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Tonello C, Dias GB, Nunes RB, Fussuma CY, Sousa LR, Feitosa LB, Flores RL, Alonso N. Mandibular Dysmorphology and Clinical Presentation in Treacher Collins Syndrome. Cleft Palate Craniofac J 2023:10556656231184967. [PMID: 37437901 DOI: 10.1177/10556656231184967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023] Open
Abstract
INTRODUCTION Treacher Collins syndrome is a rare congenital disease characterized by the multiple craniofacial malformations. Although the deformities affecting patients with Treacher Collins syndrome have been well characterized, the effects of these malformations to clinical severity of the syndrome are not well understood. OBJECTIVE To determine the association of specific Treacher Collins mandibular malformations with clinical severity. DESIGN A retrospective radiographic observational study. SETTING Study conducted at a single institution, a quaternary craniofacial care center. PATIENTS 54 patients with Treacher Collins syndrome. INTERVENTIONS Computed tomography (CT), clinical photographs and medical history were included in this analysis. Mandibles were isolated from CT data and reconstructed in three dimensions using Mimics software. Cephalometric measurements were performed on CT data. Clinical severity was determined by Teber and Vincent scores. Association of craniofacial dysmorphology to clinical severity was determined by Spearman rank coefficient. MAIN OUTCOME MEASURES The main results obtained were the measurements of the mandibles and the quantification of the malformations of the evaluated patients. RESULTS Among the most frequent findings in the sample are hypoplasia of the zygomatic complex, descending palpebral cleft and mandibular hypoplasia. Patients with a lower ramus/corpus ratio had a higher (more severe) Teber and Vincent classification. CONCLUSION Patients with the most compromised mandible are also the patients with the highest number of malformations, thus, the most severe patients.
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Affiliation(s)
- C Tonello
- Craniofacial Surgeon of Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, São Paulo, Brazil
| | - G B Dias
- Bauru School Dentistry, University of São Paulo, São Paulo, Brazil
| | - R B Nunes
- Craniofacial Surgeon of Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, São Paulo, Brazil
| | - C Y Fussuma
- Craniofacial Surgeon of Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, São Paulo, Brazil
| | - L R Sousa
- Bauru School Dentistry, University of São Paulo, São Paulo, Brazil
| | - L B Feitosa
- Craniofacial Surgeon of Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, São Paulo, Brazil
| | - R L Flores
- Craniofacial Surgeon of The Hansjörg Department of Plastic Surgery, New York University Langone Health, New York City, NY, USA
| | - N Alonso
- Craniofacial Surgeon of Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, São Paulo, Brazil
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Abstract
Recent research activities have provided new insights in vitamin D metabolism in various conditions. Furthermore, substantial progress has been made in the analysis of vitamin D metabolites and related biomarkers, such as vitamin D binding protein. Liquid chromatography tandem mass spectrometric (LC-MS/MS) methods are capable of accurately measuring multiple vitamin D metabolites in parallel. Nevertheless, only 25(OH)D and the biologically active form 1,25(OH)2D are routinely measured in clinical practice. While 25(OH)D remains the analyte of choice for the diagnosis of vitamin D deficiency, 1,25(OH)2D is only recommended in a few conditions with a dysregulated D metabolism. 24,25(OH)2D, free and bioavailable 25(OH)D, and the vitamin D metabolite ratio (VMR) have shown promising results, but technical pitfalls in their quantification, limited clinical data and the lack of reference values, impede their use in clinical practice. LC-MS/MS is the preferred method for the measurement of all vitamin D related analytes as it offers high sensitivity and specificity. In particular, 25(OH)D and 24,25(OH)2D can accurately be measured with this technology. When interpreted together, they seem to provide a functional measure of vitamin D metabolism beyond the analysis of 25(OH)D alone. The determination of VDBP, free and bioavailable 25(OH)D is compromised by unresolved analytical issues, lacking reference intervals and insufficient clinical data. Therefore, future research activities should focus on analytical standardization and exploration of their clinical value. This review provides an overview on established and new vitamin D related biomarkers including their pathophysiological role, preanalytical and analytical aspects, expected values, indications and influencing conditions.
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Affiliation(s)
- N Alonso
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - S Zelzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - G Eibinger
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - M Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
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Abstract
Vitamin K, a cofactor for the γ-glutamyl carboxylase enzyme, is required for the post-translational activation of osteocalcin and matrix Gla protein, which play a key role in bone and muscle homeostasis. In vivo and in vitro models for osteoporosis and sarcopenia suggest the vitamin K could exert a positive effect in both conditions. In bone, it increases osteoblastogenesis, whilst decreases osteoclast formation and function. In muscle, it is associated with increased satellite cell proliferation and migration and might play a role in energy metabolism. Observational trials suggest that high levels of vitamin K are associated with increased bone mineral density and reduced fracture risk. However, interventional studies for vitamin K supplementation yielded conflicting results. Clinical trials in sarcopenia suggest that vitamin K supplementation could improve muscle mass and function. One of the main limitations on the vitamin K studies are the technical challenges to measure its levels in serum. Thus, they are obtained from indirect sources like food questionnaires, or levels of undercarboxylated proteins, which can be affected by other environmental or biological processes. Although current research appoints to a beneficial effect of vitamin K in bone and muscle, further studies overcoming the current limitations are required in order to incorporate this supplementation in the clinical management of patients with osteosarcopenia.
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Affiliation(s)
- N Alonso
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - A Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - E Fritz-Petrin
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - D Enko
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - M Herrmann
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
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Domingo M, Teis A, Alonso N, Julian T, Bares D, Barcelo E, Revuelta-Lopez E, Gonzalez B, Codina P, Cediel G, Santiago-Vacas E, Santesmases J, Zamora E, Lupon J, Bayes-Genis A. Effect of diuretic down-titration on pulmonary congestion assessed by lung ultrasound when introducing sodium-glucose cotransporter 2 inhibitors. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.951] [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
Background
Mechanistic pathways of sodium-glucose cotransporter 2 inhibitors (SGLT2i) benefits in heart failure (HF) remain unclear.
