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Lorentz JF, Calijuri ML, Rad C, Cecon PR, Assemany PP, Martinez JM, Kholssi R. Microalgae biomass as a conditioner and regulator of soil quality and fertility. Environ Monit Assess 2024; 196:198. [PMID: 38265731 DOI: 10.1007/s10661-024-12355-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 01/11/2024] [Indexed: 01/25/2024]
Abstract
Characteristics of an acid soil cultivated with Urochloa brizantha cv. Marandu were evaluated in relation to two types of fertilization: a conventional one, chemical based on nitrogen and potassium, and a biofertilizer, based on microalgae biomass. The results were compared among three treatments, control, conventional, and biological fertilization, with seven replications each. The study evaluated microalgae community, total carbon and nitrogen contents, mineral nitrogen, and enzymatic activity. Chlorella vulgaris showed the highest organism density, which can be explained by its rapid growth and high resistance. The highest species diversity was detected in the control 1,380,938 org cm-3 and biological 1,841,250 org cm-3 treatments, with the latter showing a higher density of cyanobacteria, especially Pseudanabaena limnetica with 394,554 org cm-3. The soil treated with chemical fertilization showed higher nitrate (9.14 mg NKg-1 NO3--N) and potassium (52.32 mg dm-3) contents. The highest levels of sulfur (21.73 mg dm-3) and iron (96.46 mgdm-3) were detected in the biological treatment. The chemical treatment showed higher activity of the enzymes acid phosphatase, acetylglucosaminidase, and sulfatase, while α-glucosidase and leucine aminopeptidase stood out in the biological treatment. Soil properties were not significantly affected by the treatments. The use of microalgae biomass derived from wastewater treatment from milking parlors was evaluated and presented as a promising biofertilizer for agriculture, following the line of recovering nutrient-rich wastes. In this sense, although many challenges need to be overcome, the results suggest that microalgal-based fertilizers could lead to low-impact agriculture.
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Affiliation(s)
| | - Maria Lúcia Calijuri
- Department of Civil Engineering, Federal University of Viçosa, Viçosa, MG, Brazil
| | - Carlos Rad
- Composting Research Group, Faculty of Sciences, University of Burgos, Burgos, Spain
| | | | - Paula Peixoto Assemany
- Department of Environmental Engineering, Federal University of Lavras, Lavras, MG, Brazil
| | - Jorge Miñon Martinez
- Composting Research Group, Faculty of Sciences, University of Burgos, Burgos, Spain
| | - Rajaa Kholssi
- Composting Research Group, Faculty of Sciences, University of Burgos, Burgos, Spain
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Soller B, Martinez JM, Rishel Brakey H, Mickel N, Sood A. Navigating Barriers and Challenges to Achieving Critical Career Milestones Among Faculty Mentees. Chron Mentor Coach 2023; 7:207-212. [PMID: 38187469 PMCID: PMC10768922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
For faculty members, job satisfaction, compensation, and career advancement hinge on achieving 'critical' career milestones (e.g., external funding, tenure). Faculty face unique barriers to achieving career milestones (Bagley et al., 2018), and therefore must employ tailored strategies to overcome challenges. The current project extends research on barriers to career milestones (Soller et al., 2022) to examine strategies faculty employ to overcome barriers in the pursuit of critical career milestones. Thirty-seven faculty members participated across eight US academic institutions, including 22 under-represented minorities in science (URM-S; women or racial/ ethnic minorities). Respondents identified critical career milestones they achieved or will pursue within the next 24 months and then discussed strategies used and suggestions for achieving milestones during semi-structured qualitative interviews. The research team conducted a thematic, qualitative, descriptive analysis of qualitative data using NVivo software in a systematic, interactive, team-based process. Four key strategies emerged for navigating barriers in the pursuit of critical career milestones: 1) Careful engagement of mentors and allies; 2) Collaborate and network; 3) Set boundaries and prioritize; and 4) Reflect on values and use personal strengths. Administrators should aim to remove structural barriers, particularly those that reduce equity (Davis et al., 2022). Identifying strategies that faculty employ to overcome challenges can enhance mentoring by helping mentors understand how mentees overcome unique challenges, particularly those that are not easily addressed through structural interventions.
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Affiliation(s)
- B Soller
- University of Maryland-Baltimore County, University of New Mexico, University of Oklahoma
| | - J M Martinez
- University of Maryland-Baltimore County, University of New Mexico, University of Oklahoma
| | - H Rishel Brakey
- University of Maryland-Baltimore County, University of New Mexico, University of Oklahoma
| | - N Mickel
- University of Maryland-Baltimore County, University of New Mexico, University of Oklahoma
| | - A Sood
- University of Maryland-Baltimore County, University of New Mexico, University of Oklahoma
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Padilla L, Dakhel S, Adan J, Masa M, Martinez JM, Roque L, Coll T, Hervas R, Calvis C, Llinas L, Buenestado S, Castellsague J, Messeguer R, Mitjans F, Hernandez JL. S100A7: from mechanism to cancer therapy. Oncogene 2017; 36:6749-6761. [PMID: 28825725 DOI: 10.1038/onc.2017.283] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 06/02/2017] [Accepted: 07/08/2017] [Indexed: 12/21/2022]
Abstract
Within the tumor, malignant and stromal cells support each other by secreting a wide variety of growth factors and cytokines, allowing tumor growth and disease progression. The identification and regulation of those key factors in this crosstalk has opened the opportunity to develop new therapeutic strategies that not only act on the tumor cells but also on the stroma. Among these factors, S100A7 protein has gained interest in the last years. With key roles in cell motility its expression correlates with increased tumor growth, angiogenesis and metastatic potential. This work aims to deepen in the role played by extracellular S100A7 in the tumor microenvironment, offering a new integrative insight of its mechanism of action on each cellular compartment (tumor, endothelial, immune and fibroblast). As a result, we demonstrate its implication in cell migration and invasion, and its important contribution to the formation of a proinflammatory and proangiogenic environment that favors tumor progression and metastasis. Furthermore, we define its possible role in the pre-metastatic niche formation. Considering the relevance of S100A7 in cancer progression, we have developed neutralizing monoclonal antibodies, reporting for the first time the proof of principle of this promising therapeutic strategy for cancer treatment.
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Affiliation(s)
- L Padilla
- Biomed Division, LEITAT Technological Center, Barcelona, Spain
| | - S Dakhel
- Biomed Division, LEITAT Technological Center, Barcelona, Spain
| | - J Adan
- Biomed Division, LEITAT Technological Center, Barcelona, Spain
| | - M Masa
- Biomed Division, LEITAT Technological Center, Barcelona, Spain
| | - J M Martinez
- Biomed Division, LEITAT Technological Center, Barcelona, Spain
| | - L Roque
- Biomed Division, LEITAT Technological Center, Barcelona, Spain
| | - T Coll
- Biomed Division, LEITAT Technological Center, Barcelona, Spain
| | - R Hervas
- Biomed Division, LEITAT Technological Center, Barcelona, Spain
| | - C Calvis
- Biomed Division, LEITAT Technological Center, Barcelona, Spain
| | - L Llinas
- Biomed Division, LEITAT Technological Center, Barcelona, Spain
| | - S Buenestado
- Biomed Division, LEITAT Technological Center, Barcelona, Spain
| | - J Castellsague
- Biomed Division, LEITAT Technological Center, Barcelona, Spain
| | - R Messeguer
- Biomed Division, LEITAT Technological Center, Barcelona, Spain
| | - F Mitjans
- Biomed Division, LEITAT Technological Center, Barcelona, Spain
| | - J L Hernandez
- Biomed Division, LEITAT Technological Center, Barcelona, Spain
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Paladini D, Alfirevic Z, Carvalho JS, Khalil A, Malinger G, Martinez JM, Rychik J, Ville Y, Gardiner H. ISUOG consensus statement on current understanding of the association of neurodevelopmental delay and congenital heart disease: impact on prenatal counseling. Ultrasound Obstet Gynecol 2017; 49:287-288. [PMID: 27891680 DOI: 10.1002/uog.17324] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 10/06/2016] [Indexed: 06/06/2023]
Affiliation(s)
- D Paladini
- Fetal Medicine & Surgery Unit, Istituto G.Gaslini, Genoa, Italy
| | - Z Alfirevic
- Department of Women's and Children's Health, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - J S Carvalho
- Fetal Medicine Unit, St George's Hospital and St George's University of London, London, UK
- Centre for Fetal Cardiology, Royal Brompton Hospital, London, UK
| | - A Khalil
- Fetal Medicine Unit, St George's Hospital and St George's University of London, London, UK
| | - G Malinger
- OB-GYN Ultrasound Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - J M Martinez
- Fetal Medicine, Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Clínic and Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - J Rychik
- Fetal Heart Program, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Y Ville
- Maternité, Hôpital Universitaire Necker-Enfants Malades, Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - H Gardiner
- The Fetal Center, University of Texas Health Science Center at Houston, Houston, TX, USA
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Paladini D, Alfirevic Z, Carvalho JS, Khalil A, Malinger G, Martinez JM, Rychik J, Gardiner H. Prenatal counseling for neurodevelopmental delay in congenital heart disease: results of a worldwide survey of experts' attitudes advise caution. Ultrasound Obstet Gynecol 2016; 47:667-671. [PMID: 26749377 DOI: 10.1002/uog.15852] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 11/21/2015] [Accepted: 12/29/2015] [Indexed: 06/05/2023]
Affiliation(s)
- D Paladini
- Fetal Medicine and Surgery Unit- Istituto G.Gaslini, Genoa, Italy
| | - Z Alfirevic
- Department of Women's and Children's Health, Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - J S Carvalho
- Fetal Medicine Unit, St George's University of London
- Brompton Centre for Fetal Cardiology, Royal Brompton Hospital, London, UK
| | - A Khalil
- Fetal Medicine Unit, Department of Obstetrics and Gynaecology, St George's Hospital, London, UK
| | - G Malinger
- Ob-Gyn Ultrasound Unit, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - J M Martinez
- Fetal Medicine, Barcelona Center for Maternal Fetal and Neonatal Medicine, Hospital Clínic and Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - J Rychik
- Fetal Heart Program, Children's Hospital of Philadelphia, PA, USA
| | - H Gardiner
- The Fetal Center, University of Texas Health Science Center at Houston, Houston, TX, USA
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Ortiz JU, Eixarch E, Peguero A, Lobmaier SM, Bennasar M, Martinez JM, Gratacós E. Chorioamniotic membrane separation after fetoscopy in monochorionic twin pregnancy: incidence and impact on perinatal outcome. Ultrasound Obstet Gynecol 2016; 47:345-349. [PMID: 26148097 DOI: 10.1002/uog.14936] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Revised: 05/10/2015] [Accepted: 06/19/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To evaluate the incidence of chorioamniotic membrane separation (CMS) after fetoscopy in monochorionic diamniotic (MCDA) twins and its impact on pregnancy outcome. METHODS The study group comprised a consecutive series of 338 women with an MCDA pregnancy complicated by twin-twin transfusion syndrome (TTTS) or selective intrauterine growth restriction (sIUGR) treated with selective laser photocoagulation of communicating vessels (SLPCV) or cord occlusion (CO). Data obtained included cervical length, gestational age at procedure, type and duration of surgery and placental location. The incidence of CMS, the rates of miscarriage and preterm prelabor rupture of membranes (PPROM), gestational age at delivery and neonatal survival were recorded. RESULTS Of the study population of MCDA pregnancies, 270 (79.9%) had TTTS and 68 (20.1%) had sIUGR. SLPCV was performed in 252 (74.6%) cases and CO in 86 (25.4%). Postoperative CMS was observed in 70 (20.7%) cases. Patients with CMS had higher rates of miscarriage (14.3% vs 7.1%; P = 0.049), PPROM before 32 weeks (43.3% vs 13.7%; P < 0.001) and preterm delivery before 32 weeks (53.3% vs 26.1%; P < 0.001) and a lower rate of neonatal survival of at least one twin (81.7% vs 93.6%; P = 0.003). Multivariate analysis showed that gestational age at surgery was the only independent predictor, with the highest proportion of CMS occurring in cases that underwent surgery before 18 weeks' gestation (odds ratio, 2.941 (95% CI, 1.640-5.275); P < 0.001). There was no influence of cervical length, placental location, duration of surgery or type of surgery on the risk of CMS. CONCLUSIONS CMS complicated one-fifth of all MCDA pregnancies that underwent fetoscopy. It appeared to be more common in those who underwent surgery before 18 weeks' gestation and was associated with poorer outcomes. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.
