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Racca A, Alvarez M, Garcia Martinez S, Rodriguez I, Gonzalez-Foruria I, Polyzos NP, Coroleu B. Assessment of progesterone levels on the day of pregnancy test determination: A novel concept toward individualized luteal phase support. Front Endocrinol (Lausanne) 2023; 14:1090105. [PMID: 36817599 PMCID: PMC9929287 DOI: 10.3389/fendo.2023.1090105] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/11/2023] [Indexed: 02/04/2023] Open
Abstract
RESEARCH QUESTION The main objective of the study is to define the optimal trade-off progesterone (P4) values on the day of embryo transfer (ET), to identify low P4-human chorionic gonadotropin (hCG), and to establish whether P4 supplementation started on the hCG day can increase the success rate of the frozen embryo transfer (FET) cycle. DESIGN A single-center, cohort, retrospective study with 664 hormone replacement therapy (HRT)-FET cycles analyzed female patients who received vaginal 600 mg/day of P4 starting from 6 days before the FET, had normal P4 values on the day before ET, and whose P4 on the day of the pregnancy test was assessed. RESULTS Of the 664 cycles, 69.6% of cycles showed P4 ≥ 10.6 ng/ml, while 30.4% showed P4 < 10.6 ng/ml on the day of the hCG. Of the 411 chemical pregnancies detected, 71.8% had P4-hCG ≥ 10.6 ng/ml (group A), while 28.2% had P4-hCG < 10.6 ng/ml. Of the cycles with P4-hCG < 10.6 ng/ml, 64.7% (group B) were supplemented with a higher dose of vaginal P4 (1,000 mg/day), while 35.3% (group C) were maintained on the same dose of vaginal micronized P4. The live birth rate was 71.9%, 96%, and 7.3% for groups A, B, and C, respectively. CONCLUSION The likelihood to detect P4-hCG < 10.6 ng/ml decreased as the level of serum P4 the day before ET increased. The live birth rate (LBR) was shown to be significantly lower when P4 was low and not supplemented.
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Affiliation(s)
- A. Racca
- Department of Obstetrics Gynecology and Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
- *Correspondence: A Racca,
| | - M. Alvarez
- Department of Obstetrics Gynecology and Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
| | - S. Garcia Martinez
- Department of Obstetrics Gynecology and Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
| | - I. Rodriguez
- Department of Obstetrics Gynecology and Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
| | - I. Gonzalez-Foruria
- Department of Obstetrics Gynecology and Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
- Facultad de Medicina Universitat de Vic-Universitat Central de Catalunya, Vic, Spain
| | - NP. Polyzos
- Department of Obstetrics Gynecology and Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - B. Coroleu
- Department of Obstetrics Gynecology and Reproductive Medicine, Dexeus University Hospital, Barcelona, Spain
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Cain A, Alvarez M, Salazar C. Increase in Complications Following Vaginal Hysterectomy Compared to Laparoscopic Hysterectomy Using the ACS-NSQIP 2016 – 2019 Database. J Minim Invasive Gynecol 2022. [DOI: 10.1016/j.jmig.2022.09.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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3
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Racca A, Prats P, Garcias S, Alvarez M, Coroleu B, Polyzos N. P-403 Progesterone supplementation in frozen embryo transfer with hormonal replacement therapy is associated with a higher incidence of macrosomia. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Study question
Is there an impact of increased progesterone (P4) supplementation in hormone replacement therapy (HRT) frozen embryo transfer (FET) on obstetrical and neonatal outcomes?
Summary answer
Increased P4 supplementation from the day of FET is associated with a significantly higher risk of macrosomia and a slightly higher risk of preeclampsia.
What is known already
The most widely used method for endometrial preparation prior to FET is HRT, a sequential regimen with E2 and P4, which aims to mimic the endocrine exposure of the endometrium of the physiological cycle. However, in ∼40% of the patients undergoing HRT-FET cycles P4 levels before FET remain low and this may negatively affect pregnancy rates. Although recent prospective studies have shown that additional P4 supplementation in case of low serum P4 levels results in excellent reproductive outcomes, no data exist concerning the potential effect of this extra amount of P4 on obstetrical and neonatal outcomes
Study design, size, duration
This is a single-centre, retrospective-observational study. Women undergoing HRT-FET treatment meeting the inclusion criteria were allocated to one of the 2 study groups according to the P4 supplementation. Group A (277) included women with adequate levels (>10.6 ng/ml) of P4, while group B (129) included women who received P4 supplementation due to inadequate levels of P4 (<10.6 ng/ml) on the day before the FET. All FET-HRT cycles were performed between February 2018 and December 2020.
Participants/materials, setting, methods
All patients received micronized P4 (200 mg trice a day) starting six days prior to the FET and continued until 10 weeks of pregnancy. In case P4<10.6 ng/ml, P4 supplementation was initiated rather with 400mg more micronized P4 (15%) or with subcutaneous P4 (25mg more/once a day) (85%). Only patients with day5-embryos, known P4 levels prior to FET, known obstetrical and neonatal outcomes were included. Multivariable-logistic-model was fitted for macrosomia after adjusting for confounding variables.
Main results and the role of chance
Patients’ age at oocyte retrieval was 33.5 and 33.6 years (p = 0.833), while the age at delivery was 39.9 and 39.1 years (p = 0.099), respectively for groups A and B. The incidence of diabetes, hypertension, autoimmune diseases, coagulation, and kidney disorders was comparable for both arms. The mean value of P4 was 16 ± 7.7 and 8.2 ± 1.9, respectively for groups A and B. The mean gestational length was 39 weeks in both arms, with comparable rates of premature deliveries (delivery <37 weeks respectively 4.3% and 3.1 % for group A and B; p = 0.553). The rate of cesarean-section was 56% vs 47.3%, respectively for groups A and B (p = 0.103); there were 5 cases of pre-eclampsia in group A and 7 in group B (1.8% vs 5.4%; p = 0.059). The incidence of macrosomia was significantly higher in group B (6.1% vs 12.4%; P = 0.031). Similarly, group B had a higher rate of BGA-big for gestational age- babies (9.7 vs 15.5, p = 0.091). In terms of weight at delivery, pH, Apgar, and sex the two groups were comparable. Multivariable-logistic regression showed an association between macrosomia and P4 supplementation, adjusting for potential confounders such as sex, gestational diabetes, and weeks of gestation (OR 2.3, 95% CI 1.1-4.8).
Limitations, reasons for caution
The main limitation of this study is its retrospective nature. Other potential limitations are the small sample size to detect obstetrical diseases with low incidence, such as preeclampsia. Furthermore, in our study population the PE rate is lower than in the general population, due to socioeconomic-conditions, race, and previous morbidity.
Wider implications of the findings
P4-supplemented patients have a higher risk of macrosomia and a tendency for a higher risk of preeclampsia. However, more studies are needed to confirm the present exploratory findings and explain the possible physiological mechanisms underlying the association between progesterone supplementation on macrosomia and preeclampsia.
Trial registration number
NA
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Affiliation(s)
- A Racca
- Dexeus University Hospital, Reproductive Medicine Service , Barcelona, Spain
| | - P Prats
- Dexeus University Hospital, Obstetric and Gynecology Service , Barcelona, Spain
| | - S Garcias
- Dexeus University Hospital, Reproductive Medicine Service , Barcelona, Spain
| | - M Alvarez
- Dexeus University Hospital, Reproductive Medicine Service , Barcelona, Spain
| | - B Coroleu
- Dexeus University Hospital, Reproductive Medicine Service , Barcelona, Spain
| | - N.P Polyzos
- Dexeus University Hospital, Reproductive Medicine Service , Barcelona, Spain
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4
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Hassan MAA, Sayed RKA, Abdelsabour-Khalaf M, Abd-Elhafez EA, Anel-Lopez L, Riesco MF, Ortega-Ferrusola C, Montes-Garrido R, Neila-Montero M, Anel L, Alvarez M. Morphological and ultrasonographic characterization of the three zones of supratesticular region of testicular artery in Assaf rams. Sci Rep 2022; 12:8334. [PMID: 35585142 PMCID: PMC9117313 DOI: 10.1038/s41598-022-12243-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 05/09/2022] [Indexed: 11/25/2022] Open
Abstract
To fully understand the histological, morphometrical and heamodynamic variations of different supratesticular artery regions, 20 mature and healthy Assaf rams were examined through ultrasound and morphological studies. The testicular artery images of the spermatic cord as shown by B-mode analysis indicated a tortuous pattern along its course toward the testis, although it tends to be less tortuous close to the inguinal ring. Doppler velocimetric values showed a progressive decline in flow velocity, in addition to pulsatility and vessel resistivity when entering the testis, where there were significant differences in the Doppler indices and velocities among the different regions. The peak systolic velocity, pulsatility index and resistive index were higher in the proximal supratesticular artery region, followed by middle and distal ones, while the end diastolic velocity was higher in the distal supratesticular region. The total arterial blood flow and total arterial blood flow rate reported a progressive and significant increase along the testicular cord until entering the testis. Histological examination revealed presence of vasa vasorum in the tunica adventitia, with their diameter is higher in the proximal supratesticular zone than middle and distal ones. Morphometrically, the thickness of the supratesticular artery wall showed a significant decline downward toward the testis; meanwhile, the outer arterial diameter and inner luminal diameter displayed a significant increase distally. The expression of alpha smooth muscle actin and vimentin was higher in the tunica media of the proximal supratesticular artery zone than in middle and distal ones.
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Affiliation(s)
- Mohamed A A Hassan
- Department of Anatomy and Embryology, Faculty of Veterinary Medicine, Sohag University, Sohag, 82524, Egypt
| | - Ramy K A Sayed
- Department of Anatomy and Embryology, Faculty of Veterinary Medicine, Sohag University, Sohag, 82524, Egypt
| | - Mohammed Abdelsabour-Khalaf
- Department of Anatomy and Embryology, Faculty of Veterinary Medicine, South Valley University, Qena, 83523, Egypt
| | - Enas A Abd-Elhafez
- Department of Anatomy and Histology, Faculty of Veterinary Medicine, Assiut University, Assiut, 71526, Egypt
| | - L Anel-Lopez
- ITRA-ULE, INDEGSAL, University of León, 24071, León, Spain. .,Department of Veterinary Medicine, Surgery and Anatomy, University of León, 24071, León, Spain.
| | - M F Riesco
- ITRA-ULE, INDEGSAL, University of León, 24071, León, Spain.,Cellular Biology, Department of Molecular Biology, University of León, 24071, León, Spain
| | - C Ortega-Ferrusola
- Laboratory of Equine Reproduction and Equine Spermatology, Veterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
| | - R Montes-Garrido
- ITRA-ULE, INDEGSAL, University of León, 24071, León, Spain.,Department of Veterinary Medicine, Surgery and Anatomy, University of León, 24071, León, Spain
| | - M Neila-Montero
- ITRA-ULE, INDEGSAL, University of León, 24071, León, Spain.,Department of Veterinary Medicine, Surgery and Anatomy, University of León, 24071, León, Spain
| | - L Anel
- ITRA-ULE, INDEGSAL, University of León, 24071, León, Spain.,Department of Veterinary Medicine, Surgery and Anatomy, University of León, 24071, León, Spain
| | - M Alvarez
- ITRA-ULE, INDEGSAL, University of León, 24071, León, Spain.,Department of Veterinary Medicine, Surgery and Anatomy, University of León, 24071, León, Spain
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5
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Redding LE, Tu V, Abbas A, Alvarez M, Zackular JP, Gu C, Bushman FD, Kelly DJ, Barnhart D, Lee JJ, Bittinger KL. Genetic and phenotypic characteristics of Clostridium (Clostridioides) difficile from canine, bovine, and pediatric populations. Anaerobe 2022; 74:102539. [PMID: 35217150 PMCID: PMC9359814 DOI: 10.1016/j.anaerobe.2022.102539] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/02/2022] [Accepted: 02/17/2022] [Indexed: 12/15/2022]
Abstract
Objectives: Carriage of Clostridioides difficile by different species of animals has led to speculation that animals could represent a reservoir of this pathogen for human infections. The objective of this study was to compare C. difficile isolates from humans, dogs, and cattle from a restricted geographic area. Methods: C. difficile isolates from 36 dogs and 15 dairy calves underwent whole genome sequencing, and phenotypic assays assessing growth and virulence were performed. Genomes of animal-derived isolates were compared to 29 genomes of isolates from a pediatric population as well as 44 reference genomes. Results: Growth rates and relative cytotoxicity of isolates were significantly higher and lower, respectively, in bovine-derived isolates compared to pediatric- and canine-derived isolates. Analysis of core genes showed clustering by host species, though in a few cases, human strains co-clustered with canine or bovine strains, suggesting possible interspecies transmission. Geographic differences (e.g., farm, litter) were small compared to differences between species. In an analysis of accessory genes, the total number of genes in each genome varied between host species, with 6.7% of functional orthologs differentially present/absent between host species and bovine-derived strains having the lowest number of genes. Canine-derived isolates were most likely to be non-toxigenic and more likely to carry phages. A targeted study of episomes identified in local pediatric strains showed sharing of a methicillin-resistance plasmid with dogs, and historic sharing of a wide range of episomes across hosts. Bovine-derived isolates harbored the widest variety of antibiotic-resistance genes, followed by canine Conclusions: While C. difficile isolates mostly clustered by host species, occasional co-clustering of canine and pediatric-derived isolates suggests the possibility of interspecies transmission. The presence of a pool of resistance genes in animal-derived isolates with the potential to appear in humans given sufficient pressure from antibiotic use warrants concern.
