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Racca A, Alvarez M, Garcia Martinez S, Rodriguez I, Gonzalez-Foruria I, Polyzos NP, Coroleu B. Assessment of progesterone levels on the day of pregnancy test determination: A novel concept toward individualized luteal phase support. Front Endocrinol (Lausanne) 2023; 14:1090105. [PMID: 36817599 PMCID: PMC9929287 DOI: 10.3389/fendo.2023.1090105] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/11/2023] [Indexed: 02/04/2023] Open
Abstract
RESEARCH QUESTION The main objective of the study is to define the optimal trade-off progesterone (P4) values on the day of embryo transfer (ET), to identify low P4-human chorionic gonadotropin (hCG), and to establish whether P4 supplementation started on the hCG day can increase the success rate of the frozen embryo transfer (FET) cycle. DESIGN A single-center, cohort, retrospective study with 664 hormone replacement therapy (HRT)-FET cycles analyzed female patients who received vaginal 600 mg/day of P4 starting from 6 days before the FET, had normal P4 values on the day before ET, and whose P4 on the day of the pregnancy test was assessed. RESULTS Of the 664 cycles, 69.6% of cycles showed P4 ≥ 10.6 ng/ml, while 30.4% showed P4 < 10.6 ng/ml on the day of the hCG. Of the 411 chemical pregnancies detected, 71.8% had P4-hCG ≥ 10.6 ng/ml (group A), while 28.2% had P4-hCG < 10.6 ng/ml. Of the cycles with P4-hCG < 10.6 ng/ml, 64.7% (group B) were supplemented with a higher dose of vaginal P4 (1,000 mg/day), while 35.3% (group C) were maintained on the same dose of vaginal micronized P4. The live birth rate was 71.9%, 96%, and 7.3% for groups A, B, and C, respectively. CONCLUSION The likelihood to detect P4-hCG < 10.6 ng/ml decreased as the level of serum P4 the day before ET increased. The live birth rate (LBR) was shown to be significantly lower when P4 was low and not supplemented.
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Affiliation(s)
- A. Racca
- Department of Obstetrics Gynecology and Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
- *Correspondence: A Racca,
| | - M. Alvarez
- Department of Obstetrics Gynecology and Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
| | - S. Garcia Martinez
- Department of Obstetrics Gynecology and Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
| | - I. Rodriguez
- Department of Obstetrics Gynecology and Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
| | - I. Gonzalez-Foruria
- Department of Obstetrics Gynecology and Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
- Facultad de Medicina Universitat de Vic-Universitat Central de Catalunya, Vic, Spain
| | - NP. Polyzos
- Department of Obstetrics Gynecology and Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - B. Coroleu
- Department of Obstetrics Gynecology and Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
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Cain A, Alvarez M, Salazar C. Increase in Complications Following Vaginal Hysterectomy Compared to Laparoscopic Hysterectomy Using the ACS-NSQIP 2016 – 2019 Database. J Minim Invasive Gynecol 2022. [DOI: 10.1016/j.jmig.2022.09.035] [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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3
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Racca A, Prats P, Garcias S, Alvarez M, Coroleu B, Polyzos N. P-403 Progesterone supplementation in frozen embryo transfer with hormonal replacement therapy is associated with a higher incidence of macrosomia. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Study question
Is there an impact of increased progesterone (P4) supplementation in hormone replacement therapy (HRT) frozen embryo transfer (FET) on obstetrical and neonatal outcomes?
Summary answer
Increased P4 supplementation from the day of FET is associated with a significantly higher risk of macrosomia and a slightly higher risk of preeclampsia.
What is known already
The most widely used method for endometrial preparation prior to FET is HRT, a sequential regimen with E2 and P4, which aims to mimic the endocrine exposure of the endometrium of the physiological cycle. However, in ∼40% of the patients undergoing HRT-FET cycles P4 levels before FET remain low and this may negatively affect pregnancy rates. Although recent prospective studies have shown that additional P4 supplementation in case of low serum P4 levels results in excellent reproductive outcomes, no data exist concerning the potential effect of this extra amount of P4 on obstetrical and neonatal outcomes
Study design, size, duration
This is a single-centre, retrospective-observational study. Women undergoing HRT-FET treatment meeting the inclusion criteria were allocated to one of the 2 study groups according to the P4 supplementation. Group A (277) included women with adequate levels (>10.6 ng/ml) of P4, while group B (129) included women who received P4 supplementation due to inadequate levels of P4 (<10.6 ng/ml) on the day before the FET. All FET-HRT cycles were performed between February 2018 and December 2020.
Participants/materials, setting, methods
All patients received micronized P4 (200 mg trice a day) starting six days prior to the FET and continued until 10 weeks of pregnancy. In case P4<10.6 ng/ml, P4 supplementation was initiated rather with 400mg more micronized P4 (15%) or with subcutaneous P4 (25mg more/once a day) (85%). Only patients with day5-embryos, known P4 levels prior to FET, known obstetrical and neonatal outcomes were included. Multivariable-logistic-model was fitted for macrosomia after adjusting for confounding variables.
Main results and the role of chance
Patients’ age at oocyte retrieval was 33.5 and 33.6 years (p = 0.833), while the age at delivery was 39.9 and 39.1 years (p = 0.099), respectively for groups A and B. The incidence of diabetes, hypertension, autoimmune diseases, coagulation, and kidney disorders was comparable for both arms. The mean value of P4 was 16 ± 7.7 and 8.2 ± 1.9, respectively for groups A and B. The mean gestational length was 39 weeks in both arms, with comparable rates of premature deliveries (delivery <37 weeks respectively 4.3% and 3.1 % for group A and B; p = 0.553). The rate of cesarean-section was 56% vs 47.3%, respectively for groups A and B (p = 0.103); there were 5 cases of pre-eclampsia in group A and 7 in group B (1.8% vs 5.4%; p = 0.059). The incidence of macrosomia was significantly higher in group B (6.1% vs 12.4%; P = 0.031). Similarly, group B had a higher rate of BGA-big for gestational age- babies (9.7 vs 15.5, p = 0.091). In terms of weight at delivery, pH, Apgar, and sex the two groups were comparable. Multivariable-logistic regression showed an association between macrosomia and P4 supplementation, adjusting for potential confounders such as sex, gestational diabetes, and weeks of gestation (OR 2.3, 95% CI 1.1-4.8).
Limitations, reasons for caution
The main limitation of this study is its retrospective nature. Other potential limitations are the small sample size to detect obstetrical diseases with low incidence, such as preeclampsia. Furthermore, in our study population the PE rate is lower than in the general population, due to socioeconomic-conditions, race, and previous morbidity.
Wider implications of the findings
P4-supplemented patients have a higher risk of macrosomia and a tendency for a higher risk of preeclampsia. However, more studies are needed to confirm the present exploratory findings and explain the possible physiological mechanisms underlying the association between progesterone supplementation on macrosomia and preeclampsia.
Trial registration number
NA
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Affiliation(s)
- A Racca
- Dexeus University Hospital, Reproductive Medicine Service , Barcelona, Spain
| | - P Prats
- Dexeus University Hospital, Obstetric and Gynecology Service , Barcelona, Spain
| | - S Garcias
- Dexeus University Hospital, Reproductive Medicine Service , Barcelona, Spain
| | - M Alvarez
- Dexeus University Hospital, Reproductive Medicine Service , Barcelona, Spain
| | - B Coroleu
- Dexeus University Hospital, Reproductive Medicine Service , Barcelona, Spain
| | - N.P Polyzos
- Dexeus University Hospital, Reproductive Medicine Service , Barcelona, Spain
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4
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Hassan MAA, Sayed RKA, Abdelsabour-Khalaf M, Abd-Elhafez EA, Anel-Lopez L, Riesco MF, Ortega-Ferrusola C, Montes-Garrido R, Neila-Montero M, Anel L, Alvarez M. Morphological and ultrasonographic characterization of the three zones of supratesticular region of testicular artery in Assaf rams. Sci Rep 2022; 12:8334. [PMID: 35585142 PMCID: PMC9117313 DOI: 10.1038/s41598-022-12243-z] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 05/09/2022] [Indexed: 11/25/2022] Open
Abstract
To fully understand the histological, morphometrical and heamodynamic variations of different supratesticular artery regions, 20 mature and healthy Assaf rams were examined through ultrasound and morphological studies. The testicular artery images of the spermatic cord as shown by B-mode analysis indicated a tortuous pattern along its course toward the testis, although it tends to be less tortuous close to the inguinal ring. Doppler velocimetric values showed a progressive decline in flow velocity, in addition to pulsatility and vessel resistivity when entering the testis, where there were significant differences in the Doppler indices and velocities among the different regions. The peak systolic velocity, pulsatility index and resistive index were higher in the proximal supratesticular artery region, followed by middle and distal ones, while the end diastolic velocity was higher in the distal supratesticular region. The total arterial blood flow and total arterial blood flow rate reported a progressive and significant increase along the testicular cord until entering the testis. Histological examination revealed presence of vasa vasorum in the tunica adventitia, with their diameter is higher in the proximal supratesticular zone than middle and distal ones. Morphometrically, the thickness of the supratesticular artery wall showed a significant decline downward toward the testis; meanwhile, the outer arterial diameter and inner luminal diameter displayed a significant increase distally. The expression of alpha smooth muscle actin and vimentin was higher in the tunica media of the proximal supratesticular artery zone than in middle and distal ones.
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Affiliation(s)
- Mohamed A A Hassan
- Department of Anatomy and Embryology, Faculty of Veterinary Medicine, Sohag University, Sohag, 82524, Egypt
| | - Ramy K A Sayed
- Department of Anatomy and Embryology, Faculty of Veterinary Medicine, Sohag University, Sohag, 82524, Egypt
| | - Mohammed Abdelsabour-Khalaf
- Department of Anatomy and Embryology, Faculty of Veterinary Medicine, South Valley University, Qena, 83523, Egypt
| | - Enas A Abd-Elhafez
- Department of Anatomy and Histology, Faculty of Veterinary Medicine, Assiut University, Assiut, 71526, Egypt
| | - L Anel-Lopez
- ITRA-ULE, INDEGSAL, University of León, 24071, León, Spain. .,Department of Veterinary Medicine, Surgery and Anatomy, University of León, 24071, León, Spain.
| | - M F Riesco
- ITRA-ULE, INDEGSAL, University of León, 24071, León, Spain.,Cellular Biology, Department of Molecular Biology, University of León, 24071, León, Spain
| | - C Ortega-Ferrusola
- Laboratory of Equine Reproduction and Equine Spermatology, Veterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
| | - R Montes-Garrido
- ITRA-ULE, INDEGSAL, University of León, 24071, León, Spain.,Department of Veterinary Medicine, Surgery and Anatomy, University of León, 24071, León, Spain
| | - M Neila-Montero
- ITRA-ULE, INDEGSAL, University of León, 24071, León, Spain.,Department of Veterinary Medicine, Surgery and Anatomy, University of León, 24071, León, Spain
| | - L Anel
- ITRA-ULE, INDEGSAL, University of León, 24071, León, Spain.,Department of Veterinary Medicine, Surgery and Anatomy, University of León, 24071, León, Spain
| | - M Alvarez
- ITRA-ULE, INDEGSAL, University of León, 24071, León, Spain.,Department of Veterinary Medicine, Surgery and Anatomy, University of León, 24071, León, Spain
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5
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Al-Khan A, Alshowaikh K, Krishnamoorthy K, Saber S, Alvarez M, Pappas L, Mannion C, Kayaalp E, Francis A, Alvarez-Perez J. Pulsatile vessel at the posterior bladder wall: A new sonographic marker for placenta percreta. J Obstet Gynaecol Res 2022; 48:1149-1156. [PMID: 35233884 DOI: 10.1111/jog.15208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/12/2022] [Accepted: 02/16/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE We investigated using "pulsatile vessels at the posterior bladder wall" as a novel sonographic marker to demonstrate the severity of placenta accreta spectrum (PAS). METHODS This observational case-control study of 30 pregnant women was performed at Hackensack Meridian Health's Center for Abnormal Placentation in 2020. The case group was made up of women with historically described sonographic signs of PAS and was compared against two control groups: (1) women with uncomplicated placenta previa and (2) women with no evidence of placenta previa sonographically. All patients were evaluated with Color Flow Doppler ultrasound to assess the presence of arterial vessels at the posterior bladder wall. The flow characteristics and resistance indices (RI) were noted in the presence of pulsatile vessels. All patients' placentation was clinically confirmed at delivery. Patients with clinical invasive placentation underwent histopathological diagnosis to confirm disease presence. RESULTS Hundred percent of subjects in our series with suspected PAS exhibited pulsatile arterial vessels at the posterior bladder wall sonographically with a low RI of 0.38 ± 0.1 at an average of 24.6 ± 5.2 gestational weeks. Cases were histopathologically confirmed to have placenta percreta after delivery. Patients in either of the control groups did not display pulsatile vessels at the posterior bladder wall during antenatal sonographic evaluations and had no clinical evidence of PAS. CONCLUSION The presence of posterior urinary bladder wall pulsatile arterial vessels with low RI, in addition to traditional sonographic markers increases the suspicion of severe PAS. Thus, these findings allow for the greater opportunity for coordination of patient care prior to delivery.