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Affiliation(s)
- J U Ortiz
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
- Frauenklinik und Poliklinik, Technische Universität München, Munich, Germany
| | - E Eixarch
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - A Peguero
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - S M Lobmaier
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
- Frauenklinik und Poliklinik, Technische Universität München, Munich, Germany
| | - M Bennasar
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - J M Martinez
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
| | - E Gratacós
- BCNatal - Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
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Ortiz JU, Crispi F, Yamamoto R, Masoller N, Eixarch E, Lobmaier SM, Schneider KTM, Martinez JM, Gratacós E. Beurteilung der längsventrikulären Funktion bei Zwillingen mit feto-fetalem Transfusionssyndrom vor und nach der Lasertherapie. Z Geburtshilfe Neonatol 2015. [DOI: 10.1055/s-0035-1566508] [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: 10/22/2022]
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Torres Montebruno X, Martinez JM, Eixarch E, Gómez O, García Aparicio L, Castañón M, Gratacos E. Fetoscopic laser surgery to decompress distal urethral obstruction caused by prolapsed ureterocele. Ultrasound Obstet Gynecol 2015; 46:623-626. [PMID: 25865633 DOI: 10.1002/uog.14876] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 03/27/2015] [Accepted: 04/05/2015] [Indexed: 06/04/2023]
Abstract
We report on the successful use of fetoscopic surgery to treat a case of prolapsed ureterocele in a female fetus. At 21 weeks' gestation, a double renal system with an intravesical ureterocele obstructing the bladder outlet was diagnosed, causing severe megacystis, bilateral hydronephrosis and progressive oligohydramnios. Ultrasound evaluation following referral to our center confirmed severe bilateral hydronephrosis with pelvic and calyceal dilatation, but amniotic fluid volume was normal and the ureterocele was not visualized in the bladder. Instead, a cystic mass within the external genitalia was observed, suggestive of a prolapsed ureterocele, causing intermittently severe obstruction of the urethra. The parents were counseled about the uncertain prognosis and fetal surgery to decompress the urinary system was proposed. The procedure involved firing a contact diode laser until perforation of the ureterocele was achieved. Following laser surgery, resolution of megacystis, reduction of hydronephrosis and normalization of amniotic fluid volume were observed. Our report demonstrates that fetoscopic decompression of a distal urethral obstruction is feasible in the rare event of congenital prolapsed ureterocele.
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Affiliation(s)
- X Torres Montebruno
- BCNatal, Barcelona Center for Maternal-Fetal Medicine and Neonatology, Hospital Clínic and Hospital Sant Joan de Déu, IDIBAPS, University of Barcelona, and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) - Maternal-Fetal Medicine and Neonatology, Barcelona, Spain
| | - J M Martinez
- BCNatal, Barcelona Center for Maternal-Fetal Medicine and Neonatology, Hospital Clínic and Hospital Sant Joan de Déu, IDIBAPS, University of Barcelona, and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) - Maternal-Fetal Medicine and Neonatology, Barcelona, Spain
| | - E Eixarch
- BCNatal, Barcelona Center for Maternal-Fetal Medicine and Neonatology, Hospital Clínic and Hospital Sant Joan de Déu, IDIBAPS, University of Barcelona, and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) - Maternal-Fetal Medicine and Neonatology, Barcelona, Spain
| | - O Gómez
- BCNatal, Barcelona Center for Maternal-Fetal Medicine and Neonatology, Hospital Clínic and Hospital Sant Joan de Déu, IDIBAPS, University of Barcelona, and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) - Maternal-Fetal Medicine and Neonatology, Barcelona, Spain
| | - L García Aparicio
- Department of Pediatric Surgery, Hospital Sant Joan de Déu, Barcelona, Spain
| | - M Castañón
- Department of Pediatric Surgery, Hospital Sant Joan de Déu, Barcelona, Spain
| | - E Gratacos
- BCNatal, Barcelona Center for Maternal-Fetal Medicine and Neonatology, Hospital Clínic and Hospital Sant Joan de Déu, IDIBAPS, University of Barcelona, and Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) - Maternal-Fetal Medicine and Neonatology, Barcelona, Spain
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Mula R, Grande M, Bennasar M, Crispi F, Borobio V, Martinez JM, Gratacos E, Borrell A. Further insights into diastolic dysfunction in first-trimester trisomy-21 fetuses. Ultrasound Obstet Gynecol 2015; 45:205-210. [PMID: 24706444 DOI: 10.1002/uog.13380] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 02/20/2014] [Accepted: 03/26/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To assess fetal cardiac function in first-trimester trisomy-21 fetuses as compared with fetuses with other aneuploidies, euploid fetuses with cardiac defects or isolated increased nuchal translucency (NT) and controls. METHODS During a 2.5-year period, NT, ductus venosus (DV) blood flow, diastolic filling time, early filling time, tricuspid flow, tricuspid and mitral valve E/A velocity ratios, left ventricle shortening fraction, left myocardial performance index and fetal heart rate were assessed in fetuses with a crown-rump length between 45 and 84 mm undergoing chorionic villus sampling at our center. Cardiac parameters among study groups were compared with the use of 95% CIs. RESULTS The study population comprised 28 fetuses with trisomy 21, 25 with other aneuploidies, 94 euploid fetuses with abnormal findings (27 with cardiac defects, 31 with other structural anomalies and 36 with isolated increased NT) and 271 controls. Trisomy-21 fetuses showed signs of diastolic dysfunction such as increased DV pulsatility index and E/A ratios together with a higher prevalence of tricuspid regurgitation. However, no differences were found in euploid fetuses with cardiac defects or isolated increased NT. CONCLUSIONS No signs of cardiac dysfunction were observed in euploid fetuses with increased NT or cardiac defects, while in trisomy-21 fetuses signs of diastolic dysfunction could be potentially attributed to volume overload.
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Affiliation(s)
- R Mula
- Maternal-Fetal Medicine Department, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
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Roberts BR, Toca HT, Martinez JM. Predictors of survival of therapeutic hypothermia based on analysis of a consecutive American inner-city population over 4 years. Crit Care 2015. [PMCID: PMC4470530 DOI: 10.1186/cc14508] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Lenox-Smith A, Martinez JM, Perahia D, Dowsett SA, Dennehy EB, Lopez-Romero P, Demyttenaere K. Treatment and outcomes for patients with depression who are partial responders to SSRI treatment: post-hoc analysis findings from the FINDER European observational study. J Affect Disord 2014; 169:149-56. [PMID: 25194783 DOI: 10.1016/j.jad.2014.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 07/22/2014] [Accepted: 08/04/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Remission is the goal in depression, but in practice many patients only experience a partial response to treatment. We sought to determine the prevalence, management and subsequent outcomes of partial responder patients. METHODS Patients enrolled in the naturalistic Factors Influencing Depression Endpoints Research (FINDER) study with the Hospital Anxiety and Depression Scale depression subscale (HADS-D) score >10 at baseline who received only SSRI(s) between 0 and 3 months comprised the study cohort (n=1147). Patients were categorized as remitters, partial responders or non-responders at 3 months and then followed up at 6 months. RESULTS At 3 months, 29.4% of the study population were considered non-responders, 27.6% were partial responders, and 39.3% were remitters. Most partial responders at 3 months remained on the same SSRI for the next 3 months. Of the 247 partial responders at 3 months and remained on the same SSRI(s) between 3 and 6 months, 10.9% met criteria for non-response at 6 months, 32.4% remained partial responders, and 56.3% achieved remission. Quality of life outcomes for the partial responders were significantly worse than those in remission (p<0.05). LIMITATIONS FINDER was an observational study; the current analysis was conducted post-hoc. Multivariable methods were not applied and findings are primarily descriptive and exploratory. CONCLUSIONS Partial response is common and patients in partial response have a poorer quality of life than those achieving remission. Despite this, the majority of partial responders continue to take the same SSRI. Our findings underscore the importance of continuing to strive for remission.
