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Mira JJ, Torres D, Gil V, Carratalá C. Loneliness impact on healthcare utilization in primary care: A retrospective study. J Healthc Qual Res 2024:S2603-6479(24)00027-7. [PMID: 38670900 DOI: 10.1016/j.jhqr.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/13/2024] [Accepted: 04/03/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND An increased number of patients seek help for loneliness in primary care. OBJECTIVE To analyze whether loneliness was associated with a higher utilization of healthcare facilities. METHODS Observational, retrospective study based on the review of routinely coded data in the digital medical record system in a random sample of patients aged 65 or older, stratified by population size of their residence area. A minimum sample size was estimated at 892 medical records. Loneliness was defined as the negative feeling that arises when there is a mismatch between the quantity and quality of a person's social relationships and those, they desire. Thirty-three primary care nurses (30 females and 3 males) were reviewing the data. RESULTS A total of 932 medical records of patients were reviewed (72% belonged to female patients). Of these, 657 individuals were living alone (71.9%). DeJong Scale average scores was 8.9 points (SD 3.1, 95CI 8.6-9.1). The average annual attendance to primary care ranged from 12.2 visits per year in the case of family practice, 10.7 nurse, 0.7 social workers. The average number of home visits was 3.2, and the urgent consultations attended at health centers were 1.5 per year. Higher feelings of loneliness were associated with extreme values in the frequency of healthcare resource usage. Compared to their peers of the same age, the additional healthcare resource consumption amounted to €802.18 per patient per year. CONCLUSION Loneliness is linked to higher healthcare resource usage in primary care, with individuals experiencing poorer physical and mental health utilizing these resources up to twice as much as their peers of the same age.
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Affiliation(s)
- J J Mira
- Healthcare District Alicante-Sant Joan, Fisabio, Alicante, Spain; Health Psychology Department, Universidad Miguel Hernandez, Elche, Spain; RICAPPS (Research Network on Chronicity, Primary Care, and Prevention and Health Promotion), Spain.
| | - D Torres
- Healthcare District Alicante-Sant Joan, Fisabio, Alicante, Spain
| | - V Gil
- RICAPPS (Research Network on Chronicity, Primary Care, and Prevention and Health Promotion), Spain; Medicine Department, Universidad Miguel Hernandez, Sant Joan, Spain
| | - C Carratalá
- RICAPPS (Research Network on Chronicity, Primary Care, and Prevention and Health Promotion), Spain; Medicine Department, Universidad Miguel Hernandez, Sant Joan, Spain
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Araujo EGE, Corral G, Ochoa N, Torres D, Gutiérrez M. Clinical improvement after intraarticular and intraosseous injections of platelet rich plasma combined with hyaluronic acid for knee osteoarthritis. Case series. Acta Ortop Mex 2023; 37:350-355. [PMID: 38467456] [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] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
INTRODUCTION knee osteoarthritis (KOA) is known as the most common form of osteoarthrosis with a 6% prevalence in people over 30 years old, and more than 40% in the population over 70 years old. The use of PRP led to diverse results and this disparity can be attributed to the dissimilar methods of PRP preparation. This study aims to assess the functional effects of intraosseous (IO) and intraarticular (IA) injections of platelet rich plasma (PRP) followed by IA injections of hyaluronic acid (HA). OBJECTIVES this study aimed to assess the functional effects of intraosseous (IO) and intraarticular (IA) injections of platelet rich plasma (PRP) followed by IA injections of hyaluronic acid (HA), administered 3 and 4 weeks after the initiation of treatment in 33 patients with grade II-III (Ahlback scale) knee osteoarthritis (KOA). MATERIAL AND METHODS retrospectively, 33 patients were assessed using the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index and visual analogue scale (VAS) score. They were followed-up for 12.92 months on average. Patients were divided into three groups based on age and four groups based on the follow-up period. RESULTS the pre-operative mean of the WOMAC index was 44.35 ± 20.20 and the post-operative mean was 22.81 ± 17.25 (p < 0.001). The pre-operative and post-operative mean of the VAS scores were 5.79 ± 2.01 and 2.41 ± 1.43 (p < 0.001), respectively. The largest improvement in WOMAC (from 42.86 to 13.69) was observed in the youngest patients (44 to 55 years old) and the largest reduction in VAS (from 6.89 to 2.22) was seen in patients aged 56 to 70 years. CONCLUSION the combination of IO and IA plasma rich in growth factor (PRGF) treatment with the IA-HA treatment yielded excellent results, diminishing pain and improving motor functionality in patients with KOA.
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Affiliation(s)
- E G E Araujo
- Clínica Anglo Americana. Formación Ortopedia TLC. Clínica Centenario. Universidad Nacional Mayor de San Marcos. Lima, Perú
| | - G Corral
- Artritis y Reumatología Centro Médico Imbanaco. Cali, Colombia
| | - N Ochoa
- Departamento de Ortopedia, Fundación Santa Fe de Bogotá, Colombia
| | - D Torres
- Departamento de Ortopedia, Clínica Anglo Americana. Educación Ortopedia TLC
| | - M Gutiérrez
- Departamento de Ortopedia, Centro Médico Imbanaco. Cali, Colombia
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Nievas S, Coniglio A, Takahashi WY, López GA, Larama G, Torres D, Rosas S, Etto RM, Galvão CW, Mora V, Cassán F. Unraveling Azospirillum's colonization ability through microbiological and molecular evidence. J Appl Microbiol 2023; 134:7110407. [PMID: 37024272 DOI: 10.1093/jambio/lxad071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 03/16/2023] [Accepted: 04/04/2023] [Indexed: 04/08/2023]
Abstract
It is known that members of the bacterial genus Azospirillum can promote the growth of a great variety of plants, an ability harnessed by the industry to create bioproducts aimed to enhance the yield of economically relevant crops. Its versatile metabolism allows this bacterium to adapt to numerous environments, from optimal to extreme or highly polluted. The fact of having been isolated from soil and rhizosphere samples collected worldwide and many other habitats proves its remarkable ubiquity. Azospirillum rhizospheric and endophytic lifestyles are governed by several mechanisms, leading to efficient niche colonization. These mechanisms include cell aggregation and biofilm formation, motility, chemotaxis, phytohormone and other signaling molecules production, and cell-to-cell communication, in turn, involved in regulating Azospirillum interactions with the surrounding microbial community. Despite being infrequently mentioned in metagenomics studies after its introduction as an inoculant, an increasing number of studies detected Azospirillum through molecular tools (mostly 16S rRNA sequencing) as part of diverse, even unexpected, microbiomes. This review focuses on Azospirillum traceability and the performance of the available methods, both classical and molecular. An overview of Azospirillum occurrence in diverse microbiomes and the less-known features explaining its notorious ability to colonize niches and prevail in multiple environments is provided.
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Affiliation(s)
- S Nievas
- Laboratorio de Fisiología Vegetal y la Interacción Planta-microorganismo, Instituto de Investigaciones Agrobiotecnológicas (INIAB-CONICET), UNRC, Argentina
| | - A Coniglio
- Laboratorio de Fisiología Vegetal y la Interacción Planta-microorganismo, Instituto de Investigaciones Agrobiotecnológicas (INIAB-CONICET), UNRC, Argentina
| | - W Y Takahashi
- Microbial Molecular Biology Laboratory, State University of Ponta Grossa, CEP 84030-900 Ponta Grossa, PR, Brazil
| | - G A López
- Laboratorio de Fisiología Vegetal y la Interacción Planta-microorganismo, Instituto de Investigaciones Agrobiotecnológicas (INIAB-CONICET), UNRC, Argentina
| | - G Larama
- Agriaquaculture Nutritional Genomic Center, CGNA, Temuco, Chile
- Centro de Modelación y Computación Científica, Universidad de La Frontera, Temuco, Chile
| | - D Torres
- Laboratorio de Fisiología Vegetal y la Interacción Planta-microorganismo, Instituto de Investigaciones Agrobiotecnológicas (INIAB-CONICET), UNRC, Argentina
| | - S Rosas
- Laboratorio de Fisiología Vegetal y la Interacción Planta-microorganismo, Instituto de Investigaciones Agrobiotecnológicas (INIAB-CONICET), UNRC, Argentina
| | - R M Etto
- Microbial Molecular Biology Laboratory, State University of Ponta Grossa, CEP 84030-900 Ponta Grossa, PR, Brazil
| | - C W Galvão
- Microbial Molecular Biology Laboratory, State University of Ponta Grossa, CEP 84030-900 Ponta Grossa, PR, Brazil
| | - V Mora
- Laboratorio de Fisiología Vegetal y la Interacción Planta-microorganismo, Instituto de Investigaciones Agrobiotecnológicas (INIAB-CONICET), UNRC, Argentina
| | - F Cassán
- Laboratorio de Fisiología Vegetal y la Interacción Planta-microorganismo, Instituto de Investigaciones Agrobiotecnológicas (INIAB-CONICET), UNRC, Argentina
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Thacker C, Nealon K, Torres D, Leonard D, Young K, Rapp M. Fewer Levels of Dedicated Trauma Care Leads to Better Outcomes. Am Surg 2022:31348211069798. [PMID: 35098740 DOI: 10.1177/00031348211069798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Dedicated trauma intensive care units (ICUs) staffed by surgical intensivists lead to better patient outcomes. Increased length of stay (LOS) leads to worse outcomes. Little research has focused on the effect of dedicated trauma medical-surgical units or ICU/medicalsurgical systems. In 2018, our Level 1 trauma center transitioned from 3 non-dedicated levels of care (ICU/stepdown unit/medical-surgical) to 2 dedicated levels of care (ICU/medical-surgical). Our objective was to look at patient outcomes pre- and post-intervention. METHODS Retrospective analysis of trauma registry data was performed on patients (age ≥18) admitted to the trauma service at a Level 1 rural trauma center over 46-months. In the pre-intervention group, step down and medical-surgical patients were combined as "Non-ICU" for analysis. Standard statistical analysis was performed. RESULTS Analysis included 6103 patients. The group demographics were similar, except pre-intervention patients had higher ISS and fewer comorbidities. Emergency department LOS decreased from 30 versus 13.9% (P < .0001) and 15.9 versus 5.8% (P < .0001) for greater than 3 and 6 hours, respectively. Median LOS decreased for all patients (P < .0001). Mortality dropped from 9.0 versus 5.5% (P = .0009) for ICU and 1.7 versus 0.26% (P = .0013) for non-ICU patients. Overall patient mortality was level at 3.7%. Inpatient complications dropped from 9.9 versus 8.5% (P = .07). Unplanned ICU readmissions were unchanged (P = .4169). For patients with 3+ comorbidities, overall LOS dropped by 2 days (P < .0001) and home discharge increased from 42.8 versus 51% (P < .0001). CONCLUSION Implementation of 2 levels of dedicated care has decreased ED and hospital LOS for all trauma patients without increasing mortality or complications. Patients with extensive comorbidities saw the most improvements.