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Affiliation(s)
- Abdulla Al-Khan
- Center for Abnormal Placentation, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Hackensack-Meridian Health, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Khadija Alshowaikh
- Center for Abnormal Placentation, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Hackensack-Meridian Health, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Kaila Krishnamoorthy
- Center for Abnormal Placentation, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Hackensack-Meridian Health, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA.,Department of Obstetrics, Gynecology, and Women's Health, Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Shelley Saber
- Center for Abnormal Placentation, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Hackensack-Meridian Health, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Manuel Alvarez
- Center for Abnormal Placentation, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Hackensack-Meridian Health, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Leigh Pappas
- Center for Abnormal Placentation, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Hackensack-Meridian Health, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Ciaran Mannion
- Center for Abnormal Placentation, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Hackensack-Meridian Health, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Emre Kayaalp
- Center for Abnormal Placentation, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Hackensack-Meridian Health, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Antonia Francis
- Center for Abnormal Placentation, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Hackensack-Meridian Health, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Jesus Alvarez-Perez
- Center for Abnormal Placentation, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Hackensack-Meridian Health, Hackensack University Medical Center, Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
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6
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Redding LE, Tu V, Abbas A, Alvarez M, Zackular JP, Gu C, Bushman FD, Kelly DJ, Barnhart D, Lee JJ, Bittinger KL. Genetic and phenotypic characteristics of Clostridium (Clostridioides) difficile from canine, bovine, and pediatric populations. Anaerobe 2022; 74:102539. [PMID: 35217150 PMCID: PMC9359814 DOI: 10.1016/j.anaerobe.2022.102539] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/02/2022] [Accepted: 02/17/2022] [Indexed: 12/15/2022]
Abstract
Objectives: Carriage of Clostridioides difficile by different species of animals has led to speculation that animals could represent a reservoir of this pathogen for human infections. The objective of this study was to compare C. difficile isolates from humans, dogs, and cattle from a restricted geographic area. Methods: C. difficile isolates from 36 dogs and 15 dairy calves underwent whole genome sequencing, and phenotypic assays assessing growth and virulence were performed. Genomes of animal-derived isolates were compared to 29 genomes of isolates from a pediatric population as well as 44 reference genomes. Results: Growth rates and relative cytotoxicity of isolates were significantly higher and lower, respectively, in bovine-derived isolates compared to pediatric- and canine-derived isolates. Analysis of core genes showed clustering by host species, though in a few cases, human strains co-clustered with canine or bovine strains, suggesting possible interspecies transmission. Geographic differences (e.g., farm, litter) were small compared to differences between species. In an analysis of accessory genes, the total number of genes in each genome varied between host species, with 6.7% of functional orthologs differentially present/absent between host species and bovine-derived strains having the lowest number of genes. Canine-derived isolates were most likely to be non-toxigenic and more likely to carry phages. A targeted study of episomes identified in local pediatric strains showed sharing of a methicillin-resistance plasmid with dogs, and historic sharing of a wide range of episomes across hosts. Bovine-derived isolates harbored the widest variety of antibiotic-resistance genes, followed by canine Conclusions: While C. difficile isolates mostly clustered by host species, occasional co-clustering of canine and pediatric-derived isolates suggests the possibility of interspecies transmission. The presence of a pool of resistance genes in animal-derived isolates with the potential to appear in humans given sufficient pressure from antibiotic use warrants concern.
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Affiliation(s)
- L E Redding
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania, School of Veterinary Medicine, Kennett Square, PA, 19348, USA.
| | - V Tu
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, PA, 19104, USA
| | - A Abbas
- Division of Protective Immunity, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - M Alvarez
- Division of Protective Immunity, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - J P Zackular
- Division of Protective Immunity, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA; Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - C Gu
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - F D Bushman
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - D J Kelly
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania, School of Veterinary Medicine, Kennett Square, PA, 19348, USA
| | - D Barnhart
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania, School of Veterinary Medicine, Kennett Square, PA, 19348, USA
| | - J J Lee
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, PA, 19104, USA
| | - K L Bittinger
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, PA, 19104, USA
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Benavides M, Alcaide-Garcia J, Torres E, Gil S, Durán G, Reyna C, Wolman R, Alvarez M, Kushnir M, Faull I, Muñoz M, Alba E. 503P Mutational landscape in synchronous unresectable metastatic colorectal cancer (mCRC) according to upfront primary tumour resection (UPTR). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1022] [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] Open
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8
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Alvarez M, Racca A, García S, Martínez F, González-Foruria I, Parriego M, Coroleu B. P–672 Higher pregnancy outcomes in patients undergoing embryo transfer-under hormonal replacement therapy where an individualised Progesterone supplementation was applied on the day of β-hCG. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Does progesterone-supplementation (PS) from the day of β-hCG assessment improve pregnancy rates in embryo transfer-under hormonal replacement therapy (ET-HRT) in patient with Progesterone (P)<10.6 ng/mL?
Summary answer
Reduced P on the β-hCG day is associated with lower pregnancy-rates and higher miscarriage-rate. PS from the same day showed significant increase of reproductive outcomes.
What is known already
Up until now, in ART, very little has been done to understand whether the P intake should be personalized during the luteal phase. Most recent studies on the topic showed that low P levels on the day of ET-HRT or on the day before are associated with decreased pregnancy rates; however, when low P values are supplemented from the day before embryo-transfer (ET), similar results to cases with adequate P are reported. Nevertheless, little is known about the association between low P level, on the day of β-hCG (P- β-hCG) and PS from this day in ET-HRT, and pregnancy outcomes.
Study design, size, duration
This is a single centre, cohort, retrospective study conducted at a university-affiliated fertility centre between January 2018 and June 2020 where PS took place from the day of positive β-hCG determination when P < 10.6 ng/mL. In total 789 ET-HRT cycles were analysed of which 239 were performed in both fresh and frozen heterologous ET-HRT (het-ET), 336 in homologous ET-HRT (hom-FET) and 214 in euploid ET-HRT (eu-FET) after preimplantation genetic testing for aneuploidies IVF cycles (PGT-A).
Participants/materials, setting, methods
Women undergoing ET-HRT with normal P (>10.6ng/mL) on the day before ET were screened for P on the day of β-hCG. All women received vaginal P 200 mg/8 hours for the second part of HRT. PS was performed by adding P to the HRT when P- β-hCG was considered low (<10.6 ng/mL). Primary outcome: ongoing-pregnancy-rate (OPR); secondary outcome: miscarriage-rate (MR). Both were evaluated by considering PS on the day of β-hCG as a categorical variable.
Main results and the role of chance
Patients characteristics were comparable between groups (het-ET, hom-FET and eu-FET) although significantly lower body mass index was found when P- β-hCG>10.6 ng/mL compared to the subgroup with P- β-hCG<10.6 ng/mL and no PS (p = 0.012). Overall clinical pregnancy rate was 52.1% with no-significant differences between groups (48.5% in het-ET, 52.9% in hom-FET and 54.7% in eu-FET). P- β-hCG was considered as adequate in 75.7% (311/411) ET-HRT with positive β-hCG and low in 24.3% (100/411), with no differences between groups. In case of positive β-hCG and P- β-hCG >10.6 ng/mL, OPR was 83.6% and MR was 16.4%, with no-significant differences between groups. Among the 100 low P- β-hCG, 80 ET-HRT received PS. In this subgroup OPR was 96.2% and MR was 3.8%, with no-significant differences between groups. In 20 out of 100 ET with P- β-hCG <10.6 ng/mL, no PS was added for different reasons. This group showed the lowest OPR (30%) and the highest MR (70%), again with no between-group differences according to het-ET, hom-FET or eu-FET. Miscarriage rate was significantly higher (p < 0.001) when P- β-hCG was <10.6 ng/mL and no PS was added to HRT compared to P- β-hCG <10.6 ng/mL but with PS, and also compared to the P- β-hCG >10.6 ng/mL group.
Limitations, reasons for caution
The main limitation of the study is due to its retrospective nature and the small sample of patients with P- β-hCG<10.6 ng/mL that was not supplemented. Furthermore, the cut-off of P- β-hCG was arbitrarily decided upon previous studies, and lastly different routes of administration were considered for the PS.
Wider implications of the findings: The results of this study showed that individualization of Progesterone supplementation in ET-HRT may be a crucial turn point in order to increase the pregnancy rates and decrease the miscarriage rates. An adequate PS should be considered in case of low P- β-hCG levels for both het-ET, hom-FET and eu-FET.