Purpose
To investigate the effects of SGLT2i and simultaneous diuretic down-titration on pulmonary congestion assessed by lung ultrasound (LUS) and by HF biomarkers.
Methods
Prospective observational study in outpatients with HF and type 2 diabetes assigned to a SGLT2i. LUS was performed at baseline (just before starting SGLT2i), at 15 days and at 3-months of follow-up. Eight thoracic areas were examined. Diuretic regime was reduced at baseline, when LUS and clinical assessment allowed. The main outcome was short-time change in B-lines sum. Secondary endpoints evaluated N-terminal pro-B-type natriuretic peptide (NTproBNP), cancer antigen 125 (CA125) and interleukin-1 receptor-like 1 (ST2)
Results
88 patients were included (age, 66.8±9.9 years; 93.2% male; 77.3% in NYHA II functional class; 75% treated with loop diuretics). The median of lines B was 2 (RIQ 1–4), 2 (RIQ 1–4) and 2 (RIQ 0–4) at the initial visit, 15 days and 3 months, respectively (initial vs. 3 months, p=0.21) (Table 1). The number of patients treated with loop diuretics decreased from 66 to 33 (p<0.001) and the mean dose of furosemide (or equivalent) in those who continued decreased from 61±5 mg/day to 45.8±20 mg/day (p<0.001). There were no hospitalizations for HF in the 3 months of follow-up. None of the biomarkers showed statistically differences at 3 months of follow-up (Table 1).
Conclusions
The introduction of SGLT2i allowed a significant reduction of diuretics in chronic HF patients and diabetes, without evidence of worsening lung congestion assessed neither by LUS nor by HF biomarkers.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Domingo
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - A Teis
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - N Alonso
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - T Julian
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - D Bares
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - E Barcelo
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - E Revuelta-Lopez
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - B Gonzalez
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - P Codina
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - G Cediel
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - E Santiago-Vacas
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - J Santesmases
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - E Zamora
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - J Lupon
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
| | - A Bayes-Genis
- University Hospital Germans Trias and Pujol de Badalona , Badalona , Spain
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Olivares Hernandez A, García J, Alonso N, Corchete Sánchez L, Perez García J, Mesia Nin R, Rubió-Casadevall J, Garcia Giron C, Iglesias Docampo L, Carral Maseda A, Taberna Sanz M, Vazquez S, Gómez Muñoz A, del Barco E, González Sarmiento R, Cruz Hernandez J. 701P Genomic alteration relationships with toxicity to TPF induction chemotherapy in head and neck squamous cell carcinoma patients participating in a clinical trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.825] [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: 11/01/2022] Open
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García J, Olivares Hernandez A, Alonso N, Corchete Sánchez L, Fernandez-Mateos J, Perez García J, Hernández M, Seijas Tamayo R, Mesia Nin R, Rubió-Casadevall J, Garcia Giron C, Iglesias L, Carral Maseda A, Adansa Klain J, Taberna Sanz M, Vazquez S, Gómez Muñoz A, del Barco E, González Sarmiento R, Cruz Hernandez J. 692P Copy number alterations and response to radiotherapy + cisplatin vs radiotherapy + cetuximab after docetaxel-cisplatin-fluorouracil induction chemotherapy in patients with locally advanced unresectable head and neck cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.816] [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] Open
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Escabia C, Codina Verdaguer P, Buchaca D, Spitaleri G, Domingo M, Santiago-Vacas E, Cediel G, Zamora E, Alonso N, Troya M, Santesmases J, Crespo E, Nunez J, Lupon J, Bayes-Genis A. Long-term evolution of estimated glomerular filtration rate in patients with type 2 diabetes and heart failure. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Limited data are available on the very long-term trajectory of glomerular filtration rate (GFR) in patients with chronic heart failure (HF) and type 2 diabetes mellitus (T2D).
Purpose
To prospectively assess dynamic trajectories of GFR estimated by CKD-EPI in a real-life cohort of HF patients based on the presence or absence of T2D over a 14-year follow-up.
Methods
In a prospective observational registry of real-life HF outpatients, estimated GFR (eGFR) was calculated by CKD-EPI at baseline and on a structured schedule every 3 months up to 14 years. We included in the analysis only eGFR values that were assessed at scheduled visits, discarding urgent renal function assessments. Loess (locally weighted error sum of squares) curves were plotted for the subgroups according to baseline T2D up to 14 years of follow-up. Loess curves are useful to observe a trend or relationship on nonlinear data observed over time.
Results
2386 patients were consecutively included from August 2001 to December 2018. 43.2% of the patients had a history of T2D. Mean age was 67.0±12.6 years, 28.9% were women and 71.0% had HF with reduced ejection fraction (EF<40%). 25080 eGFR values were included in the analysis with a median of 8 values per patient [IQR 4–15] and a range between 1 and 47.
Diabetic patients had a worse baseline eGFR and presented a persistent decline over time. On the contrary non-diabetic patients presented an early decrease, mid-term improvement and a late progressive decline (Figure 1).
Conclusions
eGFR long-term trajectories in diabetic and non-diabetic patients with chronic HF were significantly different.