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Affiliation(s)
| | | | | | | | | | - Megan Rapp
- 21599Geisinger Medical Center, Danville, PA, USA
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Dhara S, Chhangawala S, Chintalapudi H, Askan G, Aveson V, Massa AL, Zhang L, Torres D, Makohon-Moore AP, Lecomte N, Melchor JP, Bermeo J, Cardenas A, Sinha S, Glassman D, Nicolle R, Moffitt R, Yu KH, Leppanen S, Laderman S, Curry B, Gui J, Balachandran VP, Iacobuzio-Donahue C, Chandwani R, Leslie CS, Leach SD. Pancreatic cancer prognosis is predicted by an ATAC-array technology for assessing chromatin accessibility. Nat Commun 2021; 12:3044. [PMID: 34031415 PMCID: PMC8144607 DOI: 10.1038/s41467-021-23237-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 04/09/2021] [Indexed: 12/12/2022] Open
Abstract
Unlike other malignancies, therapeutic options in pancreatic ductal adenocarcinoma (PDAC) are largely limited to cytotoxic chemotherapy without the benefit of molecular markers predicting response. Here we report tumor-cell-intrinsic chromatin accessibility patterns of treatment-naïve surgically resected PDAC tumors that were subsequently treated with (Gem)/Abraxane adjuvant chemotherapy. By ATAC-seq analyses of EpCAM+ PDAC malignant epithelial cells sorted from 54 freshly resected human tumors, we show here the discovery of a signature of 1092 chromatin loci displaying differential accessibility between patients with disease free survival (DFS) < 1 year and patients with DFS > 1 year. Analyzing transcription factor (TF) binding motifs within these loci, we identify two TFs (ZKSCAN1 and HNF1b) displaying differential nuclear localization between patients with short vs. long DFS. We further develop a chromatin accessibility microarray methodology termed "ATAC-array", an easy-to-use platform obviating the time and cost of next generation sequencing. Applying this methodology to the original ATAC-seq libraries as well as independent libraries generated from patient-derived organoids, we validate ATAC-array technology in both the original ATAC-seq cohort as well as in an independent validation cohort. We conclude that PDAC prognosis can be predicted by ATAC-array, which represents a low-cost, clinically feasible technology for assessing chromatin accessibility profiles.
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Affiliation(s)
- S Dhara
- Dartmouth Geisel School of Medicine and Norris Cotton Cancer Center, Hanover, NH, USA
| | - S Chhangawala
- Weill Cornell Graduate School of Medical Sciences, New York, NY, USA
- Computational Biology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - H Chintalapudi
- Dartmouth Geisel School of Medicine and Norris Cotton Cancer Center, Hanover, NH, USA
| | - G Askan
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - V Aveson
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, New York, NY, USA
| | - A L Massa
- Dartmouth Geisel School of Medicine and Norris Cotton Cancer Center, Hanover, NH, USA
| | - L Zhang
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - D Torres
- Dartmouth Geisel School of Medicine and Norris Cotton Cancer Center, Hanover, NH, USA
| | - A P Makohon-Moore
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - N Lecomte
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - J P Melchor
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - J Bermeo
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - A Cardenas
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - S Sinha
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - D Glassman
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - R Nicolle
- Programme Cartes d'Identité des Tumeurs, Ligue Nationale Contre Le Cancer, Paris, France
| | - R Moffitt
- Stony Brook University, Stony Brook, NY, USA
| | - K H Yu
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - S Leppanen
- Agilent Technologies Inc., Santa Clara, CA, USA
| | - S Laderman
- Agilent Technologies Inc., Santa Clara, CA, USA
| | - B Curry
- Agilent Technologies Inc., Santa Clara, CA, USA
| | - J Gui
- Dartmouth Geisel School of Medicine and Norris Cotton Cancer Center, Hanover, NH, USA
| | - V P Balachandran
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - C Iacobuzio-Donahue
- David M. Rubenstein Center for Pancreatic Cancer Research, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - C S Leslie
- Computational Biology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - S D Leach
- Dartmouth Geisel School of Medicine and Norris Cotton Cancer Center, Hanover, NH, USA.
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Saravia A, Torres D, Levitt D, Stowe CV, Molina P, Simon L. Chronic binge alcohol impairs glucose‐insulin dynamics in SIV‐infected female rhesus macaques. FASEB J 2021. [DOI: 10.1096/fasebj.2021.35.s1.01813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- A. Saravia
- PhysiologyDepartment of PhysiologyLouisiana State University Health Sciences CenterNew OrleansLA
| | - D. Torres
- PhysiologyDepartment of PhysiologyLouisiana State University Health Sciences CenterNew OrleansLA
| | - D. Levitt
- PhysiologyDepartment of PhysiologyLouisiana State University Health Sciences CenterNew OrleansLA
| | - C. V. Stowe
- PhysiologyDepartment of PhysiologyLouisiana State University Health Sciences CenterNew OrleansLA
| | - P. Molina
- PhysiologyDepartment of PhysiologyLouisiana State University Health Sciences CenterNew OrleansLA
| | - L. Simon
- PhysiologyDepartment of PhysiologyLouisiana State University Health Sciences CenterNew OrleansLA
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Barcellos P, Torres D, Borges N. Validation of new predictive equations for resting energy expenditure in patients with liver diseases. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Santos R, Nobre-Menezes M, Carrilho-Ferreira P, Jorge C, Francisco A, Infante-Oliveira E, Duarte J, Cardoso P, Torres D, Aguiar-Ricardo I, Rigueira J, Rodrigues T, Nunes-Ferreira A, Pinto F, Silva P. One stent versus two stents for distal LM PCI: insights from the experience of a high volume center. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1475] [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
Introduction
Distal left main (LM) PCIremains a challenge. One of the most debated issues is whether to use a single vs 2 stent provisional strategy. While most studies and guidelines favour a single stent strategy, the recent DK-CRUSH V trial has shown better results with a 2 stent strategy.
Objective
To evaluate the performance of a single vs dual stent strategy for LM PCI in a real-world population setting.
Methods
Single-center procedural prospective registry of patients (pts) submitted to LM PCI from 2015–2018, with retrospective event analysis. Demographic, clinical data and procedure characteristics were analysed. Results were obtained with χ2 test, T student test, Kaplan-Meier survival analysis, logistic and Cox regression.
Results
100 pts (73 men; 69±11 years) were included. Co-morbidities were very frequent (85 had hypertension, 54 had diabetes, 71 had dyslipidemia and 39 were past smokers). 32 had reduced LVEF (<40%) and 45 previous CABG. The decision to proceed to PCI vs surgery was undertaken individually by the local HeartTeam. Most of the procedures (57) were in an acute coronary syndrome setting (11 in STEMI, 7 with cardiogenic shock). The anatomical distribution of the lesions was: distal in 69 pts (61 involved the LAD and or Cx ostium), mid shaft in 7 pts, ostial in 18 pts and diffuse in 6 pts. Protected left main PCI encompassed 41% of the procedures.
The complication rate was 7%. During a mean follow-up of 866±400 days, there were 4 peri-procedural deaths, 1-year mortality rate of 10% and 22 pts died overall.
In pts submitted to distal LM PCI, a single stent was used in 49 pts (66%) versus a 2 stent approach in 23 pts (31%). The only significant difference between these groups were diabetes (66% in the single stent vs 32% in the 2 stent group, p=0.006) and protected LM (51% in the single stent vs 26.1% in the two stent group, p=0.046).
While a 2 stent strategy was associated with higher mortality by Kaplan Meyer analysis (LogRank = 11.07, p=0.001), it was not an independent predictor of mortality in Cox regression. Cox univariate analysis identified LVEF <40% (OR 2.2, CI 1.01–4.9, p=0.047) and complications (OR 3.1, CI 1.4 – 6.9, p=0.004) as the only predictors of death. In multivariate analysis, only the latter was an independent predictor of mortality (OR 2.6, IC 1.1–5.9, p=0.028). The use of a 2 stent strategy was significantly associated with complications (χ2=5.1 p=0.024)) and was the only independent predictor of it (OR 3.8, IC 1.1–12.8, p=0.03). This was true even in the subgroup of protected LM PCI.