Trial registration number
Not applicable
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Affiliation(s)
- M Alvarez
- Reproductive Medicine Service. Dexeus Mujer. Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproductive Medicine, Barcelona, Spain
| | - A Racca
- Reproductive Medicine Service. Dexeus Mujer. Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproductive Medicine, Barcelona, Spain
| | - S García
- Reproductive Medicine Service. Dexeus Mujer. Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproductive Medicine, Barcelona, Spain
| | - F Martínez
- Reproductive Medicine Service. Dexeus Mujer. Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproductive Medicine, Barcelona, Spain
| | - I González-Foruria
- Reproductive Medicine Service. Dexeus Mujer. Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproductive Medicine, Barcelona, Spain
| | - M Parriego
- Reproductive Medicine Service. Dexeus Mujer. Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproductive Medicine, Barcelona, Spain
| | - B Coroleu
- Reproductive Medicine Service. Dexeus Mujer. Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproductive Medicine, Barcelona, Spain
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Crowley M, Obeng S, Patel A, Gamez‐Jimenez L, Restrepo L, Ho N, Alvarez M, Thadisetti A, Kern E, Pallares V, Leon F, Mottinelli M, Zuarth Gonzalez J, McCurdy C, McMahon L, Hiranita T. Assessment of Contribution of 7‐Hydroxymitragynine and Mitragynine Pseudoindoxyl to the MU‐Opioid Activity of Mitragynine. FASEB J 2021. [DOI: 10.1096/fasebj.2021.35.s1.05475] [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)
| | - Samuel Obeng
- PharmacodynamicsUniversity of FlordiaGainesvilleFL
| | - Avi Patel
- PharmacodynamicsUniversity of FlordiaGainesvilleFL
| | | | | | - Nicholas Ho
- PharmacodynamicsUniversity of FlordiaGainesvilleFL
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Patel A, Obeng S, Gamez‐Jimenez L, Ho N, Alvarez M, Thadisetti A, Kern E, León F, Mottinelli M, Gonzalez J, McCurdy C, McMahon L, Hiranita T. The Lofexidine‐Like Discriminative Effects of the Primary Kratom Alkaloid Mitragynine in Rats. FASEB J 2021. [DOI: 10.1096/fasebj.2021.35.s1.04912] [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)
- Avi Patel
- PharmacodynamicsUniversity of FloridaGainesvilleFL
| | - Samuel Obeng
- Pharmacodynamics, Medicinal ChemistryUniversity of FloridaGainesvilleFL
| | | | - Nicholas Ho
- PharmacodynamicsUniversity of FloridaGainesvilleFL
| | | | | | | | - Francisco León
- Drug Discovery & Biomedical Sciences (DDBS)Horizon I Building ‐ 112AUniversity of South CarolinaColumbiaSC
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11
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Rossi-Pool R, Zainos A, Alvarez M, Diaz-deLeon G, Romo R. A continuum of invariant sensory and behavioral-context perceptual coding in secondary somatosensory cortex. Nat Commun 2021; 12:2000. [PMID: 33790301 PMCID: PMC8012659 DOI: 10.1038/s41467-021-22321-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 03/08/2021] [Indexed: 11/08/2022] Open
Abstract
A crucial role of cortical networks is the conversion of sensory inputs into perception. In the cortical somatosensory network, neurons of the primary somatosensory cortex (S1) show invariant sensory responses, while frontal lobe neuronal activity correlates with the animal's perceptual behavior. Here, we report that in the secondary somatosensory cortex (S2), neurons with invariant sensory responses coexist with neurons whose responses correlate with perceptual behavior. Importantly, the vast majority of the neurons fall along a continuum of combined sensory and categorical dynamics. Furthermore, during a non-demanding control task, the sensory responses remain unaltered while the sensory information exhibits an increase. However, perceptual responses and the associated categorical information decrease, implicating a task context-dependent processing mechanism. Conclusively, S2 neurons exhibit intriguing dynamics that are intermediate between those of S1 and frontal lobe. Our results contribute relevant evidence about the role that S2 plays in the conversion of touch into perception.
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Affiliation(s)
- Román Rossi-Pool
- Instituto de Fisiología Celular─Neurociencias, Universidad Nacional Autónoma de México, Mexico City, Mexico.
| | - Antonio Zainos
- Instituto de Fisiología Celular─Neurociencias, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Manuel Alvarez
- Instituto de Fisiología Celular─Neurociencias, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Gabriel Diaz-deLeon
- Instituto de Fisiología Celular─Neurociencias, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Ranulfo Romo
- Instituto de Fisiología Celular─Neurociencias, Universidad Nacional Autónoma de México, Mexico City, Mexico.
- Centro de Ciencias de la Complejidad, Universidad Nacional Autónoma de México, Mexico City, Mexico.
- El Colegio Nacional, Mexico City, Mexico.
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12
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Le Roy C, Barja S, Sepúlveda C, Guzmán M, Olivarez M, Figueroa M, Alvarez M. Deficiencia de vitamina D y de hierro en niños y adolescentes con parálisis cerebral. Neurologia 2021; 36:112-118. [DOI: 10.1016/j.nrl.2017.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 10/23/2017] [Accepted: 11/05/2017] [Indexed: 11/25/2022] Open
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13
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van der Nelson H, O'Brien S, Burnard S, Mayer M, Alvarez M, Knowlden J, Winter C, Dailami N, Marques E, Burden C, Siassakos D, Draycott T. Intramuscular oxytocin versus Syntometrine ® versus carbetocin for prevention of primary postpartum haemorrhage after vaginal birth: a randomised double-blinded clinical trial of effectiveness, side effects and quality of life. BJOG 2021; 128:1236-1246. [PMID: 33300296 DOI: 10.1111/1471-0528.16622] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare intramuscular oxytocin, Syntometrine® and carbetocin for prevention of postpartum haemorrhage after vaginal birth. DESIGN Randomised double-blinded clinical trial. SETTING Six hospitals in England. POPULATION A total of 5929 normotensive women having a singleton vaginal birth. METHODS Randomisation when birth was imminent. MAIN OUTCOME MEASURES Primary: use of additional uterotonic agents. Secondary: weighed blood loss, transfusion, manual removal of placenta, adverse effects, quality of life. RESULTS Participants receiving additional uterotonics: 368 (19.5%) oxytocin, 298 (15.6%) Syntometrine and 364 (19.1%) carbetocin. When pairwise comparisons were made: women receiving carbetocin were significantly more likely to receive additional uterotonics than those receiving Syntometrine (odds ratio [OR] 1.28, 95% CI 1.08-1.51, P = 0.004); the difference between carbetocin and oxytocin was non-significant (P = 0.78); Participants receiving Syntometrine were significantly less likely to receive additional uterotonics than those receiving oxytocin (OR 0.75, 95% CI 0.65-0.91, P = 0.002). Non-inferiority between carbetocin and Syntometrine was not shown. Use of Syntometrine reduced non-drug PPH treatments compared with oxytocin (OR 0.64, 95% CI 0.42-0.97) but not carbetocin (P = 0.64). Rates of PPH and blood transfusion were not different. Syntometrine was associated with an increase in maternal adverse effects and reduced ability of the mother to bond with her baby. CONCLUSIONS Non-inferiority of carbetocin to Syntometrine was not shown. Carbetocin is not significantly different to oxytocin for use of additional uterotonics. Use of Syntometrine reduced use of additional uterotonics and need for non-drug PPH treatments compared with oxytocin. Increased maternal adverse effects are a disadvantage of Syntometrine. TWEETABLE ABSTRACT IM carbetocin does not reduce additional uterotonic use compared with IM Syntometrine or oxytocin.
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Affiliation(s)
- H van der Nelson
- North Bristol NHS Trust, Bristol, UK.,University of Bristol, Bristol, UK
| | - S O'Brien
- North Bristol NHS Trust, Bristol, UK.,University of Bristol, Bristol, UK
| | - S Burnard
- Royal United Hospitals NHS Trust, Bath, UK
| | - M Mayer
- North Bristol NHS Trust, Bristol, UK
| | - M Alvarez
- North Bristol NHS Trust, Bristol, UK
| | | | - C Winter
- North Bristol NHS Trust, Bristol, UK
| | - N Dailami
- University of the West of England, Bristol, UK
| | - E Marques
- North Bristol NHS Trust, Bristol, UK
| | - C Burden
- North Bristol NHS Trust, Bristol, UK.,University of Bristol, Bristol, UK
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14
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Cotte L, Hocqueloux L, Lefebvre M, Pradat P, Bani-Sadr F, Huleux T, Poizot-Martin I, Pugliese P, Rey D, Cabié A, Chirouze C, Drobacheff-Thiébaut C, Foltzer A, Bouiller K, Hustache-Mathieu L, Lepiller Q, Bozon F, Babre O, Brunel AS, Muret P, Chevalier E, Jacomet C, Laurichesse H, Lesens O, Vidal M, Mrozek N, Aumeran C, Baud O, Corbin V, Goncalvez E, Mirand A, brebion A, Henquell C, Lamaury I, Fabre I, Curlier E, Ouissa R, Herrmann-Storck C, Tressieres B, Receveur MC, Boulard F, Daniel C, Clavel C, Roger PM, Markowicz S, Chellum Rungen N, Merrien D, Perré P, Guimard T, Bollangier O, Leautez S, Morrier M, Laine L, Boucher D, Point P, Cotte L, Ader F, Becker A, Boibieux A, Brochier C, Brunel-Dalmas F, Cannesson O, Chiarello P, Chidiac C, Degroodt S, Ferry T, Godinot M, Livrozet JM, Makhloufi D, Miailhes P, Perpoint T, Perry M, Pouderoux C, Roux S, Triffault-Fillit C, Valour F, Charre C, Icard V, Tardy JC, Trabaud MA, Ravaux I, Ménard A, Belkhir AY, Colson P, Dhiver C, Madrid A, Martin-Degioanni M, Meddeb L, Mokhtari M, Motte A, Raoux A, Toméi C, Tissot-Dupont H, Poizot-Martin I, Brégigeon S, Zaegel-Faucher O, Obry-Roguet V, Laroche H, Orticoni M, Soavi MJ, Ressiot E, Ducassou MJ, Jaquet I, Galie S, Colson H, Ritleng AS, Ivanova A, Debreux C, Lions C, Rojas-Rojas T, Cabié A, Abel S, Bavay J, Bigeard B, Cabras O, Cuzin L, Dupin de Majoubert R, Fagour L, Guitteaud K, Marquise A, Najioullah F, Pierre-François S, Pasquier J, Richard P, Rome K, Turmel JM, Varache C, Atoui N, Bistoquet M, Delaporte E, Le Moing V, Makinson A, Meftah N, Merle de Boever C, Montes B, Montoya Ferrer A, Tuaillon E, Reynes J, Lefèvre B, Jeanmaire E, Hénard S, Frentiu E, Charmillon A, Legoff A, Tissot N, André M, Boyer L, Bouillon MP, Delestan M, Goehringer F, Bevilacqua S, Rabaud C, May T, Raffi F, Allavena C, Aubry O, Billaud E, Biron C, Bonnet B, Bouchez S, Boutoille D, Brunet-Cartier C, Deschanvres C, Gaborit BJ, Grégoire A, Grégoire M, Grossi O, Guéry R, Jovelin T, Lefebvre M, Le Turnier P, Lecomte R, Morineau P, Reliquet V, Sécher S, Cavellec M, Paredes E, Soria A, Ferré V, André-Garnier E, Rodallec A, Pugliese P, Breaud S, Ceppi C, Chirio D, Cua E, Dellamonica P, Demonchy E, De Monte A, Durant J, Etienne C, Ferrando S, Garraffo R, Michelangeli C, Mondain V, Naqvi A, Oran N, Perbost I, Carles M, Klotz C, Maka A, Pradier C, Prouvost-Keller B, Risso K, Rio V, Rosenthal E, Touitou I, Wehrlen-Pugliese S, Zouzou G, Hocqueloux L, Prazuck T, Gubavu C, Sève A, Giaché S, Rzepecki V, Colin M, Boulard C, Thomas G, Cheret A, Goujard C, Quertainmont Y, Teicher E, Lerolle N, Jaureguiberry S, Colarino R, Deradji O, Castro A, Barrail-Tran A, Yazdanpanah Y, Landman R, Joly V, Ghosn J, Rioux C, Lariven S, Gervais A, Lescure FX, Matheron S, Louni F, Julia Z, Le GAC S, Charpentier C, Descamps D, Peytavin G, Duvivier C, Aguilar C, Alby-Laurent F, Amazzough K, Benabdelmoumen G, Bossi P, Cessot G, Charlier C, Consigny PH, Jidar K, Lafont E, Lanternier F, Leporrier J, Lortholary O, Louisin C, Lourenco J, Parize P, Pilmis B, Rouzaud C, Touam F, Valantin MA, Tubiana R, Agher R, Seang S, Schneider L, PaLich R, Blanc C, Katlama C, Bani-Sadr F, Berger JL, N’Guyen Y, Lambert D, Kmiec I, Hentzien M, Brunet A, Romaru J, Marty H, Brodard V, Arvieux C, Tattevin P, Revest M, Souala F, Baldeyrou M, Patrat-Delon S, Chapplain JM, Benezit F, Dupont M, Poinot M, Maillard A, Pronier C, Lemaitre F, Morlat C, Poisson-Vannier M, Jovelin T, Sinteff JP, Gagneux-Brunon A, Botelho-Nevers E, Frésard A, Ronat V, Lucht F, Rey D, Fischer P, Partisani M, Cheneau C, Priester M, Mélounou C, Bernard-Henry C, de Mautort E, Fafi-Kremer S, Delobel P, Alvarez M, Biezunski N, Debard A, Delpierre C, Gaube G, Lansalot P, Lelièvre L, Marcel M, Martin-Blondel G, Piffaut M, Porte L, Saune K, Robineau O, Ajana F, Aïssi E, Alcaraz I, Alidjinou E, Baclet V, Bocket L, Boucher A, Digumber M, Huleux T, Lafon-Desmurs B, Meybeck A, Pradier M, Tetart M, Thill P, Viget N, Valette M. Microelimination or Not? The Changing Epidemiology of Human Immunodeficiency Virus-Hepatitis C Virus Coinfection in France 2012–2018. Clin Infect Dis 2021; 73:e3266-e3274. [DOI: 10.1093/cid/ciaa1940] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/01/2021] [Indexed: 01/15/2023] Open
Abstract
Abstract
Background
The arrival of highly effective, well-tolerated, direct-acting antiviral agents (DAA) led to a dramatic decrease in hepatitis C virus (HCV) prevalence. Human immunodeficiency virus (HIV)-HCV–coinfected patients are deemed a priority population for HCV elimination, while a rise in recently acquired HCV infections in men who have sex with men (MSM) has been described. We describe the variations in HIV-HCV epidemiology in the French Dat’AIDS cohort.