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Affiliation(s)
| | | | | | | | - E B Dennehy
- Eli Lilly & Company, Indianapolis, IN, USA; Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA
| | | | - K Demyttenaere
- Section of Psychiatry, University Psychiatric Center KuLeuven-Campus Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium
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Duran X, Vanroelen C, Martinez JM, Benavides FG, Deboosere P. Comparing the association between social security status and mortality in Belgium and Spain. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku166.104] [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: 11/13/2022] Open
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13
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Ortiz JU, Martinez JM, Masoller N, Eixarch E, Crispi F, Gómez O, Lobmaier SM, Bennasar M, Gratacós E. Perinatal outcome after laser therapy of recipient twins affected by right ventricle outflow tract obstruction. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388040] [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: 10/24/2022] Open
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Ortiz JU, Crispi F, Yamamoto R, Gómez O, Bennasar M, Masoller N, Lobmaier SM, Martinez JM, Gratacós E. Fetal ventricular long axis function in twin-to-twin transfusion syndrome before and after laser surgery. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388032] [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: 10/24/2022] Open
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Lobmaier SM, Cruz-Lemini M, Valenzuela-Alcaraz B, Ortiz JU, Martinez JM, Gratacós E, Crispi F. Influence of equipment and settings on myocardial performance index repeatability and definition of settings to achieve optimal reproducibility. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388045] [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: 10/24/2022] Open
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Ortiz JU, Eixarch E, Peguero A, Lobmaier SM, Sanz M, Martinez JM, Gratacós E. Incidence and clinical implications of chorioamniotic membrane separation after fetoscopic surgery in monochorionic twin pregnancies. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388052] [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: 10/24/2022] Open
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Lobmaier SM, Cruz-Lemini M, Valenzuela-Alcaraz B, Ortiz JU, Martinez JM, Gratacos E, Crispi F. Influence of equipment and settings on myocardial performance index repeatability and definition of settings to achieve optimal reproducibility. Ultrasound Obstet Gynecol 2014; 43:632-639. [PMID: 24639072 DOI: 10.1002/uog.13365] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/28/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To compare left myocardial performance index (MPI) values and reproducibility using different settings and ultrasound equipment in order to standardize optimal machine settings. METHODS Left MPI was prospectively evaluated by one observer performing conventional Doppler in 62 fetuses (28-36 weeks of gestational age) using different settings (changing sweep speed, gain and wall motion filter (WMF)) and two different ultrasound devices (Siemens Antares, Siemens; Voluson 730 Expert, GE Medical Systems). Intraclass coefficients of agreement (ICCs) were calculated using Bland-Altman analysis. RESULTS Using baseline settings on the Siemens, mean (SD) MPI was 0.44 (0.05) with an ICC of 0.81. Decreasing the sweep speed resulted in decreasing average MPI values (0.43) and decreasing ICC (0.61). Lowering gain also influenced average MPI values (0.46) and ICC (0.76). Raising gain resulted in similar MPI values (0.45) with better ICC (0.90) compared with baseline settings. Raising wall motion filter (WMF) provided the best ICC (0.94) compared with the other settings. Changing the ultrasound equipment resulted in an ICC of 0.64. The optimal settings to achieve the highest reproducibility in measurement of MPI were sweep speed 8, gain 60 dB and WMF 281 Hz for Siemens Antares and sweep speed 5, gain -10 dB and WMF 210 Hz for Voluson 730 Expert. CONCLUSION Changing ultrasound settings or equipment may affect the calculation and repeatability of measurement of MPI values. Strict standardization of methods decreases the variability of this parameter for fetal cardiac function assessment.
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Affiliation(s)
- S M Lobmaier
- BCNatal-Barcelona Center for Maternal-Fetal and Neonatal Medicine (Hospital Clínic and Hospital Sant Joan de Deu), IDIBAPS, University of Barcelona, and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain; Frauenklinik und Poliklinik, Technische Universität München, Munich, Germany
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Ortiz JU, Martinez JM, Masoller N, Eixarch E, Crispi F, Lobmaier SM, Bennasar M, Gómez O, Gratacós E. Perinatales Outcome von Akzeptor-Zwillingen mit Obstruktion des rechten Ausflusstraktes nach Lasertherapie. Z Geburtshilfe Neonatol 2013. [DOI: 10.1055/s-0033-1361355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Borrell A, Grande M, Bennasar M, Borobio V, Jimenez JM, Stergiotou I, Martinez JM, Cuckle H. First-trimester detection of major cardiac defects with the use of ductus venosus blood flow. Ultrasound Obstet Gynecol 2013; 42:51-57. [PMID: 23152003 DOI: 10.1002/uog.12349] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 02/27/2013] [Accepted: 10/31/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To assess the best method of combining fetal nuchal translucency (NT) and ductus venosus (DV) blood flow measurements in the detection of major cardiac defects in chromosomally normal fetuses during the first-trimester scan. METHODS During an 8-year period NT and DV blood flow were routinely assessed at 11-14 weeks' gestation. Only chromosomally normal singleton pregnancies were included in the study. When a cardiac defect was suspected, or when increased fetal NT and/or absent or reversed (AR) A-wave in the DV was observed, early fetal echocardiography was offered. Data on routine second- and third-trimester scans, neonatal follow-up or postmortem examination were obtained from hospital records. The detection and false-positive rates for all major cardiac defects were calculated for several screening strategies, including: NT or DV pulsatility index for veins (DV-PIV) above a fixed normal centile; AR A-wave; risk based on NT and DV-PIV or A-wave velocity above a fixed normal centile; and combinations of these strategies. RESULTS The study population included 37 chromosomally normal fetuses with a major cardiac defect and 12 799 unaffected pregnancies. Fetal NT above the 95(th) or the 99(th) centile and AR A-wave was observed in 40, 27 and 39% of the fetuses with major cardiac defects, respectively. A 47% detection rate with a 2.7% false-positive rate was obtained when AR A-wave or NT above the 99(th) centile was used as the selection criterion. CONCLUSIONS Half of major fetal cardiac defects could be detected in the first trimester if NT and DV Doppler are used to select 2.7% of the general pregnant population for extended fetal echocardiography.
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Affiliation(s)
- A Borrell
- Department of Maternal-Fetal Medicine, Institute of Gynecology, Obstetrics and Neonatology, Hospital Clínic Barcelona, Catalonia, Spain.
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Cruz-Martinez R, Castañon M, Moreno-Alvarez O, Acosta-Rojas R, Martinez JM, Gratacos E. Usefulness of lung-to-head ratio and intrapulmonary arterial Doppler in predicting neonatal morbidity in fetuses with congenital diaphragmatic hernia treated with fetoscopic tracheal occlusion. Ultrasound Obstet Gynecol 2013; 41:59-65. [PMID: 22689226 DOI: 10.1002/uog.11212] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/18/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To explore the potential value of intrapulmonary artery Doppler velocimetry in predicting neonatal morbidity in fetuses with left-sided congenital diaphragmatic hernia (CDH) treated with fetoscopic tracheal occlusion (FETO). METHODS Observed/expected lung-to-head ratio (O/E-LHR), and intrapulmonary Doppler pulsatility index and peak early-diastolic reversed flow were evaluated within 24 h before FETO in a consecutive cohort of 51 fetuses with left-sided CDH at between 24 and 33 weeks' gestation. Lung Doppler parameters were converted into Z-scores and defined as abnormal if the pulsatility index had a Z-score of > 1.0 or the peak early-diastolic reversed flow had a Z-score of > 3.5. The association of O/E-LHR and Doppler velocimetry with neonatal outcome was assessed using multiple linear or logistic regression analysis adjusted for gestational age at birth. RESULTS Among the 26 fetuses that survived, 18 (69.2%) had normal and eight (30.8%) had abnormal Doppler values. O/E-LHR was not associated with neonatal morbidity in surviving fetuses. Compared with the group with normal Doppler parameters, cases with abnormal intrapulmonary Doppler were associated with a significant increase in the duration of mechanical ventilation (average increase of 21.2 (95% CI, 9.99-32.5) days; P < 0.01), conventional ventilation (15.2 (95% CI, 7.43-23.0) days; P < 0.01), high-frequency ventilation (6.34 (95% CI, 0.69-11.99) days; P < 0.05), nitric oxide therapy (5.73 (95% CI, 0.60-10.9) days; P < 0.05), oxygen support (36.5 (95% CI, 16.3-56.7) days; P < 0.01), parenteral nutrition (19.1 (95% CI, 7.53-30.7) days; P < 0.01) and stay in neonatal intensive care unit (42.7 (95% CI, 22.9-62.6) days; P < 0.001), and with significantly higher rates of high-frequency ventilation (87.5 vs. 44.4%;P < 0.05), oxygen requirement at 28 days of age (75.0 vs. 11.1%; P < 0.01), gastroesophageal reflux (62.5 vs. 22.2%; P < 0.05) and tube feeding at discharge (37.5 vs. 5.56%; P < 0.05). CONCLUSION As previously reported, O/E-LHR did not predict neonatal morbidity. In contrast, intrapulmonary artery Doppler evaluation was predictive of neonatal morbidity in CDH fetuses treated with FETO.