Conclusion
In a real-world setting of challenging LM PCI cases, a single stent strategy for distal LM PCI performed better. The use of 2 stents was an independent predictor of complications, strongly associated with increased risk of death. While a LM PCI must be undertaken on an individual basis, a single stent provisional strategy, whenever feasible, seems to be the best option.
Funding Acknowledgement
Type of funding source: Public hospital(s). Main funding source(s): Hospita Santa Maria
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Affiliation(s)
- R Santos
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - M Nobre-Menezes
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - P Carrilho-Ferreira
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - C Jorge
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - A.R Francisco
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - E Infante-Oliveira
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - J Duarte
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - P Cardoso
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - D Torres
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - I Aguiar-Ricardo
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - J Rigueira
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - T Rodrigues
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - A Nunes-Ferreira
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - F.J Pinto
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
| | - P.C Silva
- Santa Maria University Hospital/CHULN, CAML, CCUL, Lisbon School of Medicine, Universidade de Lisboa, Cardiology Department, Lisbon, Portugal
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Smith E, Paseka J, Bhatti D, Torres D, Bertoni J. Treatable vitamin deficiencies in Parkinson's Disease: A case for routine screening. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.298] [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: 11/30/2022]
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Costa de Miranda R, Rauber F, Moraes M, Torres D, Lopes C, Rodrigues S, Bertazzi Levy R. Consumption of ultra-processed foods on free sugar intake of Portuguese infants: The Upper Project. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The dietary share of ultra-processed foods (UPF) has been associated with low diet quality, including high content of free sugar, mainly in adults' populations. We aim to assess the influence of UPF consumption on free sugar intake of Portuguese infants.
Methods
Cross-sectional representative study including 573 infants (6-23 months old) who participated in the 2015-2016 National Food, Nutrition and Physical Activity Survey. Dietary intake was collected by two non-consecutive food diaries (time interval 8-15 days). Food items were classified according food processing degree by the NOVA system. Total energy intake and percentage provided by each NOVA food groups as well as the free sugar content of the overall diet were assessed. Mean free sugar intake was evaluated across quintiles (Q) of UPF consumption by linear regression adjusted for socioeconomic covariates.
Results
Mean energy intake was 935 kcal/day, in which 49.1% was derived from unprocessed/minimally processed foods, 7.2% from processed culinary ingredients, 7.0% from processed foods and 36.6% from UPF. The mean dietary share of UPF ranged from 12.5% (Q1) to 65.5% (Q5) of total energy. Within UPF, infant formulas (19.3%), milk-based drinks (6.7%) and sweet snacks (4.8%) contributed the most to energy intake. Mean free sugar intake in the overall diet accounted for 8.1% of total energy intake, in which 92.5% came from UPF. As the UPF consumption increased, the dietary content of free sugar increased significantly (β = 0.77; p < 0.001). Contribution of free sugar in total energy intake raised from 2.9% to 12.7%, representing an increment of 338% from the lower to the upper quintile of the dietary share of UPF.
Conclusions
Portuguese infants had an important intake of free sugar. Nearly all of this intake came from UPF, which calls for public health efforts to avoid UPF consumption by this population group.
Funding
FAPESP 2018/07391-9, 2019/05972-7 (MCR), 2016/14302-7 (FR); POCI-01-0145-FEDER-032090.
Key messages
Ultra-processed foods contributed with 36.6% of total energy intake and 92.5% of free sugar in the diets of Portuguese infants. As the ultra-processed foods consumption increased, the dietary content of free sugar increased significantly from 2.9% (Q1) to 12.7% (Q5), representing an increment of 338%.
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Affiliation(s)
- R Costa de Miranda
- Faculty of Medicine/Department of Preventative Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - F Rauber
- Faculty of Medicine/Department of Preventative Medicine, University of Sao Paulo, Sao Paulo, Brazil
- School of Public Health/ Department of Nutrition, University of Sao Paulo, Sao Paulo, Brazil
| | - M Moraes
- Faculty of Nutrition and Food Science, University of Porto, Porto, Portugal
| | - D Torres
- Faculty of Nutrition and Food Science, University of Porto, Porto, Portugal
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
| | - C Lopes
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
- Department of Public Health and Forensic Sciences, University of Porto, Porto, Portugal
| | - S Rodrigues
- Faculty of Nutrition and Food Science, University of Porto, Porto, Portugal
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
| | - R Bertazzi Levy
- Faculty of Medicine/Department of Preventative Medicine, University of Sao Paulo, Sao Paulo, Brazil
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12
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Martinez M, Cole J, Dove J, Blansfield J, Shabahang M, Wild J, Widom K, Torres D, Factor M. Outcomes of Endoscopic and Surgical Pancreatic Necrosectomy: A Single Institution Experience. Am Surg 2020. [DOI: 10.1177/000313481908500946] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Pancreatic necrosis can be managed conservatively; however, infection of pancreatic necrosis usually dictates more aggressive management. Our study aimed to assess the outcomes of open pancreatic necrosectomy (OPN) and endoscopic pancreatic necrosectomy (EPN) in a single center. Data from patients undergoing pancreatic necrosectomy at the Geisinger Medical Center from January 1, 2007, to April 25, 2016, were collected and retrospectively analyzed. Cohorts were composed of EPN (n = 22) and OPN (n = 34) groups. The prevalence of preoperative respiratory failure, septic shock, and multiorgan dysfunction syndrome was higher in the OPN group. The OPN group presented with a higher Bedside Index Severity in Acute Pancreatitis score. Postoperative abscess, persistent kidney dysfunction, and death were more frequent in the OPN group. The EPN group had a higher read-mission rate. The results of the univariate analysis for complication and mortality demonstrated that higher mortality and persistent kidney dysfunction were associated with the procedure type, specifically OPN and with a higher Bedside Index Severity in Acute Pancreatitis score. Patients who presented with higher severity of disease underwent an OPN, whereas EPN often was performed successfully in a more benign clinical setting. However, patients with infected necrosis are served best in a tertiary medical facility where multiple treatment modalities are available.
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Affiliation(s)
- Manuel Martinez
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Joshua Cole
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - James Dove
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Joseph Blansfield
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Mohsen Shabahang
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Jeffrey Wild
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Kenneth Widom
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Denise Torres
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Matthew Factor
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
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13
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Martins C, Vidal A, De Boevre M, De Saeger S, Nunes C, Torres D, Goios A, Lopes C, Alvito P, Assunção R. Burden of disease associated with dietary exposure to carcinogenic aflatoxins in Portugal using human biomonitoring approach. Food Res Int 2020; 134:109210. [PMID: 32517894 DOI: 10.1016/j.foodres.2020.109210] [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: 02/17/2020] [Revised: 03/27/2020] [Accepted: 03/29/2020] [Indexed: 12/11/2022]
Abstract
Human biomonitoring is an important tool to assess human exposure to chemicals, contributing to describe trends of exposure over time and to identify population groups that could be under risk. Aflatoxins are genotoxic and carcinogenic food contaminants causing hepatocellular carcinoma, the third leading cause of cancer deaths worldwide. In Portugal, scarce data are available regarding exposure to aflatoxins and no previous study used human biomonitoring data to comprehensively characterize the associated burden of disease. 24 h urine and first-morning urine paired samples were collected by 94 participants and were analyzed by liquid chromatography-tandem mass spectrometry for the quantitative determination of aflatoxins (B1, B2, G1, G2 and M1). Deterministic and probabilistic models were developed to assess the Portuguese exposure to aflatoxins and to estimate the health impact of this exposure, estimating the attributed Disability-Adjusted Life Years (DALYs). Aflatoxins were detected in a maximum of 13% (AFB1), 16% (AFB2), 1% (AFG1), 2% (AFG2) and 19% (AFM1) of the urine samples. Data obtained through the probabilistic approach revealed an estimated mean probable daily intake of 13.43 ng/kg body weight per day resulting in 0.13 extra cases of hepatocellular carcinoma, corresponding to mean annual DALYs of 172.8 for the Portuguese population (10291027 inhabitants). The present study generated for the first time and within a human biomonitoring study, reliable and crucial data to characterize the burden associated to the exposure to aflatoxins of the Portuguese population. The obtained results constitute an imperative support to risk managers in the establishment of preventive policy measures that contribute to ensure public health protection.