Funding Acknowledgement
Type of funding sources: None. eGFR evolution according to baseline T2D
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Affiliation(s)
- C Escabia
- Germans Trias i Pujol Hospital, Badalona, Spain
| | | | - D Buchaca
- Barcelona Supercomputing Center, Barcelona, Spain
| | - G Spitaleri
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - M Domingo
- Germans Trias i Pujol Hospital, Badalona, Spain
| | | | - G Cediel
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - E Zamora
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - N Alonso
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - M.I Troya
- Germans Trias i Pujol Hospital, Badalona, Spain
| | | | - E Crespo
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - J Nunez
- INCLIVA Foundation, Valencia, Spain
| | - J Lupon
- Germans Trias i Pujol Hospital, Badalona, Spain
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Spitaleri G, Cediel G, Santiago-Vacas E, Codina P, Domingo M, Zamora E, Santesmases J, Diez-Quevedo C, Troya M, Boldo M, Altimir S, Alonso N, Rivas C, Lupon J, Bayes-Genis A. Differences in long-term all-cause and cardiovascular mortality according to heart failure aetiology in ambulatory patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Heart failure (HF) is the final stage of many cardiac disorders. Mortality in heart HF remains challenging despite improvement in outcomes proved in clinical trials in HF with reduced ejection fraction and it can be influenced by the aetiology of HF.
Purpose
To assess differences in long-term mortality (up to 18 years) in a real-life cohort of HF outpatients according to the aetiology of HF.
Methods
Consecutive patients with HF admitted at the HF Clinic from August 2001 to September 2019 were included. Follow-up was closed at 30.9.2020. HF aetiology was divided into ischemic heart disease (IHD), dilated cardiomyopathy (CM) –including non-compaction CM–, hypertensive CM, alcohol-derived CM, drug-derived CM, valvular disease, hypertrophic CM and others. For the present analysis, this latter group was excluded due to the big heterogeneity and limited number of patients in each subtype of aetiology. All-cause death and cardiovascular death were the primary end-points. Fine & Gray method for competing risk was used for cardiovascular mortality analysis.
Results
Out of 2387 patients included (age 66.5±12.5 years, 71.3% men, LVEF 35.4%±14.2, mainly in NYHA class II [65.5%] and III [26.5%]), 1317 deaths were recorded (731 from cardiovascular cause) during a maximum follow-up of 18 years (median 4.1 years [IQR 2–7.8] for the total cohort, 5.3 years [IQR 2.6–9.7] for survivors). Figure 1 shows Cox regression multivariable analysis for all-cause death and cardiovascular mortality. Considering IHD aetiology as reference, only dilated CM showed significantly lower risk of all-cause death, and only drug-induced CM showed higher risk of all-cause death. However, when cardiovascular mortality was considered almost all aetiologies showed significant lower risk of cardiovascular death than IHD. Figure 2 shows adjusted survival curves (A) and adjusted incidence curves of cardiovascular death (B) based on HF aetiology.
Conclusions
After adjusting for multiple prognostic factors among the studied HF aetiologies, dilated CM and drug-related CM showed the lowest and the highest risk of all-cause death, respectively. Patients with IHD showed the highest adjusted risk of cardiovascular death.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- G Spitaleri
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - G Cediel
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - E Santiago-Vacas
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - P Codina
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - M Domingo
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - E Zamora
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - J Santesmases
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - C Diez-Quevedo
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - M Troya
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - M Boldo
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - S Altimir
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - N Alonso
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - C Rivas
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - J Lupon
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - A Bayes-Genis
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
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Cediel Calderon G, Teis A, Codina P, Domingo M, Santiago-Vacas E, Spitaleri G, Zamora E, Santasmases J, Alonso N, Lupon J, Bayes-Genis A. Clinical and prognostic significance of the inflammatory markers GlycA and GlycB in chronic heart failure of both ischemic and non-ischemic etiologies. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0870] [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
Background
N-acetylglucosamine/galactosamine (GlycA) and sialic acid (GlycB) constitute evolving nuclear magnetic resonance (NMR) biomarkers of systemic inflammation. They have been increasingly studied and associated with cardiovascular (CV) disease and incident heart failure (HF), but little is known about its value in chronic HF population.
Purpose
We aimed to examine the association on long-term CV outcomes of GlycA and GlycB in chronic HF relative to aetiology.
Methods
We prospectively included a cohort of 429 HF patients admitted to an ambulatory HF Unit. Plasma GlycA and GlycB concentrations were determined using NMR spectroscopy. The primary endpoint was a composite of CV death and readmission due to HF. Competing risk regression models were performed with non-CV death as the competing event. Because an interaction existed between GlycA and GlycB with ischemic etiology (p<0.01), we examined this further.
Results
The mean (SD) follow-up was 4.5±2.9 years. Median concentrations (IQR) for GlycA and GlycB were 5.4 (4.9–6.2) mmol/L and 1.9 (1.7–2.2) mmol/L, respectively. A total of 92 (41.1%) and 123 (60.0%) patients from non-ischemic and ischemic etiology, respectively, the clinical endpoint. In ischaemic HF patients (47.8%; n=205) both markers were not associated with the primary endpoint. Conversely, in non-ischemic HF patients (52.2%; n=224), GlycA and GlycB exhibited association with the primary endpoint in univariable and after multivariable adjustment (HR 1.14; 95% confidence interval [CI]: 1.02–1.28, p=0.018 and HR 1.91; 95% CI: 1.27–2.88, p=0.002; respectively. Figure 1 and 2). In this subgroup, a correlation analysis with well-known biomarkers (NT-proBNP, hs-TnT and ST2) only evidenced a positively and significantly correlation of GlycB with ST2 (r=0.26, p<0.001). No association was found with NYHA functional class.
Conclusions
GlycA and GlycB represent an evolving approach of inflammation status with prognostic value of long-term CV related events in non-ischemic HF patients.
