1
|
Arratia G, San-Martín F, Brkljaca N, Agüero C, Vergara M, Guzmán AM. [Cryoglobulinemic vasculitis due to hyperviscosity and cryogel formation as the onset of multiple myeloma. Report of one case]. Rev Med Chil 2022; 150:832-835. [PMID: 37906918 DOI: 10.4067/s0034-98872022000600832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 09/21/2022] [Indexed: 11/02/2023]
Abstract
Multiple Myeloma (MM) is characterized by a clonal expansion of plasma cells in the bone marrow. These cells typically produce a monoclonal immunoglobulin, and its symptoms arise either from plasma cell infiltration in several organs, or secondary to the presence of a monoclonal protein peak. Symptoms can be summarized by the acronym CRAB (hypercalcemia, renal failure, anemia and bone lesions). Sometimes, in the setting of a protein secreting monoclonal gammopathy, formation of cryoglobulins develops. Cryoglobulins are plasma proteins that precipitate at low temperatures, forming a cold - induced precipitate at small vessels, causing a wide range of clinical manifestations. We report a female consulting for ulcers lasting 2 months in the left foot associated with purpuric lesions in both lower limbs. Protein electrophoresis showed a monoclonal peak in the gamma region. Bone marrow aspirate showed 27% of plasma cells with kappa chain restriction by cytometry. The presence of cryoglobulins was confirmed. The patient was treated with dexamethasone and bortezomib, with a progressive healing of lower limb lesions and disappearance of cryoglobulins. She was discharged in good conditions.
Collapse
Affiliation(s)
- Gabriel Arratia
- Departamento de Laboratorios Clínicos, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Fernanda San-Martín
- Departamento de Medicina Interna, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Nicolás Brkljaca
- Departamento de Medicina Interna, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Maximiliano Vergara
- Departamento de Hematología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ana María Guzmán
- Departamento de Laboratorios Clínicos, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| |
Collapse
|
2
|
Vergara M. Diagnosis and treatment of hepatitis B. What contributions can prisons make? Rev Esp Sanid Penit 2021; 23:119-127. [PMID: 35411915 PMCID: PMC8802821 DOI: 10.18176/resp.00041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 06/23/2021] [Indexed: 11/20/2022]
Abstract
Hepatitis B is a parenterally and sexually transmitted infection. Vaccination for the disease is highly effective, and its inclusion in Spain as part of a systematic and universal schedule for newborns has led to a significant decrease of incidence in the national population. However, the number of inmates born in other countries - some from endemic areas of HBV infection -, the mechanisms of transmission and lack of vaccination in third world countries mean that its prevalence in the prison population is higher than in the general population. These institutions therefore play an essential role in detecting and managing hepatitis B. In this paper, the situation of hepatitis B in prisons is reviewed and recommendations are proposed to optimize its control.
Collapse
Affiliation(s)
- M Vergara
- Hepatology Unit. Digestive Disease Service. Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT. Universitat Autònoma de Barcelona. Sabadell. Barcelona. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd). Instituto Carlos III. Madrid. Spain
| |
Collapse
|
3
|
Sarmiento M, Rojas P, Triantafilo N, Campbell J, García MJ, Ocqueteau M, Sandoval V, Rojas A, Gazmuri JT, Guerrero G, Vergara M, Bertin P, Ramírez P, Jara V, Gutiérrez C, Soto K, Arellano S, Pizarro I, Lorca C. [Age does not affect the outcome of allogeneic hematopoietic precursor transplantation for acute myeloid leukemia]. Rev Med Chil 2021; 149:22-29. [PMID: 34106132 DOI: 10.4067/s0034-98872021000100022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 11/23/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND In our country, transplantation centers differ in the age limit for allogeneic hematopoietic transplantation (ALOHT). In our program, transplants with age- adjusted conditioning are performed in patients until 70 years old. Currently more than 60% of ALOHT reported to the Center for International Bone Marrow Transplantation Research (CIBMTR) are performed in patients older than 40 years. AIM To report our experience with ALOHT in acute myelogenous leukemia (AML), analyzing patient age at transplantation in different periods and transplant results in different age groups. MATERIAL AND METHODS A retrospective analysis of the database of adult hematopoietic transplants in AML patients was performed. Demographic data, disease characteristics, transplant data, survival and relapse times, and mortality were collected. RESULTS In our program, 1030 transplants were performed in adults and 119 ALOHT were performed in AML patients, between 1990 and 2020. The median age of patients in all periods was 41 years, (range 16-69). The median age was 33 and 45 years, in the periods 1990-2000 and 2000-2020 respectively (p < 0.01). Seventy-eight patients received myeloablative conditioning (median age 44 years) and 41 reduced intensity conditioning (median age 53 years). Five-year overall survival was 44.6% (confidence intervals (CI) 41-48). Non relapse mortality of all periods was 19% (CI 17 - 40%) and relapse rate was 17 % (CI 16-22). No difference in five years overall survival among patients younger than 40, 41 to 50 and over 51 years was observed. CONCLUSIONS Overall Survival, non-relapse mortality and relapse rate were similar in younger and older patients in our program and similar to those previously reported in other centers.
Collapse
Affiliation(s)
- Mauricio Sarmiento
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Patricio Rojas
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Nicolás Triantafilo
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - James Campbell
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - María José García
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Mauricio Ocqueteau
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Vicente Sandoval
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Andrés Rojas
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - José Tomás Gazmuri
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Gonzalo Guerrero
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Maximiliano Vergara
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pablo Bertin
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pablo Ramírez
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Verónica Jara
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Catherine Gutiérrez
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Katherine Soto
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Silvana Arellano
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Isabel Pizarro
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Carla Lorca
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| |
Collapse
|
4
|
Campos-Estrada C, Riquelme B, Vergara M, Altamirano C, Cavieres MF. In vitro Notch-mediated adjuvant immunogenic potency is induced by combining QS-21 and MPL in a co-culture model of PBMC and HUVEC cells. Toxicol In Vitro 2020; 68:104947. [PMID: 32679256 DOI: 10.1016/j.tiv.2020.104947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 06/30/2020] [Accepted: 07/10/2020] [Indexed: 10/23/2022]
Abstract
Few vaccine adjuvants have been approved for human use although several are currently being studied in preclinical and clinical trial. MPL is a toll-like receptor agonist able to trigger a high and persistent antibody response via-TLR-4 while QS-21 activates the NLRP3 inflammasome. Data suggest that there is a cross-talk between Notch and TLR signaling pathways modulating the polarization of the immune response in a MyD88-dependent manner. However, the role of Notch on the mechanism action of immunogenic adjuvants has not been addressed yet. This study aims to evaluate the in vitro toxicity and inflammatory response triggered by MPL and QS-21 using an in vitro human cell co-culture model and to determine whether NFκB or Notch signaling pathways are involved in their mechanism of immunotoxicity. In order to do this, we evaluated the effect of QS- 21/MPL alone or in combination using a co-culture of PBMC and HUVEC using cytotoxicity, surface expression of ECAMs, cell adhesion and cytokine release, NF-κB activation and NOTCH1 expression as observation endpoints. We found that both MPL and QS-21 were cytotoxic at concentrations over 5 μg/mL. Both adjuvants were able to trigger the expression of ECAMs and induce firm adhesion of PBMC to the endothelium. QS-21 and MPL combination demonstrated a synergistic effect on cellular recruitment and cytokine release generating a switch from Th2 to Th1 cytokine profile. Both MPL and QS-21 by themselves were able to generate significant NF-κB activation. However, this effect was not observed when both adjuvants were combined. On the contrary, the adjuvants alone and combined induced an overexpression of NOTCH-1. This is an important finding, as it provides new evidence that these adjuvants could modulate reactogenicity of vaccines through Notch signaling.
