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Erchick DJ, Hazel EA, Katz J, Lee ACC, Diaz M, Wu LSF, Yoshida S, Bahl R, Grandi C, Labrique AB, Rashid M, Ahmed S, Roy AD, Haque R, Shaikh S, Baqui AH, Saha SK, Khanam R, Rahman S, Shapiro R, Zash R, Silveira MF, Buffarini R, Kolsteren P, Lachat C, Huybregts L, Roberfroid D, Zeng L, Zhu Z, He J, Qiu X, Gebreyesus SH, Tesfamariam K, Bekele D, Chan G, Baye E, Workneh F, Asante KP, Kaali EB, Adu-Afarwuah S, Dewey KG, Gyaase S, Wylie BJ, Kirkwood BR, Manu A, Thulasiraj RD, Tielsch J, Chowdhury R, Taneja S, Babu GR, Shriyan P, Ashorn P, Maleta K, Ashorn U, Mangani C, Acevedo-Gallegos S, Rodriguez-Sibaja MJ, Khatry SK, LeClerq SC, Mullany LC, Jehan F, Ilyas M, Rogerson SJ, Unger HW, Ghosh R, Musange S, Ramokolo V, Zembe-Mkabile W, Lazzerini M, Rishard M, Wang D, Fawzi WW, Minja DTR, Schmiegelow C, Masanja H, Smith E, Lusingu JPA, Msemo OA, Kabole FM, Slim SN, Keentupthai P, Mongkolchati A, Kajubi R, Kakuru A, Waiswa P, Walker D, Hamer DH, Semrau KEA, Chaponda EB, Chico RM, Banda B, Musokotwane K, Manasyan A, Pry JM, Chasekwa B, Humphrey J, Black RE. Vulnerable newborn types: analysis of subnational, population-based birth cohorts for 541 285 live births in 23 countries, 2000-2021. BJOG 2023. [PMID: 37156239 DOI: 10.1111/1471-0528.17510] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 04/04/2023] [Accepted: 04/07/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE To examine prevalence of novel newborn types among 541 285 live births in 23 countries from 2000 to 2021. DESIGN Descriptive multi-country secondary data analysis. SETTING Subnational, population-based birth cohort studies (n = 45) in 23 low- and middle-income countries (LMICs) spanning 2000-2021. POPULATION Liveborn infants. METHODS Subnational, population-based studies with high-quality birth outcome data from LMICs were invited to join the Vulnerable Newborn Measurement Collaboration. We defined distinct newborn types using gestational age (preterm [PT], term [T]), birthweight for gestational age using INTERGROWTH-21st standards (small for gestational age [SGA], appropriate for gestational age [AGA] or large for gestational age [LGA]), and birthweight (low birthweight, LBW [<2500 g], nonLBW) as ten types (using all three outcomes), six types (by excluding the birthweight categorisation), and four types (by collapsing the AGA and LGA categories). We defined small types as those with at least one classification of LBW, PT or SGA. We presented study characteristics, participant characteristics, data missingness, and prevalence of newborn types by region and study. RESULTS Among 541 285 live births, 476 939 (88.1%) had non-missing and plausible values for gestational age, birthweight and sex required to construct the newborn types. The median prevalences of ten types across studies were T+AGA+nonLBW (58.0%), T+LGA+nonLBW (3.3%), T+AGA+LBW (0.5%), T+SGA+nonLBW (14.2%), T+SGA+LBW (7.1%), PT+LGA+nonLBW (1.6%), PT+LGA+LBW (0.2%), PT+AGA+nonLBW (3.7%), PT+AGA+LBW (3.6%) and PT+SGA+LBW (1.0%). The median prevalence of small types (six types, 37.6%) varied across studies and within regions and was higher in Southern Asia (52.4%) than in Sub-Saharan Africa (34.9%). CONCLUSIONS Further investigation is needed to describe the mortality risks associated with newborn types and understand the implications of this framework for local targeting of interventions to prevent adverse pregnancy outcomes in LMICs.
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Affiliation(s)
- D J Erchick
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - E A Hazel
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - J Katz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - A C C Lee
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - M Diaz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - L S F Wu
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - S Yoshida
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - R Bahl
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - C Grandi
- Argentine Society of Paediatrics, Ciudad Autónoma de Buenos Aires, Argentina
| | - A B Labrique
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - M Rashid
- IntraHealth International, Dhaka, Bangladesh
| | - S Ahmed
- Projahnmo Research Foundation, Dhaka, Bangladesh
| | - A D Roy
- Projahnmo Research Foundation, Dhaka, Bangladesh
| | - R Haque
- JiVitA Maternal and Child Health Research Project, Rangpur, Bangladesh
| | - S Shaikh
- JiVitA Maternal and Child Health Research Project, Rangpur, Bangladesh
| | - A H Baqui
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - S K Saha
- Child Health Research Foundation, Dhaka, Bangladesh
| | - R Khanam
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - S Rahman
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - R Shapiro
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - R Zash
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - M F Silveira
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - R Buffarini
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - P Kolsteren
- Department of Food Technology, Safety and Health, Ghent University, Ghent, Belgium
| | - C Lachat
- Department of Food Technology, Safety and Health, Ghent University, Ghent, Belgium
| | - L Huybregts
- Department of Food Technology, Safety and Health, Ghent University, Ghent, Belgium
- Poverty, Health and Nutrition Division, International Food Policy Research Institute, Washington, DC, USA
| | - D Roberfroid
- Medicine Department, Faculty of Medicine, University of Namur, Namur, Belgium
| | - L Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Z Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - J He
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, Guangzhou, China
| | - X Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Centre, Guangzhou Medical University, Guangzhou, China
| | - S H Gebreyesus
- Department of Nutrition and Dietetics, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - K Tesfamariam
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
| | - D Bekele
- Department of Obstetrics and Gynecology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - G Chan
- Department of Obstetrics and Gynecology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - E Baye
- Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - F Workneh
- Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - K P Asante
- Kintampo Health Research Centre, Research and Development Division, Kintampo, Ghana
| | - E B Kaali
- Kintampo Health Research Centre, Research and Development Division, Kintampo, Ghana
| | - S Adu-Afarwuah
- Department of Nutrition and Food Science, University of Ghana, Accra, Ghana
| | - K G Dewey
- Institute for Global Nutrition, Department of Nutrition, University of California, Davis, California, USA
| | - S Gyaase
- Department of Statistics, Kintampo Health Research Centre, Kintampo, Ghana
| | - B J Wylie
- Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New York, USA
| | - B R Kirkwood
- Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - A Manu
- Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
- University of Ghana School of Public Health, Accra, Ghana
| | | | - J Tielsch
- Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - R Chowdhury
- Centre for Health Research and Development, Society for Applied Studies, Delhi, India
| | - S Taneja
- Centre for Health Research and Development, Society for Applied Studies, Delhi, India
| | - G R Babu
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - P Shriyan
- Indian Institute of Public Health, Public Health Foundation of India, Bengaluru, India
| | - P Ashorn
- Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - K Maleta
- School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - U Ashorn
- Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - C Mangani
- School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - S Acevedo-Gallegos
- National Institute of Perinatology, Maternal-Fetal Medicine Department, Mexico City, Mexico
| | - M J Rodriguez-Sibaja
- National Institute of Perinatology, Maternal-Fetal Medicine Department, Mexico City, Mexico
| | - S K Khatry
- Nepal Nutrition Intervention Project - Sarlahi (NNIPS), Kathmandu, Nepal
| | - S C LeClerq
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Nepal Nutrition Intervention Project - Sarlahi (NNIPS), Kathmandu, Nepal
| | - L C Mullany
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - F Jehan
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - M Ilyas
- The Aga Khan University, Karachi, Pakistan
| | - S J Rogerson
- Department of Infectious Diseases, University of Melbourne, Doherty Institute, Melbourne, Victoria, Australia
| | - H W Unger
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
| | - R Ghosh
- Institute for Global Health Sciences, Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - S Musange
- School of Public Health, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - V Ramokolo
- HIV and Other Infectious Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
- Gertrude H Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, USA
| | - W Zembe-Mkabile
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
- College Graduate of Studies, University of South Africa, Johannesburg, South Africa
| | - M Lazzerini
- Institute for Maternal and Child Health - IRCCS 'Burlo Garofolo', WHO Collaborating Centre for Maternal and Child Health, Trieste, Italy
| | - M Rishard
- University Obstetrics Unit, De Soysa Hospital for Women, Colombo, Sri Lanka
- Department of Obstetrics & Gynaecology, University of Colombo, Colombo, Sri Lanka
| | - D Wang
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, Virginia, USA
| | - W W Fawzi
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - D T R Minja
- National Institute for Medical Research, Tanga Centre, Tanga, Tanzania
| | - C Schmiegelow
- Centre for Medical Parasitology, Department for Immunology and Microbiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - H Masanja
- Ifakara Health Institute, Dar es Salaam, Tanzania
| | - E Smith
- Department of Global Health, Milken Institute School of Public Health, Washington, DC, USA
| | - J P A Lusingu
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - O A Msemo
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | - F M Kabole
- Ministry of Health Zanzibar, Zanzibar, Tanzania
| | - S N Slim
- Ministry of Health Zanzibar, Zanzibar, Tanzania
| | - P Keentupthai
- College of Medicine and Public Health, Ubon Ratchathani University, Ubon Ratchathani, Thailand
| | - A Mongkolchati
- ASEAN Institute for Health Development, Mahidol University, Salaya, Thailand
| | - R Kajubi
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - A Kakuru
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - P Waiswa
- Department of Health Policy Planning and Management, Makerere University School of Public Health, New Mulago Hospital Complex, Kampala, Uganda
- Division of Global Health, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - D Walker
- Institute for Global Health Sciences and Department of Obstetrics and Gynecology, University of California San Francisco, San Francisco, California, USA
| | - D H Hamer
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
- Section of Infectious Diseases, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - K E A Semrau
- Ariadne Labs, Brigham and Women's Hospital and Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Division of Global Health Equity & Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - E B Chaponda
