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Reventun P, Sánchez-Esteban S, Cook-Calvete A, Delgado-Marín M, Roza C, Jorquera-Ortega S, Hernandez I, Tesoro L, Botana L, Zamorano JL, Zaragoza C, Saura M. Endothelial ILK induces cardioprotection by preventing coronary microvascular dysfunction and endothelial-to-mesenchymal transition. Basic Res Cardiol 2023; 118:28. [PMID: 37452166 PMCID: PMC10348984 DOI: 10.1007/s00395-023-00997-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 06/13/2023] [Accepted: 06/30/2023] [Indexed: 07/18/2023]
Abstract
Endothelial dysfunction is an early event in coronary microvascular disease. Integrin-linked kinase (ILK) prevents endothelial nitric oxide synthase (eNOS) uncoupling and, thus, endothelial dysfunction. However, the specific role of endothelial ILK in cardiac function remains to be fully elucidated. We hypothesised that endothelial ILK plays a crucial role in maintaining coronary microvascular function and contractile performance in the heart. We generated an endothelial cell-specific ILK conditional knock-out mouse (ecILK cKO) and investigated cardiovascular function. Coronary endothelial ILK deletion significantly impaired cardiac function: ejection fraction, fractional shortening and cardiac output decreased, whilst left ventricle diastolic internal diameter decreased and E/A and E/E' ratios increased, indicating not only systolic but also diastolic dysfunction. The functional data correlated with extensive extracellular matrix remodelling and perivascular fibrosis, indicative of adverse cardiac remodelling. Mice with endothelial ILK deletion suffered early ischaemic-like events with ST elevation and transient increases in cardiac troponins, which correlated with fibrotic remodelling. In addition, ecILK cKO mice exhibited many features of coronary microvascular disease: reduced cardiac perfusion, impaired coronary flow reserve and arterial remodelling with patent epicardial coronary arteries. Moreover, endothelial ILK deletion induced a moderate increase in blood pressure, but the antihypertensive drug Losartan did not affect microvascular remodelling whilst only partially ameliorated fibrotic remodelling. The plasma miRNA profile reveals endothelial-to-mesenchymal transition (endMT) as an upregulated pathway in endothelial ILK conditional KO mice. Our results show that endothelial cells in the microvasculature in endothelial ILK conditional KO mice underwent endMT. Moreover, endothelial cells isolated from these mice and ILK-silenced human microvascular endothelial cells underwent endMT, indicating that decreased endothelial ILK contributes directly to this endothelial phenotype shift. Our results identify ILK as a crucial regulator of microvascular endothelial homeostasis. Endothelial ILK prevents microvascular dysfunction and cardiac remodelling, contributing to the maintenance of the endothelial cell phenotype.
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Affiliation(s)
- P Reventun
- Facultad Medicina, Depto. Biología Sistemas (UD Fisiología), Universidad de Alcalá, IRYCIS, Mod 2 Planta 0, Ctra Madrid, Barcelona Km 33,500, Alcalá de Henares, Madrid, Spain
- School of Medicine, Department of Medicine, Cardiology Division, Johns Hopkins University, Baltimore, MD, United States
| | - S Sánchez-Esteban
- Facultad Medicina, Depto. Biología Sistemas (UD Fisiología), Universidad de Alcalá, IRYCIS, Mod 2 Planta 0, Ctra Madrid, Barcelona Km 33,500, Alcalá de Henares, Madrid, Spain
| | - A Cook-Calvete
- Facultad Medicina, Depto. Biología Sistemas (UD Fisiología), Universidad de Alcalá, IRYCIS, Mod 2 Planta 0, Ctra Madrid, Barcelona Km 33,500, Alcalá de Henares, Madrid, Spain
| | - M Delgado-Marín
- Facultad Medicina, Depto. Biología Sistemas (UD Fisiología), Universidad de Alcalá, IRYCIS, Mod 2 Planta 0, Ctra Madrid, Barcelona Km 33,500, Alcalá de Henares, Madrid, Spain
| | - C Roza
- Facultad Medicina, Depto. Biología Sistemas (UD Fisiología), Universidad de Alcalá, IRYCIS, Mod 2 Planta 0, Ctra Madrid, Barcelona Km 33,500, Alcalá de Henares, Madrid, Spain
| | - S Jorquera-Ortega
- Facultad Medicina, Depto. Biología Sistemas (UD Fisiología), Universidad de Alcalá, IRYCIS, Mod 2 Planta 0, Ctra Madrid, Barcelona Km 33,500, Alcalá de Henares, Madrid, Spain
| | - I Hernandez
- Unidad Mixta de Investigación Cardiovascular, Universidad Francisco de Vitoria, IRYCIS, Pozuelo de Alarcón, Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - L Tesoro
- Unidad Mixta de Investigación Cardiovascular, Universidad Francisco de Vitoria, IRYCIS, Pozuelo de Alarcón, Madrid, Spain
| | - L Botana
- Unidad Mixta de Investigación Cardiovascular, Universidad Francisco de Vitoria, IRYCIS, Pozuelo de Alarcón, Madrid, Spain
| | - J L Zamorano
- Servicio Cardiología, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - C Zaragoza
- Unidad Mixta de Investigación Cardiovascular, Universidad Francisco de Vitoria, IRYCIS, Pozuelo de Alarcón, Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - M Saura
- Facultad Medicina, Depto. Biología Sistemas (UD Fisiología), Universidad de Alcalá, IRYCIS, Mod 2 Planta 0, Ctra Madrid, Barcelona Km 33,500, Alcalá de Henares, Madrid, Spain.
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.
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Costa-Borges N, Giralt G, Albó E, Alvarez A, Ramos J, Hernandez I, Luis M, Calderón G, Munne S. O-122 ICSI in a box: development of a successful automated sperm injection robot with external supervision and minimal manual intervention. Hum Reprod 2021. [DOI: 10.1093/humrep/deab126.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Is it possible to automate the way sperm is injected in an oocyte and improve ICSI consistency between embryologists?
Summary answer
The developed ICSI robot demonstrated a high degree of consistency and operator skill independence, allowing human supervision and external control, but minimal manual intervention.
What is known already
ICSI is a clinical procedure that is currently performed worldwide in most IVF centers and its use will only increase with more utilization of egg freezing. Since its implementation, the technique has been conducted manually by highly skilled embryologists. However, success rates can vary significantly depending on the experience of the operator. We leverage our experience in robotics, AI algorithms and embryology to develop an automated ICSI robot that requires minimal manual intervention with the aim to standardize the consistency of the procedure and, ultimately, improve overall results maintaining embryologist oversight.
Study design, size, duration
The ICSI robot was developed to have supervised automated control on critical steps of the injection procedure, including injection pipette advancement, zona pellucida and oolemma penetration with piezo-pulses, and pipette removal after injection. Manual intervention is required only for immobilization and capture of spermatozoa with a joystick gamepad and to release the sperm in the ooplasm, without the need for micromanipulation skills. In parallel, piezo-ICSI was performed in a conventional micromanipulation station as a control.
Participants/materials, setting, methods
Hamster and mouse oocytes were collected from superovulated females. For testing the efficiency of the automated system, hamster oocytes were injected with human donor sperm, as historically used in manual ICSI training programs, and survival rates evaluated after overnight culture. Mouse oocytes were injected with mouse sperm heads and subsequently cultured in vitro for five days. Blastocysts obtained were vitrified and embryo transfers are ongoing to evaluate term developmental rates.
Main results and the role of chance
The technical components of the ICSI robot were engineered to integrate AI algorithms, optics, cell microinjectors and mechatronics. AI algorithms were developed to identify the morphological structures of MII oocytes, including the zona pellucida, perivitelline space and polar body, both in the hamster and mouse models. The system detects and analyzes both the pipette and the oocyte and chooses the best area and plane for injection, allowing automated control of the subsequent injection steps. Using the hamster oocyte-human sperm model, a survival rate of 91% (n = 110) was achieved with the robot, which was statistically similar (p = 0.335) to the results obtained in the controls injected manually (96%, n = 28). The average time spent in each injection cycle, which includes scanning of the oocyte and injection pipette, and injection of the sperm into the oocyte, was approximately two minutes per ICSI operation. This time was comparable to the time required by highly experienced operators with manual piezo-injection. In the mouse, 91% (n = 53) of the oocytes injected survived the procedure, of which, 92% developed to two-cells and 87% to the blastocyst stage. No statistical differences were found when compared these efficiencies with manual controls (n = 40, 98%, 97% and 92%, respectively).
Limitations, reasons for caution
The developed ICSI robot has shown highly consistent results, independently of operator skills, both in hamster and mouse oocytes. However, additional validations should be performed to enlarge the sample size of injected oocytes and to evaluate the efficiency of the system in other oocyte species, including translational studies to humans.
Wider implications of the findings
The combination of multidisciplinary teams allows the development of automated processes that can reduce variability in certain IVF procedures, while supervised and assisted by experienced embryologists. It is expected that other laboratory procedures can be automated in the field of assisted reproductive treatments in a near future.
Trial registration number
N/A
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Affiliation(s)
- N Costa-Borges
- Embryotools S.L., Research and Development, Barcelona, Spain
| | - G Giralt
- Overture, Research and Development, Barcelona, Spain
| | - E Albó
- Overture, Research and Development, Barcelona, Spain
| | - A Alvarez
- Overture, Research and Development, Madrid, Spain
| | - J Ramos
- Overture, Research and Development, Madrid, Spain
| | - I Hernandez
- Overture, Research and Development, Madrid, Spain
| | - M Luis
- Overture, Research and Development, Barcelona, Spain
| | - G Calderón
- Embryotools S.L., Research and Development, Barcelona, Spain
| | - S Munne
- Overture, Research and Development, Barcelona, Spain
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Donnenberg NS, Hernandez I, Normolle DP. Determining the prevalence and risk factors for prescription drug unaffordability. Res Social Adm Pharm 2021; 18:2904-2908. [PMID: 34219017 PMCID: PMC8714864 DOI: 10.1016/j.sapharm.2021.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/25/2021] [Accepted: 06/27/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Prescription affordability is a key component of healthcare accessibility and a determinant of health outcomes. Prior studies indicate that up to 1 in 4 Americans report difficulty affording prescriptions. OBJECTIVE(S) This study aims to identify factors associated with cost-based prescription refusal. METHODS We identified 17,869 study participants from the 2017 National Health Interview Survey who had been prescribed at least one medication in the past 12 months. The outcome was defined as inability to afford at least one prescription medication. Covariates included demographic data, medical history, and social attitudes. Logistic regression models were constructed to identify predictors of cost-based prescription refusal. RESULTS Among 8223 study participants, 8.1% reported the inability to afford at least one prescription medication in the past 12 months. Twenty-seven covariates were correlated with prescription unaffordability, and 8 were selected by the LASSO: Income (Odds ratio (OR) 0.55), Concerned About Bills (OR 2.0), Emergency Department Visits past 12 months (OR 1.33), Dissatisfaction with Medical Care (OR 1.3), Seeking Insurance Through the Health Insurance Marketplace (OR 1.26), Feeling Sad Most of the Time (OR 1.24), History of Asthma (OR 1.26) and History of Diabetes (OR 1.24). CONCLUSIONS Prescription unaffordability remains a significant public health problem and is more common among low-income individuals and patients with, chronic medical conditions.
