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Polanco D, González J, Gracia-Lavedan E, Pinilla L, Plana R, Molina M, Pardina M, Barbé F. Multidisciplinary virtual management of pulmonary nodules. Pulmonology 2024; 30:239-246. [PMID: 35115280 DOI: 10.1016/j.pulmoe.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 10/19/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES Multidisciplinary nodule clinics provide high-quality care and favor adherence to guidelines. Virtual care has shown savings benefits along with patient satisfaction. Our aim is to describe the first year of operation of a multidisciplinary virtual lung nodule clinic, the population evaluated and issued decisions. Secondarily, among discharged patients, we aimed to analyze their follow-up prior to the existence of our consultation, evaluating its adherence to guidelines. MATERIALS AND METHODS Observational study including all patients evaluated at the Virtual Lung Nodule Clinic (VLNC) (March 2018- March 2019). Clinical and radiological data were recorded. Recommendations, based on 2017 Fleischner Society guidelines, were categorized into follow-up, discharge or referral to lung cancer consultation. Discharged patients were classified according to adherence to guidelines of their previous management, into adequate, prolonged and non-indicated follow-up. RESULTS A total of 365 patients (58.9% men; median age 64.0 years) were included. Sixty-four percent had smoking history and 23% had chronic obstructive pulmonary disease (COPD). Most nodules were solid (87.4%) and multiple (57.5%). The median diameter was 6.00 mm. 43.8% of patients were discharged following first VLNC evaluation. Among them, 27.5% had received appropriate follow-up, but 66.9% had received poor management. Patients with prolonged follow-up (33.1%) were older (67.0 vs 60.5 years) and had larger nodules (6.00 mm vs 5.00). Non-indicated follow-up patients (33.8%) were more non-smokers (77.8% vs 31.8%) and presented smaller nodules (4.00 vs 5.00 mm). CONCLUSIONS During its first year of operation, the VLNC has evaluated a population with a relevant risk profile for lung cancer development, management of which should be cautious and adhere to guidelines. After the first VLNC assessment, approximately one-half of this population was discharged. It was noticeable that previous follow-up of discharged patients was found poorly adherent to guidelines, with a marked tendency to overmanagement.
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Affiliation(s)
- D Polanco
- Respiratory Department, University Hospital Arnau de Vilanova. Av. Alcalde Rovira Roure, 80, 25198 Lleida, Spain; Group of Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Spain
| | - J González
- Respiratory Department, University Hospital Arnau de Vilanova. Av. Alcalde Rovira Roure, 80, 25198 Lleida, Spain; Group of Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Spain
| | - E Gracia-Lavedan
- Group of Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain
| | - L Pinilla
- Group of Precision Medicine in Chronic Diseases, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain
| | - R Plana
- Respiratory Department, University Hospital Arnau de Vilanova. Av. Alcalde Rovira Roure, 80, 25198 Lleida, Spain; Group of Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Spain
| | - M Molina
- Respiratory Department, University Hospital Arnau de Vilanova. Av. Alcalde Rovira Roure, 80, 25198 Lleida, Spain
| | - M Pardina
- Department of Radiology, Arnau de Vilanova University Hospital, IRBLleida
| | - F Barbé
- Respiratory Department, University Hospital Arnau de Vilanova. Av. Alcalde Rovira Roure, 80, 25198 Lleida, Spain; Group of Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, IRBLleida, Spain; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Spain.
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Ledesma BR, Velasquez DA, Egemba C, Molina M, Ibrahim E, Costantini-Mesquita F, Deebel NA, Han S, Reis IM, Saltzman R, Ramasamy R. A phase 2 randomized, placebo-controlled crossover trial to evaluate safety and efficacy of platelet-rich plasma injections for Peyronie's disease: clinical trial update. Int J Impot Res 2024:10.1038/s41443-024-00844-3. [PMID: 38424354 DOI: 10.1038/s41443-024-00844-3] [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] [Received: 12/03/2023] [Revised: 01/13/2024] [Accepted: 02/12/2024] [Indexed: 03/02/2024]
Abstract
Peyronie's Disease (PD) is characterized by fibrotic plaques in the penile tunica albuginea, causing curvature and painful erections. Current treatments have limited established efficacy. Platelet-Rich Plasma (PRP), known for modulating inflammation, offers a potential alternative. This randomized, placebo-controlled, crossover study at the University of Miami assesses PRP's safety and efficacy for PD. Forty-one PD patients were randomized into PRP-placebo (Group A) and placebo-PRP (Group B) sequences, receiving two injections of each treatment over three months, with a crossover to receive two injections of alternate treatment over the next three months. Assessments include pain scale, goniometry, questionnaires, and curvature evaluations. Preliminary analysis of 28 patients shows that PRP is safe. There were no adverse events, including penile complications, during follow-up. Pain scores during treatments showed no significant difference between PRP and placebo (p = 0.52). Over six months, the PRP-Placebo group's median PDQ score decreased from 1.9 (IQR: 1.7-2.9) to 1.4 (IQR: 0.7-2.1). This change was not statistically significant (p = 0.098). In contrast, the Placebo-PRP group showed a significant reduction from 1.8 (IQR: 1.4-2.6) to 1.2 (IQR: 1.0-2.0) (p = 0.020). No significant changes in IIEF scores were observed. Both groups initially had a median penile curvature of 40 degrees. At 3 months, the PRP-Placebo group's curvature decreased to 38 degrees (IQR: 35-47.5), while the Placebo-PRP group decreased to 35 degrees (IQR: 30-60). At 6 months, the PRP-Placebo group showed a significant reduction to 25 degrees (IQR: 20-40, p = 0.047), while the Placebo-PRP group's reduction to 32.5 degrees (IQR: 20-50) was not significant (p = 0.490). These early results indicate a delayed PRP effect, prompting further investigation into its long-term impacts. Although limited by sample size, this study suggests PRP injections as a safe treatment for PD, with ongoing research aiming to clarify its therapeutic value.
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Affiliation(s)
- Braian R Ledesma
- Desai Sethi Urology Institute, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - David A Velasquez
- Desai Sethi Urology Institute, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Christabel Egemba
- Desai Sethi Urology Institute, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Manuel Molina
- Desai Sethi Urology Institute, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Emad Ibrahim
- Desai Sethi Urology Institute, University of Miami, Miller School of Medicine, Miami, FL, USA
| | | | - Nicholas A Deebel
- Department of Urology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Sunwoo Han
- Biostatistics and Bioinformatics Shared Resource, Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Isildinha M Reis
- Biostatistics and Bioinformatics Shared Resource, Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Russell Saltzman
- Desai Sethi Urology Institute, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Ranjith Ramasamy
- Desai Sethi Urology Institute, University of Miami, Miller School of Medicine, Miami, FL, USA.
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Planas Díaz I, Díaz Menéndez L, Cabello Laureano R, Molina M. Benefits of standardization in the management of acute appendicitis. Cir Pediatr 2024; 37:5-10. [PMID: 38180095 DOI: 10.54847/cp.2024.01.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
OBJECTIVE Acute appendicitis (AA) is the most frequent urgent surgical pathology in the pediatric population, but postoperative management is variable, with protocols minimizing variability. We present our results following the optimization of the management protocol in our institution in order to establish its efficacy in terms of number of infectious complications and optimization of resources in our environment. MATERIALS AND METHODS An observational, retrospective study of patients undergoing AA surgery from January 2018 to August 2022 was carried out. Two cohorts were compared, both before (1) and after (2) the implementation of the new protocol. They were divided according to severity in order to conduct a subgroup-based analysis -phlegmonous (PH), gangrenous (G), and perforated (P) appendicitis. RESULTS 771 patients (1: 390; 2: 381) were included, with a homogeneous distribution and a median age of 9.3 ± 2.8 years. Blood tests requested prior to discharge experienced a significant reduction (PH: 3.9% vs. 0.5%; p= 0.026; G: 97.6% vs. 13.4%, p< 0.001). Days of hospital stay decreased in the PH (1.2 IQR: 0.7 vs. 1 IQR: 0.36; p< 0.001) and G (4 IQR: 1 vs. 3 IQR: 1 days; p< 0.001) subgroups. No differences in the number of abscesses were found between groups (41 vs. 43; p= 0.73), but they were noted within subgroup G (9 vs. 2; p= 0.029). A reduction in resource expenses was detected in PH and G appendicitis. CONCLUSIONS In our study, the most widely benefited subgroup following protocol optimization was the gangrenous appendicitis subgroup, with a significant reduction in the number of complications and the use of hospital resources.
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Affiliation(s)
- I Planas Díaz
- Pediatric Surgery Department. Hospital Universitario Virgen del Rocío. Sevilla (Spain)
| | - L Díaz Menéndez
- Pediatric Surgery Department. Hospital Universitario Virgen del Rocío. Sevilla (Spain)
| | - R Cabello Laureano
- Pediatric Surgery Department. Hospital Universitario Virgen del Rocío. Sevilla (Spain)
| | - M Molina
- Pediatric Surgery Department. Hospital Universitario Virgen del Rocío. Sevilla (Spain)
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Masterson TA, Molina M, Ledesma B, Zucker I, Saltzman R, Ibrahim E, Han S, Reis I, Ramasamy R. Platelet-rich Plasma for the Treatment of Erectile Dysfunction: A Prospective, Randomized, Double-blind, Placebo-controlled Clinical Trial. Reply. J Urol 2023; 210:734-735. [PMID: 37811758 DOI: 10.1097/ju.0000000000003685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 08/21/2023] [Indexed: 10/10/2023]
Affiliation(s)
| | - Manuel Molina
- Urology, University of Miami School of Medicine, Miami, Florida
| | - Braian Ledesma
- Urology, University of Miami School of Medicine, Miami, Florida
| | - Isaac Zucker
- Urology, University of Miami School of Medicine, Miami, Florida
| | - Russel Saltzman
- Urology, University of Miami School of Medicine, Miami, Florida
| | - Emad Ibrahim
- Urology, University of Miami School of Medicine, Miami, Florida
| | - Sunwoo Han
- Urology, University of Miami School of Medicine, Miami, Florida
| | - Isildinha Reis
- Urology, University of Miami School of Medicine, Miami, Florida
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Riva N, Brstilo L, Sancho-Araiz A, Molina M, Savransky A, Roffé G, Sanz M, Tenembaum S, Katsicas MM, Trocóniz IF, Schaiquevich P. Population Pharmacodynamic Modelling of the CD19+ Suppression Effects of Rituximab in Paediatric Patients with Neurological and Autoimmune Diseases. Pharmaceutics 2023; 15:2534. [PMID: 38004515 PMCID: PMC10674351 DOI: 10.3390/pharmaceutics15112534] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/09/2023] [Accepted: 10/23/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Limited pharmacotherapy and the failure of conventional treatments in complex pathologies in children lead to increased off-label use of rituximab. We aimed to characterize the time course of CD19+ B lymphocytes (CD19+) under treatment with intravenous rituximab in children with neurologic and autoimmune diseases and to evaluate the impact of covariates (i.e., demographics, diagnosis and substitution between innovator and biosimilar product) on rituximab pharmacodynamics and disease activity. METHODS Pre- and post-drug infusion CD19+ in peripheral blood were prospectively registered. A population pharmacodynamic model describing the time course of CD19+ was developed with NONMEM v7.4. Simulations of three different rituximab regimens were performed to assess the impact on CD19+. Logistic regression analysis was performed to identify predictors of clinical response recorded through disease activity scores. RESULTS 281 measurements of CD19+ lymphocyte counts obtained from 63 children with neurologic (n = 36) and autoimmune (n = 27) diseases were available. The time course of CD19+ was described with a turn-over model in which the balance between synthesis and degradation rates is disrupted by rituximab, increasing the latter process. The model predicts half-lives (percent coefficient of variation, CV(%)) of rituximab and CD19+ of 11.6 days (17%) and 173.3 days (22%), respectively. No statistically significant effect was found between any of the studied covariates and model parameters (p > 0.05). Simulations of different regimens showed no clinically significant differences in terms of CD19+ repopulation times. A trend towards a lack of clinical response was observed in patients with lower CD19+ repopulation times and higher areas under the CD19+ versus time curve. CONCLUSIONS Rituximab pharmacodynamics was described in a real-world setting in children suffering from autoimmune and neurologic diseases. Diagnosis, substitution between innovator rituximab and its biosimilars or type of regimen did not affect rituximab-induced depletion of CD19+ nor the clinical response in this cohort of patients. According to this study, rituximab frequency and dosage may be chosen based on clinical convenience or safety reasons without affecting CD19+ repopulation times. Further studies in larger populations are required to confirm these results.
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Affiliation(s)
- Natalia Riva
- Pharmacometrics & Systems Pharmacology Research Unit, Department of Pharmaceutical Sciences, School of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (A.S.-A.); (I.F.T.)
- Unit of Innovative Treatments, Hospital de Pediatría JP Garrahan, Buenos Aires C1245 CABA, Argentina; (L.B.); (M.M.); (P.S.)
- National Council of Scientific and Technical Research (CONICET), Buenos Aires C1425 FQB, Argentina
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
| | - Lucas Brstilo
- Unit of Innovative Treatments, Hospital de Pediatría JP Garrahan, Buenos Aires C1245 CABA, Argentina; (L.B.); (M.M.); (P.S.)
- National Council of Scientific and Technical Research (CONICET), Buenos Aires C1425 FQB, Argentina
| | - Aymara Sancho-Araiz
- Pharmacometrics & Systems Pharmacology Research Unit, Department of Pharmaceutical Sciences, School of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (A.S.-A.); (I.F.T.)
- Unit of Innovative Treatments, Hospital de Pediatría JP Garrahan, Buenos Aires C1245 CABA, Argentina; (L.B.); (M.M.); (P.S.)
| | - Manuel Molina
- Unit of Innovative Treatments, Hospital de Pediatría JP Garrahan, Buenos Aires C1245 CABA, Argentina; (L.B.); (M.M.); (P.S.)
| | - Andrea Savransky
- Neurology Service, Hospital de Pediatría JP Garrahan, Buenos Aires C1245 CABA, Argentina; (A.S.); (S.T.)
| | - Georgina Roffé
- Laboratory of Cellular Immunology, Hospital de Pediatría JP Garrahan, Buenos Aires C1245 CABA, Argentina; (G.R.); (M.S.)
| | - Marianela Sanz
- Laboratory of Cellular Immunology, Hospital de Pediatría JP Garrahan, Buenos Aires C1245 CABA, Argentina; (G.R.); (M.S.)
| | - Silvia Tenembaum
- Neurology Service, Hospital de Pediatría JP Garrahan, Buenos Aires C1245 CABA, Argentina; (A.S.); (S.T.)
| | - Maria M. Katsicas
- Immunology and Rheumatology Service, Hospital de Pediatría JP Garrahan, Buenos Aires C1245 CABA, Argentina;
| | - Iñaki F. Trocóniz
- Pharmacometrics & Systems Pharmacology Research Unit, Department of Pharmaceutical Sciences, School of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain; (A.S.-A.); (I.F.T.)