Methods
This was a retrospective analysis of a prospective cohort of persons living with HIV (PLWH) from 2012 to 2018. We determined HCV prevalence, HCV incidence, proportion of viremic patients, treatment uptake, and mortality rate in the full cohort and by HIV risk factors.
Results
From 2012 to 2018, 50 861 PLWH with a known HCV status were followed up. During the period, HCV prevalence decreased from 15.4% to 13.5%. HCV prevalence among new HIV cases increased from 1.9% to 3.5% in MSM but remained stable in other groups. Recently acquired HCV incidence increased from 0.36/100 person-years to 1.25/100 person-years in MSM. The proportion of viremic patients decreased from 67.0% to 8.9%. MSM became the first group of viremic patients in 2018 (37.9%). Recently acquired hepatitis represented 59.2% of viremic MSM in 2018. DAA treatment uptake increased from 11.4% to 61.5%. More treatments were initiated in MSM in 2018 (41.2%) than in intravenous drug users (35.6%). In MSM, treatment at the acute phase represented 30.0% of treatments in 2018.
Conclusions
A major shift in HCV epidemiology was observed in PLWH in France from 2012 to 2018, leading to a unique situation in which the major group of HCV transmission in 2018 was MSM.
Clinical Trials Registration. NCT02898987.
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Affiliation(s)
- Laurent Cotte
- Department of Infectious Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Lyon, France
| | - Laurent Hocqueloux
- Department of Infectious Diseases, Centre Hospitalier Régional d’Orléans – La Source, Orléans, France
| | - Maeva Lefebvre
- Department of Infectious Diseases, Centre Hospitalier Universitaire Hôtel-Dieu, Nantes; Centre d’Investigation Clinique (CIC) 1413, INSERM, Nantes, France
| | - Pierre Pradat
- Center for Clinical Research, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Firouze Bani-Sadr
- Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Robert Debré Hospital, University Hospital, Reims, France
| | - Thomas Huleux
- Department of Infectious Diseases and Travel Diseases, Centre Hospitalier Gustave-Dron, Tourcoing, France
| | - Isabelle Poizot-Martin
- Immuno-Hematology Clinic, Assistance Publique–Hôpitaux de Marseille, Hôpital Sainte-Marguerite, Marseille, Aix-MarseilleUniversity–Inserm–Institut de Recherche pour le Développement (IRD), Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
| | - Pascal Pugliese
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Nice, Hôpital l’Archet, Nice, France
| | - David Rey
- HIV Infection Care Centre, Hôpitaux Universitaires, Strasbourg
| | - André Cabié
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Martinique, Fort de France, Université des Antilles EA4537, Fort de France, INSERM CIC1424, Fort-de-France, France
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Puig I, Alvarez M, Lozano M, Lucente G. A case of late-onset osmotic demyelination syndrome. Neurologia 2020; 36:S0213-4853(20)30311-X. [PMID: 33176921 DOI: 10.1016/j.nrl.2020.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 10/10/2020] [Indexed: 10/23/2022] Open
Affiliation(s)
- I Puig
- Department of Neuroscience, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
| | - M Alvarez
- Department of Neuroscience, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
| | - M Lozano
- Department of Neuroscience, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
| | - G Lucente
- Department of Neuroscience, Hospital Germans Trias i Pujol, Badalona, Barcelona, España; Grup de Recerca en Malalties Neuromusculars i Neuropediatriques, Department of Neurosciences, Institut Investigació en Ciències de la Salut Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España; Universitat Autonoma de Barcelona, Badalona, Barcelona, España.
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16
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Cohen O, Boumaza X, Alvarez M, Porte L, Lansalot P, Martin-Blondel G, Delobel P. Épidémie d’oreillons en milieu sportif chez des patients correctement vaccinés. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.393] [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: 10/23/2022]
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17
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Neves AR, Blockeel C, Griesinger G, Garcia-Velasco JA, Marca AL, Rodriguez I, Drakopoulos P, Alvarez M, Tournaye H, Polyzos NP. The performance of the Elecsys® anti-Müllerian hormone assay in predicting extremes of ovarian response to corifollitropin alfa. Reprod Biomed Online 2020; 41:29-36. [DOI: 10.1016/j.rbmo.2020.03.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 03/21/2020] [Accepted: 03/30/2020] [Indexed: 12/21/2022]
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18
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Richard C, Alvarez M, Carneiro JP, Hanna B, Prost L, Saini A, Scarpine V, Shemyakin A. Measurements of a 2.1 MeV H - beam with an Allison scanner. Rev Sci Instrum 2020; 91:073301. [PMID: 32752855 DOI: 10.1063/5.0004502] [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] [Received: 02/13/2020] [Accepted: 06/10/2020] [Indexed: 06/11/2023]
Abstract
Transverse 2D phase space distributions of a 2.1 MeV, 5 mA H- beam are measured at the Proton Improvement Plan II Injector Test accelerator at Fermilab with an Allison scanner. This paper describes the design, calibration, and performance of the scanner along with the main results from beam measurements. Analyses of the recorded phase portraits are performed primarily in action-phase coordinates. The stability of the action under linear optics makes it easier to compare measurements taken under different beamline conditions. The amplitude of a single measured point ("pixel") is proportional to the phase density in the corresponding portion of the beam. When the Twiss parameters are calculated using only the high-phase density part of the beam, the pixel amplitude in the beam core is found to be decreasing approximately exponentially with action and to be phase-independent. Outside of the core, the amplitudes decrease with action at a slower rate than in the core. This "tail" comprises 10%-30% of the beam, with 0.1% of the total measured intensity extending beyond action 10-20 times larger than the rms emittance. The transition from the core to the tail is accompanied by the appearance of two "branches" that are separated in phase and extend beyond the core. A set of selected measurements shows that there is no measurable emittance dilution along the beamline; the beam parameters are practically constant over a 0.5 ms pulse; and scraping in various parts of the beamline is an effective way to decrease the transverse tails by removing the branches.
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Affiliation(s)
- C Richard
- Physics and Astronomy Department, Michigan State University, East Lansing, Michigan 48824, USA
| | - M Alvarez
- Accelerator Division, Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - J P Carneiro
- Accelerator Division, Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - B Hanna
- Accelerator Division, Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - L Prost
- Accelerator Division, Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Saini
- Accelerator Division, Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - V Scarpine
- Accelerator Division, Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Shemyakin
- Accelerator Division, Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
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Velasquez G, Cajbon O, Alvarez M, Wadhi T, del Valle L. Effects Of Chronic Bicarbonate Supplementation On Kicking Performance In Highly Trained Taekwondo Athletes. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000682344.89863.cc] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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20
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Dirico M, Bedi V, Alvarez M, Finley Iv J. MANAGEMENT OF INTERMEDIATE RISK PULMONARY EMBOLI WITH THE PRESENCE OF A RIGHT VENTRICULAR THROMBUS. Chest 2020. [DOI: 10.1016/j.chest.2020.05.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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21
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Tronconi A, Carnero G, Mysuta M, Bozza A, Peltzer M, Labin B, Gavilan L, Ramirez D, Alvarez M, Gonzalez JL, Galizio N. P506Brugada Syndrome: is the addition of the electrocardiographic risk markers the clue? Europace 2020. [DOI: 10.1093/europace/euaa162.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Risk stratification in Brugada Syndrome (BS) remains a clinical challenge. Several electrocardiografic (ECG) risk markers had been described, as a spontaneous type 1 Brugada pattern (ST1B), maximal time interval between the peak and the end of the t wave in precordial leads (Tpe Max), the presence of an S Wave on DI, a PR interval (PRi) ≥ 200ms and fragmented QRS (f-QRS).
Purpose
Evaluate the association of ECG risk markers with sudden cardiac death (SCD) or appropriate shocks (A-Sh) by implantable cardioverter defibrillator (ICD) in patients (p) with BS.
Methods
From a registry of 97 p with BS with a median follow up of 2.3 years (Q1 0.7-Q3 7.8), 12 lead ECG were recorded in every p. QT peak interval (QTp) was measured between the QRS onset and the peak of the T wave. Tpe was calculated between the difference of QT and QTp in precordial leads (V1 to V6). TpeMax was defined as the most prolonged Tpe. If an S-DI was present, duration and amplitude was measured. PRi was measured on DII. Baseline characteristics: Age 44 ± 13 years, male 74 (76%), secondary prevention 2 (3%), malignant syncope 10 (10%), inducible electrophysiology study 22/43 (51%), SCD on first grade family < 35 years 12 (12%) and ICD 34 (35%). A-Sh and SCD were compared among p with ST1B vs no ST1B, TpeMax≥100 vs <100ms, S-DI ≥0.4 vs <0.4ms, S-D ≥0.1 vs <0.1mV, PRi≥200 vs <200ms and presence of f-QRS ≥ 2 spike ≥ 2 leads. Variables that were associated with A-Sh or SCD were combined. For variables with significant difference sensibility (Sen) and specificity (Spe) was calculated.
Results
During follow up 6 p presented A-Sh and no p SCD. Results are described in the Table.
Conclusion
In our study population, there was a significant higher incidence of A-Sh in p with ST1B, Tpe Max ≥ 100ms and S-DI ≥ 0.1mV. We found that the presence of one ECG risk marker had a high sensibility to predict A-Sh. The presence of the 3 ECG risk markers highly increased specificity to predict A-Sh. Further trials should be carried out to asses if ECG risk markers would allow us to differentiate which asymptomatic patients could benefit from electrophysiological study for risk stratification (high sensibility - One ECG Risk marker) or would benefit from ICD implantation (high specificity - 3 ECG Risk markers).
Abstract Figure.