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Affiliation(s)
- N S Donnenberg
- Univ of Pittsburgh, School of Pharmacy, Department of Pharmacy and Therapeutics, Pittsburgh, PA, USA.
| | - I Hernandez
- Univ of California San Diego (UCSD), Skaggs School of Pharmacy, Department of Pharmaceutical Sciences, Division of Clinical Pharmacy, La Jolla, CA, USA
| | - D P Normolle
- Univ of Pittsburgh, Graduate School of Public Health, Department of Biostatistics, Pittsburgh, PA, USA
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Freites D, Perez-Sancristobal I, Lopez Pedraza L, Álvarez Hernandez MP, Hernandez I, Colomer JI, Madrid García A, Fernandez B, Vadillo C, Rodriguez Rodriguez L, Mucientes A, León L, Abasolo L. POS1253 MORTALITY RATE RELATED TO COVID - 19 IN RHEUMATIC AND MUSCULOSKELETAL DISEASES (RMDs). Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Spain has been one of the countries most impacted by the COVID-19 pandemic. Among Spanish patients, 56,799 deaths have been reported. Although we have been in this situation of pandemic for a year, studies that show risk mortality rates in patients with rheumatic diseases continue to be scarce.Objectives:In patients with rheumatic and musculoskeletal diseases (RMDs) and infected with Covid – 19, a) we want to assess the mortality rate (MR) related to COVID-19; and b) to analyze the role of RMDs in mortality risk.Methods:An observational longitudinal study was conducted during the epidemic peak in Madrid (1stMar to 20thMay2020). All patients attended at the rheumatology outpatient clinic of a tertiary hospital with a diagnosis of RMDs and SARS - CoV 2 infection were included (according to a medical diagnosis or confirmed with a positive SARS-CoV-2 PCR diagnostic test). All patients were included since the time of COVID-19 diagnosis. Main outcome: death related to COVID-19 infection. Independent variable: type of RMDs including: autoimmune (systemic autoimmune conditions (SAC) and inflammatory joint disease (IJD)) and non–autoimmune (mechanical diseases and inflammatory diseases (microcrystalline arthritis and tendonitis)). Covariates: sociodemographic, comorbidities, chronic use of corticoids prior to COVID-19 infection. Survival techniques were used to estimate the MR related to COVID-19, given per 1,000 persons-month with a 95% confidence interval [CI]. The time of observation comprised the elapsed time between the date of COVID-19 diagnosis of infection until the date of patient’s death, or end of study. Cox multiple regression analysis was run to examine the effect of autoimmune RMDs compared to non-autoimmune RMDs on mortality risk adjusted by sex, age and comorbidities. Results were expressed by Hazard Ratio (HR) and [CI].Results:406 patients were included with RMD and Covid – 19 infection with a total follow-up 642.5 patients-month. 69.21% were women with a mean age at diagnosis of 60 ± 15.26 years. The evolution time from the diagnosis of rheumatic disease was 8 ± 8.38 years. 26% had comorbidity at baseline. 25% were chronically on corticoids prior to the infection. Of the 406 patients, 244 (60.09%) had non-autoimmune RMD (157 mechanic, 87 inflammatory) and 162 (39.9%) (106 (65.43%) IJD, 56 (34.56%) systemic condition) had autoimmune RMD. Of the 406 patients, 45 (11%) died during the follow-up, being 12± 14 days the mean time from infection to death (P50: 6[2-12] and a maximum of 60 days). MR was estimated in 70.03 [52.28-93.79] per 1,000 persons-month. MR was higher for men (MR 105[68-163]) than for women (MR 55 [37.2-81.6]) and in older people (MR <60: 4.4, [0.6-31.7]; MR 60-75 years: 38.7[17.3-86.2]; MR >75Years: 486 [354-1668]). The HR of mortality in autoimmune RMDs compared to non-autoimmune RMDs did not achieved statistical significance (HR: 1.39 [0.77-2.5], p=0.27). After adjusting for confounders, we did not find higher risk of mortality among the different types of RMDs (HR autoimmune vs non-autoinmunes: HR: 1.12 [0.6-2.02], p=0.7; HR IJD vs SAC; 1.5 [0.6-3.6], p=0.34; HR non-autoimmune vs SAC: 1.1 [0.5-2.5], P=0.7). Age (HR: 1.12; [1.10-1.15], p<0.001), and the presence of comorbidities (HR: 2.05; [1.08-3.89], p=0.027) increased the Mortality risk.Conclusion:In patients with RMD and COVID-19 infection, we found a mortality rate of 7 per 100 persons-month. This study shows that the mortality risk related to COVID-19 is similar between autoimmune and non-autoimmune diseases after adjusting by confounders. We also found that age and comorbidities are risk factors for mortality related to COVID-19 infection.References:[1]Jorge A, et al. Temporal trends in severe COVID-19 outcomes in patients with rheumatic disease: a cohort study. Lancet Rheumatol. Epub ahead of print 2021..[2]Bonfá E, et al. How COVID-19 is changing rheumatology clinical practice. Nat Rev Rheumatol 2021; 17: 11–15.[3]Hyrich KL, Machado PM. Rheumatic disease and COVID-19: epidemiology and outcomes. Nature Reviews Rheumatology 2020; 17: 71–72.Disclosure of Interests:None declared
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Hernandez I, Palmas Candia F, Burgos Pelaez R, Ciudin A, Martínez P, Millán L, Corredor R, Segurola H. Evaluation of peripherally inserted central catheters (picc) for parenteral nutrition by intracavitary electrocardiogram verification method in our hospital setting. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.516] [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]
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Viudez A, Crespo G, Dorronsoro MG, Paredes BG, Custodio A, Hernando J, Sevilla I, Goñi S, Lopez C, Benavent M, Fonseca PJ, Alonso-Orduña V, Borja IG, Hernandez I, Muñoz ML, Carmona A, Sanz JP, Vicente BLS, Jesus-Acosta AD. P-245 GETNET-SILVELUL study: An original or modified immunohistochemical score (IPS or mIPS) in patients (pts) with pancreatic neuroendocrine tumors (PanNET) treated with everolimus or CAPTEM. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.327] [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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Singh M, De Silva PM, Al-Saadi Y, Switala J, Loewen PC, Hausner G, Chen W, Hernandez I, Castillo-Ramirez S, Kumar A. Characterization of Extremely Drug-Resistant and Hypervirulent Acinetobacter baumannii AB030. Antibiotics (Basel) 2020; 9:antibiotics9060328. [PMID: 32560407 PMCID: PMC7345994 DOI: 10.3390/antibiotics9060328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 06/12/2020] [Accepted: 06/15/2020] [Indexed: 12/21/2022] Open
Abstract
Acinetobacter baumannii is an important nosocomial bacterial pathogen. Multidrug-resistant isolates of A. baumannii are reported worldwide. Some A. baumannii isolates display resistance to nearly all antibiotics, making treatment of infections very challenging. As the need for new and effective antibiotics against A. baumannii becomes increasingly urgent, there is a need to understand the mechanisms of antibiotic resistance and virulence in this organism. In this work, comparative genomics was used to understand the mechanisms of antibiotic resistance and virulence in AB030, an extremely drug-resistant and hypervirulent strain of A. baumannii that is a representative of a recently emerged lineage of A. baumannii International Clone V. In order to characterize AB030, we carried out a genomic and phenotypic comparison with LAC-4, a previously described hyper-resistant and hypervirulent isolate. AB030 contains a number of antibiotic resistance- and virulence-associated genes that are not present in LAC-4. A number of these genes are present on mobile elements. This work shows the importance of characterizing the members of new lineages of A. baumannii in order to determine the development of antibiotic resistance and virulence in this organism.
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Affiliation(s)
- Manu Singh
- Department of Microbiology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (M.S.); (P.M.D.S.); (Y.A.-S.); (J.S.); (P.C.L.); (G.H.)
| | - P. Malaka De Silva
- Department of Microbiology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (M.S.); (P.M.D.S.); (Y.A.-S.); (J.S.); (P.C.L.); (G.H.)
| | - Yasser Al-Saadi
- Department of Microbiology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (M.S.); (P.M.D.S.); (Y.A.-S.); (J.S.); (P.C.L.); (G.H.)
| | - Jacek Switala
- Department of Microbiology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (M.S.); (P.M.D.S.); (Y.A.-S.); (J.S.); (P.C.L.); (G.H.)
| | - Peter C. Loewen
- Department of Microbiology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (M.S.); (P.M.D.S.); (Y.A.-S.); (J.S.); (P.C.L.); (G.H.)
| | - Georg Hausner
- Department of Microbiology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (M.S.); (P.M.D.S.); (Y.A.-S.); (J.S.); (P.C.L.); (G.H.)
| | - Wangxue Chen
- Human Health Therapeutics, National Research Council Canada, 100 Sussex Drive, Ottawa, ON K1A 0R6, Canada;
| | - Ismael Hernandez
- Programa de Genómica Evolutiva, Centro de Ciencias Génomicas, Universidad Nacional Autónoma de México, Cuernavaca 62210, Mexico; (I.H.); (S.C.-R.)
| | - Santiago Castillo-Ramirez
- Programa de Genómica Evolutiva, Centro de Ciencias Génomicas, Universidad Nacional Autónoma de México, Cuernavaca 62210, Mexico; (I.H.); (S.C.-R.)
| | - Ayush Kumar
- Department of Microbiology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada; (M.S.); (P.M.D.S.); (Y.A.-S.); (J.S.); (P.C.L.); (G.H.)
