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McDougle M, de Araujo A, Singh A, Yang M, Braga I, Paille V, Mendez-Hernandez R, Vergara M, Woodie LN, Gour A, Sharma A, Urs N, Warren B, de Lartigue G. Separate gut-brain circuits for fat and sugar reinforcement combine to promote overeating. Cell Metab 2024; 36:393-407.e7. [PMID: 38242133 DOI: 10.1016/j.cmet.2023.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 09/25/2023] [Accepted: 12/11/2023] [Indexed: 01/21/2024]
Abstract
Food is a powerful natural reinforcer that guides feeding decisions. The vagus nerve conveys internal sensory information from the gut to the brain about nutritional value; however, the cellular and molecular basis of macronutrient-specific reward circuits is poorly understood. Here, we monitor in vivo calcium dynamics to provide direct evidence of independent vagal sensing pathways for the detection of dietary fats and sugars. Using activity-dependent genetic capture of vagal neurons activated in response to gut infusions of nutrients, we demonstrate the existence of separate gut-brain circuits for fat and sugar sensing that are necessary and sufficient for nutrient-specific reinforcement. Even when controlling for calories, combined activation of fat and sugar circuits increases nigrostriatal dopamine release and overeating compared with fat or sugar alone. This work provides new insights into the complex sensory circuitry that mediates motivated behavior and suggests that a subconscious internal drive to consume obesogenic diets (e.g., those high in both fat and sugar) may impede conscious dieting efforts.
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Affiliation(s)
- Molly McDougle
- Department of Pharmacodynamics, University of Florida, Gainesville, FL, USA; Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA; Department of Neuroscience, University of Pennsylvania, Philadelphia, PA, USA
| | - Alan de Araujo
- Department of Pharmacodynamics, University of Florida, Gainesville, FL, USA; Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA
| | - Arashdeep Singh
- Department of Pharmacodynamics, University of Florida, Gainesville, FL, USA; Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA; Monell Chemical Senses Center, Philadelphia, PA, USA; Department of Neuroscience, University of Pennsylvania, Philadelphia, PA, USA
| | - Mingxin Yang
- Department of Pharmacodynamics, University of Florida, Gainesville, FL, USA; Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA; Monell Chemical Senses Center, Philadelphia, PA, USA; Department of Neuroscience, University of Pennsylvania, Philadelphia, PA, USA
| | - Isadora Braga
- Department of Pharmacodynamics, University of Florida, Gainesville, FL, USA; Monell Chemical Senses Center, Philadelphia, PA, USA; Department of Neuroscience, University of Pennsylvania, Philadelphia, PA, USA
| | - Vincent Paille
- Monell Chemical Senses Center, Philadelphia, PA, USA; Department of Neuroscience, University of Pennsylvania, Philadelphia, PA, USA; UMR1280 Physiopathologie des adaptations nutritionnelles, INRAE, Institut des maladies de l'appareil digestif, Université de Nantes, Nantes, France
| | - Rebeca Mendez-Hernandez
- Monell Chemical Senses Center, Philadelphia, PA, USA; Department of Neuroscience, University of Pennsylvania, Philadelphia, PA, USA
| | - Macarena Vergara
- Department of Pharmacodynamics, University of Florida, Gainesville, FL, USA; Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA
| | - Lauren N Woodie
- Institute for Diabetes, Obesity and Metabolism, University of Pennsylvania, Philadelphia, PA, USA
| | - Abhishek Gour
- Department of Pharmaceutics, University of Florida, Gainesville, FL, USA
| | - Abhisheak Sharma
- Department of Pharmaceutics, University of Florida, Gainesville, FL, USA
| | - Nikhil Urs
- Department of Pharmacology, University of Florida, Gainesville, FL, USA
| | - Brandon Warren
- Department of Pharmacodynamics, University of Florida, Gainesville, FL, USA
| | - Guillaume de Lartigue
- Department of Pharmacodynamics, University of Florida, Gainesville, FL, USA; Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA; Monell Chemical Senses Center, Philadelphia, PA, USA; Department of Neuroscience, University of Pennsylvania, Philadelphia, PA, USA.
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2
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de Araujo AM, Braga I, Leme G, Singh A, McDougle M, Smith J, Vergara M, Yang M, Lin M, Khoshbouei H, Krause E, de Oliveira AG, de Lartigue G. Asymmetric control of food intake by left and right vagal sensory neurons. bioRxiv 2023:2023.05.08.539627. [PMID: 37214924 PMCID: PMC10197596 DOI: 10.1101/2023.05.08.539627] [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: 05/24/2023]
Abstract
We investigated the lateralization of gut-innervating vagal sensory neurons and their roles in feeding behavior. Using genetic, anatomical, and behavioral analyses, we discovered a subset of highly lateralized vagal sensory neurons with distinct sensory responses to intestinal stimuli. Our results demonstrated that left vagal sensory neurons (LNG) are crucial for distension-induced satiety, while right vagal sensory neurons (RNG) mediate preference for nutritive foods. Furthermore, these lateralized neurons engage different central circuits, with LNG neurons recruiting brain regions associated with energy balance and RNG neurons activating areas related to salience, memory, and reward. Altogether, our findings unveil the diverse roles of asymmetrical gut-vagal-brain circuits in feeding behavior, offering new insights for potential therapeutic interventions targeting vagal nerve stimulation in metabolic and neuropsychiatric diseases.
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Affiliation(s)
- Alan Moreira de Araujo
- Monell Chemical Sense Center, Philadelphia, PA, USA
- Dept. Neuroscience, University of Pennsylvania, Philadelphia, USA
- Dept of Pharmacodynamics, University of Florida, Gainesville, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, USA
| | - Isadora Braga
- Monell Chemical Sense Center, Philadelphia, PA, USA
- Dept. Neuroscience, University of Pennsylvania, Philadelphia, USA
- Dept of Pharmacodynamics, University of Florida, Gainesville, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, USA
| | - Gabriel Leme
- Dept of Pharmacodynamics, University of Florida, Gainesville, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, USA
| | - Arashdeep Singh
- Monell Chemical Sense Center, Philadelphia, PA, USA
- Dept. Neuroscience, University of Pennsylvania, Philadelphia, USA
- Dept of Pharmacodynamics, University of Florida, Gainesville, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, USA
| | - Molly McDougle
- Monell Chemical Sense Center, Philadelphia, PA, USA
- Dept. Neuroscience, University of Pennsylvania, Philadelphia, USA
- Dept of Pharmacodynamics, University of Florida, Gainesville, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, USA
| | - Justin Smith
- Dept of Pharmacodynamics, University of Florida, Gainesville, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, USA
| | - Macarena Vergara
- Dept of Pharmacodynamics, University of Florida, Gainesville, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, USA
| | - Mingxing Yang
- Monell Chemical Sense Center, Philadelphia, PA, USA
- Dept. Neuroscience, University of Pennsylvania, Philadelphia, USA
- Dept of Pharmacodynamics, University of Florida, Gainesville, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, USA
| | - M Lin
- Dept of Neuroscience, University of Florida, Gainesville, USA
| | - H Khoshbouei
- Dept of Neuroscience, University of Florida, Gainesville, USA
| | - Eric Krause
- Dept of Pharmacodynamics, University of Florida, Gainesville, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, USA
| | - Andre G de Oliveira
- Dept of Physiology and Biophysics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Guillaume de Lartigue
- Monell Chemical Sense Center, Philadelphia, PA, USA
- Dept. Neuroscience, University of Pennsylvania, Philadelphia, USA
- Dept of Pharmacodynamics, University of Florida, Gainesville, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, USA
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3
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McDougle M, Araujo A, Vergara M, Singh A, Yang M, Braga I, Lartigue G. Fats and Sugars Recruit Distinct Gut‐Brain Circuits To Control Food Intake And Reward. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.00r29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Alan Araujo
- PharmacodynamicsUniversity of FloridaGainesvilleFL
| | | | | | - Mingxin Yang
- PharmacodynamicsUniversity of FloridaGainesvilleFL
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4
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Vergara M. Diagnosis and treatment of hepatitis B. What contributions can prisons make? Rev Esp Sanid Penit 2021; 23:119-127. [PMID: 35411915 PMCID: PMC8802821 DOI: 10.18176/resp.00041] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 06/23/2021] [Indexed: 11/20/2022]
Abstract
Hepatitis B is a parenterally and sexually transmitted infection. Vaccination for the disease is highly effective, and its inclusion in Spain as part of a systematic and universal schedule for newborns has led to a significant decrease of incidence in the national population. However, the number of inmates born in other countries - some from endemic areas of HBV infection -, the mechanisms of transmission and lack of vaccination in third world countries mean that its prevalence in the prison population is higher than in the general population. These institutions therefore play an essential role in detecting and managing hepatitis B. In this paper, the situation of hepatitis B in prisons is reviewed and recommendations are proposed to optimize its control.