Collapse
Affiliation(s)
- C Campos-Estrada
- Escuela de Química y Farmacia, Facultad de Farmacia, Universidad de Valparaíso, Avenida Gran Bretaña 1093, Valparaíso, Chile; Centro de Investigación Farmacopea Chilena (CIFAR), Universidad de Valparaíso, Santa Marta 183, Valparaíso, Chile
| | - B Riquelme
- Escuela de Química y Farmacia, Facultad de Farmacia, Universidad de Valparaíso, Avenida Gran Bretaña 1093, Valparaíso, Chile
| | - M Vergara
- CREAS, Centro Regional de Estudios en Alimentos Saludables, Valparaíso, Chile; Escuela de Ingeniería Bioquímica, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile
| | - C Altamirano
- Escuela de Ingeniería Bioquímica, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile; CREAS, Centro Regional de Estudios en Alimentos Saludables, Valparaíso, Chile
| | - M F Cavieres
- Escuela de Química y Farmacia, Facultad de Farmacia, Universidad de Valparaíso, Avenida Gran Bretaña 1093, Valparaíso, Chile; Centro de Investigación Farmacopea Chilena (CIFAR), Universidad de Valparaíso, Santa Marta 183, Valparaíso, Chile.
| |
Collapse
|
5
|
Maritano J, Vergara M, Dib N, Preuss W, Naranjo R, Hernández P, Deramond J, Corona G, Gutiérrez P. Management of patients treated with platelet antiagregant or oral anticoagulants drugs intervened with local anesthesia in dentoalveolar surgery. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
6
|
Maritano J, Vergara M, Dib N, Preuss W, Naranjo R, Hernández P, Deramond J, Briones R, Corona G, Gutiérrez P. Hyperbaric oxygen therapy as coadjuvant treatment in patients with BONJ. Int J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.ijom.2019.03.725] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
7
|
Mauna JC, Harris SS, Pino JA, Edwards CM, DeChellis-Marks MR, Bassi CD, Garcia-Olivares J, Amara SG, Guajardo FG, Sotomayor-Zarate R, Terminel M, Castañeda E, Vergara M, Baust T, Thiels E, Torres GE. G protein βγ subunits play a critical role in the actions of amphetamine. Transl Psychiatry 2019; 9:81. [PMID: 30745563 PMCID: PMC6370791 DOI: 10.1038/s41398-019-0387-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 10/30/2018] [Accepted: 01/01/2019] [Indexed: 11/18/2022] Open
Abstract
Abnormal levels of dopamine (DA) are thought to contribute to several neurological and psychiatric disorders including drug addiction. Extracellular DA levels are regulated primarily via reuptake by the DA transporter (DAT). Amphetamine, a potent psychostimulant, increases extracellular DA by inducing efflux through DAT. Recently, we discovered that G protein βγ subunits (Gβγ) interact with DAT, and that in vitro activation of Gβγ promotes DAT-mediated efflux. Here, we investigated the role of Gβγ in the actions of amphetamine in DA neurons in culture, ex vivo nucleus accumbens (NAc), and freely moving rats. Activation of Gβγ with the peptide myr-Ser-Ile-Arg-Lys-Ala-Leu-Asn-Ile-Leu-Gly-Tyr-Pro-Asp-Tyr-Asp (mSIRK) in the NAc potentiated amphetamine-induced hyperlocomotion, but not cocaine-induced hyperlocomotion, and systemic or intra-accumbal administration of the Gβγ inhibitor gallein attenuated amphetamine-induced, but not cocaine-induced hyperlocomotion. Infusion into the NAc of a TAT-fused peptide that targets the Gβγ-binding site on DAT (TAT-DATct1) also attenuated amphetamine-induced but not cocaine-induced hyperlocomotion. In DA neurons in culture, inhibition of Gβγ with gallein or blockade of the Gβγ-DAT interaction with the TAT-DATct1 peptide decreased amphetamine-induced DA efflux. Furthermore, activation of Gβγ with mSIRK potentiated and inhibition of Gβγ with gallein reduced amphetamine-induced increases of extracellular DA in the NAc in vitro and in freely moving rats. Finally, systemic or intra-accumbal inhibition of Gβγ with gallein blocked the development of amphetamine-induced, but not cocaine-induced place preference. Collectively, these results suggest that interaction between Gβγ and DAT plays a critical role in the actions of amphetamine and presents a novel target for modulating the actions of amphetamine in vivo.
Collapse
Affiliation(s)
- J. C. Mauna
- 0000 0004 1936 9000grid.21925.3dDepartment of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - S. S. Harris
- 0000 0004 1936 8091grid.15276.37Department of Pharmacology and Therapeutics, University of Florida College of Medicine, Gainesville, FL USA
| | - J. A. Pino
- 0000 0004 1936 8091grid.15276.37Department of Pharmacology and Therapeutics, University of Florida College of Medicine, Gainesville, FL USA
| | - C. M. Edwards
- 0000 0004 1936 9000grid.21925.3dDepartment of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - M. R. DeChellis-Marks
- 0000 0004 1936 9000grid.21925.3dDepartment of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - C. D. Bassi
- 0000 0004 1936 9000grid.21925.3dDepartment of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - J. Garcia-Olivares
- 0000 0001 2297 5165grid.94365.3dLaboratory of Cellular and Molecular Neurobiology, National Institute of Mental Health, NIH, Bethesda, MD USA
| | - S. G. Amara
- 0000 0001 2297 5165grid.94365.3dLaboratory of Cellular and Molecular Neurobiology, National Institute of Mental Health, NIH, Bethesda, MD USA
| | - F. G. Guajardo
- 0000 0004 1936 8091grid.15276.37Department of Pharmacology and Therapeutics, University of Florida College of Medicine, Gainesville, FL USA ,0000 0000 8912 4050grid.412185.bLaboratory of Neurochemistry and Neuropharmacology, Center for Neurobiology and Brain Plasticity, Universidad de Valparaíso, Valparaíso, Chile
| | - R. Sotomayor-Zarate
- 0000 0000 8912 4050grid.412185.bLaboratory of Neurochemistry and Neuropharmacology, Center for Neurobiology and Brain Plasticity, Universidad de Valparaíso, Valparaíso, Chile
| | - M. Terminel
- 0000 0001 0668 0420grid.267324.6Department of Psychology, University of Texas at El Paso, El Paso, TX USA
| | - E. Castañeda
- 0000 0001 0668 0420grid.267324.6Department of Psychology, University of Texas at El Paso, El Paso, TX USA
| | - M. Vergara
- 0000 0004 1936 8091grid.15276.37Department of Pharmacology and Therapeutics, University of Florida College of Medicine, Gainesville, FL USA
| | - T. Baust
- 0000 0004 1936 9000grid.21925.3dDepartment of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - E. Thiels
- 0000 0004 1936 9000grid.21925.3dDepartment of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA USA
| | - G. E. Torres
- 0000 0004 1936 8091grid.15276.37Department of Pharmacology and Therapeutics, University of Florida College of Medicine, Gainesville, FL USA ,0000 0004 1936 8091grid.15276.37Center for Addiction Research and Education, University of Florida College of Medicine, Gainesville, FL USA
| |
Collapse
|
8
|
Marco A, Roget M, Cervantes M, Forné M, Planella R, Miquel M, Ortiz J, Navarro M, Gallego C, Vergara M. Comparison of effectiveness and discontinuation of interferon-free therapy for hepatitis C in prison inmates and noninmates. J Viral Hepat 2018; 25:1280-1286. [PMID: 29851225 DOI: 10.1111/jvh.12940] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 05/17/2018] [Indexed: 12/15/2022]
Abstract
Chronic hepatitis C treatment with direct acting antiviral (DAA) therapy during incarceration is an attractive option, due to its short duration and to the possibility of directly observed treatment or supervision. The aim of this study is to compare the effectiveness and rates of discontinuation of DAA treatment in prisoners and nonprisoners. We studied all patients treated in the 10 prisons of Catalonia and at 3 public hospitals in the Barcelona area between 1 January 2015 and 30 April 2016. We analysed sustained viral response (SVR) and rates of discontinuation through intention-to-treat and modified-intention-to-treat analyses, the latter excluding discontinuations due to release from prison. One hundred and eighty-eight inmates and 862 noninmates were included. Prisoners were significantly younger than nonprisoners, with higher proportions of men, drug users, HIV infection, genotypes 1a and 3 and more treatment with psychiatric drugs. Overall, 98.4% of patients completed treatment. The discontinuation rate was low, but higher in inmates (3.7% vs 1.2% noninmates; P = .003) and in community patients >65 years old (2.8% vs 1.2% in under 65 seconds; P = .008). Among the inmates, 7 (42.8%) discontinuations were due to release. SVR was 93.1% in inmates vs 96.5% in noninmates (P = .08) by intention-to-treat and 95.1% vs 96.5% (P = .37) by modified intention-to-treat. Virologic failure rates were similar (3.8% vs 3% in noninmates; P = .60). SVR, virologic failure and discontinuation rates were similar in inmates and noninmates. Currently, prisons are considered a priority for the implementation of DAA. Improved coordination between penitentiary and community health systems would help to ensure therapeutic continuity in released prisoners.