- Correspondence:
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Hernandez I, Abasolo L, Fernandez B, Madrid García A, Font J, Pato E, Rodriguez Rodriguez L. SAT0522 PROGRESSION OF VISION-RELATED QUALITY OF LIFE AND IDENTIFICATION OF RISK FACTORS IN NON-INFECTIOUS UVEITIS PATIENTS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Uveitis are characterized by inflammation of the middle layer of the eye wall. In developed countries uveitis are the second major treatable cause of blindness in those 20–65 years of age. Additionally, more than 50% of the subjects affected with these conditions will develop complications related to the uveitis, and more than 30% will suffer visual impairment. As a result, these conditions are associated with an important burden. The assessment of the patient’s quality of life (QoL) through standardized and validated questionnaires allows us to evaluate objectively the burden of the disease. Several studies have shown that the QoL of uveitis patients is reduced when compared with that of general population. Moreover, several socio-demographic and clinical related characteristics have been associated with impaired QoL. However, no longitudinal analysis of the vision-related (VR) QoL in clinical practice has been carried out.Objectives:To describe VR-QoL in non-infectious uveitis (NIU) patients during a follow-up period of two years. Furthermore, to analyse the influence of socio-demographic, clinical and treatment factors on the progression of VR-QoL.Methods:Longitudinal prospective study which includes patients examined in a multidisciplinary tertiary uveitis clinic, with a diagnosis of NIU. In each of these patients a yearly determination of VR-QoL was carried out following the VFQ-25 questionnaire, finally including all those who had completed at least an initial questionnaire and a second one after two years of follow-up. Analysis of risk factors at baseline in repeated VFQ-25 measurements was carried out by generalized estimating equations (GEE) models. Variables related to demographic, clinical and treatment factors with a determination of p-value <0.15 were included in multivariable models, which were then compared using theQuasi Akaike Information Criteria(qAIC). A local Ethics Committee approved the execution of this project.Results:128 patients were included, 117 of which also had an evaluation after the first year of follow-up. 55.5% were female with a median age of 34 years at the start of symptoms and of 37 years at the moment of attending our clinic for the first time. First evaluation of VR-QoL was determined a median (p25-p75) of 6.1 (1.8-13.1) years after that first visit. The most frequent locations of NIU were anterior (41.1%), panuveitis (27.4%), posterior (16.1%) and intermediate (15.3%). At our first evaluation, 27.3% of patients were receiving treatment with topical steroids, 22.3% oral, 49.2% immunosuppressant drugs (both synthetic and/or biological) and 19.05% biological therapies. The median (p25-p75) VFG25 determinations at baseline, first and second years of follow-up were 0.87 (0.78-0.93), 0.88 (0.80-0.93) y 0.89 (0.81-0.94), with no significant differences (first year vs. Baseline p = 0.54; 2 years vs. Baseline p = 0.61).In the GEE multivariable models the presence at baseline of permanent incapacity due to NIU, concomitant thyroid disease, worse visual acuity, unilateral pattern, cataracts, retinal vasculitis, epiretinal membrane and use of azathioprine were independently associated with a worse VR-QoL (Table 1).Table 1.Risk factors related to VR-QoL in patients with NIUVariablesCoef. (IC 95%)p-valueVisual acuity23.6 (12.3 - 34.8)<0.01Permanent incapacity-24.8 (-33.7 - -15.9)<0.01Unilateral NIU-2.9 (-5.7 - -0.006)0.05Cataracts-5.2 (-10 - -0.3)0.037Vasculitis-13.3 (-23.4 - -3.1)0.011Epiretinal membrane-6.8 (-12.7 - -0.8)0.026Azathioprine-7.5 (-14.7 - -0.3)0.041Conclusion:During these two years of follow-up, no significant changes have taken place regarding VR-QoL in patients with NIU assessed at a tertiary centre. Other than visual acuity at baseline, certain ocular manifestations and clinical comorbidities have also been shown to have an independent effect on the VR-QoL of these patients.Disclosure of Interests:None declared
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Madrid García A, Freites Nuñez D, Font J, Hernandez I, León L, Colomer JI, González-Álvaro I, Fernandez B, Jover JA, Abasolo L, Rodriguez Rodriguez L. SAT0051 REMISSION IN RHEUMATOID ARTHRITIS PATIENTS: A CLUSTER ANALYSIS TO IDENTIFY AND CHARACTERIZE SUBPOPULATIONS OF PATIENTS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Disease Activity Score (DAS) is a continuous measure of Rheumatoid Arthritis (RA) activity, used in clinical practice for monitoring disease progression and for documenting treatment response. According to EULAR, the clinical desired target is to achieve a remission state (or failing that, low disease activity). However, the population of RA patients in this state could be heterogenous.Objectives:To characterize the level of heterogeneity of RA patients in remission by identifying clusters based on the DAS28 components; and to describe inter and intra-class cluster demographic and clinical characteristicsMethods:Patients from Hospital Clínico San Carlos cohort, stored in a departmental electronic health record from January 1st, 2000 to December 30th, 2018, diagnose with RA according ACR 1986/ 2010 criteria were eligible for this study. Only observations with a DAS28 Erythrocyte Sedimentation Rate (ESR) value < 2.6 value were considered. ESR, patient’s Global Health (GH), and tender and swollen joints were used for calculating the clusters. Different aggregation levels for joints were studied as well as the input variable types. Isolated joints, joints grouped by the type of affectation (swollen or tender) or anatomic location or laterality aggregation levels were considered. Variables expressed as present or absent (i.e. dichotomous), continuous (count of joins) and categorical (type of joints) were also studied. Gower’s distance, used for dealing with variables of different type, was employed to calculate the distance matrix. The number of suitable clusters was chosen from two to seven clusters based on the width value of a Silhouette analyses. Finally, Partitioning Around Medoids (PAM) was used as the clustering algorithm. Differences among clusters regarding demographic and clinical characteristics were analyzed using t-student chi2 test.Results:812 patients with 1,431 observations were analyzed in this study. The joint aggregation level which showed a highest Silhouette width value (0.708) was the anatomic one. In this aggregation level, five dichotomous variables (presence of tenderness and/or swelling in right and/or left shoulder, elbow, wrist, knee and hand (including both metacarpophalangeal and proximal interphalangeal joints) and two continuous variables (ESR and GH) were used. Two clusters were found: the cluster A) with 1,305 observations and 742 patients and the B) with 126 observations and 115 patients. Cluster b) had a statistically significant higher DAS28-ESR value (higher number of tender and swollen joints, and higher GH, but lower ESR), longer follow-up time (6.5 vs. 4.7 years), higher VAS-pain score (10 vs. 2), and higher HAQ score (0.25 vs. 0.12). In addition, the proportion of patients treated with oral corticosteroids (63% s. 50%) and biological therapy (29% vs. 12%) was higher.Conclusion:We have identified two clinically distinct populations of RA patients in remission according to DAS28-ESR <2.6. Each subgroup could be associated with different outcomes during follow-up, such as radiographic progression or risk of relapse.Disclosure of Interests:Alfredo Madrid García: None declared, Dalifer Freites Nuñez: None declared, Judit Font: None declared, Isabel Hernandez: None declared, Leticia León: None declared, Jose Ignacio Colomer: None declared, Isidoro González-Álvaro Grant/research support from: Roche Laboratories, Consultant of: Lilly, Sanofi, Paid instructor for: Lilly, Speakers bureau: Abbvie, MSD, Roche, Lilly, Benjamin Fernandez: None declared, J Angel Jover: None declared, Lydia Abasolo: None declared, Luis Rodriguez Rodriguez: None declared
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Fraichard C, Bonnet F, Garnier A, Hébert-Schuster M, Bouzerara A, Gerbaud P, Ferecatu I, Fournier T, Hernandez I, Trabado S, Guibourdenche J. Placental production of progestins is fully effective in villous cytotrophoblasts and increases with the syncytiotrophoblast formation. Mol Cell Endocrinol 2020; 499:110586. [PMID: 31539598 DOI: 10.1016/j.mce.2019.110586] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 09/06/2019] [Accepted: 09/16/2019] [Indexed: 01/18/2023]
Abstract
Placental syncytiotrophoblast (ST) is considered as the main placental endocrine tissue secreting progesterone, a steroid essential for maintenance of pregnancy. However, each step of progestins production has been poorly investigated in villous cytotrophoblast (VCT) regarding ST formation. We aimed to characterize progestins production during human differentiation of VCT into ST. VCTs were isolated from term placenta and cultivated, with or without forskolin (FSK), to stimulate trophoblast differentiation. Secreted progestins concentrations were determined by immuno-assay and Gas Chromatography-tandem mass spectrometry. Intracellular expression of cholesterol transporter and enzymes involved in steroidogenesis were studied by immunofluorescence, western-blot, and RT-qPCR. Progesterone and pregnenolone are produced by VCT and their secretion increases with VCT differentiation while 17-hydroxyprogesterone concentration remains undetectable. HSD3B1 enzyme expression increases whereas MLN64, the cholesterol placental mitochondrial transporter and P450SCC expressions do not. FSK induces progestins production. Progestins placental synthesis is effective since VCT and increases with ST formation thanks to mitochondria.
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Affiliation(s)
- C Fraichard
- UMR-S 1139, Faculté de Pharmacie, Université Paris Descartes, Paris, France
| | - F Bonnet
- Service d' Hormonologie, CHU Cochin, HUPC, AP-HP, Paris, France
| | - A Garnier
- Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Hôpitaux Universitaires Paris-Sud, CHU de Bicêtre, AP-HP, Le Kremlin Bicêtre, France; UMR-S U1185, Faculté de Médecine Paris-Sud, Université Paris-Sud, Université Paris-Saclay, Le Kremlin Bicêtre, France
| | - M Hébert-Schuster
- UMR-S 1139, Faculté de Pharmacie, Université Paris Descartes, Paris, France; Service d' Hormonologie, CHU Cochin, HUPC, AP-HP, Paris, France
| | - A Bouzerara
- UMR-S 1139, Faculté de Pharmacie, Université Paris Descartes, Paris, France; Service d' Hormonologie, CHU Cochin, HUPC, AP-HP, Paris, France
| | - P Gerbaud
- UMR-S 1180, Faculté de Pharmacie, 5 Rue JB Clément, 92296, Châtenay-Malabry, France
| | - I Ferecatu
- UMR-S 1139, Faculté de Pharmacie, Université Paris Descartes, Paris, France
| | - T Fournier
- UMR-S 1139, Faculté de Pharmacie, Université Paris Descartes, Paris, France
| | - I Hernandez
- UMR-S 1139, Faculté de Pharmacie, Université Paris Descartes, Paris, France
| | - S Trabado
- Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie, Hôpitaux Universitaires Paris-Sud, CHU de Bicêtre, AP-HP, Le Kremlin Bicêtre, France; UMR-S U1185, Faculté de Médecine Paris-Sud, Université Paris-Sud, Université Paris-Saclay, Le Kremlin Bicêtre, France
| | - J Guibourdenche
- UMR-S 1139, Faculté de Pharmacie, Université Paris Descartes, Paris, France; Service d' Hormonologie, CHU Cochin, HUPC, AP-HP, Paris, France.