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Affiliation(s)
- R Cruz-Martinez
- Department of Maternal-Fetal Medicine, Institute Clínic of Gynecology, Obstetrics and Neonatology, Hospital Clinic-IDIBAPS, University of Barcelona and Centre for Biomedical Research on Rare Diseases, Barcelona, Spain
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Shirodkar SP, Gorin MA, Sageshima J, Bird VG, Martinez JM, Zarak A, Guerra G, Chen L, Burke GW, Ciancio G. Technical modification for laparoscopic donor nephrectomy to minimize testicular pain: a complication with significant morbidity. Am J Transplant 2011; 11:1031-4. [PMID: 21521470 DOI: 10.1111/j.1600-6143.2011.03495.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The laparoscopic approach to donor nephrectomy is becoming increasingly common. While it is felt that the recovery from laparoscopic nephrectomy is quicker and less painful, a number of complications have been reported. A rarely reported on complication in the literature with significant morbidity is ipsilateral orchalgia. From 1998 to 2008, 257 hand-assisted laparoscopic donor nephrectomies were performed at our institution. Eight of 129 (6.2%) men complained of de novo ipsilateral orchalgia postoperatively. The average duration of pain was 402 days. Patients reported significant morbidity related to this complication. None, however, required further treatment. Three patients reported that they would reconsider organ donation as a result of testicular pain. Our technique originally included dissection and ligation of the gonadal vein en bloc with the ureter at the level of the left common iliac artery. Since recognizing this complication, we have adopted a gonadal vein sparing approach so as not to disturb the vessel below its point of ligation at the renal vein. To date, 50 patients have undergone the modified technique without experiencing orchalgia. In conclusion, ipsilateral testicular pan is a relatively frequent complication of laparoscopic donor nephrectomy and may be a source of significant morbidity. Using a modified surgical technique, this complication can be reduced or eradicated.
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Affiliation(s)
- S P Shirodkar
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
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Cruz-Martinez R, Van Mieghem T, Lewi L, Eixarch E, Cobo T, Martinez JM, Deprest J, Gratacos E. Incidence and clinical implications of early inadvertent septostomy after laser therapy for twin-twin transfusion syndrome. Ultrasound Obstet Gynecol 2011; 37:458-462. [PMID: 21433166 DOI: 10.1002/uog.8922] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/16/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To evaluate the incidence and clinical outcome of inadvertent septostomy after fetoscopic laser therapy for twin-twin transfusion syndrome (TTTS) and, particularly, to explore its association with the risk of developing pseudoamniotic band syndrome (PABS). METHODS In a cohort of 414 consecutive monochorionic twin pregnancies with confirmed TTTS treated with laser, the incidence of postoperative septostomy within 1 week of the procedure was recorded prospectively. Rates of preterm delivery, preterm premature rupture of membranes (PPROM), intrauterine fetal demise (IUFD) and PABS were compared among cases with and without septostomy. RESULTS The mean gestational age at laser therapy was 20.4 (range, 15.3-27.6) weeks. Postoperative septostomy occurred in 30 (7.2%) cases. Pregnancies complicated with septostomy had a significantly higher proportion of preterm delivery before 32 weeks (76.7% vs. 30.2%, P < 0.001), PPROM before 32 weeks (46.7% vs. 19.0%, P < 0.001), IUFD (43.3% vs. 25.8%, P < 0.05) and PABS (13.3% vs. 1.0%, P < 0.001), compared with pregnancies without septostomy. CONCLUSIONS Inadvertent septostomy occurred in 7% of cases after fetoscopic laser therapy and was associated with a substantially increased risk of adverse perinatal outcome and PABS.
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Affiliation(s)
- R Cruz-Martinez
- Department of Maternal-Fetal Medicine, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
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Déjardin JL, Martinez JM. Nonlinear response of the electric birefringence of polyelectrolyte solutions. J Phys Condens Matter 2010; 22:494103. [PMID: 21406769 DOI: 10.1088/0953-8984/22/49/494103] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A theoretical approach for the nonlinear ac electro-optical response in polyelectrolytes is developed in the case where a weak ac electric field superimposed on a strong dc bias electric field is applied to these electrically charged systems. By restricting ourselves to an assembly of noninteracting and nonpolar rodlike macroions, we use a perturbation procedure and establish expressions for the first two harmonic components of the electric birefringence up to the second order in the electric field strength. An attempt is also made to extend this theory to the (non-Markovian) subdiffusive regime based on a fractional kinetic equation written in a configuration space where angular and linear displacements are taken into account. The results obtained are illustrated by three-dimensional dispersion and absorption plots together with Cole-Cole-like diagrams to show the importance of the coupling effect between translation and rotation. Besides considering the stationary ac response, we have also derived, in the context of subdiffusion, new expressions for the transient electric birefringence in the presence of a constant electric field, both for the buildup and the reversing pulse. All these results are illustrated by plots demonstrating the effect of the coupling (rotation-translation) parameter a and the critical exponent α (subdiffusion). A comparison of our theoretical model with experimental measurements of the ac Kerr effect response of a polyelectrolyte solution of NaCMC appears to be quite satisfactory.
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Affiliation(s)
- J L Déjardin
- Laboratoire de Mathématiques, Physique et Systèmes, Université de Perpignan Via Domitia, 52 Avenue Paul Alduy, 66860 Perpignan Cedex, France
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Sanz-Cortes M, Martinez JM, Bennasar M, Puerto B, Gratacos E. Prenatal diagnosis of tuberous sclerosis and analysis using magnetic resonance spectroscopy. Ultrasound Obstet Gynecol 2010; 36:522-524. [PMID: 20499404 DOI: 10.1002/uog.7655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Cruz-Martinez R, Figueras F, Moreno-Alvarez O, Martinez JM, Gomez O, Hernandez-Andrade E, Gratacos E. Learning curve for lung area to head circumference ratio measurement in fetuses with congenital diaphragmatic hernia. Ultrasound Obstet Gynecol 2010; 36:32-36. [PMID: 20131334 DOI: 10.1002/uog.7577] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To assess the learning curve for the fetal lung area to head circumference ratio (LHR) calculation in fetuses with congenital diaphragmatic hernia (CDH). METHODS Three trainees with the theoretical knowledge, but without prior experience in the LHR measurement, were selected. Each trainee and one experienced examiner measured the observed to expected (O/E)-LHR in the lung contralateral to the side of the hernia by two methods-manual tracing of lung borders and multiplication of the longest diameters-in a cohort of 95 consecutive CDH fetuses. The average difference between the three trainees and the expert in the O/E-LHR measurement was calculated. A difference below 10% was considered to indicate an accurate measurement. The average learning curve was delineated using cumulative sum analysis (CUSUM). RESULTS The CUSUM plots demonstrate that the learning curve was achieved by 77 and 72 tests performed for the area obtained by the manual-tracing and multiplication-of-the-longest-diameter methods, respectively. CONCLUSION The minimum number of scans required for an inexperienced trainee to become competent in examining the LHR is on average 70.
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Affiliation(s)
- R Cruz-Martinez
- Fetal and Perinatal Medicine Research Group, Department of Maternal-Fetal Medicine, Hospital Clinic-IDIBAPS, University of Barcelona and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
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Cruz-Martinez R, Moreno-Alvarez O, Hernandez-Andrade E, Castañon M, Done E, Martinez JM, Puerto B, Deprest J, Gratacos E. Contribution of intrapulmonary artery Doppler to improve prediction of survival in fetuses with congenital diaphragmatic hernia treated with fetal endoscopic tracheal occlusion. Ultrasound Obstet Gynecol 2010; 35:572-577. [PMID: 20178111 DOI: 10.1002/uog.7593] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To evaluate the contribution of intrapulmonary artery Doppler in predicting the survival of fetuses with congenital diaphragmatic hernia (CDH) treated with fetoscopic tracheal occlusion (FETO). METHODS A cohort of 41 fetuses (between 24 and 28 weeks of gestation) with CDH was treated with FETO. The observed/expected lung-to-head ratio (O/E-LHR), pulmonary artery pulsatility index (PI), peak early diastolic reversed flow (PEDRF) and peak systolic velocity (PSV) were evaluated before FETO, and their isolated and combined value to predict survival using multiple logistic regression and decision-tree analysis was assessed. RESULTS O/E-LHR and intrapulmonary artery PI and PEDRF were significantly associated with the probability of survival (O/E-LHR > or = 26%, OR 14.2; PI < 1 Z-score, OR 8.4; and PEDRF < 3.5 Z-scores, OR 5.7). Decision-tree analysis showed that O/E-LHR was the best initial predictor of prognosis (O/E-LHR > or = 26%, 90% survival; O/E-LHR < 26%, 45% survival). For fetuses with an O/E-LHR of < 26%, Doppler parameters allowed discrimination of cases with moderate (66-71% survival) and very poor (0% survival) prognosis. CONCLUSION Intrapulmonary artery Doppler evaluation helps to refine the prediction of survival after FETO in fetuses with severe CDH.