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Affiliation(s)
- M Vergara
- Hepatology Unit. Digestive Disease Service. Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT. Universitat Autònoma de Barcelona. Sabadell. Barcelona. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd). Instituto Carlos III. Madrid. Spain
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Singh A, de Araujo AM, Krieger JP, Vergara M, Ip CK, de Lartigue G. Demystifying functional role of cocaine- and amphetamine-related transcript (CART) peptide in control of energy homeostasis: A twenty-five year expedition. Peptides 2021; 140:170534. [PMID: 33757831 PMCID: PMC8369463 DOI: 10.1016/j.peptides.2021.170534] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 02/28/2021] [Accepted: 03/16/2021] [Indexed: 12/17/2022]
Abstract
Cocaine- and amphetamine-related transcript (CART) is a neuropeptide first discovered in the striatum of the rat brain. Later, the genetic sequence and function of CART peptide (CARTp) was found to be conserved among multiple mammalian species. Over the 25 years, since its discovery, CART mRNA (Cartpt) expression has been reported widely throughout the central and peripheral nervous systems underscoring its role in diverse physiological functions. Here, we review the localization and function of CARTp as it relates to energy homeostasis. We summarize the expression changes of central and peripheral Cartpt in response to metabolic states and make use of available large data sets to gain additional insights into the anatomy of the Cartpt expressing vagal neurons and their expression patterns in the gut. Furthermore, we provide an overview of the role of CARTp as an anorexigenic signal and its effect on energy expenditure and body weight control with insights from both pharmacological and transgenic animal studies. Subsequently, we discuss the role of CARTp in the pathophysiology of obesity and review important new developments towards identifying a candidate receptor for CARTp signalling. Altogether, the field of CARTp research has made rapid and substantial progress recently, and we review the case for considering CARTp as a potential therapeutic target for stemming the obesity epidemic.
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Affiliation(s)
- Arashdeep Singh
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, USA; Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA
| | - Alan Moreira de Araujo
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, USA; Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA
| | - Jean-Philippe Krieger
- Department of Metabolic Physiology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Macarena Vergara
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, USA; Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA
| | - Chi Kin Ip
- Neuroscience Division, Garvan Institute of Medical Research, Darlinghurst, Sydney, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Guillaume de Lartigue
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, USA; Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA.
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6
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Brierley DI, Holt MK, Singh A, de Araujo A, McDougle M, Vergara M, Afaghani MH, Lee SJ, Scott K, Maske C, Langhans W, Krause E, de Kloet A, Gribble FM, Reimann F, Rinaman L, de Lartigue G, Trapp S. Central and peripheral GLP-1 systems independently suppress eating. Nat Metab 2021; 3:258-273. [PMID: 33589843 PMCID: PMC7116821 DOI: 10.1038/s42255-021-00344-4] [Citation(s) in RCA: 90] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 01/13/2021] [Indexed: 01/31/2023]
Abstract
The anorexigenic peptide glucagon-like peptide-1 (GLP-1) is secreted from gut enteroendocrine cells and brain preproglucagon (PPG) neurons, which, respectively, define the peripheral and central GLP-1 systems. PPG neurons in the nucleus tractus solitarii (NTS) are widely assumed to link the peripheral and central GLP-1 systems in a unified gut-brain satiation circuit. However, direct evidence for this hypothesis is lacking, and the necessary circuitry remains to be demonstrated. Here we show that PPGNTS neurons encode satiation in mice, consistent with vagal signalling of gastrointestinal distension. However, PPGNTS neurons predominantly receive vagal input from oxytocin-receptor-expressing vagal neurons, rather than those expressing GLP-1 receptors. PPGNTS neurons are not necessary for eating suppression by GLP-1 receptor agonists, and concurrent PPGNTS neuron activation suppresses eating more potently than semaglutide alone. We conclude that central and peripheral GLP-1 systems suppress eating via independent gut-brain circuits, providing a rationale for pharmacological activation of PPGNTS neurons in combination with GLP-1 receptor agonists as an obesity treatment strategy.
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Affiliation(s)
- Daniel I Brierley
- Centre for Cardiovascular and Metabolic Neuroscience, Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK
| | - Marie K Holt
- Department of Psychology, Program in Neuroscience, Florida State University, Gainesville, FL, USA
| | - Arashdeep Singh
- Department of Pharmacodynamics, University of Florida, Gainesville, FL, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA
| | - Alan de Araujo
- Department of Pharmacodynamics, University of Florida, Gainesville, FL, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA
| | - Molly McDougle
- Department of Pharmacodynamics, University of Florida, Gainesville, FL, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA
| | - Macarena Vergara
- Department of Pharmacodynamics, University of Florida, Gainesville, FL, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA
| | - Majd H Afaghani
- Department of Pharmacodynamics, University of Florida, Gainesville, FL, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA
| | - Shin Jae Lee
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Karen Scott
- Department of Pharmacodynamics, University of Florida, Gainesville, FL, USA
| | - Calyn Maske
- Department of Pharmacodynamics, University of Florida, Gainesville, FL, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA
| | - Wolfgang Langhans
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Eric Krause
- Department of Pharmacodynamics, University of Florida, Gainesville, FL, USA
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA
| | - Annette de Kloet
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA
- Department of Physiology and Functional Genomics, University of Florida, Gainesville, FL, USA
| | - Fiona M Gribble
- Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Frank Reimann
- Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Linda Rinaman
- Department of Psychology, Program in Neuroscience, Florida State University, Gainesville, FL, USA
| | - Guillaume de Lartigue
- Department of Pharmacodynamics, University of Florida, Gainesville, FL, USA.
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA.
| | - Stefan Trapp
- Centre for Cardiovascular and Metabolic Neuroscience, Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK.
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7
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Campos-Estrada C, Riquelme B, Vergara M, Altamirano C, Cavieres MF. In vitro Notch-mediated adjuvant immunogenic potency is induced by combining QS-21 and MPL in a co-culture model of PBMC and HUVEC cells. Toxicol In Vitro 2020; 68:104947. [PMID: 32679256 DOI: 10.1016/j.tiv.2020.104947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 06/30/2020] [Accepted: 07/10/2020] [Indexed: 10/23/2022]
Abstract
Few vaccine adjuvants have been approved for human use although several are currently being studied in preclinical and clinical trial. MPL is a toll-like receptor agonist able to trigger a high and persistent antibody response via-TLR-4 while QS-21 activates the NLRP3 inflammasome. Data suggest that there is a cross-talk between Notch and TLR signaling pathways modulating the polarization of the immune response in a MyD88-dependent manner. However, the role of Notch on the mechanism action of immunogenic adjuvants has not been addressed yet. This study aims to evaluate the in vitro toxicity and inflammatory response triggered by MPL and QS-21 using an in vitro human cell co-culture model and to determine whether NFκB or Notch signaling pathways are involved in their mechanism of immunotoxicity. In order to do this, we evaluated the effect of QS- 21/MPL alone or in combination using a co-culture of PBMC and HUVEC using cytotoxicity, surface expression of ECAMs, cell adhesion and cytokine release, NF-κB activation and NOTCH1 expression as observation endpoints. We found that both MPL and QS-21 were cytotoxic at concentrations over 5 μg/mL. Both adjuvants were able to trigger the expression of ECAMs and induce firm adhesion of PBMC to the endothelium. QS-21 and MPL combination demonstrated a synergistic effect on cellular recruitment and cytokine release generating a switch from Th2 to Th1 cytokine profile. Both MPL and QS-21 by themselves were able to generate significant NF-κB activation. However, this effect was not observed when both adjuvants were combined. On the contrary, the adjuvants alone and combined induced an overexpression of NOTCH-1. This is an important finding, as it provides new evidence that these adjuvants could modulate reactogenicity of vaccines through Notch signaling.
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Affiliation(s)
- C Campos-Estrada
- Escuela de Química y Farmacia, Facultad de Farmacia, Universidad de Valparaíso, Avenida Gran Bretaña 1093, Valparaíso, Chile; Centro de Investigación Farmacopea Chilena (CIFAR), Universidad de Valparaíso, Santa Marta 183, Valparaíso, Chile
| | - B Riquelme
- Escuela de Química y Farmacia, Facultad de Farmacia, Universidad de Valparaíso, Avenida Gran Bretaña 1093, Valparaíso, Chile
| | - M Vergara
- CREAS, Centro Regional de Estudios en Alimentos Saludables, Valparaíso, Chile; Escuela de Ingeniería Bioquímica, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - C Altamirano
- Escuela de Ingeniería Bioquímica, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile; CREAS, Centro Regional de Estudios en Alimentos Saludables, Valparaíso, Chile
| | - M F Cavieres
- Escuela de Química y Farmacia, Facultad de Farmacia, Universidad de Valparaíso, Avenida Gran Bretaña 1093, Valparaíso, Chile; Centro de Investigación Farmacopea Chilena (CIFAR), Universidad de Valparaíso, Santa Marta 183, Valparaíso, Chile.
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8
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Lee SJ, Krieger JP, Vergara M, Quinn D, McDougle M, de Araujo A, Darling R, Zollinger B, Anderson S, Pan A, Simonnet EJ, Pignalosa A, Arnold M, Singh A, Langhans W, Raybould HE, de Lartigue G. Blunted Vagal Cocaine- and Amphetamine-Regulated Transcript Promotes Hyperphagia and Weight Gain. Cell Rep 2020; 30:2028-2039.e4. [PMID: 32049029 PMCID: PMC7063787 DOI: 10.1016/j.celrep.2020.01.045] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 12/06/2019] [Accepted: 01/15/2020] [Indexed: 12/31/2022] Open
Abstract
The vagus nerve conveys gastrointestinal cues to the brain to control eating behavior. In obesity, vagally mediated gut-brain signaling is disrupted. Here, we show that the cocaine- and amphetamine-regulated transcript (CART) is a neuropeptide synthesized proportional to the food consumed in vagal afferent neurons (VANs) of chow-fed rats. CART injection into the nucleus tractus solitarii (NTS), the site of vagal afferent central termination, reduces food intake. Conversely, blocking endogenous CART action in the NTS increases food intake in chow-fed rats, and this requires intact VANs. Viral-mediated Cartpt knockdown in VANs increases weight gain and daily food intake via larger meals and faster ingestion rate. In obese rats fed a high-fat, high-sugar diet, meal-induced CART synthesis in VANs is blunted and CART antibody fails to increase food intake. However, CART injection into the NTS retains its anorexigenic effect in obese rats. Restoring disrupted VAN CART signaling in obesity could be a promising therapeutic approach.