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Affiliation(s)
- L E Redding
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania, School of Veterinary Medicine, Kennett Square, PA, 19348, USA.
| | - V Tu
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, PA, 19104, USA
| | - A Abbas
- Division of Protective Immunity, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - M Alvarez
- Division of Protective Immunity, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA
| | - J P Zackular
- Division of Protective Immunity, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA; Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - C Gu
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - F D Bushman
- Department of Microbiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - D J Kelly
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania, School of Veterinary Medicine, Kennett Square, PA, 19348, USA
| | - D Barnhart
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania, School of Veterinary Medicine, Kennett Square, PA, 19348, USA
| | - J J Lee
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, PA, 19104, USA
| | - K L Bittinger
- Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, PA, 19104, USA
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Pérez-Blanco A, López-Fraga M, Forsythe J, Pires Silva AM, Cardillo M, Novotná P, Tullius SG, Cozzi E, Ashkenazi T, Delmonico FL, Domínguez-Gil B, Brix-Zuleger M, Colenbie L, Tsoneva D, Bušić M, Nicolaos M, Adamec M, Makisalo H, Arrabal S, Pérel Y, Cantrelle C, Legeai C, Rahmel A, Menoudakou G, Sándor M, Lavee J, Bellis L, Ciaccio P, Gembutiene V, Abela C, Codrenau I, Kaminski A, Kratka M, Avsec D, Alvarez M, Carmona M, Beyeler F, Thaqi A, Haase B, Ünsal İ, Gardiner D, McGowan O, Branger P, Ericzon BG, Birrell L. Access of non-residents to transplantation of deceased donor organs: practices and strategies in the European setting. Transpl Int 2021; 34:2112-2121. [PMID: 34553794 DOI: 10.1111/tri.14113] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 11/30/2022]
Abstract
The access of non-resident patients to the deceased donor waiting list (DDWL) poses different challenges. The European Committee on Organ Transplantation of the Council of Europe (CD-P-TO) has studied this phenomenon in the European setting. A questionnaire was circulated among the Council of Europe member states to inquire about the criteria applied for non-residents to access their DDWL. Information was compiled from 28 countries. Less than 1% of recipients of deceased donor organs were non-residents. Two countries never allow non-residents to access the DDWL, four allow access without restrictions and 22 only under specific conditions. Of those, most give access to non-resident patients already in their jurisdictions who are in a situation of vulnerability (urgent life-threatening conditions). In addition, patients may be given access: (i) after assessment by a specific committee (four countries); (ii) within the framework of official cooperation agreements (15 countries); and (iii) after patients have officially lived in the country for a minimum length of time (eight countries). The ethical and legal implications of these policies are discussed. Countries should collect accurate information about residency status of waitlisted patients. Transparent criteria for the access of non-residents to DDWL should be clearly defined at national level.
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Affiliation(s)
| | - Marta López-Fraga
- European Directorate for the Quality of Medicines & HealthCare (EDQM), Council of Europe, Strasbourg, France
| | | | - Ana M Pires Silva
- Instituto Português de Sangue e da Transplantação (IPST), Lisbon, Portugal
| | - Massimo Cardillo
- Centro Nazionale Trapianti-Istituto Superiore di Sanità (CNT-ISS), Rome, Italy
| | - Petra Novotná
- Koordinační středisko transplantací (KST), Prague, Czech Republic
| | - Stefan G Tullius
- Division of Transplant Surgery, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
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7
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Benavides M, Alcaide-Garcia J, Torres E, Gil S, Durán G, Reyna C, Wolman R, Alvarez M, Kushnir M, Faull I, Muñoz M, Alba E. 503P Mutational landscape in synchronous unresectable metastatic colorectal cancer (mCRC) according to upfront primary tumour resection (UPTR). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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8
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Alvarez M, Racca A, García S, Martínez F, González-Foruria I, Parriego M, Coroleu B. P–672 Higher pregnancy outcomes in patients undergoing embryo transfer-under hormonal replacement therapy where an individualised Progesterone supplementation was applied on the day of β-hCG. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Does progesterone-supplementation (PS) from the day of β-hCG assessment improve pregnancy rates in embryo transfer-under hormonal replacement therapy (ET-HRT) in patient with Progesterone (P)<10.6 ng/mL?
Summary answer
Reduced P on the β-hCG day is associated with lower pregnancy-rates and higher miscarriage-rate. PS from the same day showed significant increase of reproductive outcomes.
What is known already
Up until now, in ART, very little has been done to understand whether the P intake should be personalized during the luteal phase. Most recent studies on the topic showed that low P levels on the day of ET-HRT or on the day before are associated with decreased pregnancy rates; however, when low P values are supplemented from the day before embryo-transfer (ET), similar results to cases with adequate P are reported. Nevertheless, little is known about the association between low P level, on the day of β-hCG (P- β-hCG) and PS from this day in ET-HRT, and pregnancy outcomes.
Study design, size, duration
This is a single centre, cohort, retrospective study conducted at a university-affiliated fertility centre between January 2018 and June 2020 where PS took place from the day of positive β-hCG determination when P < 10.6 ng/mL. In total 789 ET-HRT cycles were analysed of which 239 were performed in both fresh and frozen heterologous ET-HRT (het-ET), 336 in homologous ET-HRT (hom-FET) and 214 in euploid ET-HRT (eu-FET) after preimplantation genetic testing for aneuploidies IVF cycles (PGT-A).
Participants/materials, setting, methods
Women undergoing ET-HRT with normal P (>10.6ng/mL) on the day before ET were screened for P on the day of β-hCG. All women received vaginal P 200 mg/8 hours for the second part of HRT. PS was performed by adding P to the HRT when P- β-hCG was considered low (<10.6 ng/mL). Primary outcome: ongoing-pregnancy-rate (OPR); secondary outcome: miscarriage-rate (MR). Both were evaluated by considering PS on the day of β-hCG as a categorical variable.
Main results and the role of chance
Patients characteristics were comparable between groups (het-ET, hom-FET and eu-FET) although significantly lower body mass index was found when P- β-hCG>10.6 ng/mL compared to the subgroup with P- β-hCG<10.6 ng/mL and no PS (p = 0.012). Overall clinical pregnancy rate was 52.1% with no-significant differences between groups (48.5% in het-ET, 52.9% in hom-FET and 54.7% in eu-FET). P- β-hCG was considered as adequate in 75.7% (311/411) ET-HRT with positive β-hCG and low in 24.3% (100/411), with no differences between groups. In case of positive β-hCG and P- β-hCG >10.6 ng/mL, OPR was 83.6% and MR was 16.4%, with no-significant differences between groups. Among the 100 low P- β-hCG, 80 ET-HRT received PS. In this subgroup OPR was 96.2% and MR was 3.8%, with no-significant differences between groups. In 20 out of 100 ET with P- β-hCG <10.6 ng/mL, no PS was added for different reasons. This group showed the lowest OPR (30%) and the highest MR (70%), again with no between-group differences according to het-ET, hom-FET or eu-FET. Miscarriage rate was significantly higher (p < 0.001) when P- β-hCG was <10.6 ng/mL and no PS was added to HRT compared to P- β-hCG <10.6 ng/mL but with PS, and also compared to the P- β-hCG >10.6 ng/mL group.
Limitations, reasons for caution
The main limitation of the study is due to its retrospective nature and the small sample of patients with P- β-hCG<10.6 ng/mL that was not supplemented. Furthermore, the cut-off of P- β-hCG was arbitrarily decided upon previous studies, and lastly different routes of administration were considered for the PS.
Wider implications of the findings: The results of this study showed that individualization of Progesterone supplementation in ET-HRT may be a crucial turn point in order to increase the pregnancy rates and decrease the miscarriage rates. An adequate PS should be considered in case of low P- β-hCG levels for both het-ET, hom-FET and eu-FET.
Trial registration number
Not applicable
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Affiliation(s)
- M Alvarez
- Reproductive Medicine Service. Dexeus Mujer. Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproductive Medicine, Barcelona, Spain
| | - A Racca
- Reproductive Medicine Service. Dexeus Mujer. Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproductive Medicine, Barcelona, Spain
| | - S García
- Reproductive Medicine Service. Dexeus Mujer. Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproductive Medicine, Barcelona, Spain
| | - F Martínez
- Reproductive Medicine Service. Dexeus Mujer. Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproductive Medicine, Barcelona, Spain
| | - I González-Foruria
- Reproductive Medicine Service. Dexeus Mujer. Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproductive Medicine, Barcelona, Spain
| | - M Parriego
- Reproductive Medicine Service. Dexeus Mujer. Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproductive Medicine, Barcelona, Spain
| | - B Coroleu
- Reproductive Medicine Service. Dexeus Mujer. Dexeus University Hospital, Department of Obstetrics- Gynaecology and Reproductive Medicine, Barcelona, Spain
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Le Roy C, Barja S, Sepúlveda C, Guzmán M, Olivarez M, Figueroa M, Alvarez M. Deficiencia de vitamina D y de hierro en niños y adolescentes con parálisis cerebral. Neurologia 2021; 36:112-118. [DOI: 10.1016/j.nrl.2017.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 10/23/2017] [Accepted: 11/05/2017] [Indexed: 11/25/2022] Open
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10
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van der Nelson H, O'Brien S, Burnard S, Mayer M, Alvarez M, Knowlden J, Winter C, Dailami N, Marques E, Burden C, Siassakos D, Draycott T. Intramuscular oxytocin versus Syntometrine ® versus carbetocin for prevention of primary postpartum haemorrhage after vaginal birth: a randomised double-blinded clinical trial of effectiveness, side effects and quality of life. BJOG 2021; 128:1236-1246. [PMID: 33300296 DOI: 10.1111/1471-0528.16622] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare intramuscular oxytocin, Syntometrine® and carbetocin for prevention of postpartum haemorrhage after vaginal birth. DESIGN Randomised double-blinded clinical trial. SETTING Six hospitals in England. POPULATION A total of 5929 normotensive women having a singleton vaginal birth. METHODS Randomisation when birth was imminent. MAIN OUTCOME MEASURES Primary: use of additional uterotonic agents. Secondary: weighed blood loss, transfusion, manual removal of placenta, adverse effects, quality of life. RESULTS Participants receiving additional uterotonics: 368 (19.5%) oxytocin, 298 (15.6%) Syntometrine and 364 (19.1%) carbetocin. When pairwise comparisons were made: women receiving carbetocin were significantly more likely to receive additional uterotonics than those receiving Syntometrine (odds ratio [OR] 1.28, 95% CI 1.08-1.51, P = 0.004); the difference between carbetocin and oxytocin was non-significant (P = 0.78); Participants receiving Syntometrine were significantly less likely to receive additional uterotonics than those receiving oxytocin (OR 0.75, 95% CI 0.65-0.91, P = 0.002). Non-inferiority between carbetocin and Syntometrine was not shown. Use of Syntometrine reduced non-drug PPH treatments compared with oxytocin (OR 0.64, 95% CI 0.42-0.97) but not carbetocin (P = 0.64). Rates of PPH and blood transfusion were not different. Syntometrine was associated with an increase in maternal adverse effects and reduced ability of the mother to bond with her baby. CONCLUSIONS Non-inferiority of carbetocin to Syntometrine was not shown. Carbetocin is not significantly different to oxytocin for use of additional uterotonics. Use of Syntometrine reduced use of additional uterotonics and need for non-drug PPH treatments compared with oxytocin. Increased maternal adverse effects are a disadvantage of Syntometrine. TWEETABLE ABSTRACT IM carbetocin does not reduce additional uterotonic use compared with IM Syntometrine or oxytocin.