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
- Institute of Data Science and Artificial Intelligence, DATAI, University of Navarra, 31009 Pamplona, Spain
| | - Paula Schaiquevich
- Unit of Innovative Treatments, Hospital de Pediatría JP Garrahan, Buenos Aires C1245 CABA, Argentina; (L.B.); (M.M.); (P.S.)
- National Council of Scientific and Technical Research (CONICET), Buenos Aires C1425 FQB, Argentina
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Masterson TA, Molina M, Ledesma B, Zucker I, Saltzman R, Ibrahim E, Han S, Reis IM, Ramasamy R. Platelet-rich Plasma for the Treatment of Erectile Dysfunction: A Prospective, Randomized, Double-blind, Placebo-controlled Clinical Trial. J Urol 2023; 210:154-161. [PMID: 37120727 PMCID: PMC10330773 DOI: 10.1097/ju.0000000000003481] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/07/2023] [Indexed: 05/01/2023]
Abstract
PURPOSE We assessed the safety and efficacy of 2 injections of platelet-rich plasma for treating mild to moderate erectile dysfunction by conducting a prospective, randomized, double-blind, placebo-controlled clinical trial. MATERIALS AND METHODS Men with mild to moderate erectile dysfunction (International Index of Erectile Function scores 11-25) were randomized to receive either 2 injections of platelet-rich plasma or placebo separated by 1 month. Primary outcome was percentage of men meeting minimum clinically important difference at 1 month after the second injection. Secondary outcomes were change in International Index of Erectile Function at 1, 3, and 6 months, and changes in penile vascular parameters and adverse events at 6 months. RESULTS We randomized 61 men: 28 into platelet-rich plasma and 33 into placebo. There was no difference between groups in percentage of men meeting minimum clinically important difference at 1 month: 14 (58.3%) in platelet-rich plasma vs 15 (53.6%) in placebo (P = .730). Mean International Index of Erectile Function-Erectile Function domain changed from 17.4 (95% CI 15.8-19.0) to 21 (17.9-24.0) at 1 month in men receiving platelet-rich plasma, vs 18.6 (17.3-19.8) to 21.6 (19.1-24.1) in the placebo group; however, there was no significant difference between groups (P = .756). There were no major adverse events and only 1 minor adverse event in each group. There were no changes in penile Doppler parameters from baseline to 6 months. CONCLUSIONS The results of our prospective, double-blind, randomized, placebo-controlled clinical trial suggest that 2 injections of intracavernosal platelet-rich plasma separated by 1 month in men with mild to moderate erectile dysfunction is safe, but we found no difference in efficacy between platelet-rich plasma and placebo.
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Affiliation(s)
- Thomas A. Masterson
- Desai Sethi Urology Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Manuel Molina
- Desai Sethi Urology Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Braian Ledesma
- Desai Sethi Urology Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Isaac Zucker
- Desai Sethi Urology Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Russell Saltzman
- Desai Sethi Urology Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Emad Ibrahim
- Desai Sethi Urology Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Sunwoo Han
- Biostatistics and Bioinformatics Shared Resources, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Isildinha M. Reis
- Biostatistics and Bioinformatics Shared Resources, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ranjith Ramasamy
- Desai Sethi Urology Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
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Kresch E, Lima TFN, Molina M, Deebel NA, Reddy R, Patel M, Loloi J, Carto C, Nackeeran S, Gonzalez DC, Ory J, Ramasamy R. Efficacy and safety outcomes of a compounded testosterone pellet versus a branded testosterone pellet in men with testosterone deficiency: a single-center, open-label, randomized trial. Sex Med 2023; 11:qfad007. [PMID: 36936900 PMCID: PMC10022718 DOI: 10.1093/sexmed/qfad007] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/25/2023] [Accepted: 01/28/2023] [Indexed: 03/19/2023] Open
Abstract
Background Testosterone deficiency (TD) is a prevalent condition, especially in men ≥45 years old, and testosterone therapy (TTh) can improve the quality of life in these patients. Aim To evaluate the safety profile of compounded subcutaneous testosterone pellets and to compare the efficacy between compounded and market brand testosterone pellets for TTh: E100 (Empower Pharmacy) and Testopel (Food and Drug Administration approved), respectively. Methods This was a prospective, phase 3, randomized, noninferiority clinical trial. We enrolled 75 men diagnosed with TD and randomized them 1:1 to a market brand group and a compounded pellet group. The patients were implanted with their respective testosterone pellets: Testopel (10 pellets of 75 mg) and E100 (8 pellets of 100 mg). Outcomes We evaluated adverse events after implantation and followed men at 2, 4, and 6 months for morning laboratory levels (prior to 10 am): serum testosterone, estradiol, hematocrit, and prostate-specific antigen. Results After randomization, 33 participants were enrolled in the Testopel arm and 42 in the E100 arm. Serum testosterone levels were similar between the groups at 2, 4, and 6 months, with most men (82%) dropping to <300 ng/dL by the end of the trial. Adverse events were also similar, such as elevations in prostate-specific antigen, estradiol, and hematocrit. Most dropouts were related to persistent TD symptoms and serum testosterone <300 ng/dL, with similar rates between the groups in the study. Clinical Implications Men treated with Testopel and E100 pellets had comparable serum testosterone levels and similar adverse event rates, providing an effective choice of long-term TTh among men with TD. Strengths and Limitations Strengths include the prospective, randomized, single-blinded study design and adequate follow-up. Limitations include the lack of external validity and the single-institution cohort. Conclusion E100 compounded testosterone pellets are a noninferior option of TTh as compared with Testopel for men presenting with TD.
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Affiliation(s)
- Eliyahu Kresch
- Department of Urology, University of Florida Jacksonville, Jacksonville, FL 32209, United States
| | | | - Manuel Molina
- Desai Sethi Urological Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Nicholas A Deebel
- Department of Urology, Wake Forest School of Medicine, Winston-Salem, NC 27157, United States
| | - Rohit Reddy
- Desai Sethi Urological Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Mehul Patel
- Desai Sethi Urological Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Justin Loloi
- Department of Urology, Montefiore Medical Center, Bronx, NY 10467, United States
| | - Chase Carto
- Desai Sethi Urological Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Sirpi Nackeeran
- Desai Sethi Urological Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Daniel C Gonzalez
- Desai Sethi Urological Institute, Miller School of Medicine, University of Miami, Miami, FL 33136, United States
| | - Jesse Ory
- Department of Urology, Dalhousie University, Halifax B3H 4R2, Canada
| | - Ranjith Ramasamy
- Corresponding author: Department of Urology, Miller School of Medicine, University of Miami, Miami, FL 33136, United States.
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Rashed E, Molina M, Goldberg L, Mather P. Calcinosis Cutis in the Setting of Rapamycin Use: Balancing Infection and Vasculopathy. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.475] [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: 04/05/2023] Open
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Holzhauser L, Molina M, Joshi P, Atluri P, Goldberg L, McLean R. Gene Expression Profiling and Dd-cfdna Performance in Heart Transplant Recipients with Neuromuscular Disorders. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1219] [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: 04/05/2023] Open
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Ortega-Legaspi J, Molina M, Leon J, Cunningham A, Guerraty M, Peyster E, Julien H, McLean R, Goldberg L, Bravo P. Coronary Flow Reserve is an Independent Predictor of Major Adverse Cardiovascular Events in Long Term Heart Transplantation Survivors. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.171] [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: 04/05/2023] Open
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Richardet E, Magi I, Peruchin V, Perea P, Tello A, Molina M, Acosta L, Paradelo M, Richardet M. PP.08 Analysis of the Status of Tumor-Infiltrating Lymphocytes (TILS) In Patients With NSCLC. J Thorac Oncol 2023. [DOI: 10.1016/j.jtho.2023.01.036] [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: 02/27/2023]
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Richardet E, Richardet M, Molina M, Magi I, Peruchin V, Perea P, Tello A. PP.09 Neutrophil Lymphocyte Ratio as a Prognostic Factor in Patients With Advanced Non-small Cell Lung Cancer (NSCLC). J Thorac Oncol 2023. [DOI: 10.1016/j.jtho.2023.01.037] [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: 02/26/2023]
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Marcet-Houben M, Collado-Cala I, Fuentes-Palacios D, Gómez AD, Molina M, Garisoain-Zafra A, Chorostecki U, Gabaldón T. EvolClustDB: Exploring Eukaryotic Gene Clusters with Evolutionarily Conserved Genomic Neighbourhoods. J Mol Biol 2023:168013. [PMID: 36806474 DOI: 10.1016/j.jmb.2023.168013] [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: 11/04/2022] [Revised: 01/24/2023] [Accepted: 02/11/2023] [Indexed: 02/17/2023]
Abstract
Conservation of gene neighbourhood over evolutionary distances is generally indicative of shared regulation or functional association among genes. This concept has been broadly exploited in prokaryotes but its use on eukaryotic genomes has been limited to specific functional classes, such as biosynthetic gene clusters. We here used an evolutionary-based gene cluster discovery algorithm (EvolClust) to pre-compute evolutionarily conserved gene neighbourhoods, which can be searched, browsed and downloaded in EvolClustDB. We inferred ∼35,000 cluster families in 882 different species in genome comparisons of five taxonomically broad clades: Fungi, Plants, Metazoans, Insects and Protists. EvolClustDB allows browsing through the cluster families, as well as searching by protein, species, identifier or sequence. Visualization allows inspecting gene order per species in a phylogenetic context, so that relevant evolutionary events such as gain, loss or transfer, can be inferred. EvolClustDB is freely available, without registration, at http://evolclustdb.org/.
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Affiliation(s)
- Marina Marcet-Houben
- Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Baldiri Reixac, 10, 08028 Barcelona, Spain; Barcelona Supercomputing Centre (BSC-CNS). Plaça Eusebi Güell, 1-3, 08034 Barcelona, Spain
| | - Ismael Collado-Cala
- Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Baldiri Reixac, 10, 08028 Barcelona, Spain; Barcelona Supercomputing Centre (BSC-CNS). Plaça Eusebi Güell, 1-3, 08034 Barcelona, Spain
| | - Diego Fuentes-Palacios
- Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Baldiri Reixac, 10, 08028 Barcelona, Spain; Barcelona Supercomputing Centre (BSC-CNS). Plaça Eusebi Güell, 1-3, 08034 Barcelona, Spain
| | - Alicia D Gómez
- Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Baldiri Reixac, 10, 08028 Barcelona, Spain; Barcelona Supercomputing Centre (BSC-CNS). Plaça Eusebi Güell, 1-3, 08034 Barcelona, Spain
| | - Manuel Molina
- Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Baldiri Reixac, 10, 08028 Barcelona, Spain; Barcelona Supercomputing Centre (BSC-CNS). Plaça Eusebi Güell, 1-3, 08034 Barcelona, Spain
| | - Andrés Garisoain-Zafra
- Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Baldiri Reixac, 10, 08028 Barcelona, Spain; Barcelona Supercomputing Centre (BSC-CNS). Plaça Eusebi Güell, 1-3, 08034 Barcelona, Spain
| | - Uciel Chorostecki
- Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Baldiri Reixac, 10, 08028 Barcelona, Spain; Barcelona Supercomputing Centre (BSC-CNS). Plaça Eusebi Güell, 1-3, 08034 Barcelona, Spain
| | - Toni Gabaldón
- Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Baldiri Reixac, 10, 08028 Barcelona, Spain; Barcelona Supercomputing Centre (BSC-CNS). Plaça Eusebi Güell, 1-3, 08034 Barcelona, Spain; Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain; Centro de Investigación Biomédica En Red de Enfermedades Infecciosas (CIBERINFEC), Barcelona, Spain.
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14
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Madanat H, Martinez A, Molina M, Ayala GX. Impact of Delivering a Healthy Lifestyle Intervention: Promotora Findings from Familias Sanas y Activas II. J Health Sci Educ 2023; 1:1-7. [PMID: 37489145 PMCID: PMC10364119] [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] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
Background Community health workers, promotoras, have been identified as effective change agents of their community members' health behaviors and health status. However, few studies have examined the effects of delivering an intervention on the promotoras themselves. Objectives This study assessed whether promotoras delivering a healthy lifestyle intervention for adults improved their health behaviors and health status from baseline to 6- and 12-months post-baseline. Methods Volunteer promotoras were trained to promote healthy lifestyles including physical activity through workshops and free group exercise classes throughout their communities. Twenty completed all required trainings and delivered at least one class during the period between baseline and 12-month assessments. The promotoras were measured on the following variables: Systolic and diastolic blood pressure, waist circumference, weight, and height. Additionally, they reported their health behaviors and status including moderate-to-vigorous physical activity, beverage consumption, sleep duration, and depressive symptoms. Results Repeated measures ANOVAs showed statistically significant decreases from baseline to 6 months for systolic blood pressure (p ≤ 0.05), diastolic blood pressure (p ≤ 0.001) and body mass index (p ≤ 0.05). Changes in self-reported measures were not statistically significant although trends were observed with increases in water consumption. Conclusions Findings from this study suggest positive effects associated with delivery of a PA intervention. This is one of the first studies to focus on a cohort of promotoras to examine health outcomes from delivering a healthy lifestyle intervention. It is important to further explore these impacts on the community health workers as they have become increasingly essential to the health of some communities.
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Affiliation(s)
- H Madanat
- Graduate School of Public Health, San Diego State University, USA
- Institute for Behavioural and Community Health, San Diego State University, USA
| | - A Martinez
- California Department of Health, STD Control Branch, USA
| | - M Molina
- Institute for Behavioural and Community Health, San Diego State University, USA
| | - GX Ayala
- Graduate School of Public Health, San Diego State University, USA
- Institute for Behavioural and Community Health, San Diego State University, USA
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15
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Masterson TA, Atuluru P, Zucker I, Molina M, Ibrahim E, Nackeeran S, Kava B, Ramasamy R. Collagenase Clostridium histolyticum Treatment Improves Degree of Curvature in Peyronie's Disease with Calcified Plaques. Eur Urol Focus 2023; 9:55-59. [PMID: 36272924 DOI: 10.1016/j.euf.2022.09.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 09/13/2022] [Accepted: 09/28/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Peyronie's disease (PD) is a fibrotic condition of the penis characterized by abnormal plaque formation. Intralesional collagenase Clostridium histolyticum (CCh) is effective in noncalcified PD; however, its effectiveness in calcified PD is not well characterized. OBJECTIVE To assess curvature improvement in calcified PD plaques treated with CCh. DESIGN, SETTING, AND PARTICIPANTS We prospectively evaluated men with calcified PD electing CCh treatment at our institution from October 2018 to November 2020. We assessed curvature with artificial erection and goniometer before and at least 3 mo after treatment. We classified the type of plaque calcification based on ultrasound. INTERVENTION Intralesional CCh. Each treatment cycle consisted of two CCh injections (0.58 mg) into the plaque at the point of maximal penile curvature. The second injection was performed 72 h to 1 wk later, after which participants began modeling. All men were intended to receive a total of eight injections in four cycles, each 6 wk apart. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Change in penile curvature after CCh was measured. We assessed for differences in outcomes based on the number of injections and type of calcification. Unless otherwise specified, data are presented as medians (interquartile range). RESULTS AND LIMITATIONS Sixty men with calcified PD elected CCh; 47 had complete follow-up data. Thirty-nine men completed treatments with eight injections, while the remaining discontinued after a median of five (four to six) injections. There was no difference in response between type 2 and type 3 plaques. Curvature significantly improved by 17.5° (37.5-10.0°) in patients who completed treatment and by 15.0° (20.0-0.0°) in those who discontinued. Limitations include a small sample. CONCLUSIONS Men with calcified PD plaques improve with CCh treatment and show similar improvements regardless of calcification type. PATIENT SUMMARY In this study, we evaluated the efficacy of collagenase Clostridium histolyticum (CCh) treatment in calcified Peyronie's disease (PD) plaques. We found that treatment in calcified plaques demonstrated significant improvement in curvature and the grading of calcification did not impact the degree of curvature improvement. We conclude that participants with calcified PD plaques can benefit from nonsurgical CCh treatment.
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Affiliation(s)
- Thomas A Masterson
- Desai Sethi Urology Institute, Miller School of Medicine, University of Miami, Miami, FL, USA.
| | | | - Isaac Zucker
- Desai Sethi Urology Institute, Miller School of Medicine, University of Miami, Miami, FL, USA; Herbert Wertheim School of Medicine, Florida International University, Miami, FL, USA
| | - Manuel Molina
- Desai Sethi Urology Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Emad Ibrahim
- Desai Sethi Urology Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Sirpi Nackeeran
- Department of Urology, University of California San Diego, San Diego, CA, USA
| | - Bruce Kava
- Desai Sethi Urology Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ranjith Ramasamy
- Desai Sethi Urology Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
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Ribes-Koninckx C, Amil-Dias J, Espin B, Molina M, Segarra O, Diaz-Martin JJ. The use of amino acid formulas in pediatric patients with allergy to cow's milk proteins: Recommendations from a group of experts. Front Pediatr 2023; 11:1110380. [PMID: 37033186 PMCID: PMC10073469 DOI: 10.3389/fped.2023.1110380] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 11/28/2022] [Accepted: 03/01/2023] [Indexed: 04/11/2023] Open
Abstract
One of the most common food allergies in children is cow's milk allergy (CMA). In breast-fed infants with CMA, the mother is encouraged to avoid dairy products. If this is not possible, or in formula fed infants, use of hypoallergenic replacement formulas such as extensively hydrolyzed formulas (EHF) is recommended. However, in ∼5% of patients EHFs are not tolerated and/or allergy symptoms can persist. When EHFs are ineffective and in severe forms of CMA, amino acid-based formulas (AAF) should be considered. Six pediatric gastroenterologists with extensive experience in food allergy management reviewed scientific publications and international clinical practice guidelines to provide practical recommendations on AAF. The guidelines reviewed had discrepancies and ambiguities around the specific indications for using formulas as a milk substitute. The panel recommends AAFs as the first therapeutic option in anaphylaxis due to CMA, in acute and chronic severe food protein-induced enterocolitis syndrome, in CMA associated with multiple food allergy, and in cases of eosinophilic esophagitis not responding to an extended exclusion diet or not eating solids. The main benefit of AAF is its absence of residual allergenicity, making it a safe treatment option in severe CMA patients who do not tolerate or respond to an EHF.
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Affiliation(s)
- Carmen Ribes-Koninckx
- Pediatric Gastroenterology, Hepatology and Nutrition La Fe University and Politechnic Hospital & La Fe Research Institute, Valencia, Spain
- Correspondence: Carmen Ribes-Koninckx
| | - Jorge Amil-Dias
- Emeritus, S. João University Hospital Center, Porto, Portugal
| | - Beatriz Espin
- Pediatric Gastroenterology and Nutrition Unit, Virgen del Rocio University Hospital, Seville, Spain
| | - Manuel Molina
- Department of Pediatric Gastroenterology and Nutrition, La Paz University Hospital, Madrid, Spain
| | - Oscar Segarra
- Pediatric Gastroenterology, Hepatology and Nutrition Unit, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Juan J. Diaz-Martin
- Pediatric Gastroenterology and Nutrition, Hospital Universitario Central de Asturias, Oviedo, Spain
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17
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González M, Molina M, del Puerto I. Preface of the special issue on Branching Processes and Applications (IWBPA2021). STOCH MODELS 2022. [DOI: 10.1080/15326349.2022.2139271] [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: 11/09/2022]
Affiliation(s)
| | - M. Molina
- University of Extremadura, Badajoz, Spain
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18
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Esteban Fernandez A, Anguita M, Bonilla JL, Anguita M, Ruesgas R, Molina M, Garcia M, Bernal JL, Del Prado N, Fernandez Perez C, Marin F, Perez Villacastin J, Gomez Doblas JJ, Fernandez Rozas I, Elola FJ. 1-year hospital readmissions due to cardiovascular causes after a heart failure episode in elderly patients in Spain. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1044] [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: 11/14/2022] Open
Abstract
Abstract
Background
The prevalence of heart failure (HF) increases with age, one of the leading causes of hospitalization and death in the elderly. However, there are little data about the long-term readmission rate of elderly patients after an episode of HF admission in Spain.
Purpose
Study 1-year hospital readmissions due to cardiovascular causes in patients ≥75 years discharged to a hospital due to HF in Spain.
Methods
We performed a retrospective analysis of the Minumum basic dataset of Spain, including all episodes of HF discharged from public hospitals in Spain between 2016 and 2019. The codification was made with ICD-10. We selected patients ≥75 years with HF as the principal diagnosis. We analyzed predictors of readmissions 365 days after the index episode of HF hospitalization with Poisson regression.
Results
236,463 index episodes of HF in>75 years were included. 59.1% were female, and the mean age was 85 (SD 5.6) years. 35.0% had HF-pef, 4.3% HF-ref, and 60.7% had unknown LVEF HF.
39.6% of patients had at least one readmission (mean 1.7 readmissions by year for these patients), with no differences in sex or age. Patients with non-cardiovascular comorbidities (renal failure, chronic lung disorders, and severe hematological disorders) as well as coronary atherosclerosis and diabetes were more likely to be readmitted (Table 1).
Conclusions
After a hospital discharge for HF in patients ≥75 years, the crude ratio of readmission due to cardiovascular causes at 1-year was 39.6%. Readmissions were more likely in patients with non-cardiovascular comorbidities, predominantly renal, hematological, and chronic respiratory disorders, and those with diabetes and coronary atherosclerosis.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - M Anguita
- University Hospital Reina Sofia , Cordoba , Spain
| | - J L Bonilla
- Hospital San Juan de la Cruz , Ubeda , Spain
| | - M Anguita
- Hospital Clinico San Carlos , Madrid , Spain
| | - R Ruesgas
- Severo Ochoa Hospital , Leganes , Spain
| | - M Molina
- Severo Ochoa Hospital , Leganes , Spain
| | | | | | | | | | - F Marin
- Virgen of the Arrixaca University Hospital , Murcia , Spain
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19
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Porrello E, Molina M, Lorenzetti M, Previtali S. VP.75 Jab1 deletion in muscle lineage causes a muscular dystrophy that resembles LAMA2 disease. Neuromuscul Disord 2022. [DOI: 10.1016/j.nmd.2022.07.337] [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: 11/06/2022]
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20
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Khodamoradi K, Dullea A, Golan R, Molina M, Arora H, Masterson TA, Ramasamy R. Platelet Rich Plasma (PRP) Growth Factor Concentration Varies in Men With Erectile Dysfunction. J Sex Med 2022; 19:1488-1493. [DOI: 10.1016/j.jsxm.2022.06.003] [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] [Received: 02/16/2022] [Revised: 04/27/2022] [Accepted: 06/02/2022] [Indexed: 11/29/2022]
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21
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Crystal JS, Thompson JF, Hyngstrom J, Caracò C, Zager JS, Jahkola T, Bowles TL, Pennacchioli E, Beitsch PD, Hoekstra HJ, Moncrieff M, Ingvar C, van Akkooi A, Sabel MS, Levine EA, Agnese D, Henderson M, Dummer R, Neves RI, Rossi CR, Kane JM, Trocha S, Wright F, Byrd DR, Matter M, Hsueh EC, MacKenzie-Ross A, Kelley M, Terheyden P, Huston TL, Wayne JD, Neuman H, Smithers BM, Ariyan CE, Desai D, Gershenwald JE, Schneebaum S, Gesierich A, Jacobs LK, Lewis JM, McMasters KM, O'Donoghue C, van der Westhuizen A, Sardi A, Barth R, Barone R, McKinnon JG, Slingluff CL, Farma JM, Schultz E, Scheri RP, Vidal-Sicart S, Molina M, Testori AAE, Foshag LJ, Van Kreuningen L, Wang HJ, Sim MS, Scolyer RA, Elashoff DE, Cochran AJ, Faries MB. Therapeutic Value of Sentinel Lymph Node Biopsy in Patients With Melanoma: A Randomized Clinical Trial. JAMA Surg 2022; 157:835-842. [PMID: 35921122 PMCID: PMC9475390 DOI: 10.1001/jamasurg.2022.2055] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/19/2022] [Indexed: 12/12/2022]
Abstract
Importance Sentinel lymph node (SLN) biopsy is a standard staging procedure for cutaneous melanoma. Regional disease control is a clinically important therapeutic goal of surgical intervention, including nodal surgery. Objective To determine how frequently SLN biopsy without completion lymph node dissection (CLND) results in long-term regional nodal disease control in patients with SLN metastases. Design, Setting, and Participants The second Multicenter Selective Lymphadenectomy Trial (MSLT-II), a prospective multicenter randomized clinical trial, randomized participants with SLN metastases to either CLND or nodal observation. The current analysis examines observation patients with regard to regional nodal recurrence. Trial patients were aged 18 to 75 years with melanoma metastatic to SLN(s). Data were collected from December 2004 to April 2019, and data were analyzed from July 2020 to January 2022. Interventions Nodal observation with ultrasonography rather than CLND. Main Outcomes and Measures In-basin nodal recurrence. Results Of 823 included patients, 479 (58.2%) were male, and the mean (SD) age was 52.8 (13.8) years. Among 855 observed basins, at 10 years, 80.2% (actuarial; 95% CI, 77-83) of basins were free of nodal recurrence. By univariable analysis, freedom from regional nodal recurrence was associated with age younger than 50 years (hazard ratio [HR], 0.49; 95% CI, 0.34-0.70; P < .001), nonulcerated melanoma (HR, 0.36; 95% CI, 0.36-0.49; P < .001), thinner primary melanoma (less than 1.5 mm; HR, 0.46; 95% CI, 0.27-0.78; P = .004), axillary basin (HR, 0.61; 95% CI, 0.44-0.86; P = .005), fewer positive SLNs (1 vs 3 or more; HR, 0.32; 95% CI, 0.14-0.75; P = .008), and SLN tumor burden (measured by diameter less than 1 mm [HR, 0.39; 95% CI, 0.26-0.60; P = .001] or less than 5% area [HR, 0.36; 95% CI, 0.24-0.54; P < .001]). By multivariable analysis, younger age (HR, 0.57; 95% CI, 0.39-0.84; P = .004), thinner primary melanoma (HR, 0.40; 95% CI, 0.22-0.70; P = .002), axillary basin (HR, 0.55; 95% CI, 0.31-0.96; P = .03), SLN metastasis diameter less than 1 mm (HR, 0.52; 95% CI, 0.33-0.81; P = .007), and area less than 5% (HR, 0.58; 95% CI, 0.38-0.88; P = .01) were associated with basin control. When looking at the identified risk factors of age (50 years or older), ulceration, Breslow thickness greater than 3.5 mm, nonaxillary basin, and tumor burden of maximum diameter of 1 mm or greater and/or metastasis area of 5% or greater and excluding missing value cases, basin disease-free rates at 5 years were 96% (95% CI, 88-100) for patients with 0 risk factors, 89% (95% CI, 82-96) for 1 risk factor, 86% (95% CI, 80-93) for 2 risk factors, 80% (95% CI, 71-89) for 3 risk factors, 61% (95% CI, 48-74) for 4 risk factors, and 54% (95% CI, 36-72) for 5 or 6 risk factors. Conclusions and Relevance This randomized clinical trial was the largest prospective evaluation of long-term regional basin control in patients with melanoma who had nodal observation after removal of a positive SLN. SLN biopsy without CLND cleared disease in the affected nodal basin in most patients, even those with multiple risk factors for in-basin recurrence. In addition to its well-validated value in staging, SLN biopsy may also be regarded as therapeutic in some patients. Trial Registration ClinicalTrials.gov Identifier: NCT00297895.
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Affiliation(s)
| | - John F Thompson
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia
| | - John Hyngstrom
- Department of Surgery, University of Utah, Salt Lake City
| | - Corrado Caracò
- Istituto Nazionale Tumori IRCCS Fondazione "G. Pascale," Napoli, Italy
| | - Jonathan S Zager
- Departments of Cutaneous Oncology and Sarcoma, H. Lee Moffitt Cancer Center, Tampa, Florida
| | - Tiina Jahkola
- Department of Plastic and Reconstructive Surgery, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Tawnya L Bowles
- Department of Surgical Oncology, Intermountain Medical Center, Salt Lake City, Utah
| | - Elisabetta Pennacchioli
- Division of Melanoma, Soft Tissue Sarcomas and Rare Tumors, European Institute of Oncology, Milano, Italy
| | | | - Harald J Hoekstra
- Department of Surgery, University Hospital Groningen, Groningen, the Netherlands
| | - Marc Moncrieff
- Department of Plastic and Reconstructive Surgery, Norfolk and Norwich University Hospital, Norwich, United Kingdom
| | | | - Alexander van Akkooi
- Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | | | - Edward A Levine
- Department of Surgical Oncology, Wake Forest University, Winston-Salem, North Carolina
| | - Doreen Agnese
- Department of Surgery, Ohio State University, Columbus
| | - Michael Henderson
- Department of Surgery, University of Melbourne, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Reinhard Dummer
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - Rogerio I Neves
- Department of Surgery, Pennsylvania State University Milton S. Hershey Medical Center, Hershey
- Now at Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | | | - John M Kane
- Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, New York
| | - Steven Trocha
- Department of Surgical Oncology, Prisma Health, Columbia, South Carolina
| | - Frances Wright
- Department of Surgical Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - David R Byrd
- Department of Surgery, University of Washington, Seattle
| | - Maurice Matter
- Department of Surgery, Lausanne University Hospital, Lausanne, Switzerland
| | - Eddy C Hsueh
- Department of Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri
| | - Alastair MacKenzie-Ross
- Department of Plastic Surgery, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Mark Kelley
- Department of Surgery, Vanderbilt University, Nashville, Tennessee
| | | | - Tara L Huston
- Department of Surgery, Stony Brook University, Stony Brook, New York
| | - Jeffrey D Wayne
- Department of Surgery, Northwestern University, Chicago, Illinois
| | - Heather Neuman
- Department of Surgery, University of Wisconsin at Madison
| | - B Mark Smithers
- Department of Surgery, University of Queensland, Brisbane, Australia
| | - Charlotte E Ariyan
- Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York
| | - Darius Desai
- Department of Surgery, Saint Luke's University Hospital, Bethlehem, Pennsylvania
| | | | - Shlomo Schneebaum
- Department of Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Anja Gesierich
- Department of Dermatology, University Hospital Wurzburg, Wurzburg, Germany
| | - Lisa K Jacobs
- Department of Surgery, Johns Hopkins University, Baltimore, Maryland
| | - James M Lewis
- Department of Surgery, University of Tennessee Medical Center, Knoxville
| | - Kelly M McMasters
- Department of Surgery, University of Louisville, Louisville, Tennessee
| | | | | | - Armando Sardi
- Department of Surgical Oncology, Mercy Medical Center, Baltimore, Maryland
| | - Richard Barth
- Department of Surgery, Dartmouth-Hitchcock Medical Center, Hanover, New Hampshire
| | - Robert Barone
- Surgical Oncology, Sharp Hospital, San Diego, California
| | - J Greg McKinnon
- Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | | | - Jeffrey M Farma
- Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Erwin Schultz
- Department of Dermatology, Nuremberg General Hospital, Paracelsus Medical Center, Nuremberg, Germany
| | | | - Sergi Vidal-Sicart
- Nuclear Medicine Department, Hospital Clinic Barcelona, Barcelona, Spain
| | - Manuel Molina
- Department of Surgery, Lakeland Regional Health, Lakeland, Florida
| | | | - Leland J Foshag
- Department of Surgical Oncology, John Wayne Cancer Institute, Santa Monica, California
| | - Lisa Van Kreuningen
- Manager of Research Operations, Saint John's Cancer Institute, Santa Monica, California
| | - He-Jing Wang
- Department of Medicine Statistics Core, David Geffen School of Medicine at UCLA, University of California, Los Angeles
| | - Myung-Shin Sim
- Department of Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles
| | - Richard A Scolyer
- Melanoma Institute Australia, Department of Medicine, University of Sydney, Sydney, Australia
| | - David E Elashoff
- Department of Medicine Statistics Core, David Geffen School of Medicine at UCLA, University of California, Los Angeles
| | - Alistair J Cochran
- Department of Anatomic Pathology, David Geffen School of Medicine at UCLA, University of California, Los Angeles
| | - Mark B Faries
- The Angeles Clinic and Research Institute, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California
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22
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Pérez Prieto I, Plaza-Florido A, Molina N, Casas-Matas A, Molina M, Yoldi A, Vaquero Á, Navas P, Castilla J, Ortega F, Altmäe S. P-103 Physical fitness is positively associated with sperm quality in healthy young men. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.099] [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
Do sperm quality parameters differ between “high” and “low” cardiorespiratory fitness (CRF) and muscular strength levels in healthy young men?
Summary answer
Self-reported CRF was positively associated with sperm count and concentration, while muscular strength (objectively measured and self-reported) did not correlate with seminal parameters.
What is known already
Physical activity (i.e., any body movement that results in energy expenditure) levels are positively associated with sperm quality parameters in healthy men. In this context, physical fitness, which is modifiable by physical activity, is a powerful marker of health that integrates several body functions such as hematocirculatory, skeletomuscular, phsychoneurological and endocrine-metabolic. In particular, the main components of physical fitness (i.e., CRF and muscular strength) have been negatively related to the risk of all-cause mortality in any age population. However, the association of CRF and muscular strength with sperm quality parameters in healthy young men is unknown.
Study design, size, duration
This cross-sectional study included 253 healthy men (age= 22.63 ± 5.04 years, BMI= 22.84 ± 1.33). Semen samples and physical fitness assessment were performed between March 2019 and July 2021 at the sperm biobank (Ceifer Biobank – NextClinics). The study was approved by the Ethics Committee of Investigación Biomédica de Andalucía.
Participants/materials, setting, methods
CRF was self-reported using the The International FItness Scale (IFIS). Muscular strength was objectively assessed using a handgrip dynamometer and self-reported with IFIS. Semen samples were analysed by clinical technicians to determine sperm count, sperm concentration and progressive motility. Analysis of covariance (ANCOVA) was performed to obtain adjusted mean differences on sperm quality parameters between high and low CRF and muscular strength groups after including age and body mass index as confounders.
Main results and the role of chance
Men with higher CRF presented increased sperm count and concentration compared to men with lower CRF values (adjusted mean differences 43.581 x 106 [2.630, 84.532; 95% confidence interval] and 10.131 x 106/ml [0.799, 19.463; 95% confidence interval]; both p < 0.05). Muscular strength (objectively measured and self-reported) was not associated with any semen quality parameter (all p > 0.05) when including age and body mass index as covariates.
Limitations, reasons for caution
This study reported a positive association between self-reported CRF using IFIS questionnaire and sperm count and concentration in healthy young men. Although the validity of the self-reported CRF using IFIS has been widely proved in healthy young adults, objectively measured CRF is needed to further confirm our findings.
Wider implications of the findings
Infertility has increased in the last decades. Therefore, more research is needed to identify health indicators that affect sperm quality. Our results suggest that self-reported CRF could contribute to the identification of young men with poor seminal quality and a higher risk of infertility later in life.
Trial registration number
NA
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Affiliation(s)
- I.C Pérez Prieto
- Faculty of Sciences- University of Granada, Department of Biochemistry and Molecular Biology , Granada, Spain
- Instituto de Investigación Biosanitaria, ibs.GRANADA , Granada, Spain
| | - A Plaza-Florido
- Faculty of Sport Sciences- University of Granada, PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group- Sport and Health University Research Institute iMUDS- Department of Physical and Sports Education , Granada, Spain
| | - N.M Molina
- Faculty of Sciences- University of Granada, Department of Biochemistry and Molecular Biology , Granada, Spain
- Instituto de Investigación Biosanitaria, ibs.GRANADA , Granada, Spain
| | - A Casas-Matas
- Faculty of Sciences- University of Granada, Department of Biochemistry and Molecular Biology , Granada, Spain
| | - M Molina
- CEIFER Biobanco, NextClinics , Granada, Spain
| | - A Yoldi
- CEIFER Biobanco, NextClinics , Granada, Spain
| | - Á Vaquero
- CEIFER Biobanco, NextClinics , Granada, Spain
| | - P Navas
- CEIFER Biobanco, NextClinics , Granada, Spain
| | - J.A Castilla
- CEIFER Biobanco, NextClinics , Granada, Spain
- HU Virgen de las Nieves, Unidad Reproducción- UGC Laboratorio clínico y UGC Obstetricia y Ginecología , Granada, Spain
| | - F.B Ortega
- Faculty of Sport Sciences- University of Granada, PROFITH “PROmoting FITness and Health Through Physical Activity” Research Group- Sport and Health University Research Institute iMUDS- Department of Physical and Sports Education , Granada, Spain
- Karolinska Institutet, Department of Biosciences and Nutrition , Huddinge, Sweden
| | - S Altmäe
- Faculty of Sciences- University of Granada, Department of Biochemistry and Molecular Biology , Granada, Spain
- Instituto de Investigación Biosanitaria, ibs.GRANADA , Granada, Spain
- Karolinska Institutet, Division of Obstetrics and Gynaecology- CLINTEC , Huddinge, Sweden
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23
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de Sequera P, Pérez-García R, Molina M, Álvarez-Fernández G, Muñoz-González RI, Mérida E, Camba MJ, Blázquez LA, Alcaide MP, Echarri R. Advantages of the use of citrate over acetate as a stabilizer in hemodialysis fluid: A randomized ABC-treat study. Nefrologia 2022; 42:327-337. [PMID: 36210622 DOI: 10.1016/j.nefroe.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 06/29/2021] [Indexed: 06/16/2023] Open
Abstract
Hemodialysis (HD) with bicarbonate dialysis fluid (DF) requires the presence of an acid to prevent the precipitation of calcium and magnesium carbonate. The most used acid is acetic acid, with it several complications have been described. In a previous work we described the acute changes during an HD session with a DF with citrate instead of acetate. Now we report the results in the medium term, 16 weeks. It is a prospective, multicenter, crossover and randomized study, where 56 HD patients with bicarbonate three times a week were dialysed for 16 weeks with 3 mmol/L acetate and 16 weeks with 1 mmol/L citrate. Patients older than 18 years with a previous stay on HD of more than 3 months and with a normal functioning arteriovenous fistula were included. Epidemiological data, dialysis, bioimpedance, biochemistry before and after HD, as well as hypotensive episodes, were collected monthly. After 16 weeks of citrate treatment, preHD ionic calcium and magnesium were significantly lower and PTH higher than in the acetate period. No differences were observed in the effectiveness of dialysis. Hypotensive episodes were significantly more frequent with acetate than with citrate: 311 (14.1%) vs 238 (10.8%) sessions. The lean mass index increased by 0.96 ± 2.33 kg/m2 when patients switched from LD with acetate to citrate. HD with citrate modifies several parameters of bone mineral metabolism, not only acutely as previously described, but also in the long term. The substitution of acetate for citrate improves hemodynamic stability, producing less hypotension and can improve nutritional status.
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Affiliation(s)
- Patricia de Sequera
- Departamento de Medicina, Universidad Complutense, Madrid, Spain; Servicio de Nefrología, Hospital Universitario Infanta Leonor, Madrid, Spain.
| | - Rafael Pérez-García
- Servicio de Nefrología, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Manuel Molina
- Servicio de Nefrología, Hospital Universitario General de Santa Lucía, Cartagena, Spain
| | | | | | - Evangelina Mérida
- Servicio de Nefrología, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Maria Jesús Camba
- Servicio de Nefrología, Complejo Hospitalario Universitario de Ourense, Orense, Spain
| | - Luis Alberto Blázquez
- Servicio de Nefrología, Hospital General Universitario de Guadalajara, Guadalajara, Spain
| | - Maria Paz Alcaide
- Servicio de Nefrología, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Rocío Echarri
- Servicio de Nefrología, Hospital Universitario Infanta Sofia, Madrid, Spain
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24
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Holzhauser L, Norris M, Molina M, Chambers S, Gala K, Fallah T, Bittermann T, Atluri P, McLean R, Peyster E. A Transplant Center Experience with Basiliximab Induction Strategies - A Double Edged Sword? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.212] [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] Open
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25
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Diaz P, Gonzalez DC, Ory J, Balaji NC, Reddy R, Molina M, Ramasamy R. Comparison of Prevalence of Polycythemia between Nasal Testosterone Gel vs Intramuscular Testosterone Cypionate: Evaluation of Data from an Ongoing Phase IV, Open-Label, Randomized Clinical Trial. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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26
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Riva N, Molina M, Cornaló BL, Salvador MV, Savransky A, Tenembaum S, Katsicas MM, Monteverde M, Cáceres Guido P, Rousseau M, Staciuk R, González Correas A, Zubizarreta P, Imventarza O, Lagomarsino E, Spitzer E, Tinelli M, Schaiquevich P. Intensive Safety Monitoring of Rituximab (Biosimilar Novex ® and the Innovator) in Pediatric Patients With Complex Diseases. Front Pharmacol 2022; 12:785770. [PMID: 35153748 PMCID: PMC8827405 DOI: 10.3389/fphar.2021.785770] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 12/14/2021] [Indexed: 11/13/2022] Open
Abstract
Although rituximab is widely used off-label for complex pediatric diseases, safety reports are limited. We aimed to report evidence of its use in clinical practice, to describe the incidence of adverse drug reactions (ADR) to rituximab biosimilar Novex® and innovator, and to identify risk factors for the development of ADR in a real-life follow-up cohort of pediatric patients with complex diseases. We conducted a prospective, longitudinal, observational, single-centre study in patients that received rituximab for any complex disease, and as part of an intensive pharmacovigilance program. Demographic, pharmacological, clinical, and drug-related data were collected for all patients. ADR-free survival, including infusion-related reactions (IRR) and delayed ADR (dADR), was estimated using Kaplan-Meier curves. Risk factors were evaluated by multivariable Cox regression models. In total, 77 patients (<19 y.o.) received 187 infusions of rituximab Novex® (n = 155) or innovator rituximab (n = 32) for neurologic (Neu), immune-hematologic-rheumatic (IHR), oncologic (O) diseases, and hematopoietic stem-cell transplantation (HSCT) or solid-organ transplantation (SOT). We recorded 29 IRR and 58 dADR that occurred in 27 (35.1%) and 29 (37.7%) patients, respectively. The respiratory tract was the most affected during IRR (29.6%) and hypogammaglobulinemia (37.9 %) was the most frequent dADR. First versus subsequent infusions (HR 5.4, CI95% 2.4-12.1, p<0.05), sex (boys vs. girls, HR 0.3, CI95% 0.1-0.8, and p<0.05), and diagnosis (Neu-IHR diseases vs. O-HSCT-SOT, HR 2.3, CI95% 1.02-5.4, and p < 0.05) were significantly associated with the development of IRR. For dADR, risk factors were diagnosis (Neu-IHR diseases vs. O-HSCT-SOT, HR 0.4, CI95% 0.2-0.9, and p < 0.05) and cumulative body surface area-normalized dosage (HR 1.0003, CI95% 1.0001-1.0006, and p < 0.05). The present is the largest real-world safety assessment of rituximab in Latin-American children with complex diseases supporting its use based on the overall acceptable safety. Identification of risk factors may contribute to optimization of off-label rituximab treatment in pediatrics.
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Affiliation(s)
- Natalia Riva
- Unit of Innovative Treatments, Hospital de Pediatría JP Garrahan, Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET, Buenos Aires, Argentina
| | - Manuel Molina
- Unit of Innovative Treatments, Hospital de Pediatría JP Garrahan, Buenos Aires, Argentina
| | - Berta L Cornaló
- Unit of Innovative Treatments, Hospital de Pediatría JP Garrahan, Buenos Aires, Argentina
| | - María V Salvador
- Pharmacy, Hospital de Pediatría JP Garrahan, Buenos Aires, Argentina
| | - Andrea Savransky
- Neurology Service, Hospital de Pediatría JP Garrahan, Buenos Aires, Argentina
| | - Silvia Tenembaum
- Neurology Service, Hospital de Pediatría JP Garrahan, Buenos Aires, Argentina
| | - María M Katsicas
- Immunology and Rheumatology Service, Hospital de Pediatría JP Garrahan, Buenos Aires, Argentina
| | - Marta Monteverde
- Nephrology Unit, Hospital de Pediatría JP Garrahan, Buenos Aires, Argentina
| | - Paulo Cáceres Guido
- Pharmacy, Hospital de Pediatría JP Garrahan, Buenos Aires, Argentina.,Unit of Clinical Pharmacokinetics, Pharmacy, Hospital de Pediatría JP Garrahan, Buenos Aires, Argentina
| | - Marcela Rousseau
- Health Technology Assessment Coordination, Hospital de Pediatría JP Garrahan, Buenos Aires, Argentina
| | - Raquel Staciuk
- Bone Marrow Transplant Service, Hospital de Pediatría JP Garrahan, Buenos Aires, Argentina
| | | | - Pedro Zubizarreta
- Hematology and Oncology Service, Hospital de Pediatría JP Garrahan, Buenos Aires, Argentina
| | - Oscar Imventarza
- Liver Transplant Service, Hospital de Pediatría JP Garrahan, Buenos Aires, Argentina
| | | | - Eduardo Spitzer
- Laboratorio Elea-Phoenix S.A., Scientific Department, Los Polvorines, Argentina
| | - Marcelo Tinelli
- Laboratorio Elea-Phoenix S.A., Scientific Department, Los Polvorines, Argentina
| | - Paula Schaiquevich
- Unit of Innovative Treatments, Hospital de Pediatría JP Garrahan, Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET, Buenos Aires, Argentina
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27
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Fuentes D, Molina M, Chorostecki U, Capella-Gutiérrez S, Marcet-Houben M, Gabaldón T. PhylomeDB V5: an expanding repository for genome-wide catalogues of annotated gene phylogenies. Nucleic Acids Res 2021; 50:D1062-D1068. [PMID: 34718760 PMCID: PMC8728271 DOI: 10.1093/nar/gkab966] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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: 09/20/2021] [Revised: 10/02/2021] [Accepted: 10/05/2021] [Indexed: 12/20/2022] Open
Abstract
PhylomeDB is a unique knowledge base providing public access to minable and browsable catalogues of pre-computed genome-wide collections of annotated sequences, alignments and phylogenies (i.e. phylomes) of homologous genes, as well as to their corresponding phylogeny-based orthology and paralogy relationships. In addition, PhylomeDB trees and alignments can be downloaded for further processing to detect and date gene duplication events, infer past events of inter-species hybridization and horizontal gene transfer, as well as to uncover footprints of selection, introgression, gene conversion, or other relevant evolutionary processes in the genes and organisms of interest. Here, we describe the latest evolution of PhylomeDB (version 5). This new version includes a newly implemented web interface and several new functionalities such as optimized searching procedures, the possibility to create user-defined phylome collections, and a fully redesigned data structure. This release also represents a significant core data expansion, with the database providing access to 534 phylomes, comprising over 8 million trees, and homology relationships for genes in over 6000 species. This makes PhylomeDB the largest and most comprehensive public repository of gene phylogenies. PhylomeDB is available at http://www.phylomedb.org.
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Affiliation(s)
- Diego Fuentes
- Barcelona Supercomputing Centre (BSC-CNS). Jordi Girona 29, 08034 Barcelona, Spain.,Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Baldiri Reixac 10, 08028 Barcelona, Spain
| | - Manuel Molina
- Barcelona Supercomputing Centre (BSC-CNS). Jordi Girona 29, 08034 Barcelona, Spain.,Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Baldiri Reixac 10, 08028 Barcelona, Spain
| | - Uciel Chorostecki
- Barcelona Supercomputing Centre (BSC-CNS). Jordi Girona 29, 08034 Barcelona, Spain.,Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Baldiri Reixac 10, 08028 Barcelona, Spain
| | | | - Marina Marcet-Houben
- Barcelona Supercomputing Centre (BSC-CNS). Jordi Girona 29, 08034 Barcelona, Spain.,Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Baldiri Reixac 10, 08028 Barcelona, Spain
| | - Toni Gabaldón
- Barcelona Supercomputing Centre (BSC-CNS). Jordi Girona 29, 08034 Barcelona, Spain.,Institute for Research in Biomedicine (IRB Barcelona), The Barcelona Institute of Science and Technology, Baldiri Reixac 10, 08028 Barcelona, Spain.,Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
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28
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Capitán AG, Rubinstein P, Rubinstein F, Aguilar-Hernández A, Bracht J, Viteri S, Cabrera-Gálvez C, Gonzalez-Cao M, Moya I, Valarezo J, Mayo-De-Las-Casas C, Pedraz C, Boykin R, Warren S, Rosell R, Molina M. P22.04 Prospective Validation of an Eight Gene mRNA Signature in Plasma for the Diagnosis of Early Stage Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.358] [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: 10/20/2022]
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29
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García Peláez B, Gimenez-Capitán A, Vives Usano M, Roman R, Garzón Ibañez M, Aguado Esteban C, Rodríguez S, Aldeguer E, Jordana Ariza N, Viteri S, Aguilar-Hernández A, Moya I, Cabrera C, Catalán M, Gonzalez-Cao M, García Román S, Bertrán- Alamillo J, Garcia-Casabal F, Rosell R, Molina M, Mayo-De-Las-Casas C. P59.03 Comparison of Two RNA-Based Platforms for Detection of Fusions and Met Splicing Variant in Non Small Cell Lung Cancer Samples. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.592] [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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30
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Rainer Q, Molina M, Ibrahim E, Saltzman R, Masterson T, Ramasamy R. Peyronie's disease in a patient after COVID-19 infection: A case report. Andrologia 2021; 53:e14219. [PMID: 34397121 PMCID: PMC8420294 DOI: 10.1111/and.14219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 08/05/2021] [Indexed: 12/27/2022] Open
Abstract
Coronavirus disease 2019 (COVID‐19) is an emerging infectious disease caused by a novel coronavirus (SARS‐CoV‐2), which demonstrates the ability to invade endothelial cells and cause systemic inflammation. Many possible long‐term sequelae of COVID‐19 remain unidentified. We describe a case of a man who developed Peyronie's disease after a resolved COVID‐19 infection. Erectile dysfunction was confirmed by the International Index of Erectile Function‐15(IIEF) and Sexual Health Inventory for Men(SHIM) scores. A diagnosis was Peyronie's disease was confirmed on ultrasound. Furthermore, he was found to have low endothelial progenitor cells colony‐forming units and low brachial artery flow‐mediated vasodilation, both of that are indicative of endothelial dysfunction. This case suggests Peyronie's disease should be considered as a possible sequela of COVID‐19 infection and providers should inquire about a history of COVID‐19 infection in patients presenting with Peyronie's disease.
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Affiliation(s)
- Quinn Rainer
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Manuel Molina
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Emad Ibrahim
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Russell Saltzman
- The Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Thomas Masterson
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ranjith Ramasamy
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
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31
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de Sequera P, Pérez-García R, Molina M, Álvarez-Fernández G, Muñoz-González RI, Mérida E, Camba MJ, Blázquez LA, Alcaide MP, Echarri R. Advantages of the use of citrate over acetate as a stabilizer in hemodialysis fluid: A randomized ABC-treat study. Nefrologia 2021; 42:S0211-6995(21)00137-5. [PMID: 34391608 DOI: 10.1016/j.nefro.2021.06.006] [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: 06/24/2021] [Accepted: 06/29/2021] [Indexed: 10/20/2022] Open
Abstract
Hemodialysis (HD) with bicarbonate dialysis fluid (DF) requires the presence of an acid to prevent the precipitation of calcium and magnesium carbonate. The most used acid is acetic acid, with it several complications have been described. In a previous work, we described the acute changes during an HD session with a DF with citrate instead of acetate. Now, we report the results in the medium term, 16 weeks. It is a prospective, multicenter, crossover and randomized study, where 56 HD patients with bicarbonate three times a week were dialysed for 16 weeks with 3mmol/L acetate and 16 weeks with 1mmol/L citrate. Patients older than 18 years with a previous stay on HD of more than 3 months and with a normal functioning arteriovenous fistula were included. Epidemiological data, dialysis, bioimpedance, biochemistry before and after HD, as well as hypotensive episodes, were collected monthly. After 16 weeks of citrate treatment, pre-HD ionic calcium and magnesium were significantly lower and paratiroid hormone (PTH) higher than in the acetate period. No differences were observed in the effectiveness of dialysis. Hypotensive episodes were significantly more frequent with acetate than with citrate: 311 (14.1%) vs 238 (10.8%) sessions. The lean mass index increased by 0.96±2.33kg/m2 when patients switched from DF with acetate to citrate. HD with citrate modifies several parameters of bone mineral metabolism, not only acutely as previously described, but also in the long-term. The substitution of acetate for citrate improves hemodynamic stability, producing less hypotension and can improve nutritional status.
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Affiliation(s)
- Patricia de Sequera
- Departamento de Medicina, Universidad Complutense, Madrid, España; Servicio de Nefrología, Hospital Universitario Infanta Leonor, Madrid, España.
| | - Rafael Pérez-García
- Servicio de Nefrología, Hospital Universitario Infanta Leonor, Madrid, España
| | - Manuel Molina
- Servicio de Nefrología, Hospital Universitario General de Santa Lucía, Cartagena, España
| | | | | | - Evangelina Mérida
- Servicio de Nefrología, Hospital Universitario 12 de Octubre, Madrid, España
| | - Maria Jesús Camba
- Servicio de Nefrología, Complejo Hospitalario Universitario de Ourense, Orense, España
| | - Luis Alberto Blázquez
- Servicio de Nefrología, Hospital General Universitario de Guadalajara, Guadalajara, España
| | - María Paz Alcaide
- Servicio de Nefrología, Hospital Universitario Virgen del Rocío, Sevilla, España
| | - Rocío Echarri
- Servicio de Nefrología, Hospital Universitario Infanta Sofia, Madrid, España
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32
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Molina NM, Sola-Leyva A, Pérez-Prieto I, Vargas E, Molina M, Yoldi A, Vaquero A, Navas P, Clavero-Gilabert A, Gonzalvo-López MC, Morales N, Ramírez JP, Castilla JA, Aguilera CM, Altmäe S. O-147 Differential seminal metabolomic signature is related to sperm quality. Hum Reprod 2021. [DOI: 10.1093/humrep/deab127.015] [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
Study question
What is the entire metabolomic profile of human semen and does the metabolic composition differ between men with good-quality and low-quality semen?
Summary answer
Human semen contains ∼700 different metabolites, and the metabolomic signature differs between normozoospermic men and men with altered seminal parameters.
What is known already
Semen contains a wide diversity of metabolites as has been identified in single and targeted metabolite studies. The full composition of metabolites in human semen, however, is not known. The knowledge of the complete metabolic signature in semen and whether there are differences between metabolic composition and seminal quality could enhance our knowledge of possible factors involved in reduced sperm quality and male infertility.
Study design, size, duration
Case-control study, where a total of 100 men (age= 29.73±8.9 years) from March 2019 to March 2020 participated. The study was approved by the Ethics Committee of Investigación Biomédica de Andalucia.
Participants/materials, setting, methods
Semen samples from 69 normozoospermic and 31 oligozoospermic men were collected at the University Hospital and sperm biobank (Ceifer Biobank - NextClinics). The complete metabolome from unprocessed seminal samples was analysed by Ultrahigh Performance Liquid Chromatography-Tandem Mass Spectroscopy (UPLC-MS/MS). Raw data were extracted, peak-identified and quality control processed using Metabolon’s hardware and software (metabolon.com). Multiple regression models controlling for age and sample collection centres were applied using R software.
Main results and the role of chance
In total, 695 different metabolites were detected in the seminal samples, where docosahexaenoate (DHA; 22:6n3, PubChem ID 445580), choline phosphate (1014), dihomo-linolenate (20:3n3 or n6, 5280581), docosapentaenoate (n6 DPA; 22:5n6, 6441454), adenosine 3’,5’-cyclic monophosphate (cAMP, 6076) and N-acetylalliin (122164824) metabolites were the most prevalent. The seminal metabolomic profiles differed significantly between men with normal and low sperm parameters. The most abundant metabolites in normozoospermic men belonged to Lipid Super-Pathway, while Nucleotide Super-Pathway was predominant in semen samples with low quality (p < 0.05). More specifically, the leading Sub-Pathway in normozoospermic men was Long Chain Polyunsaturated Fatty Acid (n3 and n6), whereas Purine and Pyrimidine Metabolism Sub-Pathway prevailed in low-quality semen samples, where DHA and cAMP dominated in men with normal and low seminal quality parameters, respectively (p < 0.05 in all comparisons).
Limitations, reasons for caution
This is the first study presenting the entire metabolome signature of unprocessed human semen, and these preliminary results need to be confirmed in a bigger sample size.
Wider implications of the findings
Semen analyses applied in clinics do not evaluate the functional status of sperm, leaving the infertility causes due to male factor frequently unknown. Our study results could help to understand the molecular background of reduced seminal quality and male infertility and lead to identification of molecular biomarkers of functional sperm.
Trial registration number
not applicable
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Affiliation(s)
- N M Molina
- University of Granada, Faculty of Sciences- Department of Biochemistry and Molecular Biology, Granada, Spain
- Instituto de Investigación Biosanitaria, ibs.GRANADA, Granada, Spain
| | - A Sola-Leyva
- University of Granada, Faculty of Sciences- Department of Biochemistry and Molecular Biology, Granada, Spain
- Instituto de Investigación Biosanitaria, ibs.GRANADA, Granada, Spain
| | - I Pérez-Prieto
- University of Granada, Faculty of Sciences- Department of Biochemistry and Molecular Biology, Granada, Spain
| | - E Vargas
- University of Jaen, Faculty of Experimental Sciences- Department of Experimental Biology- Systems Biology Unit, Jaen, Spain
| | - M Molina
- CEIFER, Nextclinics, Granada, Spain
| | - A Yoldi
- CEIFER, Nextclinics, Granada, Spain
| | | | - P Navas
- CEIFER, Nextclinics, Granada, Spain
| | - A Clavero-Gilabert
- HU Virgen de las Nieves, Unidad Reproducción- UGC Laboratorio clínico y UGC Obstetricia y Ginecología, Granada, Spain
| | - M C Gonzalvo-López
- HU Virgen de las Nieves, Unidad Reproducción- UGC Laboratorio clínico y UGC Obstetricia y Ginecología, Granada, Spain
| | - N Morales
- HU Virgen de las Nieves, Unidad Reproducción- UGC Laboratorio clínico y UGC Obstetricia y Ginecología, Granada, Spain
| | | | - J A Castilla
- Instituto de Investigación Biosanitaria, ibs.GRANADA, Granada, Spain
- CEIFER, Nextclinics, Granada, Spain
- HU Virgen de las Nieves, Unidad Reproducción- UGC Laboratorio clínico y UGC Obstetricia y Ginecología, Granada, Spain
| | - C M Aguilera
- Instituto de Investigación Biosanitaria, ibs.GRANADA, Granada, Spain
- University of Granada, Faculty of Pharmacy- Department of Biochemistry and Molecular Biolog, Granada, Spain
- University of Granada, Centre of Biomedical Research- Institute of Nutrition and Food Technology “José Mataix”, Granada, Spain
- Instituto de Salud Carlos III, CIBEROBN CIBER Physiopathology of Obesity and Nutrition, Madrid, Spain
| | - S Altmäe
- University of Granada, Faculty of Sciences- Department of Biochemistry and Molecular Biology, Granada, Spain
- Instituto de Investigación Biosanitaria, ibs.GRANADA, Granada, Spain
- Competence Centre on Health Technologies, University of Tartu, Tartu, Estonia
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Geller J, Collazo I, Pai R, Hendon N, Lokeshwar SD, Arora H, Molina M, Ramasamy R. An Artificial Intelligence-Based Algorithm for Predicting Pregnancy Success Using Static Images Captured by Optical Light Microscopy during Intracytoplasmic Sperm Injection. J Hum Reprod Sci 2021; 14:288-292. [PMID: 34759619 PMCID: PMC8527076 DOI: 10.4103/jhrs.jhrs_53_21] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/11/2021] [Accepted: 07/16/2021] [Indexed: 12/02/2022] Open
Abstract
CONTEXT BACKGROUND Analysis of embryos for in vitro fertilization (IVF) involves manual grading of human embryos through light microscopy. Recent research shows that artificial intelligence techniques applied to time lapse embryo images can successfully ascertain embryo quality. However, laboratories often capture static images and cannot apply this research in a real-world setting. Further, current models do not predict the outcome of pregnancy. AIMS To create and assess a convolutional neural network to predict embryo quality using static images from a limited dataset. We considered two classification problems: predicting whether an embryo will lead to a pregnancy or not and predicting the outcome of that pregnancy. SETTINGS AND DESIGN We utilized transfer learning techniques using a pretrained Inception V1 network. All models were built using the Tensorflow software package. METHODS We utilized a total of 361 randomly sampled static images collected from four South Florida IVF clinics. Data were collected between 2016 and 2019. STATISTICAL ANALYSIS USED We utilized deep-learning techniques, including data augmentation to reduce model variance and transfer learning to bolster our limited dataset. We used a standard train/validation/ test dataset split to avoid model overfitting. RESULTS Our algorithm achieved 0.657 area under the curve for predicting pregnancy versus nonpregnancy. However, our model was unable to meaningfully predict whether a pregnancy led a to live birth. CONCLUSIONS Despite the limited dataset that achieved somewhat of a lower accuracy than conventional embryo selection, this is the first study that has successfully made IVF predictions from static images alone. Future availability of more data may allow for prospective validation and further generalisability of results.
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Affiliation(s)
- Jared Geller
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ineabelle Collazo
- Department of Urology, University of Miami – Miller School of Medicine, Miami, FL, USA
| | - Raghav Pai
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Nicholas Hendon
- Department of Urology, University of Miami – Miller School of Medicine, Miami, FL, USA
| | - Soum D. Lokeshwar
- Department of Urology, Yale University School of Medicine, New Haven, CT, USA
| | - Himanshu Arora
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Manuel Molina
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ranjith Ramasamy
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
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Gonzalez D, Kresch E, Ory J, Nackeeran S, Blachman-Braun R, Molina M, Ramasamy R. Impact of Testosterone Therapy on Hematocrit and Polycythemia: Evaluation of Data From Two Ongoing Open-Label Randomized Single-Center Clinical Trials. J Endocr Soc 2021. [PMCID: PMC8090421 DOI: 10.1210/jendso/bvab048.1544] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Introduction & Objective: Testosterone (T) replacement therapy (TRT) is the mainstay treatment for male hypogonadism. The most commonly reported adverse event among men using TRT is polycythemia. What is unknown is whether the short-acting vs. long-acting testosterone preparations have different effects on hematocrit. We hypothesized that short-acting testosterone therapy will be physiologic and have lesser effect on hematocrit compared to long-acting TRT. We evaluated data from two simultaneous ongoing open-label, randomized, two-arm clinical trials to evaluate the impact of TRT on Hematocrit and compared prevalence rates of polycythemia among subcutaneous T pellets (long-acting) and Intranasal Testosterone (Natesto) or Intramuscular Testosterone cypionate (TC) (short-acting). Subject and Methods: Hypogonadal men (2 AM serum T < 300 ng/dL assayed by LC-MS/MS) aged 18-65 years were randomized into open-label randomized clinical trials. Eligible subjects received: Trial 1: 800mg subcutaneous Testopel T pellets; Trial 2: 11mg TID Intranasal testosterone (Natesto) or 200mg x 2 weeks TC for 2 months. Serum T, Hematocrit (HCT), and prevalence of polycythemia (as defined as HCT >50%) were collected at baseline and after 2 months of therapy. Data are presented as a post-hoc analysis of the two randomized clinical trials and reported as median and interquartile range [25th-75th], paired sample analysis (baseline versus follow-up) was performed with the Wilcoxon rank test to determine change during time within the different TRT modalities, with p<0.05 considered significant. Results: Median change for serum T between baseline and 2mo follow-up to subcutaneous T pellets was 542 [454-757] ng/dL, Intranasal Testosterone 706 [517-1010] ng/dL, and TC 525 [280-712]ng/dL. T pellets showed a statistically significant increase in HCT from 44.6 [42.0-46.6] to 46.7 [42.6-48.9] (p<0.001), with a prevalence of 7/47 (14%) men developing polycythemia. A safety trigger for HCT greater than 54% occurred in 2/47 (4%). The treatment effect was independent of baseline serum testosterone. TRT with Natesto decreased HCT, from 43.4 [41.6-46.1] to 43.4 [40.6-46.5], however not statistically significant (p=0.262). TC statistically increased HCT from 41.6 [40.3-43.1] to 43.8 [43.5-47.4] (p=0.018), with 0% of men developing polycythemia in both groups. Conclusions: Long acting TRT appears to increase hematocrit compared to short-acting testosterone therapies. Treatment of hypogonadal men with Intranasal T Natesto and testosterone cypionate successfully achieved target serum T level and maintained HCT levels. Longer-term durability and safety effects of the intervention remain to be further investigated.
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35
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Kresch E, Gonzalez D, Ory J, Nackeeran S, Blachman-Braun R, Molina M, Ramasamy R. Impact of Short-Acting vs Long-Acting Testosterone Therapy on Intratesticular Testosterone Using Data From Two Open-Label Randomized Clinical Trials of Testosterone Pellets, Injections, and Intranasal Gel in Hypogonadal Men. J Endocr Soc 2021. [PMCID: PMC8089654 DOI: 10.1210/jendso/bvab048.1543] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction & Objective: Exogenous testosterone (T) replacement therapy (TRT) is typically long-acting and can potentially cause infertility in a majority of men due to suppression of HPG axis. Intratesticular testosterone is vital for spermatogenesis and can be reliably evaluated with serum 17-hydroxyprogesterone (17-OHP). Based on this observation, we hypothesized that we used serum 17-OHP as a serum biomarker for evaluating intratesticular T in men receiving TRT. We hypothesized that long-acting TRT will have a significant impact on suppressing HPG axis as compared to short-acting preparations. We evaluated data from two simultaneous open-label, randomized, two-arm clinical trials amongst different treatment preparations (Trial I) subcutaneous T pellets and (Trial II) Intranasal Testosterone (Natesto) or Intramuscular Testosterone cypionate (TC). Subject & Methods: Hypogonadal men (2 AM serum T < 300 ng/dL assayed by LC-MS/MS) aged 18-65 years were randomized into open-label randomized clinical trials. Eligible subjects received: 800mg subcutaneous Testopel T pellets (n=47); or 11mg TID Intranasal testosterone (Natesto) (n=10) or 200mg x 2 weeks TC (n=10) for 2 months. Serum T and 17-OHP were collected at baseline and after 2 months of therapy. Data are presented as a post-hoc analysis of the two randomized clinical trials and reported as the median and interquartile range [25th-75th], paired sample analysis (baseline versus follow-up) was performed with the Wilcoxon test to determine change during time within the different TRT modalities, with p<0.05 considered significant. Results: Median change for serum T between baseline and 2mo follow-up to subcutaneous T pellets was 542 [454-757] ng/dL, Intranasal Testosterone 706 [517-1010] ng/dL, and TC 525 [280-712]ng/dL.; 96% of subjects in each trial achieved mean T concentrations in the eugonadal range. We demonstrated that serum T levels were within normal range among men receiving the various therapies. As expected, we found a statistically significant decrease amongst the different T preparations in serum 17-OHP. Longer acting T preparations such as T pellets and TC demonstrated the greatest decrease in 17-OHP, from 41 [20.3-65.6] to 14 [10.3-20.8] ng/dL and 80 [48-121] ng/dL to 20 [17-36] ng/dL (p<0.001), respectively. Shorter acting T preparations such as Natesto demonstrated a statistically significant decrease in 17-OHP, from 52.5 [26-67] ng/dL to 26.5 [18-39.8]ng/dL (p=0.007), but to a lesser extent as compared to the longer-acting preparations. Conclusions: Natesto, and other short acting forms of TRT may help hyogonadal men maintain Intratesticular T that is critical for maintaining spermatogenesis. The differential effects of TRT on intratesticular T based on their half-lives is novel and should be considered during the decision making for hypogondal men who wish to preserve fertility and / or testis size.
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Wang T, Molina M, Norris M, Mather P. Chylopericardium as a Rare Entity Following Orthotopic Heart Transplantation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Oses G, Cases C, Valduvieco I, Farrús B, Alonso I, Caparrós X, Mases J, Muñoz-Guglielmetti D, Biete A, Castro C, Escudero E, Molina M, Herreros A, Saez J, Mollà M. Chronic toxicity and long-term outcome in intraoperative electron radiotherapy as boost followed by whole-breast irradiation. Clin Transl Oncol 2021; 23:1593-1600. [PMID: 33534078 DOI: 10.1007/s12094-021-02555-3] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 01/12/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE The administration of a dose boost to the tumor bed after breast-conserving surgery has proven to reduce local recurrence. Intra-operative electron radiotherapy (IOERT) offers an alternative method to deliver a boost with several advantages, such as direct visualization of the tumor bed, less inter- and intrafraction motion and a reduction in the number of medical appointments. The objective of our study is to assess chronic toxicity and long-term outcome for our patients after IOERT boost. MATERIAL AND METHODS Forty-six patients treated at our institution between July 2013 and June 2020 with IOERT boost during Breast-Conserving Surgery and consecutive whole breast irradiation were prospectively analyzed. A 10-12 Gy boost was prescribed to 42 patients and 4 patients received a 20 Gy boost. An analysis for overall survival, local relapse and distant progression was performed. Acute and chronic toxicity was assessed by CTCAE 4.0. RESULTS The median age was 64.5 years (40-90). The median follow-up was 62 months (4-86). We had no local recurrences but 2 patients (4.3%) presented a distant recurrence. Mean pathological tumor size was 16 mm (6-52). 84.8% (39) of the patients had invasive ductal carcinoma. 52.2% (24) presented histological grade II. 52.2% (24) were Luminal A like, 21.7% (10) Luminal B like, 13% (6) HER2 positive, 13% (6) triple negative. No Grade 3-4 chronic toxicity was observed. Grade 1-2 fibrosis was evidenced in 13% (6) of the patients, 4.3% (2) patients presented fat necrosis, 6.5% (3) presented seroma, 4.3% (2) had localized pain, 2.2% (1) presented localized hematoma and 2.2% (1) presented localized edema. CONCLUSIONS IOERT boost in breast cancer treatment during BCS is a safe option with low chronic toxicity. The recurrence rates are comparable to published data and emphasize that IOERT as boost is an effective treatment.
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Affiliation(s)
- G Oses
- Department of Radiation Oncology, Hospital Clínic of Barcelona, Barcelona, Spain.
| | - C Cases
- Department of Radiation Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - I Valduvieco
- Department of Radiation Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - B Farrús
- Department of Radiation Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - I Alonso
- Department of Gynecology Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - X Caparrós
- Department of Gynecology Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - J Mases
- Department of Radiation Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - D Muñoz-Guglielmetti
- Department of Radiation Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - A Biete
- Department of Radiation Oncology, Hospital Clínic of Barcelona, Barcelona, Spain.,Department of Clinical Foundations, University of Barcelona, Barcelona, Spain
| | - C Castro
- Department of Radiation Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - E Escudero
- Department of Radiation Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - M Molina
- Department of Radiation Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - A Herreros
- Department of Radiation Oncology, Hospital Clínic of Barcelona, Barcelona, Spain.,Department of Clinical Foundations, University of Barcelona, Barcelona, Spain
| | - J Saez
- Department of Radiation Oncology, Hospital Clínic of Barcelona, Barcelona, Spain
| | - M Mollà
- Department of Radiation Oncology, Hospital Clínic of Barcelona, Barcelona, Spain.,Department of Clinical Foundations, University of Barcelona, Barcelona, Spain
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Solanich X, Antolí A, Padullés N, Fanlo-Maresma M, Iriarte A, Mitjavila F, Capdevila O, Molina M, Sabater J, Bas J, Mensa-Vilaró A, Niubó J, Calvo N, Bolivar S, Rigo-Bonnin R, Arregui L, Tebé C, Hereu P, Videla S, Corbella X. Pragmatic, open-label, single-center, randomized, phase II clinical trial to evaluate the efficacy and safety of methylprednisolone pulses and tacrolimus in patients with severe pneumonia secondary to COVID-19: The TACROVID trial protocol. Contemp Clin Trials Commun 2021; 21:100716. [PMID: 33495742 PMCID: PMC7817439 DOI: 10.1016/j.conctc.2021.100716] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 10/12/2020] [Accepted: 01/11/2021] [Indexed: 12/21/2022] Open
Abstract
Introduction Some COVID-19 patients evolve to severe lung injury and systemic hyperinflammatory syndrome triggered by both the coronavirus infection and the subsequent host-immune response. Accordingly, the use of immunomodulatory agents has been suggested but still remains controversial. Our working hypothesis is that methylprednisolone pulses and tacrolimus may be an effective and safety drug combination for treating severe COVID-19 patients. Methods and analysis: TACROVID is a randomized, open-label, single-center, phase II trial to evaluate the efficacy and safety of methylprednisolone pulses and tacrolimus plus standard of care (SoC) versus SoC alone, in patients at advanced stage of COVID-19 disease with lung injury and systemic hyperinflammatory response. Patients are randomly assigned (1:1) to one of two arms (42 patients in each group). The primary aim is to assess the time to clinical stability after initiating randomization. Clinical stability is defined as body temperature ≤37.5 °C, and PaO2/FiO2 > 400 and/or SatO2/FiO2 > 300, and respiratory rate ≤24 rpm; for 48 consecutive hours. Discussion Methylprednisolone and tacrolimus might be beneficial to treat those COVID-19 patients progressing into severe pulmonary failure and systemic hyperinflammatory syndrome. The rationale for its use is the fast effect of methylprednisolone pulses and the ability of tacrolimus to inhibit both the CoV-2 replication and the secondary cytokine storm. Interestingly, both drugs are low-cost and can be manufactured on a large scale; thus, if effective and safe, a large number of patients could be treated in developed and developing countries. Trial registration number NCT04341038 / EudraCT: 2020-001445-39.
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Affiliation(s)
- X Solanich
- Department of Internal Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - A Antolí
- Department of Internal Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - N Padullés
- Department of Pharmacy, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - M Fanlo-Maresma
- Department of Internal Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - A Iriarte
- Department of Internal Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - F Mitjavila
- Department of Internal Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - O Capdevila
- Department of Internal Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - M Molina
- Department of Respiratory Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - J Sabater
- Department of Intensive Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - J Bas
- Department of Immunology, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - A Mensa-Vilaró
- Immunology Service, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - J Niubó
- Department of Microbiology, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - N Calvo
- Department of Diagnostic Imaging, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - S Bolivar
- Department of Diagnostic Imaging, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - R Rigo-Bonnin
- Department of Clinical Laboratory, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - L Arregui
- Department of BUH-ICO-IDIBELL Biobank, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - C Tebé
- Department of Statistics, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - P Hereu
- Department of Clinical Pharmacology, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Clinical Research and Clinical Trial Unit (UICEC-IDIBELL), Plataforma SCRen, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - S Videla
- Department of Clinical Pharmacology, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Clinical Research and Clinical Trial Unit (UICEC-IDIBELL), Plataforma SCRen, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - X Corbella
- Department of Internal Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.,Evaluation of Health Determinants and Health Policies Group, Hestia Chair in Integrated Health and Social Care, School of Medicine, Universitat Internacional de Catalunya, Barcelona, Spain
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Chorostecki U, Molina M, Pryszcz LP, Gabaldón T. MetaPhOrs 2.0: integrative, phylogeny-based inference of orthology and paralogy across the tree of life. Nucleic Acids Res 2020; 48:W553-W557. [PMID: 32343307 PMCID: PMC7319458 DOI: 10.1093/nar/gkaa282] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 02/28/2020] [Revised: 04/01/2020] [Accepted: 04/25/2020] [Indexed: 12/23/2022] Open
Abstract
Inferring homology relationships across genes in different species is a central task in comparative genomics. Therefore, a large number of resources and methods have been developed over the years. Some public databases include phylogenetic trees of homologous gene families which can be used to further differentiate homology relationships into orthology and paralogy. MetaPhOrs is a web server that integrates phylogenetic information from different sources to provide orthology and paralogy relationships based on a common phylogeny-based predictive algorithm and associated with a consistency-based confidence score. Here we describe the latest version of the web server which includes major new implementations and provides orthology and paralogy relationships derived from ∼8.2 million gene family trees-from 13 different source repositories across ∼4000 species with sequenced genomes. MetaPhOrs server is freely available, without registration, at http://orthology.phylomedb.org/.
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Affiliation(s)
- Uciel Chorostecki
- Barcelona Supercomputing Centre (BSC-CNS), 08034 Barcelona, Spain.,Institute for Research in Biomedicine (IRB), The Barcelona Institute of Science and Technology, 08028 Barcelona, Spain
| | - Manuel Molina
- Barcelona Supercomputing Centre (BSC-CNS), 08034 Barcelona, Spain.,Institute for Research in Biomedicine (IRB), The Barcelona Institute of Science and Technology, 08028 Barcelona, Spain
| | - Leszek P Pryszcz
- Centre for Genomic Regulation, 08003 Barcelona, Spain.,International Institute of Molecular and Cell Biology, 4 Ks. Trojdena Street, 02-109 Warsaw, Poland
| | - Toni Gabaldón
- Barcelona Supercomputing Centre (BSC-CNS), 08034 Barcelona, Spain.,Institute for Research in Biomedicine (IRB), The Barcelona Institute of Science and Technology, 08028 Barcelona, Spain.,ICREA, 08010 Barcelona, Spain
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Borderias T, Gonzalez Lizarbe S, Sanchez J, De Tapia B, Catoya S, Cabrera I, Molina M, Lozano M, Lujan E, Canteli A, Castrillo C, Ruiz Lera M, Sarralde J, Cobo M, Burgos V. Is primary graft failure still a challenge in time of venoarterial extracorporeal membrane oxygenation? Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Primary graft failure (PGF) is the leading cause of early mortality after heart transplantation (HT). Its increasing incidence during the last decade may be triggered by the disbalance between receptors and donors that forces the acceptance of suboptimal organs.
Purpose
The aim of our work was to analyse the mechanical circulatory support (MCS) with VA-ECMO in refractory to inotropes PGF and determinate its impact in terms of graft function recovery and survival.
Methods
A retrospective study, analyzing our database of circulatory assist devices between 2009 and 2019. During this period, 252 devices have been implanted (154 ECMOs and 98 ventricular assist devices) and 201 patients have received a HT. We describe the characteristics and evolution of all PGF cases managed with VA-ECMO.
Results
Thirty nine patients (19.4%) developed PGF, defined as significant left, right or biventricular systolic dysfunction in the first 24 hours after HT, associated with hemodynamic instability and requiring high dose of inotropes, intra-aortic balloon pump (IABP) or VA-ECMO. Twenty two cases (56.4%) underwent a VA-ECMO implantation by peripheral cannulation as a bridge to recovery.
The median age was 50.8 (44.3–57.3) years and 77% were male. Biventricular dysfunction was observed in 50% and isolated right ventricular dysfunction in the remaining 50%. At the time of implantation, 59% had IABP and the median of inotropic score was 24 (8–40). Two complications occurred during implantation (one because of a complex vascular access and one due to a malposition of the venous cannula). Anticoagulation was started after a median of 19 hours (10–28; 59% sodic heparin and 36% bivalirudin).
The median support duration was 6.2 days (3–9.2). Graft function was recovered in 90%, making it possible to withdraw the device successfully in 82% of patients. The remaining 18% deceased during the support (2 because of multiorgan failure and 2 due to absence of function recovery).The median hospital length of stay was 63 days (33–93) and hospital and 1-year survival was 68.1%.
Conclusion
The support with VA-ECMO allowed graft function recovery in 90% of severe PGF cases, with a similar survival rate to other centres with MCS. In a scenario with a mortality rate superior to 50%, the MCS programs have managed to increase survival, avoid retransplantation in times of donor shortage and handle the use of suboptimal donors with better chances of success.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Borderias
- University Hospital Marques de Valdecilla, Santander, Spain
| | | | - J Sanchez
- University Hospital Marques de Valdecilla, Santander, Spain
| | - B De Tapia
- University Hospital Marques de Valdecilla, Santander, Spain
| | - S Catoya
- University Hospital Marques de Valdecilla, Santander, Spain
| | - I Cabrera
- University Hospital Marques de Valdecilla, Santander, Spain
| | - M Molina
- University Hospital Marques de Valdecilla, Santander, Spain
| | - M Lozano
- University Hospital Marques de Valdecilla, Santander, Spain
| | - E Lujan
- University Hospital Marques de Valdecilla, Santander, Spain
| | - A Canteli
- University Hospital Marques de Valdecilla, Santander, Spain
| | - C Castrillo
- University Hospital Marques de Valdecilla, Santander, Spain
| | - M Ruiz Lera
- University Hospital Marques de Valdecilla, Santander, Spain
| | - J.A Sarralde
- University Hospital Marques de Valdecilla, Santander, Spain
| | - M Cobo
- University Hospital Marques de Valdecilla, Santander, Spain
| | - V Burgos
- University Hospital Marques de Valdecilla, Santander, Spain
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Lomakin AJ, Cattin CJ, Cuvelier D, Alraies Z, Molina M, Nader GPF, Srivastava N, Sáez PJ, Garcia-Arcos JM, Zhitnyak IY, Bhargava A, Driscoll MK, Welf ES, Fiolka R, Petrie RJ, De Silva NS, González-Granado JM, Manel N, Lennon-Duménil AM, Müller DJ, Piel M. The nucleus acts as a ruler tailoring cell responses to spatial constraints. Science 2020; 370:eaba2894. [PMID: 33060332 PMCID: PMC8059074 DOI: 10.1126/science.aba2894] [Citation(s) in RCA: 198] [Impact Index Per Article: 49.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 06/29/2020] [Accepted: 08/28/2020] [Indexed: 12/12/2022]
Abstract
The microscopic environment inside a metazoan organism is highly crowded. Whether individual cells can tailor their behavior to the limited space remains unclear. In this study, we found that cells measure the degree of spatial confinement by using their largest and stiffest organelle, the nucleus. Cell confinement below a resting nucleus size deforms the nucleus, which expands and stretches its envelope. This activates signaling to the actomyosin cortex via nuclear envelope stretch-sensitive proteins, up-regulating cell contractility. We established that the tailored contractile response constitutes a nuclear ruler-based signaling pathway involved in migratory cell behaviors. Cells rely on the nuclear ruler to modulate the motive force that enables their passage through restrictive pores in complex three-dimensional environments, a process relevant to cancer cell invasion, immune responses, and embryonic development.
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Affiliation(s)
- A J Lomakin
- St. Anna Children's Cancer Research Institute (CCRI), Vienna, Austria.
- Ludwig Boltzmann Institute for Rare and Undiagnosed Diseases (LBI-RUD), Vienna, Austria
- CeMM Research Center for Molecular Medicine, Austrian Academy of Sciences (ÖAW), Vienna, Austria
- Medical University of Vienna (MUV), Vienna, Austria
- Centre for Stem Cells and Regenerative Medicine, School of Basic and Medical Biosciences, King's College London, London, UK
- Institut Curie, PSL Research University, CNRS, UMR 144, Paris, France
| | - C J Cattin
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland
| | - D Cuvelier
- Institut Curie, PSL Research University, CNRS, UMR 144, Paris, France
- Institut Pierre Gilles de Gennes, PSL Research University, Paris, France
| | - Z Alraies
- Institut Curie, PSL Research University, CNRS, UMR 144, Paris, France
- Institut Pierre Gilles de Gennes, PSL Research University, Paris, France
- Institut Curie, PSL Research University, INSERM, U 932, Paris, France
| | - M Molina
- Centre for Stem Cells and Regenerative Medicine, School of Basic and Medical Biosciences, King's College London, London, UK
| | - G P F Nader
- Institut Curie, PSL Research University, CNRS, UMR 144, Paris, France
- Institut Pierre Gilles de Gennes, PSL Research University, Paris, France
| | - N Srivastava
- Institut Curie, PSL Research University, CNRS, UMR 144, Paris, France
- Institut Pierre Gilles de Gennes, PSL Research University, Paris, France
| | - P J Sáez
- Institut Curie, PSL Research University, CNRS, UMR 144, Paris, France
- Institut Pierre Gilles de Gennes, PSL Research University, Paris, France
| | - J M Garcia-Arcos
- Institut Curie, PSL Research University, CNRS, UMR 144, Paris, France
- Institut Pierre Gilles de Gennes, PSL Research University, Paris, France
| | - I Y Zhitnyak
- Institut Curie, PSL Research University, CNRS, UMR 144, Paris, France
- Institut Pierre Gilles de Gennes, PSL Research University, Paris, France
- N.N. Blokhin Medical Research Center of Oncology, Moscow, Russia
| | - A Bhargava
- Institut Curie, PSL Research University, INSERM, U 932, Paris, France
| | - M K Driscoll
- Department of Cell Biology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Lyda Hill Department of Bioinformatics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - E S Welf
- Department of Cell Biology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Lyda Hill Department of Bioinformatics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - R Fiolka
- Department of Cell Biology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Lyda Hill Department of Bioinformatics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - R J Petrie
- Department of Biology, Drexel University, Philadelphia, PA, USA
| | - N S De Silva
- Institut Curie, PSL Research University, INSERM, U 932, Paris, France
| | - J M González-Granado
- LamImSys Lab, Departamento de Fisiología, Facultad de Medicina, Universidad Autónoma de Madrid (UAM), Madrid, Spain
- Instituto de Investigación Hospital 12 de Octubre (imas12), Madrid, Spain
| | - N Manel
- Institut Curie, PSL Research University, INSERM, U 932, Paris, France
| | | | - D J Müller
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland.
| | - M Piel
- Institut Curie, PSL Research University, CNRS, UMR 144, Paris, France.