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Affiliation(s)
- Shin J Lee
- Physiology and Behavior Laboratory, ETH Zurich, Schwerzenbach, Switzerland
| | - Jean-Philippe Krieger
- Physiology and Behavior Laboratory, ETH Zurich, Schwerzenbach, Switzerland; Department of Metabolic Physiology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Macarena Vergara
- Department of Pharmacodynamics, Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA
| | | | - Molly McDougle
- Department of Pharmacodynamics, Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA; The John B. Pierce Laboratory, New Haven, CT, USA
| | - Alan de Araujo
- Department of Pharmacodynamics, Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA; The John B. Pierce Laboratory, New Haven, CT, USA; Yale University, New Haven, CT, USA
| | - Rebecca Darling
- Anatomy, Physiology and Cell Biology Department School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Benjamin Zollinger
- The John B. Pierce Laboratory, New Haven, CT, USA; Yale University, New Haven, CT, USA
| | - Seth Anderson
- The John B. Pierce Laboratory, New Haven, CT, USA; Yale University, New Haven, CT, USA
| | - Annabeth Pan
- The John B. Pierce Laboratory, New Haven, CT, USA; Yale University, New Haven, CT, USA
| | - Emilie J Simonnet
- Anatomy, Physiology and Cell Biology Department School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Angelica Pignalosa
- Physiology and Behavior Laboratory, ETH Zurich, Schwerzenbach, Switzerland
| | - Myrtha Arnold
- Physiology and Behavior Laboratory, ETH Zurich, Schwerzenbach, Switzerland
| | - Arashdeep Singh
- Department of Pharmacodynamics, Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA
| | - Wolfgang Langhans
- Physiology and Behavior Laboratory, ETH Zurich, Schwerzenbach, Switzerland
| | - Helen E Raybould
- Anatomy, Physiology and Cell Biology Department School of Veterinary Medicine, University of California Davis, Davis, CA, USA
| | - Guillaume de Lartigue
- Department of Pharmacodynamics, Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, USA; The John B. Pierce Laboratory, New Haven, CT, USA; Yale University, New Haven, CT, USA.
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9
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Koutzoumis DN, Vergara M, Pino J, Buddendorff J, Khoshbouei H, Mandel RJ, Torres GE. Alterations of the gut microbiota with antibiotics protects dopamine neuron loss and improve motor deficits in a pharmacological rodent model of Parkinson's disease. Exp Neurol 2019; 325:113159. [PMID: 31843492 DOI: 10.1016/j.expneurol.2019.113159] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 12/02/2019] [Accepted: 12/12/2019] [Indexed: 12/18/2022]
Abstract
Parkinson's disease (PD) is a debilitating condition resulting in motor and non-motor symptoms affecting approximately 10 million people worldwide. Currently, there are no pharmacological treatments that can cure the condition or effectively halt its progression. The focus of PD research has been primarily on the neurobiological basis and consequences of dopamine (DA) neuron degeneration given that the loss of DA neurons projecting from the substantia nigra to the dorsal striatum results in the development of cardinal PD motor symptoms. Alternatively, gastrointestinal dysfunction is well recognized in PD patients, and often occurs prior to the development of motor symptoms. The gut microbiota, which contains thousands of bacterial species, play important roles in intestinal barrier integrity and function, metabolism, immunity and brain function. Pre-clinical and clinical studies suggest an important link between alterations in the composition of the gut microbiota and psychiatric and neurological conditions, including PD. Several reports have documented gut dysbiosis and alterations in the composition of the gut microbiota in PD patients. Therefore, the goal of this study was to explore the contribution of the gut microbiota to the behavioral and neurochemical alterations in a rodent toxin model of DA depletion that reproduces the motor symptoms associated with PD. We observed that chronic treatment of adult rats with non-absorbable antibiotics ameliorates the neurotoxicity of 6-hydroxydopamine (6-OHDA) in a unilateral lesion model. Specifically, immunohistochemistry against the dopaminergic neuron marker tyrosine hydroxylase (TH) showed an attenuation of the degree of 6-OHDA-induced dopaminergic neuron loss in antibiotic treated animals compared to control animals. In addition, we observed a reduction in the expression of pro-inflammatory markers in the striatum of antibiotic-treated animals. The degree of motor dysfunction after 6-OHDA was also attenuated in antibiotic-treated animals as measured by paw-rearing measurements in the cylinder test, forepaw stepping test, and ipsilateral rotations observed in the amphetamine-induced rotation test. These results implicate the gut microbiota as a potential contributor to pathology in the development of PD. Further studies are necessary to understand the specific mechanisms involved in transducing alterations in the gut microbiota to changes in dopaminergic neuron loss and motor dysfunction.
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Affiliation(s)
- Dimitri N Koutzoumis
- Department of Pharmacology and Therapeutics, University of Florida College of Medicine, 1200 Newell Drive, Gainesville, FL 32610., United States of America
| | - Macarena Vergara
- Department of Pharmacology and Therapeutics, University of Florida College of Medicine, 1200 Newell Drive, Gainesville, FL 32610., United States of America
| | - Jose Pino
- Department of Pharmacology and Therapeutics, University of Florida College of Medicine, 1200 Newell Drive, Gainesville, FL 32610., United States of America; Department of Medicine, School of Medicine, University of Atacama, 1581 Los Carrera Ave, Copiapo, Chile
| | - Julia Buddendorff
- Department of Pharmacology and Therapeutics, University of Florida College of Medicine, 1200 Newell Drive, Gainesville, FL 32610., United States of America
| | - Habibeh Khoshbouei
- Department of Neuroscience, University of Florida College of Medicine, 1149 Newell Drive, Gainesville, FL 32610, United States of America
| | - Ronald J Mandel
- Department of Neuroscience, University of Florida College of Medicine, 1149 Newell Drive, Gainesville, FL 32610, United States of America
| | - Gonzalo E Torres
- Department of Molecular, Cellular, and Biomedical Sciences, City University of New York School of Medicine at City College, 160 Convent Ave, NY, New York 10031, United States of America.
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10
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Maritano J, Vergara M, Dib N, Preuss W, Naranjo R, Hernández P, Deramond J, Corona G, Gutiérrez P. Management of patients treated with platelet antiagregant or oral anticoagulants drugs intervened with local anesthesia in dentoalveolar surgery. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.654] [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: 11/27/2022]
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11
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Maritano J, Vergara M, Dib N, Preuss W, Naranjo R, Hernández P, Deramond J, Briones R, Corona G, Gutiérrez P. Hyperbaric oxygen therapy as coadjuvant treatment in patients with BONJ. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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12
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Mauna JC, Harris SS, Pino JA, Edwards CM, DeChellis-Marks MR, Bassi CD, Garcia-Olivares J, Amara SG, Guajardo FG, Sotomayor-Zarate R, Terminel M, Castañeda E, Vergara M, Baust T, Thiels E, Torres GE. G protein βγ subunits play a critical role in the actions of amphetamine. Transl Psychiatry 2019; 9:81. [PMID: 30745563 PMCID: PMC6370791 DOI: 10.1038/s41398-019-0387-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 10/30/2018] [Accepted: 01/01/2019] [Indexed: 11/18/2022] Open
Abstract
Abnormal levels of dopamine (DA) are thought to contribute to several neurological and psychiatric disorders including drug addiction. Extracellular DA levels are regulated primarily via reuptake by the DA transporter (DAT). Amphetamine, a potent psychostimulant, increases extracellular DA by inducing efflux through DAT. Recently, we discovered that G protein βγ subunits (Gβγ) interact with DAT, and that in vitro activation of Gβγ promotes DAT-mediated efflux. Here, we investigated the role of Gβγ in the actions of amphetamine in DA neurons in culture, ex vivo nucleus accumbens (NAc), and freely moving rats. Activation of Gβγ with the peptide myr-Ser-Ile-Arg-Lys-Ala-Leu-Asn-Ile-Leu-Gly-Tyr-Pro-Asp-Tyr-Asp (mSIRK) in the NAc potentiated amphetamine-induced hyperlocomotion, but not cocaine-induced hyperlocomotion, and systemic or intra-accumbal administration of the Gβγ inhibitor gallein attenuated amphetamine-induced, but not cocaine-induced hyperlocomotion. Infusion into the NAc of a TAT-fused peptide that targets the Gβγ-binding site on DAT (TAT-DATct1) also attenuated amphetamine-induced but not cocaine-induced hyperlocomotion. In DA neurons in culture, inhibition of Gβγ with gallein or blockade of the Gβγ-DAT interaction with the TAT-DATct1 peptide decreased amphetamine-induced DA efflux. Furthermore, activation of Gβγ with mSIRK potentiated and inhibition of Gβγ with gallein reduced amphetamine-induced increases of extracellular DA in the NAc in vitro and in freely moving rats. Finally, systemic or intra-accumbal inhibition of Gβγ with gallein blocked the development of amphetamine-induced, but not cocaine-induced place preference. Collectively, these results suggest that interaction between Gβγ and DAT plays a critical role in the actions of amphetamine and presents a novel target for modulating the actions of amphetamine in vivo.