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Affiliation(s)
- A Tronconi
- Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - G Carnero
- Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - M Mysuta
- Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - A Bozza
- Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - M Peltzer
- Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - B Labin
- Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - L Gavilan
- Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - D Ramirez
- Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - M Alvarez
- Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - J L Gonzalez
- Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - N Galizio
- Favaloro Foundation University Hospital, Buenos Aires, Argentina
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Illsley NP, DaSilva-Arnold SC, Zamudio S, Alvarez M, Al-Khan A. Trophoblast invasion: Lessons from abnormally invasive placenta (placenta accreta). Placenta 2020; 102:61-66. [PMID: 33218581 DOI: 10.1016/j.placenta.2020.01.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [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: 11/04/2019] [Revised: 01/01/2020] [Accepted: 01/07/2020] [Indexed: 12/20/2022]
Abstract
The invasion of the uterine wall by extravillous trophoblast is acknowledged as a crucial component of the establishment of pregnancy however, the only part of this process that has been clearly identified is the differentiation of cytotrophoblast (CTB) into the invasive extravillous trophoblast (EVT). The control of invasion, both initiation and termination, have yet to be elucidated and even the mechanism of differentiation is unclear. This review describes our studies which are designed to characterize the intracellular mechanisms that drive differentiation. We have used the over-invasion observed in abnormally invasive placenta (AIP; placenta accreta) to further interrogate this mechanism. Our results show that first trimester CTB to EVT differentiation is accomplished via an epithelial-mesenchymal transition (EMT), with EVT displaying a metastable, mesenchymal phenotype. In the third trimester, while the invasiveness of the EVT is lost, these cells still demonstrate signs of the EMT, albeit diminished. EVT isolated from AIP pregnancies do not however, show the same degree of reduction in EMT shown by normal third trimester cells. They exhibit a more mesenchymal phenotype, consistent with a legacy of greater invasiveness. The master regulatory transcription factor controlling the EMT appears, from the observational data, to be ZEB2 (zinc finger E-box binding protein 2). We verified this by overexpressing ZEB2 in the BeWo and JEG3 trophoblast cell lines and showing that they became more stellate in shape, up-regulated the expression of EMT-associated genes and demonstrated a substantially increased degree of invasiveness. The identification of the differentiation mechanism will enable us to identify the factors controlling invasion and those aberrant processes which generate the abnormal invasion seen in pathologies such as AIP and preeclampsia.
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Affiliation(s)
- Nicholas P Illsley
- Center for Abnormal Placentation, Division of Maternal-Fetal Medicine and Surgery, Department of Obstetrics and Gynecology, Hackensack University Medical Center, Hackensack, NJ, USA.
| | - Sonia C DaSilva-Arnold
- Center for Abnormal Placentation, Division of Maternal-Fetal Medicine and Surgery, Department of Obstetrics and Gynecology, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Stacy Zamudio
- Center for Abnormal Placentation, Division of Maternal-Fetal Medicine and Surgery, Department of Obstetrics and Gynecology, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Manuel Alvarez
- Center for Abnormal Placentation, Division of Maternal-Fetal Medicine and Surgery, Department of Obstetrics and Gynecology, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Abdulla Al-Khan
- Center for Abnormal Placentation, Division of Maternal-Fetal Medicine and Surgery, Department of Obstetrics and Gynecology, Hackensack University Medical Center, Hackensack, NJ, USA
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23
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Ramirez P, Orihuela C, Alvarez M, Ayala M. P634 Right atrial mechanics determined by speckle tracking strain as a more physiologic correlation in pulmonary hypertension. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Right atrial dilation has also been established as a marker of adverse outcomes in pulmonary hypertension (PH), while right atrial mechanics remain relatively understudied.
Purpose
Transthoracic echocardiography is a practical and widely used tool for risk stratification in PH. We hypothesized that right atrial (RA) strain components [RA reservoir function (ƐR), peak RA contraction (ƐCT) and RA conduit function (ƐCD)] correlates better with strong prognostic parameters as 3D right ventricle ejection fraction (3D RV EF), 6 minutes walking test, systolic pulmonary artery pressure (SPAP) and B-type natriuretic peptide (BNP).
Methods
19 patients with diagnostic PH, type 2 patients were excluded. RA strain was analyzed and determined a correlation with right ventricle function and pulmonary variables.
Results
Morphology correlation was poor with all the variables as SPAP, 6 Minutes walking test, BNP, only RA/LA index has a good correlation with BNP (R = 0.76, P = 0.0004). Right atrial mechanics with strain has good correlation: ƐR correlates with BNP (R= -0.70, P = 0.001) and with SPAP (R= -0.68, P = 0.001). ƐCD correlates with BNP (R=-0.75;P = 0,0002) and with SPAP (R=-0.68, P = 0.001). ƐCT has no correlation with E/e, 3D RV EF, SPAP, pulmonary vascular resistance (PVR), 6 minutes walking test neither BNP. Right atrial deformation sum correlations with 3D RV EF (R= -0.70, P = 0.001), with SPAP (R= -0.72, P = 0.0005), with PVR (R= -0.68, P = 0.001) and with BNP (R=-0.71, P = 0.001).
Conclusion
Right atrium morphological characteristics have poor correlation with variables that evaluate right ventricle function and with variables that predicts outcomes, as BNP, in this patients population. Only RA/LA index as morphology parameter has good correlation with BNP level. Meanwhile right atrial mechanics analyzed by strain has strong correlation with other variables of severity at PH. Right atrial deformation sum has better correlation than other strain parameters in our study.
Abstract P634 Figure. RIGHT ATRIAL DEFORMATION SUM CORRELATION
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Affiliation(s)
- P Ramirez
- National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
| | - C Orihuela
- National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico
| | - M Alvarez
- National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico
| | - M Ayala
- National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico
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24
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Zapata I, Alvarez M, Hidalgo R, Pajares B, Garcia-Anaya MJ, Toledo MD, Trigo JM, Lupiañez-Perez Y, Medina JA, Jaime Gomez-Millan J. Causes of death in patients with locally advanced head and neck cancer treated with radiotherapy and systemic therapy. BMC Cancer 2019; 19:1241. [PMID: 31864338 PMCID: PMC6925882 DOI: 10.1186/s12885-019-6427-1] [Citation(s) in RCA: 7] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 12/03/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND To investigate the incidence of non-cancer mortalities and prognostic factors associated with competitive causes of death in a homogeneous cohort of patients with locally advanced head and neck cancer treated with radiotherapy and systemic treatment. METHODS This study included 284 patients with locally advanced head and neck cancer treated with radiotherapy and systemic treatment between 2005 and 2017. The cumulative incidence of death associated with tumour, second tumours, treatment, side effects and comorbidity was calculated. A Fine and Gray regression model was used to investigate factors associated with cancer and competitive mortality. RESULTS The cumulative incidence of tumoral death at 5 and 10 years were 35 and 47% respectively, whereas the cumulative incidence of competitive mortality were 10 and 12% respectively. In the multivariate analysis, age and comorbidity were independent factors for non-cancer mortality. Patients with a high risk of non-cancer mortality presented a cumulative incidence of 17.3% at 5 years and 18.4% at 10 years. CONCLUSIONS This study demonstrated a high incidence of competing mortality in older patients with comorbidities. Non-cancer deaths should be considered when selecting patients for combination therapies and in the study design ofclinical trials.
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Affiliation(s)
- I Zapata
- Radiation Oncology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n., 29010, Malaga, Spain
| | - M Alvarez
- Laboratorio de biología molecular del cancer, centro de investigaciones medico-sanitarias (CIMES), Universidad de Málaga, Malaga, Spain.,Instituto de investigación biomédica de Malaga, Campus Teatinos s/n., 29010, Malaga, Spain.,Pathology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n., 29010, Malaga, Spain
| | - R Hidalgo
- Servicio central de Informatica, Universidad de Malaga, Malaga, Spain
| | - B Pajares
- Medical Oncology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, 29010, Malaga, Spain
| | - M J Garcia-Anaya
- Radiation Oncology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n., 29010, Malaga, Spain
| | - M D Toledo
- Radiation Oncology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n., 29010, Malaga, Spain
| | - J M Trigo
- Medical Oncology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, 29010, Malaga, Spain
| | - Y Lupiañez-Perez
- Radiation Oncology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n., 29010, Malaga, Spain
| | - J A Medina
- Radiation Oncology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n., 29010, Malaga, Spain
| | - J Jaime Gomez-Millan
- Radiation Oncology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n., 29010, Malaga, Spain. .,Instituto de investigación biomédica de Malaga, Campus Teatinos s/n., 29010, Malaga, Spain.
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25
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Alvarez M, Martínez F, Bourroul FM, Polyzos NP, Solé M, Parriego M, Rodríguez I, Barri PN, Coroleu B. Effect of embryo transfer difficulty on live birth rates studied in vitrified–warmed euploid blastocyst transfers. Reprod Biomed Online 2019; 39:940-946. [DOI: 10.1016/j.rbmo.2019.07.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 04/25/2019] [Accepted: 07/12/2019] [Indexed: 10/26/2022]
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26
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López-Menchero C, Alvarez M, Fernández P, Guzmán M, Ortiz-de-Salazar MI, Arbona C. Evolution of the residual risk of HBV, HCV and HIV transmission through blood transfusion in the Region of Valencia, Spain, during a 15-year period (2003-2017). Blood Transfus 2019; 17:418-427. [PMID: 31403928 PMCID: PMC6917534 DOI: 10.2450/2019.0058-19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 07/09/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND Towards the end of the 20th century, transfusion-transmitted viral infections (TTVI) represented a huge problem for public health. From the beginning of the screening of blood donations, this risk has decreased to the point that it is no longer possible to measure it directly and it is necessary to use mathematical models. Using one of these models, the aim of this study was to analyse the evolution of the residual risk of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) transmission through blood transfusion from 2003 to 2017 in the Region of Valencia, Spain. MATERIALS AND METHODS Using data from the Blood Transfusion Centre of the Valencian Community, the incidence rate in donors and the residual risk were calculated for each agent and year by applying the most updated version of the incidence/window period model. For the set of the three viruses, these magnitudes were calculated as the algebraic sum of the specifics ones for each of them. The evolution of both magnitudes was analysed by the Mann-Kendall trend test and the Sen estimation of trend slope. RESULTS The residual risks obtained vary depending on the agent and the year. Considering the three viruses jointly, they range from 1 per 360,380 to 1 per 44,715 donations. During the study period, there was a statistically significant downward trend in the incidence rate of HBV (p<0.05, trend slope -0.88), the residual risk of HBV (p<0.0005, slope -0.98), and the joint residual risk for the three viruses (p<0.0001, slope -0.99). DISCUSSION The current risk of TTVI is very low in the Region of Valencia. In the last 15 years, there has been a reduction in the donor incidence rate and in the residual risk for the case of HBV; such a reduction cannot be confirmed for HCV and HIV. Consideration of the three viruses jointly confirms a reduction in the residual risk; we are unable to establish whether the evolution of the joint incidence rate has contributed to this reduction or whether it is due only to the shortening of window periods.