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Affiliation(s)
- H van der Nelson
- North Bristol NHS Trust, Bristol, UK.,University of Bristol, Bristol, UK
| | - S O'Brien
- North Bristol NHS Trust, Bristol, UK.,University of Bristol, Bristol, UK
| | - S Burnard
- Royal United Hospitals NHS Trust, Bath, UK
| | - M Mayer
- North Bristol NHS Trust, Bristol, UK
| | - M Alvarez
- North Bristol NHS Trust, Bristol, UK
| | | | - C Winter
- North Bristol NHS Trust, Bristol, UK
| | - N Dailami
- University of the West of England, Bristol, UK
| | - E Marques
- North Bristol NHS Trust, Bristol, UK
| | - C Burden
- North Bristol NHS Trust, Bristol, UK.,University of Bristol, Bristol, UK
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11
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Cotte L, Hocqueloux L, Lefebvre M, Pradat P, Bani-Sadr F, Huleux T, Poizot-Martin I, Pugliese P, Rey D, Cabié A, Chirouze C, Drobacheff-Thiébaut C, Foltzer A, Bouiller K, Hustache-Mathieu L, Lepiller Q, Bozon F, Babre O, Brunel AS, Muret P, Chevalier E, Jacomet C, Laurichesse H, Lesens O, Vidal M, Mrozek N, Aumeran C, Baud O, Corbin V, Goncalvez E, Mirand A, brebion A, Henquell C, Lamaury I, Fabre I, Curlier E, Ouissa R, Herrmann-Storck C, Tressieres B, Receveur MC, Boulard F, Daniel C, Clavel C, Roger PM, Markowicz S, Chellum Rungen N, Merrien D, Perré P, Guimard T, Bollangier O, Leautez S, Morrier M, Laine L, Boucher D, Point P, Cotte L, Ader F, Becker A, Boibieux A, Brochier C, Brunel-Dalmas F, Cannesson O, Chiarello P, Chidiac C, Degroodt S, Ferry T, Godinot M, Livrozet JM, Makhloufi D, Miailhes P, Perpoint T, Perry M, Pouderoux C, Roux S, Triffault-Fillit C, Valour F, Charre C, Icard V, Tardy JC, Trabaud MA, Ravaux I, Ménard A, Belkhir AY, Colson P, Dhiver C, Madrid A, Martin-Degioanni M, Meddeb L, Mokhtari M, Motte A, Raoux A, Toméi C, Tissot-Dupont H, Poizot-Martin I, Brégigeon S, Zaegel-Faucher O, Obry-Roguet V, Laroche H, Orticoni M, Soavi MJ, Ressiot E, Ducassou MJ, Jaquet I, Galie S, Colson H, Ritleng AS, Ivanova A, Debreux C, Lions C, Rojas-Rojas T, Cabié A, Abel S, Bavay J, Bigeard B, Cabras O, Cuzin L, Dupin de Majoubert R, Fagour L, Guitteaud K, Marquise A, Najioullah F, Pierre-François S, Pasquier J, Richard P, Rome K, Turmel JM, Varache C, Atoui N, Bistoquet M, Delaporte E, Le Moing V, Makinson A, Meftah N, Merle de Boever C, Montes B, Montoya Ferrer A, Tuaillon E, Reynes J, Lefèvre B, Jeanmaire E, Hénard S, Frentiu E, Charmillon A, Legoff A, Tissot N, André M, Boyer L, Bouillon MP, Delestan M, Goehringer F, Bevilacqua S, Rabaud C, May T, Raffi F, Allavena C, Aubry O, Billaud E, Biron C, Bonnet B, Bouchez S, Boutoille D, Brunet-Cartier C, Deschanvres C, Gaborit BJ, Grégoire A, Grégoire M, Grossi O, Guéry R, Jovelin T, Lefebvre M, Le Turnier P, Lecomte R, Morineau P, Reliquet V, Sécher S, Cavellec M, Paredes E, Soria A, Ferré V, André-Garnier E, Rodallec A, Pugliese P, Breaud S, Ceppi C, Chirio D, Cua E, Dellamonica P, Demonchy E, De Monte A, Durant J, Etienne C, Ferrando S, Garraffo R, Michelangeli C, Mondain V, Naqvi A, Oran N, Perbost I, Carles M, Klotz C, Maka A, Pradier C, Prouvost-Keller B, Risso K, Rio V, Rosenthal E, Touitou I, Wehrlen-Pugliese S, Zouzou G, Hocqueloux L, Prazuck T, Gubavu C, Sève A, Giaché S, Rzepecki V, Colin M, Boulard C, Thomas G, Cheret A, Goujard C, Quertainmont Y, Teicher E, Lerolle N, Jaureguiberry S, Colarino R, Deradji O, Castro A, Barrail-Tran A, Yazdanpanah Y, Landman R, Joly V, Ghosn J, Rioux C, Lariven S, Gervais A, Lescure FX, Matheron S, Louni F, Julia Z, Le GAC S, Charpentier C, Descamps D, Peytavin G, Duvivier C, Aguilar C, Alby-Laurent F, Amazzough K, Benabdelmoumen G, Bossi P, Cessot G, Charlier C, Consigny PH, Jidar K, Lafont E, Lanternier F, Leporrier J, Lortholary O, Louisin C, Lourenco J, Parize P, Pilmis B, Rouzaud C, Touam F, Valantin MA, Tubiana R, Agher R, Seang S, Schneider L, PaLich R, Blanc C, Katlama C, Bani-Sadr F, Berger JL, N’Guyen Y, Lambert D, Kmiec I, Hentzien M, Brunet A, Romaru J, Marty H, Brodard V, Arvieux C, Tattevin P, Revest M, Souala F, Baldeyrou M, Patrat-Delon S, Chapplain JM, Benezit F, Dupont M, Poinot M, Maillard A, Pronier C, Lemaitre F, Morlat C, Poisson-Vannier M, Jovelin T, Sinteff JP, Gagneux-Brunon A, Botelho-Nevers E, Frésard A, Ronat V, Lucht F, Rey D, Fischer P, Partisani M, Cheneau C, Priester M, Mélounou C, Bernard-Henry C, de Mautort E, Fafi-Kremer S, Delobel P, Alvarez M, Biezunski N, Debard A, Delpierre C, Gaube G, Lansalot P, Lelièvre L, Marcel M, Martin-Blondel G, Piffaut M, Porte L, Saune K, Robineau O, Ajana F, Aïssi E, Alcaraz I, Alidjinou E, Baclet V, Bocket L, Boucher A, Digumber M, Huleux T, Lafon-Desmurs B, Meybeck A, Pradier M, Tetart M, Thill P, Viget N, Valette M. Microelimination or Not? The Changing Epidemiology of Human Immunodeficiency Virus-Hepatitis C Virus Coinfection in France 2012–2018. Clin Infect Dis 2021; 73:e3266-e3274. [DOI: 10.1093/cid/ciaa1940] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/01/2021] [Indexed: 01/15/2023] Open
Abstract
Abstract
Background
The arrival of highly effective, well-tolerated, direct-acting antiviral agents (DAA) led to a dramatic decrease in hepatitis C virus (HCV) prevalence. Human immunodeficiency virus (HIV)-HCV–coinfected patients are deemed a priority population for HCV elimination, while a rise in recently acquired HCV infections in men who have sex with men (MSM) has been described. We describe the variations in HIV-HCV epidemiology in the French Dat’AIDS cohort.
Methods
This was a retrospective analysis of a prospective cohort of persons living with HIV (PLWH) from 2012 to 2018. We determined HCV prevalence, HCV incidence, proportion of viremic patients, treatment uptake, and mortality rate in the full cohort and by HIV risk factors.
Results
From 2012 to 2018, 50 861 PLWH with a known HCV status were followed up. During the period, HCV prevalence decreased from 15.4% to 13.5%. HCV prevalence among new HIV cases increased from 1.9% to 3.5% in MSM but remained stable in other groups. Recently acquired HCV incidence increased from 0.36/100 person-years to 1.25/100 person-years in MSM. The proportion of viremic patients decreased from 67.0% to 8.9%. MSM became the first group of viremic patients in 2018 (37.9%). Recently acquired hepatitis represented 59.2% of viremic MSM in 2018. DAA treatment uptake increased from 11.4% to 61.5%. More treatments were initiated in MSM in 2018 (41.2%) than in intravenous drug users (35.6%). In MSM, treatment at the acute phase represented 30.0% of treatments in 2018.
Conclusions
A major shift in HCV epidemiology was observed in PLWH in France from 2012 to 2018, leading to a unique situation in which the major group of HCV transmission in 2018 was MSM.
Clinical Trials Registration. NCT02898987.
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Affiliation(s)
- Laurent Cotte
- Department of Infectious Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, Institut National de la Santé et de la Recherche Médicale (INSERM) U1052, Lyon, France
| | - Laurent Hocqueloux
- Department of Infectious Diseases, Centre Hospitalier Régional d’Orléans – La Source, Orléans, France
| | - Maeva Lefebvre
- Department of Infectious Diseases, Centre Hospitalier Universitaire Hôtel-Dieu, Nantes; Centre d’Investigation Clinique (CIC) 1413, INSERM, Nantes, France
| | - Pierre Pradat
- Center for Clinical Research, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Firouze Bani-Sadr
- Department of Internal Medicine, Clinical Immunology and Infectious Diseases, Robert Debré Hospital, University Hospital, Reims, France
| | - Thomas Huleux
- Department of Infectious Diseases and Travel Diseases, Centre Hospitalier Gustave-Dron, Tourcoing, France
| | - Isabelle Poizot-Martin
- Immuno-Hematology Clinic, Assistance Publique–Hôpitaux de Marseille, Hôpital Sainte-Marguerite, Marseille, Aix-MarseilleUniversity–Inserm–Institut de Recherche pour le Développement (IRD), Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Marseille, France
| | - Pascal Pugliese
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Nice, Hôpital l’Archet, Nice, France
| | - David Rey
- HIV Infection Care Centre, Hôpitaux Universitaires, Strasbourg
| | - André Cabié
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Martinique, Fort de France, Université des Antilles EA4537, Fort de France, INSERM CIC1424, Fort-de-France, France
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Puig I, Alvarez M, Lozano M, Lucente G. A case of late-onset osmotic demyelination syndrome. Neurologia 2020; 36:S0213-4853(20)30311-X. [PMID: 33176921 DOI: 10.1016/j.nrl.2020.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 10/10/2020] [Indexed: 10/23/2022] Open
Affiliation(s)
- I Puig
- Department of Neuroscience, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
| | - M Alvarez
- Department of Neuroscience, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
| | - M Lozano
- Department of Neuroscience, Hospital Germans Trias i Pujol, Badalona, Barcelona, España
| | - G Lucente
- Department of Neuroscience, Hospital Germans Trias i Pujol, Badalona, Barcelona, España; Grup de Recerca en Malalties Neuromusculars i Neuropediatriques, Department of Neurosciences, Institut Investigació en Ciències de la Salut Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España; Universitat Autonoma de Barcelona, Badalona, Barcelona, España.
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13
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Cohen O, Boumaza X, Alvarez M, Porte L, Lansalot P, Martin-Blondel G, Delobel P. Épidémie d’oreillons en milieu sportif chez des patients correctement vaccinés. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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14
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Richard C, Alvarez M, Carneiro JP, Hanna B, Prost L, Saini A, Scarpine V, Shemyakin A. Measurements of a 2.1 MeV H - beam with an Allison scanner. Rev Sci Instrum 2020; 91:073301. [PMID: 32752855 DOI: 10.1063/5.0004502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 06/10/2020] [Indexed: 06/11/2023]
Abstract
Transverse 2D phase space distributions of a 2.1 MeV, 5 mA H- beam are measured at the Proton Improvement Plan II Injector Test accelerator at Fermilab with an Allison scanner. This paper describes the design, calibration, and performance of the scanner along with the main results from beam measurements. Analyses of the recorded phase portraits are performed primarily in action-phase coordinates. The stability of the action under linear optics makes it easier to compare measurements taken under different beamline conditions. The amplitude of a single measured point ("pixel") is proportional to the phase density in the corresponding portion of the beam. When the Twiss parameters are calculated using only the high-phase density part of the beam, the pixel amplitude in the beam core is found to be decreasing approximately exponentially with action and to be phase-independent. Outside of the core, the amplitudes decrease with action at a slower rate than in the core. This "tail" comprises 10%-30% of the beam, with 0.1% of the total measured intensity extending beyond action 10-20 times larger than the rms emittance. The transition from the core to the tail is accompanied by the appearance of two "branches" that are separated in phase and extend beyond the core. A set of selected measurements shows that there is no measurable emittance dilution along the beamline; the beam parameters are practically constant over a 0.5 ms pulse; and scraping in various parts of the beamline is an effective way to decrease the transverse tails by removing the branches.
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Affiliation(s)
- C Richard
- Physics and Astronomy Department, Michigan State University, East Lansing, Michigan 48824, USA
| | - M Alvarez
- Accelerator Division, Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - J P Carneiro
- Accelerator Division, Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - B Hanna
- Accelerator Division, Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - L Prost
- Accelerator Division, Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Saini
- Accelerator Division, Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - V Scarpine
- Accelerator Division, Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - A Shemyakin
- Accelerator Division, Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
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15
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Dirico M, Bedi V, Alvarez M, Finley Iv J. MANAGEMENT OF INTERMEDIATE RISK PULMONARY EMBOLI WITH THE PRESENCE OF A RIGHT VENTRICULAR THROMBUS. Chest 2020. [DOI: 10.1016/j.chest.2020.05.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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16
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Tronconi A, Carnero G, Mysuta M, Bozza A, Peltzer M, Labin B, Gavilan L, Ramirez D, Alvarez M, Gonzalez JL, Galizio N. P506Brugada Syndrome: is the addition of the electrocardiographic risk markers the clue? Europace 2020. [DOI: 10.1093/europace/euaa162.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Risk stratification in Brugada Syndrome (BS) remains a clinical challenge. Several electrocardiografic (ECG) risk markers had been described, as a spontaneous type 1 Brugada pattern (ST1B), maximal time interval between the peak and the end of the t wave in precordial leads (Tpe Max), the presence of an S Wave on DI, a PR interval (PRi) ≥ 200ms and fragmented QRS (f-QRS).
Purpose
Evaluate the association of ECG risk markers with sudden cardiac death (SCD) or appropriate shocks (A-Sh) by implantable cardioverter defibrillator (ICD) in patients (p) with BS.
Methods
From a registry of 97 p with BS with a median follow up of 2.3 years (Q1 0.7-Q3 7.8), 12 lead ECG were recorded in every p. QT peak interval (QTp) was measured between the QRS onset and the peak of the T wave. Tpe was calculated between the difference of QT and QTp in precordial leads (V1 to V6). TpeMax was defined as the most prolonged Tpe. If an S-DI was present, duration and amplitude was measured. PRi was measured on DII. Baseline characteristics: Age 44 ± 13 years, male 74 (76%), secondary prevention 2 (3%), malignant syncope 10 (10%), inducible electrophysiology study 22/43 (51%), SCD on first grade family < 35 years 12 (12%) and ICD 34 (35%). A-Sh and SCD were compared among p with ST1B vs no ST1B, TpeMax≥100 vs <100ms, S-DI ≥0.4 vs <0.4ms, S-D ≥0.1 vs <0.1mV, PRi≥200 vs <200ms and presence of f-QRS ≥ 2 spike ≥ 2 leads. Variables that were associated with A-Sh or SCD were combined. For variables with significant difference sensibility (Sen) and specificity (Spe) was calculated.
Results
During follow up 6 p presented A-Sh and no p SCD. Results are described in the Table.
Conclusion
In our study population, there was a significant higher incidence of A-Sh in p with ST1B, Tpe Max ≥ 100ms and S-DI ≥ 0.1mV. We found that the presence of one ECG risk marker had a high sensibility to predict A-Sh. The presence of the 3 ECG risk markers highly increased specificity to predict A-Sh. Further trials should be carried out to asses if ECG risk markers would allow us to differentiate which asymptomatic patients could benefit from electrophysiological study for risk stratification (high sensibility - One ECG Risk marker) or would benefit from ICD implantation (high specificity - 3 ECG Risk markers).
Abstract Figure.
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Affiliation(s)
- A Tronconi
- Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - G Carnero
- Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - M Mysuta
- Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - A Bozza
- Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - M Peltzer
- Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - B Labin
- Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - L Gavilan
- Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - D Ramirez
- Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - M Alvarez
- Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - J L Gonzalez
- Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - N Galizio
- Favaloro Foundation University Hospital, Buenos Aires, Argentina
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Ramirez P, Orihuela C, Alvarez M, Ayala M. P634 Right atrial mechanics determined by speckle tracking strain as a more physiologic correlation in pulmonary hypertension. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Right atrial dilation has also been established as a marker of adverse outcomes in pulmonary hypertension (PH), while right atrial mechanics remain relatively understudied.
Purpose
Transthoracic echocardiography is a practical and widely used tool for risk stratification in PH. We hypothesized that right atrial (RA) strain components [RA reservoir function (ƐR), peak RA contraction (ƐCT) and RA conduit function (ƐCD)] correlates better with strong prognostic parameters as 3D right ventricle ejection fraction (3D RV EF), 6 minutes walking test, systolic pulmonary artery pressure (SPAP) and B-type natriuretic peptide (BNP).
Methods
19 patients with diagnostic PH, type 2 patients were excluded. RA strain was analyzed and determined a correlation with right ventricle function and pulmonary variables.
Results
Morphology correlation was poor with all the variables as SPAP, 6 Minutes walking test, BNP, only RA/LA index has a good correlation with BNP (R = 0.76, P = 0.0004). Right atrial mechanics with strain has good correlation: ƐR correlates with BNP (R= -0.70, P = 0.001) and with SPAP (R= -0.68, P = 0.001). ƐCD correlates with BNP (R=-0.75;P = 0,0002) and with SPAP (R=-0.68, P = 0.001). ƐCT has no correlation with E/e, 3D RV EF, SPAP, pulmonary vascular resistance (PVR), 6 minutes walking test neither BNP. Right atrial deformation sum correlations with 3D RV EF (R= -0.70, P = 0.001), with SPAP (R= -0.72, P = 0.0005), with PVR (R= -0.68, P = 0.001) and with BNP (R=-0.71, P = 0.001).
Conclusion
Right atrium morphological characteristics have poor correlation with variables that evaluate right ventricle function and with variables that predicts outcomes, as BNP, in this patients population. Only RA/LA index as morphology parameter has good correlation with BNP level. Meanwhile right atrial mechanics analyzed by strain has strong correlation with other variables of severity at PH. Right atrial deformation sum has better correlation than other strain parameters in our study.
Abstract P634 Figure. RIGHT ATRIAL DEFORMATION SUM CORRELATION
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Affiliation(s)
- P Ramirez
- National Institute of Cardiology Ignacio Chavez, Mexico City, Mexico
| | - C Orihuela
- National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico
| | - M Alvarez
- National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico
| | - M Ayala
- National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City, Mexico
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Zapata I, Alvarez M, Hidalgo R, Pajares B, Garcia-Anaya MJ, Toledo MD, Trigo JM, Lupiañez-Perez Y, Medina JA, Jaime Gomez-Millan J. Causes of death in patients with locally advanced head and neck cancer treated with radiotherapy and systemic therapy. BMC Cancer 2019; 19:1241. [PMID: 31864338 PMCID: PMC6925882 DOI: 10.1186/s12885-019-6427-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 12/03/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND To investigate the incidence of non-cancer mortalities and prognostic factors associated with competitive causes of death in a homogeneous cohort of patients with locally advanced head and neck cancer treated with radiotherapy and systemic treatment. METHODS This study included 284 patients with locally advanced head and neck cancer treated with radiotherapy and systemic treatment between 2005 and 2017. The cumulative incidence of death associated with tumour, second tumours, treatment, side effects and comorbidity was calculated. A Fine and Gray regression model was used to investigate factors associated with cancer and competitive mortality. RESULTS The cumulative incidence of tumoral death at 5 and 10 years were 35 and 47% respectively, whereas the cumulative incidence of competitive mortality were 10 and 12% respectively. In the multivariate analysis, age and comorbidity were independent factors for non-cancer mortality. Patients with a high risk of non-cancer mortality presented a cumulative incidence of 17.3% at 5 years and 18.4% at 10 years. CONCLUSIONS This study demonstrated a high incidence of competing mortality in older patients with comorbidities. Non-cancer deaths should be considered when selecting patients for combination therapies and in the study design ofclinical trials.
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Affiliation(s)
- I Zapata
- Radiation Oncology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n., 29010, Malaga, Spain
| | - M Alvarez
- Laboratorio de biología molecular del cancer, centro de investigaciones medico-sanitarias (CIMES), Universidad de Málaga, Malaga, Spain.,Instituto de investigación biomédica de Malaga, Campus Teatinos s/n., 29010, Malaga, Spain.,Pathology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n., 29010, Malaga, Spain
| | - R Hidalgo
- Servicio central de Informatica, Universidad de Malaga, Malaga, Spain
| | - B Pajares
- Medical Oncology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, 29010, Malaga, Spain
| | - M J Garcia-Anaya
- Radiation Oncology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n., 29010, Malaga, Spain
| | - M D Toledo
- Radiation Oncology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n., 29010, Malaga, Spain
| | - J M Trigo
- Medical Oncology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, 29010, Malaga, Spain
| | - Y Lupiañez-Perez
- Radiation Oncology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n., 29010, Malaga, Spain
| | - J A Medina
- Radiation Oncology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n., 29010, Malaga, Spain
| | - J Jaime Gomez-Millan
- Radiation Oncology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n., 29010, Malaga, Spain. .,Instituto de investigación biomédica de Malaga, Campus Teatinos s/n., 29010, Malaga, Spain.
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Abascal M, Giulianelli S, Alvarez M, Sequeira G, Vanzulli S, Elia A, Pataccini G, Lombes M, Lanari C. Progesterone receptor isoform ratio dictates antiprogestins/progestins effects on metastatic breast cancer models. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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20
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Gomez L, Arias J, Diaz D, Alvarez M, Alvarado J, Caicedo M. CLINICAL CHARACTERISTICS OF CRITICAL CARE PATIENTS WITH CONFIRMED DIAGNOSIS OF INFLUENZA PNEUMONIA AT THE UNIVERSITY HOSPITAL FUNDACIÓN SANTA FE DE BOGOTÁ. Chest 2019. [DOI: 10.1016/j.chest.2019.02.075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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21
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Sousa T, Ribeiro R, Teixeira Z, Cruz R, Alvarez M. Life span disparities between rural and urban residents in the Portuguese district of Coimbra. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz034.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T Sousa
- Research Centre for Anthropology and Health, University of Coimbra, Portugal
| | - R Ribeiro
- Department of Life Sciences, University of Coimbra, Portugal
- Centre for Functional Ecology, Department of Life Sciences, University of Coimbra, Portugal
| | - Z Teixeira
- MARE - Marine and Environmental Sciences Centre, University of Coimbra, Portugal
| | - R Cruz
- ESTeSC - Coimbra Health School, Instituto Politécnico de Coimbra, Portugal
| | - M Alvarez
- Research Centre for Anthropology and Health, University of Coimbra, Portugal
- Department of Life Sciences, University of Coimbra, Portugal
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22
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Escudero P, Yeste J, Pascual-Izarra C, Villa R, Alvarez M. Color tunable pressure sensors based on polymer nanostructured membranes for optofluidic applications. Sci Rep 2019; 9:3259. [PMID: 30824807 PMCID: PMC6397196 DOI: 10.1038/s41598-019-40267-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 02/11/2019] [Indexed: 01/21/2023] Open
Abstract
We demonstrate an integrated optical pressure sensing platform for multiplexed optofluidics applications. The sensing platform consists in an array of elastomeric on-side nanostructured membranes -effectively 2D photonic crystal- which present colour shifts in response to mechanical stress that alter their nanostructure characteristical dimensions, pitch or orientation. The photonic membranes are prepared by a simple and cost-effective method based on the infiltration of a 2D colloidal photonic crystal (CPC) with PDMS and their integration with a microfluidic system. We explore the changes in the white light diffraction produced by the nanostructured membranes when varying the pneumatic pressure in the microfluidics channels as a way to achieve a power-free array of pressure sensors that change their reflective colour depending on the bending produced on each sensor. The structural characterization of these membranes was performed by SEM, while the optical properties and the pressure-colour relation were evaluated via UV-Vis reflection spectrometry. Maximum sensitivities of 0.17 kPa-1 is obtained when measuring at Littrow configuration (θin = -θout), and close to the border of the membranes. The reflected colour change with pressure is as well monitorized by using a smartphone camera.
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Affiliation(s)
- P Escudero
- Instituto de Microelectronica de Barcelona (IMB-CNM, CSIC), Campus UAB, 08193 Bellaterra, Barcelona, Spain.,PhD in Electrical and Telecommunication Engineering, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - J Yeste
- Instituto de Microelectronica de Barcelona (IMB-CNM, CSIC), Campus UAB, 08193 Bellaterra, Barcelona, Spain
| | | | - R Villa
- Instituto de Microelectronica de Barcelona (IMB-CNM, CSIC), Campus UAB, 08193 Bellaterra, Barcelona, Spain.,CIBER de Bioengineria, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain
| | - M Alvarez
- Instituto de Microelectronica de Barcelona (IMB-CNM, CSIC), Campus UAB, 08193 Bellaterra, Barcelona, Spain.
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Kandolf Sekulovic L, Guo J, Agarwala S, Hauschild A, McArthur G, Cinat G, Wainstein A, Caglevic C, Lorigan P, Gogas H, Alvarez M, Duncombe R, Lebbe C, Peris K, Rutkowski P, Stratigos A, Forsea AM, De La Cruz Merino L, Kukushkina M, Dummer R, Hoeller C, Gorry C, Bastholt L, Herceg D, Neyns B, Vieira R, Arenberger P, Bylaite-Bucinskiene M, Babovic N, Banjin M, Putnik K, Todorovic V, Kirov K, Ocvirk J, Zhukavets A, Ymeri A, Stojkovski I, Garbe C. Access to innovative medicines for metastatic melanoma worldwide: Melanoma World Society and European Association of Dermato-oncology survey in 34 countries. Eur J Cancer 2018; 104:201-209. [PMID: 30388700 DOI: 10.1016/j.ejca.2018.09.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 09/12/2018] [Indexed: 12/19/2022]
Abstract
According to data from recent studies from Europe, a large percentage of patients have restricted access to innovative medicines for metastatic melanoma. Melanoma World Society and European Association of Dermato-oncology conducted a Web-based survey on access to first-line recommended treatments for metastatic melanoma by current guidelines (National Comprehensive Center Network, European Society for Medical Oncology [ESMO] and European Organization for Research and Treatment of Cancer/European Association of Dermato-oncology/European dermatology Forum) among melanoma experts from 27 European countries, USA, China, Australia, Argentina, Brazil, Chile and Mexico from September 1st, 2017 to July 1st, 2018. Data on licencing and reimbursement of medicines and the number of patient treated were correlated with the data on health expenditure per capita (HEPC), Mackenbach score of health policy performance, health technology assessment (HTA), ASCO and ESMO Magnitude of clinical benefit scale (ESMO MCBS) scores of clinical benefit and market price of medicines. Regression analysis for evaluation of correlation between the parameters was carried out using SPSS software. The estimated number of patients without access in surveyed countries was 13768. The recommended BRAFi + MEKi combination and anti-PD1 immunotherapy were fully reimbursed/covered in 19 of 34 (55.8%) and 17 of 34 (50%) countries, and combination anti-CTLA4+anti-PD1 in was fully covered in 6 of 34 (17.6%) countries. Median delay in reimbursement was 991 days, and it was in significant correlation with ESMO MCBS (p = 0.02), median market price (p = 0.001), HEPC and Mackenbach scores (p < 0.01). Price negotiations or managed entry agreements (MEAs) with national authorities were necessary for reimbursement. In conclusion, great discrepancy exists in metastatic melanoma treatment globally. Access to innovative medicines is in correlation with economic parameters as well as with healthcare system performance parameters. Patient-oriented drug development, market access and reimbursement pathways must be urgently found.
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Affiliation(s)
- L Kandolf Sekulovic
- Department of Dermatology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia.