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Affiliation(s)
- C Martins
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisboa, Portugal; NOVA National School of Public Health, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal; CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal; Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal.
| | - A Vidal
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, B-9000 Ghent, Belgium
| | - M De Boevre
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, B-9000 Ghent, Belgium
| | - S De Saeger
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, B-9000 Ghent, Belgium
| | - C Nunes
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal; Public Health Research Centre, Universidade NOVA de Lisboa, Avenida Padre Cruz, 1600-560 Lisboa, Portugal
| | - D Torres
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-091 Porto, Portugal; Faculty of Nutrition and Food Sciences, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - A Goios
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-091 Porto, Portugal; Faculty of Nutrition and Food Sciences, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - C Lopes
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Rua das Taipas 135, 4050-091 Porto, Portugal; Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - P Alvito
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisboa, Portugal; CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - R Assunção
- Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisboa, Portugal; CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
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14
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Fincher CR, Muraca K, Torres D, Raynes EA. The Influence of Physical Therapy on Microbiotic Dysbiosis in Patients with Rheumatoid Arthritis. FASEB J 2020. [DOI: 10.1096/fasebj.2020.34.s1.02343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Son J, Carr C, Chambers LM, Michener C, Meng Y, Yen T, Beavis A, Stone R, Wethington S, Burkett W, Richardson D, Staley AS, Ahn S, Gehrig P, Torres D, Dowdy S, Sullivan M, Modesitt S, Watson C, Secord A, Veade A, Havrilesky L, Loreen A, Griffin K, Jackson A, Fader AN, Ricci S. Adjuvant treatment in high intermediate risk early stage endometrial cancer. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2019.11.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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16
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Martins C, Assunção R, Nunes C, Torres D, Alvito P. Are Data from Mycotoxins’ Urinary Biomarkers and Food Surveys Linked? A Review Underneath Risk Assessment. Food Reviews International 2020. [DOI: 10.1080/87559129.2019.1709200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- C. Martins
- Food and Nutrition Department, National Institute of Health Doutor Ricardo Jorge, Lisboa, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisboa, Portugal
- CISP, Centro de Investigação em Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - R. Assunção
- Food and Nutrition Department, National Institute of Health Doutor Ricardo Jorge, Lisboa, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - C. Nunes
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisboa, Portugal
- CISP, Centro de Investigação em Saúde Pública, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - D. Torres
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - P. Alvito
- Food and Nutrition Department, National Institute of Health Doutor Ricardo Jorge, Lisboa, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
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Marín C, Benitez M, Otazu A, Torres D, Cotrin P, Pinzan-Vercelino C, Valarelli F, Freitas K. Correlation of age and skeletal effects after miniscrew assisted rapid palatal expansion. J Clin Exp Dent 2020; 15:e269-e276. [PMID: 37152494 PMCID: PMC10155939 DOI: 10.4317/jced.60211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/27/2023] [Indexed: 03/08/2023] Open
Abstract
Background To evaluate the skeletal and dentoalveolar effects after miniscrew assisted rapid palatal expansion (MARPE) and their correlation with the age of the patients. Settings and sample population: Sample comprised 19 patients with maxillary atresia and posterior crossbite, treated with MARPE. Cone-beam computed tomographs (CBCT) were evaluated before and after expansion. Three patients were excluded since the midpalatal suture was not opened. Thus, 16 patients (11 female; 5 male) were evaluated, with a mean age of 24.92 years (s.d.=7.60). The time between the installation of MARPE and the second CBCT was, on average, 1.64 months (s.d.=1.12). Material and Methods Linear and angular measurements were performed: bone thickness and level, tooth inclination, transverse dental widths, and nasal base and jugula widths. Comparison was performed with dependent t-test and correlations with Pearson coefficient. Results MARPE was 84.2% successful. There was significant reduction in the buccal bone thickness of the first molars and an increase in the palatal bone thickness of all teeth. First molars showed significant buccal inclination. All transverse dimensions showed a significant increase. Older patients tended to show a less maxillary transverse skeletal increase. A greater maxillary transverse increase was accompanied by a greater intermolar width increase and also a greater buccal bone loss in the mesiobuccal roots of the maxillary first molars. Conclusions MARPE corrected the maxillary atresia in adult patients, with significant transverse increases, a slight decrease in buccal bone thickness and buccal inclination of the first molars, combining skeletal and dental effects. Older patients presented less transverse skeletal increases. Key words:Palatal expansion technique, skeletal anchorage, cone-beam computed tomography.
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Martins C, Vidal A, De Boevre M, De Saeger S, Nunes C, Torres D, Goios A, Lopes C, Alvito P, Assunção R. Burden of disease attributable to exposure to aflatoxins in Portugal using Human biomonitoring data. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Human biomonitoring (HBM) is recognized as an important tool to assess the Human exposure to chemicals, contributing to describe trends and patterns of exposure over time and to identify population groups that could be under risk. Natural chemicals as mycotoxins, fungi metabolites that produce toxic effects in humans, are important compounds that could be found in foods usually consumed worldwide in a daily basis. Mycotoxins as aflatoxins (AFTs) are genotoxic, carcinogenic and immunosuppressive compounds. Hepatocellular carcinoma (HCC) is one of their main health toxic effects and is the third leading cause of cancer deaths worldwide. In Portugal, scarce data are available regarding exposure to AFTs and none previous study used HBM data to characterize comprehensively the burden associated to this exposure.
In the scope of the National Food, Nutrition, and Physical Activity Survey of the Portuguese General Population (2015-2016), 24h-urine samples from 94 participants were analyzed by liquid chromatography-mass spectrometry (LC-MS/MS) for the simultaneous determination of AFTs (B1, B2, G1, G2, M1). A model was developed to estimate the health impact of the exposure of Portuguese population to aflatoxins, estimating the number of cases of HCC and DALYs attributed to AFTs exposure.
AFTs were detected in 12.8% (AFB1), 16.0% (AFB2) and 19.1% (AFM1) of the 24h-urine samples. The estimated number of extra cases of HCC attributed to this exposure ranged from 17 to 65 cases/year; the associated DALYs for the Portuguese population ranged from 284 to 1802 years.
The present study generated, for the first time and within a HBM study, reliable data regarding the exposure of the Portuguese population to AFTs. These data were crucial to characterize the health impact associated to AFTs exposure and to support risk managers to establish preventive policy measures that contribute to ensure the public health protection.
Key messages
Portuguese population is exposed to aflatoxins, chemical food contaminants that may be harmful (carcinogenic, immunotoxic, mutagenic, teratogenic, hepatotoxic) to humans. Human biomonitoring studies provide realistic data on internal exposure at individual level, contributing to a more accurate estimation of the burden derived from this exposure.
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Affiliation(s)
- C Martins
- National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | - A Vidal
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Portugal
| | - M De Boevre
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Portugal
| | - S De Saeger
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Portugal
| | - C Nunes
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - D Torres
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - A Goios
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - C Lopes
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - P Alvito
- National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | - R Assunção
- National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
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Martins C, Vidal A, De Saeger S, Nunes C, Torres D, Goios A, Lopes C, Assunção R, Alvito P, De Boevre M. Risk assessment of Portuguese population to multiple mycotoxins: the human biomonitoring approach. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Mycotoxins constitute a relevant group of food contaminants with several associated health outcomes such as estrogenic, immunotoxic, nephrotoxic and teratogenic effects. Although scarce data are available in Portugal, human biomonitoring studies have been globally developed to assess the exposure to mycotoxins at individual level.
The present study concerned the analysis of mycotoxins in 24h urine and first-morning urine paired samples from 94 participants enrolled within the scope of the National Food, Nutrition, and Physical Activity Survey of the Portuguese General Population (2015-2016). Following a salt-assisted matrix extraction, urine samples were analyzed by liquid chromatography-mass spectrometry for the simultaneous determination of 37 urinary mycotoxins’ biomarkers and data obtained used to estimate the probable daily intake as well as the risk characterization applying the Hazard Quotient approach.
Results revealed the exposure of Portuguese population to zearalenone, deoxynivalenol, ochratoxin A, alternariol, citrinin and fumonisin B1 through the quantification in 24h urine and first-morning urine paired samples. Risk characterization data revealed a potential concern to some reported mycotoxins since the reference intake values were exceeded by some of the considered participants. Alternariol was identified for the first time in urine samples from a European country; however, risk characterization was not performed due to lack of reference intake value.
The present study contributed with reliable and evidence-based results, and confirmed that mycotoxins represent a burden and are part of the human exposome of the Portuguese population. Further studies are needed to shed a light on the determinants of exposure in order to contribute for the promotion of public health measures to reduce the mycotoxins’ exposure in Portugal.
Key messages
Portuguese population is exposed to mycotoxins, chemical food contaminants that may be harmful (carcinogenic, immunotoxic, mutagenic, teratogenic, hepatotoxic) for human health. Human biomonitoring studies provide realistic data on internal exposure at individual level, allowing a more accurate knowledge of the determinants of exposure to these contaminants.
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Affiliation(s)
- C Martins
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | - A Vidal
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - S De Saeger
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - C Nunes
- National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - D Torres
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - A Goios
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - C Lopes
- Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal
| | - R Assunção
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | - P Alvito
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | - M De Boevre
- Centre of Excellence in Mycotoxicology and Public Health, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
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Martinez M, Cole J, Dove J, Blansfield J, Shabahang M, Wild J, Widom K, Torres D, Factor M. Outcomes of Endoscopic and Surgical Pancreatic Necrosectomy: A Single Institution Experience. Am Surg 2019; 85:1017-1024. [PMID: 31638517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Pancreatic necrosis can be managed conservatively; however, infection of pancreatic necrosis usually dictates more aggressive management. Our study aimed to assess the outcomes of open pancreatic necrosectomy (OPN) and endoscopic pancreatic necrosectomy (EPN) in a single center. Data from patients undergoing pancreatic necrosectomy at the Geisinger Medical Center from January 1, 2007, to April 25, 2016, were collected and retrospectively analyzed. Cohorts were composed of EPN (n = 22) and OPN (n = 34) groups. The prevalence of preoperative respiratory failure, septic shock, and multiorgan dysfunction syndrome was higher in the OPN group. The OPN group presented with a higher Bedside Index Severity in Acute Pancreatitis score. Postoperative abscess, persistent kidney dysfunction, and death were more frequent in the OPN group. The EPN group had a higher readmission rate. The results of the univariate analysis for complication and mortality demonstrated that higher mortality and persistent kidney dysfunction were associated with the procedure type, specifically OPN and with a higher Bedside Index Severity in Acute Pancreatitis score. Patients who presented with higher severity of disease underwent an OPN, whereas EPN often was performed successfully in a more benign clinical setting. However, patients with infected necrosis are served best in a tertiary medical facility where multiple treatment modalities are available.