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Affiliation(s)
- J. C. Mauna
- 0000 0004 1936 9000grid.21925.3dDepartment of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - S. S. Harris
- 0000 0004 1936 8091grid.15276.37Department of Pharmacology and Therapeutics, University of Florida College of Medicine, Gainesville, FL USA
| | - J. A. Pino
- 0000 0004 1936 8091grid.15276.37Department of Pharmacology and Therapeutics, University of Florida College of Medicine, Gainesville, FL USA
| | - C. M. Edwards
- 0000 0004 1936 9000grid.21925.3dDepartment of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - M. R. DeChellis-Marks
- 0000 0004 1936 9000grid.21925.3dDepartment of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - C. D. Bassi
- 0000 0004 1936 9000grid.21925.3dDepartment of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - J. Garcia-Olivares
- 0000 0001 2297 5165grid.94365.3dLaboratory of Cellular and Molecular Neurobiology, National Institute of Mental Health, NIH, Bethesda, MD USA
| | - S. G. Amara
- 0000 0001 2297 5165grid.94365.3dLaboratory of Cellular and Molecular Neurobiology, National Institute of Mental Health, NIH, Bethesda, MD USA
| | - F. G. Guajardo
- 0000 0004 1936 8091grid.15276.37Department of Pharmacology and Therapeutics, University of Florida College of Medicine, Gainesville, FL USA ,0000 0000 8912 4050grid.412185.bLaboratory of Neurochemistry and Neuropharmacology, Center for Neurobiology and Brain Plasticity, Universidad de Valparaíso, Valparaíso, Chile
| | - R. Sotomayor-Zarate
- 0000 0000 8912 4050grid.412185.bLaboratory of Neurochemistry and Neuropharmacology, Center for Neurobiology and Brain Plasticity, Universidad de Valparaíso, Valparaíso, Chile
| | - M. Terminel
- 0000 0001 0668 0420grid.267324.6Department of Psychology, University of Texas at El Paso, El Paso, TX USA
| | - E. Castañeda
- 0000 0001 0668 0420grid.267324.6Department of Psychology, University of Texas at El Paso, El Paso, TX USA
| | - M. Vergara
- 0000 0004 1936 8091grid.15276.37Department of Pharmacology and Therapeutics, University of Florida College of Medicine, Gainesville, FL USA
| | - T. Baust
- 0000 0004 1936 9000grid.21925.3dDepartment of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - E. Thiels
- 0000 0004 1936 9000grid.21925.3dDepartment of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - G. E. Torres
- 0000 0004 1936 8091grid.15276.37Department of Pharmacology and Therapeutics, University of Florida College of Medicine, Gainesville, FL USA ,0000 0004 1936 8091grid.15276.37Center for Addiction Research and Education, University of Florida College of Medicine, Gainesville, FL USA
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13
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Marco A, Roget M, Cervantes M, Forné M, Planella R, Miquel M, Ortiz J, Navarro M, Gallego C, Vergara M. Comparison of effectiveness and discontinuation of interferon-free therapy for hepatitis C in prison inmates and noninmates. J Viral Hepat 2018; 25:1280-1286. [PMID: 29851225 DOI: 10.1111/jvh.12940] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 12/20/2017] [Accepted: 05/17/2018] [Indexed: 12/15/2022]
Abstract
Chronic hepatitis C treatment with direct acting antiviral (DAA) therapy during incarceration is an attractive option, due to its short duration and to the possibility of directly observed treatment or supervision. The aim of this study is to compare the effectiveness and rates of discontinuation of DAA treatment in prisoners and nonprisoners. We studied all patients treated in the 10 prisons of Catalonia and at 3 public hospitals in the Barcelona area between 1 January 2015 and 30 April 2016. We analysed sustained viral response (SVR) and rates of discontinuation through intention-to-treat and modified-intention-to-treat analyses, the latter excluding discontinuations due to release from prison. One hundred and eighty-eight inmates and 862 noninmates were included. Prisoners were significantly younger than nonprisoners, with higher proportions of men, drug users, HIV infection, genotypes 1a and 3 and more treatment with psychiatric drugs. Overall, 98.4% of patients completed treatment. The discontinuation rate was low, but higher in inmates (3.7% vs 1.2% noninmates; P = .003) and in community patients >65 years old (2.8% vs 1.2% in under 65 seconds; P = .008). Among the inmates, 7 (42.8%) discontinuations were due to release. SVR was 93.1% in inmates vs 96.5% in noninmates (P = .08) by intention-to-treat and 95.1% vs 96.5% (P = .37) by modified intention-to-treat. Virologic failure rates were similar (3.8% vs 3% in noninmates; P = .60). SVR, virologic failure and discontinuation rates were similar in inmates and noninmates. Currently, prisons are considered a priority for the implementation of DAA. Improved coordination between penitentiary and community health systems would help to ensure therapeutic continuity in released prisoners.
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Affiliation(s)
- A Marco
- Prison Health Program, Catalan Institute of Health, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - M Roget
- Hepatology Unit, Consorci Sanitari, Terrassa, Spain
| | - M Cervantes
- Infectious Disease Unit, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - M Forné
- Instituto Carlos III, CIBERehd, Madrid, Spain.,Digestive Disease, Department Hospital Universitari Mútua Terrassa, Universitat Central de Barcelona, Madrid, Spain
| | - R Planella
- Health Services of Ponent Penitentiary Centre, Madrid, Spain
| | - M Miquel
- Instituto Carlos III, CIBERehd, Madrid, Spain.,Hepatology Unit, Digestive Disease Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - J Ortiz
- Hepatology Unit, Consorci Sanitari, Terrassa, Spain
| | - M Navarro
- Infectious Disease Unit, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - C Gallego
- Health Services of Quatre Camins Penitentiary Centre, Barcelona, Spain
| | - M Vergara
- Instituto Carlos III, CIBERehd, Madrid, Spain.,Hepatology Unit, Digestive Disease Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
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Novosak M, Laczeski M, Bobadilla F, Cortese J, Pegels E, Oviedo P, Quiroga M, Delgado O, Vergara M. Genetic analysis by RAPD technique of first strains of Streptococcus agalactiae serotype IX in Misiones, Argentina. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.4172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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15
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Jarque-Bou N, Gracia-Ibáñez V, Sancho-Bru JL, Vergara M, Pérez-González A, Andrés FJ. Using kinematic reduction for studying grasping postures. An application to power and precision grasp of cylinders. Appl Ergon 2016; 56:52-61. [PMID: 27184310 DOI: 10.1016/j.apergo.2016.03.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [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: 09/25/2015] [Revised: 03/03/2016] [Accepted: 03/07/2016] [Indexed: 05/14/2023]
Abstract
The kinematic analysis of human grasping is challenging because of the high number of degrees of freedom involved. The use of principal component and factorial analyses is proposed in the present study to reduce the hand kinematics dimensionality in the analysis of posture for ergonomic purposes, allowing for a comprehensive study without losing accuracy while also enabling velocity and acceleration analyses to be performed. A laboratory study was designed to analyse the effect of weight and diameter in the grasping posture for cylinders. This study measured the hand posture from six subjects when transporting cylinders of different weights and diameters with precision and power grasps. The hand posture was measured using a Vicon(®) motion-tracking system, and the principal component analysis was applied to reduce the kinematics dimensionality. Different ANOVAs were performed on the reduced kinematic variables to check the effect of weight and diameter of the cylinders, as well as that of the subject. The results show that the original twenty-three degrees of freedom of the hand were reduced to five, which were identified as digit arching, closeness, palmar arching, finger adduction and thumb opposition. Both cylinder diameter and weight significantly affected the precision grasping posture: diameter affects closeness, palmar arching and opposition, while weight affects digit arching, palmar arching and closeness. The power-grasping posture was mainly affected by the cylinder diameter, through digit arching, closeness and opposition. The grasping posture was largely affected by the subject factor and this effect couldn't be attributed only to hand size. In conclusion, this kinematic reduction allowed identifying the effect of the diameter and weight of the cylinders in a comprehensive way, being diameter more important than weight.
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Affiliation(s)
- N Jarque-Bou
- Departamento de Ingeniería Mecánica y Construcción, Universitat Jaume I. Av. Vicent Sos Baynat, s/n, 12071, Castellón, Spain
| | - V Gracia-Ibáñez
- Departamento de Ingeniería Mecánica y Construcción, Universitat Jaume I. Av. Vicent Sos Baynat, s/n, 12071, Castellón, Spain.
| | - J L Sancho-Bru
- Departamento de Ingeniería Mecánica y Construcción, Universitat Jaume I. Av. Vicent Sos Baynat, s/n, 12071, Castellón, Spain
| | - M Vergara
- Departamento de Ingeniería Mecánica y Construcción, Universitat Jaume I. Av. Vicent Sos Baynat, s/n, 12071, Castellón, Spain
| | - A Pérez-González
- Departamento de Ingeniería Mecánica y Construcción, Universitat Jaume I. Av. Vicent Sos Baynat, s/n, 12071, Castellón, Spain
| | - F J Andrés
- Departamento de Ingeniería Mecánica y Construcción, Universitat Jaume I. Av. Vicent Sos Baynat, s/n, 12071, Castellón, Spain
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16
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Gracia-Ibáñez V, Vergara M, Sancho-Bru JL. Interdependency of the maximum range of flexion-extension of hand metacarpophalangeal joints. Comput Methods Biomech Biomed Engin 2016; 19:1800-1807. [PMID: 27198763 DOI: 10.1080/10255842.2016.1189541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Mobility of the fingers metacarpophalangeal (MCP) joints depends on the posture of the adjacent ones. Current Biomechanical hand models consider fixed ranges of movement at joints, regardless of the posture, thus allowing for non-realistic postures, generating wrong results in reach studies and forward dynamic analyses. This study provides data for more realistic hand models. The maximum voluntary extension (MVE) and flexion (MVF) of different combinations of MCP joints were measured covering their range of motion. Dependency of the MVF and MVE on the posture of the adjacent MCP joints was confirmed and mathematical models obtained through regression analyses (RMSE 7.7°).