| | - J Guo
- Department of Urology and Melanoma, Peking University Cancer Hospital & Institute, Beijing, PR China
| | - S Agarwala
- St. Luke's University Hospital and Temple University, Bethlehem, USA
| | - A Hauschild
- Department of Dermatology, University Hospital Schleswig-Holstein (UKSH), Campus Kiel, Kiel, Germany
| | - G McArthur
- Divisions of Research and Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia
| | - G Cinat
- Médica Oncóloga Instituto de Oncología Angel Roffo, Universidad de Buenos Aires Fundación CIDEA, Buenos Aires, Argentina
| | - A Wainstein
- Institute of Post-graduation, Faculdade de Ciências Médicas de Minas Gerais (FCM-MG) - Belo Horizonte (MG), Brazil
| | - C Caglevic
- Medical Oncology Service, Oncology Department, Clinica Alemana Santiago, Faculty of Medicine Clinica Alemana-Universidad Del Desarrollo, Santiago, Chile
| | - P Lorigan
- Institute of Cancer Sciences, University of Manchester, The Christie NHS Foundation Trust, Manchester, UK
| | - H Gogas
- 1(st)Department of Internal Medicine, Laiko Hospital and 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - M Alvarez
- Medico en Instituto Nacional de Cancerologia, Mexico City Area, Mexico
| | - R Duncombe
- Institute of Cancer Sciences, University of Manchester, The Christie NHS Foundation Trust, Manchester, UK
| | - C Lebbe
- APHP Dermatology Department, University Paris 7 Diderot, INSERM U976, PARIS, France
| | - K Peris
- Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - P Rutkowski
- Maria Sklodowska-Curie Institute - Oncology Center, Warsaw, Poland
| | - A Stratigos
- 1(st)Department of Internal Medicine, Laiko Hospital and 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - A-M Forsea
- Carol Davila University of Medicine and Pharmacy, Elias University Hospital Bucharest, Romania
| | - L De La Cruz Merino
- Department of Clinical Oncology, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | - R Dummer
- UniversitätsSpital Zürich-Skin Cancer Center, University Hospital, Zürich, Switzerland
| | - C Hoeller
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - C Gorry
- National Centre for Pharmacoeconomics, Old Stone Building, Trinity Centre for Health Sciences, St. James's Hospital, Dublin 8, Ireland
| | - L Bastholt
- Department of Oncology, Odense University Hospital, Denmark
| | - D Herceg
- Department of Oncology, University Hospital Zagreb, Croatia
| | - B Neyns
- Department of Medical Oncology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - R Vieira
- Department of Dermatology, Medical Faculty, University of Coimbra, Portugal
| | - P Arenberger
- Department of Dermatovenereology, Charles University 3rd Faculty of Medicine and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | | | - N Babovic
- Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
| | - M Banjin
- Department of Oncology, University Hospital Sarajevo, Bosnia and Herzegovina
| | - K Putnik
- North Estonia Medical Centre, Tallinn, Estonia
| | - V Todorovic
- Clinic for Oncology and Radiotherapy, Podgorica, Montenegro
| | - K Kirov
- Clinic of Oncodermatology, National Cancer Center, Sofia, Bulgaria
| | - J Ocvirk
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - A Zhukavets
- Belarusian Medical Academy of Postgraduate Education (BelMAPE), Minsk, Belarus
| | - A Ymeri
- University Hospital Mother Theresa, Tirana, Albania
| | - I Stojkovski
- University Clinic of Radiotherapy and Oncology, Skopje, Macedonia
| | - C Garbe
- Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
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Vivancos A, Aranda Aguilar E, Benavides M, Elez Fernandez E, Toledano M, Alvarez M, Diaz Rubio E, Gómez-España A, Garcia-Barberan V, Chica-Parrao M. Evaluation of the sensitivity of RAS mutation detection of the Idylla platform in comparison to the OncoBEAM RAS CRC assay. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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26
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Gonzalez-Foruria I, Martinez F, Rodriguez-Purata J, Rodriguez D, Rodriguez I, Alvarez M, Nicolau J, Coroleu B, Barri P, Polyzos N. Progesterone variation on the day of oocyte triggering: a prospective study with repeated measurements within the same patient. Is the progesterone elevation “story” still valid? Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Egea M, Garcia-Urra F, Bellver JA, Alvarez M, Waweru C, Quesada A. P924Economic impact associated with complications of cardiac implantable electronic devices in spain. Europace 2018. [DOI: 10.1093/europace/euy015.525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M Egea
- Medtronic Ibérica S.A, Health Economics & Outcomes Research, Madrid, Spain
| | | | - J A Bellver
- Hospital General de Castellón, Castellon, Spain
| | - M Alvarez
- Medtronic Ibérica S.A, Health Economics & Outcomes Research, Madrid, Spain
| | - C Waweru
- Medtronic plc, Minneapolis, United States of America
| | - A Quesada
- University General Hospital of Valencia, Valencia, Spain
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Janjua NZ, Islam N, Wong J, Yoshida EM, Ramji A, Samji H, Butt Z, Chong M, Alvarez M, Cook D, Tyndall M, Krajden M. A162 SHIFT IN DISPARITIES IN HCV TREATMENT FROM INTERFERON TO DAA ERA: A POPULATION BASED COHORT STUDY. J Can Assoc Gastroenterol 2018. [DOI: 10.1093/jcag/gwy008.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- N Z Janjua
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - N Islam
- Division of Gastroenterology, University of British Columbia, Vancouver, BC, Canada
| | - J Wong
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - E M Yoshida
- Division of Gastroenterology, University of British Columbia, Vancouver, BC, Canada
| | - A Ramji
- Gastrointestinal Research Institute, Vancouver, BC, Canada
| | - H Samji
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - Z Butt
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - M Chong
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - M Alvarez
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - D Cook
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - M Tyndall
- BC Centre for Disease Control, Vancouver, BC, Canada
| | - M Krajden
- BC Centre for Disease Control, Vancouver, BC, Canada
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Gunturiz Beltran C, Bertomeu Gonzalez V, Moreno Arribas J, Perez L, Martinez Ferrer JB, Alzueta J, Arcocha MF, Arenal A, Vinolas X, Alvarez M, Anguera I, Porro R, Castillo Castillo J, Bellver A, Mont L. P874Analysis of efficacy of event discrimination algorithm added to standard programming strategies based on cycle length and detection intervals in implantable defibrillator. Europace 2018. [DOI: 10.1093/europace/euy015.477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - J Moreno Arribas
- University Hospital San Juan de Alicante, Cardiology, Alicante, Spain
| | - L Perez
- University Hospital Complex A Coruña, A Coruña, Spain
| | | | - J Alzueta
- University Hospital Virgen de la Victoria, Malaga, Spain
| | | | - A Arenal
- University Hospital Gregorio Maranon, Madrid, Spain
| | - X Vinolas
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - M Alvarez
- Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - I Anguera
- University Hospital of Bellvitge, Barcelona, Spain
| | - R Porro
- Hospital San Pedro de Alcantara, Caceres, Spain
| | | | - A Bellver
- Hospital General de Castellón, Castellon, Spain
| | - L Mont
- Hospital Clinic de Barcelona, Barcelona, Spain
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30
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Gunturiz Beltran C, Bertomeu Gonzalez V, Moreno Arribas J, Perez L, Martinez Ferrer JB, Alzueta J, Arcocha MF, Arenal A, Vinolas X, Alvarez M, Anguera I, Porro R, Castillo Castillo J, Bellver A, Mont L. P1228Individual discriminators contribution to the reduction of inappropriate therapies in implantable defibrillators. Europace 2018. [DOI: 10.1093/europace/euy015.709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - J Moreno Arribas
- University Hospital San Juan de Alicante, Cardiology, Alicante, Spain
| | - L Perez
- University Hospital Complex A Coruña, A Coruña, Spain
| | | | - J Alzueta
- University Hospital Virgen de la Victoria, Malaga, Spain
| | | | - A Arenal
- University Hospital Gregorio Maranon, Madrid, Spain
| | - X Vinolas
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - M Alvarez
- Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - I Anguera
- University Hospital of Bellvitge, Barcelona, Spain
| | - R Porro
- Hospital San Pedro de Alcantara, Caceres, Spain
| | | | - A Bellver
- Hospital General de Castellón, Castellon, Spain
| | - L Mont
- Hospital Clinic de Barcelona, Barcelona, Spain
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31
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Alvarez M. Can EMG help elucidate other possible cause of gait impairment in PD? Parkinsonism Relat Disord 2018. [DOI: 10.1016/j.parkreldis.2017.11.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Andersen J, Rauch J, Sestito D, De Souza E, Miller N, Cheesman N, Alvarez M. Session Rating of Perceived Exertion (sRPE), workload, and volume load relationships during off-season resistance training in NCAA division II baseball players: An exploratory analysis. Phys Ther Sport 2017. [DOI: 10.1016/j.ptsp.2017.08.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ortega Ferrusola C, Anel-López L, Ortiz-Rodriguez JM, Martin Muñoz P, Alvarez M, de Paz P, Masot J, Redondo E, Balao da Silva C, Morrell JM, Rodriguez Martinez H, Tapia JA, Gil MC, Anel L, Peña FJ. Stallion spermatozoa surviving freezing and thawing experience membrane depolarization and increased intracellular Na . Andrology 2017; 5:1174-1182. [PMID: 28973824 DOI: 10.1111/andr.12419] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 07/03/2017] [Accepted: 07/25/2017] [Indexed: 12/13/2022]
Abstract
In order to gain insight of the modifications that freezing and thawing cause to the surviving population of spermatozoa, changes in the potential of the plasma membrane (Em) and intracellular Na+ content of stallion spermatozoa were investigated using flow cytometry. Moreover, caspase 3 activity was also investigated and the functionality of the Na+ -K+ ATPase pump was investigated before and after freezing and thawing. Cryopreservation caused a significant (p < 0.001) increase in the subpopulation of spermatozoa with depolarized sperm membranes, concomitantly with an increase (p < 0.05) in intracellular Na+ . These changes occurred in relation to activation of caspase 3 (p < 0.001). Cryopreservation reduced the activity of the Na-K+ pump and inhibition of the Na+ -K+ ATPase pump with ouabain-induced caspase 3 activation. It is concluded that inactivation of Na+ -K+ ATPase occurs during cryopreservation, an inhibition that could play a role explaining the accelerated senescence of the surviving population of spermatozoa.
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Affiliation(s)
- C Ortega Ferrusola
- Reproduction and Obstetrics Department of Animal Medicine and Surgery, University of León, León, Spain
| | - L Anel-López
- Reproduction and Obstetrics Department of Animal Medicine and Surgery, University of León, León, Spain
| | - J M Ortiz-Rodriguez
- Laboratory of Equine Reproduction and Equine Spermatology, Veterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
| | - P Martin Muñoz
- Laboratory of Equine Reproduction and Equine Spermatology, Veterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
| | - M Alvarez
- Reproduction and Obstetrics Department of Animal Medicine and Surgery, University of León, León, Spain
| | - P de Paz
- Department of Molecular Biology, University of León, León, Spain
| | - J Masot
- Laboratory of Equine Reproduction and Equine Spermatology, Veterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
| | - E Redondo
- Laboratory of Equine Reproduction and Equine Spermatology, Veterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
| | - C Balao da Silva
- Portalagre Polytechnic Institute, Superior Agriculture School of Elvas, Elvas, Portugal
| | - J M Morrell
- Division of Reproduction, Faculty of Veterinary Medicine and Animal Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - H Rodriguez Martinez
- Department of Clinical and Experimental Medicine, Faculty of Medicine & Health Sciences, Linköping University, Linköping, Sweden
| | - J A Tapia
- Laboratory of Equine Reproduction and Equine Spermatology, Veterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
| | - M C Gil
- Laboratory of Equine Reproduction and Equine Spermatology, Veterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
| | - L Anel
- Reproduction and Obstetrics Department of Animal Medicine and Surgery, University of León, León, Spain
| | - F J Peña
- Laboratory of Equine Reproduction and Equine Spermatology, Veterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
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Janjua NZ, Islam N, Wong J, Yoshida EM, Ramji A, Samji H, Butt ZA, Chong M, Cook D, Alvarez M, Darvishian M, Tyndall M, Krajden M. Shift in disparities in hepatitis C treatment from interferon to DAA era: A population-based cohort study. J Viral Hepat 2017; 24:624-630. [PMID: 28130810 DOI: 10.1111/jvh.12684] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 12/22/2016] [Indexed: 12/15/2022]
Abstract
We evaluated the shift in the characteristics of people who received interferon-based hepatitis C virus (HCV) treatments and those who received recently introduced direct-acting antivirals (DAAs) in British Columbia (BC), Canada. The BC Hepatitis Testers Cohort includes 1.5 million individuals tested for HCV or HIV, or reported cases of hepatitis B and active tuberculosis in BC from 1990 to 2013 linked to medical visits, hospitalization, cancer, prescription drugs and mortality data. This analysis included all patients who filled at least one prescription for HCV treatment until 31 July 2015. HCV treatments were classified as older interferon-based treatments including pegylated interferon/ribavirin (PegIFN/RBV) with/without boceprevir or telaprevir, DAAs with RBV or PegIFN/RBV, and newer interferon-free DAAs. Of 11 886 people treated for HCV between 2000 and 2015, 1164 (9.8%) received interferon-free DAAs (ledipasvir/sofosbuvir: n=1075; 92.4%), while 452 (3.8%) received a combination of DAAs and RBV or PegIFN/RBV. Compared to those receiving interferon-based treatment, people with HIV co-infection (adjusted odds ratio [aOR]: 2.96, 95% CI: 2.31-3.81), cirrhosis (aOR: 1.77, 95% CI: 1.45-2.15), decompensated cirrhosis (aOR: 1.72, 95% CI: 1.31-2.28), diabetes (aOR: 1.30, 95% CI: 1.10-1.54), a history of injection drug use (aOR: 1.34, 95% CI: 1.09-1.65) and opioid substitution therapy (aOR: 1.30, 95% CI: 1.01-1.67) were more likely to receive interferon-free DAAs. Socio-economically marginalized individuals were significantly less likely (most deprived vs most privileged: aOR: 0.71, 95% CI: 0.58-0.87) to receive DAAs. In conclusion, there is a shift in prescription of new HCV treatments to previously excluded groups (eg HIV-co-infected), although gaps remain for the socio-economically marginalized populations.
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Affiliation(s)
- N Z Janjua
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - N Islam
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - J Wong
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - E M Yoshida
- Division of Gastroenterology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - A Ramji
- Division of Gastroenterology, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - H Samji
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Z A Butt
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - M Chong
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - D Cook
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - M Alvarez
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - M Darvishian
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - M Tyndall
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - M Krajden
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
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Gunturiz Beltran C, Bertomeu-Gonzalez V, Moreno-Arribas J, Perez L, Martinez-Ferrer J, Alzueta J, Arcocha M, Arenal A, Vinolas X, Alvarez M, Anguera I, Porro R, Castillo-Castillo J, Cordero A, Bertomeu-Martinez V. 3875Discriminators algorithm integrated into implantable defibrillator: diagnostic capacity analysis and impact in the reduction of inappropriate therapies. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.3875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | | | - J. Moreno-Arribas
- University Hospital San Juan de Alicante, Cardiology, Alicante, Spain
| | - L. Perez
- University Hospital Complex A Coruña, A Coruña, Spain
| | | | - J. Alzueta
- University Hospital Virgen de la Victoria, Malaga, Spain
| | | | - A. Arenal
- University Hospital Gregorio Maranon, Madrid, Spain
| | - X. Vinolas
- Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - M. Alvarez
- Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - I. Anguera
- University Hospital of Bellvitge, Barcelona, Spain
| | - R. Porro
- Hospital San Pedro de Alcantara, Caceres, Spain
| | | | - A. Cordero
- University Hospital San Juan de Alicante, Cardiology, Alicante, Spain
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Pradat P, Pugliese P, Poizot-Martin I, Valantin MA, Cuzin L, Reynes J, Billaud E, Huleux T, Bani-Sadr F, Rey D, Frésard A, Jacomet C, Duvivier C, Cheret A, Hustache-Mathieu L, Hoen B, Cabié A, Cotte L, Chidiac C, Ferry T, Ader F, Biron F, Boibieux A, Miailhes P, Perpoint T, Schlienger I, Lippmann J, Braun E, Koffi J, Longuet C, Guéripel V, Augustin-Normand C, Brochier C, Degroodt S, Pugliese P, Ceppi C, Cua E, Cottalorda J, Courjon J, Dellamonica P, Demonchy E, De Monte A, Durant J, Etienne C, Ferrando S, Fuzibet J, Garraffo R, Joulie A, Risso K, Mondain V, Naqvi A, Oran N, Perbost I, Pillet S, Prouvost-Keller B, Wehrlen-Pugliese S, Rosenthal E, Sausse S, Rio V, Roger P, Brégigeon S, Faucher O, Obry-Roguet V, Orticoni M, Soavi M, Geneau de Lamarlière P, Laroche H, Ressiot E, Carta M, Ducassou M, Jacquet I, Gallie S, Galinier A, Ritleng A, Ivanova A, Blanco-Betancourt C, Lions C, Debreux C, Obry-Roguet V, Poizot-Martin I, Agher R, Katlama C, Valantin M, Duvivier C, Lortholary O, Lanternier F, Charlier C, Rouzaud C, Aguilar C, Henry B, Lebeaux D, Cessot G, Gergely A, Consigny P, Touam F, Louisin C, Alvarez M, Biezunski N, Cuzin L, Debard A, Delobel P, Delpierre C, Fourcade C, Marchou B, Martin-Blondel G, Porte M, Mularczyk M, Garipuy D, Saune K, Lepain I, Marcel M, Puntis E, Atoui N, Casanova M, Faucherre V, Jacquet J, Le Moing V, Makinson A, Merle De Boever C, Montoya-Ferrer A, Psomas C, Reynes J, Raffi F, Allavena C, Billaud E, Biron C, Bonnet B, Bouchez S, Boutoille D, Brunet C, Jovelin T, Hall N, Bernaud C, Morineau P, Reliquet V, Aubry O, Point P, Besnier M, Larmet L, Hüe H, Pineau S, André-Garnier E, Rodallec A, Choisy P, Vandame S, Huleux T, Ajana F, Alcaraz I, Baclet V, Huleux T, Melliez H, Viget N, Valette M, Aissi E, Allienne C, Meybeck A, Riff B, Bani-Sadr F, Rouger C, Berger J, N'Guyen Y, Lambert D, Kmiec I, Hentzien M, Lebrun D, Migault C, Rey D, Batard M, Bernard-Henry C, Cheneau C, de Mautort E, Fischer P, Partisani M, Priester M, Lucht F, Frésard A, Botelho-Nevers E, Gagneux-Brunon A, Cazorla C, Guglielminotti C, Daoud F, Lutz M, Jacomet C, Laurichesse H, Lesens O, Vidal M, Mrozek N, Corbin V, Aumeran C, Baud O, Casanova S, Coban D, Hustache-Mathieu L, Thiebaut-Drobacheff M, Foltzer A, Gendrin V, Bozon F, Chirouze C, Abel S, Cabié A, Césaire R, Santos GD, Fagour L, Najioullah F, Ouka M, Pierre-François S, Pircher M, Rozé B, Hoen B, Ouissa R, Lamaury I. Direct-acting antiviral treatment against hepatitis C virus infection in HIV-Infected patients - "En route for eradication"? J Infect 2017; 75:234-241. [PMID: 28579302 DOI: 10.1016/j.jinf.2017.05.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 03/17/2017] [Accepted: 05/11/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Direct-Acting Antivirals (DAAs) opened a new era in HCV treatment. We report the impact of HCV treatment in French HIV-HCV coinfected patients. METHODS All HIV-HCV patients from the Dat'AIDS cohort followed between 2012 and 2015 were included. HCV status was defined yearly as naive, spontaneous cure, sustained virological response (SVR12), failure or reinfection. RESULTS Among 32,945 HIV-infected patients, 15.2% were positive for anti-HCV antibodies. From 2012 to 2015, HCV incidence rate increased from 0.35%PY to 0.69%PY in MSM, while median incidence was 0.08%PY in other patients. Median reinfection rate was 2.56%PY in MSM and 0.22%PY in other patients. HCV treatment initiation rate rose from 8.2% in 2012 to 29.6% (48.0% in pre-treated patients vs 22.6% in naïve patients). SVR12 rate increased from 68.7% to 95.2%. By the end of 2015, 62.7% of the patients were cured either spontaneously or following SVR. CONCLUSIONS HCV treatment dramatically increased in HIV-HCV patients in France from 2012 to 2015 resulting in HCV cure in nearly two-thirds of the patients in this cohort. Combined with a declining HCV prevalence, the prevalence of active HCV infection among HIV patients will drastically decrease in the forthcoming years.
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Affiliation(s)
- Pierre Pradat
- Center for Clinical Research, Department of Hepatology, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France.
| | - Pascal Pugliese
- Department of Infectious Diseases, Centre Hospitalier Universitaire de Nice, Hôpital l'Archet, Nice, France
| | - Isabelle Poizot-Martin
- Immuno-hematology Clinic, Assistance Publique - Hôpitaux de Marseille, Hôpital Sainte-Marguerite, Marseille, France; Aix-Marseille University, Inserm U912 (SESSTIM), Marseille, France
| | - Marc-Antoine Valantin
- Department of Infectious Diseases, Assistance Publique - Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France; Sorbonne Universités, UPMC Université Paris 06, INSERM, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136), Paris, France
| | - Lise Cuzin
- CHU Toulouse, COREVIH, Toulouse, France; Université de Toulouse III, Toulouse, France; INSERM, UMR, 1027, Toulouse, France
| | - Jacques Reynes
- Department of Infectious Diseases, UMI 233 INSERM U1175, CHU de Montpellier, Montpellier, France
| | - Eric Billaud
- Department of Infectious Diseases, Hotel Dieu Hospital, Nantes, France
| | - Thomas Huleux
- Department of Infectious Diseases and Travel Diseases, Centre Hospitalier Gustave-Dron, Tourcoing, France
| | - Firouze Bani-Sadr
- Department of Internal Medicine, Infectious Diseases and Clinical Immunology, Hôpital Robert Debré, CHU, Reims, France; Université de Reims Champagne-Ardenne, Faculté de médecine, EA-4684/SFR CAP-SANTE, Reims, France
| | - David Rey
- HIV Infection Care Centre, Hôpitaux Universitaires, Strasbourg, France
| | - Anne Frésard
- Department of Infectious Diseases, CHU, Saint-Etienne, France
| | - Christine Jacomet
- Department of Infectious Diseases, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Claudine Duvivier
- Department of Infectious Diseases, Centre d'Infectiologie Necker-Pasteur, IHU Imagine, Assistance Publique - Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, EA7327, Paris, France
| | - Antoine Cheret
- Department of Internal Medicine, CHU, Bicètre, France; Université Paris Descartes, Sorbonne Paris Cité, EA7327, Paris, France
| | | | - Bruno Hoen
- Faculté de Médecine Hyacinthe Bastaraud, Université des Antilles, and Service de Maladies Infectieuses et Tropicales, Dermatologie et Médecine Interne, and Inserm CIC 1424, Centre Hospitalier Universitaire de Pointe-à-Pitre, Pointe-à-Pitre, France
| | - André Cabié
- Department of Infectious Diseases, CHU de Martinique, Fort-de-France, France; Université des Antilles EA4537 and INSERM CIC1424, Fort-de-France, France
| | - Laurent Cotte
- Department of Infectious Diseases, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France; INSERM U1052, Lyon, France.
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37
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Villanova O, Dubois D, Sapin F, Lang S, Debard A, Lelièvre L, Alvarez M, Marchou B, Delobel P, Martin-Blondel G. Amélioration des modalités de prélèvement des hémocultures aéro-anaérobies au sein d’un service de maladies infectieuses. Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.373] [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: 11/29/2022]
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38
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Islam N, Krajden M, Gilbert M, Gustafson P, Yu A, Kuo M, Chong M, Alvarez M, Wong J, Tyndall MW, Janjua NZ. Role of primary T-cell immunodeficiency and hepatitis B coinfection on spontaneous clearance of hepatitis C: The BC Hepatitis Testers Cohort. J Viral Hepat 2017; 24:421-429. [PMID: 27885757 DOI: 10.1111/jvh.12650] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 06/24/2016] [Accepted: 10/29/2016] [Indexed: 12/13/2022]
Abstract
T-cell host immune response against hepatitis C virus (HCV) has been suggested to play an important role in determining HCV infection outcome. However, data from human studies are not available. This study examined the effect of primary T-cell deficiency along with other factors on the spontaneous clearance of HCV in a large population-based cohort in British Columbia, Canada. The BC Hepatitis Testers Cohort includes all individuals tested for HCV in BC in 1990-2013 linked with data on their medical visits, hospitalizations and prescription drugs. HCV-positive individuals with at least one valid HCV PCR test on/after HCV diagnosis (n=46 783) were included in this study. To examine factors associated with the spontaneous clearance of HCV, multivariable logistic regression was fitted on the full sample, and Cox proportional hazards model on the HCV seroconverters. Spontaneous clearance was observed in 25.1% (n=11 737) of those tested for HCV. After adjusting for potential confounders, the odds of spontaneous clearance of HCV was lower in people with primary T-cell immunodeficiency (adjusted odds ratio [aOR]: 0.55, 95% CI: 0.32-0.94), and higher in females (aOR: 1.61, 95% CI: 1.54-1.68) and in those coinfected with HBV (aOR: 2.31, 95% CI: 1.93-2.77). Similar results were observed in HCV seroconverters except HBV coinfection was not significant. In conclusion, primary T-cell immunodeficiency is associated with a lower spontaneous clearance of HCV while female sex and coinfection with HBV are associated with a higher spontaneous clearance.
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Affiliation(s)
- N Islam
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.,British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - M Krajden
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - M Gilbert
- British Columbia Centre for Disease Control, Vancouver, BC, Canada.,Ontario HIV Treatment Network, Toronto, ON, Canada
| | - P Gustafson
- Department of Statistics, University of British Columbia, Vancouver, BC, Canada
| | - A Yu
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - M Kuo
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - M Chong
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - M Alvarez
- British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - J Wong
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.,British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - M W Tyndall
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.,British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - N Z Janjua
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.,British Columbia Centre for Disease Control, Vancouver, BC, Canada
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Johnson DA, Colton MD, Alvarez M, Laden F, Redline S, Adamkiewicz G. 0833 SLEEP PATTERNS IN GREEN VS CONVENTIONAL MULTIFAMILY LOW-INCOME HOUSING. Sleep 2017. [DOI: 10.1093/sleepj/zsx050.832] [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: 11/14/2022] Open
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Fernández-Caballero JA, Alvarez M, Chueca N, Pérez AB, García F. The cobas® HCV GT is a new tool that accurately identifies Hepatitis C virus genotypes for clinical practice. PLoS One 2017; 12:e0175564. [PMID: 28410425 PMCID: PMC5391928 DOI: 10.1371/journal.pone.0175564] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Accepted: 03/28/2017] [Indexed: 12/24/2022] Open
Abstract
Objective We aimed to evaluate the correct assignment of HCV genotype/subtypes 1a and 1b by cobas® HCV genotyping (GT) assay (Roche Molecular Diagnostics) compared with nonstructural protein 5B (NS5B) sequencing. Patients and methods Clinical samples from 153 patients submitted for HCV genotyping were studied. After genotyping with the cobas® HCV GT, sequencing of a 387 bp fragment in the NS5B gene and phylogenetic analysis was employed to compare genotyping results. Major discrepancies were defined as differences in the assigned genotype by cobas® HCV GT and NS5B sequencing (including genotype 1 subtypes 1a and 1b misclassification). Results Overall agreement between the cobas® HCV GT and NS5B sequencing was 98%; all the 1a, 1b, 2, 3 and 4 genotypes identified by cobas® HCV GT were concordant with NS5B sequencing. Three samples tested “indetermined” by cobas® HCV GT assay and were genotyped as 1a, 3a, and 4d by NS5B sequencing. Conclussion These results indicate that the cobas® HCV GT assay correctly identifies HCV genotypes, and points out the importance of additional methods based on DNA sequencing for resolving indeterminate results.
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Affiliation(s)
- J. A. Fernández-Caballero
- Servicio de Microbiología, Complejo Hospitalario Universitario Granada-Hospital PTS, Instituto de Investigación Biosanitaria IBS, Granada, Spain
| | - M. Alvarez
- Servicio de Microbiología, Complejo Hospitalario Universitario Granada-Hospital PTS, Instituto de Investigación Biosanitaria IBS, Granada, Spain
- * E-mail:
| | - N. Chueca
- Servicio de Microbiología, Complejo Hospitalario Universitario Granada-Hospital PTS, Instituto de Investigación Biosanitaria IBS, Granada, Spain
| | - A. B. Pérez
- Servicio de Microbiología, Complejo Hospitalario Universitario Granada-Hospital PTS, Instituto de Investigación Biosanitaria IBS, Granada, Spain
| | - F. García
- Servicio de Microbiología, Complejo Hospitalario Universitario Granada-Hospital PTS, Instituto de Investigación Biosanitaria IBS, Granada, Spain
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41
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Ortega-Ferrusola C, Anel-López L, Martín-Muñoz P, Ortíz-Rodríguez JM, Gil MC, Alvarez M, de Paz P, Ezquerra LJ, Masot AJ, Redondo E, Anel L, Peña FJ. Computational flow cytometry reveals that cryopreservation induces spermptosis but subpopulations of spermatozoa may experience capacitation-like changes. Reproduction 2016; 153:293-304. [PMID: 27965398 DOI: 10.1530/rep-16-0539] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 11/02/2016] [Accepted: 12/12/2016] [Indexed: 12/19/2022]
Abstract
The reduced lifespan of cryopreserved spermatozoa in the mare reproductive tract has been attributed to both capacitative and apoptotic changes. However, there is a lack of studies investigating both phenomena simultaneously. In order to improve our knowledge in this particular point, we studied in raw and frozen-thawed samples apoptotic and capacitative markers using a wide battery of test based in flow cytometry. Apoptotic markers evaluated were caspase 3 activity, externalization of phosphatidylserine (PS), and mitochondrial membrane potential. Markers of changes resembling capacitation were membrane fluidity, tyrosine phosphorylation, and intracellular sodium. Conventional and computational flow cytometry using nonlinear dimensionally reduction techniques (t-distributed stochastic neighbor embedding (t-SNE)) and automatic classification of cellular expression by nonlinear stochastic embedding (ACCENSE) were used. Most of the changes induced by cryopreservation were apoptotic, with increase in caspase 3 activation (P < 0.01), PS translocation to the outer membrane (P < 0.001), loss of mitochondrial membrane potential (P < 0.05), and increase in intracellular Na+ (P < 0.01). Average values of markers of capacitative changes were not affected by cryopreservation; however, the analysis of the phenotype of individual spermatozoa using computational flow cytometry revealed the presence of subpopulations of spermatozoa experiencing capacitative changes. For the first time advanced computational techniques were applied to the analysis of spermatozoa, and these techniques were able to disclose relevant information of the ejaculate that remained hidden using conventional flow cytometry.
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Affiliation(s)
| | - L Anel-López
- Reproduction and Obstetrics Department of Animal Medicine and Surgery
| | - P Martín-Muñoz
- Laboratory of Equine Reproduction and Equine SpermatologyVeterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
| | - J M Ortíz-Rodríguez
- Laboratory of Equine Reproduction and Equine SpermatologyVeterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
| | - M C Gil
- Laboratory of Equine Reproduction and Equine SpermatologyVeterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
| | - M Alvarez
- Reproduction and Obstetrics Department of Animal Medicine and Surgery
| | - P de Paz
- Department of Molecular BiologyUniversity of León, León, Spain
| | - L J Ezquerra
- Laboratory of Equine Reproduction and Equine SpermatologyVeterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
| | - A J Masot
- Laboratory of Equine Reproduction and Equine SpermatologyVeterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
| | - E Redondo
- Laboratory of Equine Reproduction and Equine SpermatologyVeterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
| | - L Anel
- Reproduction and Obstetrics Department of Animal Medicine and Surgery
| | - F J Peña
- Laboratory of Equine Reproduction and Equine SpermatologyVeterinary Teaching Hospital, University of Extremadura, Cáceres, Spain
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Gomez-Millan J, Pajares B, Perez-Villa L, Carnero A, Alvarez M, De Luque V, Rivas F, Trigo JM, Toledo MD, Alba E, Medina JA. Subcellular localisation of pMEK has a different prognosis in locally advanced head and neck cancer treated with concomitant radiochemotherapy. BMC Cancer 2016; 16:829. [PMID: 27793200 PMCID: PMC5084350 DOI: 10.1186/s12885-016-2869-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 10/21/2016] [Indexed: 12/30/2022] Open
Abstract
Background MEK1 (MAP2K1) and MEK2 (MAP2K2) are closely related dual-specificity protein kinases which function by phosphorylating both serine/threonine and tyrosine residues of their substrates ERK1 and ERK2, controlling fundamental cellular processes that include cell growth and proliferation. To investigate the prognostic significance of pMEK expression in the nucleus and cytoplasm among patients with locally advanced head and neck cancer treated with concurrent radiochemotherapy. Methods Immunohistochemistry was performed on the retrieved archival tissue of 96 patients to detect pMEK, p53 and Ki-67. Results Sixty-six percent of patients were positive for pMEK expression in the nucleus and 41 % in cytoplasm. On univariate analysis, high nuclear pMEK was predictive of worse 5y-DFS and 5y-OS, with a trend to significance (26 % vs. 41 %, p = 0.09; 36 % vs. 47 %, p = 0.07). High cytoplasmic pMEK was predictive of better 5-y OS and 5-y DFS outcomes (61 % vs. 27 %, p = 0.01; 46 % vs. 22 %, p = 0.02). On multivariate analysis, low cytoplasmic pMEK and high nuclear pMEK predicted worse DFS and OS (p = 0.01; p = 0.04 and p = 0.02; p = 0.02 respectively). Conclusions Subcellular localisation of pMEK has different prognosis in locally advanced head and neck cancer treated with radiochemotherapy.
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Affiliation(s)
- J Gomez-Millan
- Radiation Oncology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, 29010, Malaga, Spain.
| | - B Pajares
- Medical Oncology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, 29010, Malaga, Spain.
| | - L Perez-Villa
- Pathology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, 29010, Malaga, Spain
| | - A Carnero
- Instituto de Biomedicina de Sevilla (IBIS), Consejo superior de investigaciones científicas, Campus Universitario Virgen del Rocío, Avda, Manuel Siurot s/n, 41013, Sevilla, Spain
| | - M Alvarez
- Pathology Department, Facultad de Medicina, UMA, Campus Teatinos s/n, 29010, Malaga, Spain
| | - V De Luque
- Medical Oncology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, 29010, Malaga, Spain
| | - F Rivas
- Agencia Sanitaria Costa del Sol, Unidad de Investigación, Autovia A-7, Km 187, 29063, Marbella, Málaga, Spain.,Red Nacional de Investigación de Servicios de Salud en Enfermedades crónicas (REDISSEC), Madrid, Spain
| | - J M Trigo
- Medical Oncology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, 29010, Malaga, Spain
| | - M D Toledo
- Radiation Oncology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, 29010, Malaga, Spain
| | - E Alba
- Medical Oncology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, 29010, Malaga, Spain
| | - J A Medina
- Radiation Oncology Department, Hospital Universitario Virgen de la Victoria, Campus Teatinos s/n, 29010, Malaga, Spain
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Alvarez M, Sanchez-Muñoz A, Santonja A, Fernández YP, Miramón J, Pedrinaci IZ, Llacer C, de Luque V, León ML, Jerez J, Villa LP, Lavado R, Ramirez C, Jiménez A, Rodrigo I, García E, Vicioso L, Conejo EA. Prognostic significance of immunohistochemical subtyping and PAM50 intrinsic subtypes in male breast cancer (MaBC). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw365.68] [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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Lopez-Urueña E, Anel-López L, Borragan S, Ortega Ferrusola C, Manrique P, de Paz P, Anel L, Alvarez M. The use of gelatine in long-term storage (up to 48 hr) at 5°C preserves the pre-freezing and post-thawing quality of brown bear sperm. Reprod Domest Anim 2016; 51:700-7. [PMID: 27418181 DOI: 10.1111/rda.12734] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 06/19/2016] [Indexed: 12/17/2022]
Abstract
Sedimentation of spermatozoa occurs during long-term liquid storage and this may produce deleterious changes. Our aim was to apply gelatine supplementation during long-term pre-freezing storage of bear sperm, applying final dilution and 6% glycerol at room temperature and cool in straws. We tested four models of sperm storage using a 1:1 dilution in TTF-ULE-Bear extender (TesT-fructose-egg yolk-glycerol 6%): (i) second 1:1 dilution at room temperature (RT), cooling at 5°C in a tube and final dilution (100 × 10(6) sperm ml(-1) ) (Standard); (ii) final dilution at RT and cooling in a tube (FD-Tube); (iii) final dilution at RT and cooling in 0.25 ml plastic straw (FD-Straw); and (iv) final dilution at RT in extender supplemented with 1.5% gelatine (Gelatine) and cooling in a 0.25 ml plastic straw. A Standard sample was stored at 5°C for 1 hr (Control); the rest of the samples (Standard, FD-Tube, FD-Straw, Gelatine) were stored for 24 or 48 hrs before freezing (100 × 10(6) sperm ml(-1) , glycerol 6%). The quality of the samples was assessed for motility by CASA, and viability (SYBR-14/propidium iodide-PI-; VIAB), acrosomal status (PNA-FITC/PI; iACR) and apoptotic status (YO-PRO-1/PI; YOPRO-) by flow cytometry. At pre-freezing, after 48 hr, Gelatine showed significantly higher viability (for VIAB and YOPRO-) and progressiveness (PM, LIN and STR). At 48 hr, Gelatine showed similar YOPRO-, iACR, LIN, STR and ALH respect to Control. At both 24 and 48 h post-thawing, Gelatine sample had similar scores for YOPRO-, iACR, LIN, STR, WOB and VIAB (only 24 hr) when compared with Control, and lower for TM, PM, rapidPM, VAP and ALH. No differences were found among others experimental groups with respect to Control. In conclusion, gelatine could be a suitable alternative to preserve the viability and progressive motility of brown bear ejaculates during long-term pre-freezing storage at 5°C.
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Affiliation(s)
- E Lopez-Urueña
- ITRA-ULE, INDEGSAL, University of León, León, Spain.,Animal Reproduction and Obstetrics, University of León, León, Spain
| | | | | | | | - P Manrique
- ITRA-ULE, INDEGSAL, University of León, León, Spain
| | - P de Paz
- ITRA-ULE, INDEGSAL, University of León, León, Spain. .,Molecular Biology (Cell Biology), University of León, León, Spain.
| | - L Anel
- ITRA-ULE, INDEGSAL, University of León, León, Spain.,Animal Reproduction and Obstetrics, University of León, León, Spain
| | - M Alvarez
- ITRA-ULE, INDEGSAL, University of León, León, Spain.,Animal Reproduction and Obstetrics, University of León, León, Spain
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Mourguet M, Jeannel J, Laffont MA, Benouaich X, Alvarez M, Marchou B, Soler V. [Case report of cytomegalovirus anterior uveitis in an immunocompetent one-eyed patient with an intraocular dexamethasone implant]. J Fr Ophtalmol 2016; 39:e113-4. [PMID: 27155910 DOI: 10.1016/j.jfo.2015.04.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Revised: 04/06/2015] [Accepted: 04/10/2015] [Indexed: 10/21/2022]
Affiliation(s)
- M Mourguet
- Service de maladies infectieuses et tropicales, bâtiment urgences-réanimation-médecines, CHU Purpan, 1, place du Pr-Joseph-Baylac, 31059 Toulouse, France.
| | - J Jeannel
- Service de maladies infectieuses et tropicales, bâtiment urgences-réanimation-médecines, CHU Purpan, 1, place du Pr-Joseph-Baylac, 31059 Toulouse, France
| | - M-A Laffont
- Service de maladies infectieuses et tropicales, bâtiment urgences-réanimation-médecines, CHU Purpan, 1, place du Pr-Joseph-Baylac, 31059 Toulouse, France
| | - X Benouaich
- Nouvelle clinique de l'Union, chemin Ratalens, 31240 Saint-Jean, France
| | - M Alvarez
- Service de maladies infectieuses et tropicales, bâtiment urgences-réanimation-médecines, CHU Purpan, 1, place du Pr-Joseph-Baylac, 31059 Toulouse, France
| | - B Marchou
- Service de maladies infectieuses et tropicales, bâtiment urgences-réanimation-médecines, CHU Purpan, 1, place du Pr-Joseph-Baylac, 31059 Toulouse, France
| | - V Soler
- Service d'ophtalmologie, hôpital Pierre-Paul-Riquet, CHU Purpan, 1, place du Pr-Joseph-Baylac, 31059 Toulouse, France
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Mahíllo B, Alvarez M, Carmona M, López-Fraga M, Domínguez-Gil B, Matesanz R. SP647PROGRESS OF KIDNEY TRANSPLANTATION ACTIVITIES IN THE EUROPEAN UNION (2005- 2014): DATA FROM THE NEWSLETTER TRANSPLANT OF THE COUNCIL OF EUROPE. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw178.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Foust CM, Preite V, Schrey AW, Alvarez M, Robertson MH, Verhoeven KJF, Richards CL. Genetic and epigenetic differences associated with environmental gradients in replicate populations of two salt marsh perennials. Mol Ecol 2016; 25:1639-52. [PMID: 26880043 DOI: 10.1111/mec.13522] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [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: 07/01/2015] [Revised: 11/27/2015] [Accepted: 12/16/2015] [Indexed: 12/14/2022]
Abstract
While traits and trait plasticity are partly genetically based, investigating epigenetic mechanisms may provide more nuanced understanding of the mechanisms underlying response to environment. Using AFLP and methylation-sensitive AFLP, we tested the hypothesis that differentiation to habitats along natural salt marsh environmental gradients occurs at epigenetic, but not genetic loci in two salt marsh perennials. We detected significant genetic and epigenetic structure among populations and among subpopulations, but we found multilocus patterns of differentiation to habitat type only in epigenetic variation for both species. In addition, more epigenetic than genetic loci were correlated with habitat in both species. When we analysed genetic and epigenetic variation simultaneously with partial Mantel, we found no correlation between genetic variation and habitat and a significant correlation between epigenetic variation and habitat in Spartina alterniflora. In Borrichia frutescens, we found significant correlations between epigenetic and/or genetic variation and habitat in four of five populations when populations were analysed individually, but there was no significant correlation between genetic or epigenetic variation and habitat when analysed jointly across the five populations. These analyses suggest that epigenetic mechanisms are involved in the response to salt marsh habitats, but also that the relationships among genetic and epigenetic variation and habitat vary by species. Site-specific conditions may also cloud our ability to detect response in replicate populations with similar environmental gradients. Future studies analysing sequence data and the correlation between genetic variation and DNA methylation will be powerful to identify the contributions of genetic and epigenetic response to environmental gradients.
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Affiliation(s)
- C M Foust
- Department of Integrative Biology, University of South Florida, 4202 E. Fowler Ave, SCA 110, Tampa, FL, 33620, USA
| | - V Preite
- Department of Terrestrial Ecology, Netherlands Institute of Ecology (NIOO-KNAW), Droevendaalsesteeg 10, Wageningen, 6708 PB, the Netherlands
| | - A W Schrey
- Department of Biology, Armstrong State University, Science Center, 11935 Abercorn Street, Savannah, GA, 31419, USA
| | - M Alvarez
- Department of Integrative Biology, University of South Florida, 4202 E. Fowler Ave, SCA 110, Tampa, FL, 33620, USA
| | - M H Robertson
- Department of Integrative Biology, University of South Florida, 4202 E. Fowler Ave, SCA 110, Tampa, FL, 33620, USA
| | - K J F Verhoeven
- Department of Terrestrial Ecology, Netherlands Institute of Ecology (NIOO-KNAW), Droevendaalsesteeg 10, Wageningen, 6708 PB, the Netherlands
| | - C L Richards
- Department of Integrative Biology, University of South Florida, 4202 E. Fowler Ave, SCA 110, Tampa, FL, 33620, USA
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48
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Alvarez-Meza A, Cardenas-Pena D, Castro-Ospina AE, Alvarez M, Castellanos-Dominguez G. Tensor-product kernel-based representation encoding joint MRI view similarity. Annu Int Conf IEEE Eng Med Biol Soc 2015; 2014:3897-900. [PMID: 25570843 DOI: 10.1109/embc.2014.6944475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
To support 3D magnetic resonance image (MRI) analysis, a marginal image similarity (MIS) matrix holding MR inter-slice relationship along every axis view (Axial, Coronal, and Sagittal) can be estimated. However, mutual inference from MIS view information poses a difficult task since relationships between axes are nonlinear. To overcome this issue, we introduce a Tensor-Product Kernel-based Representation (TKR) that allows encoding brain structure patterns due to patient differences, gathering all MIS matrices into a single joint image similarity framework. The TKR training strategy is carried out into a low dimensional projected space to get less influence of voxel-derived noise. Obtained results for classifying the considered patient categories (gender and age) on real MRI database shows that the proposed TKR training approach outperforms the conventional voxel-wise sum of squared differences. The proposed approach may be useful to support MRI clustering and similarity inference tasks, which are required on template-based image segmentation and atlas construction.
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Hofstra LM, Sauvageot N, Albert J, Alexiev I, Garcia F, Struck D, Van de Vijver DAMC, Åsjö B, Beshkov D, Coughlan S, Descamps D, Griskevicius A, Hamouda O, Horban A, Van Kasteren M, Kolupajeva T, Kostrikis LG, Liitsola K, Linka M, Mor O, Nielsen C, Otelea D, Paraskevis D, Paredes R, Poljak M, Puchhammer-Stöckl E, Sönnerborg A, Staneková D, Stanojevic M, Van Laethem K, Zazzi M, Zidovec Lepej S, Boucher CAB, Schmit JC, Wensing AMJ, Puchhammer-Stockl E, Sarcletti M, Schmied B, Geit M, Balluch G, Vandamme AM, Vercauteren J, Derdelinckx I, Sasse A, Bogaert M, Ceunen H, De Roo A, De Wit S, Echahidi F, Fransen K, Goffard JC, Goubau P, Goudeseune E, Yombi JC, Lacor P, Liesnard C, Moutschen M, Pierard D, Rens R, Schrooten Y, Vaira D, Vandekerckhove LPR, Van den Heuvel A, Van Der Gucht B, Van Ranst M, Van Wijngaerden E, Vandercam B, Vekemans M, Verhofstede C, Clumeck N, Van Laethem K, Beshkov D, Alexiev I, Lepej SZ, Begovac J, Kostrikis L, Demetriades I, Kousiappa I, Demetriou V, Hezka J, Linka M, Maly M, Machala L, Nielsen C, Jørgensen LB, Gerstoft J, Mathiesen L, Pedersen C, Nielsen H, Laursen A, Kvinesdal B, Liitsola K, Ristola M, Suni J, Sutinen J, Descamps D, Assoumou L, Castor G, Grude M, Flandre P, Storto A, Hamouda O, Kücherer C, Berg T, Braun P, Poggensee G, Däumer M, Eberle J, Heiken H, Kaiser R, Knechten H, Korn K, Müller H, Neifer S, Schmidt B, Walter H, Gunsenheimer-Bartmeyer B, Harrer T, Paraskevis D, Hatzakis A, Zavitsanou A, Vassilakis A, Lazanas M, Chini M, Lioni A, Sakka V, Kourkounti S, Paparizos V, Antoniadou A, Papadopoulos A, Poulakou G, Katsarolis I, Protopapas K, Chryssos G, Drimis S, Gargalianos P, Xylomenos G, Lourida G, Psichogiou M, Daikos GL, Sipsas NV, Kontos A, Gamaletsou MN, Koratzanis G, Sambatakou H, Mariolis H, Skoutelis A, Papastamopoulos V, Georgiou O, Panagopoulos P, Maltezos E, Coughlan S, De Gascun C, Byrne C, Duffy M, Bergin C, Reidy D, Farrell G, Lambert J, O'Connor E, Rochford A, Low J, Coakely P, O'Dea S, Hall W, Mor O, Levi I, Chemtob D, Grossman Z, Zazzi M, de Luca A, Balotta C, Riva C, Mussini C, Caramma I, Capetti A, Colombo MC, Rossi C, Prati F, Tramuto F, Vitale F, Ciccozzi M, Angarano G, Rezza G, Kolupajeva T, Vasins O, Griskevicius A, Lipnickiene V, Schmit JC, Struck D, Sauvageot N, Hemmer R, Arendt V, Michaux C, Staub T, Sequin-Devaux C, Wensing AMJ, Boucher CAB, van de Vijver DAMC, van Kessel A, van Bentum PHM, Brinkman K, Connell BJ, van der Ende ME, Hoepelman IM, van Kasteren M, Kuipers M, Langebeek N, Richter C, Santegoets RMWJ, Schrijnders-Gudde L, Schuurman R, van de Ven BJM, Åsjö B, Kran AMB, Ormaasen V, Aavitsland P, Horban A, Stanczak JJ, Stanczak GP, Firlag-Burkacka E, Wiercinska-Drapalo A, Jablonowska E, Maolepsza E, Leszczyszyn-Pynka M, Szata W, Camacho R, Palma C, Borges F, Paixão T, Duque V, Araújo F, Otelea D, Paraschiv S, Tudor AM, Cernat R, Chiriac C, Dumitrescu F, Prisecariu LJ, Stanojevic M, Jevtovic D, Salemovic D, Stanekova D, Habekova M, Chabadová Z, Drobkova T, Bukovinova P, Shunnar A, Truska P, Poljak M, Lunar M, Babic D, Tomazic J, Vidmar L, Vovko T, Karner P, Garcia F, Paredes R, Monge S, Moreno S, Del Amo J, Asensi V, Sirvent JL, de Mendoza C, Delgado R, Gutiérrez F, Berenguer J, Garcia-Bujalance S, Stella N, de Los Santos I, Blanco JR, Dalmau D, Rivero M, Segura F, Elías MJP, Alvarez M, Chueca N, Rodríguez-Martín C, Vidal C, Palomares JC, Viciana I, Viciana P, Cordoba J, Aguilera A, Domingo P, Galindo MJ, Miralles C, Del Pozo MA, Ribera E, Iribarren JA, Ruiz L, de la Torre J, Vidal F, Clotet B, Albert J, Heidarian A, Aperia-Peipke K, Axelsson M, Mild M, Karlsson A, Sönnerborg A, Thalme A, Navér L, Bratt G, Karlsson A, Blaxhult A, Gisslén M, Svennerholm B, Bergbrant I, Björkman P, Säll C, Mellgren Å, Lindholm A, Kuylenstierna N, Montelius R, Azimi F, Johansson B, Carlsson M, Johansson E, Ljungberg B, Ekvall H, Strand A, Mäkitalo S, Öberg S, Holmblad P, Höfer M, Holmberg H, Josefson P, Ryding U. Transmission of HIV Drug Resistance and the Predicted Effect on Current First-line Regimens in Europe. Clin Infect Dis 2015; 62:655-663. [PMID: 26620652 PMCID: PMC4741360 DOI: 10.1093/cid/civ963] [Citation(s) in RCA: 118] [Impact Index Per Article: 13.1] [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: 06/08/2015] [Accepted: 11/06/2015] [Indexed: 11/13/2022] Open
Abstract
Transmitted human immunodeficiency virus drug resistance in Europe is stable at around 8%. The impact of baseline mutation patterns on susceptibility to antiretroviral drugs should be addressed using clinical guidelines. The impact on baseline susceptibility is largest for nonnucleoside reverse transcriptase inhibitors. Background. Numerous studies have shown that baseline drug resistance patterns may influence the outcome of antiretroviral therapy. Therefore, guidelines recommend drug resistance testing to guide the choice of initial regimen. In addition to optimizing individual patient management, these baseline resistance data enable transmitted drug resistance (TDR) to be surveyed for public health purposes. The SPREAD program systematically collects data to gain insight into TDR occurring in Europe since 2001. Methods. Demographic, clinical, and virological data from 4140 antiretroviral-naive human immunodeficiency virus (HIV)–infected individuals from 26 countries who were newly diagnosed between 2008 and 2010 were analyzed. Evidence of TDR was defined using the WHO list for surveillance of drug resistance mutations. Prevalence of TDR was assessed over time by comparing the results to SPREAD data from 2002 to 2007. Baseline susceptibility to antiretroviral drugs was predicted using the Stanford HIVdb program version 7.0. Results. The overall prevalence of TDR did not change significantly over time and was 8.3% (95% confidence interval, 7.2%–9.5%) in 2008–2010. The most frequent indicators of TDR were nucleoside reverse transcriptase inhibitor (NRTI) mutations (4.5%), followed by nonnucleoside reverse transcriptase inhibitor (NNRTI) mutations (2.9%) and protease inhibitor mutations (2.0%). Baseline mutations were most predictive of reduced susceptibility to initial NNRTI-based regimens: 4.5% and 6.5% of patient isolates were predicted to have resistance to regimens containing efavirenz or rilpivirine, respectively, independent of current NRTI backbones. Conclusions. Although TDR was highest for NRTIs, the impact of baseline drug resistance patterns on susceptibility was largest for NNRTIs. The prevalence of TDR assessed by epidemiological surveys does not clearly indicate to what degree susceptibility to different drug classes is affected.
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Affiliation(s)
- L Marije Hofstra
- Luxembourg Institute of Health, Luxembourg.,Department of Virology, University Medical Center Utrecht, The Netherlands
| | | | - Jan Albert
- Karolinska Institute, Solna.,Karolinska University Hospital, Stockholm, Sweden
| | - Ivailo Alexiev
- National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Federico Garcia
- Complejo Hospitalario Universitario de Granada, Instituto de Investigación IBS Granada; on behalf of Cohorte de Adultos de la Red de Investigación en SIDA, Spain
| | | | | | | | - Danail Beshkov
- National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | | | - Diane Descamps
- AP-HP Groupe hospitalier Bichat-Claude Bernard, IAME INSERM UMR 1137, Université Paris Diderot Sorbonne Paris Cité, Paris, France
| | | | | | | | | | | | | | - Kirsi Liitsola
- Department of Infectious Diseases, National Institute for Health and Welfare, Helsinki, Finland
| | - Marek Linka
- National Reference Laboratory for HIV/AIDS, National Institute of Public Health, Prague, Czech Republic
| | - Orna Mor
- National HIV Reference Laboratory, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | | | - Dan Otelea
- National Institute for Infectious Diseases "Prof. dr. Matei Bals", Bucharest, Romania
| | | | | | - Mario Poljak
- Faculty of Medicine, Slovenian HIV/AIDS Reference Centre, University of Ljubljana, Slovenia
| | | | - Anders Sönnerborg
- Karolinska Institute, Solna.,Karolinska University Hospital, Stockholm, Sweden
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Alves AFF, Alvarez M, Ribeiro SM, Duarte SB, Miranda JRA, Pina DR. Association between subjective evaluation and physical parameters for radiographic images optimization. Phys Med 2015; 32:123-32. [PMID: 26573131 DOI: 10.1016/j.ejmp.2015.10.095] [Citation(s) in RCA: 14] [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] [Received: 07/22/2015] [Revised: 10/28/2015] [Accepted: 10/30/2015] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The purpose of this study was to develop a methodology to optimize computed radiographic techniques to image the skull, chest, and pelvis of a standard patient. METHODS Optimization was performed by varying exposure levels with different tube voltages to generate images of an anthropomorphic phantom. Image quality was evaluated using visual grading analysis and measuring objective parameters such as the effective detective quantum efficiency and the contrast-to-noise ratio. Objective and subjective evaluations were compared to obtain an optimized technique for each anatomic region. RESULTS Gold standard techniques provided a significant reduction in X-ray doses compared to the techniques used in our radiology service, without compromising diagnostic accuracy. They were chosen as follows 102 kVp/1.6 mAs for skull; 81 kVp/4.5 mAs for pelvis and 90 kVp/3.2 mAs for chest. CONCLUSION There is a range of acceptable techniques that produce adequate images for diagnosis in computed radiography systems. This aspect allows the optimization process to be focused on the patient dose without compromising diagnostic capabilities. This process should be performed through association of quantitative and qualitative parameters, such as effective detective quantum efficiency, contrast-to-noise ratio, and visual grading analysis.
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Affiliation(s)
- A F F Alves
- Department of Physics and Biophysics, Biosciences Institute of Botucatu, São Paulo State University, Distrito de Rubião Junior S/N, Botucatu, São Paulo, 18618-000, Brazil.
| | - M Alvarez
- Department of Physics and Biophysics, Biosciences Institute of Botucatu, São Paulo State University, Distrito de Rubião Junior S/N, Botucatu, São Paulo, 18618-000, Brazil.
| | - S M Ribeiro
- Department of Tropical Diseases and Diagnostic Imaging, Botucatu Medical School São Paulo State University, Distrito de Rubião Junior S/N, Botucatu, São Paulo, 18618-000, Brazil.
| | - S B Duarte
- Brazilian Center of Physics Research - CBPF-MCT, Dr. Xavier Sigaud, 150, Rio de Janeiro, 22290-180, Brazil.
| | - J R A Miranda
- Department of Physics and Biophysics, Biosciences Institute of Botucatu, São Paulo State University, Distrito de Rubião Junior S/N, Botucatu, São Paulo, 18618-000, Brazil.
| | - D R Pina
- Department of Tropical Diseases and Diagnostic Imaging, Botucatu Medical School São Paulo State University, Distrito de Rubião Junior S/N, Botucatu, São Paulo, 18618-000, Brazil.
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