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Reddy A, Nethercott SL, Teh W, De Bie EMD, Pepke-Zaba J, Sheares KK, Cannon J, Taboada D, Hadinnapola C, Martin CA, Toshner MR. Prevalence and clinical impact of atrioventricular conduction disease in patients with idiopathic pulmonary arterial hypertension. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Although bradycardia-related sudden death is common in patients with idiopathic pulmonary arterial hypertension (IPAH), the prevalence and prognostic significance of atrioventricular (AV) conduction disease in this patient group is not well-established.
Objectives
– Determine the prevalence of AV conduction disorders in patients with IPAH
– Investigate the relationship between AV block and functional outcomes and mortality.
Method
12-lead electrocardiograms (ECGs) of patients with IPAH were analysed. Patients were categorised according to the presence or absence of AV block. Demographic, pulmonary haemodynamic, cardiac structural characteristics and expression of genes associated with cardiac conduction were compared and functional and mortality outcomes analysed between groups.
Student's t-tests and χ2 tests were used to compare data. Survival was estimated using Kaplan-Meier analyses. Initial exploratory covariates were included in a univariate analysis and those terms with P-value of <0.1 were then used to generate a Cox proportional-hazards multivariate model.
Results
135 IPAH patients (mean age 55±16 years, 28.1% male) were eligible for analysis. Median follow up was 9 years (interquartile range 4–14 years).
AV block was seen in 34.8% of patients with IPAH compared to 10.8% of matched comparators (p<0.001), drawn from patients attending hospital for non-PAH related reasons.
IPAH patients with conduction disease were more likely to be older (59±16 vs 53±17 years, p=0.038). AV block was associated with more severe right ventricular (RV) basal dilatation (5.1±1.0 vs 4.3±0.7cm, p=0.013) and worse RV function (fractional area change 26±9% vs 31±9%, p=0.14). Pulmonary haemodynamics, right atrial size and resting and exertional oxygen saturations were not significantly different. Expression of HCN1, HCN2, SCN1B, SCN5A, CAV1, and KCN2 genes in peripheral blood from a subcohort was similar between those with and without AV block.
Lower 6 minute walk distances (344±153 vs 408±140m, p=0.035) and worse CAMPHOR scores across all 3 domains were seen in those with AV block (figure 1), and mortality was significantly higher (36.2 vs 13.6%, p=0.002) (figure 2). On multivariate analysis the presence of bundle branch block (BBB) was independently associated with a 2.1-fold increased risk of death (95% CI 1.89–4.85, p=0.045).
Conclusions
AV conduction disorders are more prevalent in IPAH than the general population, and are associated with worse prognosis and functional status. Prospective study is required to validate this finding.
In our cohort AV block could not be explained by hypoxia, differences in pulmonary haemodynamics nor, in a small subgroup, by differential expression of specific transmembrane ion channels implicated in cardiac conduction. More detailed investigation into causal mechanisms of AV block in IPAH could establish whether improved prognosis could be achieved by treatment of AV block.