- Department of Biological Sciences, School of Natural Sciences, University of Zambia, Lusaka, Zambia
| | - R M Chico
- Department of Disease Control, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - B Banda
- Research Unit for Environmental Sciences and Management, North-West University, Potchefstroom, South Africa
| | - K Musokotwane
- Health Specialist PMTCT and Pediatric AIDS, UNICEF, Lusaka, Zambia
| | - A Manasyan
- University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - J M Pry
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - B Chasekwa
- Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe
| | - J Humphrey
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - R E Black
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Diaz M, Camargo L, Rojas A, Castillo E, Tavera L, López N, Ramos E, Porto M. Cognitive alterations in patients with alterations in sleep architecture in a court of Colombian patients. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Gordan L, Diaz M, Patel A, Fink M, Wenk D, Roos A, Jiang J, Tam J, Sathyan P, Febbo P. 1162P Tissue and liquid biopsy utilization in advanced NSCLC in a large community US practice. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Sirotti S, Adinolfi A, Damiani A, Becce F, Cazenave T, Cipolletta E, Christiansen SN, Delle Sedie A, Diaz M, Figus F, Filippucci E, Hammer HB, Mandl P, Maccarter D, Micu M, Möller I, Mortada MA, Mouterde G, Naredo E, Porta F, Reginato A, Sakellariou G, Schmidt WA, Scirè CA, Serban T, Vlad V, Vreju FA, Wakefield R, Zufferey P, Sarzi-Puttini P, Iagnocco A, Pineda C, Keen H, D’agostino MA, Terslev L, Filippou G. OP0168 DEVELOPMENT OF AN ULTRASOUND SCORING SYSTEM FOR CPPD EXTENT: RESULTS FROM A DELPHI PROCESS AND WEB-RELIABILITY EXERCISE BY THE OMERACT US WORKING GROUP. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundUltrasound (US) has proven to be an excellent imaging technique for detecting calcium pyrophosphate (CPP) deposition disease (CPPD); it is also widely available and inexpensive and can be performed during the clinic visit making it the preferred imaging modality for many rheumatologists. However, no validated grading systems have yet been developed allowing for a quantification of the extent of crystal deposition in CPPD.ObjectivesThe aim of this study was to develop a scoring system for the quantification of CPP deposition at a patient level according to the OMERACT framework.MethodsAs part of the OMERACT methodology, we performed a systematic literature review (SLR) and meta-analysis aimed to estimate the prevalence of CPP deposition in peripheral joints by imaging, in order to identify relevant joints for CPPD monitoring. A preliminary survey was also circulated among the members of the OMERACT US – CPPD working group to collect their own suggestions according to their personal experience. Subsequently, a Delphi survey was prepared and circulated between members of the group, including statements that reflected both the results of the SLR and of the preliminary survey. In total, 32 statements were generated regarding the type of scoring for single structures, the sites to be included, the final scoring at patient level, and the scanning technique. Participants were asked to reply on a 5-point Likert scale (1, strongly disagree to 5, strongly agree) and agreement was achieved when 4 and 5 grades reached 75% or more of concordance. In case of disagreement, new statements were proposed according to the members’ suggestions and circulated for voting in a subsequent round. After agreement of a scoring system, the validation process began. Two rounds of a web-based exercise on static images were conducted on 120 images representing equally all sites under investigation and all degrees of crystal deposition, to assess the intra- and inter-reader reliability of the new scoring system. Representative images of the scoring system were visible throughout the entire exercise in order to facilitate the scoring of the lesions.ResultsThree Delphi rounds were needed to reach agreement on all items. 32/41 members of the OMERACT US-CPPD working group replied in the first round, 26/32 in the second, and 25/26 in the third round. Twenty statements were approved in the first round, 3 in the second, and 3 in the third round. Only the knees (menisci and hyaline cartilage) and the triangular fibrocartilage of the wrist were included in the final score, using a four-grade system (0-3). It was decided that each anatomical structure should be scored separately and then also summed in order to define the joint score. The sum of the assessed joints was the total score at patient level. The final scoring system with the definitions and the relative technical notes is represented in Figure 1. 33/41 members participated to the reliability exercise. The inter-reader reliability of the scoring was substantial (kappa of 0.72), and the intra-reader reliability was almost perfect (kappa of 0.82).ConclusionThis is the first study for developing a scoring system for the extent of CPP crystal deposition in patients with CPPD. The scoring system demonstrated to be reliable in static images. The next step of the validation process is to assess the reliability of the scoring system in a patient-based exercise. This study represents a fundamental step in the OMERACT process of validating US as an outcome measure instrument, and above proposed scoring system will hopefully provide a useful tool for clinical practice and research.Disclosure of InterestsNone declared
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Zimmer-Faust AG, Steele JA, Xiong X, Staley C, Griffith M, Sadowsky MJ, Diaz M, Griffith JF. A Combined Digital PCR and Next Generation DNA-Sequencing Based Approach for Tracking Nearshore Pollutant Dynamics Along the Southwest United States/Mexico Border. Front Microbiol 2021; 12:674214. [PMID: 34421839 PMCID: PMC8377738 DOI: 10.3389/fmicb.2021.674214] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 02/28/2021] [Accepted: 05/25/2021] [Indexed: 12/27/2022] Open
Abstract
Ocean currents, multiple fecal bacteria input sources, and jurisdictional boundaries can complicate pollution source tracking and associated mitigation and management efforts within the nearshore coastal environment. In this study, multiple microbial source tracking tools were employed to characterize the impact and reach of an ocean wastewater treatment facility discharge in Mexico northward along the coast and across the Southwest United States- Mexico Border. Water samples were evaluated for fecal indicator bacteria (FIB), Enterococcus by culture-based methods, and human-associated genetic marker (HF183) and Enterococcus by droplet digital polymerase chain reaction (ddPCR). In addition, 16S rRNA gene sequence analysis was performed and the SourceTracker algorithm was used to characterize the bacterial community of the wastewater treatment plume and its contribution to beach waters. Sampling dates were chosen based on ocean conditions associated with northern currents. Evidence of a gradient in human fecal pollution that extended north from the wastewater discharge across the United States/Mexico border from the point source was observed using human-associated genetic markers and microbial community analysis. The spatial extent of fecal contamination observed was largely dependent on swell and ocean conditions. These findings demonstrate the utility of a combination of molecular tools for understanding and tracking specific pollutant sources in dynamic coastal water environments.
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Affiliation(s)
- Amity G Zimmer-Faust
- Southern California Coastal Water Research Project, Costa Mesa, CA, United States
| | - Joshua A Steele
- Southern California Coastal Water Research Project, Costa Mesa, CA, United States
| | - Xianyi Xiong
- BioTechnology Institute, University of Minnesota Twin Cities, Saint Paul, MN, United States
| | - Christopher Staley
- BioTechnology Institute, University of Minnesota Twin Cities, Saint Paul, MN, United States
| | - Madison Griffith
- Southern California Coastal Water Research Project, Costa Mesa, CA, United States
| | - Michael J Sadowsky
- Department of Soil, Water, and Climate, University of Minnesota Twin Cities, Saint Paul, MN, United States
| | - Margarita Diaz
- Proyecto Fronterizo de Educación Ambiental, A.C., Tijuana, Mexico
| | - John F Griffith
- Southern California Coastal Water Research Project, Costa Mesa, CA, United States
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Lozano FM, Bernabeu A, Lledo B, Morales R, Diaz M, Aranda FI, Llacer J, Bernabeu R. Characterization of the vaginal and endometrial microbiome in patients with chronic endometritis. Eur J Obstet Gynecol Reprod Biol 2021; 263:25-32. [PMID: 34144490 DOI: 10.1016/j.ejogrb.2021.05.045] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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: 12/21/2020] [Revised: 03/24/2021] [Accepted: 05/30/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To compare the endometrial and vaginal microbiome of women with and without chronic endometritis. STUDY DESIGN A cohort study with 60 patients undergoing assisted reproductive treatment with their own or donated gametes was undertaken. Vaginal and endometrial samples were taken in the cycle prior to embryo transfer. The endometrial and vaginal microbiome was analysed by mass sequencing of the V3V4 region of 16S rRNA gene. Bioinformatics analysis was performed using QIIME2 and MicrobiomeAnalyst packages. Alpha diversity, beta diversity and taxonomic characterization were compared between samples that tested positive and negative for chronic endometritis on CD138 immunohistochemistry. RESULTS Different bacterial communities were detected when vaginal and endometrial samples were analysed in patients with and without endometritis diagnosed using CD138 immunohistochemistry. In patients with endometritis, a higher alpha-diversity index was found in vaginal samples (p = 0.15 for the Shannon index) and significant differences were found in endometrial samples (p = 0.01 for the Shannon index). In the beta-diversity analysis, no significant differences were observed between the groups with and without endometritis. Vaginal and endometrial samples from women with endometritis showed a microbiome pattern that was not dominated by Lactobacillus spp. Relative abundance analysis identified Ralstonia and Gardnerella spp. in endometrial samples, and Streptoccoccus and Ureaplasma spp. in vaginal samples of patients diagnosed with chronic endometritis on CD138 immunohistochemistry. When comparing endometrial and vaginal samples diagnosed with endometritis on CD138 immunohistochemistry, both alpha diversity (p = 0.06 for the Shannon index and p = 0.08 for the Simpson index) and beta diversity (p < 0.001) showed significant differences. Lactobacillus spp. (p = 3.76E-4), Ralstonia spp. (p = 8.19E-4), Delftia spp. (p = 0.004) and Anaerobacillus spp. (p = 0.004) were identified in these sample groups. CONCLUSION These results demonstrate the existence of a characteristic vaginal and endometrial microbiota in patients with chronic endometritis. Different genera and species were identified in patients with and without chronic endometritis depending on whether the sample was endometrial or vaginal. There is a clear relationship between changes in the vaginal microbiome and chronic endometritis. The microbiota is a continuum throughout the female reproductive tract, so study of the vaginal microbiota could be useful for the diagnosis of diseases of the upper reproductive tract, such as chronic endometritis.
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Affiliation(s)
- F M Lozano
- Instituto Bernabeu Biotech, Alicante, Spain.
| | - A Bernabeu
- Instituto Bernabeu of Fertility and Gynaecology, Alicante, Spain
| | - B Lledo
- Instituto Bernabeu Biotech, Alicante, Spain
| | - R Morales
- Instituto Bernabeu Biotech, Alicante, Spain
| | - M Diaz
- Instituto Bernabeu of Fertility and Gynaecology, Alicante, Spain
| | - F I Aranda
- Servicio Anatomía Patológica, HGUA, Alicante, Spain
| | - J Llacer
- Instituto Bernabeu of Fertility and Gynaecology, Alicante, Spain
| | - R Bernabeu
- Instituto Bernabeu of Fertility and Gynaecology, Alicante, Spain
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Hocké C, Diaz M, Bernard V, Frantz S, Lambert M, Mathieu C, Grellety-Cherbero M. [Genitourinary menopause syndrome. Postmenopausal women management: CNGOF and GEMVi clinical practice guidelines]. Gynecol Obstet Fertil Senol 2021; 49:394-413. [PMID: 33757926 DOI: 10.1016/j.gofs.2021.03.025] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Genitourinary menopause syndrome (SGUM) is defined as a set of symptoms associated with a decrease of estrogen and other sexual steroids during menopause. The main symptoms are vulvovaginal (dryness, burning, itching), sexual (dyspareunia), and urinary (urinary infections, pollakiuria, nycturia, pain, urinary incontinence by urgenturia). SGUM leads to an alteration of the quality of life, and affects especially women's sexuality. OBJECTIVE The objective of this review was to elaborate guidelines for clinical practice regarding the management of SGUM in postmenopausal women, and in particular, in women with a history of breast cancer, treated or not with hormone therapy. MATERIALS AND METHODS A systematic review of the literature on SGUM management was conducted on Pubmed, Medline and Cochrane Library. Recommendations from international scholarly societies were also taken into account: International Menopause Society (IMS) https://www.imsociety.org, The North American Menopause Society (NAMS) https://www.menopause.org, Canadian Menopause Society https://www.sigmamenopause.com, European Menopause and Andropause Society (EMAS) https://www.emas-online.org, International Society for the Study of Women's Sexual Health (ISSWSH) https://www.isswsh.org. RESULTS Vaginal use of lubricants, moisturizers and hyaluronic acid improves the symptoms of SGUM and may be offered to all patients. For postmenopausal women, local estrogen will be preferred to the oral route because of their safety and efficacy on all symptoms of SGUM during low-dose use. Prasterone is a local treatment that can be proposed as an effective alternative for the management of dyspareunia and sexual function disorder. Current data on oral testosterone, tibolone, oral or transdermal DHEA and herbal medicine are currently limited. Ospemifène, which has shown a significant improvement in sexual symptoms, is not currently marketed in France. In the particular case of women with a history of breast cancer, non-hormonal regimens are a first-line therapy. Current data on the risk of breast cancer recurrence when administering low-dose local estrogen are reassuring but do not support a conclusion that this treatment is safe. CONCLUSION SGUM is a common symptom that can affect the quality of life of postmenopausal women. A treatment should be systematically proposed. Local non-hormonal treatment may be offered in all women. Local low-dose estrogen therapy and Prasterone has shown an interest in the management of symptoms. In women before a history of breast cancer, local non-hormonal treatment should be offered first-line. The safety of low-dose local estrogen therapy and Prasterone cannot be established at this time. Other alternatives exist but are not currently recommended in France due to lack of data.
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Affiliation(s)
- C Hocké
- Service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
| | - M Diaz
- Service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - V Bernard
- Service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - S Frantz
- Service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - M Lambert
- Service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - C Mathieu
- Service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
| | - M Grellety-Cherbero
- Service de chirurgie gynécologique et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
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Jimenez Britez G, Freixa X, Sabate M, Diaz M, Hernandez-Enriquez M. Optimal antiplatelet therapy in out-hospital cardiac arrest with mild therapeutic hypothermia. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1436] [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
Background
Out-of-Hospital Cardiac Arrest (OHCA) and Mild therapeutic hypothermia (MTH) has been linked to an increased risk of Stent Thrombosis (ST) in comatose survivors who underwent percutaneous coronary intervention (PCI). There is no formal recommendation about which antiplatelet regimen should be used in patients with Acute Coronary Syndrome (ACS) after OHCA
Methods
Prospective, single center study.
We compared antiplatelet efficacy of clopidogrel and ticagrelor at different time points after primary PCI in OHCA patients underwent MTH with 2 systems (VerifyNow®) and light transmission aggregometry.
With the system (VerifyNow®) the results were expressed in P2Y12 reaction units (PRU) in response to ADP-prostaglandin E1.
With the aggregometry in vitro platelet aggregation was measured in response to ADP (20 lmol/L at 37 C). The main result was the percentage of maximal platelet aggregation
Results
24 consecutive OHCA patients were included in our hospital.
We confirmed that residual platelet activity was higher with clopidogrel than with ticagrelor, expressed by PRU, 2 h after loading dose (229±56 vs. 180±30, p<0.014), 6h after loading dose during MTH (203±45 vs. 135±51, p<0.004), 24h after loading dose during MTH (188±52 vs. 58±64, p<0.0001), after warming (200±55 vs. 27±24, p<0.0001) and 24 h after warming (201±57 vs. 31±24, p<0.0001).
With the aggregometry we observed higher percentajes of maximal platelet aggregation in response to ADP with clopidogrel than ticagrelor since 6 hs after loading dose. 2 h after loading dose (44±17 vs. 36±23, p: 0.439), 6h after loading dose during MTH (42±13 vs. 24±20, p<0.02), 24h after loading dose during MTH (26±20 vs. 9.5±6.5, p<0.005), after warming (26±16 vs. 12±8, p<0.02)..
Conclusion
In this study, we observed a lower antiplatelet efficacy of clopidogrel compared with ticagrelor in patients with OHCA after PCI with MHT. This decrease in antiplatelet efficacy persists after the warming. Similarly to other settings, ticagrelor might be a valid alternative to clopidogrel in those patients
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Ministerio de Economía y Competitividad. Instituto Carlos III, Fondo Investigaciόn Sanitaria. Spain
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Affiliation(s)
| | - X Freixa
- Hospital Clinic de Barcelona, Cardiology, Barcelona, Spain
| | - M Sabate
- Hospital Clinic de Barcelona, Cardiology, Barcelona, Spain
| | - M Diaz
- Hospital Clinic de Barcelona, Cardiology, Barcelona, Spain
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Carton de Tournai D, Vandernoot I, Marangoni M, Faverly D, Diaz M, Casagranda A, Berlingin E, Van Maldergem L. CYLD-related cutaneous syndrome: variable p.Pro482fs*6 phenotype in five individuals from two unrelated families. J Eur Acad Dermatol Venereol 2020; 35:e81-e83. [PMID: 32678957 DOI: 10.1111/jdv.16823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- D Carton de Tournai
- Department of Dermatology, Ambroise Paré University Hospital, Mons, Belgium.,Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - I Vandernoot
- Department of Dermatology, Ambroise Paré University Hospital, Mons, Belgium.,Center of Human Genetics, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - M Marangoni
- Center of Human Genetics, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - D Faverly
- Center of Morphological Pathology, Brussels, Belgium
| | - M Diaz
- Department of Oncology, Ambroise Paré University Hospital, Mons, Belgium
| | - A Casagranda
- Department of Dermatology, Ambroise Paré University Hospital, Mons, Belgium
| | - E Berlingin
- Department of Dermatology, Ambroise Paré University Hospital, Mons, Belgium
| | - L Van Maldergem
- Clinical Investigation Center 1431, National Institute of Health and Medical Research (INSERM), Paris, France.,Center of Human Genetics, University of Franche-Comté, Besançon, France
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Diaz M, Reyes S, Adur A, Cuartero V, Leon T, Raffa I, Sanchez P, Dioca M. P-7 Induction chemotherapy in locally advanced rectal cancer: Retrospective report of efficacy and safety in an Argentinean university institution, a feasibility perspective. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Garcia Carazo S, Peiteado D, Villalva A, Nuño L, Diaz M, Balsa A, Aguado P. AB0895 RELATIONSHIP BETWEEN BONE MINERAL DENSITY, INFLAMMATORY ACTIVITY AND AUTOIMMUNITY IN A COHORT OF EARLY RHEUMATOID ARTHRITIS PATIENTS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:The etiology of bone loss in Rheumatoid Arthritis (RA) is multifactorial and systemic inflammation plays a relevant role. Recently, a relationship between autoimmunity and bone mineral density (BMD) has been described in patients with RA.Objectives:To study BMD and biochemical parameters of bone metabolism in a cohort of patients with early rheumatoid arthritis, and assess the relationship between them and autoimmunity and other markers of inflammation.Methods:A prospective longitudinal study was performed. 128 patients from an early Rheumatoid Arthritis Unit (ERAU) were included. All of them fullfilled ACR 2010 classification criteria for RA. Demographic, clinical, biochemical, immunological, radiological and densitometric data, and also inflammatory activity index DAS 28, HAQ functional index, were collected. Any value >20 IU/mL for RF and >30 IU/mL for ACPA was defined as positive.Results:Between January 2009 and June 2017, 801 patients were evaluated in our ERAU. After two years of follow-up, the most frequent definitive diagnoses were: Early RA 221 (27.6%), Undifferentiated Arthritis 97 (12.1%), Psoriatic Arthritis 62 (7.7%), Spondyloarthritis 54 (6.7%) and autoimmune Diseases 28 (3.4%).From the 128 patients with early rheumatoid arthritis evaluated, 104 (81.9%) were ACPA positive and 98 (77.2%) FR positive. The mean BMD in the total column was 0.96 ±0.14 g/cm2 and in the femoral neck was 0.76 ±0.12 g/cm2. No correlation of BMD with autoimmunity markers was found in either of the two locations studied, while a negative relationship between BMD and the PCR inflammation marker (BMD femoral neck: rho-0.203, p = 0.027 and BMD lumbar spine rho =-0.27, p 0.003) was found. The BMD did not correlate with DAS28 nor the HAQ index.The mean baseline serum calcidiol value was 20.7±8 ng/ml, and a negative correlation of basal serum calcidiol with the functional HAQ index was observed (rho=-0.23, p= 0.008). No correlation between other autoimmunity (FR and ACPA) and inflammation (VSG, PCR and DAS 28) markers and vitamin D was found.Conclusion:The BMD in patients with early rheumatoid arthritis of our cohort correlates with the PCR inflammation marker. Unlike other studies shows, in our cohort, serological autoimmunity factors do not have shown to have an independent effect on BMD.References:[1]Llorente I, Merino M, Ortiz AM, et al. Anti-citrullinated protein antibodies are associated with decreased bone mineral density: baseline data from a register of early arthritis patients. Rheumatol Int (2017) 37:799–806Disclosure of Interests:Sara Garcia Carazo: None declared, Diana Peiteado: None declared, Alejandro Villalva: None declared, Laura Nuño: None declared, Mariana Diaz: None declared, Alejandro Balsa Grant/research support from: BMS, Roche, Consultant of: AbbVie, Gilead, Lilly, Pfizer, UCB, Sanofi, Sandoz, Speakers bureau: AbbVie, Lilly, Sanofi, Novartis, Pfizer, UCB, Roche, Nordic, Sandoz, Pilar Aguado: None declared
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Watanabe N, Levri J, Peng V, Scharf SM, Diaz M. 0634 Volume-Assured Pressure Support is Effective Treatment for Obstructive Sleep Apnea Patients Who Failed CPAP Titration. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction
Obstructive sleep apnea (OSA) is a common disease, often treated using continuous positive airway pressure (CPAP). In many cases, patients fail an attended CPAP titration study, often due to inadequate control of AHI, and treatment-emergent central apneas as CPAP is increased. Here, we report our experience using volume-assured pressure support (VAPS) for these patients.
Methods
We retrospectively reviewed records of 45 adults who had OSA diagnosed on polysomnography (PSG) in whom CPAP titration had failed. In these patients, VAPS-AE (adjustable expiratory pressure) titrations were performed. Patients with central sleep apnea on baseline PSG were excluded.
Results
Reasons for CPAP titration failure included: treatment emergent central apneas (25), failure of maximum CPAP pressure to treat OSA (18), and persistent hypoxia (2). Average age was 57.9±13.1, BMI was 40.2±8.7, 26 males, Epworth sleepiness score was 10.7±7.9. The following significant changes from baseline PSG to VAPS titration were observed: AHI: 65.3±29.3 to 22.3 ±16.1 (p<.001) events/hour. Time < 88% saturation: 63.7 (median) to 6.9 (median) min (p<.001). The number of patients with AHI<15 was 0 on PSG and 16 (36%) on VAPS-AE, while the number of patients with AHI<30 was 7 (16%) on PSG and 32 (71%) on VAPS-AE. Improvement in AHI was not related to gender, age, or narcotic use, but was correlated with BMI: ΔAHI = 12.2 - (1.4 * BMI); p=.05. VAPS resulted in improved sleep architecture: slow wave sleep increased (medians: 1.4% to 19.6% total sleep time (TST)) (p<.001), REM sleep increased (medians 6.4% to 13.6% TST) (p<.01).
Conclusion
For OSA patients for whom CPAP titration failed, titration with VAPS-AE was an effective treatment for many patients.
Support
N/A
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Affiliation(s)
- N Watanabe
- University of Maryland Medical Center, Baltimore, MD
| | - J Levri
- Univeristy of Maryland Medical Center, Baltimore, MD
| | - V Peng
- University of Maryland Medical Center, Baltimore, MD
| | | | - M Diaz
- University of Maryland Medical Center, Baltimore, MD
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Levri JM, Watanabe N, Peng V, Scharf SM, Diaz M. 0633 Volume Assured Pressure Support is an Effective Treatment in Patients with Central Sleep Apnea Syndrome. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Central sleep apnea syndrome (CSA) is commonly found in patients with congestive heart failure, brainstem disorders, and narcotic use. Various treatment modalities have been used with varied effectiveness in reducing the apnea-hypopnea index (AHI) and improving ventilation in patients with CSA. This study assessed whether Volume Assured Pressure Support (VAPS), a BiLevel mode of ventilation, is effective in treating CSA.
Methods
We performed a retrospective review of polysomnography (PSG) and VAPS titration studies on 11 patients at our institution: 7 patients had CSA with Cheyne-Stokes Respiration, 2 patients had CSA attributed to narcotic use, and 2 patients had primary CSA. CSA was diagnosed if more than 50% of the disordered breathing events were central. Five patients had failed a Continuous Positive Airway Pressure (CPAP) titration and then proceeded to VAPS while in 6 patients, VAPS was the initial treatment modality tried. We examined the effectiveness of VAPS in reducing AHI, improving oxygenation, and improving sleep architecture.
Results
Among the 11 patients, age was 63.0±12.1 yo, BMI was 33.7 ±4.5, 7 were males, Epworth sleepiness score was 9.3±4.9. The following significant changes from baseline PSG to VAPS titration were observed: AHI: 59.1± 8.0 to 27.2 ± 9.9 (p<.01); Time ≤ 88% O2 saturation (min): 48.1±14.5 to 15.4±6.1 (p<.05). Improvement in AHI was not related to gender, body mass index, narcotic use, or age. No significant changes in sleep architecture between the two studies were found. Ten (91%) patients had AHI > 30 on initial PSG. In 6 (55%) patients AHI was reduced to <15 with VAPS use. An additional patient had AHI reduced to 22.2, while 4 (36%) patients did not achieve an AHI < 30 with VAPS.
Conclusion
VAPS is an effective mode of treating CSA in the majority of patients.
Support
NA
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Affiliation(s)
- J M Levri
- University of Maryland Medical Center, Baltimore, MD
| | - N Watanabe
- University of Maryland Medical Center, Baltimore, MD
| | - V Peng
- Univeristy of Maryland Medical Center, Baltimore, MD
| | | | - M Diaz
- Univeristy of Maryland Medical Center, Baltimore, MD
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López-Jaramillo P, Barbosa E, Molina DI, Sanchez R, Diaz M, Camacho PA, Lanas F, Pasquel M, Accini JL, Ponte-Negretti CI, Alcocer L, Cobos L, Wyss F, Sebba-Barroso W, Coca A, Zanchetti A. Latin American Consensus on the management of hypertension in the patient with diabetes and the metabolic syndrome. J Hypertens 2020; 37:1126-1147. [PMID: 30882601 DOI: 10.1097/hjh.0000000000002072] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
: The prevalence of hypertension, type 2 diabetes mellitus (DM2) and the metabolic syndrome continues to increase in Latin America, while the rates of diagnosis, treatment and control of these disorders remain low. The frequency of the risk factors that constitute the metabolic syndrome and are associated with an increased risk of cardiovascular disease has not diminished since the publication of the previous consensus. This document discusses the socioeconomic, demographic, environmental and cultural characteristics of most associated Latin American countries and partially explains the lack of better results in improving clinical and public health actions that allow high morbidity and mortality rates caused by cardiovascular diseases and DM2 to be reduced through programs aligned with the so-called precision medicine, which should be predictive, preventive, personalized and participatory. The Consensus ratifies the diagnostic criteria expressed in the previous consensus to define hypertension and DM2 but, for the metabolic syndrome, and in the absence of evidence, the recommendation is to implement a cohort study that determines the abdominal perimeter value associated with hard outcomes, such as DM2 and CVD. Meanwhile, we recommend modifying the criterion to more than 94 cm in men and more than 84 cm in women according to WHO recommendations. We also recommend the carrying out of a study that identifies the situation of hypertension and DM2 in people of African ancestry who, in Latin America, exceed 75 million and whose epidemiology does not include solid studies. With respect to the proposed therapeutic targets, we recommended maintaining those defined in the previous consensus, but insisting that early pharmacological management of prediabetes with metformin should be introduced, as should the treatment of diabetic hypertensive patients with a combination therapy of two fixed-dose antihypertensive drugs and management with statins. To increase adherence, the use of different drugs combined in a single pill (polypill) is recommended. The simplification of the therapeutic regimen is accompanied by greater control of cardiovascular risk factors, both in primary and secondary prevention, and has been shown to be cost-effective. The consensus recommends the use of the currently available polypill combining an angiotensin-converting enzyme inhibitor, a statin and aspirin for secondary cardiovascular prevention and in patients with a high cardiovascular risk, such as hypertension patients with DM2.
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Affiliation(s)
- Patricio López-Jaramillo
- Clinica de Síndrome Metabolico, Prediabetes y Diabetes, Direccion de Investigaciones FOSCAL y Facultad de Salud, Universidad de Santander (UDES), Bucaramanga, Colombia
| | | | - Dora I Molina
- Universidad de Caldas e IPS Médicos Internistas de Caldas, Manizales, Colombia
| | - Ramiro Sanchez
- Hospital Universitario Fundacion Favaloro, Buenos Aires, Argentina
| | | | - Paul A Camacho
- Direccion de Investigaciones FOSCAL y Facultad de Salud, Universidad Autonoma de Bucaramanga (UNAB), Bucaramanga, Colombia
| | | | | | - José L Accini
- Fundacion Hospital Universidad del Norte y Universidad Libre, Barranquilla, Colombia
| | | | - Luis Alcocer
- Instituto Mexicano de Salud Cardiovascular, Ciudad de Mexico, Mexico
| | - Leonardo Cobos
- Unidad de Cardiologia, Hospital El Pino, Santiago, Chile
| | - Fernando Wyss
- Servicios y Tecnologica Cardiovascular de Gautemala, S.A., Guatemala
| | | | - Antonio Coca
- Hospital Clínico, Universidad de Barcelona, Spain
| | - Alberto Zanchetti
- Istituto Auxologico Italiano, IRCCS, and Università degli Studi of Milan, Italy
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Denninghoff V, Muino A, Diaz M, Harada L, Lence A, Turon P, Labbrozzi M, Aguas S, Peñaloza P, Avagnina A, Adler I. Mutational status of PIK3ca oncogene in oral cancer-In the new age of PI3K inhibitors. Pathol Res Pract 2019; 216:152777. [PMID: 31831300 DOI: 10.1016/j.prp.2019.152777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 11/26/2019] [Accepted: 12/01/2019] [Indexed: 10/25/2022]
Abstract
In the new age of PI3K inhibitors, the mutational status of PI3Kca oncogene in the Cavity Squamous Cell Carcinoma (OC-SCC) needs further analysis. It is the sixth most common cancer in the world. The aim of this study was to evaluate PI3Kca oncogene mutations and to correlate them with the clinical-histological characteristics of individuals presenting these tumors. We recruited 74 individuals with OC-SCC diagnosis (period 2000-2014). Histological sections were used. DNA was purified; PIK3ca gene exons 9 and 20 were amplified and sequenced. In 49/74 cases (66 %), the complete sequence of both codons was analyzed by Sanger method. We found that 7/49 (14 %) individuals mutated. In exon 9 we found 1/49 (2 %), and in exon 20 M1043I 8/49 (16 %). We have found the coexistence of more than one mutation in a same individual (E542 K and M1043I). A positive association was observed between the mutational status of the codon 9 (E542 K) and the tongue location. In conclusion, the frequency of PI3Kca gene mutation in OC-SCC was 16 %, which is similar to that reported for other populations. We found a mutation not previously described (M1043I) in this pathology. Should its biological effect be confirmed, it must be added to the list of PIK3ca mutations. Total mutations in the PIK3ca were 32 %, with tongue being the site at the greatest risk (E542K-E545K-M1043I). These findings would facilitate the identification of patients with therapeutic targets in the near future.
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Affiliation(s)
- V Denninghoff
- Stomatology, Faculty of Dentistry, University of Buenos Aires, Argentina; Pathology Department, Center for Medical Education and Clinical Research (CEMIC), Argentina; National Scientific and Technical Research Council (CONICET), Ciudad Autónoma de Buenos Aires, Argentina.
| | - A Muino
- Stomatology, Faculty of Dentistry, University of Buenos Aires, Argentina
| | - M Diaz
- Stomatology, Faculty of Dentistry, University of Buenos Aires, Argentina
| | - L Harada
- Stomatology, Faculty of Dentistry, University of Buenos Aires, Argentina
| | - A Lence
- Stomatology, Faculty of Dentistry, University of Buenos Aires, Argentina
| | - P Turon
- Stomatology, Faculty of Dentistry, University of Buenos Aires, Argentina
| | - M Labbrozzi
- Stomatology, Faculty of Dentistry, University of Buenos Aires, Argentina
| | - S Aguas
- Stomatology, Faculty of Dentistry, University of Buenos Aires, Argentina
| | - P Peñaloza
- Pathology Department, Center for Medical Education and Clinical Research (CEMIC), Argentina
| | - A Avagnina
- Pathology Department, Center for Medical Education and Clinical Research (CEMIC), Argentina
| | - I Adler
- Stomatology, Faculty of Dentistry, University of Buenos Aires, Argentina
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Diaz M, Cataldo M, Ledezma P, Keller J, Doederer K. Unravelling the mechanisms controlling the electro-generation of ferrate using four iron salts in boron-doped diamond electrodes. J Electroanal Chem (Lausanne) 2019. [DOI: 10.1016/j.jelechem.2019.113501] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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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Ocampo-Garcés A, Diaz M, Villanueva K, Córdova T, Mauro J, Cáceres T, Bassi A, Repetto G. Sleep architecture in 22q11.2 microdeletion syndrome patients: polysomnographic study of prodromal signs of Parkinson's Disease and obstructive sleep apnea. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Patel M, Doo J, Diaz M, Stuparich MA, Tran BV, Nahas S. 1279 Total Laparoscopic Hysterectomy in an 18 Week Sized Uterus with Persistent Gestational Trophoblastic Disease. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Vives M, Herrera J, Gasco I, Diaz M, Torres S, Regi K, Rodriguez C, Baldo X. Individualized peep after recruitment maneuver during one lung ventilation and pulmonary complications for thoracic surgery: a prospective observational cohort. J Cardiothorac Vasc Anesth 2019. [DOI: 10.1053/j.jvca.2019.07.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Herrera J, Vives M, Gasco I, Diaz M, Torres S, Regi K, Rodriguez C, Baldo X. Use of intravenous lidocaine infusion during thoracic surgery: a prospective observational cohort. J Cardiothorac Vasc Anesth 2019. [DOI: 10.1053/j.jvca.2019.07.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Diaz M, Avila A, Degens H, Coeckelberghs E, Vanhees L, Cornelissen V, Azzawi M. Acute resveratrol supplementation in coronary artery disease: towards patient stratification. SCAND CARDIOVASC J 2019; 54:14-19. [PMID: 31429599 DOI: 10.1080/14017431.2019.1657584] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Resveratrol (RV) is a polyphenol with antioxidant, anti-inflammatory and cardio-protective properties. Our objective was to investigate whether acute supplementation with high doses of RV would improve flow-mediated dilation (FMD) and oxygen consumption (VO2) kinetics in older coronary artery disease (CAD) patients. Design: We employed a placebo-controlled, single-blind, crossover design in which ten participants (aged 66.6 ± 7.8 years) received either RV or placebo (330 mg, 3× day-1) during three consecutive days plus additional 330 mg in the morning of the fourth day with a seven-day wash-out period in-between. On the fourth day, FMD of the brachial artery and VO2 on-kinetics were determined. Results: RV improved FMD in patients who had undergone coronary artery bypass grafting (CABG; -1.4 vs. 5.0%; p = .004), but not in those who had undergone percutaneous coronary intervention (PCI; 4.2 vs. -0.2%; NS). Conclusion: Acute high dose supplementation with RV improved FMD in patients after CABG surgery but impaired FMD in patients who underwent PCI. The revascularization method-related differential effects of RV may be due to its direct effects on endothelial-dependent dilator responses. Our findings have important implications for personalized treatment and stratification of older CAD patients.
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Affiliation(s)
- M Diaz
- Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK.,Swedish Red Cross University College, Huddinge, Sweden
| | - A Avila
- Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK.,Research Group for Cardiovascular and Respiratory Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - H Degens
- Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK.,Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania
| | - E Coeckelberghs
- Research Group for Cardiovascular and Respiratory Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - L Vanhees
- Research Group for Cardiovascular and Respiratory Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - V Cornelissen
- Research Group for Cardiovascular and Respiratory Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - M Azzawi
- Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, UK
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Landa A, Sánchez B, Diaz M, Otaño M, Medina A, Catalán CF, Santos A, Izquierdo L, La Casta Muñoa A. Splanchnic vein thrombosis in cholangiocarcinoma. A retrospective observational study. Donostia University Hospital. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rodriguez P, Briones D, Arenas G, Diaz M, Ulloa C. Surgical extraction of mesiodens using a vestibular-nasal approach: a case series and a discussion of the technique. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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24
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Jagdheesh R, Diaz M, Marimuthu S, Ocaña J. Chemical analysis on laser processed Ultrahydrophobic Ti-6Al-4V surface by high vacuum Process. Data Brief 2019; 22:954-959. [PMID: 30740477 PMCID: PMC6355998 DOI: 10.1016/j.dib.2019.01.015] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 12/20/2018] [Accepted: 01/07/2019] [Indexed: 12/01/2022] Open
Abstract
A technique has been developed for fabrication of ultrahydrophobic Ti-6Al-4V surface by vacuum process. This report has the data related to the article “Hybrid laser and vacuum process for rapid ultrahydrophobic Ti-6Al-4 V surface formation” on the fabrication of ultrahydrophobic Ti-6Al-4V by Vacuum process (Jagdheesh et al., 2019). The present data consist of X-ray photo electron spectroscopy spectrums recorded for the laser patterned ultrahydrophobic samples, droplet image and surface chemical composition of laser patterned Ti-6Al-4V samples before vacuum process(b. v. p.) and after vacuum process (a. v. p.) for 120 min. The presented data give a clear idea about the chemical modification evolved during the vacuum process.
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Affiliation(s)
- R. Jagdheesh
- Centro Láser, Universidad Politécnica de Madrid, Ctra. de Valencia Km, 7.3, 28031 Madrid, Spain
- Corresponding author.
| | - M. Diaz
- Centro Láser, Universidad Politécnica de Madrid, Ctra. de Valencia Km, 7.3, 28031 Madrid, Spain
| | - S. Marimuthu
- The Manufacturing Technology Centre, Coventry CV7 9JU, United Kingdom
| | - J.L. Ocaña
- Centro Láser, Universidad Politécnica de Madrid, Ctra. de Valencia Km, 7.3, 28031 Madrid, Spain
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25
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Ferri J, Ford JM, Roach BJ, Turner JA, van Erp TG, Voyvodic J, Preda A, Belger A, Bustillo J, O'Leary D, Mueller BA, Lim KO, McEwen SC, Calhoun VD, Diaz M, Glover G, Greve D, Wible CG, Vaidya JG, Potkin SG, Mathalon DH. Resting-state thalamic dysconnectivity in schizophrenia and relationships with symptoms. Psychol Med 2018; 48:2492-2499. [PMID: 29444726 DOI: 10.1017/s003329171800003x] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Schizophrenia (SZ) is a severe neuropsychiatric disorder associated with disrupted connectivity within the thalamic-cortico-cerebellar network. Resting-state functional connectivity studies have reported thalamic hypoconnectivity with the cerebellum and prefrontal cortex as well as thalamic hyperconnectivity with sensory cortical regions in SZ patients compared with healthy comparison participants (HCs). However, fundamental questions remain regarding the clinical significance of these connectivity abnormalities. METHOD Resting state seed-based functional connectivity was used to investigate thalamus to whole brain connectivity using multi-site data including 183 SZ patients and 178 matched HCs. Statistical significance was based on a voxel-level FWE-corrected height threshold of p < 0.001. The relationships between positive and negative symptoms of SZ and regions of the brain demonstrating group differences in thalamic connectivity were examined. RESULTS HC and SZ participants both demonstrated widespread positive connectivity between the thalamus and cortical regions. Compared with HCs, SZ patients had reduced thalamic connectivity with bilateral cerebellum and anterior cingulate cortex. In contrast, SZ patients had greater thalamic connectivity with multiple sensory-motor regions, including bilateral pre- and post-central gyrus, middle/inferior occipital gyrus, and middle/superior temporal gyrus. Thalamus to middle temporal gyrus connectivity was positively correlated with hallucinations and delusions, while thalamus to cerebellar connectivity was negatively correlated with delusions and bizarre behavior. CONCLUSIONS Thalamic hyperconnectivity with sensory regions and hypoconnectivity with cerebellar regions in combination with their relationship to clinical features of SZ suggest that thalamic dysconnectivity may be a core neurobiological feature of SZ that underpins positive symptoms.
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Affiliation(s)
- J Ferri
- Department of Psychiatry,University of California,San Francisco, San Francisco, CA,USA
| | - J M Ford
- Department of Psychiatry,University of California,San Francisco, San Francisco, CA,USA
| | - B J Roach
- San Francisco VA Health Care System,San Francisco, CA,USA
| | - J A Turner
- The Mind Research Network,Albuquerque, NM,USA
| | - T G van Erp
- Department of Psychiatry and Human Behavior,University of California,Irvine, Irvine, CA,USA
| | - J Voyvodic
- Department of Psychiatry,Duke University,Raleigh-Durham, NC,USA
| | - A Preda
- Department of Psychiatry and Human Behavior,University of California,Irvine, Irvine, CA,USA
| | - A Belger
- Department of Psychiatry,University of North Carolina,Chapel Hill, NC,USA
| | - J Bustillo
- Department of Psychiatry,University of New Mexico,Albuquerque, NM,USA
| | - D O'Leary
- Department of Psychiatry,University of Iowa,Iowa City, IA,USA
| | - B A Mueller
- Department of Psychiatry,University of Minnesota,Minneapolis, MN,USA
| | - K O Lim
- Department of Psychiatry,University of Minnesota,Minneapolis, MN,USA
| | - S C McEwen
- Department of Psychiatry,University of California,Los Angeles, Los Angeles, CA,USA
| | - V D Calhoun
- The Mind Research Network,Albuquerque, NM,USA
| | - M Diaz
- Department of Psychiatry,Duke University,Raleigh-Durham, NC,USA
| | - G Glover
- Department of Radiology,Stanford University,Stanford, CA,USA
| | - D Greve
- Department of Radiology,Massachusetts General Hospital,Boston, MA,USA
| | - C G Wible
- Department of Psychiatry,Harvard University,Boston, MA,USA
| | - J G Vaidya
- Department of Psychiatry,University of Iowa,Iowa City, IA,USA
| | - S G Potkin
- Department of Psychiatry and Human Behavior,University of California,Irvine, Irvine, CA,USA
| | - D H Mathalon
- Department of Psychiatry,University of California,San Francisco, San Francisco, CA,USA
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Wagner L, Singleton B, Diaz M, Spetz J, Brush B. FOREIGN NURSES EXPERIENCES AND PERCEPTIONS OF GERIATRIC CARE IN NURSING HOMES. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- L Wagner
- School of Nursing, San Francisco, California, United States
| | | | - M Diaz
- UCSF School of Nursing, San Francisco CA
| | - J Spetz
- UCSF School of Nursing, San Francisco, CA
| | - B Brush
- ANP-BC Univeristy of Michigan School of Nursing, Ann Arbor MI
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Pilnik N, Bengio V, Canigiani M, Diaz M. P31 Genetic Profile in NSLC Biopsy Samples - A Multicenter Local Study. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.07.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Abstract
Introduction Focussing on the potential role of cardiovascular cell therapy, we investigated the spatial relationship between pericytes (cells with cardiac repair capabilities that ensheath blood vessels) and endogenous cardiac progenitors within stem cells' niches. We explored possible changes in their co-localisation in developing human hearts from foetal to adult stage and following ischaemia. Methods Foetal and adult human heart specimens, obtained under ethical consent (University of Edinburgh ethics committee), were used for immunohistochemistry, cell isolation, culture and differentiation. Multi-lineage differentiation in culture, by single and double staining was completed for CD 146+ foetal pericytes and c-kit+ cells. Endothelial markers (CD31) gene expression was quantified by qPCR. Results c-kit+ cells frequency and coexpression with pericytes decrease with heart development, already evident by gestation week 19th. Pericytes and c-kit+ cells express the early cardiac transcription factors Nkx2.5 and Islet 1. Only c-kit+ cells express the stemness marker SSEA3 (24%), known to progressively decrease with cell differentiation. Endothelial differentiation assessment shows that cardiac pericytes and c-kit+ cells do not form CD31+ networks. This finding correlates with absence of staining for CD31 marker in both cultured cells' types. The cardiac marker α-actin was present in both cell populations. In healthy adult heart, pericyte markers CD146 localise within the vasculature. Following ischaemia this pericyte marker becomes also evident outside the vasculature.In healthy adult atrium, c-kit expression is low and coexpression with other markers inconspicuous. Ischaemia leads to increased c-kit expression, particularly in blood vessels <50um diameter. Furthermore, following ischaemia c-kit, endothelium and pericyte markers co-localise within the same atrial cells. Blood vessels >50μm diameter showed mostly only staining for endothelial (vWF) and pericyte (CD146) markers, with no co-expression of c-kit marker identified. Staining patterns within the ischaemic regions of the right and left atrial appendages revealed low levels of colocalisation between vWF and CD146. Acute ischaemia of the left ventricle affected the detection of cardiac stem cells markers in the area of injury, due to myocardium disruption. Conclusion Foetal heart pericytes and c-kit+ cells express early cardiac transcription factors and show trans-differentiation potential, which decreases in healthy adult hearts. The preservation and activity of cardiac stem cells niches within the atrium vasculature appears re-activated in post-ischaemic hearts. Better understanding of cardiac c-kit+ and pericyte cells during-human embryonic development and during ischaemia may identify alternative novel therapeutic strategy against coronary artery disease.
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Affiliation(s)
- D A Lerman
- MRC Centre for Regenerative Medicine, The University of Edinburgh, Edinburgh, United Kingdom, Regenerative Medicine - EDINBURGH - United Kingdom
| | - M Diaz
- University of Edinburgh, Edinburgh University Medical School Deanery of Biomedical Sciences - Edinburgh - United Kingdom
| | - B Peault
- MRC Centre for Regenerative Medicine, The University of Edinburgh, Edinburgh, United Kingdom, Regenerative Medicine - EDINBURGH - United Kingdom
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Diaz M, Caro J, Salas A, Carrasco X, Mena B. Differences in rem muscle activity among patients with Parkinson´s disease related REM sleep behaviour disorder and patients with suspected OSA. chilean experience with sinbar montages. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Fernández-Lucas M, Ruperto Lope M, Diaz M, Rodríguez-Mendiola N, Ruíz-Roso G, Teruel J, Liaño F. MON-P126: Controlled Randomized Study in Anorexic Hemodialysis Patients Treated with Megestrol Acetate Compared with Placebo. Clin Nutr 2017. [DOI: 10.1016/s0261-5614(17)30959-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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32
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Ortiz-Bautista C, Diaz M, Delgado-Nicolas M, Moran-Fernandez L, De Juan-Baguda J, Ponz I, Rodriguez-Chaverri A, Lora-Pablos D, Delgado-Jimenez J. P585Evaluation of a nurse-led cross intervention program in heart failure. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Simon P, Diaz M, Cusick M, Santoni B, Frankle M. 3D image-based morphometric analysis of the scapular neck length in subjects undergoing reverse shoulder arthroplasty. Clin Anat 2017; 31:43-55. [PMID: 28514491 DOI: 10.1002/ca.22911] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 04/26/2017] [Accepted: 04/26/2017] [Indexed: 01/31/2023]
Abstract
Scapular notching after RSA may, in part, be related to a patient's scapular morphology. The purpose of this study was to develop a novel 3 D measurement technique to describe infraglenoid tubercle morphometry. We hypothesize that the parameters describing infraglenoid tubercle would be normally distributed and would correlate with individual's demographics and glenoid morphometry. A group of 110 subjects treated with RSA were evaluated. Scapular geometry was obtained from pre-operative CT scans. The scapular neck length was defined in anterior and posterior view as the orthogonal distance between the glenoid surface and (a) the point of most significant change of curvature on lateral pillar; (b) the most lateral portion of the infraglenoid tubercle. Scapular neck angle, maximum anatomical adduction angle, glenoid width, height and version were also measured. Scapular neck length measured in the anterior and posterior view were normally distributed with mean values of 17.6 ± 2.8 mm and 7.9 ± 2.5 mm, respectively. Scapular neck angle was on average 112.4 ± 10.6° and maximal adduction angle was 17.6 ± 2.8°. No significant associations between infraglenoid tubercle morphometric parameters, demographic, glenoid size or version were identified. Improved understanding of the patient-specific risk factors for scapular notching will help surgeons with pre-surgical planning and implant selection. Parametrization of the infraglenoid tubercle presented in this study showed normal distribution in the population unrelated to gender, side or demographics. The size of the infraglenoid tubercle is a unique trait, pre-operative evaluation of the scapular neck should be always warranted to decrease the incidence of post-operative notching. Clin. Anat. 31:43-55, 2018. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- P Simon
- Phillip Spiegel Orthopaedic Research Laboratory, Foundation for Orthopaedic Research and Education, Tampa, Florida.,Department of Orthopaedic and Sport Medicine, University of South Florida, Tampa, Florida
| | - M Diaz
- Phillip Spiegel Orthopaedic Research Laboratory, Foundation for Orthopaedic Research and Education, Tampa, Florida
| | - M Cusick
- Department of Shoulder and Elbow Surgery, Florida Orthopaedic Institute, Tampa, Florida
| | - B Santoni
- Phillip Spiegel Orthopaedic Research Laboratory, Foundation for Orthopaedic Research and Education, Tampa, Florida.,Department of Orthopaedic and Sport Medicine, University of South Florida, Tampa, Florida
| | - M Frankle
- Department of Orthopaedic and Sport Medicine, University of South Florida, Tampa, Florida.,Department of Shoulder and Elbow Surgery, Florida Orthopaedic Institute, Tampa, Florida
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Micozzi S, Bartolomé B, Sanchís-Merino ME, Alfaya T, Aldunate T, Diaz M, Pastor-Vargas C. Hypersensitivity to Quail Egg Proteins: What About Hen Egg? J Investig Allergol Clin Immunol 2017; 26:316-318. [PMID: 27763859 DOI: 10.18176/jiaci.0076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- S Micozzi
- University General Hospital Gregorio Marañón, Madrid, Spain.,Gregorio Marañón Health Research Institute, Madrid, Spain
| | - B Bartolomé
- R&D Department Bial-Aristegui, Bilbao, Spain
| | | | - T Alfaya
- University General Hospital of Ciudad Real, Ciudad Real, Spain
| | - T Aldunate
- Hospital Reina Sofía of Tudela, Navarra, Spain
| | - M Diaz
- University and Polytechnic Hospital La Fe, Valencia, Spain
| | - C Pastor-Vargas
- Immunology Department, IIS-Fundación Jiménez Díaz, Madrid, Spain
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Plascencia H, Diaz M, Gascon G, Garduno S, Guerrero-Bobadilla C, Marquez-De Alba S, Gonzalez-Barba G. Management of permanent teeth with necrotic pulps and open apices according to the stage of root development. J Clin Exp Dent 2017; 9:e1329-e1339. [PMID: 29302286 PMCID: PMC5741847 DOI: 10.4317/jced.54287] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 10/09/2017] [Indexed: 11/05/2022] Open
Abstract
Background Material and Methods Results Conclusions
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Clark D, Wong K, Diaz M, Olch A. Pilot Study to Implement a Quality of Life Survey as a Clinical Tool in an Underserved Pediatric Cancer Population. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1947] [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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Beltrán-Catalán E, Calvo-Rio V, Blanco-Alonso R, Fernandez C, Rodriguez P, Hernandez M, Herreras J, Cordero M, Mesquida M, Adan A, Hernandez M, Diaz-Valle D, Torre I, Diaz M, Maiz O, Insua S, Francisco F, Almodovar R, Ruiz O, Jimenez F, Manero J, Gandia M, Nolla J, Gonzalez-Gay M. FRI0485 Comparative Study on Adalimumab vs Infliximab for Treatment of Uveitic Cystoid Macular Edema Due To Behcet's Disease. Multicentre Study of 34 Patients. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
Ultrahydrophobic self cleaning surface is fabricated with nanosecond laser source on aluminium foil.
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Affiliation(s)
- R. Jagdheesh
- Centro Láser
- Universidad Politécnica de Madrid
- Madrid
- Spain
| | - M. Diaz
- Centro Láser
- Universidad Politécnica de Madrid
- Madrid
- Spain
| | - J. L. Ocaña
- Centro Láser
- Universidad Politécnica de Madrid
- Madrid
- Spain
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Martinez EA, Nohalez A, Martinez CA, Parrilla I, Vila J, Colina I, Diaz M, Reixach J, Vazquez JL, Roca J, Cuello C, Gil MA. The Recipients' Parity Does Not Influence Their Reproductive Performance Following Non-Surgical Deep Uterine Porcine Embryo Transfer. Reprod Domest Anim 2015; 51:123-9. [PMID: 26661993 DOI: 10.1111/rda.12654] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 11/16/2015] [Indexed: 12/19/2022]
Abstract
With the development of the non-surgical deep uterine (NsDU) embryo transfer (ET) technology, the commercial applicability of ET in pigs is now possible. There are, nevertheless, many factors that influence NsDU-ET effectiveness that need to be addressed. The aim of this study was to evaluate the effects of the weaned recipients' parity on fertility and prolificacy following NsDU-ET. The recipients (n = 120) were selected based on their reproductive history and body condition and grouped into three categories according to their parity: primiparous sows, sows of parity 2 and sows of parities from 3 to 5. Thirty fresh embryos (morulae and unhatched blastocysts) were non-surgically transferred into one uterine horn of each recipient. It was possible to insert the NsDU-ET catheter through the cervix along a uterine horn in 98.3% of the recipients. The parity had no influence on the difficulty grade of the insertions or on the percentage of correct insertions. The cervix and uterine wall were not perforated during the insertions, and vaginal discharge was not observed after transfer in any of the recipients. There were no differences in the pregnancy rates (74.8%), farrowing rates (71.2%) or litter sizes (9.6 ± 3.3) between groups. Also, there were no differences between groups regarding to the piglets' birthweights or piglet production efficiency. In conclusion, these results demonstrate that weaned sows from parity 1 to 5 are appropriate to be used as recipients in NsDU-ET programs, which increase the possibilities for the utilization of ET in the recipient farms.
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Affiliation(s)
- E A Martinez
- Department of Animal Medicine and Surgery, University of Murcia, Murcia, Spain
| | - A Nohalez
- Department of Animal Medicine and Surgery, University of Murcia, Murcia, Spain
| | - C A Martinez
- Department of Animal Medicine and Surgery, University of Murcia, Murcia, Spain
| | - I Parrilla
- Department of Animal Medicine and Surgery, University of Murcia, Murcia, Spain
| | - J Vila
- Department of Research and Development, Selección Batallé S.A., Girona, Spain
| | - I Colina
- Department of Research and Development, Selección Batallé S.A., Girona, Spain
| | - M Diaz
- Department of Research and Development, Selección Batallé S.A., Girona, Spain
| | - J Reixach
- Department of Research and Development, Selección Batallé S.A., Girona, Spain
| | - J L Vazquez
- Department of Animal Medicine and Surgery, University of Murcia, Murcia, Spain
| | - J Roca
- Department of Animal Medicine and Surgery, University of Murcia, Murcia, Spain
| | - C Cuello
- Department of Animal Medicine and Surgery, University of Murcia, Murcia, Spain
| | - M A Gil
- Department of Animal Medicine and Surgery, University of Murcia, Murcia, Spain
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Freire M, Gromaz J, Diaz M, Alonso E, Aspe B, Atanes A, Bejerano M, Blanco F, Graña J, Lopez C, Oreiro N, Pinto J, De Toro F. AB1257-HPR Project to Develop Support Materials for Teaching and Training in Rheumatology Using Icts: Two Years of Experience at the Rheumatology Service of the Complexo Hospitalario Universitario de a Coruña. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Diaz M, Villota O, Ceron C, Moller I, Naredo E, Saabi D. AB1075 From a Formal Training Program in Musculoskeletal Ultrasound (MSKUS) to a High Reproducibility for Doppler Ultrasound in Rheumatoid Arthritis: The Lucky Experience. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Garcia-Carazo S, de Miguel E, Martinez-Feito A, Pascual-Salcedo D, Arribas-Arribas M, Jermann T, Diaz M, Martin-Mola E, Balsa A. THU0112 Utility of Calprotectin Levels as a Marker of Remission in Rheumatoid Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Beamud SG, León JG, Kruk C, Pedrozo F, Diaz M. Using trait-based approaches to study phytoplankton seasonal succession in a subtropical reservoir in arid central western Argentina. Environ Monit Assess 2015; 187:271. [PMID: 25893768 DOI: 10.1007/s10661-015-4519-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Accepted: 04/09/2015] [Indexed: 06/04/2023]
Abstract
The application of trait-based approaches has become a widely applied tool to analyse community assembly processes and dynamics in phytoplankton communities. Its advantages include summarizing information of many species without losing essentials of the main driving processes. Here, we used trait-based approaches to study phytoplankton temporal succession in a subtropical reservoir. We applied a combined approach including morphological traits (i.e. volume, surface) and functional clustering of species (morphology-based functional groups (MBFG) and Reynolds' groups) and related the clustering of species with the environment. We found that this reservoir is characterized by a low richness and a bimodal distribution of phytoplankton biomass. Taxonomic and functional classifications were coincident, and the dominant species and groups biomasses were explained by the same group of variables. For instance, group X₂, MBFG V and Carteria sp. biomasses were explained by: pH, Secchi disk depth, N-NH₄; while group B, MBFG VI and Cyclotella ocellata biomasses were explained by stability of the water column, incident solar radiation, Secchi disk depth and N-NH4. From our results, we state that functional and taxonomic classifications are complementary rather than opposed approaches, and their specific uses depend exclusively on the aim of the study and the characteristics of the environment under evaluation. Our work is the first description of phytoplankton dynamics in a reservoir in the arid central western Argentina (Cuyo region).
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Affiliation(s)
- S G Beamud
- INIBIOMA (CONICET), Centro Regional Universitario Bariloche, Universidad Nacional del Comahue, Quintral 1250, 8400, Bariloche, Argentina,
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López-Jaramillo P, Sánchez RA, Diaz M, Cobos L, Bryce A, Parra-Carrillo JZ, Lizcano F, Lanas F, Sinay I, Sierra ID, Peñaherrera E, Bendersky M, Schmid H, Botero R, Urina M, Lara J, Foss MC, Márquez G, Harrap S, Ramírez AJ, Zanchetti A. [Latin American consensus on hypertension in patients with diabetes type 2 and metabolic syndrome]. ACTA ACUST UNITED AC 2015; 58:205-25. [PMID: 24863082 DOI: 10.1590/0004-2730000003019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2013] [Accepted: 03/06/2014] [Indexed: 12/30/2022]
Abstract
The present document has been prepared by a group of experts, members of cardiology, endocrinology, internal medicine, nephrology and diabetes societies of Latin American countries, to serve as a guide to physicians taking care of patients with diabetes, hypertension and comorbidities or complications of both conditions. Although the concept of metabolic syndrome is currently disputed, the higher prevalence in Latin America of that cluster of metabolic alterations has suggested that metabolic syndrome is a useful nosography entity in the context of Latin American medicine. Therefore, in the present document, particular attention is paid to this syndrome in order to alert physicians on a particular high-risk population, usually underestimated and undertreated. These recommendations result from presentations and debates by discussion panels during a 2-day conference held in Bucaramanga, in October 2012, and all the participants have approved the final conclusions. The authors acknowledge that the publication and diffusion of guidelines do not suffice to achieve the recommended changes in diagnostic or therapeutic strategies, and plan suitable interventions overcoming knowledge, attitude and behavioural barriers, preventing both physicians and patients from effectively adhering to guideline recommendations.
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Affiliation(s)
- Patricio López-Jaramillo
- Fundación Oftalmológica de Santander FOSCAL, Universidad de Santander UDES, Bucaramanga, Colômbia
| | - Ramiro A Sánchez
- Unidad de Metabolismo e Hipertensión Arterial, Hospital Universitario, Fundación Favaloro, Buenos Aires, Argentina
| | | | | | | | | | - Fernando Lizcano
- Asociación Colombiana de Endocrinología, Universidad de la Sabana, Bogotá, Colômbia
| | | | - Isaac Sinay
- Instituto Cardiológico de Buenos Aires, Buenos aires, Argentina
| | - Iván D Sierra
- Asociación Latinoamericana de Diabetes, Bogotá, Colômbia
| | | | | | - Helena Schmid
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil
| | | | - Manuel Urina
- Sociedad Colombiana de Cardiología, Bogotá, Colômbia
| | - Joffre Lara
- Sociedad Ecuatoriana de Aterosclerosis, Guayaquil, Equador
| | | | | | | | - Agustín J Ramírez
- Unidad de Metabolismo e Hipertensión Arterial, Hospital Universitario, Fundación Favaloro, Buenos Aires, Argentina
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Alford SH, Rattan R, Diaz M, Munkarah A. Association of high-density lipoprotein cholesterol with ovarian cancer diagnosis. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2015.01.458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Diaz M, Manuel C, Ana V, Esther D, Sergio P, Eva Maria G, Nuria M, Gregorio R, Jose M. DI-001 Analysis of the use, effectiveness and safety of treatment with Trastuzumab-Emtansine in metastatic breast cancer. Eur J Hosp Pharm 2015. [DOI: 10.1136/ejhpharm-2015-000639.180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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López AM, Noriega LG, Diaz M, Torres N, Tovar AR. Plasma branched-chain and aromatic amino acid concentration after ingestion of an urban or rural diet in rural Mexican women. BMC Obes 2015. [PMID: 26217523 PMCID: PMC4511236 DOI: 10.1186/s40608-015-0038-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background People living in rural areas are prone to move to urban cities experiencing a dramatic change in the type of protein consumed. However, it is not know if those changes are associated with changes in the plasma amino acid concentration, especially the branched chain amino acids. Thus, the aim of the present study was to evaluate, in a rural Mexican population, the plasma amino acid profile after consumption of typical Mexican rural or urban diet. Results We evaluated the plasma amino acid concentrations of women from a rural population at 0, 30, 60, 90, 120, 180 and 240 min after ingestion of a typical Mexican rural or urban diet. Ingestion of a Mexican urban diet induced a higher increase in leucine, isoleucine, valine, phenylalanine, tyrosine and proline than ingestion of a Mexican rural diet in women from a Mexican rural population. Arginine, histidine, lysine, threonine, alanine, glycine and serine had the same area under the curve regardless of the experimental diet. Conclusions Ingestion of a Mexican urban diet induced a higher increase in leucine, isoleucine, valine, phenylalanine, tyrosine and proline than ingestion of a Mexican rural diet in women from a Mexican rural area.
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Affiliation(s)
- Adriana M López
- Departamento de Fisiología de la Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, México
| | - Lilia G Noriega
- Departamento de Fisiología de la Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, México
| | - Margarita Diaz
- Departamento de Fisiología de la Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, México
| | - Nimbe Torres
- Departamento de Fisiología de la Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, México
| | - Armando R Tovar
- Departamento de Fisiología de la Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, México
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Wittenmyer RA, Tuomi M, Butler RP, Jones HRA, Anglada-Escudé G, Horner J, Tinney CG, Marshall JP, Carter BD, Bailey J, Salter GS, O'Toole SJ, Wright D, Crane JD, Schectman SA, Arriagada P, Thompson I, Minniti D, Jenkins JS, Diaz M. GJ 832c: A SUPER-EARTH IN THE HABITABLE ZONE. ACTA ACUST UNITED AC 2014. [DOI: 10.1088/0004-637x/791/2/114] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Sanz N, Diaz M, López-Bermejo A, Sierra C, Fernández A, de Zegher F, Ibáñez L. Newborns with lower levels of circulating polyunsaturated fatty acids (PUFA) are abdominally more adipose. Pediatr Obes 2014; 9:e68-72. [PMID: 24311559 DOI: 10.1111/j.2047-6310.2013.00200.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Revised: 08/13/2013] [Accepted: 08/15/2013] [Indexed: 01/09/2023]
Abstract
BACKGROUND Maternal nutrition is the main source of Poly-Unsaturated Fatty Acids (PUFA) for the fetus. PUFA may influence the accumulation of fat in early life. OBJECTIVES & METHODS In 33 breastfed infants born appropriate-for-gestational-age, we studied whether body composition (judged by absorptiometry at 2 wk and 4 mo) relates to PUFA levels (assessed by gas chromatography) in the maternal or fetal circulation at birth. RESULTS Abdominal fat at 2 wk associated negatively to umbilical-cord levels of separate PUFA (linoleic, arachidonic, eicosapentanoic and docosahexaenoic acid; all P between 0.001 and 0.015). Collectively, the assessed n-6 PUFA on one hand and the n-3 PUFA on the other hand associated negatively to the absolute amount of abdominal fat (in grams; P = 0.001 and P = 0.002, respectively) and to the relative amount of abdominal fat (fraction of total fat; P = 0.001 and P = 0.006, respectively). No other significant associations were observed. CONCLUSION In conclusion, newborns with lower levels of circulating PUFA were found to be abdominally more adipose. The mechanisms underpinning these associations remain to be determined.
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Affiliation(s)
- N Sanz
- Endocrinology Unit, Hospital Sant Joan de Déu, University of Barcelona, Esplugues, Barcelona, Spain
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