Funding Acknowledgement
Type of funding sources: None. Figure 1. Probability of MACE by GlycA tertilesFigure 2. Probability of MACE by GlycB tertiles
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Affiliation(s)
- G Cediel Calderon
- University Hospital Germans Trias i Pujol de Badalona, Badalona, Spain
| | - A Teis
- University Hospital Germans Trias i Pujol de Badalona, Badalona, Spain
| | - P Codina
- University Hospital Germans Trias i Pujol de Badalona, Badalona, Spain
| | - M Domingo
- University Hospital Germans Trias i Pujol de Badalona, Badalona, Spain
| | - E Santiago-Vacas
- University Hospital Germans Trias i Pujol de Badalona, Badalona, Spain
| | - G Spitaleri
- University Hospital Germans Trias i Pujol de Badalona, Badalona, Spain
| | - E Zamora
- University Hospital Germans Trias i Pujol de Badalona, Badalona, Spain
| | - J Santasmases
- University Hospital Germans Trias i Pujol de Badalona, Badalona, Spain
| | - N Alonso
- University Hospital Germans Trias i Pujol de Badalona, Badalona, Spain
| | - J Lupon
- University Hospital Germans Trias i Pujol de Badalona, Badalona, Spain
| | - A Bayes-Genis
- University Hospital Germans Trias i Pujol de Badalona, Badalona, Spain
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Spitaleri G, Cediel G, Santiago-Vacas E, Codina P, Domingo M, Zamora E, Santesmases J, Diez-Quevedo C, Troya M, Boldo M, Alonso N, Gonzalez B, Nunez J, Lupon J, Bayes-Genis A. Kidney function derangements during summer in ambulatory heart failure patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0863] [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
Background
Heart failure (HF) is characterized by alterations in kidney function that are associated with poor prognosis and can be related to the evolution of the disease or induced by medical treatment. High temperatures during summer may result in some degree of dehydration, especially in patients treated with diuretics, and may contribute to transient glomerular filtration rate (eGFR) reduction.
Objective
To assess creatinine and eGFR changes during summer in ambulatory heart failure patients.
Methods
Consecutive patients with HF admitted at our HF Clinic (Spain) from August 2001 to December 2020 were included. eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. We included in the analysis creatinine and eGFR values that were assessed at planned visits only, discarding urgent renal function assessments. Creatinine and eGFR values were grouped according to the period of the year (summer [from June to September, both included] vs. the rest of the year). Changes in creatinine and eGFR between the rest of the year and summer for each patient were evaluated using paired samples t-test.
Results
Out of 37360 creatinine and eGFR values, 25458 were included in the analysis for a total of 2423 patients (median number of observations for each patient: 8, IQR 4–15). Mean creatinine and eGFR were 1.4±1.0 mg/dl and 63.0±27.7 ml/min, respectively. Table 1 shows baseline patient characteristics. Creatinine increased significantly during summer (1.44±0.9 mg/dl vs. 1.48±1.1 mg/dl, p<0.001). Similarly, eGFR was lower in summer as compared to the rest of the year 60.6±25.4 ml/min vs. 59.4±26.0 ml/min, p<0.001.
Conclusions
In ambulatory HF patients in a Mediterranean area, we found significant worsening of renal function during summer, likely related to an imbalance between water intake and fluid loss. To prevent summer-driven kidney stress, diuretic treatment should be carefully adjusted during the hottest months of the year.
Funding Acknowledgement
Type of funding sources: None. Table 1
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Affiliation(s)
- G Spitaleri
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - G Cediel
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - E Santiago-Vacas
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - P Codina
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - M Domingo
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - E Zamora
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - J Santesmases
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - C Diez-Quevedo
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - M Troya
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - M Boldo
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - N Alonso
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - B Gonzalez
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - J Nunez
- Instituto de Investigacion Sanitaria INCLIVA, Valencia, Spain
| | - J Lupon
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
| | - A Bayes-Genis
- Germans Trias i Pujol Hospital, Heart Failure Clinic and Cardiology Service, Badalona, Spain
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Lu X, Forte AJ, Alperovich M, Alonso N, Persing JA. Does different cranial suture synostosis influence orbit volume and morphology in Apert syndrome? Int J Oral Maxillofac Surg 2021; 51:338-346. [PMID: 34400025 DOI: 10.1016/j.ijom.2021.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 07/25/2021] [Accepted: 07/28/2021] [Indexed: 10/20/2022]
Abstract
This study was performed to compare the orbital and peri-orbital morphological variations in Apert syndrome patients with different cranial vault suture synostosis, so as to provide an anatomic basis for individualized surgical planning. Computed tomography scans of 57 unoperated Apert syndrome patients and 59 controls were subgrouped as follows: type I, bilateral coronal synostosis; type II, pansynostosis; type III, perpendicular combinations of cranial vault suture synostoses. Orbit bony cavity volume was significantly reduced in type I and type II, by 19% (P < 0.001) and 24% (P < 0.001), respectively. However, the reduction of orbital cavity volume in type III did not reach statistical significance. Globe volume projection beyond the orbital rim, however, increased by 76% (P < 0.001) in type III, versus an increase of 54% (P < 0.001) in type I and 53% (P < 0.001) in type II, due to different ethmoid and sphenoid bone malformations. Maxillary bone volume was only significantly reduced in type I bicoronal synostosis (by 24%, P = 0.048). Both type I and type II developed relatively less zygoma and sphenoid bone volume. Different cranial vault suture synostoses have varied influence on peri-orbital development in Apert syndrome. Instead of mitigating the abnormalities resulting from bicoronal synostosis in type I, additional midline suture synostosis worsens the exorbitism due to a more misshaped ethmoid.
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Affiliation(s)
- X Lu
- Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, Connecticut, USA.
| | - A J Forte
- Division of Plastic and Reconstructive Surgery, Mayo Clinic Florida, Jacksonville, Florida, USA.
| | - M Alperovich
- Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, Connecticut, USA.
| | - N Alonso
- Department of Plastic Surgery, University of São Paulo, São Paulo, Brazil.
| | - J A Persing
- Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, Connecticut, USA.