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Walker C, Moosavi A, Young K, Fluck M, Torres D, Widom K, Wild J. Factors Associated with Failure of Nonoperative Management for Complicated Appendicitis. Am Surg 2019. [DOI: 10.1177/000313481908500840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In recent years, nonoperative management of complicated appendicitis has become more common. Patients managed nonoperatively do well, but there is a paucity of literature on patients who fail nonoperative management. The purpose of this study was to examine the overall failure rate, morbidity associated with failure, and potential predictors of failure in nonop management of appendicitis. This is a descriptive retrospective review of patients from a single hospital system who were diagnosed with advanced appendicitis and underwent nonop management between January 1, 2007, and November of 2017. The data were obtained through review of patient charts from the electronic medical record. Failure was defined as requirement of an operation due to ongoing infection secondary to appendicitis. There were 183 patients initially managed non-operatively, with 70 patients failing nonoperative management. Patients failing nonoperative management experienced longer hospitalization (6.2 vs 2.9 days, P < 0.0001), and more patients in the failure group required admission to the ICU (10.0% vs 1.8%, P = 0.028). Multivariate analysis revealed that longer duration of symptoms reduced the likelihood of failure (odds ratio: 0.77 [0.64–0.92]). In this retrospective review, 38 per cent of patients failed nonop management of appendicitis. Symptom duration could provide insight for clinicians in assessing the role of non-operative management because increasing symptom duration reduced the likelihood of failure.
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Affiliation(s)
- Charles Walker
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Ali Moosavi
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Katelyn Young
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Marcus Fluck
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Denise Torres
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Kenneth Widom
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Jeffrey Wild
- From the Department of General Surgery, Geisinger Medical Center, Danville, Pennsylvania
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Walker C, Moosavi A, Young K, Fluck M, Torres D, Widom K, Wild J. Factors Associated with Failure of Nonoperative Management for Complicated Appendicitis. Am Surg 2019; 85:865-870. [PMID: 31560305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In recent years, nonoperative management of complicated appendicitis has become more common. Patients managed nonoperatively do well, but there is a paucity of literature on patients who fail nonoperative management. The purpose of this study was to examine the overall failure rate, morbidity associated with failure, and potential predictors of failure in nonop management of appendicitis. This is a descriptive retrospective review of patients from a single hospital system who were diagnosed with advanced appendicitis and underwent nonop management between January 1, 2007, and November of 2017. The data were obtained through review of patient charts from the electronic medical record. Failure was defined as requirement of an operation due to ongoing infection secondary to appendicitis. There were 183 patients initially managed nonoperatively, with 70 patients failing nonoperative management. Patients failing nonoperative management experienced longer hospitalization (6.2 vs 2.9 days, P < 0.0001), and more patients in the failure group required admission to the ICU (10.0% vs 1.8%, P = 0.028). Multivariate analysis revealed that longer duration of symptoms reduced the likelihood of failure (odds ratio: 0.77 [0.64-0.92]). In this retrospective review, 38 per cent of patients failed nonop management of appendicitis. Symptom duration could provide insight for clinicians in assessing the role of nonoperative management because increasing symptom duration reduced the likelihood of failure.
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Martins C, Vidal A, De Boevre M, De Saeger S, Nunes C, Torres D, Goios A, Lopes C, Assunção R, Alvito P. Exposure assessment of Portuguese population to multiple mycotoxins: The human biomonitoring approach. Int J Hyg Environ Health 2019; 222:913-925. [DOI: 10.1016/j.ijheh.2019.06.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 04/18/2019] [Accepted: 06/24/2019] [Indexed: 12/11/2022]
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Mador B, Fuselli P, Choudhary D, Bokhari F, Tanenbaum B, Tze N, Wong TH, Grant I, Sahi S, Tanenbaum B, Figueira S, Knight H, Grant I, Beno S, Moore L, Macpherson A, Laverty C, Watson I, Watson I, Laverty C, Bérubé M, Cowan S, Homer K, Bouderba S, Soltana K, Fransblow L, Fransblow L, Bérubé M, Gonthier C, Bryson A, Bokhari F, Rados A, Courval V, Masales C, Trust MD, Hogan J, Warriner Z, Lalande A, Chung D, Tanenbaun B, Kuper T, Mckee J, Bratu I, Makish A, Versolatto A, Ramagnano S, Mehrnoush V, Kang D, Moore L, Schellenberg M, LeBreton M, Javidan AP, Schwartz G, Doucet J, Cunningham A, Clarke R, Paradis T, Beamish I, Hilsden R, Raizman I, Green R, Green R, Green R, Esmail R, Moon J(J, Cheng V, Brisson A, Beno S, Heck C, Koeck E, Schneider P, Bal C, Ko YM(D, Martinez M, Kim D, Tierney J, Emigh B, Lie J, Tierney J, MacLean A, Milton L, Bradley N, Kim M, White J, Harris I, Tekian A, Babul S, Cowle S, Turcotte K, Dhillon R, Chadha K, Fu CY, Bajan F, Welsh S, Kaminsky M, Dennis A, Starr F, Butler C, Messer T, Poulakidas S, Ramagnano S, Grushka J, Beckett A, Filteau C, Larocque J, Nadkarni N, Chua WC, Loo L, Ang ASH, Iau PTC, Goo JTT, Chan KC, Adam TN, Seow DCC, Ng YS, Malhotra R, Chan AWM, Matchar DB, Van Nguyen H, Ong MEH, Lampron J, Bougie A, Brown C, Patel A, Edwards L, Spitz K, Ramagnano S, Lampron J, Nucete M, Lindsey S, Lampron J, Figueira S, Matar M, Michael D, Rosenfield D, Harvey G, Jessa K, Tardif PA, Mercier E, Berthelot S, Lecky F, Cameron P, Archambault P, Tien H, Beckett A, Nathens A, Luz LTD, Benjamin S, Chisholm A, Benjamin S, Chisholm A, Tien H, Beckett A, Nathens A, Luz LTD, Pasquotti T, Klassen B, Brisson A, Tze N, Fawcett V, Tsang B, Kabaroff A, Verhoeff K, Turner S, Kim M, Widder S, Fung C, Widder S, Kim M, Moore L, Lecky F, Lawrence T, Soltana K, Mansour T, Moore L, Bouderba S, Turgeon A, Krouchev R, Mercier E, Friedman D, Souranis A, Slapcoff L, Friedman D, Fakir MB, Turcotte V, Valiquette MP, Bernard F, Giroux M, Côté MÈ, Gagné A, Dollé S, Gélinas C, Belcaïd A, Truchon C, Moore L, Clément J, Pelletier LP, Ivkov V, Gamble K, Constable L, Haegert J, Bajani F, Fu CY, Welsh S, Kaminsky M, Dennis A, Starr F, Messer T, Butler C, Tatebe L, Poulakidas S, Thauvette D, Engels P, Klassen B, Coates A, De Silva S, Schellenberg M, Biswas S, Inaba K, Cheng V, Warriner Z, Love B, Demetriades D, Schellenberg M, Inaba K, Trust MD, Love B, Cheng V, Strumwasser A, Demetriades D, Joos E, Dawe P, Hameed M, Evans D, Garraway N, Gawaziuk J, Cristall N, Logsetty S, Ramagnano S, Federman N, Murphy P, Parry N, Leeper R, McBeth P, Wachs J, Hamilton D, Ball C, Gillman L, Kirkpatrick A, Dulai S, Falconer C, McLachlin M, Armstrong A, Parry N, Vogt K, Shi Q, Coates A, Engels P, Rice T, Nathens A, Naidu D, Brubacher J, Chan H, Erdelyi S, Kubasiak J, Bokhari F, Kaminsky M, Lauzier F, Tardif PA, Lamontagne F, Chassé M, Stelfox HT, Kortbeek J, Lessard-Bonaventure P, Truchon C, Turgeon A, Cheng V, Inaba K, Foran C, Warriner Z, Trust MD, Clark D, Demetriades D, Levesque K, Lampron J, Nathens A, Tien H, Luz LTD, Jing R, McFarlan A, Liu M, Sander B, Fowler R, Rizoli S, Ferrada P, Murthi S, Nirula R, Edwards S, Cantrell E, Han J, Haase D, Singleton A, Birkas Y, Casola G, Coimbra R, Condron M, Schreiber M, Azarow K, Hamilton N, Long W, Maxwell B, Jafri M, Whitman L, Wilson H, Wong H, Grushka J, Razek T, Fata P, Deckelbaum D, Kawaja K, Beckett A, Razek T, Deckelbaum D, Grushka J, Fata P, Beckett A, Lund M, Leeper R, Conn LG, Strauss R, Haas B, Beckett A, Nathens A, Tien H, Callum J, Luz LTD, Higgins S, Coles J, Erdogan M, Coles J, Higgins S, Erdogan M, Erdogan M, Kureshi N, Fenerty L, Thibault-Halman G, Walling S, Clarke DB, Vis C, Nosworthy S, Razek T, Boulanger N, Deckelbaum D, Grushka J, Fata P, Beckett A, Khwaja K, Schellenberg M, Inaba K, Warriner Z, Trust MD, Matsushima K, Lam L, Demetriades D, Lakha N, Wong H, McLauchlin L, Ashe CS, Logie SA, Lenton-Brym T, Rosenfield D, McDowall D, Wales P, Principi T, Mis J, Kaminsky M, Bokhari F, Rahbar E, Cotton B, Bryan P, MacGillivray S, Thompson G, Wishart I, Hameed M, Joos E, Evans D, Garraway N, Dawe P, Wild J, Widom K, Torres D, Blansfield J, Shabahang M, Dove J, Fluck M, Hameed M, Roux L, Nicol A, Schulenberg L, Fredericks C, Messer T, Starr F, Dennis A, Bokhari F, Kaminsky M, Teixeira P, Coopwood B, Aydelotte J, Cardenas T, Ali S, Brown C, Dawe P, Fredericks C, Matta LD, Messer T, Starr F, Dennis A, Kaminsky M, Bokhari F, Jiang HY, Yoon J, Kim M, Widder S, Hameed M, Wray C, Agarwal A, Harvin J. 2019 Trauma Association of Canada Annual Scientific Meeting Abstracts. Can J Surg 2019; 62:S3-S35. [PMID: 31091053 DOI: 10.1503/cjs.008619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Yen T, Beavis A, Stone R, Wethington S, Carr C, Son J, Chambers LM, Ricci S, Burkett W, Richardson D, Staley A, Ahn S, Gehrig P, Torres D, Dowdy S, Sullivan M, Modesitt S, Watson C, Secord A, Veade A, Havrilesky L, Loreen A, Griffin K, Jackson A, Fader A. Early-stage endometrial cancer with lymphovascular space invasion: Chemotherapy improves progression free survival and reduces distant metastases. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.04.675] [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: 10/26/2022]
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Pisco J, Bilhim T, Costa N, Pinheiro L, Torres D, Oliveira A. 03:00 PM Abstract No. 3 ■ DISTINGUISHED ABSTRACT Short-, medium-, and long-term results of first and repeated prostatic artery embolization for benign prostatic hyperplasia: 1500 patients’ follow up to 9 years. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Pisco J, Bilhim T, Costa N, Pinheiro L, Torres D, Oliveira A. 04:03 PM Abstract No. 10 Repeated prostatic artery embolization for patients with benign prostatic hyperplasia and initial clinical failure or recurrence of a previous procedure. J Vasc Interv Radiol 2019. [DOI: 10.1016/j.jvir.2018.12.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Malekpour M, Widom K, Dove J, Blansfield J, Shabahang M, Torres D, Wild JL. Management of computed tomography scan detected hemothorax in blunt chest trauma: What computed tomography scan measurements say? World J Radiol 2018; 10:184-189. [PMID: 30631406 PMCID: PMC6323492 DOI: 10.4329/wjr.v10.i12.184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 09/17/2018] [Accepted: 10/24/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the hemothorax size for which tube thoracostomy is necessary.