Funding Acknowledgement
Type of funding sources: None. Figure 1Figure 2
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Affiliation(s)
- A Reddy
- Royal Papworth Hospital, Cambridge, United Kingdom
| | | | - W Teh
- Royal Papworth Hospital, Cambridge, United Kingdom
| | - E M D De Bie
- University of Cambridge, Cambridge, United Kingdom
| | - J Pepke-Zaba
- Royal Papworth Hospital, Cambridge, United Kingdom
| | - K K Sheares
- Royal Papworth Hospital, Cambridge, United Kingdom
| | - J Cannon
- Royal Papworth Hospital, Cambridge, United Kingdom
| | - D Taboada
- Royal Papworth Hospital, Cambridge, United Kingdom
| | | | - C A Martin
- Royal Papworth Hospital, Cambridge, United Kingdom
| | - M R Toshner
- Royal Papworth Hospital, Cambridge, United Kingdom
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Grenfell RFQ, Taboada D, Coutinho LA, Pedrosa MLC, Assis JV, Oliveira MSP, Cruz RR, Almeida A, Silva-Moraes V, Katz N, Coelho PMZ. Innovative methodology for point-of-care circulating cathodic antigen with rapid urine concentration for use in the field for detecting low Schistosoma mansoni infection and for control of cure with high accuracy. Trans R Soc Trop Med Hyg 2019. [PMID: 29522211 DOI: 10.1093/trstmh/try014] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background Prior to eliminating schistosomiasis, efforts must address accurate and fast individual diagnosis. Diagnosis is still inaccurate by parasitological and point-of-care circulating cathodic antigen (POC-CCA) in areas of low endemicity. Methods Our group has optimized POC-CCA with a 30 min urine concentration step with no need for specialized technicians or equipment and with high accuracy. We evaluated this new method, called POC-CCA filter (FLT), in two Brazilian endemic areas with distinct profiles. Results At baseline, POC-CCA had a poor performance with several false results and undefined trace readings, revealing a prevalence rate of 10% against a rate of 23% for POC-CCA FLT, which was similar to the parasitological rates. Accuracy increased from as low as 0.36 to 0.96 after urine concentration in one area. POC-CCA properly diagnosed only half of the cases at three post-treatment time points, while POC-CCA FLT was able to diagnose 96, 83 and 100%, respectively. Conclusions The improvement of conventional POC methodology by a fast and simple urine concentration step provided not only an increase in its accuracy before and after praziquantel treatment, but also preserved its applicability in low-prevalence endemic areas, allowing the definition of trace readings as negative cases.
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Affiliation(s)
- Rafaella F Q Grenfell
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, 30190-002, Brazil.,Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, Georgia 30602-7387, USA
| | - Diana Taboada
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Lucélia A Coutinho
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Maria Luysa C Pedrosa
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Jéssica V Assis
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Matheus S P Oliveira
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Renata R Cruz
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Aureo Almeida
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Vanessa Silva-Moraes
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Naftale Katz
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, 30190-002, Brazil
| | - Paulo Marcos Z Coelho
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, 30190-002, Brazil
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Marcin Sierra M, Arroyo M, Cadena Torres M, Ramírez Cruz N, García Hernández F, Taboada D, Galicia Martínez Á, Govezensky T, Sciutto E, Toledo A, Fleury A. Extraparenchymal neurocysticercosis: Demographic, clinicoradiological, and inflammatory features. PLoS Negl Trop Dis 2017; 11:e0005646. [PMID: 28599004 PMCID: PMC5479594 DOI: 10.1371/journal.pntd.0005646] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 06/21/2017] [Accepted: 05/17/2017] [Indexed: 12/24/2022] Open
Abstract