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Affiliation(s)
- V Gracia-Ibáñez
- a Departamento de Ingeniería Mecánica y Construcción , Universitat Jaume I , Castelló , Spain
| | - M Vergara
- a Departamento de Ingeniería Mecánica y Construcción , Universitat Jaume I , Castelló , Spain
| | - J-L Sancho-Bru
- a Departamento de Ingeniería Mecánica y Construcción , Universitat Jaume I , Castelló , Spain
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17
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Menacho I, Sequeira E, Muns M, Barba O, Leal L, Clusa T, Fernandez E, Moreno L, Raben D, Lundgren J, Gatell JM, Garcia F, Cayuelas L, Aragunde V, Vergara M, Catalan M, Moreno MA, Hormigo G, Siso A, Herreras Z, Sebastian L, Benito L, Picas A, Hoyo J, Giner MJ, Cararach D, Moles E, Moro ML, Arrabal P, Roca D, Prego S, Ferrer X, Egido A, Ventosa C, Garcia S, Muñoz S, Massana A, Sole J, Curiel M, Heras F, Leon A. Comparison of two HIV testing strategies in primary care centres: indicator-condition-guided testingvs. testing of those with non-indicator conditions. HIV Med 2013; 14 Suppl 3:33-7. [DOI: 10.1111/hiv.12064] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2013] [Indexed: 11/28/2022]
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18
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Oviedo P, Pegels E, Laczeski M, Quiroga M, Vergara M. Phenotypic and genotypic characterization of Streptococcus agalactiae in pregnant women. First study in a province of Argentina. Braz J Microbiol 2013; 44:253-8. [PMID: 24159312 PMCID: PMC3804206 DOI: 10.1590/s1517-83822013005000030] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2010] [Accepted: 07/02/2012] [Indexed: 11/22/2022] Open
Abstract
Group B Streptococcus (GBS) is the leading cause of neonatal infections. Our purpose was to characterize GBS colonization in pregnant women, current serotypes, resistance phenotypes and genes associated with virulence. In Misiones, Argentina, there are no previous data on this topic. Vaginal-rectal swabs from 3125 pregnant women were studied between 2004 and 2010. GBS strains were identified by conventional and serological methods (Phadebact Strep B Test, ETC International, Bactus AB, Sweden). Serotypes were detected using Strep-B Latex (Statens Serum Institut, Denmark). Resistance phenotypes were determined by the double-disk test. Genes were studied by PCR. Maternal colonization was 9.38%. Resistance to erythromycin was 11.6%, and the constitutive phenotype was the predominant one. Serotype Ia was the most frequent, whereas serotypes IV, VI, VII and VIII were not detected. The lmb, bca and hylB genes were detected in more than 79% of the strains. In this study, the colonization rate with GBS and the serotype distribution were compared with studies reported in other areas of the country. The high resistance to erythromycin in Misiones justifies performing antibiotic susceptibility testing. The serotype distribution, the genes encoding putative virulence factors, and the patterns of resistance phenotypes of GBS may vary in different areas. They thus need to be evaluated in each place to devise strategies for prevention.
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Affiliation(s)
- P Oviedo
- Facultad de Ciencias Exactas, Químicas y Naturales, Universidad Nacional de Misiones, Posadas, Misiones, Argentina
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19
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Cabré M, Rudi N, Pontes C, Vergara M, Parra I, Gorgas MQ. GRP-121 Multidisciplinary Monitoring of Psychiatric Morbidity of HCV-Infected Patients Treated with Interferon and Ribavirin. Eur J Hosp Pharm 2013. [DOI: 10.1136/ejhpharm-2013-000276.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Abstract
The trophic interactions between the scyphozoan medusa Chrysaora plocamia and the palm ruff Seriolella violacea were investigated off northern Chile and showed that large numbers of hyperiid amphipods parasitizing the medusa may channel energy back to the fishes, which feed on the parasites. The biomass of hyperiids eaten by the fish was a function of the biomass of hyperiids parasitizing the medusa. This temporally available food supply may enhance fish recruitment. The large number of hyperiids parasitizing diverse jellyfish species represents a missing trophic link in current efforts to understand the effects of jellyfish blooms on marine food webs.
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Affiliation(s)
- J M Riascos
- Universidad de Antofagasta, Instituto de Investigaciones Oceanológicas, Climate Change Ecology Research Group, CENSOR laboratory, Avenida Universidad de Antofagasta 02800, Antofagasta, Chile.
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Moore-Carrasco R, Donoso W, Sutin F, Vergara M, Toloza L, Gonzalez J, Morales E, Palomo I. Expresión de ICAM-1 en el Endotelio de Arterias Humanas Mediante Inmunohistoquímica. INT J MORPHOL 2011. [DOI: 10.4067/s0717-95022011000400047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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22
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Macias VR, Pinzón C, Fierro F, Vergara M, Martínez D, Rosado A, Gutiérrez CG, Rosales-Torres AM. Identification of soluble forms of vascular endothelial growth factor receptors, sVEGFR-1 and sVEGFR-2, in bovine dominant follicles. Reprod Domest Anim 2011; 47:e39-42. [PMID: 21988522 DOI: 10.1111/j.1439-0531.2011.01919.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The development of dominant follicles requires the parallel growth of a vascular network, regulated by VEGF and its receptors VEGFR-1 and VEGFR-2. Here, we demonstrate the presence of mRNA for the soluble forms of VEGFR-1 and VEGFR-2 by RT-PCR and the respective proteins by Western blot, in bovine dominant follicles. The 3' end of the mRNA coding region and the deduced C-terminal amino acid sequence of the bovine VEGFR soluble forms were similar to those previously described in human and mice. The relative abundance of sVEGFR-1 was higher in dominant follicles of day 4, decreasing on day 6 and further on day 9 of the cycle. In contrast, sVEGFR-2 expression was low on day 4 follicles and increased as the cycle advanced, becoming greater on day 9. The changes of sVEGFR-1 and sVEGFR-2 with the age of the bovine dominant follicle indicate a physiological role in its growth and atresia.
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Affiliation(s)
- V R Macias
- Departamento de Producción Agrícola y Animal, UAM-Xochimilco, México, D.F., México
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Becerra S, Vergara M, Gozález R, Osses N, Altamirano C. Condition of Mild Hypothermia does not Promote an Increase in Specific Productivity of Recombinant Protein in Continuous Culture of CHO Cells. J Biotechnol 2010. [DOI: 10.1016/j.jbiotec.2010.09.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rosales-Torres A, Alonso I, Vergara M, Romano M, Castillo-Juárez H, Ávalos A, Rosado A, Gutiérrez C. Vascular endothelial growth factor isoforms 120, 164 and 205 are reduced with atresia in ovarian follicles of sheep. Anim Reprod Sci 2010; 122:111-7. [DOI: 10.1016/j.anireprosci.2010.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Revised: 07/23/2010] [Accepted: 08/03/2010] [Indexed: 01/23/2023]
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Stevens B, Flechner S, Wei LJ, Friedman G, Vergara M, Jiang H, Tedesco-Silva H, Cibrik D. SIMILAR RISK OF RENAL GRAFT LOSS DUE TO THROMBOSIS FOR EVEROLIMUS VERSUS MPA-BASED REGIMENS. Transplantation 2010. [DOI: 10.1097/00007890-201007272-00809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Quiroga M, Lezcano MT, Martin Talavera B, Cáceres MG, Vergara M. Beta-lactam resistance in variants of Aeromonas spp. selected in vitro under antibiotic pressure. J Chemother 2010; 21:701-2. [PMID: 20071297 DOI: 10.1179/joc.2009.21.6.701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Vergara M, Becerra S, Altamirano C. Glycosylation stage leads production of extracellular rh-tPA at sub-physiological temperatures of culture. N Biotechnol 2009. [DOI: 10.1016/j.nbt.2009.06.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Altamirano C, Berrios J, Diaz-Barrera A, Bazan C, Vergara M. Simultaneus effect of low temperatures and mannose concentration on CHP cells cultures producing rh-tPA. N Biotechnol 2009. [DOI: 10.1016/j.nbt.2009.06.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bejarano G, Vergara M, Dalmau B, Puig J, Bella MR, Suárez D, Calvet X. Prospective evaluation of liver fibrosis in chronic viral hepatitis C infection using the Sabadell NIHCED (Non-Invasive Hepatitis-C-Related Cirrhosis Early Detection) index. Rev Esp Enferm Dig 2009; 101:325-335. [PMID: 19527078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
INTRODUCTION liver disease resulting from chronic hepatitis C virus (HCV) infection follows an asymptomatic course towards cirrhosis and its complications in 20-40% of cases. Earlier studies demonstrated that advanced fibrosis is a prognostic factor. The "gold standard" for the evaluation of fibrosis grade is liver biopsy. Our group validated a predictive index - NIHCED - based on demographic, laboratory parameters, and echographic data to determine the presence of cirrhosis. OBJECTIVE our objective is to evaluate whether the NIHCED score predicts the presence of advanced fibrosis in patients with chronic HCV infection. MATERIAL AND METHODS this prospective study included patients with chronic HCV infection who underwent liver biopsy and were administered the NIHCED score. Fibrosis grade correlated with the NIHCED score using the ROC curve analysis and Spearman s correlation coefficient. RESULTS in total 321 patients were included (male/female ratio 1.27) with a mean age of 48 +/- 14 years. Liver biopsy showed that 131 (30.5%) had no fibrosis or had portal expansion while 190 (69.5%) had advanced fibrosis or cirrhosis. At a cut-off point of 6, sensitivity was 72%, specificity was 76.3%, positive predictive value (PPV) was 81%, negative predictive value (NPV) was 63.7%, and diagnostic accuracy was 72.5%, with an area under the curve (AUC) of 0.787, and a Spearman s correlation coefficient of r = 0.65. CONCLUSIONS the NIHCED score predicts the presence of advanced fibrosis in an elevated percentage of patients with a need of liver biopsy.