METHODS Over a 5-year period, we included all patients who were admitted with blunt chest trauma to our level 1 trauma center. Focus was placed on identifying the hemothorax size requiring tube thoracostomy.
RESULTS A total number of 274 hemothoraces were studied. All patients with hemothoraces measuring above 3 cm received a chest tube. The 50% predicted probability of tube thoracostomy was 2 cm. Pneumothorax was associated with odds of receiving tube thoracostomy for hemothoraces below 2 cm (Odds Ratio: 4.967, 95%CI: 2.225-11.097, P < 0.0001).
CONCLUSION All patients with a hemothorax size greater than 3% underwent tube thoracostomy. Prospective studies are warranted to elucidate the clinical outcome of patients with smaller hemothoraces.
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Affiliation(s)
- Mahdi Malekpour
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, PA 17822, United States
| | - Kenneth Widom
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, PA 17822, United States
| | - James Dove
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, PA 17822, United States
| | - Joseph Blansfield
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, PA 17822, United States
| | - Mohsen Shabahang
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, PA 17822, United States
| | - Denise Torres
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, PA 17822, United States
| | - Jeffrey L Wild
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, PA 17822, United States
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Pérez-Rodríguez S, Torres D, Lázaro M. Effect of oxygen and structural properties on the electrical conductivity of powders of nanostructured carbon materials. POWDER TECHNOL 2018. [DOI: 10.1016/j.powtec.2018.09.038] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Francomacaro LM, Walker C, Jaap K, Dove J, Hunsinger M, Widom K, Torres D, Shabahang M, Blansfield J, Wild J. Sarcopenia predicts poor outcomes in urgent exploratory laparotomy. Am J Surg 2018; 216:1107-1113. [DOI: 10.1016/j.amjsurg.2018.10.039] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 10/08/2018] [Accepted: 10/24/2018] [Indexed: 01/06/2023]
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García ID, Plaul SE, Torres D, Del Fresno PS, Miranda LA, Colautti DC. Effect of photoperiod on ovarian maturation in Cheirodon interruptus (Teleostei: Characidae). BRAZ J BIOL 2018; 79:669-677. [PMID: 30379240 DOI: 10.1590/1519-6984.188607] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 03/08/2018] [Indexed: 11/21/2022] Open
Abstract
Cheirodon interruptus is a ubiquitous small characid that inhabits the Pampean region and commonly used as bait. Its vast market is supplied from the wild population causing a significant environmental impact. In this study, we assess the effect of photoperiod on ovarian maturation in order to evaluate its potential as a tool to manipulate reproduction under artificial conditions. Four treatments in triplicate (light: dark, L: D) were tested: 24L: 0D, 12L: 12D, 0L: 24D and a progressive photoperiod corresponding to the daily photoperiod increments in wild during winter-spring transition, accelerated three times. The experiment was conducted for 45 days. Gonadosomatic index (GSI), oocyte mean diameter, vitellogenic oocyte proportions, plasma estradiol concentrations (E2), condition factor (Kn) and standard length were estimated. Values of mean GSI, oocyte diameter, vitellogenic oocyte proportions and E2 concentration were maximum in the progressive treatment indicating vitellogenesis stimulation. In turn the same parameters were minimum in the 24L: 0D, revealing the vitellogenesis inhibition. This study showed that photoperiodic regime play an important role in the onset of ovarian maturation in C. interruptus.
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Affiliation(s)
- I D García
- Laboratorio de Ecología de Peces, Instituto de Limnología "Dr. Raúl A. Ringuelet" - ILPLA/ CONICET-UNLP, Boulevard 120 y 62, 1460, CP 1900, CC 712, La Plata, Buenos Aires, Argentina
| | - S E Plaul
- Laboratorio de Histología y Embriología Descriptiva, Experimental y Comparada, Facultad de Ciencias Veterinarias - UNLP, Av. 60 y 118, La Plata, Buenos Aires, Argentina
| | - D Torres
- Ministerio de Agroindustria, Subsecretaría de Pesca y Acuicultura de la Nación, Dirección de Pesca Continental, Paseo Colón 982, 1073, Buenos Aires, Argentina
| | - P S Del Fresno
- Laboratorio de Ictiofisiología y Acuicultura, Instituto de Investigaciones Biotecnológicas-Instituto Tecnológico de Chascomús "Dr. Raúl Alfonsín" - IIB-INTECH/ CONICET-UNSAM, Intendente Marino, Km 8.200 (B7130IWA), Chascomús, Buenos Aires, Argentina
| | - L A Miranda
- Laboratorio de Ictiofisiología y Acuicultura, Instituto de Investigaciones Biotecnológicas-Instituto Tecnológico de Chascomús "Dr. Raúl Alfonsín" - IIB-INTECH/ CONICET-UNSAM, Intendente Marino, Km 8.200 (B7130IWA), Chascomús, Buenos Aires, Argentina
| | - D C Colautti
- Laboratorio de Ecología de Peces, Instituto de Limnología "Dr. Raúl A. Ringuelet" - ILPLA/ CONICET-UNLP, Boulevard 120 y 62, 1460, CP 1900, CC 712, La Plata, Buenos Aires, Argentina
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Martins C, De Boevre M, De Saeger S, Assunção R, Nunes C, Torres D, Goios A, Lopes C, Alvito P, Vidal A. Exposure of Portuguese population to mycotoxins: the contribution of human biomonitoring studies. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky214.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- C Martins
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Lisbon, Portugal
| | - M De Boevre
- Laboratory of Food Analysis, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - S De Saeger
- Laboratory of Food Analysis, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - R Assunção
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Lisbon, Portugal
| | - C Nunes
- NOVA National School of Public Health, Universidade NOVA de Lisboa, Lisbon, Portugal
- Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - D Torres
- Faculty of Nutrition and Food Sciences, University of Porto; Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - A Goios
- Faculty of Nutrition and Food Sciences, University of Porto; Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - C Lopes
- Department of Public Health and Forensic Sciences, and Medical Education, Faculty of Medicine, University of Porto; Epidemiology Research Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - P Alvito
- National Institute of Health Dr. Ricardo Jorge, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Lisbon, Portugal
| | - A Vidal
- Laboratory of Food Analysis, Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
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Wang C, Sidiqi B, Yorke E, Mcknight D, Dick-Godfrey R, Torres D, Gelblum D, Rimner A, Wu A. MA01.10 Toxicity and Local Control in “Ultra-Central” Lung Tumors Treated With SBRT or High-Dose Hypofractionated RT. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.320] [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: 10/28/2022]
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Favier P, Torres D, Tabar M, Gismondi M, Piñeiro F, Perez J, Blugerman G, Erbin M, Rolon M, Macchi A, Pérez H. Living with dogs and cats: Is it a risk factor for skin and soft tissues infections caused by community-acquired methicillin-resistant Staphylococcus aureus? Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3462] [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: 10/28/2022] Open
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Zerboni S, Chevel J, Torres D, Rearte A, Bonvehi P, Temporiti E, Querci M, Videla C, Romano V, Echavarria M, Marcone D, Herrera F. Respiratory infections by human Rhinoviruses in oncohematological and stem cell transplant patients: do they have the same clinical impact as other respiratory viruses? Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3646] [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: 10/28/2022] Open
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Herrera F, Laborde A, Rossi IR, Guerrini G, Jordan R, Valledor A, Nenna A, Costantini P, Dictar M, Caeiro J, Torres D, Ibañez MG, Vizcarra P, Palacios C, Carena A. Prognostic factors for 7-day and 30-day mortality during gram-negative bacteremia episodes in cancer and hematopoietic stem cell transplant patients. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Hokenstad A, Torres D, Klennert S, Bird M, Weinhold M, Shah M, Mundi M, Langstraat C, Kumar A. Weight management in patients with endometrial cancer: Increasing awareness and clinical referral in cancer survivors. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Taboada M, Calvo A, Doldán P, Ramas M, Torres D, González M, Rodríguez A, Lombardía M, Fernandez C, Baluja A, Otero P, Álvarez J. Are «off hours» intubations a risk factor for complications during intubation? A prospective, observational study. Med Intensiva 2017; 42:527-533. [PMID: 29275003 DOI: 10.1016/j.medin.2017.10.010] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 10/24/2017] [Accepted: 10/25/2017] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To compare the complications and the difficulty of orotracheal intubation procedures performed in the Intensive Care Unit during the off-hours period and the on-hours period. DESIGN A prospective, observational and non-interventional cohort study covering a period of 27 months was carried out. Working days between 8:00 a. m. and 7:59 p. m. were considered «on-hours», while the remaining shifts were regarded as «off-hours». SCOPE An 18-bed surgical in a Intensive Care Unit of a third-level hospital. PATIENTS All orotracheal intubation patients admitted to the ICU from January 2015 to March 2017 were included. Patients were stratified into 2groups according to whether intubation was performed on-hours or off-hours. INTERVENTIONS Non-interventional study. VARIABLES OF INTEREST The reason for intubation, time and day on which intubation was performed, degree of intubation difficulty (number of attempts, Cormack-Lehane laryngoscopic vision, need for accessory material) and complications during intubation. RESULTS A total of 252 patients were intubated; of these, 132 were included in the on-hours group and 120 patients in the off-hours group. In the off-hours group we observed a greater percentage of urgent and emergent intubations compared to the on-hours group. However, no differences were found between the 2groups in relation to the other variables studied. CONCLUSIONS During the off-hours period, orotracheal intubation was not associated to a greater number of complications or to greater difficulty of the technique in our Unit.