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Affiliation(s)
| | - Manuel Alvarez
- Blood Transfusion Centre of the Valencian Community, Valencia, Spain
| | - Pascual Fernández
- Department of Clinical Medicine, School of Medicine, Miguel Hernández University, Sant Joan d'Alacant, Spain
| | - María Guzmán
- Blood Transfusion Centre of the Valencian Community, Valencia, Spain
| | | | - Cristina Arbona
- Blood Transfusion Centre of the Valencian Community, Valencia, Spain
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27
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Abascal M, Giulianelli S, Alvarez M, Sequeira G, Vanzulli S, Elia A, Pataccini G, Lombes M, Lanari C. Progesterone receptor isoform ratio dictates antiprogestins/progestins effects on metastatic breast cancer models. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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28
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Gomez L, Arias J, Diaz D, Alvarez M, Alvarado J, Caicedo M. CLINICAL CHARACTERISTICS OF CRITICAL CARE PATIENTS WITH CONFIRMED DIAGNOSIS OF INFLUENZA PNEUMONIA AT THE UNIVERSITY HOSPITAL FUNDACIÓN SANTA FE DE BOGOTÁ. Chest 2019. [DOI: 10.1016/j.chest.2019.02.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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29
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Sousa T, Ribeiro R, Teixeira Z, Cruz R, Alvarez M. Life span disparities between rural and urban residents in the Portuguese district of Coimbra. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz034.084] [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: 11/14/2022] Open
Affiliation(s)
- T Sousa
- Research Centre for Anthropology and Health, University of Coimbra, Portugal
| | - R Ribeiro
- Department of Life Sciences, University of Coimbra, Portugal
- Centre for Functional Ecology, Department of Life Sciences, University of Coimbra, Portugal
| | - Z Teixeira
- MARE - Marine and Environmental Sciences Centre, University of Coimbra, Portugal
| | - R Cruz
- ESTeSC - Coimbra Health School, Instituto Politécnico de Coimbra, Portugal
| | - M Alvarez
- Research Centre for Anthropology and Health, University of Coimbra, Portugal
- Department of Life Sciences, University of Coimbra, Portugal
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30
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Escudero P, Yeste J, Pascual-Izarra C, Villa R, Alvarez M. Color tunable pressure sensors based on polymer nanostructured membranes for optofluidic applications. Sci Rep 2019; 9:3259. [PMID: 30824807 PMCID: PMC6397196 DOI: 10.1038/s41598-019-40267-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 02/11/2019] [Indexed: 01/21/2023] Open
Abstract
We demonstrate an integrated optical pressure sensing platform for multiplexed optofluidics applications. The sensing platform consists in an array of elastomeric on-side nanostructured membranes -effectively 2D photonic crystal- which present colour shifts in response to mechanical stress that alter their nanostructure characteristical dimensions, pitch or orientation. The photonic membranes are prepared by a simple and cost-effective method based on the infiltration of a 2D colloidal photonic crystal (CPC) with PDMS and their integration with a microfluidic system. We explore the changes in the white light diffraction produced by the nanostructured membranes when varying the pneumatic pressure in the microfluidics channels as a way to achieve a power-free array of pressure sensors that change their reflective colour depending on the bending produced on each sensor. The structural characterization of these membranes was performed by SEM, while the optical properties and the pressure-colour relation were evaluated via UV-Vis reflection spectrometry. Maximum sensitivities of 0.17 kPa-1 is obtained when measuring at Littrow configuration (θin = -θout), and close to the border of the membranes. The reflected colour change with pressure is as well monitorized by using a smartphone camera.
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Affiliation(s)
- P Escudero
- Instituto de Microelectronica de Barcelona (IMB-CNM, CSIC), Campus UAB, 08193 Bellaterra, Barcelona, Spain.,PhD in Electrical and Telecommunication Engineering, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - J Yeste
- Instituto de Microelectronica de Barcelona (IMB-CNM, CSIC), Campus UAB, 08193 Bellaterra, Barcelona, Spain
| | | | - R Villa
- Instituto de Microelectronica de Barcelona (IMB-CNM, CSIC), Campus UAB, 08193 Bellaterra, Barcelona, Spain.,CIBER de Bioengineria, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain
| | - M Alvarez
- Instituto de Microelectronica de Barcelona (IMB-CNM, CSIC), Campus UAB, 08193 Bellaterra, Barcelona, Spain.
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31
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Alcarraz C, Muñiz J, Mas L, Olivera M, Morante Z, Alvarez M, Mantilla R, Araujo J, Pinto J. [Optimal cytoreduction in advanced ovarian cancer treated with dose-dense paclitaxel and carboplatin followed by interval surgery at the Peruvian National Institute of Neoplastic Diseases]. ACTA ACUST UNITED AC 2019; 35:46-54. [PMID: 29924276 DOI: 10.17843/rpmesp.2018.351.3599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 03/07/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To determine the rate of optimal cytoreduction in patients with advanced ovarian cancer who received neoadjuvant chemotherapy with dose-dense carboplatin and paclitaxel followed by interval debulking surgery (IDS). MATERIALS AND METHODS A retrospective study of a series of cases of Peruvian women treated with neoadjuvant chemotherapy with carboplatin (6 AUC mg/mL/min) and paclitaxel (80 mg/m2 weekly) followed by IDS, at the National Institute of Neoplastic Diseases during the 2010-2014 period. RESULTS The 41 patients who made it to the interval surgery had a median age of 59 years (range: 47-73 years). In 37 (90.2%) patients, high-grade serous adenocarcinoma histology was reported. Thirty-four (82.9%) achieved optimal cytoreduction and five (14.7%), a complete pathological response. Progression-free survival at one year and two years was 74.7% and 51.8%, respectively. Overall survival at one year and two years was 85.2% and 71.4%, respectively. The risk of progression and death was greater in patients without optimal cytoreduction and in patients with postsurgery levels of carcinoembryonic antigen 125 > 30 U/mL. CONCLUSIONS Neoadjuvant therapy with dose-dense carboplatin and paclitaxel achieved an elevated frequency of optimal cytoreduction. The post-surgery levels of carcinoembryonic antigen 125 and optimal cytoreduction were independent factors of progression-free survival and overall survival.
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Affiliation(s)
- Cindy Alcarraz
- Instituto Nacional de Enfermedades Neoplásicas. Lima, Perú
| | - Johana Muñiz
- Instituto Nacional de Enfermedades Neoplásicas. Lima, Perú
| | - Luis Mas
- Instituto Nacional de Enfermedades Neoplásicas. Lima, Perú
| | - Mivael Olivera
- Instituto Nacional de Enfermedades Neoplásicas. Lima, Perú
| | - Zaida Morante
- Instituto Nacional de Enfermedades Neoplásicas. Lima, Perú
| | - Manuel Alvarez
- Instituto Nacional de Enfermedades Neoplásicas. Lima, Perú
| | - Raul Mantilla
- Instituto Nacional de Enfermedades Neoplásicas. Lima, Perú
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33
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Kandolf Sekulovic L, Guo J, Agarwala S, Hauschild A, McArthur G, Cinat G, Wainstein A, Caglevic C, Lorigan P, Gogas H, Alvarez M, Duncombe R, Lebbe C, Peris K, Rutkowski P, Stratigos A, Forsea AM, De La Cruz Merino L, Kukushkina M, Dummer R, Hoeller C, Gorry C, Bastholt L, Herceg D, Neyns B, Vieira R, Arenberger P, Bylaite-Bucinskiene M, Babovic N, Banjin M, Putnik K, Todorovic V, Kirov K, Ocvirk J, Zhukavets A, Ymeri A, Stojkovski I, Garbe C. Access to innovative medicines for metastatic melanoma worldwide: Melanoma World Society and European Association of Dermato-oncology survey in 34 countries. Eur J Cancer 2018; 104:201-209. [PMID: 30388700 DOI: 10.1016/j.ejca.2018.09.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 09/12/2018] [Indexed: 12/19/2022]
Abstract
According to data from recent studies from Europe, a large percentage of patients have restricted access to innovative medicines for metastatic melanoma. Melanoma World Society and European Association of Dermato-oncology conducted a Web-based survey on access to first-line recommended treatments for metastatic melanoma by current guidelines (National Comprehensive Center Network, European Society for Medical Oncology [ESMO] and European Organization for Research and Treatment of Cancer/European Association of Dermato-oncology/European dermatology Forum) among melanoma experts from 27 European countries, USA, China, Australia, Argentina, Brazil, Chile and Mexico from September 1st, 2017 to July 1st, 2018. Data on licencing and reimbursement of medicines and the number of patient treated were correlated with the data on health expenditure per capita (HEPC), Mackenbach score of health policy performance, health technology assessment (HTA), ASCO and ESMO Magnitude of clinical benefit scale (ESMO MCBS) scores of clinical benefit and market price of medicines. Regression analysis for evaluation of correlation between the parameters was carried out using SPSS software. The estimated number of patients without access in surveyed countries was 13768. The recommended BRAFi + MEKi combination and anti-PD1 immunotherapy were fully reimbursed/covered in 19 of 34 (55.8%) and 17 of 34 (50%) countries, and combination anti-CTLA4+anti-PD1 in was fully covered in 6 of 34 (17.6%) countries. Median delay in reimbursement was 991 days, and it was in significant correlation with ESMO MCBS (p = 0.02), median market price (p = 0.001), HEPC and Mackenbach scores (p < 0.01). Price negotiations or managed entry agreements (MEAs) with national authorities were necessary for reimbursement. In conclusion, great discrepancy exists in metastatic melanoma treatment globally. Access to innovative medicines is in correlation with economic parameters as well as with healthcare system performance parameters. Patient-oriented drug development, market access and reimbursement pathways must be urgently found.
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Affiliation(s)
- L Kandolf Sekulovic
- Department of Dermatology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia.
| | - J Guo
- Department of Urology and Melanoma, Peking University Cancer Hospital & Institute, Beijing, PR China
| | - S Agarwala
- St. Luke's University Hospital and Temple University, Bethlehem, USA
| | - A Hauschild
- Department of Dermatology, University Hospital Schleswig-Holstein (UKSH), Campus Kiel, Kiel, Germany
| | - G McArthur
- Divisions of Research and Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia
| | - G Cinat
- Médica Oncóloga Instituto de Oncología Angel Roffo, Universidad de Buenos Aires Fundación CIDEA, Buenos Aires, Argentina
| | - A Wainstein
- Institute of Post-graduation, Faculdade de Ciências Médicas de Minas Gerais (FCM-MG) - Belo Horizonte (MG), Brazil
| | - C Caglevic
- Medical Oncology Service, Oncology Department, Clinica Alemana Santiago, Faculty of Medicine Clinica Alemana-Universidad Del Desarrollo, Santiago, Chile
| | - P Lorigan
- Institute of Cancer Sciences, University of Manchester, The Christie NHS Foundation Trust, Manchester, UK
| | - H Gogas
- 1(st)Department of Internal Medicine, Laiko Hospital and 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - M Alvarez
- Medico en Instituto Nacional de Cancerologia, Mexico City Area, Mexico
| | - R Duncombe
- Institute of Cancer Sciences, University of Manchester, The Christie NHS Foundation Trust, Manchester, UK
| | - C Lebbe
- APHP Dermatology Department, University Paris 7 Diderot, INSERM U976, PARIS, France
| | - K Peris
- Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - P Rutkowski
- Maria Sklodowska-Curie Institute - Oncology Center, Warsaw, Poland
| | - A Stratigos
- 1(st)Department of Internal Medicine, Laiko Hospital and 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - A-M Forsea
- Carol Davila University of Medicine and Pharmacy, Elias University Hospital Bucharest, Romania
| | - L De La Cruz Merino
- Department of Clinical Oncology, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | - R Dummer
- UniversitätsSpital Zürich-Skin Cancer Center, University Hospital, Zürich, Switzerland
| | - C Hoeller
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - C Gorry
- National Centre for Pharmacoeconomics, Old Stone Building, Trinity Centre for Health Sciences, St. James's Hospital, Dublin 8, Ireland
| | - L Bastholt
- Department of Oncology, Odense University Hospital, Denmark
| | - D Herceg
- Department of Oncology, University Hospital Zagreb, Croatia
| | - B Neyns
- Department of Medical Oncology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - R Vieira
- Department of Dermatology, Medical Faculty, University of Coimbra, Portugal
| | - P Arenberger
- Department of Dermatovenereology, Charles University 3rd Faculty of Medicine and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | | | - N Babovic
- Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
| | - M Banjin
- Department of Oncology, University Hospital Sarajevo, Bosnia and Herzegovina
| | - K Putnik
- North Estonia Medical Centre, Tallinn, Estonia
| | - V Todorovic
- Clinic for Oncology and Radiotherapy, Podgorica, Montenegro
| | - K Kirov
- Clinic of Oncodermatology, National Cancer Center, Sofia, Bulgaria
| | - J Ocvirk
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - A Zhukavets
- Belarusian Medical Academy of Postgraduate Education (BelMAPE), Minsk, Belarus
| | - A Ymeri
- University Hospital Mother Theresa, Tirana, Albania
| | - I Stojkovski
- University Clinic of Radiotherapy and Oncology, Skopje, Macedonia
| | - C Garbe
- Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
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Vivancos A, Aranda Aguilar E, Benavides M, Elez Fernandez E, Toledano M, Alvarez M, Diaz Rubio E, Gómez-España A, Garcia-Barberan V, Chica-Parrao M. Evaluation of the sensitivity of RAS mutation detection of the Idylla platform in comparison to the OncoBEAM RAS CRC assay. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Gonzalez-Foruria I, Martinez F, Rodriguez-Purata J, Rodriguez D, Rodriguez I, Alvarez M, Nicolau J, Coroleu B, Barri P, Polyzos N. Progesterone variation on the day of oocyte triggering: a prospective study with repeated measurements within the same patient. Is the progesterone elevation “story” still valid? Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Al-Khan A, Guirguis G, Zamudio S, Alvarez M, Martimucci K, Luke D, Alvarez-Perez J. Preoperative cystoscopy could determine the severity of placenta accreta spectrum disorders: An observational study. J Obstet Gynaecol Res 2018; 45:126-132. [PMID: 30136333 DOI: 10.1111/jog.13794] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 04/30/2018] [Accepted: 08/01/2018] [Indexed: 11/28/2022]
Abstract
AIM In the surgical treatment of placenta accreta spectrum disorders, cystoscopy for prophylactic stent placement is performed to protect the ureters from potential injury. Despite its frequent use, the use of cystoscopy in assessing the severity of these disorders has not been explored. Our objective was to find out if the abnormal findings documented during cystoscopy are associated with disease severity. METHODS In this retrospective, observational cohort study (n = 56), the bladder wall was evaluated at the time of ureteral stent placement via cystoscopy in prenatally diagnosed placenta accreta spectrum cases. Three abnormal findings were commonly present in these cases: bulging of the posterior bladder wall, neovascularization and arterial pulsatility in the area of neovascularization. These findings were stratified according to severity in histologically confirmed specimens. Continuous variables were compared via two-tailed t-tests and Wilcoxon rank sum tests. Categorical data were evaluated using logistic regression analysis. RESULTS Neovascularization affected 84%, bulging 71% and pulsatility 54% of the cases. Bulging and neovascularization increased with disease severity. Pulsatility occurred exclusively in percretas. Bulging was associated with a 12-fold (OR = 11.6, 95% CI 2.94-46.33, P = 0.0005) increased likelihood of percreta and neovascularization with a 17-fold (OR = 17.06, 95% CI 2.98-97.79, P = 0.0014) increase. Neovascularization and/or the presence of bulging of the bladder have high positive predictive value for placenta increta and percreta (91.5% and 95.0%, respectively). Cystoscopy can be used to assess the severity of placenta accreta spectrum cases preoperatively, especially when placentation is over the previous uterine scar and is in proximity to the bladder wall.