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12
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Lu X, Forte AJ, Wilson A, Park KE, Allam O, Alperovich M, Steinbacher DM, Tonello C, Alonso N, Persing JA. Growth patterns of the airway in Crouzon syndrome patients with different types of cranial vault suture synostosis. Int J Oral Maxillofac Surg 2020; 50:924-932. [PMID: 33384236 DOI: 10.1016/j.ijom.2020.11.023] [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: 08/16/2020] [Revised: 09/30/2020] [Accepted: 11/30/2020] [Indexed: 11/26/2022]
Abstract
The severity of obstructive respiratory difficulty varies among affected Crouzon syndrome patients. The aim of this study was to investigate the correlation between the restricted airway volume in Crouzon syndrome and the associated type of cranial vault suture synostosis. Computed tomography scans of 68 unoperated Crouzon syndrome patients and 89 control subjects were subgrouped into four types: type I, bilateral coronal synostosis; type II, sagittal synostosis; type III, pansynostosis; type IV, perpendicular combinations of synostoses. Measurements were made using Mimics software. Of type I Crouzon patients, 42% had a restricted nasal airway (P=0.002), while the pharyngeal airway volume was not significantly reduced. Type II Crouzon patients grew normal segmental airway volumes. Crouzon patients of type III developed simultaneously reduced nasal and pharyngeal airway volumes in infancy, by 38% (P=0.034) and 51% (P=0.014), respectively. However, the nasal airway achieved a normal volume by 2 years of age without any intervention, while the pharyngeal airway remained significantly reduced up to 6 years of age, by 42% (P=0.013), compared to controls. Type IV Crouzon patients developed a reduced nasal airway volume (32%, P=0.048) and a non-significant restricted pharyngeal airway (18%, P=0.325). Airway compromise in Crouzon syndrome is variable when associated with different craniosynostosis fusion patterns. Type II (sagittal synostosis) Crouzon patients grew a normal nasopharyngeal airway volume. Those with types I (bicoronal synostosis) and IV (perpendicular synostoses) had significantly restricted nasal airways and a tendency towards a reduced pharyngeal volume. Type III (pansynostosis) Crouzon infants had the worst restriction of both airways, although there was some improvement with age.
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Affiliation(s)
- X Lu
- Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - A J Forte
- Division of Plastic and Reconstructive Surgery, Mayo Clinic Florida, Jacksonville, Florida, USA
| | - A Wilson
- Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - K E Park
- Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - O Allam
- Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - M Alperovich
- Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - D M Steinbacher
- Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - C Tonello
- Department of Craniofacial Surgery, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/USP), Bauru, São Paulo, Brazil
| | - N Alonso
- Department of Plastic Surgery, University of São Paulo, São Paulo, Brazil
| | - J A Persing
- Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, Connecticut, USA.
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13
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Lu X, Forte AJ, Allam O, Park KE, Junn A, Alperovich M, Steinbacher DM, Tonello C, Alonso N, Persing JA. Nasopharyngeal airway and subcranial space analysis in Pfeiffer syndrome. Br J Oral Maxillofac Surg 2020; 59:592-598. [PMID: 33863588 DOI: 10.1016/j.bjoms.2020.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 07/26/2020] [Accepted: 10/15/2020] [Indexed: 12/16/2022]
Abstract
Tracheotomy in infancy helps patients with Pfeiffer syndrome to survive by preventing respiratory crisis, but difficulty in decannulation may consequently be a challenge. This study has investigated the regional abnormalities of the nasopharyngeal airway in children with Pfeiffer syndrome to provide an anatomical basis for the surgical treatment and decannulation of the upper airway. Seventy-two preoperative computed tomograms (CT) (Pfeiffer syndrome n=30; control n=42) were included. The airway volume, cross-sectional area, and cephalometrics were measured using Materialise software. Patients with Pfeiffer syndrome developed a 50% (p<0.001) reduction of nasal airway volume, and a 44% (p=0.003) restriction in pharyngeal airway volume. In patients with Pfeiffer syndrome the cross-sectional area at the choana was only half that of the controls (p<0.001). The posterior width of the nasal airway in patients with Pfeiffer syndrome was shortened by 13% (p=0.003), and the height reduced by 21% (p<0.001). The cross-sectional areas at the condylion and gonion levels, which indicate the calibre of the pharyngeal airway at the entrance and midsection, were reduced by 67% (p<0.001) and 47% (p<0.001), respectively, when compared with the controls. The volume of the nasal airway in patients with Pfeiffer syndrome was significantly restricted in length, height, and width, and by choanal stenosis in all cases in this cohort. The reduced anteroposterior length of the nasal airway contributed to the shortened maxilla more than the anteroposterior position. The limited height and width of the nasal pathway was the result of a hypoplastic sphenoid. Restricted mediolateral and anteroposterior dimensions were evident across the entire course of the pharyngeal airway. Mediolateral maxillary expansion in addition to maxillomandibular advancement is therefore likely to benefit these patients.
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Affiliation(s)
- X Lu
- Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT, USA.
| | - A J Forte
- Division of Plastic and Reconstructive Surgery, Mayo Clinic Florida, Jacksonville, FL, USA.
| | - O Allam
- Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT, USA.
| | - K E Park
- Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT, USA.
| | - A Junn
- Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT, USA.
| | - M Alperovich
- Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT, USA.
| | - D M Steinbacher
- Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT, USA.
| | - C Tonello
- Department of Craniofacial Surgery, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/USP), Bauru, São Paulo, Brazil.
| | - N Alonso
- Department of Plastic Surgery, University of São Paulo, São Paulo, Brazil.
| | - J A Persing
- Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT, USA.
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14
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Castelblanco E, Barranco M, Quifer P, Yanes O, Weber R, Ortega E, Alonso N, Mauricio D. Lipidomic profile and subclinical carotid atherosclerosis in diabetes mellitus. Atherosclerosis 2020. [DOI: 10.1016/j.atherosclerosis.2020.10.485] [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: 11/24/2022]
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15
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Codina P, De Antonio M, Santiago-Vacas E, Domingo M, Zamora E, Santesmases J, Subirana I, Buchaca D, Alonso N, Troya M, Velayos P, Pulido A, Nunez J, Lupon J, Bayes-Genis A. How mortality risk estimated by MAGGIC-HF, SHFM and BCN-Bio HF scores is modified after 12-month management in a multidisciplinary HF Clinic. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1123] [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: 11/15/2022] Open
Abstract
Abstract
Background
Heart failure (HF) contemporary management has significantly improved over the past two decades leading to better survival. How application of the contemporary HF management guidelines affects the risk of death estimated by available web-based risk scores is not elucidated.