Collapse
Affiliation(s)
- A Marco
- Prison Health Program, Catalan Institute of Health, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - M Roget
- Hepatology Unit, Consorci Sanitari, Terrassa, Spain
| | - M Cervantes
- Infectious Disease Unit, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - M Forné
- Instituto Carlos III, CIBERehd, Madrid, Spain.,Digestive Disease, Department Hospital Universitari Mútua Terrassa, Universitat Central de Barcelona, Madrid, Spain
| | - R Planella
- Health Services of Ponent Penitentiary Centre, Madrid, Spain
| | - M Miquel
- Instituto Carlos III, CIBERehd, Madrid, Spain.,Hepatology Unit, Digestive Disease Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - J Ortiz
- Hepatology Unit, Consorci Sanitari, Terrassa, Spain
| | - M Navarro
- Infectious Disease Unit, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - C Gallego
- Health Services of Quatre Camins Penitentiary Centre, Barcelona, Spain
| | - M Vergara
- Instituto Carlos III, CIBERehd, Madrid, Spain.,Hepatology Unit, Digestive Disease Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | | |
Collapse
|
9
|
Novosak M, Laczeski M, Bobadilla F, Cortese J, Pegels E, Oviedo P, Quiroga M, Delgado O, Vergara M. Genetic analysis by RAPD technique of first strains of Streptococcus agalactiae serotype IX in Misiones, Argentina. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.4172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
|
10
|
Abstract
There is controversy about the effectiveness of branched chain amino acids for treatment of hepatic encephalopathy. Searching in Epistemonikos database, which is maintained by screening multiple databases, we identified seven systematic reviews including 32 randomized controlled trials, of which 30 address the question of this article. We extracted results, combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded branched chain amino acids might improve hepatic encephalopathy, but they probably lead to little or no effect on mortality.
Collapse
Affiliation(s)
- Maximiliano Vergara
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile. E-mail: . Address: Facultad de Medicina, Pontificia Universidad Católica de Chile, Lira 63, Santiago Centro, Chile
| | - Victoria Castro-Gutiérrez
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile
| | - Gabriel Rada
- Proyecto Epistemonikos, Santiago, Chile; Programa de Salud Basada en Evidencia, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Departamento de Medicina Interna, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; GRADE working group; The Cochrane Collaboration
| |
Collapse
|
11
|
Jarque-Bou N, Gracia-Ibáñez V, Sancho-Bru JL, Vergara M, Pérez-González A, Andrés FJ. Using kinematic reduction for studying grasping postures. An application to power and precision grasp of cylinders. Appl Ergon 2016; 56:52-61. [PMID: 27184310 DOI: 10.1016/j.apergo.2016.03.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 03/03/2016] [Accepted: 03/07/2016] [Indexed: 05/14/2023]
Abstract
The kinematic analysis of human grasping is challenging because of the high number of degrees of freedom involved. The use of principal component and factorial analyses is proposed in the present study to reduce the hand kinematics dimensionality in the analysis of posture for ergonomic purposes, allowing for a comprehensive study without losing accuracy while also enabling velocity and acceleration analyses to be performed. A laboratory study was designed to analyse the effect of weight and diameter in the grasping posture for cylinders. This study measured the hand posture from six subjects when transporting cylinders of different weights and diameters with precision and power grasps. The hand posture was measured using a Vicon(®) motion-tracking system, and the principal component analysis was applied to reduce the kinematics dimensionality. Different ANOVAs were performed on the reduced kinematic variables to check the effect of weight and diameter of the cylinders, as well as that of the subject. The results show that the original twenty-three degrees of freedom of the hand were reduced to five, which were identified as digit arching, closeness, palmar arching, finger adduction and thumb opposition. Both cylinder diameter and weight significantly affected the precision grasping posture: diameter affects closeness, palmar arching and opposition, while weight affects digit arching, palmar arching and closeness. The power-grasping posture was mainly affected by the cylinder diameter, through digit arching, closeness and opposition. The grasping posture was largely affected by the subject factor and this effect couldn't be attributed only to hand size. In conclusion, this kinematic reduction allowed identifying the effect of the diameter and weight of the cylinders in a comprehensive way, being diameter more important than weight.
Collapse
Affiliation(s)
- N Jarque-Bou
- Departamento de Ingeniería Mecánica y Construcción, Universitat Jaume I. Av. Vicent Sos Baynat, s/n, 12071, Castellón, Spain
| | - V Gracia-Ibáñez
- Departamento de Ingeniería Mecánica y Construcción, Universitat Jaume I. Av. Vicent Sos Baynat, s/n, 12071, Castellón, Spain.
| | - J L Sancho-Bru
- Departamento de Ingeniería Mecánica y Construcción, Universitat Jaume I. Av. Vicent Sos Baynat, s/n, 12071, Castellón, Spain
| | - M Vergara
- Departamento de Ingeniería Mecánica y Construcción, Universitat Jaume I. Av. Vicent Sos Baynat, s/n, 12071, Castellón, Spain
| | - A Pérez-González
- Departamento de Ingeniería Mecánica y Construcción, Universitat Jaume I. Av. Vicent Sos Baynat, s/n, 12071, Castellón, Spain
| | - F J Andrés
- Departamento de Ingeniería Mecánica y Construcción, Universitat Jaume I. Av. Vicent Sos Baynat, s/n, 12071, Castellón, Spain
| |
Collapse
|
12
|
Gracia-Ibáñez V, Vergara M, Sancho-Bru JL. Interdependency of the maximum range of flexion-extension of hand metacarpophalangeal joints. Comput Methods Biomech Biomed Engin 2016; 19:1800-1807. [PMID: 27198763 DOI: 10.1080/10255842.2016.1189541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Mobility of the fingers metacarpophalangeal (MCP) joints depends on the posture of the adjacent ones. Current Biomechanical hand models consider fixed ranges of movement at joints, regardless of the posture, thus allowing for non-realistic postures, generating wrong results in reach studies and forward dynamic analyses. This study provides data for more realistic hand models. The maximum voluntary extension (MVE) and flexion (MVF) of different combinations of MCP joints were measured covering their range of motion. Dependency of the MVF and MVE on the posture of the adjacent MCP joints was confirmed and mathematical models obtained through regression analyses (RMSE 7.7°).
Collapse
Affiliation(s)
- V Gracia-Ibáñez
- a Departamento de Ingeniería Mecánica y Construcción , Universitat Jaume I , Castelló , Spain
| | - M Vergara
- a Departamento de Ingeniería Mecánica y Construcción , Universitat Jaume I , Castelló , Spain
| | - J-L Sancho-Bru
- a Departamento de Ingeniería Mecánica y Construcción , Universitat Jaume I , Castelló , Spain
| |
Collapse
|
13
|
González A, Vergara M, Heredia A, Llanos L, Araos F. [Libman-Sacks endocarditis associated with antiphospholipid syndrome. Report of one case]. Rev Med Chil 2014; 141:1206-10. [PMID: 24522426 DOI: 10.4067/s0034-98872013000900015] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 06/12/2013] [Indexed: 11/17/2022]
Abstract
Libman-Sacks endocarditis is a non-infectious valvular damage associated with autoimmune disorders such as Systemic Lupus Erythematosus and Antiphospholipid Syndrome. We report a 17-year-old female consulting in the emergency room due to a right hemiparesis and aphasia. A magnetic resonance imaging showed multiple infarctions in the territory of the left middle cerebral artery, presumably of embolic origin. A trans-esophageal echocardiogram showed a vegetation in the mitral valve. Blood cultures were negative. Antinuclear antibodies and serological tests for antiphospholipid syndrome were positive. Oral anticoagulation was started and the patient was discharged. After six months of follow up, antiphospholipid antibodies are still positive.