- Institut Pierre Gilles de Gennes, PSL Research University, Paris, France
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Molina M, Mota M, Ramos A. Estimation of parameters in biological species with several mating and reproduction alternatives. Math Biosci 2020; 329:108471. [PMID: 32941873 DOI: 10.1016/j.mbs.2020.108471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 09/05/2020] [Indexed: 10/23/2022]
Abstract
With the purpose of modeling the demographic dynamics of biological species in which different mating and reproduction alternatives are feasible, in Molina et al. (2014) we introduced a new mathematical model based on discrete-time branching processes. Assuming that the reproduction phase is governed by probability distributions belonging to the power series family, some reproductive parameters for such species were estimated. In this work, in a more general statistical context, we generalize this research. By considering observations, until a given generation, of the number of female and male individuals in each generation, we now investigate several inferential questions about the parameters of biological interest included in the mathematical model. We study such questions using procedures based on Bayesian statistical methodology. We apply the proposed methods to describe the dynamics of salmonid species.
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Affiliation(s)
- Manuel Molina
- Department of Mathematics, University of Extremadura, Spain; Institute of Advanced Scientific Computation, University of Extremadura, Spain.
| | - Manuel Mota
- Department of Mathematics, University of Extremadura, Spain; Institute of Advanced Scientific Computation, University of Extremadura, Spain
| | - Alfonso Ramos
- Department of Mathematics, University of Extremadura, Spain; Institute in Livestock and Cynegetic, University of Extremadura, Spain
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Affiliation(s)
- Manuel R de Jesús
- Department of Urology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Ranjith Ramasamy
- Department of Urology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Emad Ibrahim
- Department of Urology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Manuel Molina
- Department of Urology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Thomas A Masterson
- Department of Urology, University of Miami, Miller School of Medicine, Miami, FL, USA.,Bruce W. Carter VA Medical Center, division of Urology, Miami FL, United States
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Meinersmann RJ, Berrang ME, Bradshaw JK, Molina M, Cosby DE, Genzlinger LL, Snyder BJ. Recovery of thermophilic Campylobacter by three sampling methods from river sites in Northeast Georgia, USA, and their antimicrobial resistance genes. Lett Appl Microbiol 2020; 71:102-107. [PMID: 31560126 PMCID: PMC9109067 DOI: 10.1111/lam.13224] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 09/13/2019] [Accepted: 09/18/2019] [Indexed: 02/01/2023]
Abstract
Sixteen sites in the watershed of the South Fork of the Broad River (SFBR) in Northeastern Georgia, USA, were sampled in two seasons to detect Campylobacter. Sites were classified as mostly influenced by forest, pasture, wastewater pollution control plants (WPC) or mixed use. Sampling was repeated in the late spring and late fall for 2 years for a total of 126 samples. Free-catch water and sediment grab samples were taken at each site; Moore's swabs were placed for up to 3 days at most sites. A total of 56 isolates of thermophilic Campylobacter were recovered. Thirteen samplings were positive by two or three methods, and 26 samplings were positive by only one method; once by Moore's swab only and 25 times by free-catch water only. Campylobacter was detected at 58% of cattle pasture sites, 30% of forested sites and 81% of WPC sites. Twenty-one of the isolates carried antimicrobial resistance genes, mostly blaOXA-61. Free-catch water samples were more efficient than Moore's swabs or sediment samples for recovery of Campylobacter, which was more likely to be detected in streams near cattle pastures and human communities than in forested land. SIGNIFICANCE AND IMPACT OF THE STUDY: The role of environmental water in transmitting Campylobacter was investigated, and methods for recovery of the organism were compared. The sequence types of recovered Campylobacter correlated with adjacent land use without regard to the method used to isolate the organisms. Sequence types and antimicrobial resistance genes associated with cattle were most prevalent near pastures. Even though types were recurrent at a given site, types appeared to be lost or replaced as the water flowed downstream.
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Affiliation(s)
| | - M E Berrang
- USDA Agricultural Research Service, Athens, GA, USA
| | - J K Bradshaw
- Environmental Protection Agency, Athens, GA, USA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - M Molina
- Environmental Protection Agency, Athens, GA, USA
| | - D E Cosby
- USDA Agricultural Research Service, Athens, GA, USA
| | | | - B J Snyder
- Environmental Protection Agency, Athens, GA, USA
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Genuardi M, Zhang Y, Mazurek J, Hanff T, Molina M, Atluri P, Zamani P, McLean R, Goldberg L, Birati E. Peak Oxygen Consumption and Survival after Heart Transplant is Similar in Patients with and without Comorbid Obstructive Sleep Apnea. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.557] [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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Hanff T, Harhay M, Kimmel S, Molina M, Acker M, Bermudez C, Atluri P, Mazurek J, Wald J, McLean R, Goldberg L, Birati E. The Role of Human Leukocyte Antigen Sensitization as a Risk Factor for Mortality in Patients Bridged to Heart Transplantation with VA-ECMO. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1283] [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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Patel P, Katz J, Lokeshwar SD, Molina M, Reis IM, Clavijo R, Ramasamy R. Phase II Randomized, Clinical Trial Evaluating 2 Schedules of Low-Intensity Shockwave Therapy for the Treatment of Erectile Dysfunction. Sex Med 2020; 8:214-222. [PMID: 32184082 PMCID: PMC7261672 DOI: 10.1016/j.esxm.2020.01.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/17/2019] [Accepted: 01/20/2020] [Indexed: 01/05/2023] Open
Abstract
PURPOSE To evaluate safety and clinical response of Low-intensity Shockwave Therapy (Li-SWT) for the treatment of erectile dysfunction. MATERIALS & METHODS A single-institution, 2 arm, phase II randomized clinical trial was conducted between February 2017 and April 2019. Patients were randomized into 2 groups, with Li-SWT delivering a total of 3,600 shocks over 5 days (720 once a day, Group A) or over 2 weeks (600 once a day, 3 times a week, Group B). Patients were evaluated for the safety of therapy and completed the International Index of Erectile Function-Erectile Function domain and the Erectile Hardness Scale assessment at baseline, and at 1, 3, and 6 months visits. RESULTS Among 87 evaluable patients, 45 and 42 were allocated to Groups A and B treatment schedules, respectively, and 80 patients (40 per group) completed the 6-month evaluation. No adverse events were reported during treatment or during follow-up. There were statistically significant (P < .05) improvements in International Index of Erectile Function-Erectile Function score (mean increase of 2.7 [95% CI = 1.2, 4.2] and 2.7 points [95% CI = 1.4, 4.1] for Groups A and B, respectively) and in Erectile Hardness Scale (mean increase of 0.6 points (95% CI = 0.3, 0.8) and 0.5 (95% CI = 0.2, 0.8) for Groups A and B, respectively) at 6 months, with no differences between groups. CONCLUSION No difference in outcomes was found when Li-SWT 3,600 shocks were delivered over 1 or 2 weeks at 6 months follow-up and both schedules were safe with no adverse events during or after treatment. Further trials with longer follow-up and sham arm will provide valuable information regarding treatment efficacy and durability. Patel P, Katz J, Lokeshwar SD, et al. Phase II Randomized, Clinical Trial Evaluating 2 Schedules of Low-Intensity Shockwave Therapy for the Treatment of Erectile Dysfunction. Sex Med 2020;8:214-222.
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Affiliation(s)
- Premal Patel
- Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jonathan Katz
- Department of Urology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Soum D Lokeshwar
- Department of Urology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Manuel Molina
- Department of Urology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Isildinha M Reis
- Division of Biostatistics, Department of Public Health Sciences, University of Miami, Miller School of Medicine Miami, Miami, FL, USA; Biostatistics and Bioinformatics Shared Resource, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Raul Clavijo
- Department of Urology, University of California, Davis, School of Medicine, Sacramento, CA, USA
| | - Ranjith Ramasamy
- Department of Urology, University of Miami, Miller School of Medicine, Miami, FL, USA.
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Algazi A, Bhatia S, Agarwala S, Molina M, Lewis K, Faries M, Fong L, Levine LP, Franco M, Oglesby A, Ballesteros-Merino C, Bifulco CB, Fox BA, Bannavong D, Talia R, Browning E, Le MH, Pierce RH, Gargosky S, Tsai KK, Twitty C, Daud AI. Intratumoral delivery of tavokinogene telseplasmid yields systemic immune responses in metastatic melanoma patients. Ann Oncol 2020; 31:532-540. [PMID: 32147213 DOI: 10.1016/j.annonc.2019.12.008] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [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: 09/05/2019] [Revised: 11/27/2019] [Accepted: 12/23/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Interleukin 12 (IL-12) is a pivotal regulator of innate and adaptive immunity. We conducted a prospective open-label, phase II clinical trial of electroporated plasmid IL-12 in advanced melanoma patients (NCT01502293). PATIENTS AND METHODS Patients with stage III/IV melanoma were treated intratumorally with plasmid encoding IL-12 (tavokinogene telseplasmid; tavo), 0.5 mg/ml followed by electroporation (six pulses, 1500 V/cm) on days 1, 5, and 8 every 90 days in the main study and additional patients were treated in two alternative schedule exploration cohorts. Correlative analyses for programmed death-ligand 1 (PD-L1), flow cytometry to assess changes in immune cell subsets, and analysis of immune-related gene expression were carried out on pre- and post-treatment samples from study patients, as well as from additional patients treated during exploration of additional dosing schedules beyond the pre-specified protocol dosing schedule. Response was measured by study-specific criteria to maximize detection of latent and potentially transient immune responses in patients with multiple skin lesions and toxicities were graded by the Common Terminology Criteria for Adverse Events version 4.0 (CTCAE v4.0). RESULTS The objective overall response rate was 35.7% in the main study (29.8% in all cohorts), with a complete response rate of 17.9% (10.6% in all cohorts). The median progression-free survival in the main study was 3.7 months while the median overall survival was not reached at a median follow up of 29.7 months. A total of 46% of patients in all cohorts with uninjected lesions experienced regression of at least one of these lesions and 25% had a net regression of all untreated lesions. Transcriptomic and immunohistochemistry analysis showed that immune activation and co-stimulatory transcripts were up-regulated but there was also increased adaptive immune resistance. CONCLUSIONS Intratumoral Tavo was well tolerated and led to systemic immune responses in advanced melanoma patients. While tumor regression and increased immune infiltration were observed in treated as well as untreated/distal lesions, adaptive immune resistance limited the response.
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Affiliation(s)
- A Algazi
- Department of Medicine, University of California, San Francisco, San Francisco, USA
| | - S Bhatia
- Department of Medicine, University of Washington, Seattle, USA
| | - S Agarwala
- St. Luke's Cancer Center, Bethlehem, USA
| | - M Molina
- Lakeland Health Medical Center, Lakeland, USA
| | - K Lewis
- University of Colorado Cancer Center - Anschutz, Denver, USA
| | - M Faries
- Providence John Wayne Cancer Institute, Santa Monica, USA
| | - L Fong
- Department of Medicine, University of California, San Francisco, San Francisco, USA
| | - L P Levine
- Department of Medicine, University of California, San Francisco, San Francisco, USA
| | - M Franco
- Department of Medicine, University of California, San Francisco, San Francisco, USA
| | - A Oglesby
- Department of Medicine, University of California, San Francisco, San Francisco, USA
| | - C Ballesteros-Merino
- Earle A. Chiles Research Institute at Providence Portland Medical Center, Portland, USA
| | - C B Bifulco
- Earle A. Chiles Research Institute at Providence Portland Medical Center, Portland, USA
| | - B A Fox
- Earle A. Chiles Research Institute at Providence Portland Medical Center, Portland, USA
| | - D Bannavong
- OncoSec Medical Incorporated, San Diego, USA
| | - R Talia
- OncoSec Medical Incorporated, San Diego, USA
| | - E Browning
- OncoSec Medical Incorporated, San Diego, USA
| | - M H Le
- OncoSec Medical Incorporated, San Diego, USA
| | - R H Pierce
- OncoSec Medical Incorporated, San Diego, USA
| | - S Gargosky
- OncoSec Medical Incorporated, San Diego, USA
| | - K K Tsai
- Department of Medicine, University of California, San Francisco, San Francisco, USA
| | - C Twitty
- OncoSec Medical Incorporated, San Diego, USA
| | - A I Daud
- Department of Medicine, University of California, San Francisco, San Francisco, USA.
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Patel P, Katz J, Molina M, Reis I, Clavijo R, Ramasamy R. 323 Phase II, Open-label, Randomized, Clinical Trial Evaluating Two Schedules of Low-intensity Shockwave Therapy for the Treatment of Erectile Dysfunction. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2019.11.144] [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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50
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Masterson T, Molina M, Ibrahim E, Ramasmay R. 409 Evaluation of the Prevalence and Grading of Calcified Plaques Among Men with Peyronie's Disease: A Prospective Analysis. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2019.11.253] [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: 10/25/2022]
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