Objective
To assess changes in mortality risk prediction after a after a 12-month management period in a multidisciplinary HF Clinic.
Methods
Out of 1,689 consecutive patients with HF admitted at our ambulatory HF Clinic from May 2006 to November 2018, those who completed one year follow-up were considered for the study. Patients without NTproBNP measurement or with more than 3 missing variables for risk estimation were excluded. Three contemporary web-based HF risk scores were evaluated: MAGGIC-HF, Seattle HF Model (SHFM) and the Barcelona Bio-HF Calculator containing NTproBNP (BCN Bio-HF). Risk of all-cause death at one year and at 3 years were calculated at baseline and re-evaluated after 12-month management in a multidsisciplinary HF Clinic. Wilcoxon paired data test was used to compare changes in mortality risk estimation over time and test equality of matched pairs for comparing estimated change among tools. 442 patients used to derive the Barcelona Bio-HF Calculator were excluded for discrimination purposes.
Results
1,157 patients were included (age 65.7±12.7 years, 70.4% men). A significant reduction in mortality risk estimation was observed with the three HF risk scores evaluated at 12-months (Table). The BCN Bio-HF model showed significantly different changes in risk estimation, fact that indeed was partnered with numerically better discrimination. AUC at 1 and 3 years, respectively, were: BCN Bio-HF (0.773 and 0.775), MAGGIC HF (0.686 and 0.748) and SHFM (0.773 and 0.739).
Conclusions
The three web-based risk scores evaluated showed a significant reduction in mortality risk estimation after 12 month management in a multidisciplinary HF Clinic. The BCN Bio-HF score showed higher reduction in estimated risk, together with better discrimination, likely because it incorporates contemporary treatment and use of biomarkers.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- P Codina
- Germans Trias i Pujol Hospital, Badalona, Spain
| | | | | | - M Domingo
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - E Zamora
- Germans Trias i Pujol Hospital, Badalona, Spain
| | | | - I Subirana
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - D Buchaca
- Barcelona Supercomputing Center, Barcelona, Spain
| | - N Alonso
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - M.I Troya
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - P Velayos
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - A Pulido
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - J Nunez
- Hospital General Universitario de Valencia, Valencia, Spain
| | - J Lupon
- Germans Trias i Pujol Hospital, Badalona, Spain
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16
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Zamora E, De Antonio M, Domingo M, Santiago-Vacas E, Codina P, Santesmases J, Troya M, Diez-Quevedo C, Boldo M, Alonso N, Gonzalez B, Rivas C, Nunez J, Lupon J, Bayes-Genis A. Heart failure hospitalization trends during a very long-term follow-up up to 18 years. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Heart Failure (HF) is the first cause of hospitalizations in people older than 65 years. Often patients suffer recurrent hospital admissions.
Objective
To assess recurrent HF-related hospitalizations during very long-term follow-up in a cohort of HF outpatients managed in an ambulatory structured HF Unit.
Methods
End of follow-up was 31.8.2019 (at least 1-year follow-up for alive patients, up to 18 years). Heart failure hospitalizations were defined as unplanned hospitalizations of at least 24 hours due to worsening heart failure and were identified from clinic records, hospital wards, or electronic Catalan history record. Death was recorded from the same sources and Spanish Health System and Spanish Death Registry. Lost information during follow-up was adequately censored (1 patient for survival status and 37 for HF-related hospitalizations).
Results
A total of 2355 patients were included. Follow-up span a total of 12,472 patients-years. 1682 HF-related hospitalizations were recorded in 725 patients (13.5 per 100 patients-years). Number of admissions ranged from 0 in 1630 patients to 22 in 1 patient (patients with hospitalizations, median 2 [Q1-Q3, 1–3]; 118 patients had 4 or more hospitalizations). HF hospitalization density incidence was higher during the 10 first years in patients with HF hospitalizations in the precedent year before HF Clinic baseline visit (table). By contrast, if only patients who died during follow-up were considered (N=1299), hospitalization trends significantly increased in their last period of life: 11.7%, 8.9%, 13.6%, 20.8% and 44.9% from the first to the last period (quintile) of their trajectory, respectively.