Background Extraparenchymal neurocysticercosis (ExPNCC), an infection caused by Taenia solium cysticerci that mainly occurs in the ventricular compartment (Ve) or the basal subarachnoid space (SAb), is more severe but less frequent and much less studied than parenchymal neurocysticercosis (ParNCC). Demographic, clinical, radiological, and lumbar cerebrospinal fluid features of patients affected by ExPNCC are herein described and compared with those of ParNCC patients. Methodology and principal findings 429 patients with a confirmed diagnosis of neurocysticercosis, attending the Instituto Nacional de Neurología y Neurocirugía, a tertiary reference center in Mexico City, from 2000 through 2014, were included. Demographic information, signs and symptoms, radiological patterns, and lumbar cerebrospinal fluid (CSF) laboratory values were retrieved from medical records for all patients. Data were statistically analyzed to assess potential differences depending on cyst location and to determine the effects of age and sex on the disease presentation. In total, 238 ExPNCC and 191 ParNCC patients were included. With respect to parenchymal cysts, extraparenchymal parasites were diagnosed at an older age (P = 0.002), chiefly caused intracranial hypertension (P < 0.0001), were more frequently multiple and vesicular (P < 0.0001), and CSF from these patients showed higher protein concentration and cell count (P < 0.0001). SAb patients were diagnosed at an older age than Ve patients, and showed more frequently seizures, vesicular cysticerci, and higher CSF cellularity. Gender and age modulated some traits of the disease. Conclusions This study evidenced clear clinical, radiological, and inflammatory differences between ExPNCC and ParNCC, and between SAb and Ve patients, and demonstrated that parasite location determines different pathological entities. Neurocysticercosis (NCC) is caused by the establishment of Taenia solium larvae in the human central nervous system. While NCC diagnosis, treatment, and prevention have clearly improved in the last 40 years, the disease still causes significant morbidity and mortality in endemic regions of Latin America, Asia, and Africa. Herein we described demographic, clinical, radiological, and cerebrospinal fluid features of a large series of NCC patients, and evaluated the relevance of parasite location on disease presentation. 191 patients with parenchymal parasites, 125 patients with extraparenchymal cysts, and 113 patients lodging parasites in both locations were included. Our results clearly demonstrated that differences in parasite location actually determines distinct diseases, with wide variations in severity. This is particularly evident when comparing parenchymal with extraparenchymal patients and ventricular with subarachnoid patients. Gender and age also modulate some characteristics of the disease. In conclusion, parasite location is one of the most important features of the disease, which must be considered when approaching an NCC patient.
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Affiliation(s)
- Mariana Marcin Sierra
- Research Unit on Neuroinflammation, Instituto de Investigaciones Biomédicas - Universidad Nacional Autónoma de México / Facultad de Medicina – Universidad Nacional Autónoma de México / Instituto Nacional de Neurología y Neurocirugía, México City, México
| | - Mariana Arroyo
- Research Unit on Neuroinflammation, Instituto de Investigaciones Biomédicas - Universidad Nacional Autónoma de México / Facultad de Medicina – Universidad Nacional Autónoma de México / Instituto Nacional de Neurología y Neurocirugía, México City, México
| | - May Cadena Torres
- Research Unit on Neuroinflammation, Instituto de Investigaciones Biomédicas - Universidad Nacional Autónoma de México / Facultad de Medicina – Universidad Nacional Autónoma de México / Instituto Nacional de Neurología y Neurocirugía, México City, México
| | - Nancy Ramírez Cruz
- Research Unit on Neuroinflammation, Instituto de Investigaciones Biomédicas - Universidad Nacional Autónoma de México / Facultad de Medicina – Universidad Nacional Autónoma de México / Instituto Nacional de Neurología y Neurocirugía, México City, México
| | - Fernando García Hernández
- Research Unit on Neuroinflammation, Instituto de Investigaciones Biomédicas - Universidad Nacional Autónoma de México / Facultad de Medicina – Universidad Nacional Autónoma de México / Instituto Nacional de Neurología y Neurocirugía, México City, México
| | - Diana Taboada
- Research Unit on Neuroinflammation, Instituto de Investigaciones Biomédicas - Universidad Nacional Autónoma de México / Facultad de Medicina – Universidad Nacional Autónoma de México / Instituto Nacional de Neurología y Neurocirugía, México City, México
| | - Ángeles Galicia Martínez
- Research Unit on Neuroinflammation, Instituto de Investigaciones Biomédicas - Universidad Nacional Autónoma de México / Facultad de Medicina – Universidad Nacional Autónoma de México / Instituto Nacional de Neurología y Neurocirugía, México City, México
| | - Tzipe Govezensky
- Immunology Department, Instituto de Investigaciones Biomédicas – Universidad Nacional Autónoma de México, México City, México
| | - Edda Sciutto
- Immunology Department, Instituto de Investigaciones Biomédicas – Universidad Nacional Autónoma de México, México City, México
| | - Andrea Toledo
- Research Unit on Neuroinflammation, Instituto de Investigaciones Biomédicas - Universidad Nacional Autónoma de México / Facultad de Medicina – Universidad Nacional Autónoma de México / Instituto Nacional de Neurología y Neurocirugía, México City, México
| | - Agnès Fleury
- Research Unit on Neuroinflammation, Instituto de Investigaciones Biomédicas - Universidad Nacional Autónoma de México / Facultad de Medicina – Universidad Nacional Autónoma de México / Instituto Nacional de Neurología y Neurocirugía, México City, México
- Neurocysticercosis Clinic, Instituto Nacional de Neurología y Neurocirugía, México City, México
- * E-mail:
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Taboada D, Navío M, Jurado R, Fernández V, Bayón C, Álvarez MJ, Morales I, Ponce G, Rubio G, Mingote JC, Cruz F, Jiménez MÁ. Factor structure and psychometric properties of the TFEQ in morbid obese patients, candidates to bariatric surgery. Psicothema 2017; 27:141-50. [PMID: 25927694 DOI: 10.7334/psicothema2014.46] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND To analyze the factor structure and psychometric properties of the TFEQ in a morbid obese Spanish sample of bariatric surgery candidates. METHOD Multi-trait/ multi-item analyses and alpha coefficients were conducted to test the convergent /discriminant validity and the internal consistency reliability. Principal components analyses (varimax) were used to explore the factor structure. Sub-group factor analyses by gender, age and body mass index (BMI) were conducted to identify unstable items. RESULTS The internal structure of the original TFEQ factors was unsatisfactory, especially the Disinhibition Scale. Most Disinhibition and Hunger items were grouped on one factor labeled “Dysregulation Eating”. Cognitive Restraint was split into two factors. The first one, related to the behavioral component of Restraint, labeled “Restrained Behaviour” and the second one related to weight and eating concerns called “Predisposition to Restraint”. CONCLUSIONS The original factor structure of the TFEQ was not replicated. A revised 23-item instrument, representing the three new derived factors is offered as a valid screening instrument for severely obese patients.
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Zalewska KI, Swietlik EM, Hernandez JS, Cannon JE, Taboada D, Newnham M, Hadinnapola C, Morrell NW, Toshner MR, Zaba JP. S135 Circulating metabolites in chronic thromboembolic pulmonary hypertension and chronic thromboembolic pulmonary vascular occlusion. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Swietlik EM, Taboada D, Ruggiero A, Bales E, Harlow L, Fletcher A, Cannon JE, Sheares K, Jenkins DP, Pepke-Zaba J, Toshner M. P27 Evaluation and baseline characteristics of patients with chronic thromboembolic disease in a single referral centre. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Swietlik EM, Taboada D, Ruggiero A, Bales E, Harlow L, Fletcher A, Cannon JE, Sheares K, Jenkins DP, Pepke-Zaba J, Toshner T. P29 Exercise intolerance in chronic thromboembolic disease: evaluation, underlying mechanisms and clinical implications. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Siqueira LMV, Couto FFB, Taboada D, Oliveira ÁAD, Carneiro NFDF, Oliveira E, Coelho PMZ, Katz N. Performance of POC-CCA® in diagnosis of schistosomiasis mansoni in individuals with low parasite burden. Rev Soc Bras Med Trop 2016; 49:341-7. [DOI: 10.1590/0037-8682-0070-2016] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 05/13/2016] [Indexed: 01/19/2023] Open
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Cannon J, Su L, Page K, Ponnaberanam A, Toshner M, Taboada D, Sheares K, Ng C, Dunning J, Tsui S, Jenkins D, Pepke-Zaba J. S122 Outcome After Pulmonary Endarterectomy (pea): Long Term Follow-up Of The Uk National Cohort. Thorax 2014. [DOI: 10.1136/thoraxjnl-2014-206260.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Pilkington SA, Taboada D, Martinez G. Pulmonary hypertension and its management in patients undergoing non-cardiac surgery. Anaesthesia 2014; 70:56-70. [DOI: 10.1111/anae.12831] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2014] [Indexed: 11/26/2022]
Affiliation(s)
- S. A. Pilkington
- Department of Anaesthesia; The Queen Elizabeth Hospital NHS Foundation Trust; King's Lynn UK
| | - D. Taboada
- Pulmonary Vascular Disease Unit; Papworth Hospital NHS Foundation Trust; Cambridge UK
| | - G. Martinez
- Department of Anaesthesia; Papworth Hospital NHS Foundation Trust; Cambridge UK
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Grenfell RFQ, Coelho PMZ, Taboada D, de Mattos ACA, Davis R, Harn DA. Newly established monoclonal antibody diagnostic assays for Schistosoma mansoni direct detection in areas of low endemicity. PLoS One 2014; 9:e87777. [PMID: 24498191 PMCID: PMC3909226 DOI: 10.1371/journal.pone.0087777] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Accepted: 01/02/2014] [Indexed: 01/07/2023] Open
Abstract
Background Current available methods for diagnosis of schistosomiasis mansoni lack sufficient sensitivity, which results in underreporting of infectious in areas of low endemicity. Methodology/Principal Findings We developed three novel diagnostic methodologies for the direct detection of schistosome infection in serum samples. These three new methods were evaluated with positive patients from a low endemicity area in southeast Brazil. The basis of the assay was the production of monoclonal antibodies against the protein backbone of heavily glycosylated Circulating Cathodic Antigen (CCA). The antibodies were also selected for having no specificity to repeating poly-Lewis x units. Assays based on the detection CCA-protein should not encounter a limitation in sensitivity due to a biological background of this particular epitope. Three diagnostic methodologies were developed and validated, (i) Immunomagnetic Separation based on improved incubation steps of non-diluted serum, (ii) Direct Enzyme-linked Immunosorbent Assay and (iii) Fluorescent Microscopy Analysis as a qualitative assay. The two quantitative assays presented high sensitivity (94% and 92%, respectively) and specificity (100%), equivalent to the analysis of 3 stool samples and 16 slides by Kato-Katz, showing promising results on the determination of cure. Conclusions/Significance The Immunomagnetic Separation technique showed excellent correlation with parasite burden by Cohen coefficient. The qualitative method detected 47 positive individuals out of 50 with the analysis of 3 slides. This easy-to-do method was capable of discriminating positive from negative cases, even for patients with low parasite burden.
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Affiliation(s)
- Rafaella Fortini Queiroz Grenfell
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, Brazil
- Department of Infectious Diseases, College of Veterinary Medicine, and Center for Tropical and Emerging Global Diseases, University of Georgia (UGA), Athens, Georgia, United States of America
| | - Paulo Marcos Zech Coelho
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, Brazil
- * E-mail:
| | - Diana Taboada
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, Brazil
| | - Ana Carolina Alves de Mattos
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Belo Horizonte, Minas Gerais, Brazil
| | - Ruth Davis
- Monoclonal Antibody Facility, College of Veterinary Medicine, University of Georgia (UGA), Athens, Georgia, United States of America
| | - Donald A. Harn
- Department of Infectious Diseases, College of Veterinary Medicine, and Center for Tropical and Emerging Global Diseases, University of Georgia (UGA), Athens, Georgia, United States of America
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Sanz-Fuentenebro J, Taboada D, Palomo T, Aragües M, Ovejero S, Del Alamo C, Molina V. Randomized trial of clozapine vs. risperidone in treatment-naïve first-episode schizophrenia: results after one year. Schizophr Res 2013; 149:156-61. [PMID: 23870807 DOI: 10.1016/j.schres.2013.07.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 06/06/2013] [Accepted: 07/01/2013] [Indexed: 10/26/2022]
Abstract
In first-episode patients with psychosis, clozapine may be potentially valuable as an initial treatment seeking to limit early on clinical and cognitive deterioration. Nevertheless, until recently its restricted use has limited the study of this possibility. Our research group is developing a non-commercial, multicentric and open label study on the differential efficacy between clozapine and risperidone in first-episode schizophrenia. In this paper, we present the results related to clinical variables after a one-year follow-up. So far, we have recruited 30 patients diagnosed with schizophrenia or schizophreniform disorder with illness duration of less than two years. The patients had not received any previous treatment and they were randomized to treatment with clozapine or risperidone. Our results indicate that on average, patients on clozapine adhered to their original treatment for a longer time period than patients on risperidone. By last observation carried forward (LOCF) analysis, patients on clozapine and risperidone displayed similar clinical improvements, although marginally greater improvements in positive and total symptoms scores were found in the clozapine group. At the 12-month point we observed a marginal improvement in negative symptom scores in patients on clozapine. Subjective secondary effects, as measured with the Udvalg for KliniskeUndersøgelser (UKU) scale, correlated negatively with negative symptoms at follow-up. Our data, although preliminary, suggest that clozapine may have a slightly superior efficacy in the initial year of treatment of first-episode treatment-naïve patients with schizophrenia, and this can be explained for the most part by greater adherence to this treatment.
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Berman M, Taboada D, Sheares K, Pepke-Zaba J, Carmen T, Dunning J, Tsui S, Jenkins D. Pulmonary Endarterectomy in Patients with Borderline Pulmonary Hypertension. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.867] [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: 11/26/2022] Open
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Taboada D, Álvarez-Alonso MJ, Denia F. Aportaciones del Neuropsicólogo en un Hospital General, desde la Unidad de Interconsulta y Enlace del Servicio de Psiquiatría. Clín Contemp 2013. [DOI: 10.5093/cc2013a12] [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: 11/22/2022] Open
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Grenfell RFQ, Silva-Moraes V, Taboada D, de Mattos ACA, de Castro AKS, Coelho PMZ. Immunodiagnostic methods: what is their role in areas of low endemicity? ScientificWorldJournal 2012; 2012:593947. [PMID: 23319886 PMCID: PMC3539347 DOI: 10.1100/2012/593947] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Accepted: 11/28/2012] [Indexed: 01/10/2023] Open
Abstract
Worldwide Schistosomiasis mansoni continues to be a serious public health problem. Over the past decades, control programmes have made remarkable progress in reducing S. mansoni infections to a relatively low level in Brazil and African countries. Endemic regions are currently circumscribed in certain core areas where reinfection and repeated chemotherapy are frequent and, consequently, are related to residents with low parasite load. At present, diagnosis is predominately a key step for final disease control although low endemicity area residents are hardly detected by most of the available assays. In this paper, we review the current status and efforts made aiming at the improvement of diagnostic tools for S. mansoni in low endemicity infections. The establishment of diagnostic assays—simple, affordable, sensitive, and specific for field diagnosis of S. mansoni—is essential and should be given high priority.
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Affiliation(s)
- Rafaella Fortini Queiroz Grenfell
- Schistosomiasis Laboratory, Rene Rachou Research Center, Oswaldo Cruz Foundation (Fiocruz), Avenida Augusto de Lima, 1715/201 Belo Horizonte, MG, Brazil
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McCabe C, Taboada D, Mackenzie-Ross R, Harvey I, Sheares K, White P, Axell R, Hoole S, Shapiro L, Pepke-Zaba J. S41 Conductance-Derived Right Ventricular Stroke Work Measured by Pressure Volume Loops in Chronic Thromboembolic Pulmonary Vascular Disease. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Taboada D, Treacey C, Jenkins D, Zaba JP, Sheares K. S22 Improved symptoms and quality of life after pulmonary endarterectomy (PEA) in patients with chronic thromboembolic disease (CTED) and borderline pulmonary hypertension (PH). Thorax 2011. [DOI: 10.1136/thoraxjnl-2011-201054b.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Jurado R, Morales I, Taboada D, Denia F, Mingote JC, Jiménez MÁ, Palomo T, Rubio G. Coping strategies and quality of life among liver transplantation candidates. Psicothema 2011; 23:74-79. [PMID: 21266145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The maintenance of self-reported quality of life (QL) among people on the liver transplantation waiting list is one of the priority objectives of transplantation teams. Although there are different determinant factors of QL, results are not conclusive. In our study, the goal was to evaluate both the influence of cirrhosis etiology (ethylic and non-ethylic) and the coping strategies used concerning QL. A sample of 93 patients was selected, divided into two groups: ethylic cirrhosis (EC) and non-ethylic cirrhosis (NEC). QL was evaluated through the SF-36 Health Survey, and coping strategies through the Medical Coping Modes Questionnaire (MCMQ). Our results indicated that subjects with EC obtained similar QL levels to subjects with NEC, on all the SF-36 and MCMQ subscales. Furthermore, negative correlations were found between avoidance and acceptance-resignation coping strategies with the SF-36 components. Consequently, the acceptance-resignation strategy was associated with a worse perception of physical functioning, general and mental health, and vitality and role-emotional. Overall, these results suggest that cirrhosis etiology is not a determinant factor of QL, whereas the acceptance-resignation coping strategy might lead to lower self-perception of QL.
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Affiliation(s)
- Rosa Jurado
- Servicio de Psiquiatría, Hospital Universitario 12 de Octubre, Madrid, Spain.
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Reyero F, Ponce G, Rodriguez-Jimenez R, Fernandez-Dapica P, Taboada D, Martin V, Navio M, Jimenez-Arriero MA, Hoenicka J, Palomo T. High frequency of childhood ADHD history in women with fibromyalgia. Eur Psychiatry 2010; 26:482-3. [PMID: 20620028 DOI: 10.1016/j.eurpsy.2010.03.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Revised: 03/23/2010] [Accepted: 03/25/2010] [Indexed: 12/20/2022] Open
Abstract
Fibromyalgia and ADHD share some clinical features, and a reduced dopamine function has been proposed for both disorders. Here we found, in a large sample of fibromyalgia female patients, a higher frequency of childhood ADHD antecedent when compared with healthy women. Our data suggest that Fibromyalgia and ADHD have some common etiopathological mechanism.
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Affiliation(s)
- F Reyero
- Department of Psychiatry, Hospital Universitario 12 de Octubre, Av. Andalucía s/n, Madrid E 28041, Spain
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Abstract
Focal abnormalities of gyration (FAG) are developmental disorders that may occur in isolated patients or, as in the case being reported, as part of a familial disorder. Analysis of individuals in a family spanning three generations was carried out using MRI. Abnormalities, present in all members of generations II and III, included focal cortical dysplasia (three patients), focal cortical infolding (two patients) and schizencephaly (one patient); associated minor anomalies, such as white matter abnormalities, were seen in the remaining three members of generations II and III. MRI recognition of FAG in the family being reported proved useful in defining their phenotypical expression and providing proper counselling for individual family members.
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Affiliation(s)
- L Muntaner
- Department of Radiology, Son Dureta University Hospital, Palma de Mallorca, Spain
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Alonso A, Taboada D, Alvarez JA, Vidal-Sampedro J, Vieito X. Spontaneous hematomas caused by microangiomatosis of the basal ganglia. Presentation of two cases in the newborn period. Childs Brain 1984; 11:202-11. [PMID: 6723438 DOI: 10.1159/000120178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
We present 2 cases of tumors of the gray basal nuclei with intraventricular hemorrhage and secondary hydrocephalus. Because of the patients' ages, the absence of traumatic antecedents and the angiographic characteristics, the findings were diagnosed as gliomas. In both cases, the existence of hematomas provoked by microangiomatosis was proved after the operation. The differential diagnostic between these two entities is discussed.
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Abstract
A large, highly ossified craniopharyngioma was diagnosed and surgically treated in a 2-year-old girl. About 20 teeth were macroscopically identified in the operative specimen, some of them totally developed, complete with crown and root. Pathological study established the diagnosis of craniopharyngioma with formation of teeth. Only five cases have been reported previously, and only one patient survived the operation. The patient is alive 3 years after surgical treatment. Radiotherapy was not used.
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Abstract
A 8-month-old girl had an ependymoma in the clivus, 2 X 6 cm in size, connected with the fourth ventricle by a cord of tissue 0.5 cm thick. There were no indications to make us suspect the origin of the tumour in the fourth ventricle, or that it was a case of ependymoma.
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Castel V, Ferris J, Verdeguer A, Moreno JA, Taboada D. [Neuroblastoma with opso-cerebello-myoclonic syndrome and malformation of the posterior fossa]. An Esp Pediatr 1980; 13:1047-50. [PMID: 7212467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Abstract
Nine newborn infants with histories of perinatal asphyxia are presented. The pneumoencephalographic findings which led to the diagnosis are typical and constant. They include marked subcortical atrophy with rounded, dilated, and undisplaced lateral ventricles. Cystography with 3 cc of air demonstrated multiple subcortical and pareventricular cavities, without communication with the ventricular system, but with the typical honeycomb appearance of paraventricular and subcortical leukomalacia described in postmortem findings. The CT findings are typical, and provide the location of the cavities as well as their density.
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Abstract
Congenital medulloblastoma caused severe hydrocephalus in two patients, one aged one day and the other 5 months.
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Abstract
Two children, aged 18 months and 6 years, who had Recklinghausen's disease, had occlusion of cerebral arteries. One child had no motor deficit but the other had right hemiparesis and partial occlusion of the left posterior cerebral artery, a fact not found in the literature.
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Abstract
Four cases of ventricular diverticulum are presented, 2 with spontaneous ventriculostomy. In 2 patients, the cause was monoventricular hydrocephalus through congenital stenosis of the foramen of Monro, with paraventricular diverticula and spontaneous ventriculostomy. Both patients had a cystic space in the quadrigeminal and supracerebellar cistern. In one patient during pneumoencephalography, the ventricular diverticulum filled via the ventriculostomy. The other 2 patients had congenital stenosis of the Sylvian aqueduct with the formation of a large supratentoria cyst connecting with the posterior part of the third ventricule.
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Abstract
Two cases of congenital atresia of the foramen of Monro are described, one 8 days old and the other 2 months old. Both are associated with a parieto-occipital paraventricular diverticulum and spontaneous ventriculostomy with the passing of the cerebrospinal fluid to the posterior fossa and the formation of a cyst in the supracerebella region which compressed and displaced the structures of the posterior fossa.
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Alvarez Garijo JA, Vila Mengual M, Taboada D, Alonso A. [Acute subdural hematomas of the newborn infant. Report of 5 cases]. Rev Esp Otoneurooftalmol Neurocir 1979; 37:29-31. [PMID: 461919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Vila Mengual M, Alvarez Garijo JA, Taboada D, Alonso A. [Giant arteriovenous fistulae of the vein of Galen. Surgical treatment]. Rev Esp Otoneurooftalmol Neurocir 1979; 37:32-4. [PMID: 461920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Alonso A, Taboada D, Ceres L, Beltran J, Olague R, Nogues A. Intracranial calcification in a neonate with the Sturge Weber syndrome and additional problems. Pediatr Radiol 1979; 8:39-41. [PMID: 431990 DOI: 10.1007/bf00973676] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The neonate in this report had severe encephalotrigeminal angiomatosis with intracranial calcification, cranial hemiatrophy, microcephaly and generalised severe cerebral atrophy. Such findings are not common in the newborn with this syndrome.
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