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Affiliation(s)
- G Bejarano
- Service of Digestive Diseases, Universitat Autonoma de Barcelona, Barcelona, Spain.
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Bejarano G, Vergara M, Gil M, Dalmau B, Puig J, Bella MR, Suárez D, Calvet X. Evaluación de la fibrosis hepática en la hepatitis crónica por virus C mediante la aplicación prospectiva del Sabadell's NIHCED score: Sabadell's Non Invasive, Hepatitis C Related-Cirrhosis Early Detection Score. Rev esp enferm dig 2009. [DOI: 10.4321/s1130-01082009000500004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Vergara M, Gil M, Dalmau B, Ribot R, Navarro C, Martín A, Penafreta M, Puig J, Martín J, Perendreu J, Falcó J, Bella R. [Natural history of hepatocellular carcinoma in a cohort of pacients from a county hospital]. Rev Esp Enferm Dig 2008; 100:682-687. [PMID: 19159171 DOI: 10.4321/s1130-01082008001100003] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND hepatocellular carcinoma (HCC) is a cancer with high incidence and mortality. OBJECTIVE our aim was to describe the natural history of a patient cohort with HCC, and to identify the factors associated with survival. PATIENTS AND METHODS a retrospective and descriptive study of patients diagnosed with HCC between 1995 and 2002. Qualitative variables were expressed as frequencies and percentages. Quantitative variables were expressed as medians and standard deviations. Survival was calculated using the Kaplan-Meier method and log rank. RESULTS a total of 154 patients were analyzed. The men-to-women ratio was 2.9/1. Mean age was 68 +/- 9 years. 82% of patients died during a median follow-up of 28 months. Median survival was 21.5 months (95% CI: 16.98-26.04). Curative treatment was done in 40.3% of diagnosed patients, and 59.7% of patients received palliative treatment. Factors associated with survival were: ascites, number of lesions at diagnosis, and curative treatment. No statistical differences were found for the next factors: age, sex, etiology of cirrhosis, and Child-Pugh stage at diagnosis. CONCLUSIONS factors associated with low survival in patients with HCC were ascites and number of lesions. Curative treatment is associated with a higher survival when compared to palliative treatment.
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Affiliation(s)
- M Vergara
- Unidad de Enfermedades Digestivas, Barcelona, Spain.
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Villoria A, Garcia P, Calvet X, Gisbert JP, Vergara M. Meta-analysis: high-dose proton pump inhibitors vs. standard dose in triple therapy for Helicobacter pylori eradication. Aliment Pharmacol Ther 2008; 28:868-77. [PMID: 18644011 DOI: 10.1111/j.1365-2036.2008.03807.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The evidence on whether high-dose proton pump inhibitors (PPIs) increase cure rates of Helicobacter pylori treatment has not been previously assessed. AIM To evaluate the evidence on the usefulness of high-dose PPI in standard triple therapy by performing a systematic review and a meta-analysis. METHODS A systematic search was performed in multiple databases and in the abstracts submitted to the Digestive Diseases Week, the European Helicobacter Study Group congress and the United European Gastroenterology Week. Randomized trials comparing a standard dose of a PPI with high-dose PPI both twice a day in triple therapy combining a PPI plus clarithromycin and either amoxicillin or metronidazole were selected. Relative risk (RR) and 95% confidence intervals (95% CIs) for all comparisons were calculated using Review Manager. RESULTS Six studies fulfilled the inclusion criteria. All used triple therapy for 7 days. A mean intention-to-treat cure rate of 82% was achieved with high-dose PPI and one of 74% with standard dose (RR: 1.09; 95% CI: 1.01-1.17). Subgroup analysis showed that the maximum increase was observed when the PPI compared were omeprazole 20 mg or pantoprazole 40 mg vs. esomeprazole 40 mg. CONCLUSION High-dose PPI seems more effective than standard-dose for curing H. pylori infection in 7-day triple therapy.
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Affiliation(s)
- A Villoria
- Digestive Diseases Unit, Hospital de Sabadell, Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain
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Quiroga M, Pegels E, Oviedo P, Pereyra E, Vergara M. Antibiotic susceptibility patterns and prevalence of group B Streptococcus isolated from pregnant women in Misiones, Argentina. Braz J Microbiol 2008; 39:245-50. [PMID: 24031210 PMCID: PMC3768385 DOI: 10.1590/s1517-83822008000200009] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2007] [Revised: 11/22/2007] [Accepted: 05/05/2008] [Indexed: 11/22/2022] Open
Abstract
This study was performed to determine the susceptibility patterns and the colonization rate of Group B Streptococcus (GBS) in a population of pregnant women. From January 2004 to December 2006, vaginal-rectal swabs were obtained from 1105 women attending Dr. Ramón Madariaga Hospital, in Posadas, Misiones, Argentina. The carriage rate of GBS among pregnant women was 7.6%. A total of 62 GBS strains were randomly selected for in vitro susceptibility testing to penicillin G, ampicillin, tetracycline, levofloxacin, gatifloxacin, ciprofloxacin, quinupristin-dalfopristin, linezolid, vancomycin, rifampicin, trimethoprim- sulfametoxazol, nitrofurantoin, gentamicin, clindamycin and erythromycin, and determination of resistance phenotypes. No resistance to penicillin, ampicillin, quinupristin-dalfopristin, linezolid, and vancomycin was found. Of the isolates examined 96.8%, 98.3%, 46.8%, and 29.0% were susceptible to rifampicin, nitrofurantoin, trimethoprim-sulfametoxazol and tetracycline, respectively. Rank order of susceptibility for the quinolones was: gatifloxacin (98.4%) > levofloxacin (93.5%) > ciprofloxacin (64.5%). The rate of resistance to erythromycin (9.7%) was higher than that of other reports from Argentina. High-level resistance to gentamicin was not detected in any of the isolates. Based on our finding of 50% of GBS isolates with MIC to gentamicin equal o lower than 8 μg/ml, a concentration used in one of the selective media recommended for GBS isolation, we suggested, at least in our population, the use of nalidixic acid and colistin in selective media with the aim to improve the sensitivity of screening cultures for GBS carriage in women.
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Affiliation(s)
- M Quiroga
- Universidad Nacional de Misiones , Posadas, Misiones , Argentina
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Quiroga M, Cáeres M, Stefañk R, Villalba V, Rodriguez M, Radice M, Gutkind G, Vergara M. Characterization of Extended-Spectrum β-Lactamases in Clinical Isolates of Klebsiella pneumoniaeand Escherichia colifrom Posadas, Misiones, Argentina. J Chemother 2008; 20:130-3. [DOI: 10.1179/joc.2008.20.1.130] [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: 10/31/2022]
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Abstract
BACKGROUND Endoscopic therapy reduces rebleeding rate, need for surgery, and mortality in patients with bleeding peptic ulcers. Injection of epinephrine is the most popular therapeutic method. Guidelines disagree on the need for a second haemostatic procedure immediately after epinephrine. OBJECTIVES The objective of this review was to determine whether the addition of a second procedure improves efficacy or patient outcomes or both after epinephrine injection in adults with high risk bleeding ulcers. SEARCH STRATEGY We searched the Cochrane Central Register of Controlled Trials - CENTRAL (which includes the Cochrane Upper Gastrointestinal and Pancreatic Diseases Group Trials Register) (The Cochrane Library Issue 1, 2006), MEDLINE (1966 to February 2006), EMBASE (1980 to February 2006) and reference lists of articles. We also contacted experts in the field. SELECTION CRITERIA Randomised studies comparing endoscopic treatment: epinephrine alone versus epinephrine associated with a second haemostatic method in adults with haemorrhage from peptic ulcer disease with major stigmata of bleeding as defined by the Forrest classification. Bleeding must have been confirmed by endoscopy. DATA COLLECTION AND ANALYSIS Two authors independently assessed trial quality and extracted data. MAIN RESULTS Seventeen studies including 1763 people were included. Adding a second procedure reduced further bleeding rate from 18.8% to 10.4%; Peto Odds Ratio 0.51; 95% confidence interval (CI) 0.39 to 0.66, and emergency surgery from 10.8% to 7.1%; OR 0.63; 95% CI 0.45 to 0.89. Mortality fell from 5% to 2.5% OR 0.50; 95% CI 0.30 to 0.82. Subanalysis showed that the risk of further bleeding decreased regardless of which second procedure was applied. In addition, the risk was reduced in all subgroups. AUTHORS' CONCLUSIONS Additional endoscopic treatment after epinephrine injection reduces further bleeding, the need for surgery and mortality in patients with bleeding peptic ulcer.