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Affiliation(s)
- M Taboada
- Unidad de Cuidados Críticos Postoperatorios, Servicio de Anestesiología y Reanimación, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, España.
| | - A Calvo
- Unidad de Cuidados Críticos Postoperatorios, Servicio de Anestesiología y Reanimación, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - P Doldán
- Unidad de Cuidados Críticos Postoperatorios, Servicio de Anestesiología y Reanimación, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - M Ramas
- Unidad de Cuidados Críticos Postoperatorios, Servicio de Anestesiología y Reanimación, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - D Torres
- Unidad de Cuidados Críticos Postoperatorios, Servicio de Anestesiología y Reanimación, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - M González
- Unidad de Cuidados Críticos Postoperatorios, Servicio de Anestesiología y Reanimación, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - A Rodríguez
- Unidad de Cuidados Críticos Postoperatorios, Servicio de Anestesiología y Reanimación, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - M Lombardía
- Unidad de Cuidados Críticos Postoperatorios, Servicio de Anestesiología y Reanimación, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - Cr Fernandez
- Unidad de Cuidados Críticos Postoperatorios, Servicio de Anestesiología y Reanimación, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - A Baluja
- Unidad de Cuidados Críticos Postoperatorios, Servicio de Anestesiología y Reanimación, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - P Otero
- Unidad de Cuidados Críticos Postoperatorios, Servicio de Anestesiología y Reanimación, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, España
| | - J Álvarez
- Unidad de Cuidados Críticos Postoperatorios, Servicio de Anestesiología y Reanimación, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, España
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Malekpour M, Younus JM, Jaap K, Neuhaus N, Widom K, Rapp M, Dove J, Hunsinger M, Blansfield J, Shabahang M, Torres D, Wild J. Mode of Transport and Clinical Outcome in Rural Trauma: A Helicopter versus Ambulance Comparison. Am Surg 2017. [DOI: 10.1177/000313481708301228] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Helicopter Emergency Medical Services (HEMS) is presumably an effective way of patient transport in rural trauma, yet the literature addressing its effectiveness is scarce. In this study, we compared the clinical outcome of rural trauma patients between Ground Emergency Medical Services (GEMS) and HEMS transportation from the beginning of 2006 to the end of 2012. Focus was placed on identifying factors associated with survival to discharge in these patients. Over the seven-year study period, 4492 patients met the inclusion criteria with 2414 patients (54%) being transferred by GEMS and 2078 patients (46%) being transferred by HEMS. In comparison with GEMS, patients transferred by HEMS were younger men who were admitted with a higher mean Injury Severity Score and a lower mean Glasgow Coma Score (all Ps < 0.0001). HEMS patients were more frequently intubated before arrival at the trauma center (32% vs 9%, P < 0.0001) and were more frequently transferred to the operating room from the emergency department (11% vs 5%, P < 0.0001). In multivariate analysis, transfer by HEMS was associated with a significant increase in survival to discharge (odds ratio: 1.57, 95% confidence interval: 1.03–2.40, P = 0.036). Blunt injury, no intubation, and Glasgow Coma Score >8 were also associated with significantly improved odds of survival to discharge (all P < 0.0001). These findings show that although patients transferred by HEMS arrived in less favorable clinical conditions, HEMS transfer was associated with significantly higher odds of survival in rural trauma.
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Affiliation(s)
- Mahdi Malekpour
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Jabran M. Younus
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Kathryn Jaap
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Nina Neuhaus
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Kenneth Widom
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Megan Rapp
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - James Dove
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Marie Hunsinger
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Joseph Blansfield
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Mohsen Shabahang
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Denise Torres
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Jeffrey Wild
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
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41
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Malekpour M, Younus JM, Jaap K, Neuhaus N, Widom K, Rapp M, Dove J, Hunsinger M, Blansfield J, Shabahang M, Torres D, Wild J. Mode of Transport and Clinical Outcome in Rural Trauma: A Helicopter versus Ambulance Comparison. Am Surg 2017; 83:1413-1417. [PMID: 29336764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Helicopter Emergency Medical Services (HEMS) is presumably an effective way of patient transport in rural trauma, yet the literature addressing its effectiveness is scarce. In this study, we compared the clinical outcome of rural trauma patients between Ground Emergency Medical Services (GEMS) and HEMS transportation from the beginning of 2006 to the end of 2012. Focus was placed on identifying factors associated with survival to discharge in these patients. Over the seven-year study period, 4492 patients met the inclusion criteria with 2414 patients (54%) being transferred by GEMS and 2078 patients (46%) being transferred by HEMS. In comparison with GEMS, patients transferred by HEMS were younger men who were admitted with a higher mean Injury Severity Score and a lower mean Glasgow Coma Score (all Ps < 0.0001). HEMS patients were more frequently intubated before arrival at the trauma center (32% vs 9%, P < 0.0001) and were more frequently transferred to the operating room from the emergency department (11% vs 5%, P < 0.0001). In multivariate analysis, transfer by HEMS was associated with a significant increase in survival to discharge (odds ratio: 1.57, 95% confidence interval: 1.03-2.40, P = 0.036). Blunt injury, no intubation, and Glasgow Coma Score >8 were also associated with significantly improved odds of survival to discharge (all P < 0.0001). These findings show that although patients transferred by HEMS arrived in less favorable clinical conditions, HEMS transfer was associated with significantly higher odds of survival in rural trauma.
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Malekpour M, Bridgham K, Jaap K, Erwin R, Widom K, Rapp M, Leonard D, Baro S, Dove J, Hunsinger M, Blansfield J, Shabahang M, Torres D, Wild J. The Effect of Sarcopenia on Outcomes in Geriatric Blunt Trauma. Am Surg 2017; 83:1203-1208. [PMID: 29183520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Elderly patients are at a higher risk of morbidity and mortality after trauma, which is reflected through higher frailty indices. Data collection using existing frailty indices is often not possible because of brain injury, dementia, or inability to communicate with the patient. Sarcopenia is a reliable objective measure for frailty that can be readily assessed in CT imaging. In this study, we aimed to evaluate the effect of sarcopenia on the outcomes of geriatric blunt trauma patients. Left psoas area (LPA) was measured at the level of the third lumbar vertebra on the axial CT images. LPA was normalized for height (LPA mm2/m2) and after stratification by gender, sarcopenia was defined as LPA measurements in the lowest quartile. A total of 1175 patients consisting of 597 males and 578 females were studied. LPAs below 242.6 mm2/m2 in males and below 187.8 mm2/m2 in females were considered to be sarcopenic. We found sarcopenia in 149 males and 145 females. In multivariate analysis, sarcopenia was associated with a higher risk of in-hospital mortality (odds ratio [OR]: 1.61, 95% confidence interval [CI]: 1.01-2.56) and a higher risk of discharge to less favorable destinations (OR: 1.42, 95% CI: 1.05-1.97). Lastly, sarcopenic patients had an increased risk of prolonged hospitalization (hazard ratio: 1.21, 95% CI: 1.04-1.40).
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43
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Lopes C, Torres D, Oliveira A, Severo M, Lobato L, Correia D, Guiomar S, Alarcao V, Oliveira L. Nutritional intake and contribution of foods to nutrient inadequacy – the Portuguese Dietary Survey. Eur J Public Health 2017. [DOI: 10.1093/eurpub/ckx187.319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- C Lopes
- Institute of Public Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - D Torres
- Institute of Public Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - A Oliveira
- Institute of Public Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - M Severo
- Institute of Public Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - L Lobato
- Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal
| | - D Correia
- Institute of Public Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - S Guiomar
- National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
| | - V Alarcao
- Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - L Oliveira
- National Health Institute Doutor Ricardo Jorge, Lisbon, Portugal
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44
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Malekpour M, Bridgham K, Jaap K, Erwin R, Widom K, Rapp M, Leonard D, Baro S, Dove J, Hunsinger M, Blansfield J, Shabahang M, Torres D, Wild J. The Effect of Sarcopenia on Outcomes in Geriatric Blunt Trauma. Am Surg 2017. [DOI: 10.1177/000313481708301120] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Elderly patients are at a higher risk of morbidity and mortality after trauma, which is reflected through higher frailty indices. Data collection using existing frailty indices is often not possible because of brain injury, dementia, or inability to communicate with the patient. Sarcopenia is a reliable objective measure for frailty that can be readily assessed in CT imaging. In this study, we aimed to evaluate the effect of sarcopenia on the outcomes of geriatric blunt trauma patients. Left psoas area (LPA) was measured at the level of the third lumbar vertebra on the axial CT images. LPA was normalized for height (LPA mm2/m2) and after stratification by gender, sarcopenia was defined as LPA measurements in the lowest quartile. A total of 1175 patients consisting of 597 males and 578 females were studied. LPAs below 242.6 mm2/m2 in males and below 187.8 mm2/m2 in females were considered to be sarcopenic. We found sarcopenia in 149 males and 145 females. In multivariate analysis, sarcopenia was associated with a higher risk of in-hospital mortality (odds ratio [OR]: 1.61, 95% confidence interval [CI]: 1.01–2.56) and a higher risk of discharge to less favorable destinations (OR: 1.42, 95% CI: 1.05–1.97). Lastly, sarcopenic patients had an increased risk of prolonged hospitalization (hazard ratio: 1.21, 95% CI: 1.04–1.40).
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Affiliation(s)
- Mahdi Malekpour
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Kelly Bridgham
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Kathryn Jaap
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Ryan Erwin
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Kenneth Widom
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Megan Rapp
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Diane Leonard
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Susan Baro
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - James Dove
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Marie Hunsinger
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Joseph Blansfield
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Mohsen Shabahang
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Denise Torres
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Jeffrey Wild
- Department of Surgery, Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
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45
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Barcellos P, Borges N, Torres D. MON-P142: Validation of Predictive Equations for Resting Energy Expenditure in Adults and Eldery non-Critically ILL Portuguese Patients. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30943-3] [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: 11/25/2022]
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46
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Nobre Menezes M, Francisco A, Agostinho J, Carrilho Ferreira P, Jorge C, Torres D, Cardoso P, Infante De Oliveira E, Canas Da Silva P, Pinto F. P2372Can we rely on iFR for avoiding FFR? Conclusions of a 5-year experience. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2372] [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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47
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Gaspar Lopes Francisco A, Menezes M, Lima Da Silva G, Goncalves I, Rigueira J, Carrilho Ferreira P, Jorge C, Infante De Oliveira E, Torres D, Cardoso P, Pinto F, Canas Da Silva P. P2371iFR diagnostic accuracy using FFR as gold standard: insights from a 5-year experience. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2371] [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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Torres D, Bermejo JL, Rashid MU, Briceño I, Gil F, Beltran A, Ariza V, Hamann U. Prevalence and Penetrance of BRCA1 and BRCA2 Germline Mutations in Colombian Breast Cancer Patients. Sci Rep 2017; 7:4713. [PMID: 28680148 PMCID: PMC5498630 DOI: 10.1038/s41598-017-05056-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 05/23/2017] [Indexed: 12/01/2022] Open
Abstract
Pathogenic BRCA1/2 germline mutations confer high risks of breast and ovarian cancer to women of European ancestry. Characterization of BRCA1/2 mutations in other ethnic groups is also medically important. We comprehensively screened 68 Colombian breast/ovarian cancer families for small-range mutations, 221 families for large-genomic rearrangements, and 1,022 unselected breast cancer cases for Colombian founder mutations in BRCA1/2. The risk of cancer among relatives of mutation carriers and the mutation penetrance were estimated by survival analysis. Identified BRCA2 mutations included 6310delGA and the recurrent 1991del4 mutations. A novel large BRCA2 deletion was found in 0.9% of the screened families. Among unselected breast cancer cases, 3.3% tested positive for BRCA1/3450del4, 2.2% for BRCA1/A1708E, 1.1% for BRCA2/3034del4, and 0.4% for BRCA2/1991del4. Female relatives of carriers of BRCA1/2 founder mutations showed a 5.90 times higher risk of breast cancer, when the woman herself carried a BRCA1 mutation compared to a non-carrier (95% CI 2.01–17.3). The estimated cumulative risk of breast cancer by age 70 years for BRCA1 mutations carriers was 14% (95% CI 5–38) compared to 3% for the general Colombian population (relative risk of breast cancer 4.05). Together with known founder mutations, reported novel variants may ease a cost-effective BRCA1/2 screening in women with Colombian ancestry.
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Affiliation(s)
- D Torres
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Institute of Human Genetics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - J Lorenzo Bermejo
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - M U Rashid
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Basic Sciences Research, Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH & RC), Lahore, Pakistan
| | - I Briceño
- Institute of Human Genetics, Pontificia Universidad Javeriana, Bogota, Colombia.,Universidad de la Sabana, Bogota, Colombia
| | - F Gil
- Unit of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogota, Colombia
| | - A Beltran
- Universidad Nacional, Bogota, Colombia
| | - V Ariza
- Universidad Nacional, Bogota, Colombia
| | - U Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany.
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Young K, Benson M, Higgins A, Dove J, Hunsinger M, Shabahang M, Blansfield J, Torres D, Widom K, Wild J. In the Modern Era of CT, Do Blunt Trauma Patients with Markers for Blunt Bowel or Mesenteric Injury Still Require Exploratory Laparotomy? Am Surg 2017. [DOI: 10.1177/000313481708300728] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
After blunt trauma, certain CT markers, such as free intraperitoneal air, strongly suggest bowel perforation, whereas other markers, including free intraperitoneal fluid without solid organ injury, may be merely suspicious for acute injury. The present study aims to delineate the safety of non-operative management for markers of blunt bowel or mesenteric injury (BBMI) that are suspicious for significant bowel injury after blunt trauma. This was a retrospective review of adult blunt trauma patients with abdominopelvic CT scans on admission to a Level I trauma center between 2012 and 2014. Patients with CT evidence of acute BBMI without solid organ injury were included. The CT markers for BBMI included free intraperitoneal fluid, bowel hematoma, bowel wall thickening, mesenteric edema, hematoma and stranding. Two thousand blunt trauma cases were reviewed, and 94 patients (4.7%) met inclusion criteria. The average Injury Severity Score was 13.6 ± 10.1 and the median hospital stay was four days. The most common finding was free fluid (74 patients, 78.7%). The majority of patients (92, 97.9%) remained asymptomatic or clinically improved without abdominal surgery. After a change in abdominal examination, two patients (2.1%) underwent laparotomy with bowel perforation found in only one patient. Thus, 93 patients did not have a surgically significant injury, indicating that these markers demonstrate 1.1 per cent positive predictive value for bowel perforation. The presence of these markers after blunt trauma does not mandate laparotomy, though it should prompt thorough and continued vigilance toward the abdomen.
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Affiliation(s)
- Katelyn Young
- Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Melina Benson
- Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Andrew Higgins
- Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - James Dove
- Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Marie Hunsinger
- Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Mohsen Shabahang
- Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Joseph Blansfield
- Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Denise Torres
- Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Kenneth Widom
- Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
| | - Jeffrey Wild
- Section of Trauma and Acute Care Surgery, Geisinger Medical Center, Danville, Pennsylvania
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50
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Young K, Benson M, Higgins A, Dove J, Hunsinger M, Shabahang M, Blansfield J, Torres D, Widom K, Wild J. In the Modern Era of CT, Do Blunt Trauma Patients with Markers for Blunt Bowel or Mesenteric Injury Still Require Exploratory Laparotomy? Am Surg 2017; 83:722-727. [PMID: 28738942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
After blunt trauma, certain CT markers, such as free intraperitoneal air, strongly suggest bowel perforation, whereas other markers, including free intraperitoneal fluid without solid organ injury, may be merely suspicious for acute injury. The present study aims to delineate the safety of nonoperative management for markers of blunt bowel or mesenteric injury (BBMI) that are suspicious for significant bowel injury after blunt trauma. This was a retrospective review of adult blunt trauma patients with abdominopelvic CT scans on admission to a Level I trauma center between 2012 and 2014. Patients with CT evidence of acute BBMI without solid organ injury were included. The CT markers for BBMI included free intraperitoneal fluid, bowel hematoma, bowel wall thickening, mesenteric edema, hematoma and stranding. Two thousand blunt trauma cases were reviewed, and 94 patients (4.7%) met inclusion criteria. The average Injury Severity Score was 13.6 ± 10.1 and the median hospital stay was four days. The most common finding was free fluid (74 patients, 78.7%). The majority of patients (92, 97.9%) remained asymptomatic or clinically improved without abdominal surgery. After a change in abdominal examination, two patients (2.1%) underwent laparotomy with bowel perforation found in only one patient. Thus, 93 patients did not have a surgically significant injury, indicating that these markers demonstrate 1.1 per cent positive predictive value for bowel perforation. The presence of these markers after blunt trauma does not mandate laparotomy, though it should prompt thorough and continued vigilance toward the abdomen.
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