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Chee VA, Teran E, Hernandez I, Wright L, Izurieta R, Reina-Ortiz M, Flores M, Bejarano S, Dào LU, Baldwin J, Martinez-Tyson D. 'Desculturización,' urbanization, and nutrition transition among urban Kichwas Indigenous communities residing in the Andes highlands of Ecuador. Public Health 2019; 176:21-28. [PMID: 31679636 DOI: 10.1016/j.puhe.2019.07.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 02/11/2018] [Revised: 03/25/2019] [Accepted: 07/17/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND The nutrition transition continues to affect populations throughout the world. The added impact of market integration and urbanization exacerbates the impact of the nutrition transition upon Indigenous populations worldwide. OBJECTIVES This study aims to explore the nutritional concerns of the urban Kichwas community residing in the Andes highlands of Ecuador. STUDY DESIGN This is a qualitative study. METHODS Eight focus groups were conducted with Kichwas men and women in November 2015 in the Imbabura province of the Andes in Ecuador. DATA ANALYSIS Applied thematic analysis was used to analyze findings regarding nutrition. RESULTS The participants shared concerns regarding increased intake of fast food, poor meal timing, and a shift in the child's food preferences that rejects traditional foods. They attributed these concerns to urbanization resulting from an increase in dual-income households and a loss of cultural identity. CONCLUSIONS Synergistic cultural factors are related to nutritional concerns voiced by the urban Kichwas community. PUBLIC HEALTH IMPLICATIONS Syndemic theory is a useful interpretive lens regarding nutritional trends within the Kichwas communities as they relate to the increased risk of chronic disease.
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Affiliation(s)
- V A Chee
- University of South Florida, College of Public Health, Tampa, FL, USA.
| | - E Teran
- Universidad San Francisco de Quito, Colegio de Ciencias de la Salud, Quito, Ecuador
| | - I Hernandez
- Universidad San Francisco de Quito, Colegio de Ciencias de la Salud, Quito, Ecuador; Pontificia Universidad Catolica del Ecuador, Facultad de Enfermería, Quito, Ecuador
| | - L Wright
- University of South Florida, College of Public Health, Tampa, FL, USA
| | - R Izurieta
- University of South Florida, College of Public Health, Tampa, FL, USA
| | - M Reina-Ortiz
- University of South Florida, College of Public Health, Tampa, FL, USA
| | - M Flores
- Universidad San Francisco de Quito, Colegio de Ciencias de la Salud, Quito, Ecuador
| | - S Bejarano
- University of South Florida, College of Public Health, Tampa, FL, USA
| | - L U Dào
- University of South Florida, College of Public Health, Tampa, FL, USA
| | - J Baldwin
- Northern Arizona University, Center for Health Equity Research, Flagstaff, AZ, USA
| | - D Martinez-Tyson
- University of South Florida, College of Public Health, Tampa, FL, USA
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Acena A, Franco-Pelaez JA, Pello Lazaro AM, Gonzalez Parra E, Gonzalez Lorenzo O, Martinez Milla J, Hernandez I, Martin Mariscal ML, Lopez Castillo M, Kallmeyer A, Lorenzo O, Albert L, Gonzalez Casasus ML, Egido J, Tunon J. P2749PCSK9 and HS-CRP are predictors of the progression of aortic stenosis in patients with stable coronary artery. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1066] [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
Objective
There has been a great interest in knowing the factors associated with progression of aortic stenosis to try to slow down this evolution.
Methods
We studied 283 patients with chronic ischemic heart disease recording a broad number of clinical, therapeutic and analytical variables including inflammation and mineral metabolism biomarkers. We analyzed if any of these factors is a determinant of progression to aortic stenosis, defined as an increase in maximum flow speed across the aortic valve of at least 0.5 m/s.
Results
20 patients (7%) progressed to aortic stenosis in 72.4 months of follow-up. Among the patients who developed aortic stenosis, a greater age, greater percentage of peripheral arterial disease (PAD), lower treatment with beta-blockers, estimated Glomerular Filtration Rate (eGFR), total cholesterol, LDL, High-sensitivity C-reactive protein (HS-CRP), high-sensitivity troponin, N-terminal pro b-type natriuretic peptide and galectin 3 were found.
The results of the multivariate analysis showed that plasma levels of Proprotein convertase subtilisin/kexin type 9 (PCSK9) [OR: 0.668 per every increase in 100.000 μg/ml CI (0.457–0.977); p=0.038], HS-CRP [OR: 1.034 per every increase in 1 mg/dl CI (1.005–1.063); p=0.022], dyslipidemia [OR: 4.622 CI (1.285–16.618); p=0.019], PAD [OR: 9.453 CI (1.703–52.452); p=0.010], and eGFR [OR: 0.962 CI (0.939–0.986); p=0.002], remained a parameter with the ability to independently predict the progression of aortic stenosis
Conclusions
In patients with chronic ischemic heart disease, low PCSK9 and high HS-CRP plasmatic levels, low eFGR, PAD and dyslipidemia were independent predictors of progression of aortic stenosis. More studies are needed to investigate the relationships between the progression of aortic stenosis PCSK9 and inflammation.
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Affiliation(s)
- A Acena
- Foundation Jimenez Diaz, Cardiology, Madrid, Spain
| | | | | | | | | | | | - I Hernandez
- Foundation Jimenez Diaz, Cardiology, Madrid, Spain
| | | | | | - A Kallmeyer
- Foundation Jimenez Diaz, Cardiology, Madrid, Spain
| | - O Lorenzo
- Foundation Jimenez Diaz, Madrid, Spain
| | - L Albert
- University Hospital 12 de Octubre, Madrid, Spain
| | - M L Gonzalez Casasus
- Hospital Central De La Defensa Gomez Ulla, Laboratory of Nephrology and Mineral Metabolism, Madrid, Spain
| | - J Egido
- Foundation Jimenez Diaz, Nephrology, Madrid, Spain
| | - J Tunon
- Foundation Jimenez Diaz, Cardiology, Madrid, Spain
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Perez Olivares Delgado C, Tenorio J, Aurtenetxe A, Cristo MJ, Navas P, Hernandez I, Moreno A, Bedate P, Martinez A, Palomino J, Arribas F, Escribano P. P3677Heritable veno-oclusive pulmonary disease in iberian romani patients: the difficulty of genetic counseling and its impact in the perpetuation of the disease. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Pulmonary veno-oclussive disease (PVOD) is a rare form of pulmonary hypertension of poor prognosis and difficult diagnosis. A founder mutation in EIF2KA4 gene has been described in Iberian Romani patients with familial PVOD.
Aims
genetically and clinically characterize a cohort of Iberian Romani patients with familial PVOD. To perform the family screening, analyze the phenotype and socio-cultural determinants which may influence on disease's course and spreading.
Methods
Patients with familial PVOD were included from November 2011 until February 2019. Clinical and survival data were obtained from the Spanish National Registry of PAH. Genetic analysis of EIF2KA4 was performed in patients and relatives.
Results
13 index cases were included, all of them Iberian Romani, carrying the founder mutation (p.Pro1115Leu) in EIF2KA4. Genetic screening revealed 74 of healthy heterozygotes and 13 homozygotes: among them 10 affected and 3 unaffected at baseline assessment (7, 28 and 37 years old). More than half of their family members, including one complete family, refused genetic screening. The survival free of transplant or death was 77.3% and 52.4%, at 1 and 3 years, respectively.
Baseline characteristics Total n=23 Age, years (SD) 23.6 (11.8) Male sex, % 52.2 Functional class NYHA III-IV, % 85 Pulmonary vascular resistance, UW (SD) 10 (5.4) DLCO, % 31.1 6MWT, meters (SD) 352.4 (160) Lung transplant, % 47.8 Survival free of transplant 3 years, % 52.4 DLCO, diffusing capacity for carbon monoxide; 6MWT, 6-minute walk test.
Conclusions
Patients were seriously ill from a young age. They have early pregnancy and high number of children. The high frequency of endogamy in the Romani population is likely to have an important impact on the transmission of PVOD, as it would favor the appearance of new homozygous carriers. Currently, our major concern is the low range of family members that accepted to be studied, more than 50% of family members rejected genetic studies and counseling.
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Affiliation(s)
| | - J Tenorio
- University Hospital La Paz, Medical and molecular genetic institute, Madrid, Spain
| | - A Aurtenetxe
- University Hospital 12 de Octubre, Cardiology department, Madrid, Spain
| | - M J Cristo
- Universitary Virgen Macarena Hospital, Cardiology department, Sevilla, Spain
| | - P Navas
- University Hospital Gregorio Maranon, Cardiology department, Madrid, Spain
| | - I Hernandez
- Foundation Jimenez Diaz, Cardiology department, Madrid, Spain
| | - A Moreno
- University Hospital Vall d'Hebron, Pediatric department, Barcelona, Spain
| | - P Bedate
- University Hospital Central de Asturias, Respiratory department, Oviedo, Spain
| | - A Martinez
- University Hospital Marques de Valdecilla, Respiratory department, Santander, Spain
| | - J Palomino
- University Hospital 12 de Octubre, Cardiology department, Madrid, Spain
| | - F Arribas
- University Hospital 12 de Octubre, Cardiology department, Madrid, Spain
| | - P Escribano
- University Hospital 12 de Octubre, Cardiology department, Madrid, Spain
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Sun YW, Liu W, Hernandez I, Gonzalez J, Rodriguez F, Dunstan DJ, Humphreys CJ. 3D Strain in 2D Materials: To What Extent is Monolayer Graphene Graphite? Phys Rev Lett 2019; 123:135501. [PMID: 31697529 DOI: 10.1103/physrevlett.123.135501] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 05/28/2019] [Indexed: 06/10/2023]
Abstract
This work addresses a fundamental question: To what extent is graphene graphite? In particular does 2D graphene have many of the same 3D mechanical properties as graphite, such as the bulk modulus and elastic constant c_{33}? We have obtained, for the first time, unambiguous Raman spectra from unsupported monolayer graphene under pressure. We have used these data to quantify the out-of-plane stiffness of monolayer graphene, which is hard to define due to its 2D nature. Our data indicate a first physically meaningful out-of-plane stiffness of monolayer graphene, and find it to be consistent with that of graphite. We also report a shift rate of the in-plane phonon frequency of unsupported monolayer graphene to be 5.4 cm^{-1} GPa^{-1}, very close to that of graphite (4.7 cm^{-1} GPa^{-1}), contrary to the previous value for supported graphene. Our results imply that monolayer graphene has similar in-plane and out-of-plane stiffnesses, and anharmonicities to graphite.