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Affiliation(s)
- M Vergara
- Hospital de Sabadell, Unitat de Malaties Digestives, Institut Universitari Parc Tauli, Universitat Autonoma de Barcelona. Parc Tauli s/n, Sabadell, Spain, 08208.
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Serrera A, del Pozo J, Martinez A, Alonso M, Gonzalez R, Leiva J, Vergara M, Lasa I. P1786 Dispersin B therapy of Staphylococcus aureus experimental port-related bloodstream infection. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71625-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Castillo E, Vergara M, Moreno Y. Landfill leachate treatment using a rotating biological contactor and an upward-flow anaerobic sludge bed reactor. Waste Manag 2007; 27:720-6. [PMID: 17011178 DOI: 10.1016/j.wasman.2006.08.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2005] [Revised: 08/07/2006] [Accepted: 08/10/2006] [Indexed: 05/12/2023]
Abstract
This paper describes the feasibility of an aerobic system (rotating biological contactor, RBC) and a biological anaerobic system (upward-flow anaerobic sludge bed reactor) at small scale for the treatment of a landfill leachate. In the first phase of the aerobic system study, a cyclic-batch RBC system was used to select perforated acetate discs among three different acetate disc configurations. These discs were chosen on the basis of high COD removal (65%) and biological stability. In the second phase, the RBC system (using four stages) was operated continuously at different hydraulic retention times (HRT), at different rotational speeds, and with varying organic concentrations of the influent leachate (2500-9000mgL(-1)). Forty percent of the total surface area of each perforated disc was submerged in the leachate. A COD removal of about 52% was obtained at an HRT of 24h and a rotational speed of 6rpm. For the anaerobic system, the reactor was evaluated with a volumetric organic load of 3273g-COD m(-3) day(-1) at an HRT of 54, 44, 39, 24 and 17h. At these conditions, the system reached COD removal efficiencies of 62%, 61%, 59%, 44% and 24%, respectively.
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Affiliation(s)
- E Castillo
- Centro de Estudios e Investigaciones Ambientales, Universidad Industrial de Santander, Calle 9a Carrera 27, Aptdo. Aéreo 678, Bucaramanga, Colombia.
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Calvet X, Vergara M, Brullet E. [Endoscopic treatment of bleeding ulcers: has everything been said and done?]. Gastroenterol Hepatol 2005; 28:347-53. [PMID: 15989817 DOI: 10.1157/13076353] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Endoscopic treatment reduces bleeding recurrence, the need for surgery and mortality in patients with bleeding ulcers. However endoscopic treatment fails in 10-15% of patients, leading to high morbidity and mortality. The therapeutic measures with demonstrated effectiveness in reducing the risk of hemorrhagic recurrence and its complications are combined endoscopic treatment (adrenaline plus a second hemostatic intervention) and proton pump inhibitors. Also useful, although there is less evidence, are immediate resuscitation and <<second look>> endoscopy. Some studies suggest that activated recombinant factor VII infusion or supra-selective arterial embolization can be useful in severe hemorrhage. Further studies are required to determine optimal treatment according to the characteristics of each patient.
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Affiliation(s)
- X Calvet
- Unitat de Malalties Digestives, Hospital de Sabadell, Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Barcelona, España.
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Abstract
AIM To evaluate whether eradication of Helicobacter pylori prevents peptic ulcer in non-steroidal anti-inflammatory drug users by means of a meta-analysis. MATERIAL AND METHODS A systematic search was performed in MEDLINE, EMBASE, the Cochrane Controlled Trials Register and the AGA congress. Randomized trials comparing H. pylori eradication vs. non-eradication or eradication vs. a proton pump inhibitor in patients receiving a non-steroidal anti-inflammatory drug were selected. RESULTS Five studies and 939 patients were included in the analysis; 34 of 459 (7.4%) patients developed a peptic ulcer in the eradicated group vs. 64 of 480 (13.3%) in the control group. The odds ratio was 0.43 (95% confidence interval: 0.20-0.93). Sub-analyses showed a significant reduction of risk for non-steroidal anti-inflammatory drug-naive (odds ratio = 0.26; 95% confidence interval: 0.14-0.49) but not for previously treated patients (odds ratio = 0.95, 95% confidence interval: 0.53-1.72). Two studies with a total of 385 patients compared eradication vs. a proton pump inhibitor; five of 196 (2.6%) developed a peptic ulcer in the eradicated group vs. zero of 189 (0%) in the proton pump inhibitor group (odds ratio = 7.43; 95% confidence interval: 1.27-43.6). CONCLUSION Helicobacter pylori eradication reduces the incidence of peptic ulcer in the overall population receiving non-steroidal anti-inflammatory drugs. It appears to be especially effective when performed in non-steroidal anti-inflammatory drug-naïve patients. Nonetheless, eradication seems less effective than treatment with a maintenance proton pump inhibitor for preventing non-steroidal anti-inflammatory drug-associated ulcers.
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Affiliation(s)
- M Vergara
- Unitat de Malalties Digestives, Hospital de Sabadell, Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Barcelona, Spain
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Netto C, Vergara M, Calvet X, Brullet E, Bella R, Musulén E. [Cecal cytomegalovirus infection following appendicectomy in a patient with ulcerative colitis]. Gastroenterol Hepatol 2005; 28:285-8. [PMID: 15871812 DOI: 10.1157/13074064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
We report a patient who, 3 months after being diagnosed with ulcerative colitis, was admitted to hospital because of malaise and right lower abdominal pain. An open appendectomy was performed. Histological study showed ulcerative colitis affecting the appendix. After surgery, the patient presented a refractory outbreak of ulcerative colitis requiring treatment with steroids and cyclosporin A. Despite this treatment, the patient continued to pass abundant fresh blood associated with severe anemia. Colonoscopy showed only granular and congestive cecal mucosa. Biopsies showed intracytoplasmic inclusion bodies with immunohistochemical stains positive for cytomegalovirus (CMV) infection. Rectorrhagia and anemia quickly disappeared after beginning treatment with ganciclovir. Appendicular ulcerative colitis is not uncommonly associated with distal colitis. In addition, diffuse CMV infection complicating ulcerative colitis treatment is not unusual. By contrast, isolated, segmentary infection by CMV in the proximal colon is extremely rare. Until now, only three patients with localized CMV infection have been described, and all three cases occurred in the context of ileoanal anastomosis.
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Affiliation(s)
- C Netto
- Servei de Medicina, Corporació Parc Taulí, Sabadell, Barcelona, Spain
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Vargas VM, Torres D, Corona F, Vergara M, Gómez LE, Delgado-Lezama R, Cueva-Rolón R. Cholinergic facilitation of erection and ejaculation in spinal cord-transected rats. Int J Impot Res 2004; 16:86-90. [PMID: 14963478 DOI: 10.1038/sj.ijir.3901169] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Penile reflexes (PRs) were monitored in chronic spinal cord-transected rats by identifying them visually, and at the same time they were recorded as the electromyographic activity of bulbospongiosus muscles. Intraperitoneal injection of the agonist muscarine (10 microg) produced a facilitation of PRs. A decrease in the latency, an increase in the number of clusters and often an increase in the duration of cups were found after muscarine. In addition, 66% (six out of nine) of the animals ejaculated after muscarine. These results suggest that cholinergic receptor stimulation may be involved in erectile and ejaculatory mechanisms mediated by the spinal cord.
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Affiliation(s)
- V M Vargas
- Departamento de Agrobiología, Universidad Autónoma de Tlaxcala, Tlaxcala, Mexico
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Abstract
The ideal diameter for a tool handle for males and females has been determined using an existing biomechanical model of the hand validated in previous works. The model estimates a 33-mm optimum diameter tool handle for the general population (males and females). When the optimum diameter for a tool handle is selected, the muscles exert the minimum force needed to hold the tool and perform gripping activities. Optimal handle design reduces the force required for gripping a tool, protects the underlying joint structures, and reduces the risk of developing cumulative trauma associated with repetitive task requiring high grip forces and awkward postures. This article provides a design parameter for optimal tool diameter to aid the therapist in the selection of assistive devices, built-up handles, or for the fabrication of a tool handle.
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Affiliation(s)
- Joaqun L Sancho-Bru
- Departament de Tecnologia, Universitat Jaume I Campus de Riu Sec 12071, Castelló, Spain
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Campo R, Brullet E, Junquera F, Puig-Diví V, Vergara M, Calvet X, Marco J, Chuecos M, Sánchez A, Alcázar A, Ruiz M, Puig M, Real J. Sedación en la endoscopia digestiva. Resultados de una encuesta hospitalaria en Cataluña. Gastroenterología y Hepatología 2004; 27:503-7. [PMID: 15544734 DOI: 10.1016/s0210-5705(03)70516-0] [Citation(s) in RCA: 13] [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: 11/21/2022]
Abstract
INTRODUCTION The need for sedation is increasing in digestive endoscopy units (DEU). There are no data on the use of sedation in DEU in Catalonia (Spain). OBJECTIVE To evaluate the use of sedation in DEU in Catalonia. MATERIAL AND METHOD A questionnaire on the practice of sedation was designed and sent to the heads of medical and nursing staff of the DEU of 63 public and private hospitals in Catalonia. Two mailings were sent with an interval of three months between each. The questionnaire included 62 items on the characteristics of the hospital and the DEU, number of explorations, frequency of sedation use, drugs employed, participation of an anesthesiologist, use of monitoring, and complications. RESULTS Forty-four DEU (70%) corresponding to 31 public hospitals and 13 private hospitals completed the questionnaire. Evaluation of sedation patterns was based on 105,904 explorations performed in the various DEU (56,453 gastroscopies, 47,278 colonoscopies and 2,173 endoscopic retrograde cholangiopancreatographies (ERCP) in 2001. Sedation, sedation-analgesia or anesthesia was used in 17% of gastroscopies, 61% of colonoscopies and 100% of ERCP. Sedation was administered by an anesthesiologist in 7% of gastroscopies, 25% of colonoscopies and 38% of ERCP. Anesthesiologist administration was more frequent in private than in public centers (gastroscopies: 25% vs. 2%; colonoscopies: 57% vs. 9%, p < 0.001). No deaths associated with the use of sedation were reported. Eighty-nine percent of the DEU complied with standard recommendations for the practice of sedation. CONCLUSIONS In Catalonia, the use of sedation is highly variable, depending on the endoscopic procedure and the DEU. Use of sedation in infrequent in gastroscopy, fairly widespread in colonoscopy and routine in ERCP. Anesthesiologist administration is significantly more frequent in private hospitals. Most DEU follow standard sedation practices.