Collapse
|
14
|
Menacho I, Sequeira E, Muns M, Barba O, Leal L, Clusa T, Fernandez E, Moreno L, Raben D, Lundgren J, Gatell JM, Garcia F, Cayuelas L, Aragunde V, Vergara M, Catalan M, Moreno MA, Hormigo G, Siso A, Herreras Z, Sebastian L, Benito L, Picas A, Hoyo J, Giner MJ, Cararach D, Moles E, Moro ML, Arrabal P, Roca D, Prego S, Ferrer X, Egido A, Ventosa C, Garcia S, Muñoz S, Massana A, Sole J, Curiel M, Heras F, Leon A. Comparison of two HIV testing strategies in primary care centres: indicator-condition-guided testingvs. testing of those with non-indicator conditions. HIV Med 2013; 14 Suppl 3:33-7. [DOI: 10.1111/hiv.12064] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2013] [Indexed: 11/28/2022]
|
15
|
Oviedo P, Pegels E, Laczeski M, Quiroga M, Vergara M. Phenotypic and genotypic characterization of Streptococcus agalactiae in pregnant women. First study in a province of Argentina. Braz J Microbiol 2013; 44:253-8. [PMID: 24159312 PMCID: PMC3804206 DOI: 10.1590/s1517-83822013005000030] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2010] [Accepted: 07/02/2012] [Indexed: 11/22/2022] Open
Abstract
Group B Streptococcus (GBS) is the leading cause of neonatal infections. Our purpose was to characterize GBS colonization in pregnant women, current serotypes, resistance phenotypes and genes associated with virulence. In Misiones, Argentina, there are no previous data on this topic. Vaginal-rectal swabs from 3125 pregnant women were studied between 2004 and 2010. GBS strains were identified by conventional and serological methods (Phadebact Strep B Test, ETC International, Bactus AB, Sweden). Serotypes were detected using Strep-B Latex (Statens Serum Institut, Denmark). Resistance phenotypes were determined by the double-disk test. Genes were studied by PCR. Maternal colonization was 9.38%. Resistance to erythromycin was 11.6%, and the constitutive phenotype was the predominant one. Serotype Ia was the most frequent, whereas serotypes IV, VI, VII and VIII were not detected. The lmb, bca and hylB genes were detected in more than 79% of the strains. In this study, the colonization rate with GBS and the serotype distribution were compared with studies reported in other areas of the country. The high resistance to erythromycin in Misiones justifies performing antibiotic susceptibility testing. The serotype distribution, the genes encoding putative virulence factors, and the patterns of resistance phenotypes of GBS may vary in different areas. They thus need to be evaluated in each place to devise strategies for prevention.
Collapse
Affiliation(s)
- P Oviedo
- Facultad de Ciencias Exactas, Químicas y Naturales, Universidad Nacional de Misiones, Posadas, Misiones, Argentina
| | | | | | | | | |
Collapse
|
16
|
Cabré M, Rudi N, Pontes C, Vergara M, Parra I, Gorgas MQ. GRP-121 Multidisciplinary Monitoring of Psychiatric Morbidity of HCV-Infected Patients Treated with Interferon and Ribavirin. Eur J Hosp Pharm 2013. [DOI: 10.1136/ejhpharm-2013-000276.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
17
|
Abstract
The trophic interactions between the scyphozoan medusa Chrysaora plocamia and the palm ruff Seriolella violacea were investigated off northern Chile and showed that large numbers of hyperiid amphipods parasitizing the medusa may channel energy back to the fishes, which feed on the parasites. The biomass of hyperiids eaten by the fish was a function of the biomass of hyperiids parasitizing the medusa. This temporally available food supply may enhance fish recruitment. The large number of hyperiids parasitizing diverse jellyfish species represents a missing trophic link in current efforts to understand the effects of jellyfish blooms on marine food webs.
Collapse
Affiliation(s)
- J M Riascos
- Universidad de Antofagasta, Instituto de Investigaciones Oceanológicas, Climate Change Ecology Research Group, CENSOR laboratory, Avenida Universidad de Antofagasta 02800, Antofagasta, Chile.
| | | | | | | | | |
Collapse
|
18
|
Macias VR, Pinzón C, Fierro F, Vergara M, Martínez D, Rosado A, Gutiérrez CG, Rosales-Torres AM. Identification of soluble forms of vascular endothelial growth factor receptors, sVEGFR-1 and sVEGFR-2, in bovine dominant follicles. Reprod Domest Anim 2011; 47:e39-42. [PMID: 21988522 DOI: 10.1111/j.1439-0531.2011.01919.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The development of dominant follicles requires the parallel growth of a vascular network, regulated by VEGF and its receptors VEGFR-1 and VEGFR-2. Here, we demonstrate the presence of mRNA for the soluble forms of VEGFR-1 and VEGFR-2 by RT-PCR and the respective proteins by Western blot, in bovine dominant follicles. The 3' end of the mRNA coding region and the deduced C-terminal amino acid sequence of the bovine VEGFR soluble forms were similar to those previously described in human and mice. The relative abundance of sVEGFR-1 was higher in dominant follicles of day 4, decreasing on day 6 and further on day 9 of the cycle. In contrast, sVEGFR-2 expression was low on day 4 follicles and increased as the cycle advanced, becoming greater on day 9. The changes of sVEGFR-1 and sVEGFR-2 with the age of the bovine dominant follicle indicate a physiological role in its growth and atresia.
Collapse
Affiliation(s)
- V R Macias
- Departamento de Producción Agrícola y Animal, UAM-Xochimilco, México, D.F., México
| | | | | | | | | | | | | | | |
Collapse
|
19
|
Becerra S, Vergara M, Gozález R, Osses N, Altamirano C. Condition of Mild Hypothermia does not Promote an Increase in Specific Productivity of Recombinant Protein in Continuous Culture of CHO Cells. J Biotechnol 2010. [DOI: 10.1016/j.jbiotec.2010.09.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
20
|
Rosales-Torres A, Alonso I, Vergara M, Romano M, Castillo-Juárez H, Ávalos A, Rosado A, Gutiérrez C. Vascular endothelial growth factor isoforms 120, 164 and 205 are reduced with atresia in ovarian follicles of sheep. Anim Reprod Sci 2010; 122:111-7. [DOI: 10.1016/j.anireprosci.2010.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Revised: 07/23/2010] [Accepted: 08/03/2010] [Indexed: 01/23/2023]
|
21
|
Stevens B, Flechner S, Wei LJ, Friedman G, Vergara M, Jiang H, Tedesco-Silva H, Cibrik D. SIMILAR RISK OF RENAL GRAFT LOSS DUE TO THROMBOSIS FOR EVEROLIMUS VERSUS MPA-BASED REGIMENS. Transplantation 2010. [DOI: 10.1097/00007890-201007272-00809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
22
|
Quiroga M, Lezcano MT, Martin Talavera B, Cáceres MG, Vergara M. Beta-lactam resistance in variants of Aeromonas spp. selected in vitro under antibiotic pressure. J Chemother 2010; 21:701-2. [PMID: 20071297 DOI: 10.1179/joc.2009.21.6.701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
23
|
Vergara M, Becerra S, Altamirano C. Glycosylation stage leads production of extracellular rh-tPA at sub-physiological temperatures of culture. N Biotechnol 2009. [DOI: 10.1016/j.nbt.2009.06.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
24
|
Altamirano C, Berrios J, Diaz-Barrera A, Bazan C, Vergara M. Simultaneus effect of low temperatures and mannose concentration on CHP cells cultures producing rh-tPA. N Biotechnol 2009. [DOI: 10.1016/j.nbt.2009.06.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
25
|
|
26
|
Bejarano G, Vergara M, Dalmau B, Puig J, Bella MR, Suárez D, Calvet X. Prospective evaluation of liver fibrosis in chronic viral hepatitis C infection using the Sabadell NIHCED (Non-Invasive Hepatitis-C-Related Cirrhosis Early Detection) index. Rev Esp Enferm Dig 2009; 101:325-335. [PMID: 19527078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
INTRODUCTION liver disease resulting from chronic hepatitis C virus (HCV) infection follows an asymptomatic course towards cirrhosis and its complications in 20-40% of cases. Earlier studies demonstrated that advanced fibrosis is a prognostic factor. The "gold standard" for the evaluation of fibrosis grade is liver biopsy. Our group validated a predictive index - NIHCED - based on demographic, laboratory parameters, and echographic data to determine the presence of cirrhosis. OBJECTIVE our objective is to evaluate whether the NIHCED score predicts the presence of advanced fibrosis in patients with chronic HCV infection. MATERIAL AND METHODS this prospective study included patients with chronic HCV infection who underwent liver biopsy and were administered the NIHCED score. Fibrosis grade correlated with the NIHCED score using the ROC curve analysis and Spearman s correlation coefficient. RESULTS in total 321 patients were included (male/female ratio 1.27) with a mean age of 48 +/- 14 years. Liver biopsy showed that 131 (30.5%) had no fibrosis or had portal expansion while 190 (69.5%) had advanced fibrosis or cirrhosis. At a cut-off point of 6, sensitivity was 72%, specificity was 76.3%, positive predictive value (PPV) was 81%, negative predictive value (NPV) was 63.7%, and diagnostic accuracy was 72.5%, with an area under the curve (AUC) of 0.787, and a Spearman s correlation coefficient of r = 0.65. CONCLUSIONS the NIHCED score predicts the presence of advanced fibrosis in an elevated percentage of patients with a need of liver biopsy.
Collapse
Affiliation(s)
- G Bejarano
- Service of Digestive Diseases, Universitat Autonoma de Barcelona, Barcelona, Spain.
| | | | | | | | | | | | | |
Collapse
|
27
|
Bejarano G, Vergara M, Gil M, Dalmau B, Puig J, Bella MR, Suárez D, Calvet X. Evaluación de la fibrosis hepática en la hepatitis crónica por virus C mediante la aplicación prospectiva del Sabadell's NIHCED score: Sabadell's Non Invasive, Hepatitis C Related-Cirrhosis Early Detection Score. Rev esp enferm dig 2009. [DOI: 10.4321/s1130-01082009000500004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
28
|
Vergara M, Gil M, Dalmau B, Ribot R, Navarro C, Martín A, Penafreta M, Puig J, Martín J, Perendreu J, Falcó J, Bella R. [Natural history of hepatocellular carcinoma in a cohort of pacients from a county hospital]. Rev Esp Enferm Dig 2008; 100:682-687. [PMID: 19159171 DOI: 10.4321/s1130-01082008001100003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND hepatocellular carcinoma (HCC) is a cancer with high incidence and mortality. OBJECTIVE our aim was to describe the natural history of a patient cohort with HCC, and to identify the factors associated with survival. PATIENTS AND METHODS a retrospective and descriptive study of patients diagnosed with HCC between 1995 and 2002. Qualitative variables were expressed as frequencies and percentages. Quantitative variables were expressed as medians and standard deviations. Survival was calculated using the Kaplan-Meier method and log rank. RESULTS a total of 154 patients were analyzed. The men-to-women ratio was 2.9/1. Mean age was 68 +/- 9 years. 82% of patients died during a median follow-up of 28 months. Median survival was 21.5 months (95% CI: 16.98-26.04). Curative treatment was done in 40.3% of diagnosed patients, and 59.7% of patients received palliative treatment. Factors associated with survival were: ascites, number of lesions at diagnosis, and curative treatment. No statistical differences were found for the next factors: age, sex, etiology of cirrhosis, and Child-Pugh stage at diagnosis. CONCLUSIONS factors associated with low survival in patients with HCC were ascites and number of lesions. Curative treatment is associated with a higher survival when compared to palliative treatment.
Collapse
Affiliation(s)
- M Vergara
- Unidad de Enfermedades Digestivas, Barcelona, Spain.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Villoria A, Garcia P, Calvet X, Gisbert JP, Vergara M. Meta-analysis: high-dose proton pump inhibitors vs. standard dose in triple therapy for Helicobacter pylori eradication. Aliment Pharmacol Ther 2008; 28:868-77. [PMID: 18644011 DOI: 10.1111/j.1365-2036.2008.03807.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The evidence on whether high-dose proton pump inhibitors (PPIs) increase cure rates of Helicobacter pylori treatment has not been previously assessed. AIM To evaluate the evidence on the usefulness of high-dose PPI in standard triple therapy by performing a systematic review and a meta-analysis. METHODS A systematic search was performed in multiple databases and in the abstracts submitted to the Digestive Diseases Week, the European Helicobacter Study Group congress and the United European Gastroenterology Week. Randomized trials comparing a standard dose of a PPI with high-dose PPI both twice a day in triple therapy combining a PPI plus clarithromycin and either amoxicillin or metronidazole were selected. Relative risk (RR) and 95% confidence intervals (95% CIs) for all comparisons were calculated using Review Manager. RESULTS Six studies fulfilled the inclusion criteria. All used triple therapy for 7 days. A mean intention-to-treat cure rate of 82% was achieved with high-dose PPI and one of 74% with standard dose (RR: 1.09; 95% CI: 1.01-1.17). Subgroup analysis showed that the maximum increase was observed when the PPI compared were omeprazole 20 mg or pantoprazole 40 mg vs. esomeprazole 40 mg. CONCLUSION High-dose PPI seems more effective than standard-dose for curing H. pylori infection in 7-day triple therapy.
Collapse
Affiliation(s)
- A Villoria
- Digestive Diseases Unit, Hospital de Sabadell, Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain
| | | | | | | | | |
Collapse
|
30
|
Quiroga M, Pegels E, Oviedo P, Pereyra E, Vergara M. Antibiotic susceptibility patterns and prevalence of group B Streptococcus isolated from pregnant women in Misiones, Argentina. Braz J Microbiol 2008; 39:245-50. [PMID: 24031210 PMCID: PMC3768385 DOI: 10.1590/s1517-83822008000200009] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2007] [Revised: 11/22/2007] [Accepted: 05/05/2008] [Indexed: 11/22/2022] Open
Abstract
This study was performed to determine the susceptibility patterns and the colonization rate of Group B Streptococcus (GBS) in a population of pregnant women. From January 2004 to December 2006, vaginal-rectal swabs were obtained from 1105 women attending Dr. Ramón Madariaga Hospital, in Posadas, Misiones, Argentina. The carriage rate of GBS among pregnant women was 7.6%. A total of 62 GBS strains were randomly selected for in vitro susceptibility testing to penicillin G, ampicillin, tetracycline, levofloxacin, gatifloxacin, ciprofloxacin, quinupristin-dalfopristin, linezolid, vancomycin, rifampicin, trimethoprim- sulfametoxazol, nitrofurantoin, gentamicin, clindamycin and erythromycin, and determination of resistance phenotypes. No resistance to penicillin, ampicillin, quinupristin-dalfopristin, linezolid, and vancomycin was found. Of the isolates examined 96.8%, 98.3%, 46.8%, and 29.0% were susceptible to rifampicin, nitrofurantoin, trimethoprim-sulfametoxazol and tetracycline, respectively. Rank order of susceptibility for the quinolones was: gatifloxacin (98.4%) > levofloxacin (93.5%) > ciprofloxacin (64.5%). The rate of resistance to erythromycin (9.7%) was higher than that of other reports from Argentina. High-level resistance to gentamicin was not detected in any of the isolates. Based on our finding of 50% of GBS isolates with MIC to gentamicin equal o lower than 8 μg/ml, a concentration used in one of the selective media recommended for GBS isolation, we suggested, at least in our population, the use of nalidixic acid and colistin in selective media with the aim to improve the sensitivity of screening cultures for GBS carriage in women.
Collapse
Affiliation(s)
- M Quiroga
- Universidad Nacional de Misiones , Posadas, Misiones , Argentina
| | | | | | | | | |
Collapse
|
31
|
Quiroga M, Cáeres M, Stefañk R, Villalba V, Rodriguez M, Radice M, Gutkind G, Vergara M. Characterization of Extended-Spectrum β-Lactamases in Clinical Isolates of Klebsiella pneumoniaeand Escherichia colifrom Posadas, Misiones, Argentina. J Chemother 2008; 20:130-3. [DOI: 10.1179/joc.2008.20.1.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
32
|
Abstract
BACKGROUND Endoscopic therapy reduces rebleeding rate, need for surgery, and mortality in patients with bleeding peptic ulcers. Injection of epinephrine is the most popular therapeutic method. Guidelines disagree on the need for a second haemostatic procedure immediately after epinephrine. OBJECTIVES The objective of this review was to determine whether the addition of a second procedure improves efficacy or patient outcomes or both after epinephrine injection in adults with high risk bleeding ulcers. SEARCH STRATEGY We searched the Cochrane Central Register of Controlled Trials - CENTRAL (which includes the Cochrane Upper Gastrointestinal and Pancreatic Diseases Group Trials Register) (The Cochrane Library Issue 1, 2006), MEDLINE (1966 to February 2006), EMBASE (1980 to February 2006) and reference lists of articles. We also contacted experts in the field. SELECTION CRITERIA Randomised studies comparing endoscopic treatment: epinephrine alone versus epinephrine associated with a second haemostatic method in adults with haemorrhage from peptic ulcer disease with major stigmata of bleeding as defined by the Forrest classification. Bleeding must have been confirmed by endoscopy. DATA COLLECTION AND ANALYSIS Two authors independently assessed trial quality and extracted data. MAIN RESULTS Seventeen studies including 1763 people were included. Adding a second procedure reduced further bleeding rate from 18.8% to 10.4%; Peto Odds Ratio 0.51; 95% confidence interval (CI) 0.39 to 0.66, and emergency surgery from 10.8% to 7.1%; OR 0.63; 95% CI 0.45 to 0.89. Mortality fell from 5% to 2.5% OR 0.50; 95% CI 0.30 to 0.82. Subanalysis showed that the risk of further bleeding decreased regardless of which second procedure was applied. In addition, the risk was reduced in all subgroups. AUTHORS' CONCLUSIONS Additional endoscopic treatment after epinephrine injection reduces further bleeding, the need for surgery and mortality in patients with bleeding peptic ulcer.
Collapse
Affiliation(s)
- M Vergara
- Hospital de Sabadell, Unitat de Malaties Digestives, Institut Universitari Parc Tauli, Universitat Autonoma de Barcelona. Parc Tauli s/n, Sabadell, Spain, 08208.
| | | | | |
Collapse
|
33
|
Serrera A, del Pozo J, Martinez A, Alonso M, Gonzalez R, Leiva J, Vergara M, Lasa I. P1786 Dispersin B therapy of Staphylococcus aureus experimental port-related bloodstream infection. Int J Antimicrob Agents 2007. [DOI: 10.1016/s0924-8579(07)71625-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
34
|
Castillo E, Vergara M, Moreno Y. Landfill leachate treatment using a rotating biological contactor and an upward-flow anaerobic sludge bed reactor. Waste Manag 2007; 27:720-6. [PMID: 17011178 DOI: 10.1016/j.wasman.2006.08.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2005] [Revised: 08/07/2006] [Accepted: 08/10/2006] [Indexed: 05/12/2023]
Abstract
This paper describes the feasibility of an aerobic system (rotating biological contactor, RBC) and a biological anaerobic system (upward-flow anaerobic sludge bed reactor) at small scale for the treatment of a landfill leachate. In the first phase of the aerobic system study, a cyclic-batch RBC system was used to select perforated acetate discs among three different acetate disc configurations. These discs were chosen on the basis of high COD removal (65%) and biological stability. In the second phase, the RBC system (using four stages) was operated continuously at different hydraulic retention times (HRT), at different rotational speeds, and with varying organic concentrations of the influent leachate (2500-9000mgL(-1)). Forty percent of the total surface area of each perforated disc was submerged in the leachate. A COD removal of about 52% was obtained at an HRT of 24h and a rotational speed of 6rpm. For the anaerobic system, the reactor was evaluated with a volumetric organic load of 3273g-COD m(-3) day(-1) at an HRT of 54, 44, 39, 24 and 17h. At these conditions, the system reached COD removal efficiencies of 62%, 61%, 59%, 44% and 24%, respectively.
Collapse
Affiliation(s)
- E Castillo
- Centro de Estudios e Investigaciones Ambientales, Universidad Industrial de Santander, Calle 9a Carrera 27, Aptdo. Aéreo 678, Bucaramanga, Colombia.
| | | | | |
Collapse
|
35
|
Calvet X, Vergara M, Brullet E. [Endoscopic treatment of bleeding ulcers: has everything been said and done?]. Gastroenterol Hepatol 2005; 28:347-53. [PMID: 15989817 DOI: 10.1157/13076353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Endoscopic treatment reduces bleeding recurrence, the need for surgery and mortality in patients with bleeding ulcers. However endoscopic treatment fails in 10-15% of patients, leading to high morbidity and mortality. The therapeutic measures with demonstrated effectiveness in reducing the risk of hemorrhagic recurrence and its complications are combined endoscopic treatment (adrenaline plus a second hemostatic intervention) and proton pump inhibitors. Also useful, although there is less evidence, are immediate resuscitation and <<second look>> endoscopy. Some studies suggest that activated recombinant factor VII infusion or supra-selective arterial embolization can be useful in severe hemorrhage. Further studies are required to determine optimal treatment according to the characteristics of each patient.
Collapse
Affiliation(s)
- X Calvet
- Unitat de Malalties Digestives, Hospital de Sabadell, Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Barcelona, España.
| | | | | |
Collapse
|
36
|
Abstract
AIM To evaluate whether eradication of Helicobacter pylori prevents peptic ulcer in non-steroidal anti-inflammatory drug users by means of a meta-analysis. MATERIAL AND METHODS A systematic search was performed in MEDLINE, EMBASE, the Cochrane Controlled Trials Register and the AGA congress. Randomized trials comparing H. pylori eradication vs. non-eradication or eradication vs. a proton pump inhibitor in patients receiving a non-steroidal anti-inflammatory drug were selected. RESULTS Five studies and 939 patients were included in the analysis; 34 of 459 (7.4%) patients developed a peptic ulcer in the eradicated group vs. 64 of 480 (13.3%) in the control group. The odds ratio was 0.43 (95% confidence interval: 0.20-0.93). Sub-analyses showed a significant reduction of risk for non-steroidal anti-inflammatory drug-naive (odds ratio = 0.26; 95% confidence interval: 0.14-0.49) but not for previously treated patients (odds ratio = 0.95, 95% confidence interval: 0.53-1.72). Two studies with a total of 385 patients compared eradication vs. a proton pump inhibitor; five of 196 (2.6%) developed a peptic ulcer in the eradicated group vs. zero of 189 (0%) in the proton pump inhibitor group (odds ratio = 7.43; 95% confidence interval: 1.27-43.6). CONCLUSION Helicobacter pylori eradication reduces the incidence of peptic ulcer in the overall population receiving non-steroidal anti-inflammatory drugs. It appears to be especially effective when performed in non-steroidal anti-inflammatory drug-naïve patients. Nonetheless, eradication seems less effective than treatment with a maintenance proton pump inhibitor for preventing non-steroidal anti-inflammatory drug-associated ulcers.
Collapse
Affiliation(s)
- M Vergara
- Unitat de Malalties Digestives, Hospital de Sabadell, Institut Universitari Parc Taulí, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | | | | |
Collapse
|
37
|
Netto C, Vergara M, Calvet X, Brullet E, Bella R, Musulén E. [Cecal cytomegalovirus infection following appendicectomy in a patient with ulcerative colitis]. Gastroenterol Hepatol 2005; 28:285-8. [PMID: 15871812 DOI: 10.1157/13074064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
We report a patient who, 3 months after being diagnosed with ulcerative colitis, was admitted to hospital because of malaise and right lower abdominal pain. An open appendectomy was performed. Histological study showed ulcerative colitis affecting the appendix. After surgery, the patient presented a refractory outbreak of ulcerative colitis requiring treatment with steroids and cyclosporin A. Despite this treatment, the patient continued to pass abundant fresh blood associated with severe anemia. Colonoscopy showed only granular and congestive cecal mucosa. Biopsies showed intracytoplasmic inclusion bodies with immunohistochemical stains positive for cytomegalovirus (CMV) infection. Rectorrhagia and anemia quickly disappeared after beginning treatment with ganciclovir. Appendicular ulcerative colitis is not uncommonly associated with distal colitis. In addition, diffuse CMV infection complicating ulcerative colitis treatment is not unusual. By contrast, isolated, segmentary infection by CMV in the proximal colon is extremely rare. Until now, only three patients with localized CMV infection have been described, and all three cases occurred in the context of ileoanal anastomosis.
Collapse
Affiliation(s)
- C Netto
- Servei de Medicina, Corporació Parc Taulí, Sabadell, Barcelona, Spain
| | | | | | | | | | | |
Collapse
|
38
|
Vargas VM, Torres D, Corona F, Vergara M, Gómez LE, Delgado-Lezama R, Cueva-Rolón R. Cholinergic facilitation of erection and ejaculation in spinal cord-transected rats. Int J Impot Res 2004; 16:86-90. [PMID: 14963478 DOI: 10.1038/sj.ijir.3901169] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Penile reflexes (PRs) were monitored in chronic spinal cord-transected rats by identifying them visually, and at the same time they were recorded as the electromyographic activity of bulbospongiosus muscles. Intraperitoneal injection of the agonist muscarine (10 microg) produced a facilitation of PRs. A decrease in the latency, an increase in the number of clusters and often an increase in the duration of cups were found after muscarine. In addition, 66% (six out of nine) of the animals ejaculated after muscarine. These results suggest that cholinergic receptor stimulation may be involved in erectile and ejaculatory mechanisms mediated by the spinal cord.
Collapse
Affiliation(s)
- V M Vargas
- Departamento de Agrobiología, Universidad Autónoma de Tlaxcala, Tlaxcala, Mexico
| | | | | | | | | | | | | |
Collapse
|
39
|
Abstract
The ideal diameter for a tool handle for males and females has been determined using an existing biomechanical model of the hand validated in previous works. The model estimates a 33-mm optimum diameter tool handle for the general population (males and females). When the optimum diameter for a tool handle is selected, the muscles exert the minimum force needed to hold the tool and perform gripping activities. Optimal handle design reduces the force required for gripping a tool, protects the underlying joint structures, and reduces the risk of developing cumulative trauma associated with repetitive task requiring high grip forces and awkward postures. This article provides a design parameter for optimal tool diameter to aid the therapist in the selection of assistive devices, built-up handles, or for the fabrication of a tool handle.
Collapse
Affiliation(s)
- Joaqun L Sancho-Bru
- Departament de Tecnologia, Universitat Jaume I Campus de Riu Sec 12071, Castelló, Spain
| | | | | | | |
Collapse
|
40
|
Campo R, Brullet E, Junquera F, Puig-Diví V, Vergara M, Calvet X, Marco J, Chuecos M, Sánchez A, Alcázar A, Ruiz M, Puig M, Real J. Sedación en la endoscopia digestiva. Resultados de una encuesta hospitalaria en Cataluña. Gastroenterología y Hepatología 2004; 27:503-7. [PMID: 15544734 DOI: 10.1016/s0210-5705(03)70516-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The need for sedation is increasing in digestive endoscopy units (DEU). There are no data on the use of sedation in DEU in Catalonia (Spain). OBJECTIVE To evaluate the use of sedation in DEU in Catalonia. MATERIAL AND METHOD A questionnaire on the practice of sedation was designed and sent to the heads of medical and nursing staff of the DEU of 63 public and private hospitals in Catalonia. Two mailings were sent with an interval of three months between each. The questionnaire included 62 items on the characteristics of the hospital and the DEU, number of explorations, frequency of sedation use, drugs employed, participation of an anesthesiologist, use of monitoring, and complications. RESULTS Forty-four DEU (70%) corresponding to 31 public hospitals and 13 private hospitals completed the questionnaire. Evaluation of sedation patterns was based on 105,904 explorations performed in the various DEU (56,453 gastroscopies, 47,278 colonoscopies and 2,173 endoscopic retrograde cholangiopancreatographies (ERCP) in 2001. Sedation, sedation-analgesia or anesthesia was used in 17% of gastroscopies, 61% of colonoscopies and 100% of ERCP. Sedation was administered by an anesthesiologist in 7% of gastroscopies, 25% of colonoscopies and 38% of ERCP. Anesthesiologist administration was more frequent in private than in public centers (gastroscopies: 25% vs. 2%; colonoscopies: 57% vs. 9%, p < 0.001). No deaths associated with the use of sedation were reported. Eighty-nine percent of the DEU complied with standard recommendations for the practice of sedation. CONCLUSIONS In Catalonia, the use of sedation is highly variable, depending on the endoscopic procedure and the DEU. Use of sedation in infrequent in gastroscopy, fairly widespread in colonoscopy and routine in ERCP. Anesthesiologist administration is significantly more frequent in private hospitals. Most DEU follow standard sedation practices.
Collapse
Affiliation(s)
- R Campo
- Servicio de Aparato Digestivo, Corporació Parc Taulí, Sabadell, Barcelona, Spain.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Vergara M, Vallve M, Gisbert JP, Calvet X. Meta-analysis: comparative efficacy of different proton-pump inhibitors in triple therapy for Helicobacter pylori eradication. Aliment Pharmacol Ther 2003. [PMID: 12969092 DOI: 10.1046/j.1365-2036.2003.01746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND It is not known whether certain proton-pump inhibitors are more efficacious than others when used in triple therapy for Helicobacter pylori eradication. AIM To compare the efficacy of different proton-pump inhibitors in triple therapy by performing a meta-analysis. METHODS A MEDLINE search was performed. Abstracts of the European Helicobacter pylori Study Group and the American Gastroenterological Association congresses from 1996 to 2002 were also examined. Randomized studies with at least two branches of triple therapy that differed only in terms of type of proton-pump inhibitor were included in a meta-analysis using Review Manager 4.1. RESULTS Fourteen studies were included. Intention-to-treat cure rates were similar for omeprazole and lansoprazole: 74.7% vs. 76%, odds ratio (OR) 0.91 [95% confidence interval (CI) 0.69-1.21] in a total of 1085 patients; for omeprazole and rabeprazole: 77.9% vs. 81.2%, OR 0.81 (95% CI 0.58-1.15) in a total of 825 patients; for omeprazole and esomeprazole: 87.7% vs. 89%, OR 0.89 (95% CI 0.58-1.35) in 833 patients; and for lansoprazole and rabeprazole: 81% vs. 85.7%, OR 0.77 (95% CI 0.48-1.22) in 550 patients. CONCLUSION The efficacy of various proton-pump inhibitors seems to be similar when used for H. pylori eradication in standard triple therapy.
Collapse
Affiliation(s)
- M Vergara
- Unitat de Malalties Digestives, Hospital de Sabadell, Institut Universitari Parc Taulí, UAB, Sabadell, Barcelona, Spain
| | | | | | | |
Collapse
|
42
|
Vergara M, Vallve M, Gisbert JP, Calvet X. Meta-analysis: comparative efficacy of different proton-pump inhibitors in triple therapy for Helicobacter pylori eradication. Aliment Pharmacol Ther 2003; 18:647-54. [PMID: 12969092 DOI: 10.1046/j.1365-2036.2003.01746.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND It is not known whether certain proton-pump inhibitors are more efficacious than others when used in triple therapy for Helicobacter pylori eradication. AIM To compare the efficacy of different proton-pump inhibitors in triple therapy by performing a meta-analysis. METHODS A MEDLINE search was performed. Abstracts of the European Helicobacter pylori Study Group and the American Gastroenterological Association congresses from 1996 to 2002 were also examined. Randomized studies with at least two branches of triple therapy that differed only in terms of type of proton-pump inhibitor were included in a meta-analysis using Review Manager 4.1. RESULTS Fourteen studies were included. Intention-to-treat cure rates were similar for omeprazole and lansoprazole: 74.7% vs. 76%, odds ratio (OR) 0.91 [95% confidence interval (CI) 0.69-1.21] in a total of 1085 patients; for omeprazole and rabeprazole: 77.9% vs. 81.2%, OR 0.81 (95% CI 0.58-1.15) in a total of 825 patients; for omeprazole and esomeprazole: 87.7% vs. 89%, OR 0.89 (95% CI 0.58-1.35) in 833 patients; and for lansoprazole and rabeprazole: 81% vs. 85.7%, OR 0.77 (95% CI 0.48-1.22) in 550 patients. CONCLUSION The efficacy of various proton-pump inhibitors seems to be similar when used for H. pylori eradication in standard triple therapy.