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Affiliation(s)
- Abdulla Al-Khan
- Center for Abnormal Placentation, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Surgery, Department of Research and Department of Pathology, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - George Guirguis
- Center for Abnormal Placentation, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Surgery, Department of Research and Department of Pathology, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Stacy Zamudio
- Center for Abnormal Placentation, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Surgery, Department of Research and Department of Pathology, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Manuel Alvarez
- Center for Abnormal Placentation, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Surgery, Department of Research and Department of Pathology, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Kristina Martimucci
- Center for Abnormal Placentation, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Surgery, Department of Research and Department of Pathology, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Davlyn Luke
- Center for Abnormal Placentation, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Surgery, Department of Research and Department of Pathology, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Jesus Alvarez-Perez
- Center for Abnormal Placentation, Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Surgery, Department of Research and Department of Pathology, Hackensack University Medical Center, Hackensack, New Jersey, USA
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Spillane NT, Zamudio S, Alvarez-Perez J, Andrews T, Nyirenda T, Alvarez M, Al-Khan A. Increased incidence of respiratory distress syndrome in neonates of mothers with abnormally invasive placentation. PLoS One 2018; 13:e0201266. [PMID: 30048504 PMCID: PMC6062082 DOI: 10.1371/journal.pone.0201266] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 07/11/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The incidence of abnormally invasive placentation (AIP) is increasing. Most of these pregnancies are delivered preterm. We sought to characterize neonatal outcomes in AIP pregnancies. METHODS In this retrospective case-control study (2006-2015), AIP neonates (n = 108) were matched to two controls each for gestational age, antenatal glucocorticoid exposure, sex, plurity, and delivery mode. Medical records were reviewed for neonatal and maternal characteristics/outcomes. Univariate and multivariate Poisson regressions were performed to determine relative risk ratios (RR). RESULTS There were no mortalities. All neonatal outcomes were similar except for respiratory distress syndrome (RDS), which affected 37% of AIP neonates (versus 21% of controls). AIP neonates required respiratory support (64.8% vs. 51.9%) and continuous positive airway pressure (53.7% vs. 42.1%) for a longer duration. Univariate regression yielded elevated RRs for RDS for AIP (RR 1.78, 95% CI 1.24-2.54), placenta previa (RR = 1.94, 95% CI 1.36-2.76), and placenta previa with bleeding (RR 2.29, 95% CI 1.36-3.86). One episode of bleeding had a RR of 2.43 (95% CI 1.57-3.76), 2 or more episodes had a RR of 2.95 (95% CI 1.96-4.44), and bleeding/abruption as the delivery indication had a RR of 2.57 (95% CI 1.82-3.64). A multivariate regression stratifying for AIP and evaluating the combined and individual associations of AIP, bleeding, placenta previa, and GA, resulted in elevated RRs for placenta previa alone (RR 2.16, 95% CI 1.15-4.06) and placenta previa and bleeding (RR 1.69, 95% CI 1.001-2.85). CONCLUSIONS The increased incidence of RDS at later gestational ages in AIP is driven by placenta previa. AIP neonates required respiratory support for a longer duration than age-matched controls. Providers should be prepared to counsel expectant parents and care for affected neonates.
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Affiliation(s)
- Nicole T. Spillane
- Department of Pediatrics, Division of Neonatology, Hackensack University Medical Center, Hackensack, New Jersey, United States of America
- Rutgers University, New Jersey Medical School, Newark, New Jersey, United States of America
- * E-mail:
| | - Stacy Zamudio
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Surgery, Center for Abnormal Placentation, Hackensack University Medical Center, Hackensack, New Jersey, United States of America
| | - Jesus Alvarez-Perez
- Rutgers University, New Jersey Medical School, Newark, New Jersey, United States of America
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Surgery, Center for Abnormal Placentation, Hackensack University Medical Center, Hackensack, New Jersey, United States of America
| | - Tracy Andrews
- Office of Research Administration, Department of Research Hackensack University Medical Center, Hackensack, New Jersey, United States of America
| | - Themba Nyirenda
- Office of Research Administration, Department of Research Hackensack University Medical Center, Hackensack, New Jersey, United States of America
| | - Manuel Alvarez
- Rutgers University, New Jersey Medical School, Newark, New Jersey, United States of America
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Surgery, Center for Abnormal Placentation, Hackensack University Medical Center, Hackensack, New Jersey, United States of America
| | - Abdulla Al-Khan
- Rutgers University, New Jersey Medical School, Newark, New Jersey, United States of America
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine and Surgery, Center for Abnormal Placentation, Hackensack University Medical Center, Hackensack, New Jersey, United States of America
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Alvarez M, Tucta F, Quispe E, Meza V. Incidence of the inoculation of beneficial microorganisms in the strawberry (Fragaria sp.) crop. Sci agropec 2018. [DOI: 10.17268/sci.agropecu.2018.01.04] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Egea M, Garcia-Urra F, Bellver JA, Alvarez M, Waweru C, Quesada A. P924Economic impact associated with complications of cardiac implantable electronic devices in spain. Europace 2018. [DOI: 10.1093/europace/euy015.525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Egea
- Medtronic Ibérica S.A, Health Economics & Outcomes Research, Madrid, Spain
| | | | - J A Bellver
- Hospital General de Castellón, Castellon, Spain
| | - M Alvarez
- Medtronic Ibérica S.A, Health Economics & Outcomes Research, Madrid, Spain
| | - C Waweru
- Medtronic plc, Minneapolis, United States of America
| | - A Quesada
- University General Hospital of Valencia, Valencia, Spain
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Janjua NZ, Islam N, Wong J, Yoshida EM, Ramji A, Samji H, Butt Z, Chong M, Alvarez M, Cook D, Tyndall M, Krajden M. A162 SHIFT IN DISPARITIES IN HCV TREATMENT FROM INTERFERON TO DAA ERA: A POPULATION BASED COHORT STUDY. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- N Z Janjua
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - N Islam
- Division of Gastroenterology, University of British Columbia, Vancouver, BC, Canada
| | - J Wong
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - E M Yoshida
- Division of Gastroenterology, University of British Columbia, Vancouver, BC, Canada
| | - A Ramji
- Gastrointestinal Research Institute, Vancouver, BC, Canada
| | - H Samji
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - Z Butt
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - M Chong
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - M Alvarez
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - D Cook
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - M Tyndall
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - M Krajden
- BC Centre for Disease Control, Vancouver, BC, Canada
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Gunturiz Beltran C, Bertomeu Gonzalez V, Moreno Arribas J, Perez L, Martinez Ferrer JB, Alzueta J, Arcocha MF, Arenal A, Vinolas X, Alvarez M, Anguera I, Porro R, Castillo Castillo J, Bellver A, Mont L. P874Analysis of efficacy of event discrimination algorithm added to standard programming strategies based on cycle length and detection intervals in implantable defibrillator. Europace 2018. [DOI: 10.1093/europace/euy015.477] [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: 11/12/2022] Open
Affiliation(s)
| | | | - J Moreno Arribas
- University Hospital San Juan de Alicante, Cardiology, Alicante, Spain
| | - L Perez
- University Hospital Complex A Coruña, A Coruña, Spain
| | | | - J Alzueta
- University Hospital Virgen de la Victoria, Malaga, Spain
| | | | - A Arenal
- University Hospital Gregorio Maranon, Madrid, Spain
| | - X Vinolas
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - M Alvarez
- Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - I Anguera
- University Hospital of Bellvitge, Barcelona, Spain
| | - R Porro
- Hospital San Pedro de Alcantara, Caceres, Spain
| | | | - A Bellver
- Hospital General de Castellón, Castellon, Spain
| | - L Mont
- Hospital Clinic de Barcelona, Barcelona, Spain
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Gunturiz Beltran C, Bertomeu Gonzalez V, Moreno Arribas J, Perez L, Martinez Ferrer JB, Alzueta J, Arcocha MF, Arenal A, Vinolas X, Alvarez M, Anguera I, Porro R, Castillo Castillo J, Bellver A, Mont L. P1228Individual discriminators contribution to the reduction of inappropriate therapies in implantable defibrillators. Europace 2018. [DOI: 10.1093/europace/euy015.709] [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: 11/12/2022] Open
Affiliation(s)
| | | | - J Moreno Arribas
- University Hospital San Juan de Alicante, Cardiology, Alicante, Spain
| | - L Perez
- University Hospital Complex A Coruña, A Coruña, Spain
| | | | - J Alzueta
- University Hospital Virgen de la Victoria, Malaga, Spain
| | | | - A Arenal
- University Hospital Gregorio Maranon, Madrid, Spain
| | - X Vinolas
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - M Alvarez
- Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - I Anguera
- University Hospital of Bellvitge, Barcelona, Spain
| | - R Porro
- Hospital San Pedro de Alcantara, Caceres, Spain
| | | | - A Bellver
- Hospital General de Castellón, Castellon, Spain
| | - L Mont
- Hospital Clinic de Barcelona, Barcelona, Spain
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DaSilva-Arnold SC, Zamudio S, Al-Khan A, Alvarez-Perez J, Mannion C, Koenig C, Luke D, Perez AM, Petroff M, Alvarez M, Illsley NP. Human trophoblast epithelial-mesenchymal transition in abnormally invasive placenta†. Biol Reprod 2018; 99:409-421. [DOI: 10.1093/biolre/ioy042] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 02/07/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sonia C DaSilva-Arnold
- Department of Obstetrics and Gynecology, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Stacy Zamudio
- Department of Obstetrics and Gynecology, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Abdulla Al-Khan
- Department of Obstetrics and Gynecology, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Jesus Alvarez-Perez
- Department of Obstetrics and Gynecology, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Ciaran Mannion
- Department of Pathology, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Christopher Koenig
- Department of Pathology, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Davlyn Luke
- Department of Obstetrics and Gynecology, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Anisha M Perez
- Department of Obstetrics and Gynecology, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Margaret Petroff
- Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Manuel Alvarez
- Department of Obstetrics and Gynecology, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Nicholas P Illsley
- Department of Obstetrics and Gynecology, Hackensack University Medical Center, Hackensack, New Jersey, USA
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Alvarez M. Can EMG help elucidate other possible cause of gait impairment in PD? Parkinsonism Relat Disord 2018. [DOI: 10.1016/j.parkreldis.2017.11.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Rossi-Pool R, Zainos A, Alvarez M, Zizumbo J, Vergara J, Romo R. Decoding a Decision Process in the Neuronal Population of Dorsal Premotor Cortex. Neuron 2017; 96:1432-1446.e7. [PMID: 29224726 DOI: 10.1016/j.neuron.2017.11.023] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 10/24/2017] [Accepted: 11/14/2017] [Indexed: 11/25/2022]
Abstract
When trained monkeys discriminate the temporal structure of two sequential vibrotactile stimuli, dorsal premotor cortex (DPC) showed high heterogeneity among its neuronal responses. Notably, DPC neurons coded stimulus patterns as broader categories and signaled them during working memory, comparison, and postponed decision periods. Here, we show that such population activity can be condensed into two major coding components: one that persistently represented in working memory both the first stimulus identity and the postponed informed choice and another that transiently coded the initial sensory information and the result of the comparison between the two stimuli. Additionally, we identified relevant signals that coded the timing of task events. These temporal and task-parameter readouts were shown to be strongly linked to the monkeys' behavior when contrasted to those obtained in a non-demanding cognitive control task and during error trials. These signals, hidden in the heterogeneity, were prominently represented by the DPC population response.
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Affiliation(s)
- Román Rossi-Pool
- Instituto de Fisiología Celular, Neurociencias, Universidad Nacional Autónoma de México, 04510 Mexico City, Mexico.
| | - Antonio Zainos
- Instituto de Fisiología Celular, Neurociencias, Universidad Nacional Autónoma de México, 04510 Mexico City, Mexico
| | - Manuel Alvarez
- Instituto de Fisiología Celular, Neurociencias, Universidad Nacional Autónoma de México, 04510 Mexico City, Mexico
| | - Jerónimo Zizumbo
- Instituto de Fisiología Celular, Neurociencias, Universidad Nacional Autónoma de México, 04510 Mexico City, Mexico
| | - José Vergara
- Instituto de Fisiología Celular, Neurociencias, Universidad Nacional Autónoma de México, 04510 Mexico City, Mexico
| | - Ranulfo Romo
- Instituto de Fisiología Celular, Neurociencias, Universidad Nacional Autónoma de México, 04510 Mexico City, Mexico; El Colegio Nacional, 06020 Mexico City, Mexico.
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Andersen J, Rauch J, Sestito D, De Souza E, Miller N, Cheesman N, Alvarez M. Session Rating of Perceived Exertion (sRPE), workload, and volume load relationships during off-season resistance training in NCAA division II baseball players: An exploratory analysis. Phys Ther Sport 2017. [DOI: 10.1016/j.ptsp.2017.08.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Abstract
Precancerous cervical lesions precede the development of invasive cervical cancer by 10-20 years, making cervical cancer preventable if these lesions are detected and effectively treated. Treatment has evolved in the last few decades and now includes ablative options that can be performed in lower-resource settings where surgical excision is not feasible or routinely available. Gas-based cryotherapy, which freezes cervical tissue to induce localized necrosis, is the most commonly used ablative treatment. However, its implementation in low-resource settings is difficult because the refrigerant gas can be difficult to procure and transport, and is expensive. New cryotherapy devices that do not require an external supply of gas appear promising. Thermal coagulation, which burns cervical tissue to induce necrosis, has become more widely available in the last few years owing to its portability and the feasibility of using battery-powered devices. These two ablative treatments successfully eradicate 75%-85% of high-grade cervical lesions and have minor adverse effects.
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Affiliation(s)
| | - Dan Murokora
- Uganda Women's Health Initiative, Kampala, Uganda
| | | | - Manuel Alvarez
- Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
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Ortega Ferrusola C, Anel-López L, Ortiz-Rodriguez JM, Martin Muñoz P, Alvarez M, de Paz P, Masot J, Redondo E, Balao da Silva C, Morrell JM, Rodriguez Martinez H, Tapia JA, Gil MC, Anel L, Peña FJ. Stallion spermatozoa surviving freezing and thawing experience membrane depolarization and increased intracellular Na . Andrology 2017; 5:1174-1182. [PMID: 28973824 DOI: 10.1111/andr.12419] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 07/03/2017] [Accepted: 07/25/2017] [Indexed: 12/13/2022]
Abstract
In order to gain insight of the modifications that freezing and thawing cause to the surviving population of spermatozoa, changes in the potential of the plasma membrane (Em) and intracellular Na+ content of stallion spermatozoa were investigated using flow cytometry. Moreover, caspase 3 activity was also investigated and the functionality of the Na+ -K+ ATPase pump was investigated before and after freezing and thawing. Cryopreservation caused a significant (p < 0.001) increase in the subpopulation of spermatozoa with depolarized sperm membranes, concomitantly with an increase (p < 0.05) in intracellular Na+ . These changes occurred in relation to activation of caspase 3 (p < 0.001). Cryopreservation reduced the activity of the Na-K+ pump and inhibition of the Na+ -K+ ATPase pump with ouabain-induced caspase 3 activation. It is concluded that inactivation of Na+ -K+ ATPase occurs during cryopreservation, an inhibition that could play a role explaining the accelerated senescence of the surviving population of spermatozoa.
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Affiliation(s)
- C Ortega Ferrusola
- Reproduction and Obstetrics Department of Animal Medicine and Surgery, University of León, León, Spain
| | - L Anel-López
- Reproduction and Obstetrics Department of Animal Medicine and Surgery, University of León, León, Spain
| | - J M Ortiz-Rodriguez
- Laboratory of Equine Reproduction and Equine Spermatology, Veterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
| | - P Martin Muñoz
- Laboratory of Equine Reproduction and Equine Spermatology, Veterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
| | - M Alvarez
- Reproduction and Obstetrics Department of Animal Medicine and Surgery, University of León, León, Spain
| | - P de Paz
- Department of Molecular Biology, University of León, León, Spain
| | - J Masot
- Laboratory of Equine Reproduction and Equine Spermatology, Veterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
| | - E Redondo
- Laboratory of Equine Reproduction and Equine Spermatology, Veterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
| | - C Balao da Silva
- Portalagre Polytechnic Institute, Superior Agriculture School of Elvas, Elvas, Portugal
| | - J M Morrell
- Division of Reproduction, Faculty of Veterinary Medicine and Animal Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - H Rodriguez Martinez
- Department of Clinical and Experimental Medicine, Faculty of Medicine & Health Sciences, Linköping University, Linköping, Sweden
| | - J A Tapia
- Laboratory of Equine Reproduction and Equine Spermatology, Veterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
| | - M C Gil
- Laboratory of Equine Reproduction and Equine Spermatology, Veterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
| | - L Anel
- Reproduction and Obstetrics Department of Animal Medicine and Surgery, University of León, León, Spain
| | - F J Peña
- Laboratory of Equine Reproduction and Equine Spermatology, Veterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
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Janjua NZ, Islam N, Wong J, Yoshida EM, Ramji A, Samji H, Butt ZA, Chong M, Cook D, Alvarez M, Darvishian M, Tyndall M, Krajden M. Shift in disparities in hepatitis C treatment from interferon to DAA era: A population-based cohort study. J Viral Hepat 2017; 24:624-630. [PMID: 28130810 DOI: 10.1111/jvh.12684] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [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: 11/01/2016] [Accepted: 12/22/2016] [Indexed: 12/15/2022]
Abstract
We evaluated the shift in the characteristics of people who received interferon-based hepatitis C virus (HCV) treatments and those who received recently introduced direct-acting antivirals (DAAs) in British Columbia (BC), Canada. The BC Hepatitis Testers Cohort includes 1.5 million individuals tested for HCV or HIV, or reported cases of hepatitis B and active tuberculosis in BC from 1990 to 2013 linked to medical visits, hospitalization, cancer, prescription drugs and mortality data. This analysis included all patients who filled at least one prescription for HCV treatment until 31 July 2015. HCV treatments were classified as older interferon-based treatments including pegylated interferon/ribavirin (PegIFN/RBV) with/without boceprevir or telaprevir, DAAs with RBV or PegIFN/RBV, and newer interferon-free DAAs. Of 11 886 people treated for HCV between 2000 and 2015, 1164 (9.8%) received interferon-free DAAs (ledipasvir/sofosbuvir: n=1075; 92.4%), while 452 (3.8%) received a combination of DAAs and RBV or PegIFN/RBV. Compared to those receiving interferon-based treatment, people with HIV co-infection (adjusted odds ratio [aOR]: 2.96, 95% CI: 2.31-3.81), cirrhosis (aOR: 1.77, 95% CI: 1.45-2.15), decompensated cirrhosis (aOR: 1.72, 95% CI: 1.31-2.28), diabetes (aOR: 1.30, 95% CI: 1.10-1.54), a history of injection drug use (aOR: 1.34, 95% CI: 1.09-1.65) and opioid substitution therapy (aOR: 1.30, 95% CI: 1.01-1.67) were more likely to receive interferon-free DAAs. Socio-economically marginalized individuals were significantly less likely (most deprived vs most privileged: aOR: 0.71, 95% CI: 0.58-0.87) to receive DAAs. In conclusion, there is a shift in prescription of new HCV treatments to previously excluded groups (eg HIV-co-infected), although gaps remain for the socio-economically marginalized populations.
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Affiliation(s)
- N Z Janjua
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - N Islam
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - J Wong
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - E M Yoshida
- Division of Gastroenterology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - A Ramji
- Division of Gastroenterology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - H Samji
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Z A Butt
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - M Chong
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - D Cook
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - M Alvarez
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - M Darvishian
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - M Tyndall
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - M Krajden
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
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50
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Gunturiz Beltran C, Bertomeu-Gonzalez V, Moreno-Arribas J, Perez L, Martinez-Ferrer J, Alzueta J, Arcocha M, Arenal A, Vinolas X, Alvarez M, Anguera I, Porro R, Castillo-Castillo J, Cordero A, Bertomeu-Martinez V. 3875Discriminators algorithm integrated into implantable defibrillator: diagnostic capacity analysis and impact in the reduction of inappropriate therapies. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.3875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - J. Moreno-Arribas
- University Hospital San Juan de Alicante, Cardiology, Alicante, Spain
| | - L. Perez
- University Hospital Complex A Coruña, A Coruña, Spain
| | | | - J. Alzueta
- University Hospital Virgen de la Victoria, Malaga, Spain
| | | | - A. Arenal
- University Hospital Gregorio Maranon, Madrid, Spain
| | - X. Vinolas
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - M. Alvarez
- Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - I. Anguera
- University Hospital of Bellvitge, Barcelona, Spain
| | - R. Porro
- Hospital San Pedro de Alcantara, Caceres, Spain
| | | | - A. Cordero
- University Hospital San Juan de Alicante, Cardiology, Alicante, Spain
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