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Affiliation(s)
- R Campo
- Servicio de Aparato Digestivo, Corporació Parc Taulí, Sabadell, Barcelona, Spain.
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Vergara M, Vallve M, Gisbert JP, Calvet X. Meta-analysis: comparative efficacy of different proton-pump inhibitors in triple therapy for Helicobacter pylori eradication. Aliment Pharmacol Ther 2003. [PMID: 12969092 DOI: 10.1046/j.1365-2036.2003.01746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND It is not known whether certain proton-pump inhibitors are more efficacious than others when used in triple therapy for Helicobacter pylori eradication. AIM To compare the efficacy of different proton-pump inhibitors in triple therapy by performing a meta-analysis. METHODS A MEDLINE search was performed. Abstracts of the European Helicobacter pylori Study Group and the American Gastroenterological Association congresses from 1996 to 2002 were also examined. Randomized studies with at least two branches of triple therapy that differed only in terms of type of proton-pump inhibitor were included in a meta-analysis using Review Manager 4.1. RESULTS Fourteen studies were included. Intention-to-treat cure rates were similar for omeprazole and lansoprazole: 74.7% vs. 76%, odds ratio (OR) 0.91 [95% confidence interval (CI) 0.69-1.21] in a total of 1085 patients; for omeprazole and rabeprazole: 77.9% vs. 81.2%, OR 0.81 (95% CI 0.58-1.15) in a total of 825 patients; for omeprazole and esomeprazole: 87.7% vs. 89%, OR 0.89 (95% CI 0.58-1.35) in 833 patients; and for lansoprazole and rabeprazole: 81% vs. 85.7%, OR 0.77 (95% CI 0.48-1.22) in 550 patients. CONCLUSION The efficacy of various proton-pump inhibitors seems to be similar when used for H. pylori eradication in standard triple therapy.
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Affiliation(s)
- M Vergara
- Unitat de Malalties Digestives, Hospital de Sabadell, Institut Universitari Parc Taulí, UAB, Sabadell, Barcelona, Spain
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Vergara M, Vallve M, Gisbert JP, Calvet X. Meta-analysis: comparative efficacy of different proton-pump inhibitors in triple therapy for Helicobacter pylori eradication. Aliment Pharmacol Ther 2003; 18:647-54. [PMID: 12969092 DOI: 10.1046/j.1365-2036.2003.01746.x] [Citation(s) in RCA: 71] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND It is not known whether certain proton-pump inhibitors are more efficacious than others when used in triple therapy for Helicobacter pylori eradication. AIM To compare the efficacy of different proton-pump inhibitors in triple therapy by performing a meta-analysis. METHODS A MEDLINE search was performed. Abstracts of the European Helicobacter pylori Study Group and the American Gastroenterological Association congresses from 1996 to 2002 were also examined. Randomized studies with at least two branches of triple therapy that differed only in terms of type of proton-pump inhibitor were included in a meta-analysis using Review Manager 4.1. RESULTS Fourteen studies were included. Intention-to-treat cure rates were similar for omeprazole and lansoprazole: 74.7% vs. 76%, odds ratio (OR) 0.91 [95% confidence interval (CI) 0.69-1.21] in a total of 1085 patients; for omeprazole and rabeprazole: 77.9% vs. 81.2%, OR 0.81 (95% CI 0.58-1.15) in a total of 825 patients; for omeprazole and esomeprazole: 87.7% vs. 89%, OR 0.89 (95% CI 0.58-1.35) in 833 patients; and for lansoprazole and rabeprazole: 81% vs. 85.7%, OR 0.77 (95% CI 0.48-1.22) in 550 patients. CONCLUSION The efficacy of various proton-pump inhibitors seems to be similar when used for H. pylori eradication in standard triple therapy.
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Affiliation(s)
- M Vergara
- Unitat de Malalties Digestives, Hospital de Sabadell, Institut Universitari Parc Taulí, UAB, Sabadell, Barcelona, Spain
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Abstract
A three-dimensional scalable biomechanical model of the four fingers of the hand to evaluate power grip is proposed. The model has been validated by means of reproducing an experiment in which the subjects exerted the maximal voluntary grasping force over cylinders of different diameters. The model is used to simulate the cylinder grip for two hand sizes and for five different handle diameters. The reduction of the muscle forces using different handle diameters has been studied. The model can be applied to the design and evaluation of handles for power grip and to the study of power grasp for normal and abnormal hands.
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Affiliation(s)
- Joaquín L Sancho-Bru
- Department de Tecnologia, Universitat Jaume I. Campus de Riu Sec., 12071 Castelló, Spain.
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Vallve M, Vergara M, Gisbert JP, Calvet X. Single vs. double dose of a proton pump inhibitor in triple therapy for Helicobacter pylori eradication: a meta-analysis. Aliment Pharmacol Ther 2002; 16:1149-56. [PMID: 12030958 DOI: 10.1046/j.1365-2036.2002.01270.x] [Citation(s) in RCA: 98] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Triple therapies combining a double dose of proton pump inhibitor plus two antibiotics are the standard treatment for Helicobacter pylori infection. Some reports suggest that the use of half the dose of proton pump inhibitor is equally effective. AIM To compare the efficacy of a single vs. double dose of proton pump inhibitor in triple therapy. METHODS We conducted a MEDLINE search. The search strategy included the words (pylori) AND (triple, PPI, proton pump, omeprazole, rabeprazole, pantoprazole, lansoprazole, clarithromycin, amoxicillin, amoxycillin or metronidazole). Abstracts of the articles obtained and papers presented at the European Helicobacter pylori Study Group and American Gastroenterological Association congresses from 1996 to 2001 were examined. Inclusion criteria were: (i) randomized studies with at least two branches of triple therapy including a proton pump inhibitor and two standard antibiotics; (ii) branches could differ only in terms of proton pump inhibitor dosage. A meta-analysis was conducted using conventional shareware (Review Manager 4.1). RESULTS Thirteen studies met the inclusion criteria with a total of 2391 patients. Cure rates with double doses of proton pump inhibitor were higher in both the intention-to-treat analysis (83.9% vs. 77.7%; Peto odds ratio, 1.51; 95% confidence interval, 1.23-1.85; P < 0.01) and per protocol analysis (89% vs. 81%; Peto odds ratio, 1.96; 95% confidence interval, 1.55-2.47; P < 0.01). CONCLUSION Triple therapies containing a single dose of proton pump inhibitor are less effective than those containing a standard double dose of proton pump inhibitor.
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Affiliation(s)
- M Vallve
- Unitat de Malalties Digestives, Corporació Parc Taulí, Parc Taulí s/n, 08208 Sabadell, Barcelona, Spain
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Vergara M, Casellas F, Badia X, Malagelada JR. Assessing the quality of life of household members of patients with inflammatory bowel disease: development and validation of a specific questionnaire. Am J Gastroenterol 2002; 97:1429-37. [PMID: 12094861 DOI: 10.1111/j.1572-0241.2002.05684.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Household members of patients with inflammatory bowel disease (IBD) are impacted in their daily lives by close interaction with chronic illness. However, the effect of IBD on the quality of life of household members has not been evaluated because appropriate instruments to measure it are lacking. The aim of this study was to develop and validate a specific instrument to measure the quality of life of household members of patients with IBD. METHODS Household members were interviewed to generate an initial pool of items. A group of investigators excluded redundant and incomprehensible items, and the resulting preliminary questionnaire was completed by 81 subjects. Further item reduction was performed using the psychometric method. The psychometric properties of the final questionnaire were determined in a group of 106 subjects. RESULTS Of the initial 67 items, 19 were excluded by investigators. The remaining 48 items were answered by 81 household members, and 32 items were excluded by factor analysis. Two others were excluded because of poor comprehension. The definitive questionnaire consisted of 14 items. CONCLUSIONS We have developed and validated a questionnaire to measure the quality of life of household members of IBD patients. It will greatly enhance the possibilities of quantifying the effects of IBD on home life and should become a useful tool in health care planning.
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Affiliation(s)
- M Vergara
- Digestive System Research Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
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Sobrino JF, Campo R, Brullet E, Montserrat A, Vergara M, Gil M, Dalmau B, Calvet X. [Paracetamol-codeine induced hepatic colic]. Gastroenterol Hepatol 2001; 24:365-6. [PMID: 11481075 DOI: 10.1016/s0210-5705(01)70196-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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