Collapse
Affiliation(s)
- M Vergara
- Unitat de Malalties Digestives, Hospital de Sabadell, Institut Universitari Parc Taulí, UAB, Sabadell, Barcelona, Spain
| | | | | | | |
Collapse
|
43
|
Abstract
A three-dimensional scalable biomechanical model of the four fingers of the hand to evaluate power grip is proposed. The model has been validated by means of reproducing an experiment in which the subjects exerted the maximal voluntary grasping force over cylinders of different diameters. The model is used to simulate the cylinder grip for two hand sizes and for five different handle diameters. The reduction of the muscle forces using different handle diameters has been studied. The model can be applied to the design and evaluation of handles for power grip and to the study of power grasp for normal and abnormal hands.
Collapse
Affiliation(s)
- Joaquín L Sancho-Bru
- Department de Tecnologia, Universitat Jaume I. Campus de Riu Sec., 12071 Castelló, Spain.
| | | | | | | |
Collapse
|
44
|
Vallve M, Vergara M, Gisbert JP, Calvet X. Single vs. double dose of a proton pump inhibitor in triple therapy for Helicobacter pylori eradication: a meta-analysis. Aliment Pharmacol Ther 2002; 16:1149-56. [PMID: 12030958 DOI: 10.1046/j.1365-2036.2002.01270.x] [Citation(s) in RCA: 98] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Triple therapies combining a double dose of proton pump inhibitor plus two antibiotics are the standard treatment for Helicobacter pylori infection. Some reports suggest that the use of half the dose of proton pump inhibitor is equally effective. AIM To compare the efficacy of a single vs. double dose of proton pump inhibitor in triple therapy. METHODS We conducted a MEDLINE search. The search strategy included the words (pylori) AND (triple, PPI, proton pump, omeprazole, rabeprazole, pantoprazole, lansoprazole, clarithromycin, amoxicillin, amoxycillin or metronidazole). Abstracts of the articles obtained and papers presented at the European Helicobacter pylori Study Group and American Gastroenterological Association congresses from 1996 to 2001 were examined. Inclusion criteria were: (i) randomized studies with at least two branches of triple therapy including a proton pump inhibitor and two standard antibiotics; (ii) branches could differ only in terms of proton pump inhibitor dosage. A meta-analysis was conducted using conventional shareware (Review Manager 4.1). RESULTS Thirteen studies met the inclusion criteria with a total of 2391 patients. Cure rates with double doses of proton pump inhibitor were higher in both the intention-to-treat analysis (83.9% vs. 77.7%; Peto odds ratio, 1.51; 95% confidence interval, 1.23-1.85; P < 0.01) and per protocol analysis (89% vs. 81%; Peto odds ratio, 1.96; 95% confidence interval, 1.55-2.47; P < 0.01). CONCLUSION Triple therapies containing a single dose of proton pump inhibitor are less effective than those containing a standard double dose of proton pump inhibitor.
Collapse
Affiliation(s)
- M Vallve
- Unitat de Malalties Digestives, Corporació Parc Taulí, Parc Taulí s/n, 08208 Sabadell, Barcelona, Spain
| | | | | | | |
Collapse
|
45
|
Vergara M, Casellas F, Badia X, Malagelada JR. Assessing the quality of life of household members of patients with inflammatory bowel disease: development and validation of a specific questionnaire. Am J Gastroenterol 2002; 97:1429-37. [PMID: 12094861 DOI: 10.1111/j.1572-0241.2002.05684.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Household members of patients with inflammatory bowel disease (IBD) are impacted in their daily lives by close interaction with chronic illness. However, the effect of IBD on the quality of life of household members has not been evaluated because appropriate instruments to measure it are lacking. The aim of this study was to develop and validate a specific instrument to measure the quality of life of household members of patients with IBD. METHODS Household members were interviewed to generate an initial pool of items. A group of investigators excluded redundant and incomprehensible items, and the resulting preliminary questionnaire was completed by 81 subjects. Further item reduction was performed using the psychometric method. The psychometric properties of the final questionnaire were determined in a group of 106 subjects. RESULTS Of the initial 67 items, 19 were excluded by investigators. The remaining 48 items were answered by 81 household members, and 32 items were excluded by factor analysis. Two others were excluded because of poor comprehension. The definitive questionnaire consisted of 14 items. CONCLUSIONS We have developed and validated a questionnaire to measure the quality of life of household members of IBD patients. It will greatly enhance the possibilities of quantifying the effects of IBD on home life and should become a useful tool in health care planning.
Collapse
Affiliation(s)
- M Vergara
- Digestive System Research Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | | | | | | |
Collapse
|
46
|
Sobrino JF, Campo R, Brullet E, Montserrat A, Vergara M, Gil M, Dalmau B, Calvet X. [Paracetamol-codeine induced hepatic colic]. Gastroenterol Hepatol 2001; 24:365-6. [PMID: 11481075 DOI: 10.1016/s0210-5705(01)70196-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
47
|
|
48
|
Vergara M, Brullet E, Campo R, Calvet X, Blanch L. [Fulminant infection caused by varicella herpes zoster in patient with Crohn disease undergoing treatment with azathioprine]. Gastroenterol Hepatol 2001; 24:47. [PMID: 11219139 DOI: 10.1016/s0210-5705(01)70132-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
49
|
Benassi FO, Vergara M, von Specht MH, García MA, Quiroga MI, Pucciarelli AB, Zubreski E, Laczeski M, Martin BM, Leardini N, Gutkind G. [Beta-lactam antibiotic sensitivity in Aeromonas spp. of clinical, animal, and environmental origin]. Rev Argent Microbiol 2001; 33:47-51. [PMID: 11407020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
Susceptibility to beta-lactam antibiotics was investigated in Aeromonas spp. Microorganisms were isolated from both, clinical and water creek samples, as well as from processed raw chicken carcasses. Aeromonas like colonies were identified by means of Aerokey II and API 20 E System (Bio-Merieux). A. hydrophila prevailed both of human origin (44%) and water creek samples (41%), while A. caviae ranked first among raw chicken samples (65%). Dilution testing by Agar Method was performed to determine minimum inhibitory concentration (MIC), following NCCLS standards. All tested microorganisms were susceptible to third generation cephalosporin, cefepime, imipenem, aztreonam, and resistant to ampicillin. Only with cefepime and aztreonam exceptions, strains of human origin showed higher values of MIC90 than environmental ones. These results suggest that antibiotic resistance is mainly due to a steady environmental pressure, on account of the widely used above mentioned compounds.
Collapse
Affiliation(s)
- F O Benassi
- Facultad de Ciencias Exactas Químicas y Naturales, Universidad Nacional de Misiones, Félix de Azara 1552, 3300 Posadas, Pcia. de Misiones
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Abstract
OBJECTIVE To describe and validate a system to record the lumbar curvature, specially designed for the ergonomic evaluation of chairs. DESIGN The technique consists of a flexible goniometer and requires a model of lumbar flexion (relationship between length and angle). BACKGROUND Most of the techniques do not allow using the backrest of the chair or do not record continuously. METHODS Precision, repeatability and reproducibility of the measurements have been analysed, as well as the lumbar flexion model. RESULTS A suitable lumbar model of flexion and the repeatability and reproducibility errors obtained are presented. CONCLUSIONS The linear model is a good one to represent the flexion of the lumbar spine. The measurements are reproducible and the errors are similar or lower than with conventional inclinometers. Relevance The device may help to investigate the relationship between lumbar pain and curvature, and to evaluate the lumbar curvature in sedentary work.
Collapse
Affiliation(s)
- M Vergara
- Departamento de Tecnologia, Universitat Jaume I, Campus de Riu Sec., 12071, Castellon, Spain.
| | | |
Collapse
|