Conclusions
HF hospitalizations occur during the whole HF trajectory, with an increasing trend at the end of the every patient trajectory.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- E Zamora
- Germans Trias i Pujol Hospital, Badalona, Spain
| | | | - M Domingo
- Germans Trias i Pujol Hospital, Badalona, Spain
| | | | - P Codina
- Germans Trias i Pujol Hospital, Badalona, Spain
| | | | - M.I Troya
- Germans Trias i Pujol Hospital, Badalona, Spain
| | | | - M Boldo
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - N Alonso
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - B Gonzalez
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - C Rivas
- Germans Trias i Pujol Hospital, Badalona, Spain
| | - J Nunez
- University General Hospital of Valencia, Valencia, Spain
| | - J Lupon
- Germans Trias i Pujol Hospital, Badalona, Spain
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17
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Lu X, Forte AJ, Fan F, Zhang Z, Teng L, Yang B, Alperovich M, Steinbacher DM, Alonso N, Persing JA. Racial disparity of Crouzon syndrome in maxilla and mandible. Int J Oral Maxillofac Surg 2020; 49:1566-1575. [PMID: 32362538 DOI: 10.1016/j.ijom.2020.04.005] [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: 11/17/2019] [Revised: 02/17/2020] [Accepted: 04/06/2020] [Indexed: 12/26/2022]
Abstract
The racial disparity of facial features in craniosynostosis patients is not fully understood. The aim of this study was to explore the difference in maxillary and mandibular morphology and spatial position in Asian and Caucasian Crouzon syndrome patients. Ninety-one computed tomography scans were included (12 Asian Crouzon syndrome patients, 22 Asian controls; 16 Caucasian Crouzon syndrome patients, 41 Caucasian controls) and measured using Materialise software. The maxillary and mandibular volumes of Asian patients were both reduced by 19% (P=0.102 and P=0.187), and those of Caucasian patients were reduced by 15% (P=0.142) and 14% (P=0.211) when compared to the respective race-specific controls. Maxilla length of Asian patients was reduced by 6.36mm (14%, P=0.003), while the reduction in Caucasian patients was 4.88mm (10%, P=0.038). ANS was retracted 11.99mm (P<0.001) in Asian patients and 11.54mm (P<0.001) in Caucasian patients. The ANB angle was narrowed by 13.17° (P<0.001) in Asian patients compared to Asian controls, and by 7.02° (P<0.001) in Caucasian patients compared to Caucasian controls. The retrusive midface profiles of Asian and Caucasian Crouzon syndrome look similar; both result from the combined effect of hypoplastic size and backward displacement. However, the insufficiency was found to be more a failure of the anteroposterior maxillary length in Asian patients, and more due to posterior maxillary positioning in Caucasian patients. Therefore, prognathism in Crouzon syndrome patients is more likely caused by displacement rather than elongation of mandibular length in both races. Crouzon syndrome results in the same extent of overall volume deficiency of the maxilla and mandible in these races.
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Affiliation(s)
- X Lu
- Chinese Academy of Medical Sciences, Peking Union Medical College, Plastic Surgery Hospital, Beijing, China; Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT, USA
| | - A J Forte
- Division of Plastic and Reconstructive Surgery, Mayo Clinic Florida, Jacksonville, FL, USA
| | - F Fan
- Chinese Academy of Medical Sciences, Peking Union Medical College, Plastic Surgery Hospital, Beijing, China
| | - Z Zhang
- Chinese Academy of Medical Sciences, Peking Union Medical College, Plastic Surgery Hospital, Beijing, China
| | - L Teng
- Chinese Academy of Medical Sciences, Peking Union Medical College, Plastic Surgery Hospital, Beijing, China
| | - B Yang
- Chinese Academy of Medical Sciences, Peking Union Medical College, Plastic Surgery Hospital, Beijing, China
| | - M Alperovich
- Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT, USA
| | - D M Steinbacher
- Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT, USA
| | - N Alonso
- Department of Plastic Surgery, University of São Paulo, São Paulo, Brazil
| | - J A Persing
- Division of Plastic and Reconstructive Surgery, Yale School of Medicine, New Haven, CT, USA.
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18
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Griffa N, Moyano RD, Canal AM, Travería GE, Santangelo MP, Alonso N, Romano MI. Development and diagnostic validation of an ELISA based on an antigenic mixture for the detection of bovine tuberculosis. Vet J 2020; 256:105426. [PMID: 32113584 DOI: 10.1016/j.tvjl.2020.105426] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 01/31/2019] [Revised: 01/09/2020] [Accepted: 01/13/2020] [Indexed: 11/16/2022]
Abstract
Programs for the eradication of bovine tuberculosis (bTB) focus on the tuberculin skin test (TST) and slaughter of reactor cattle. However, the disease remains an animal health concern in several countries and improving the efficiency of the TST has become a critical issue. The detection of Mycobacterium bovis antibodies in serum, within weeks after the TST, may be a rapid and inexpensive way to improve bTB control. This study reports the validation of an enzyme-linked immunosorbent assay (ELISA) to detect bovine tuberculosis as an ancillary test to TST in dairy farms in Argentina. The estimated validation parameters were within the established requirements of the World Organization for Animal Health (OIE). The test demonstrated high repeatability, with coefficients of variation <25%. High test reproducibility through interlaboratory testing was also found, with an estimated Pearson coefficient of 0.9648 (95% confidence intervals 0.9315-0.9820). The ELISA detected tuberculous cattle unidentified by the TST. Of 43 animals sent to slaughterhouses that were ELISA positive 15-17 days after a negative TST, 36 were confirmed as infected with M. bovis by histopathology and IS6110 PCR. According to ROC curve analysis of results of 145 cattle from M. bovis-free herds and the 36 M. bovis-infected cattle, at a corrected optical density cut-off point of 0.3853, specificity was 95.95% and the positive predictive value at this cut-off was 83.72%. The ELISA detection test validated in this study could be readily applied in dairy farms, to complement a prior TST and improve livestock health.
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Affiliation(s)
- N Griffa
- Instituto de Agrobiotecnología y Biología Molecular (IABiMo), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto Nacional de Tecnología Agropecuaria (INTA), Argentina
| | - R D Moyano
- Instituto de Agrobiotecnología y Biología Molecular (IABiMo), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto Nacional de Tecnología Agropecuaria (INTA), Argentina
| | - A M Canal
- Facultad de Ciencias Veterinarias, Universidad Nacional del Litoral, Argentina
| | - G E Travería
- Centro de Diagnóstico e Investigaciones Veterinarias (CEDIVE) de la Facultad de Ciencias Veterinarias - Universidad de la Plata, Argentina
| | - M P Santangelo
- Instituto de Agrobiotecnología y Biología Molecular (IABiMo), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto Nacional de Tecnología Agropecuaria (INTA), Argentina
| | - N Alonso
- Instituto de Agrobiotecnología y Biología Molecular (IABiMo), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto Nacional de Tecnología Agropecuaria (INTA), Argentina.
| | - M I Romano
- Instituto de Agrobiotecnología y Biología Molecular (IABiMo), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto Nacional de Tecnología Agropecuaria (INTA), Argentina
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19
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Zamora E, Gonzalez B, Rivas C, Diaz V, Velayos P, Lupon J, De Antonio M, Domingo M, Moliner P, Santiago-Vacas E, Cachero M, Joaquim C, Alonso N, Santesmases J, Bayes-Genis A. P2607Quick nutritional assessment and prognosis in outpatients with heart failure with mid-range ejection fraction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0931] [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
Background
Nutritional status is an important prognostic factor in patients with heart failure (HF) beyond body mass index, although its prognostic value in patients with mid-range left ventricular ejection fraction (HFmrEF) is not completely elucidated. In a pilot study we observed that the Mini Nutritional Assessment Short Form (MNA-SF) was the best approach for the screening of nutritional status in HF outpatients over others screening tools.