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Affiliation(s)
- Y W Sun
- School of Engineering and Materials Science, Queen Mary University of London, London E1 4NS, United Kingdom
| | - W Liu
- College of Information Science and Electronic Engineering, Zhejiang University, Hangzhou 310027, China
| | - I Hernandez
- Departamento CITIMAC, Universidad de Cantabria, Santander 39005, Spain
| | - J Gonzalez
- Departamento CITIMAC, Universidad de Cantabria, Santander 39005, Spain
| | - F Rodriguez
- Departamento CITIMAC, Universidad de Cantabria, Santander 39005, Spain
| | - D J Dunstan
- School of Physics and Astronomy, Queen Mary University of London, London E1 4NS, United Kingdom
| | - C J Humphreys
- School of Engineering and Materials Science, Queen Mary University of London, London E1 4NS, United Kingdom
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Đào LU, Terán E, Bejarano S, Hernandez I, Reina Ortiz M, Chee V, Flores M, Izurieta R, Baldwin J, Martinez Tyson D. Risk and resiliency: the syndemic nature of HIV/AIDS in the indigenous highland communities of Ecuador. Public Health 2019; 176:36-42. [PMID: 31104808 DOI: 10.1016/j.puhe.2019.02.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 10/11/2018] [Accepted: 02/25/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES This community-based study explores the syndemic nature of HIV/AIDS risk and resilience among Indigenous Kichwa communities in the province of Imbabura, Ecuador. This study elucidates individual and community-level factors that serve to exacerbate HIV/AIDS risk, as they relate to underlying macrolevel, structural forces. Critically, this study also elicited opportunities for community-based opportunities for resiliency from HIV/AIDS. STUDY DESIGN Exploratory qualitative study. METHODS Guided by syndemic theory, a qualitative study was conducted to explore HIV risk and resilience among Indigenous Kichwa communities in the Northern Andean highlands of Ecuador. Eight focus groups (n = 59) with men and women from two communities were conducted. The data were analyzed using applied thematic analysis techniques. RESULTS Identified risk factors for HIV/AIDS centered around the following themes: (1) parents leaving the community for work, (2) alcohol and drug consumption, (3) unprotected sex, and (4) barriers to health care. Identified HIV/AIDS resiliency factors included the preservation of Indigenous culture and family-focused interventions. CONCLUSIONS The identified risk factors for HIV/AIDS are interrelated within a complex syndemic relationship. The mutually reinforcing individual-level risk factors of substance abuse and risky sexual behavior coalesce with violence to exacerbate the risk for HIV/AIDS acquisition among Ecuadorian Highland Indigenous communities. Moreover, HIV/AIDS risk prevails in the macrolevel context of disproportionate unemployment among Indigenous peoples and a systematically fragmented healthcare system. It is critical that public health professionals work to revolutionize the systematic discrimination that underpins indigenous health disparities at-large.
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Affiliation(s)
- L U Đào
- University of South Florida, College of Public Health, Tampa, FL, USA.
| | - E Terán
- Universidad San Francisco de Quito, Colegio de Ciencias de la Salud, Quito, Ecuador
| | - S Bejarano
- University of South Florida, College of Public Health, Tampa, FL, USA
| | - I Hernandez
- Pontificia Universidad Católica del Ecuador, Facultad de Enfermería, Quito, Ecuador
| | - M Reina Ortiz
- University of South Florida, College of Public Health, Tampa, FL, USA
| | - V Chee
- University of South Florida, College of Public Health, Tampa, FL, USA
| | - M Flores
- Universidad San Francisco de Quito, Colegio de Ciencias de la Salud, Quito, Ecuador
| | - R Izurieta
- University of South Florida, College of Public Health, Tampa, FL, USA
| | - J Baldwin
- Northern Arizona University, Center for Health Equity Research, Flagstaff, AZ, USA
| | - D Martinez Tyson
- University of South Florida, College of Public Health, Tampa, FL, USA
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Reyes RV, Díaz M, Ebensperger G, Herrera EA, Quezada SA, Hernandez I, Sanhueza EM, Parer JT, Giussani DA, Llanos AJ. The role of nitric oxide in the cardiopulmonary response to hypoxia in highland and lowland newborn llamas. J Physiol 2018; 596:5907-5923. [PMID: 29369354 PMCID: PMC6265547 DOI: 10.1113/jp274340] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 01/17/2018] [Indexed: 01/19/2023] Open
Abstract
KEY POINTS Perinatal hypoxia causes pulmonary hypertension in neonates, including humans. However, in species adapted to hypoxia, such as the llama, there is protection against pulmonary hypertension. Nitric oxide (NO) is a vasodilatator with an established role in the cardiopulmonary system of many species, but its function in the hypoxic pulmonary vasoconstrictor response in the newborn llama is unknown. Therefore, we studied the role of NO in the cardiopulmonary responses to acute hypoxia in high- and lowland newborn llamas. We show that high- compared to lowland newborn llamas have a reduced pulmonary vasoconstrictor response to acute hypoxia. Protection against excessive pulmonary vasoconstriction in the highland llama is mediated via enhancement of NO pathways, including increased MYPT1 and reduced ROCK expression as well as Ca2+ desensitization. Blunting of pulmonary hypertensive responses to hypoxia through enhanced NO pathways may be an adaptive mechanism to withstand life at high altitude in the newborn llama. ABSTRACT Llamas are born in the Alto Andino with protection against pulmonary hypertension. The physiology underlying protection against pulmonary vasoconstrictor responses to acute hypoxia in highland species is unknown. We determined the role of nitric oxide (NO) in the cardiopulmonary responses to acute hypoxia in high- and lowland newborn llamas. The cardiopulmonary function of newborn llamas born at low (580 m) or high altitude (3600 m) was studied under acute hypoxia, with and without NO blockade. In pulmonary arteries, we measured the reactivity to potassium and sodium nitroprusside (SNP), and in lung we determined the content of cGMP and the expression of the NO-related proteins: BKCa, PDE5, PSer92-PDE5, PKG-1, ROCK1 and 2, MYPT1, PSer695-MYPT1, PThr696-MYPT1, MLC20 and PSer19-MLC20. Pulmonary vascular remodelling was evaluated by morphometry and based on α-actin expression. High- compared to lowland newborn llamas showed lower in vivo pulmonary arterial pressor responses to acute hypoxia. This protection involved enhanced NO function, as NO blockade reverted the effect and the pulmonary arterial dilatator response to SNP was significantly enhanced in highland neonates. The pulmonary expression of ROCK2 and the phosphorylation of MLC20 were lower in high-altitude llamas. Conversely, MYPT1 was up-regulated whilst PSer695-MYPT1 and PThr695-MYPT1 did not change. Enhanced NO-dependent mechanisms were insufficient to prevent pulmonary arterial remodelling. Combined, the data strongly support that in the highland newborn llama reduced ROCK, increased MYPT1 expression and Ca2+ desensitization in pulmonary tissue allow an enhanced NO biology to limit hypoxic pulmonary constrictor responses. Blunting of hypoxic pulmonary hypertensive responses may be an adaptive mechanism to life at high altitude.
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Affiliation(s)
- Roberto V. Reyes
- Laboratorio de Bioquímica y Biología Molecular de la Hipoxia, Programa de Fisiopatología, Instituto de Ciencias Biomédicas, Facultad de MedicinaUniversidad de ChileSantiagoChile
- International Center for Andean Studies (INCAS)Universidad de ChileSantiagoChile
| | - Marcela Díaz
- Departamento de Promoción de la Salud de la Mujer y el Recién Nacido, Facultad de MedicinaUniversidad de ChileSantiagoChile
- Laboratorio de Mecanismos de Stress y Adaptación Vascular, Programa de Fisiopatología, Instituto de Ciencias Biomédicas, Facultad de MedicinaUniversidad de ChileSantiagoChile
| | - Germán Ebensperger
- Laboratorio de Mecanismos de Stress y Adaptación Vascular, Programa de Fisiopatología, Instituto de Ciencias Biomédicas, Facultad de MedicinaUniversidad de ChileSantiagoChile
| | - Emilio A. Herrera
- International Center for Andean Studies (INCAS)Universidad de ChileSantiagoChile
- Laboratorio de Función y Reactividad Vascular, Programa de Fisiopatología, Instituto de Ciencias Biomédicas, Facultad de MedicinaUniversidad de ChileSantiagoChile
| | - Sebastián A. Quezada
- Laboratorio de Bioquímica y Biología Molecular de la Hipoxia, Programa de Fisiopatología, Instituto de Ciencias Biomédicas, Facultad de MedicinaUniversidad de ChileSantiagoChile
| | - Ismael Hernandez
- Laboratorio de Bioquímica y Biología Molecular de la Hipoxia, Programa de Fisiopatología, Instituto de Ciencias Biomédicas, Facultad de MedicinaUniversidad de ChileSantiagoChile
| | - Emilia M. Sanhueza
- Laboratorio de Fisiología y Fisiopatología del Desarrollo, Programa de Fisiopatología, Instituto de Ciencias Biomédicas, Facultad de MedicinaUniversidad de ChileSantiagoChile
| | - Julian T. Parer
- Department of Obstetrics, Gynecology and Reproductive SciencesUniversity of California San FranciscoCaliforniaUSA
| | - Dino A. Giussani
- Department of Physiology, Development and NeuroscienceUniversity of CambridgeUK
| | - Aníbal J. Llanos
- International Center for Andean Studies (INCAS)Universidad de ChileSantiagoChile
- Laboratorio de Fisiología y Fisiopatología del Desarrollo, Programa de Fisiopatología, Instituto de Ciencias Biomédicas, Facultad de MedicinaUniversidad de ChileSantiagoChile
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Whiteman A, Mejia A, Hernandez I, Loaiza JR. Socioeconomic and demographic predictors of resident knowledge, attitude, and practice regarding arthropod-borne viruses in Panama. BMC Public Health 2018; 18:1261. [PMID: 30428861 PMCID: PMC6236898 DOI: 10.1186/s12889-018-6172-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 10/31/2018] [Indexed: 12/30/2022] Open
Abstract
Background We sought to identify if socioeconomic and demographic factors play a role in resident knowledge, attitude, and practice regarding Dengue, Chikungunya, and Zika in order to inform effective management procedures for disease prevention in Panama, a middle-income tropical country in Central America. All three are arthropod-borne viruses transmitted by Aedes mosquito vectors present in the focal region of Panama City, the largest city in Central America and an urban region of extreme socioeconomic polarization. Methods Between November 2017 and February 2018, we administered standardized, anonymous knowledge, attitude, and practice surveys to 263 residents split between two neighborhoods of high socioeconomic status (SES) and two neighborhoods of low SES. We then summed the knowledge, attitude, and practice scores respectively, and used linear and logistic regressions to quantify relationships with socioeconomic and demographic factors. Results Low-SES neighborhoods with high proportions of low income residents, residents over 70 years old had lower mean knowledge scores compared to other groups. Furthermore, residents in neighborhoods of low SES reported more mosquito biting relative to residents in neighborhoods of high SES, yet comparably lower level of concerns for disease transmission. Additionally, knowledge was lower for the more novel emergent threats of Chikungunya and Zika, compared to the endemic Dengue. Conclusion Findings suggest that low-SES neighborhoods with high proportions of low income, low education, and elderly residents should be targeted for outreach programs designed to prevent DENV, CHIKV, or ZIKV in Panama City. These outcomes support our initial hypotheses as lower relative knowledge and fewer practices related to the prevention of Dengue, Chikungunya, and Zika were found in low-SES neighborhoods. There is also a widespread lack of adequate knowledge regarding these diseases as well as low levels of concern in areas of highly reported mosquito biting. We provide suggestions for taking neighborhood socioeconomic status and specific aspects resident health literacy and attitude into account for creating more effective outreach campaigns as both endemic and novel arthropod-borne disease rates continue to increase throughout Latin America. Electronic supplementary material The online version of this article (10.1186/s12889-018-6172-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- A Whiteman
- Department of Geography & Earth Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC, 28223, USA. .,Smithsonian Tropical Research Institute, P.O. Box 0843-03092, Balboa, Ancón, Republic of Panama.
| | - A Mejia
- Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), P.O. Box 0843-01103, Panamá, República de Panamá
| | - I Hernandez
- Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), P.O. Box 0843-01103, Panamá, República de Panamá
| | - J R Loaiza
- Smithsonian Tropical Research Institute, P.O. Box 0843-03092, Balboa, Ancón, Republic of Panama.,Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), P.O. Box 0843-01103, Panamá, República de Panamá.,Programa Centroamericano de Maestría en Entomología, Universidad de Panamá, Panama City, República de Panamá
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Rodriguez-Gomez O, Sanabria A, Perez-Cordon A, Sanchez-Ruiz D, Abdelnour C, Valero S, Hernandez I, Rosende-Roca M, Mauleon A, Vargas L, Alegret M, Espinosa A, Ortega G, Guitart M, Gailhajanet A, Sotolongo-Grau O, Moreno-Grau S, Ruiz S, Tarragona M, Serra J, Martin E, Peleja E, Lomeña F, Campos F, Vivas A, Gomez-Chiari M, Tejero MA, Giménez J, Pesini P, Sarasa M, Martinez G, Ruiz A, Tarraga L, Boada M. FACEHBI: A Prospective Study of Risk Factors, Biomarkers and Cognition in a Cohort of Individuals with Subjective Cognitive Decline. Study Rationale and Research Protocols. J Prev Alzheimers Dis 2018; 4:100-108. [PMID: 29186280 DOI: 10.14283/jpad.2016.122] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Long-term longitudinal studies with multimodal biomarkers are needed to delve into the knowledge of preclinical AD. Subjective cognitive decline has been proposed as a risk factor for the development of cognitive impairment. Thus, including individuals with SCD in observational studies may be a cost-effective strategy to increase the prevalence of preclinical AD in the sample. OBJECTIVES To describe the rationale, research protocols and baseline characteristics of participants in the Fundació ACE Healthy Brain Initiative (FACEHBI). DESIGN FACEHBI is a clinical trial (EudraCT: 2014-000798-38) embedded within a long-term observational study of individuals with SCD. SETTING Participants have been recruited at the memory clinic of Fundació ACE (Barcelona) from two different sources: patients referred by a general practitioner and individuals from an Open House Initiative. PARTICIPANTS 200 individuals diagnosed with SCD with a strictly normal performance in a comprehensive neuropsychological battery. MEASUREMENTS Individuals will undergo an extensive neuropsychological protocol, risk factor assessment and a set of multimodal biomarkers including florbetaben PET, structural and functional MRI, diffusion tensor imaging, determination of amyloid species in plasma and neurophthalmologic assessment with optical coherence tomography. RESULTS Two hundred individuals have been recruited in 15 months. Mean age was 65.9 years; mean MMSE was 29.2 with a mean of 14.8 years of education. CONCLUSIONS FACEHBI is a long-term study of cognition, biomarkers and lifestyle that has been designed upon an innovative symptom-based approach using SCD as target population. It will shed light on the pathophysiology of preclinical AD and the role of SCD as a risk marker for the development of cognitive impairment.
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Affiliation(s)
- O Rodriguez-Gomez
- Octavio Rodriguez-Gomez, MD., Gran Via De Carles III, 85 BIS. CP: 08028. Barcelona. Spain, E-mail: , Fax: 0034 934193542, Telephone number: 0034 934304720
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Romero-Laorden N, Zapatero A, San Jose L, Lozano Mejorada R, Pacheco M, Rivera L, Hernandez I, Aragon I, González T, Colomer Bosch R. “PRIME Study": Searching for immune biomarkers in advanced castration resistant prostate cancer (CRPC) patients treated with standard therapy. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy315.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ponz De Antonio I, De Juan Baguda J, Rodriguez Chaverri A, Moran Fernandez L, Blazquez Bermejo Z, Garcia Cosio Carmena MD, Ortiz Bautista C, Hernandez I, Escribano Subias P, Munera Jimenez C, Gutierrez Garcia R, Salguero Bodes R, Arribas Ynsaurriaga F, Delgado Jimenez JF. P6527Hemodynamic evaluation of patients with advanced heart failure receiving ambulatory intermittent cycles of levosimendan as bridge to transplant. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | - I Hernandez
- University Hospital 12 de Octubre, Cardiology, Madrid, Spain
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21
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Alam M, Hernandez I, Paus R, Jimenez F. Image Gallery: Intravital visualization of the dynamic changes in human hair follicle cycling. Br J Dermatol 2018; 178:e396. [DOI: 10.1111/bjd.16569] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- M. Alam
- Mediteknia Skin & Hair Lab; Las Palmas de Gran Canaria Spain
- Universidad Fernando Pessoa Canarias; Las Palmas de Gran Canaria Spain
- Monasterium Laboratory; Muenster Germany
| | - I. Hernandez
- Mediteknia Skin & Hair Lab; Las Palmas de Gran Canaria Spain
| | - R. Paus
- Department of Dermatology; University of Manchester; Manchester U.K
- Department of Dermatology and Cutaneous Surgery; University of Miami Miller School of Medicine; Miami FL U.S.A
| | - F. Jimenez
- Mediteknia Skin & Hair Lab; Las Palmas de Gran Canaria Spain
- Universidad Fernando Pessoa Canarias; Las Palmas de Gran Canaria Spain
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Reyes RV, Castillo-Galán S, Hernandez I, Herrera EA, Ebensperger G, Llanos AJ. Revisiting the Role of TRP, Orai, and ASIC Channels in the Pulmonary Arterial Response to Hypoxia. Front Physiol 2018; 9:486. [PMID: 29867539 PMCID: PMC5949889 DOI: 10.3389/fphys.2018.00486] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 04/16/2018] [Indexed: 12/11/2022] Open
Abstract
The pulmonary arteries are exquisitely responsive to oxygen changes. They rapidly and proportionally contract as arterial PO2 decrease, and they relax as arterial PO2 is re-established. The hypoxic pulmonary vasoconstriction (HPV) is intrinsic since it does not require neural or endocrine factors, as evidenced in isolated vessels. On the other hand, pulmonary arteries also respond to sustained hypoxia with structural and functional remodeling, involving growth of smooth muscle medial layer and later recruitment of adventitial fibroblasts, secreted mitogens from endothelium and changes in the response to vasoconstrictor and vasodilator stimuli. Hypoxic pulmonary arterial vasoconstriction and remodeling are relevant biological responses both under physiological and pathological conditions, to explain matching between ventilation and perfusion, fetal to neonatal transition of pulmonary circulation and pulmonary artery over-constriction and thickening in pulmonary hypertension. Store operated channels (SOC) and receptor operated channels (ROC) are plasma membrane cationic channels that mediate calcium influx in response to depletion of internal calcium stores or receptor activation, respectively. They are involved in both HPV and pathological remodeling since their pharmacological blockade or genetic suppression of several of the Stim, Orai, TRP, or ASIC proteins in SOC or ROC complexes attenuate the calcium increase, the tension development, the pulmonary artery smooth muscle proliferation, and pulmonary arterial hypertension. In this Mini Review, we discussed the evidence obtained in in vivo animal models, at the level of isolated organ or cells of pulmonary arteries, and we identified and discussed the questions for future research needed to validate these signaling complexes as targets against pulmonary hypertension.
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Affiliation(s)
- Roberto V Reyes
- Unidad de Fisiología y Fisiopatología Perinatal, Programa de Fisiopatología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile.,International Center for Andean Studies, Universidad de Chile, Santiago, Chile
| | - Sebastián Castillo-Galán
- Unidad de Fisiología y Fisiopatología Perinatal, Programa de Fisiopatología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Ismael Hernandez
- Unidad de Fisiología y Fisiopatología Perinatal, Programa de Fisiopatología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Emilio A Herrera
- Unidad de Fisiología y Fisiopatología Perinatal, Programa de Fisiopatología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile.,International Center for Andean Studies, Universidad de Chile, Santiago, Chile
| | - Germán Ebensperger
- Unidad de Fisiología y Fisiopatología Perinatal, Programa de Fisiopatología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile.,International Center for Andean Studies, Universidad de Chile, Santiago, Chile
| | - Aníbal J Llanos
- Unidad de Fisiología y Fisiopatología Perinatal, Programa de Fisiopatología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile.,International Center for Andean Studies, Universidad de Chile, Santiago, Chile
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Hawkshaw N, Hardman J, Alam M, Hernandez I, Jimenez-Acosta F, Paus R. 1355 Mapping of Wnt/β-catenin signals during the telogen-to-anagen transition of human hair follicles. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.1372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hernandez I, Estrella A, Salazar J, Duarte Y, Torres E, Lopez C, Teran E. SUN-P130: Cardiovascular Risk and ATPIII Goals Achievement in Ecuadorian Population. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30497-1] [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: 10/18/2022]
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Zaragoza C, Ramirez-Carracedo R, Pascual M, Reventun P, Cuadrado I, Hernandez I, Diaz J, Zamorano J, Saura M, Sanmartin M. P6292Ivabradine induces cardiac protection by decreasing Extracellular Matrix Metalloproteinase Inducer EMMPRIN through microparticle secretion in a swine model of coronary ischemia/reperfusion. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6292] [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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Velazquez Martin M, Albarran A, Hernandez I, Mayordomo S, Revilla Y, Roldan A, Lopez Gude M, Cortina J, Alonso G, Quezada A, Pilkington P, Perez Vela J, Jimenez C, Alonso S, Escribano P. P2598Is pressure wire useful to predict reperfusion pulmonary edema after balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension? Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Velazquez Martin M, Albarran A, Hernandez I, Alonso S, Perez M, Mayordomo S, Jimenez C, Quezada A, Lopez Gude M, Cortina J, Roldan A, Coto B, Tovar N, Perez Vela J, Escribano P. P2602Predictors of reperfusion pulmonary edema and hemodynamic improvement at follow-up after balloon pulmonary angioplasty in patients with chronic thromboembolic pulmonary hypertension. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2602] [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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Castillo-Galán S, Quezada S, Moraga FA, Ebensperger G, Herrera EA, Beñaldo F, Hernandez I, Ebensperger R, Ramirez S, Llanos AJ, Reyes RV. 2-AMINOETHYLDIPHENYLBORINATE MODIFIES THE PULMONARY CIRCULATION IN PULMONARY HYPERTENSIVE NEWBORN LAMBS WITH PARTIAL GESTATION AT HIGH ALTITUDE. Am J Physiol Lung Cell Mol Physiol 2016; 311:L788-L799. [PMID: 27542806 DOI: 10.1152/ajplung.00230.2016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 08/14/2016] [Indexed: 12/22/2022] Open
Abstract
Calcium signaling through store operated channels (SOC) is involved in hypoxic pulmonary hypertension. We determined whether a treatment with 2-aminoethyldiphenylborinate (2-APB), a compound with SOC blocker activity, reduces pulmonary hypertension and vascular remodeling. Twelve newborn lambs exposed to perinatal chronic hypoxia were studied, 6 of them received a 2-APB treatment and the other 6 received vehicle treatment, for 10 days in both cases. Throughout this period, we recorded cardiopulmonary variables and on day 11 we evaluated the response to an acute hypoxic challenge. Additionally, we assessed the vasoconstrictor and vasodilator function in isolated pulmonary arteries as well as their remodeling in lung slices. 2-APB reduced pulmonary arterial pressure at the third and tenth days, cardiac output between the fourth and eighth days, and pulmonary vascular resistance at the tenth day of treatment. The pulmonary vasoconstrictor response to acute hypoxia was reduced by the end of treatment. 2-APB also decreased maximal vasoconstrictor response to the thromboxane mimetic U46619 and endothelin-1 and increased maximal relaxation to 8-Br-cGMP. The maximal relaxation and potency to phosphodiesterase-5 and Rho-kinase inhibition with sildenafil and fasudil respectively, were also increased. Finally, 2-APB reduced the medial and adventitial layers' thickness, the expression of α-actin and the percentage of Ki67+ nuclei of small pulmonary arteries. Taken together, our results indicate that 2-APB reduces pulmonary hypertension, vasoconstrictor responses and pathological remodeling in pulmonary hypertensive lambs. We conclude that SOC targeting may be a useful strategy for the treatment of neonatal pulmonary hypertension, however, further testing of specific blockers is needed.
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Affiliation(s)
| | - Sebastián Quezada
- Universidad de Chile, Facultad de Medicina, Instituto de Ciencias Biomédicas (ICBM)
| | | | - Germán Ebensperger
- Facultad de Medicina, Universidad de Chile, Instituto de Ciencias Biomédicas (ICBM), Santiago, Chile
| | | | | | - Ismael Hernandez
- Facultad de Medicina, Universidad de Chile, Instituto de Ciencias Biomédicas (ICBM), Santiago, Chile
| | - Renato Ebensperger
- Facultad de Medicina, Universidad de Chile, Instituto de Ciencias Biomédicas (ICBM), Santiago, Chile
| | - Santiago Ramirez
- Facultad de Medicina, Universidad de Chile, Instituto de Ciencias Biomédicas (ICBM), Santiago, Chile
| | | | - Roberto V Reyes
- Universidad de Chile, Facultad de Medicina, Instituto de Ciencias Biomédicas (ICBM)
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Flores Lopez E, Hernandez I, Valle L. PM142 Index of Inflammation in Patients With Acute Coronary Ischemic Syndrome in Relation With The Syntax Score. Glob Heart 2016. [DOI: 10.1016/j.gheart.2016.03.329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Άlvarez-Payero M, Maceiras F, Melero R, Mouriño C, Martin A, Rodríguez-Rodríguez M, Ucha M, Martínez N, Hernandez I, Barbazán C, Rodríguez M, Balboa V, Uña J, Piñeiro G, Pego J. AB1125-HPR Health- Related Quality of Life in Patients with Chronic Inflammatory Arthropathies and Biologic Therapy. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Hernandez I, Piñera A. Incidence of fracture events with teriparatide: role of study design. Osteoporos Int 2015; 26:2219. [PMID: 26092065 DOI: 10.1007/s00198-015-3207-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 06/10/2015] [Indexed: 10/23/2022]
Affiliation(s)
- I Hernandez
- Department of Health Policy and Management, Graduate School of Public Health, University of Pittsburgh, 130 De Soto St, Pittsburgh, PA, 15261, USA,
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Garza Leal J, Hernandez I, Castillo Saenz L, Harris M. AEGEA Vapor System: An In Vivo Peri-Hysterectomy Study. J Minim Invasive Gynecol 2014. [DOI: 10.1016/j.jmig.2014.08.481] [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: 11/16/2022]
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McKay T, Jimenez E, Svihla V, Castillo T, Cantareros A, Hernandez I. Using Interactive Learning Assessments (ILA) to Incorporate Professional Foundations in Undergraduate Learning. J Acad Nutr Diet 2014. [DOI: 10.1016/j.jand.2014.06.032] [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]
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Cortes Garcia M, Hernandez I, De La Cruz E, Romero AM, Avila P, Palfy JA, Navas MA, Benezet J, Rubio JM, Farre J. Results of cardiac resynchronisation therapy in a very elderly population. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p3176] [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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Mosesson MW, Holyst T, Hernandez I, Siebenlist KR. Evidence for covalent linkage between some plasma α2-antiplasmin molecules and Aα chains of circulating fibrinogen. J Thromb Haemost 2013; 11:995-8. [PMID: 23506433 DOI: 10.1111/jth.12193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 03/03/2013] [Indexed: 12/01/2022]
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Parrau D, Ebensperger G, Herrera EA, Moraga F, Riquelme RA, Ulloa CE, Rojas RT, Silva P, Hernandez I, Ferrada J, Diaz M, Parer JT, Cabello G, Llanos AJ, Reyes RV. Store-operated channels in the pulmonary circulation of high- and low-altitude neonatal lambs. Am J Physiol Lung Cell Mol Physiol 2013; 304:L540-8. [PMID: 23418093 DOI: 10.1152/ajplung.00024.2012] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We determined whether store-operated channels (SOC) are involved in neonatal pulmonary artery function under conditions of acute and chronic hypoxia, using newborn sheep gestated and born either at high altitude (HA, 3,600 m) or low altitude (LA, 520 m). Cardiopulmonary variables were recorded in vivo, with and without SOC blockade by 2-aminoethyldiphenylborinate (2-APB), during basal or acute hypoxic conditions. 2-APB did not have effects on basal mean pulmonary arterial pressure (mPAP), cardiac output, systemic arterial blood pressure, or systemic vascular resistance in both groups of neonates. During acute hypoxia 2-APB reduced mPAP and pulmonary vascular resistance in LA and HA, but this reduction was greater in HA. In addition, isolated pulmonary arteries mounted in a wire myograph were assessed for vascular reactivity. HA arteries showed a greater relaxation and sensitivity to SOC blockers than LA arteries. The pulmonary expression of two SOC-forming subunits, TRPC4 and STIM1, was upregulated in HA. Taken together, our results show that SOC contribute to hypoxic pulmonary vasoconstriction in newborn sheep and that SOC are upregulated by chronic hypoxia. Therefore, SOC may contribute to the development of neonatal pulmonary hypertension. We propose SOC channels could be potential targets to treat neonatal pulmonary hypertension.
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Affiliation(s)
- Daniela Parrau
- Laboratorios de Fisiología y Fisiopatología del Desarrollo, y de Bioquímica y Biología Molecular de la Hipoxia, Programa de Fisiopatología, Instituto de Ciencias Biomédicas (ICBM), Facultad de Medicina, Universidad de Chile, Santiago, Chile
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Hernandez M, Hernandez I, Rodriguez F, Pertegal M, Bonacasa B, Salom MG, Quesada T, Fenoy FJ. Endothelial dysfunction in gestational hypertension induced by catechol-O-methyltransferase inhibition. Exp Physiol 2013; 98:856-66. [DOI: 10.1113/expphysiol.2012.067389] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Bacq Y, Sentilhes L, Reyes HB, Glantz A, Kondrackiene J, Binder T, Nicastri PL, Locatelli A, Floreani A, Hernandez I, Di Martino V. Efficacy of ursodeoxycholic acid in treating intrahepatic cholestasis of pregnancy: a meta-analysis. Gastroenterology 2012; 143:1492-501. [PMID: 22892336 DOI: 10.1053/j.gastro.2012.08.004] [Citation(s) in RCA: 185] [Impact Index Per Article: 15.4] [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] [Received: 11/23/2011] [Revised: 07/14/2012] [Accepted: 08/07/2012] [Indexed: 12/21/2022]
Abstract
BACKGROUND & AIMS We performed a meta-analysis to evaluate the effects of ursodeoxycholic acid (UDCA) on pruritus, liver test results, and outcomes of babies born to women with intrahepatic cholestasis of pregnancy (ICP). METHODS We performed a systematic review of 9 published, randomized controlled trials (3 double blinded) that compared the effects of UDCA to other drugs, placebo, or no specific treatment (controls) in patients with ICP. We analyzed data from 454 patients: 207 received only UDCA, 70 received only placebo, 42 received cholestyramine, 36 received dexamethasone for 1 week and then placebo for 2 weeks, 65 received S-adenosyl-methionine, and 34 received no specific treatment. To achieve consistency among end points, a standard questionnaire was sent to all corresponding authors. For each end point, we performed pooled analysis that compared the effects of UDCA with those of all controls and UDCA with those of placebos. RESULTS In pooled analyses that compared UDCA with all controls, UDCA was associated with total resolution of pruritus (odds ratio [OR], 0.23; 95% confidence interval [CI], 0.07-0.74; P < .01), reduced pruritis (OR, 0.27; 95% CI, 0.13-0.55; P < .0001), normalization of serum levels of alanine aminotransferase (ALT) (OR, 0.23; 95% CI, 0.10-0.50; P < .001), decreased serum level of ALT (OR, 0.24; 95% CI, 0.11-0.52; P < .0001), reduced serum levels of bile acids (OR, 0.37; 95% CI, 0.19-0.75; P < .001), fewer premature births (OR, 0.44; 95% CI, 0.24-0.79; P < .01), reduced fetal distress (OR, 0.46; 95% CI, 0.25-0.86; P < .01), less frequent respiratory distress syndrome (OR, 0.30; 95% CI, 0.12-0.74; P < .01), and fewer neonates in the intensive care unit (OR, 0.49; 95% CI, 0.25-0.98; P = .046). In pooled analyses that compared the effects of UDCA with placebo, UDCA reduced pruritus (OR, 0.21; 95% CI, 0.07-0.62; P < .01), normalized (OR, 0.18; 95% CI, 0.06-0.52; P < .001) or decreased serum levels of ALT (OR, 0.12; 95% CI, 0.05-0.31; P < .0001), and reduced serum levels of bile acids (OR, 0.30; 95% CI, 0.12-0.73; P < .01). CONCLUSIONS Based on a meta-analysis, UDCA is effective in reducing pruritus and improving liver test results in patients with ICP; UDCA therapy might also benefit fetal outcomes.
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Affiliation(s)
- Yannick Bacq
- Service d'Hépatogastroentérologie, CHRU de Tours, Tours, France.
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Garza-Leal J, Hernandez I, Castillo L, Diamond M, Wiseman D, Davis P. O186 SAFETY AND FEASIBILITY OF PROGEL AB™ IN REDUCING ADHESIONS AFTER LAPAROSCOPIC MYOMECTOMY. Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)60616-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lorenzo N, Barberá A, Domínguez MC, Torres AM, Hernandez MV, Hernandez I, Gil R, Ancizar J, Garay H, Reyes O, Altruda F, Silengo L, Padrón G. Therapeutic effect of an altered peptide ligand derived from heat-shock protein 60 by suppressing of inflammatory cytokines secretion in two animal models of rheumatoid arthritis. Autoimmunity 2012; 45:449-59. [PMID: 22686732 DOI: 10.3109/08916934.2012.697592] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [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]
Abstract
Rheumatoid arthritis is a systemic autoimmune disease mediated by T cells. Productive engagement of T cell receptors by major histocompatibility complex-peptide leads to proliferation, differentiation and the definition of effector functions. Altered peptide ligands (APL) generated by amino acid substitutions in the antigenic peptide have diverse effects on T cell response. We predicted a novel T cell epitope from human heat-shock protein 60, an autoantigen involved in the pathogenesis of rheumatoid arthritis. Three APLs were designed from this epitope and it was demonstrated that these peptides induce the activation of T cells through their ability to modify cell cycle phase's distribution of CD4+T cells from RA patients. Also, IL-17, TNF-α and IL-10 levels were determined in PBMC from these patients. Unlike the wild-type peptide and the other two APLs, APL2 increased the IL-10 level and suppressed IL-17 secretion in these assays. Therapeutic effect of this APL in adjuvant arthritis (AA) and collagen-induced arthritis (CIA) models was also evaluated. Clinical score, histopathology, inflammatory and regulatory cytokine concentration were monitored in the animals. APL2 efficiently inhibited the progression of AA and CIA with a significant reduction of the clinical and histopathologic score. Therapeutic effect of APL2 on CIA was similar to that obtained with MTX; the standard treatment for RA. This effect was associated with a decrease of TNF-α and IL-17 levels. These results suggest that the therapeutic effect of APL2 is mediated in part by down-regulation of inflammatory cytokines and support the potential use of APL2 as a therapeutic drug in RA patients.
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Affiliation(s)
- N Lorenzo
- Biomedical Research Department, Center for Genetic Engineering and Biotechnology, Havana, Cuba.
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Garza-Leal J, Hernandez I, Castillo L, Coad J. Quality Hysterosalpingography Following Concomitant Adiana® Transcervical Sterilization and NovaSure® Endometrial Ablation with Histopathology Correlation. J Minim Invasive Gynecol 2010. [DOI: 10.1016/j.jmig.2010.08.214] [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: 10/19/2022]
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Garza-Leal J, Hernandez I, Castillo L, Chill N, Coad J. Successful AEGEA Vapor-Based Endometrial Ablation: An In Vivo Peri-Hysterectomy Study. J Minim Invasive Gynecol 2010. [DOI: 10.1016/j.jmig.2010.08.582] [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: 11/16/2022]
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Garza-Leal J, Castillo L, Hernandez I, Costas M, Stillman M, Coad J. Concominant Use of Adiana® Permanent Contraception and NovaSure® Impedance Controlled Endometrial Ablation: A Peri-Hysterectomy Study. J Minim Invasive Gynecol 2009. [DOI: 10.1016/j.jmig.2009.08.259] [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: 11/28/2022]
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Garza-Leal J, Hernandez I, Castillo L, Coad J. AEGEA Vapor-Based Endometrial Ablation: Perihysterectomy Proof of Concept. J Minim Invasive Gynecol 2009. [DOI: 10.1016/j.jmig.2009.08.244] [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: 10/20/2022]
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Teran E, Hernandez I, Nieto B, Tavara R, Ocampo J. O931 Coenzyme Q10 supplementation during pregnancy reduces the risk of pre-eclampsia. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)61304-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ramirez-Lorca R, Boada M, Saez ME, Hernandez I, Mauleon A, Rosende-Roca M, Martinez-Lage P, Gutierrez M, Real LM, Lopez-Arrieta J, Gayan J, Antunez C, Gonzalez-Perez A, Tarraga L, Ruiz A. GAB2 gene does not modify the risk of Alzheimer's disease in Spanish APOE 4 carriers. J Nutr Health Aging 2009; 13:214-9. [PMID: 19262956 DOI: 10.1007/s12603-009-0061-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The genetic basis of Alzheimer's disease (AD) is being analyzed in multiple whole genome association studies (WGAS). The GAB2 gene has been proposed as a modifying factor of APOE epsilon 4 allele in a recent case-control WGAS conducted in the US. Given the potential application of these novel results in AD diagnostics, we decided to make an independent replication to examine the GAB2 gene effect in our series. DESIGN We are conducting a multicenter population-based study of AD in Spain. PARTICIPANTS We analyzed a total of 1116 Spanish individuals. Specifically, 521 AD patients, 475 controls from the general population and 120 neurologically-normal elderly controls (NNE controls). METHODS We have genotyped GAB2 (rs2373115 G/T) and APOE rs429358 (SNP112)/rs7412 (SNP158) polymorphisms using real time-PCR technologies. RESULTS As previously reported in Spain, APOE epsilon 4 allele was strongly associated with AD in our series (OR=2.88 [95% C.I. 2.16- 3.84], p=7.38E-11). Moreover, a large effect for epsilone 4/epsilone 4 genotype was also observed (OR=14.45 [95% C.I., 3.34-125.2], p=1.8E-6). No difference between the general population and the NNE controls series were observed for APOE genotypes (P > 0.61). Next, we explored GAB2 rs2373115 SNP singlelocus association using different genetic models and comparing AD versus controls or NNE controls. No evidence of association with AD was observed for this GAB2 marker (p > 0.17). To evaluate GAB2-APOE genegene interactions, we stratified our series according to APOE genotype and case-control status, in accordance with the original studies. Again, no evidence of genetic association with AD was observed in any strata of GAB2-APOE loci pair (p > 0.34). CONCLUSION GAB2 rs2373115 marker does not modify the risk of Alzheimer's disease in Spanish APOE epsilon 4 carriers.
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Mosesson MW, Cooley BC, Hernandez I, Diorio JP, Weiler H. Thrombosis risk modification in transgenic mice containing the human fibrinogen thrombin-binding gamma' chain sequence. J Thromb Haemost 2009; 7:102-10. [PMID: 18983496 DOI: 10.1111/j.1538-7836.2008.03213.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Thrombin binding activity in murine fibrin (Antithrombin I) is restricted to its E domains inasmuch as murine gamma' chains (mu-gamma') do not bind thrombin. This feature prompted us to produce a 'gain-of-function' transgenic mouse in which the wild-type (WT) C-terminal mu-gamma' chain fibrinogen sequence had been replaced with the C-terminal thrombin-binding human gamma' sequence. RESULTS This procedure resulted in a murine fibrinogen species containing chimeric hu-gamma' chains (hu-gamma' fibrinogen). As anticipated, thrombin bound to WT fibrin at a single class of sites, whereas thrombin binding to heterodimeric hu-gamma'-containing fibrin was increased, reflecting its content of hu-gamma' chains. In an electrolytically-induced femoral vein thrombosis injury model, we found no differences in the volume of thrombus generation between WT and heterozygous hu-gamma' mice. However, heterozygous factor (F) V Leiden (FVL(+/-)) mice developed greater thrombus volumes than did WT controls (P < 0.01). In doubly heterozygous FVL(+/-), hu-gamma' mice, thrombus formation was reduced to WT levels (P < 0.05). CONCLUSIONS Murine hu-gamma' fibrinogen down-regulates venous thrombosis in the presence of another known thrombosis risk factor, FV Leiden. This finding indicates that hu-gamma' chain-containing fibrinogen is a thrombosis risk modifier.
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Affiliation(s)
- M W Mosesson
- Blood Research Institute, BloodCenter of Wisconsin, Milwaukee, WI 53201-2178, USA.
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Garza-Leal J, Hernandez I, Castillo L, Bailey N, Price P, Coad J. Essure® Transcervical Sterilization Combined with NovaSure® Endometrial Ablation: A Perihysterectomy Safety Study. J Minim Invasive Gynecol 2008. [DOI: 10.1016/j.jmig.2008.09.166] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Garza-Leal J, Castillo L, Hernandez I, Livengood R, Price P, Coad J. Essure® Transcervical Sterilization Combined with the Hydro Thermablator® System for Endometrial Ablation: A Perihysterectomy Safety Study. J Minim Invasive Gynecol 2008. [DOI: 10.1016/j.jmig.2008.09.002] [Citation(s) in RCA: 3] [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: 11/29/2022]
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Mosesson MW, Siebenlist KR, Hernandez I, Lee KN, Christiansen VJ, McKee PA. Evidence that alpha2-antiplasmin becomes covalently ligated to plasma fibrinogen in the circulation: a new role for plasma factor XIII in fibrinolysis regulation. J Thromb Haemost 2008; 6:1565-70. [PMID: 18564219 PMCID: PMC4489681 DOI: 10.1111/j.1538-7836.2008.03056.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Plasma alpha2-antiplasmin (alpha2AP) is a rapid and effective inhibitor of the fibrinolytic enzyme plasmin. Congenital alpha2AP deficiency results in a severe hemorrhagic disorder due to accelerated fibrinolysis. It is well established that in the presence of thrombin-activated factor XIII (FXIIIa), alpha2AP becomes covalently ligated to the distal alpha chains of fibrin or fibrinogen at lysine 303 (two potential sites per molecule). Some time ago we showed that alpha2AP is covalently linked to plasma fibrinogen . That singular observation led to our hypothesis that native plasma factor XIII (FXIII), which is known to catalyze covalent cross-linking of fibrinogen in the presence of calcium ions, can also incorporate alpha2AP into fibrinogen in the circulation. RESULTS AND CONCLUSIONS We now provide evidence that FXIII incorporates I 125-labelled alpha2AP into the Aalpha-chain sites on fibrinogen or fibrin. We also measured the content of alpha2AP in isolated plasma fibrinogen fractions by ELISA and found that substantial amounts were present (1.2-1.8 moles per mole fibrinogen). We propose that alpha2AP becomes ligated to fibrinogen while in the circulation through the action of FXIII, and that its immediate presence in plasma fibrinogen contributes to regulation of in vivo fibrinolysis.
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Affiliation(s)
- M W Mosesson
- Blood Research Institute, BloodCenter of Wisconsin, Milwaukee, WI, USA.
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