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Affiliation(s)
- R Cruz-Martinez
- Department of Maternal-Fetal Medicine, Institute Clínic of Gynecology, Obstetrics and Neonatology, Hospital Clinic-IDIBAPS, University of Barcelona and Centre for Biomedical Research on Rare Diseases (CIBER-ER), Barcelona, Spain
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Figueras F, Benavides A, Del Rio M, Crispi F, Eixarch E, Martinez JM, Hernandez-Andrade E, Gratacós E. Monitoring of fetuses with intrauterine growth restriction: longitudinal changes in ductus venosus and aortic isthmus flow. Ultrasound Obstet Gynecol 2009; 33:39-43. [PMID: 19115231 DOI: 10.1002/uog.6278] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVES To explore in growth-restricted fetuses the sequence of changes in aortic isthmus and ductus venosus blood flow in relation to other arterial Doppler parameters commonly used to evaluate fetal wellbeing. METHODS Umbilical and middle cerebral arteries, ductus venosus and aortic isthmus were explored serially by means of pulsed Doppler in a cohort of singleton small-for-gestational age fetuses requiring delivery before 34 weeks. Longitudinal changes in the last 30 days before delivery were modeled by multilevel analysis. Individual regression lines for each variable were calculated for each fetus and from these the regression lines for the whole group were derived, in order to estimate the mean time point at which each Doppler parameter became abnormal (outside the 5th-95th centile range). A survival analysis was performed during the monitoring period, in which the endpoint was an abnormal Doppler pulsatility index. RESULTS A total of 162 observations were performed on 46 fetuses (median, 3; range, 2-10). The median gestational age at inclusion was 28.9 (range, 23.6-33.4) weeks and delivery occurred at a median gestational age of 30.5 (range, 25.9-33.9) weeks. Six (13%) cases of perinatal mortality occurred. Umbilical and middle cerebral artery Doppler showed an almost linear deterioration throughout monitoring, becoming abnormal on average 24 days and 20 days before delivery, respectively. Aortic isthmus Doppler became abnormal on average 13 days before delivery, while ductus venosus Doppler did so within the last week before delivery. CONCLUSIONS In preterm growth-restricted fetuses, aortic isthmus blood flow becomes abnormal on average 1 week earlier than does that in the ductus venosus. This could provide a sound basis to better define management protocols aimed to improve intact fetal survival.
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Affiliation(s)
- F Figueras
- Maternal-Fetal Medicine Department, Hospital Clinic, University of Barcelona, Barcelona, Spain.
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Gratacós E, Lewi L, Muñoz B, Acosta-Rojas R, Hernandez-Andrade E, Martinez JM, Carreras E, Deprest J. A classification system for selective intrauterine growth restriction in monochorionic pregnancies according to umbilical artery Doppler flow in the smaller twin. Ultrasound Obstet Gynecol 2007; 30:28-34. [PMID: 17542039 DOI: 10.1002/uog.4046] [Citation(s) in RCA: 261] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
OBJECTIVES To evaluate a classification of selective intrauterine growth restriction (sIUGR) in monochorionic (MC) twins based on the characteristics of umbilical artery (UA) Doppler flow in the smaller twin, in terms of association with clinical outcome and with the pattern of placental anastomoses. METHODS One hundred and thirty-four MC twins diagnosed with sIUGR at 18-26 weeks were classified as Type I (UA Doppler with positive diastolic flow, n = 39), Type II (persistent absent or reversed end-diastolic flow, n = 30) and Type III (intermittent absent or reversed end-diastolic flow, n = 65). Perinatal outcome, placental sharing and the pattern of anastomoses were compared with those in 76 uncomplicated MC twins. RESULTS Mean gestational age at delivery was 35.5 (range, 30-38) weeks in controls, 35.4 (range, 16-38) weeks in Type I, 30.7 (range, 27-40) weeks in Type II (P < 0.0001) and 31.6 (range, 23-39) weeks in Type III (P < 0.0001) pregnancies. Fetal weight discordance was significantly higher in Type II (38%) and Type III (36%) than in Type I (29%) (P < 0.0001) pregnancies. Deterioration of the growth-restricted fetus occurred in 90% of Type II cases, compared with 0% and 10.8% of Types I and III, respectively (P < 0.001). Unexpected intrauterine fetal death of the smaller twin occurred in 15.4% of Type III cases, compared with 2.6% and 0% of Types I and II respectively (P < 0.05). Parenchymal brain lesions in the larger twin were observed in 19.7% of Type III cases and less than 5% in the other groups (P < 0.05). Placental discordance (larger/smaller) was 1.3 in controls, compared with 1.8, 2.6 and 4.4 in Types I, II and III, respectively (P < 0.01). The proportion of cases with arterioarterial anastomoses > 2 mm in diameter was 55% in controls, 70% in Type I, 18% in Type II (P < 0.01) and 98% in Type III (P < 0.01). CONCLUSION sIUGR can be classified on the basis of umbilical artery Doppler into three types that correlate with different clinical behavior and different patterns of placental anastomoses. This classification may be of help in clinical decision-making and when comparing clinical studies.
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Affiliation(s)
- E Gratacós
- Fetal Medicine Unit and Department of Obstetrics, Hospital Clínic-IDIBAPS, University of Barcelona, Barcelona, Spain.
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Figueras F, Fernandez S, Eixarch E, Gomez O, Martinez JM, Puerto B, Gratacos E. Middle cerebral artery pulsatility index: reliability at different sampling sites. Ultrasound Obstet Gynecol 2006; 28:809-13. [PMID: 17019746 DOI: 10.1002/uog.2816] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
OBJECTIVES To analyze the interobserver reliability of measurement of the middle cerebral artery (MCA) pulsatility index (PI) at two different sampling sites. METHODS This study included 100 consecutive singleton pregnancies between 24 and 40 weeks with normal fetal growth. The PI was calculated by two independent operators at proximal and distal sampling sites of the near-field MCA. Reliability analyses were performed between observers at each sampling site by means of the intraclass correlation coefficient (ICC) for agreement. Differences between observers were explored and agreement limits calculated by means of the Bland-Altman test. RESULTS Satisfactory flow velocity waveforms were obtained successfully in each fetus at both sampling sites. Peak systolic, end-diastolic and time-averaged maximum velocities were significantly higher at the proximal compared with the distal sampling site. Conversely, PI was significantly higher at the distal compared with the proximal site. ICCs for PI were 0.3 and 0.33 at the proximal and the distal sampling sites, respectively. The 95% interval of the PI differences between observers were +0.91 and -1.14 at the proximal and +1.03 and -1.08 at the distal sampling sites. In about 30% of the cases the PI difference between observers was greater than 0.5 at both sampling sites. CONCLUSIONS Moderate interobserver reliability in the measurement of end-diastolic and time-averaged maximum MCA flow velocities results in limited agreement of the PI calculation at both proximal and distal sampling sites. These results may preclude its clinical applicability.
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Affiliation(s)
- F Figueras
- Obstetric Department, Hospital Clinic, Universitat de Barcelona, IDIBAPS, Barcelona, Spain.
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Clèries R, Ribes J, Esteban L, Martinez JM, Borràs JM. Time trends of breast cancer mortality in Spain during the period 1977-2001 and Bayesian approach for projections during 2002-2016. Ann Oncol 2006; 17:1783-91. [PMID: 16971661 DOI: 10.1093/annonc/mdl303] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In recent decades, changes in breast cancer (BC) mortality trends have been observed across Europe. Our objective is to describe BC mortality trend in Spain during 1977-2001 and to estimate BC mortality projection in the period 2002-2016 using a Bayesian approach. MATERIAL AND METHODS An age-period-cohort (APC) analysis has been carried out in order to investigate the effect of the age, period and birth cohort on BC mortality in Spain during 1977-2001 and to estimate future trends for the period 2002-2016. A Bayesian APC model with an autoregressive structure for the age parameters has been used for projections of BC mortality. RESULTS BC mortality rates increased 2.18% per year during 1977-1991 followed by a significant fall after 1992 (estimated annual percent change = -2.67%; 95% confidence interval = -2.97, -2.31). Cohorts born before 1952 showed higher risk of death from BC than those born after this year. Projections showed an increase of mortality among women older than 50 years in the period 2002-2016 (range of increase = 10%-40%). CONCLUSIONS The decrease of BC mortality since 1992 could be attributable to BC down-staging due to early detection and effectiveness of cancer treatment. The effect of ageing on the female population, immigration and the increase of BC incidence observed in Spain could explain the increase in BC mortality predicted for the years to come among women older than 50 years. BC screening to the whole Spanish population and new treatments introduced in the last few years could modify the predictions of BC mortality. Future forecasting studies should be carried out considering these new factors in the natural history of BC in Spain.
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Affiliation(s)
- R Clèries
- Servei d'Epidemiologia i Registre del Càncer de l'Institut Català d'Oncologia-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
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Estrada-Peña A, Martinez JM, Sanchez Acedo C, Quilez J, Del Cacho E. Phenology of the tick, Ixodes ricinus, in its southern distribution range (central Spain). Med Vet Entomol 2004; 18:387-397. [PMID: 15642006 DOI: 10.1111/j.0269-283x.2004.00523.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
The abundance, seasonal activity patterns and development rates of the tick Ixodes ricinus (L.) (Acari: Ixodidae), as well as microclimate features of the site of study, are described for a 9-year-long study (1994-2002) in north-central Spain. According to drag captures, larvae had a unimodal activity pattern, with a maximum observed around July-August, whereas nymphs displayed a bimodal pattern (May-June and August-September) with strong dominance of spring activity. An inversion of this pattern, with larger autumn peak, was observed in years with humid summers. Adults showed a small spring peak and a large autumn one. In the later years of the study, a small increase in the adult spring peak of activity was noticed, correlated with mild winters. Over the entire period of study, a clear increase in the total tick abundance was detected. Statistically significant differences between years were observed for some climate variables (saturation deficit, winter temperatures and number of days with temperatures above 6 degrees C), but a consistent and constant pattern of change was not observed in any climate variable. Temperature requirements for developing stages showed a sharp decrease in weeks 35-51 (eggs) and 38-50 (larvae and nymphs), a feature attributed to the presence of the morphogenetic diapause, beginning around September. Development rates obtained under quasi-natural conditions were almost twice those reported for other sites, suggesting an adaptation of this local, largely isolated I. ricinus population. According to drag captures and field-obtained development rates, interchange of nymphs between the two cohorts is common in this site, and seems to be influenced by the winter temperature and the date of larval engorgement.
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Affiliation(s)
- A Estrada-Peña
- Department of Parasitology, Veterinary Faculty, Zaragoza, Spain.