Purpose
To assess the prognostic role of malnutrition or risk of malnutrition in HFmrEF outpatients after the implementation of the MNA-SF screening tool in a routine way in a multidisciplinary HF.
Methods
The MNA-SF screening tool was administered during the global nurse evaluation of patients. The scoring ranges from 0 to 14, being 0 to7 as malnutrition status, 8 to 11 as at risk of malnutrition and 12 to 14 as normal nutritional status. For the present study those patients with malnutrition and at risk of malnutrition were merged and considered abnormal nutritional status. All-cause death was the primary end-point. Univariate and multivariate (backward conditional stepwise) Cox regression analyses were performed.
Results
Since October 2016 to November 2017, 153 HFmrEF patients were studied (mean age 68.8±11.7 years, 72.5% men, body mass index 28.4±4.4, LVEF 44% ± 3, NYHA class I 5.9%, II 86.3%, and III 7.8%). According to the MNA-SF 25 patients were (16.3%) fulfilled criteria of malnutrition (4) or where at risk of malnutrition (21). During a mean follow-up of 17.4±6.1 months, 23 patients died (15%). In the univariate analysis, nutritional abnormal status was significantly associated with all-cause death (HR 2.93 [1.23–7], p=0.02). In the multivariate analysis which included age, sex, NYHA functional class, body mass index, ischemic aetiology of HF and years of duration of HF, abnormal nutritional status remained significantly associated with all-cause mortality (HR 3.64 [1.39–9.54], p=0.009), together with NYHA functional class (HR 7.93 [2.69–23.4], p<0.001) and years of HF duration (HR 1.10 [1.04–1.16], p=0.001).
Conclusions
Nutritional status assessed with the screening MNA-SF was an independent predictor of all-cause death in ambulatory patients with HFmrEF – beyond BMI – together with NYHA functional class and HF duration.
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Affiliation(s)
- E Zamora
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - B Gonzalez
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - C Rivas
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - V Diaz
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - P Velayos
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - J Lupon
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - M De Antonio
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - M Domingo
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - P Moliner
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | | | - M Cachero
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - C Joaquim
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - N Alonso
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - J Santesmases
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - A Bayes-Genis
- Germans Trias i Pujol University Hospital, Barcelona, Spain
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20
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Moliner P, Lupon J, De Antonio M, Domingo M, Santiago-Vacas E, Zamora E, Santesmases J, Diez-Quevedo C, Troya MI, Boldo M, Altimir S, Alonso N, Gonzalez B, Nunez J, Bayes-Genis A. P4150Causes of death in a heart failure clinic in Spain along 17 years. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Advances in heart failure (HF) treatment have achieved a reduction of death in HF patients in the last two decades. Indeed, not only mortality has been reduced but also the mode of death might have been modified through these years.
Purpose
To assess the causes of death in outpatients attended in a HF Unit since the year 2002 up to the year 2018.
Methods
Causes of death were classified as follows: progression of HF (worsening HF or treatment-resistant HF, in the absence of another cause); sudden death (any unexpected death, witnessed or not, of a previously stable patient with no evidence of worsening HF or any other known cause of death); acute myocardial infarction; stroke; procedural (post-diagnostic or post-therapeutic); other cardiovascular causes (e.g., rupture of an aneurysm, peripheral ischemia, or aortic dissection), and non-cardiovascular. Patients who died of unknown cause were excluded from the analysis. Fatal events were identified from the clinical records of patients with HF, hospital wards, the emergency room, general practitioners, or by contacting the patient's relatives. Furthermore, data were verified from the databases of the Catalan and Spanish Health Systems. Trends on every cause of death were assessed by linear regression.
Results
Since August 2001 to May 2018, 2295 HF patients were admitted to the HF clinic (age 66.4±12.8 years, 71% men, 49% from ischemic aetiology, mean LVEF 35.2% ± 14). During the 17 years of the study, 1201 deaths were recorded. Seventy-eight patients (6.5% of deaths) were excluded due to unknown cause of death. The evolution in the mode of death by years is shown in the figure. Two trends were observed: a decrease in sudden death (p=0.05) and a very significant linear increase in non-cardiovascular causes of death (p<0.001). The decrease of sudden death was mainly driven from changes observed in the first 10 years (p=0.014); thereafter the incidence of sudden death remained stable (p=0.18). Remarkably we did not observe significant changes in HF progression as mode of death (p=0.17).
Conclusions
During the 17 years of the study, a very significant trend towards higher percentage of non-cardiovascular deaths was progressively observed. On the other hand, percentage of sudden death showed a gradual decrease, mainly driven from the changes observed in the first 10 years.
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Affiliation(s)
- P Moliner
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - J Lupon
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - M De Antonio
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - M Domingo
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | | | - E Zamora
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - J Santesmases
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - C Diez-Quevedo
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - M I Troya
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - M Boldo
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - S Altimir
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - N Alonso
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - B Gonzalez
- Germans Trias i Pujol University Hospital, Barcelona, Spain
| | - J Nunez
- University Hospital Clinic of Valencia, Valencia, Spain
| | - A Bayes-Genis
- Germans Trias i Pujol University Hospital, Barcelona, Spain
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Sillero ID, Flores ML, Sánchez-Cousido L, Piedra MR, Lia NL, Alonso N, