Couceiro R, Abal M, Vidal A, Esteban M, Muñoz-Fontela C, Nieto A, Rodríguez MS, Collado M, Rivas C. Conjugation of SUMO to p85 leads to a novel mechanism of PI3K regulation. Oncogene 2015; 35:2873-80. [DOI: 10.1038/onc.2015.356] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 07/17/2015] [Accepted: 08/22/2015] [Indexed: 12/19/2022]
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Humeres C, Montenegro J, Varela M, Ayala P, Vivar R, Letelier A, Olmedo I, Catalán M, Rivas C, Baeza P, Muñoz C, García L, Lavandero S, Díaz-Araya G. 4-Phenylbutyric acid prevent cytotoxicity induced by thapsigargin in rat cardiac fibroblast. Toxicol In Vitro 2014; 28:1443-8. [DOI: 10.1016/j.tiv.2014.07.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 07/29/2014] [Accepted: 07/31/2014] [Indexed: 12/27/2022]
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de la Cruz-Herrera CF, Campagna M, Lang V, del Carmen González-Santamaría J, Marcos-Villar L, Rodríguez MS, Vidal A, Collado M, Rivas C. SUMOylation regulates AKT1 activity. Oncogene 2014; 34:1442-50. [PMID: 24704831 DOI: 10.1038/onc.2014.48] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 11/27/2013] [Accepted: 01/06/2014] [Indexed: 01/09/2023]
Abstract
Serine threonine kinase AKT has a central role in the cell, controlling survival, proliferation, metabolism and angiogenesis. Deregulation of its activity underlies a wide range of pathological situations, including cancer. Here we show that AKT is post-translationally modified by the small ubiquitin-like modifier (SUMO) protein. Interestingly, neither SUMO conjugation nor activation of SUMOylated AKT is regulated by the classical AKT targeting to the cell membrane or by the phosphoinositide 3-kinase pathway. We demonstrate that SUMO induces the activation of AKT, whereas, conversely, down-modulation of the SUMO machinery diminishes AKT activation and cell proliferation. Furthermore, an AKT SUMOylation mutant shows reduced activation, and decreased anti-apoptotic and pro-tumoral activities in comparison with the wild-type protein. These results identify SUMO as a novel key regulator of AKT phosphorylation and activity.
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Affiliation(s)
- C F de la Cruz-Herrera
- Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología-CSIC, Madrid, Spain
| | - M Campagna
- Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología-CSIC, Madrid, Spain
| | - V Lang
- Ubiquitylation and Cancer Molecular Biology laboratory, Inbiomed, San Sebastian-Donostia, Gipuzkoa, Spain
| | | | - L Marcos-Villar
- Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología-CSIC, Madrid, Spain
| | - M S Rodríguez
- Ubiquitylation and Cancer Molecular Biology laboratory, Inbiomed, San Sebastian-Donostia, Gipuzkoa, Spain
| | - A Vidal
- Departamento de Fisioloxía and Centro de Investigación en Medicina Molecular (CIMUS), Universidade de Santiago de Compostela, Instituto de Investigaciones Sanitarias (IDIS), Santiago de Compostela, Spain
| | - M Collado
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), SERGAS, Santiago de Compostela, Spain
| | - C Rivas
- 1] Department of Molecular and Cellular Biology, Centro Nacional de Biotecnología-CSIC, Madrid, Spain [2] Centro de Investigación en Medicina Molecular (CIMUS), Universidade de Santiago de Compostela, Instituto de Investigaciones Sanitarias (IDIS), Santiago de Compostela, Spain
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40
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Jarque I, Tormo M, Bello JL, Rovira M, Batlle M, Julià A, Tabares S, Rivas C, Fernández-Sevilla A, García-Boyero R, Debén G, González-Campos J, Capote FJ, Sanz MA. Caspofungin for the treatment of invasive fungal disease in hematological patients (ProCAS Study). Med Mycol 2013; 51:150-4. [DOI: 10.3109/13693786.2012.693213] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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41
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Vargas F, Rivas C, Medrano M. Interaction of emodin, aloe-emodin, and rhein with human serum albumin: a fluorescence spectroscopic study. Toxicol Mech Methods 2012; 14:227-31. [PMID: 20021135 DOI: 10.1080/15376520490434467] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The interaction of the dihydroxyanthraquinones, emodin (1), aloe-emodin (2), and rhein (3) with human serum albumin (HSA) has been studied through fluorescence spectroscopy. Quenching studies and the association constant of the anthraquinoid compounds 1, 2, and 3 in the presence of HSA were estimated. The binding and quenching studies suggest that only emodin (1) may serve as a useful fluorescence probe for structure/function studies of different emodin binding proteins. No photoinduced binding was observed after irradiation of compounds 1, 2, and 3 in presence of human serum albumin.
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Affiliation(s)
- F Vargas
- Laboratorio de Fotoquímica, Centro de Química, Instituto Venezolano de Investigaciones Científicas I.V.I.C., Caracas, Venezuela
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42
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Burguera JL, Burguera M, Rivas C, Carrero P. On-line cryogenic trapping with microwave heating for the determination and speciation of arsenic by flow injection/hydride generation/atomic absorption spectrometry. Talanta 2012; 45:531-42. [PMID: 18967034 DOI: 10.1016/s0039-9140(97)00189-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/1997] [Revised: 06/12/1997] [Accepted: 06/13/1997] [Indexed: 11/17/2022]
Abstract
An on-line flow injection-hydride generation/atomic absorption spectrometry method was developed for the preconcentration and selective determination of inorganic arsenic [As(III) and As(V)] and its methylated species. The separation of the arsenic species was performed by an automated pH-selective arsines generation technique, using sodium tetrahydroborate(III) as reductant. Each arsine was cryogenically trapped in a PTFE coil, knotted and sealed inside another wider diameter tube, through which liquid nitrogen was suctioned by negative pressure. Then, based on their different boiling points, the arsine species were selectively liberated by using a heating cycle of microwave radiation, followed by atomic absorption detection. A sample solution aliquot mixed with 1% citric acid was used for the determination of As(III) alone, while a second sample aliquot mixed with 2 mol l(-1) nitric acid was used for the quantitative determination of total inorganic arsenic, monomethylarsonic acid and dimethylarsinic acid. Based on 10 ml sample, the detection limits lie within the range 20-60 ng As l(-1), which are sufficiently low to detect the arsines-forming species in natural waters. These values are negatively affected by the reagents purity and background noise due to flame flickering, but the sensitivity can substantially be improved by increasing sample size or running several consecutive reactions.
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Affiliation(s)
- J L Burguera
- Venezuelan Andean Institute for Chemical Research (IVAIQUIM), Faculty of Sciences, University of Los Andes, P.O. Box 542, Mérida, Venezuela
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González-Santamaría J, Campagna M, Ortega-Molina A, Marcos-Villar L, de la Cruz-Herrera CF, González D, Gallego P, Lopitz-Otsoa F, Esteban M, Rodríguez MS, Serrano M, Rivas C. Regulation of the tumor suppressor PTEN by SUMO. Cell Death Dis 2012; 3:e393. [PMID: 23013792 PMCID: PMC3461367 DOI: 10.1038/cddis.2012.135] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 08/24/2012] [Accepted: 08/27/2012] [Indexed: 01/04/2023]
Abstract
The crucial function of the PTEN tumor suppressor in multiple cellular processes suggests that its activity must be tightly controlled. Both, membrane association and a variety of post-translational modifications, such as acetylation, phosphorylation, and mono- and polyubiquitination, have been reported to regulate PTEN activity. Here, we demonstrated that PTEN is also post-translationally modified by the small ubiquitin-like proteins, small ubiquitin-related modifier 1 (SUMO1) and SUMO2. We identified lysine residue 266 and the major monoubiquitination site 289, both located within the C2 domain required for PTEN membrane association, as SUMO acceptors in PTEN. We demonstrated the existence of a crosstalk between PTEN SUMOylation and ubiquitination, with PTEN-SUMO1 showing a reduced capacity to form covalent interactions with monoubiquitin and accumulation of PTEN-SUMO2 conjugates after inhibition of the proteasome. Moreover, we found that virus infection induces PTEN SUMOylation and favors PTEN localization at the cell membrane. Finally, we demonstrated that SUMOylation contributes to the control of virus infection by PTEN.
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Affiliation(s)
- J González-Santamaría
- Centro Nacional de Biotecnología, CSIC, Campus Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - M Campagna
- Centro Nacional de Biotecnología, CSIC, Campus Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - A Ortega-Molina
- Centro Nacional de Investigaciones Oncológicas, Melchor Fernández Almagro, 28029 Madrid, Spain
| | - L Marcos-Villar
- Centro Nacional de Biotecnología, CSIC, Campus Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - C F de la Cruz-Herrera
- Centro Nacional de Biotecnología, CSIC, Campus Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - D González
- Centro Nacional de Biotecnología, CSIC, Campus Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - P Gallego
- Centro Nacional de Biotecnología, CSIC, Campus Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - F Lopitz-Otsoa
- Proteomics Unit, CIC bioGUNE, CIBERehd, Bizkaia Technology Park. Building 801A, 48160 Derio, Spain
| | - M Esteban
- Centro Nacional de Biotecnología, CSIC, Campus Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | - M S Rodríguez
- Proteomics Unit, CIC bioGUNE, CIBERehd, Bizkaia Technology Park. Building 801A, 48160 Derio, Spain
- Ubiquitylation and Cancer Molecular Biology laboratory, Inbiomed, San Sebastian-Donostia, 20009 Gipuzkoa, Spain
| | - M Serrano
- Centro Nacional de Investigaciones Oncológicas, Melchor Fernández Almagro, 28029 Madrid, Spain
| | - C Rivas
- Centro Nacional de Biotecnología, CSIC, Campus Universidad Autónoma de Madrid, 28049 Madrid, Spain
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Coitinho C, Greif G, Robello C, van Ingen J, Rivas C. Identification of Mycobacterium tuberculosis complex by polymerase chain reaction of Exact Tandem Repeat-D fragment from mycobacterial cultures. Int J Mycobacteriol 2012; 1:146-8. [DOI: 10.1016/j.ijmyco.2012.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Accepted: 07/22/2012] [Indexed: 10/27/2022] Open
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Greif G, Coitinho C, Rivas C, van Ingen J, Robello C. Molecular analysis of isoniazid-resistant Mycobacterium tuberculosis isolates in Uruguay [Short communication]. Int J Tuberc Lung Dis 2012; 16:947-9. [DOI: 10.5588/ijtld.11.0559] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- G. Greif
- Unidad de Biología Molecular, Institut Pasteur de Montevideo, Montevideo, Uruguay
| | - C. Coitinho
- Departamento de Laboratorio, Comisión Honoraria de Lucha Anti-Tuberculosis y Enfermedades Prevalentes, Montevideo, Uruguay
| | - C. Rivas
- Departamento de Laboratorio, Comisión Honoraria de Lucha Anti-Tuberculosis y Enfermedades Prevalentes, Montevideo, Uruguay
| | - J. van Ingen
- Department of Clinical Microbiology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - C. Robello
- Unidad de Biología Molecular, Institut Pasteur de Montevideo, Montevideo, Uruguay; Departamento de Bioquímica, Facultad de Medicina, Montevideo, Uruguay
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Campagna M, Herranz D, Garcia MA, Marcos-Villar L, González-Santamaría J, Gallego P, Gutierrez S, Collado M, Serrano M, Esteban M, Rivas C. SIRT1 stabilizes PML promoting its sumoylation. Cell Death Differ 2011; 18:72-9. [PMID: 20577263 PMCID: PMC3131875 DOI: 10.1038/cdd.2010.77] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [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: 11/02/2009] [Revised: 05/25/2010] [Accepted: 05/26/2010] [Indexed: 12/18/2022] Open
Abstract
SIRT1, the closest mammalian homolog of yeast Sir2, is an NAD(+)-dependent deacetylase with relevant functions in cancer, aging, and metabolism among other processes. SIRT1 has a diffuse nuclear localization but is recruited to the PML nuclear bodies (PML-NBs) after PML upregulation. However, the functions of SIRT1 in the PML-NBs are unknown. In this study we show that primary mouse embryo fibroblasts lacking SIRT1 contain reduced PML protein levels that are increased after reintroduction of SIRT1. In addition, overexpression of SIRT1 in HEK-293 cells increases the amount of PML protein whereas knockdown of SIRT1 reduces the size and number of PML-NBs and the levels of PML protein in HeLa cells. SIRT1 stimulates PML sumoylation in vitro and in vivo in a deacetylase-independent manner. Importantly, the absence of SIRT1 reduces the apoptotic response of vesicular stomatitis virus-infected cells and favors the extent of this PML-sensitive virus replication. These results show a novel function of SIRT1 in the control of PML and PML-NBs.
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Affiliation(s)
- M Campagna
- Centro Nacional de Biotecnología, CSIC, Campus Universidad Autónoma, Madrid 28049, Spain
| | - D Herranz
- Spanish National Cancer Research Centre (CNIO), 3 Melchor Fernández Almagro, Madrid 28029, Spain
| | - M A Garcia
- Centro Nacional de Biotecnología, CSIC, Campus Universidad Autónoma, Madrid 28049, Spain
- Instituto de Biopatología y Medicina Regenerativa, Centro de Investigación Biomédica, Parque Tecnológico de Ciencias de la Salud, Avenida del Conocimiento sn, Granada 18100, Spain
| | - L Marcos-Villar
- Centro Nacional de Biotecnología, CSIC, Campus Universidad Autónoma, Madrid 28049, Spain
- Departamento de Microbiología II, Fac Farmacia, Universidad Complutense de Madrid, Plaza Ramón y Cajal sn, Madrid 28040, Spain
| | - J González-Santamaría
- Centro Nacional de Biotecnología, CSIC, Campus Universidad Autónoma, Madrid 28049, Spain
| | - P Gallego
- Centro Nacional de Biotecnología, CSIC, Campus Universidad Autónoma, Madrid 28049, Spain
| | - S Gutierrez
- Centro Nacional de Biotecnología, CSIC, Campus Universidad Autónoma, Madrid 28049, Spain
| | - M Collado
- Spanish National Cancer Research Centre (CNIO), 3 Melchor Fernández Almagro, Madrid 28029, Spain
| | - M Serrano
- Spanish National Cancer Research Centre (CNIO), 3 Melchor Fernández Almagro, Madrid 28029, Spain
| | - M Esteban
- Centro Nacional de Biotecnología, CSIC, Campus Universidad Autónoma, Madrid 28049, Spain
| | - C Rivas
- Centro Nacional de Biotecnología, CSIC, Campus Universidad Autónoma, Madrid 28049, Spain
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Rivas C, Coitinho C, Dafond V, Corbo M, Baldjian M. Performance of the Ogawa-Kudoh method for isolation of mycobacteria in a laboratory with large-scale workload. Rev Argent Microbiol 2010; 42:87-90. [PMID: 20589326 DOI: 10.1590/s0325-75412010000200003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Accepted: 03/30/2010] [Indexed: 11/21/2022] Open
Abstract
In Uruguay (population 3,323,906; notified tuberculosis incidence 18.4/100,000), virtually all 30,000 samples yearly collected for mycobacterial culture countrywide are processed in a central laboratory. An average of 110 samples are routinely shipped daily and maintained 48-96 hours at room temperature until cultured on Löwenstein-Jensen slants using the standard NALC-NaOH decontamination procedure. The much simpler Kudoh decontamination/culture method -swab and Ogawa (acidified) medium- was compared with NALC-NaOH/Löwenstein-Jensen for isolation of mycobacteria from sputa under routine conditions. To this aim, 784 sputum samples were cultured by both methods in the summertime. Gross agreement was 0.99, kappa: 1. Kudoh performance was as follows: sensitivity 100% and accuracy 98.9%. Assays using a modified culture medium, different decontamination times and NaOH concentrations showed the versatility of this procedure. Thus, the Kudoh method is suitable for culturing mycobacteria from naturally contaminated samples even when processing is deferred two to four days after collection.