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Martinez JM, Wagner KE, Snider RH, Nylen ES, Muller B, Sarani B, Becker KL, White JC. Late immunoneutralization of procalcitonin arrests the progression of lethal porcine sepsis. Surg Infect (Larchmt) 2003; 2:193-202; discussion 202-3. [PMID: 12593709 DOI: 10.1089/109629601317202678] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Procalcitonin (ProCT) is becoming increasingly recognized as a mediator as well as a marker of sepsis. Serum ProCT concentrations rise soon after induction of sepsis and remain elevated over a prolonged period of time. In contrast, many pro-inflammatory cytokines, e.g., tumor necrosis factor alpha (TNF-alpha) and interleukin-1 beta (IL-1beta), rise and decline early in the course of sepsis. Researchers have improved survival in animal models of sepsis by prophylactically blocking IL-1beta and TNF-alpha with immunotherapy, but therapeutic treatment has been less successful in clinical trials. We hypothesized that the sustained elevation of ProCT in the serum would allow for effective therapeutic immunoneutralization of this peptide late in the course of sepsis. METHODS Lethal polymicrobial sepsis was induced in 10 castrated, male Yorkshire pigs by intraabdominal spillage of cecal contents (1 gm/kg) and intraabdominal instillation of 2 x 10(11) cfu of a toxigenic strain of E. coli (O18:K1:H7). The treated group (n = 5) received an intravenous infusion of purified rabbit antiserum to the aminoterminus of porcine ProCT. The control group (n = 5) received nonreactive, purified rabbit IgG. The purified antiserum was infused to all animals 3 h after the induction of sepsis, at which time very severe physiologic dysfunction was manifest, and many of the animals appeared to be preterminal. Physiologic and metabolic parameters were measured until death or for 15 h after induction of sepsis, at which time all surviving animals were euthanized. RESULTS Therapeutic immunoneutralization of serum ProCT improved most measured physiologic and metabolic parameters in septic pigs. Specifically, there was a significant increase in mean arterial pressure, urine output and cardiac index in all animals treated with ProCT antibody. Serum creatinine was significantly lower in treated animals. Although acidosis was not as severe in treated animals, as indicated by higher pH values and lower lactate concentrations, these results did not achieve statistical significance. Significantly, 11 h after the induction of sepsis there was 100% mortality in the control group while only one animal in the treated group expired. CONCLUSION The prolonged elevation of ProCT concentrations in sepsis allows neutralization of this peptide to be effective during the course of this disorder. These findings suggest that immunoneutralization of ProCT may be a useful treatment in clinical situations where sepsis is already fully established.
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Affiliation(s)
- J M Martinez
- Department of Surgery, George Washington University, Washington, DC, USA.
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Abstract
Estrogen receptor levels were determined in capacitated and noncapacitated sperm cells of normospermic men by the charcoal dextran method. The estrogen receptor of the nuclear matrix was released using hypertonic solutions. The distribution of the estrogen receptor was higher by 30% in capacitated spermatozoa as related to noncapacitated spermatozoa. The values of estrogen receptors in capacitated and noncapacitated spermatozoa were 91 +/- 21 fmol/10(8) sperm cells and 26 +/- 7 fmol/10(8) sperm cells, respectively. The association of estrogen receptor-nuclear matrix may be an important factor in the regulation of the transcription of the sperm genome of capacitated spermatozoa during the pronuclei stage.
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Affiliation(s)
- L Calzada
- Unidad de Investigación Médica en Biología Reproductiva, Subjefatura de Investigación Biomédica, Instituto Mexicano del Seguro Social, D.F., México.
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Martinez JM, Kent JM, Coplan JD, Browne ST, Papp LA, Sullivan GM, Kleber M, Perepletchikova F, Fyer AJ, Klein DF, Gorman JM. Respiratory variability in panic disorder. Depress Anxiety 2002; 14:232-7. [PMID: 11754131 DOI: 10.1002/da.1072] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Disordered breathing may play an important role in the pathophysiology of panic disorder. Several studies have now indicated that panic disorder patients have greater respiratory variability than normal controls. In this study, we examine baseline respiratory measures in four diagnostic groups to determine whether greater respiratory variability is specific to panic disorder and whether effective anti-panic treatment alters respiratory variability. Patients with panic disorder, major depression, or premenstrual dysphoric disorder, and normal control subjects underwent two respiratory exposures (5% and 7% CO(2) inhalation), while in a canopy system. Panic disorder patients returned after 12 weeks of either anti-panic medication or cognitive behavioral therapy, and were retested. Normal control subjects were also retested after a period of 12 weeks. Panic disorder patients had significantly greater respiratory variability at baseline than normal control subjects and patients with major depression. The premenstrual dysphoric patients also had greater variability than the normal control group. Panic disorder patients who panicked to 7% CO(2) inhalation had significantly greater baseline variability than panic disorder patients who did not panic. Anti-panic treatment did not significantly alter baseline respiratory variability. Our data suggest that increased respiratory variability may be an important trait feature for some panic disorder patients and may make them more vulnerable to CO(2)-induced panic.
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Affiliation(s)
- J M Martinez
- Department of Psychiatry, Columbia University, New York, New York 10032, USA.
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Abstract
Estrogen receptor (ER) and progesterone receptor (PgR) levels were determined in patients with a ductal infiltrating breast carcinoma. In premenopausal patients, the distribution of the PgR was higher than that of the ER. With increasing age of the patients, the concentration of the ER increased, whereas the PgR values showed an inverse relationship. According to the menstrual status, ER and PgR values were found to be higher in postmenopausal patients than in premenopausal ones. In relation to body fat distribution, in premenopausal patients the ER or PgR values were not found to be statistically significantly different (data no shown). In postmenopausal patients, the concentration of ER was diminished by 20% in patients with obesity of the upper body segment and by 40% in patients with obesity of the lower body segment as compared with the ER values of nonobese patients. While the PgR values diminished by 20% in patients with obesity of the lower body segment, in relation to PgR values of patients with obesity of the upper body segment, we found no statistically significant differences when compared with the PgR values of nonobese patients. With regard to the body mass index, this has remained constant in both types of body fat distribution. When body mass index values were compared with serum ER and PgR levels, no statistically significant differences were found.
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Affiliation(s)
- L Calzada
- Unidad de Investigación Médica en Biología Reproductiva, Subjefatura de Investigación Biomédica, Instituto Mexicano del Seguro Social, México D.F., México.
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Goetz RR, Klein DF, Papp LA, Martinez JM, Gorman JM. Acute panic inventory symptoms during CO(2) inhalation and room-air hyperventilation among panic disorder patients and normal controls. Depress Anxiety 2002; 14:123-36. [PMID: 11668665 DOI: 10.1002/da.1054] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
There is scant literature on anxiety symptoms induced during respiratory challenges developed to induce panic symptoms and attacks. Here we report on the prevalence of Acute Panic Inventory (API) symptoms during three consecutive respiratory challenges to patients with panic disorder (PD) and normal controls (NC). The challenges performed using a closed canopy system included voluntary room air hyperventilation (RAH), inhalation of 5% CO(2), and 7% CO(2)-enriched air. The PD patients were 41 men and 53 women whose mean age was 33.4 (SD = 8.55). The normal comparison group consisted of 35 men and 27 women with a mean age of 31.3 (SD = 9.21). The diagnosis of panic disorder was made using the Structured Clinical Interview for DSM-III-R. All potential normal controls underwent structured clinical interview using the Schedule for Affective Disorders and Schizophrenia-Lifetime Version Modified for the Study of Anxiety Disorders (SADS-LA), and must have been free of a lifetime history of anxiety disorders, affective disorders, substance use disorders, and schizophrenia. All participants also had a complete medical evaluation and were in good health. The experiment consisted of seven experimental epochs: three baseline/recovery periods each followed by a respiratory challenge, and then a final recovery epoch. The API was administered at the end of each epoch. Clinical staff trained and experienced in rating panic attacks rated participants' response during each challenge as panic or no panic. Three groups were defined for analysis: PD patients who panicked, PD patients who did not panic, and NC who did not panic. Staff ratings indicated that the 7% CO(2) challenge was the most panicogenic, followed by the 5% CO(2), and the RAH challenges. Conventional statistics (analysis of variance and partial correlations) indicated that many baseline symptoms as well as symptom increments differed across groups, and were associated with the outcome of panic/no panic during each challenge. However, logistic regression analysis indicated that only a few symptoms independently predicted the panic/no panic outcome because many symptoms were redundant. The symptom cluster of fear in general, dizziness, difficulties with concentrating, and doing one's job predicted panic to RAH. The cluster of fear in general, confusion, dyspnea, and twitching/trembling predicted the response to 5% CO(2). Finally, fear in general, confusion, twitching/ trembling and dizziness predicted the response to 7% CO(2). While univariate analyses indicated that many symptoms distinguished between panic and no panic outcome, logistic regression revealed that group differences were subsumed under a few prominent symptoms, namely, fear in general, confusion, dizziness, twitching/trembling, and dyspnea. The results are discussed in the context of patient (having a diagnosis of PD) and panic effects (rated as panicking to a challenge).
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Affiliation(s)
- R R Goetz
- Department of Clinical Psychobiology, New York State Psychiatric Institute, New York, New York 10032, USA
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Calzada L, Torres-Calleja J, Martinez JM, Pedrón N. Measurement of androgen and estrogen receptors in breast tissue from subjects with anabolic steroid-dependent gynecomastia. Life Sci 2001; 69:1465-9. [PMID: 11554608 DOI: 10.1016/s0024-3205(01)01227-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In order to assess the relationship between anabolic steroid administration and gynecomastia, we studied the effects produced by administering nandrolone decanoate and a mixture of propionate, phenilpropionate, isocaproate and testosterone decanoate to bodybuilders during a six month period. The following significant changes occurred: a 53% reduction in serum testosterone; LH and FSH levels were suppressed to 77% and 87%, respectively, in comparison to control values; and although 45% of the subjects showed an increase in serum estradiol levels, no statistically significant differences were found compared with control estradiol levels. With regard to estradiol and androgen receptors, 85% of gynecomastia tissue contained estradiol or androgen receptors, while 40% contained both. The mean values of estradiol and androgen receptors in the cytosol were 65 +/- 10 and 52 +/- 5 fmol/mg protein, respectively. Nuclear androgen and estradiol receptor levels were 33 +/- 7 and 67.5 +/- 9 fmol/mg protein, respectively. The presence of hormone receptors in gynecomastia receptive cells provides support for the hypothesis that gynecomastia is steroid-dependent.
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Affiliation(s)
- L Calzada
- Unidad de Investigación Médica en Medicina Reproductiva, Instituto Mexicano del Seguro Social, México DF.
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Abstract
This study analyses the variables associated with the decisions made by families of potential organ donors to give or deny consent for the extraction of organs. Different indicators were recorded in 68 cases of family interview for petition of consent carried out in 13 Spanish hospitals. Those variables showing the strongest relation with family decision (donation/refusal of consent) are knowledge shown by the family about the deceased's wishes with regard to donation (p<0.001), family relationship climate (p<0.01), expression of family's satisfaction level with medical attention received (p<0.01) and number of relatives present at the consent request interview (p<0.01). Logistic regression on family decision with considered variables correctly predicted relatives' final choice in 98.4% of cases. In turn, multivariate exploratory analysis highlights a potential association between the expression of the deceased's wishes and several concurrent variables in the process (satisfaction with personal treatment and medical attention received, emotional reactions in the interviews of notification of death and consent request). It also shows that patterns of reaction and family participation in this process may vary according to the sex of the deceased relative. Results suggest that both educational efforts devoted to promoting a positive attitude toward donation in the general population and the training of health professionals involved in the generation of organs may be key factors in reducing organ shortage.
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Affiliation(s)
- J M Martinez
- Departamento de Psicologia Social y Metodologia, Facultad de Psicologia, Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, Spain
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Borrell A, Martinez JM, Farre MT, Azulay M, Cararach V, Fortuny A. Reversed end-diastolic flow in first-trimester umbilical artery: an ominous new sign for fetal outcome. Am J Obstet Gynecol 2001; 185:204-7. [PMID: 11483929 DOI: 10.1067/mob.2001.114872] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The purpose of this study was to assess the fetal outcome of first-trimester pregnancies with reversed end-diastolic flow in the umbilical artery. STUDY DESIGN Doppler studies in the umbilical artery were carried out in 2970 consecutive pregnancies scanned at 10 to 14 weeks. RESULTS We observed 11 (0.4%) cases of reversed end-diastolic flow. Of these, an autosomal trisomy was shown in 7 and a congenital heart defect in 2 additional fetuses. Fetal demise was observed in 5 pregnancies, neonatal death was observed in 1, and termination of pregnancy was carried out in 4. Only 1 fetus survived. CONCLUSIONS Reversed end-diastolic flow in first-trimester umbilical artery signals an ominous prognosis even with normal karyotype.
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Affiliation(s)
- A Borrell
- Prenatal Diagnosis Unit, Institute of Gynecology, Obstetrics and Neonatology, Hospital Clinic, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), University of Barcelona Medical School, Villaroel 170, Barcelona 08036, Catalonia, Spain
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Kent JM, Papp LA, Martinez JM, Browne ST, Coplan JD, Klein DF, Gorman JM. Specificity of panic response to CO(2) inhalation in panic disorder: a comparison with major depression and premenstrual dysphoric disorder. Am J Psychiatry 2001; 158:58-67. [PMID: 11136634 DOI: 10.1176/appi.ajp.158.1.58] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The behavioral response to CO(2) inhalation has been used to differentiate panic disorder patients from normal subjects and other clinical populations. This study extended examination of the diagnostic specificity of CO(2)-induced anxiety by testing panic disorder patients and clinical populations with reported low and high sensitivity to CO(2) inhalation (patients with major depression and patients with premenstrual dysphoric disorder, respectively). METHOD The behavioral responses to inhalation of 5% and 7% CO(2), administered by means of a respiratory canopy, were studied in 50 patients with panic disorder, 21 with major depression, and 10 with premenstrual dysphoric disorder and in 34 normal comparison subjects. Occurrence of panic attacks was judged with DSM-IV criteria by a blind rater. Subjects were rated on three behavioral scales at baseline and after each CO(2) inhalation. RESULTS Panic disorder patients had a higher rate of CO(2)-induced panic attacks than depressed patients and normal subjects, whose panic rates were not distinguishable. The panic rate for patients with premenstrual dysphoric disorder was similar to that for panic disorder patients and higher than that for normal subjects. Subjects with CO(2)-induced panic attacks had similarly high ratings on the behavioral scales, regardless of diagnosis, including the small number of panicking normal subjects. Seven percent CO(2) was a more robust panicogen than 5%, and response to 7% CO(2 )better distinguished panic disorder patients from normal subjects than response to 5% CO(2). CONCLUSIONS Patients with panic disorder and patients with premenstrual dysphoric disorder are highly susceptible to CO(2)-induced panic attacks, and depressed patients appear to be insensitive to CO(2) inhalation. The symptoms of CO(2)-induced panic attacks have a similar intensity regardless of the subject's diagnosis.
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Affiliation(s)
- J M Kent
- Biological Studies Unit, New York State Psychiatric Institute, New York, NY 10032, USA.
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Abstract
Fifteen patients with panic disorder participated in a 12-week treatment trial with open-label nefazodone. Nefazodone was well-tolerated with minimal side effects; none of the patients reported sexual dysfunction, and only one patient experienced weight gain. Although the response rate was lower than that found with most other antipanic medications, given its favorable side effect profile, nefazodone may be a good alternative for patients apprehensive about potential adverse drug reactions.
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Affiliation(s)
- L A Papp
- Department of Clinical Psychobiology, New York State Psychiatric Institute, New York 10032,USA.
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Martinez JM, Russell JM, Hirschfeld RM. Tolerability of oral loading of divalproex sodium in the treatment of acute mania. Depress Anxiety 2000; 7:83-6. [PMID: 9614597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To conduct a pilot study on the safety and tolerability of a dosage strategy for divalproex sodium beginning with 30 mg/kg/day. It is hypothesized that loading at this level will reach therapeutic levels of valproate more quickly, which in turn will decrease the latency of the therapeutic effect. METHOD We conducted a retrospective chart review of all acutely manic patients admitted to our facility over a 12-month period. Those inpatients treated with initial divalproex sodium dosages of 30 mg/kg/day for 2 days, followed by 20 mg/kg/day thereafter, were then included in the study. The serum valproate levels and daily Brief Psychiatric Rating Scale (BPRS) scores were documented for each subject. Any adverse changes in daily vital signs, serum liver enzymes, and blood cell counts were noted as well. Nursing and physician notes were then reviewed for any observed or reported adverse effects. RESULTS Twelve acutely manic inpatients were enrolled in the study. Three subjects did not complete the treatment and are not included in this analysis. The remaining nine subjects completed the treatment, had a mean decrease in BPRS scores of 33.3%, and were discharged at least in partial remission. Six subjects had serum valproate levels drawn within 48-72 h of the initial dose, with a mean valproate level of 93.5 mcg/ml. All nine subjects tolerated the treatment reasonably well, with one subject reporting sedation, one reporting sedation and constipation, and one reporting nausea, emesis, and urinary frequency. A transient, asymptomatic decrease in white blood cell count and a low granulocyte count were also noted in one subject. CONCLUSION A divalproex dosage strategy beginning with 30 mg/kg/day for 2 days, followed by 20 mg/kg/day thereafter, was reasonably well tolerated in this group of acutely manic patients, even with the concurrent use of other psychotropic medications. Blood levels of 56 to 124 mcg/ml were observed within 3 days after initiating treatment.
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Affiliation(s)
- J M Martinez
- Department of Psychiatry, University of Texas Medical Branch, Galveston 77555, USA
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Abstract
OBJECTIVE To assess the natural evolution of nuchal thickness in trisomy 18 fetuses. METHODS Serial measurements of nuchal thickness were performed over a 1- to 5-week period in 17 fetuses with trisomy 18, from the 10th to the 20th week of pregnancy. To avoid a confounding effect due to gestational age, nuchal thickness was also expressed in standard deviations (SD) for the corresponding gestational week. In addition, the changes were assessed in terms of the presence of clinically positive thickening, considered as such when its measurement was above 2.5 SD for the corresponding gestational week. RESULTS On the initial nuchal thickness measurement, sensitivity for trisomy 18 decreased from 66% on assessment at 10-13 weeks of gestation to 38% at 14-16 weeks. In serial determinations, a mean increase of 1.3 mm [95% confidence interval (CI), 0.1-2.5] was observed for a mean period of 21 days. When corrected for gestational age, the mean increase of 0.2 SD (95% CI, -1.2 to -1.6) was found to be non-significant. No clinically relevant changes were recorded on re-examination, with nuchal thickening remaining stable in 76% of cases. CONCLUSION Nuchal thickening at re-examination was observed in a similar proportion of trisomy 18 fetuses as when initially observed.
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Affiliation(s)
- A Borrell
- Prenatal Diagnosis Unit, Department of Obstetrics and Gynecology, Hospital Clinic, IDIBAPS (Institut d'Investigacions Biomèdiques August Pi i Sunyer), University of Barcelona Medical School, Barcelona, Catalonia, Spain
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Martinez JM, Elfarissi H, De Velasco B, Ochoa GH, Miller AM, Clark YM, Matsumoto B, Robles LJ. Distribution of tubulin, kinesin, and dynein in light- and dark-adapted octopus retinas. Vis Neurosci 2000; 17:127-38. [PMID: 10750834 DOI: 10.1017/s0952523800171135] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [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: 11/06/2022]
Abstract
Cephalopod retinas exhibit several responses to light and dark adaptation, including rhabdom size changes, photopigment movements, and pigment granule migration. Light- and dark-directed rearrangements of microfilament and microtubule cytoskeletal transport pathways could drive these changes. Recently, we localized actin-binding proteins in light-/dark-adapted octopus rhabdoms and suggested that actin cytoskeletal rearrangements bring about the formation and degradation of rhabdomere microvilli subsets. To determine if the microtubule cytoskeleton and associated motor proteins control the other light/dark changes, we used immunoblotting and immunocytochemical procedures to map the distribution of tubulin, kinesin, and dynein in dorsal and ventral halves of light- and dark-adapted octopus retinas. Immunoblots detected alpha- and beta-tubulin, dynein intermediate chain, and kinesin heavy chain in extracts of whole retinas. Epifluorescence and confocal microscopy showed that the tubulin proteins were distributed throughout the retina with more immunoreactivity in retinas exposed to light. Kinesin localization was heavy in the pigment layer of light- and dark-adapted ventral retinas but was less prominent in the dorsal region. Dynein distribution also varied in dorsal and ventral retinas with more immunoreactivity in light- and dark-adapted ventral retinas and confocal microscopy emphasized the granular nature of this labeling. We suggest that light may regulate the distribution of microtubule cytoskeletal proteins in the octopus retina and that position, dorsal versus ventral, also influences the distribution of motor proteins. The microtubule cytoskeleton is most likely involved in pigment granule migration in the light and dark and with the movement of transport vesicles from the photoreceptor inner segments to the rhabdoms.
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Affiliation(s)
- J M Martinez
- Biology Department, California State University, Carson 90747, USA
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Toranzo JM, Martinez JM, Metlich MA, Hurtado JA. Ultrasonography-guided percutaneous drainage of cervicofacial infections. Dentomaxillofac Radiol 1999; 28:257. [PMID: 10455392 DOI: 10.1038/sj/dmfr/4600454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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De Velasco B, Martinez JM, Ochoa GH, Miller AM, Clark YM, Matsumoto B, Robles LJ. Identification and immunolocalization of actin cytoskeletal components in light- and dark-adapted octopus retinas. Exp Eye Res 1999; 68:725-37. [PMID: 10375436 DOI: 10.1006/exer.1999.0654] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [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: 11/22/2022]
Abstract
Photoreceptors in the octopus retina are of the rhabdomeric type, with rhabdomeres arising from the plasma membrane on opposite sides of the cylindrical outer segment. Each rhabdomere microvillus has an actin filament core, but other actin-binding proteins have not been identified. We used immunoblotting techniques to identify actin-binding proteins in octopus retinal extracts and immunofluorescence microscopy to localize the same proteins in fixed tissue. Antibodies directed against alpha-actinin and vinculin recognized single protein bands on immunoblots of octopus retinal extract with molecular weights comparable to the same proteins in other tissues. Anti-filamin identified two closely spaced bands similar in molecular weight to filamin in other species. Antibodies to the larger of the Drosophila ninaC gene products, p174, identified two bands lower in molecular weight than p174. Anti-villin localized a band that was significantly less in molecular weight than villin found in other cells. Epifluorescence and confocal microscopy were used to map the location of the same actin-binding proteins in dark- and light-adapted octopus photoreceptors and other retinal cells. Antibodies to most of the actin-binding proteins showed heavy staining of the photoreceptor proximal/supportive cell region accompanied by rhabdom membrane and rhabdom tip staining, although subtle differences were detected with individual antibodies. In dark-adapted retinas anti-alpha-actinin stained the photoreceptor proximal/supportive cell region where an extensive junctional complex joins these two cell types, but in the light, immunoreactivity extended above the junctional complex into the rhabdom bases. Most antibodies densely stained the rhabdom tips but anti-villin exhibited a striated pattern of localization at the tips. We believe that the actin-binding proteins identified in the octopus retina may play a significant role in the formation of new rhabdomere microvilli in the dark. We speculate that these proteins and actin remain associated with an avillar membrane that connects opposing sets of rhabdomeres in light-adapted retinas. Association of these cytoskeletal proteins with the avillar membrane would constitute a pool of proteins that could be recruited for rapid microvillus formation from the previously avillar region.
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Affiliation(s)
- B De Velasco
- Biology Department, California State University, Dominguez Hills, 1000 East Victoria Street, Carson, CA, 90747, USA
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Borrell A, Antolin E, Costa D, Farre MT, Martinez JM, Fortuny A. Abnormal ductus venosus blood flow in trisomy 21 fetuses during early pregnancy. Am J Obstet Gynecol 1998; 179:1612-7. [PMID: 9855606 DOI: 10.1016/s0002-9378(98)70034-1] [Citation(s) in RCA: 74] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Our purpose was to assess the ductus venosus blood flow in trisomy 21 fetuses in the first half of pregnancy and the relation of this blood flow to nuchal thickness. STUDY DESIGN The ductus venosus blood flow has been studied in 534 consecutive fetuses between 10 and 18 weeks of gestation who were undergoing prenatal invasive diagnostic procedures. Before the sampling, the velocity during atrial contraction, the pulsatility index for veins, and the ratio of systole-end-systole to diastole were established in the Doppler waveforms and eventually correlated with the fetal karyotype. RESULTS Ductus venosus waveforms were successfully obtained in 82% of the pregnancies. Eleven fetuses were found to have trisomy 21; the pulsatility index was abnormally increased (>95th percentile) in 73% (8/11), the ratio of systole-end-systole to diastole was abnormally increased in 45% (5/11), and the velocity during atrial contraction was decreased (<5th percentile) in 27% (3/11). CONCLUSIONS An abnormally increased ductus venosus pulsatility index was found in a substantial proportion of early trisomy 21 fetuses, and this was apparently independent of nuchal thickening.
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Affiliation(s)
- A Borrell
- Department of Obstetrics and Gynecology and the Genetics Service, Hospital Clinic, University of Barcelona Medical School, Barcelona, Spain
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Abstract
Reversed end-diastolic umbilical artery velocities and a reduced chorionic sac were first seen at 10 weeks in a pregnancy subsequently showing a normal male karyotype on chorionic villi. Four weeks later Doppler studies demonstrated normal umbilical artery waveforms. At 20 weeks, ultrasound examination of the fetus revealed a mild pericardic effusion, hypoplastic righ heart with hypertrophic myocardium and a single umbilical artery, suggesting pulmonary atresia. After neonatal death, pathological studies confirmed pulmonary atresia. This case suggests that reversed end-diastolic umbilical flow in the first trimester may identify a subgroup of fetuses with a lethal abnormality (heart defect, severe intra-uterine retardation, aneuploidy or others).
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Affiliation(s)
- A Borrell
- Department of Obstetrics and Gynaecology, Hospital Clinic IDIBAPS, University of Barcelona Medical School, Catalonia, Spain
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Martinez JM, Echevarría M, Borrell A, Puerto B, Ojuel J, Fortuny A. Fetal heart rate and nuchal translucency in detecting chromosomal abnormalities other than Down syndrome. Obstet Gynecol 1998; 92:68-71. [PMID: 9649096 DOI: 10.1016/s0029-7844(98)00102-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [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: 02/08/2023]
Abstract
OBJECTIVE To evaluate whether the combined use of fetal heart rate (FHR) and nuchal translucency measurements would be useful in the prediction of fetal chromosomal abnormalities at 10-13 weeks' gestation. METHODS In a prospective study, 1053 (553 reported previously) consecutive singleton pregnancies between 10 and 13 weeks' gestation underwent chorionic villus sampling at our institution. Fetal heart rate and fetal nuchal translucency thickness were measured immediately before the invasive procedure. RESULTS Thirty-five abnormal karyotypes were diagnosed, including 17 trisomy 21, seven trisomy 18, one trisomy 13, one trisomy 9, four unbalanced translocation, two Klinefelter syndrome, one Turner syndrome, one deletion of chromosome 18, and one true mosaicism. Using 95% of normal ranges as the cutoff for both measurements, the detection rate for all chromosomal anomalies was 77.1%, with a false-positive rate (1-specificity) of 7.7%, a positive predictive value of 25.7%, and a negative predictive value of 99.2%. Fetal heart rate improved the sensitivity of nuchal thickness in trisomies 21 and 18 (from 62.5% to 75%) and was particularly useful to detect other chromosomal anomalies (from 27.2% to 81.8%). CONCLUSION Our findings suggest that there is an added role of FHR in ultrasound screening of chromosomal abnormalities, specifically for those other than trisomy 21 and 18. The value of a single measurement of fetal heart rate for screening purposes needs to be confirmed by further investigation in a low-risk population.
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Affiliation(s)
- J M Martinez
- Prenatal Diagnosis Unit, Department of Obstetrics and Gynaecology, Hospital Clinic, Barcelona, Spain
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Papp LA, Sinha SS, Martinez JM, Coplan JD, Amchin J, Gorman JM. Low-dose venlafaxine treatment in panic disorder. Psychopharmacol Bull 1998; 34:207-9. [PMID: 9641002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Venlafaxine, a structurally novel antidepressant that combines mechanisms of action of both the cyclic antidepressants and SSRIs, may be effective in the treatment of panic disorder. Thirteen patients with DSM-IV panic disorder with or without agoraphobia participated in an open-label, fixed-flexible dose treatment study with venlafaxine. All patients who completed the 10-week trial exhibited statistically significant decreases in scores on anxiety symptoms as well as complete cessation of panic attacks at an effective mean daily dose of 47 mg per day. Venlafaxine was well tolerated in all completers. Venlafaxine may be an effective antipanic agent, even at lower than typical antidepressant dosages.
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Affiliation(s)
- L A Papp
- Biological Studies Unit, New York State Psychiatric Institute, College of Physicians and Surgeons, Columbia University, NY, USA
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