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Affiliation(s)
- C Rivas
- Comisión Honoraria para la Lucha Antituberculosa y Enfermedades Prevalentes, Departamento Laboratorio, Centro de Referencia Nacional para Micobacterias, Montevideo, Uruguay.
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Santos M, Rivas C, Echezarreta G, Bernacer M, Santon A, Robledo M, Benitez J. Immunophenotypic and Gene Rearrangement Analysis in Null- or T-Cell Neoplasias: Study of 16 Cases. Leuk Lymphoma 2009; 4:381-8. [DOI: 10.3109/10428199109068090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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49
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Coitinho C, Rivas C. Auxiliary tools in tuberculosis. The hemolysis in pleural fluids underestimate the values of adenosine deaminase activity determined by the method of Giusti. Rev Argent Microbiol 2008; 40:101-105. [PMID: 18705490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
The increase of adenosine deaminase (ADA) activity in pleural fluids (PF) is considered a useful tool in the diagnosis of pleural tuberculosis. It is known that numerous photometric methods are interfered by the hemolysis, as a result, hemolyzed specimens -or with blood- received in the laboratory are frequently rejected. In order to establish if the values of ADA were affected by the hemolysis or blood, ADA was determined in individual and pooled PF samples with the aggregate of erythrocyte lysate (H) or hemolyzed whole blood (HWB) from 312 mg/l to 12 g/l (final concentrations of hemoglobin in the samples), and plasma in appropriate dilutions. Negative interferences were caused by the H and HWB, starting already of 500 mg/l with relative errors until 50% in some cases, depending on the ADA activity. Increments of hemoglobin increased the negative interference. The aggregate of plasma increased slightly the ADA activity although it was insufficient for neutralize the negative effect of hemolysis. The clinical significance of the negative interference is in relation to the amount of hemoglobin present in the sample and the ADA activity. Near the cutoff (40 U/l) this interference can lead to discard erroneously the diagnosis of pleural tuberculosis.
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Affiliation(s)
- C Coitinho
- Comisión Honoraria para la Lucha Antituberculosa y Enfermedades Prevalentes, Centro de Referencia Nacional para Micobacterias, Departamento de Laboratorio, Montevideo, Uruguay.
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Vargas F, Rivas C, Zoltan T, Fuentes A, Padrón L, Díaz Y, Izzo C. Photodegradation and in vitro phototoxicity of aceclofenac. Pharmazie 2007; 62:337-41. [PMID: 17557739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Aceclofenac (Airtal) (1) is a photoallergic and phototoxic anti-inflammatory and analgesic agent. This drug is photolabile under aerobic and anaerobic conditions. Irradiation of an ethanol-solution of aceclofenac under oxygen or argon at 290-320 nm affords via decarboxlation compound 2 as the main isolated and spectroscopically identified photoproduct, besides hydroxylamine derivates 3 and 4. A radical intermediate was evidenced spectrophotometrically with GSH and DTNB, as well as by the dimerization of cysteine. Red blood cell lysis photosensitized by 1-4 was investigated. Furthermore, in a lipid-photoperoxidation test with linoleic acid the in vitro phototoxicity of aceclofenac was also verified. The photoinduced generation of peroxide by compound 1 was determined during the irradiation in presence of NADPH by chemiluminescence. In relation to the photoallergic activity of this drug, the interaction of aceclofenac with human serum albumin (HSA) has been studied through fluorescence spectroscopy. No photoinduced binding was observed after irradiation of compounds 1 in the presence of human serum albumin.
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Affiliation(s)
- F Vargas
- Laboratorio de Fotoquímica, Centro de Química, Instituto Venezolano de Investigaciones Científicas I.V.I.C., Caracas, Venezuela.
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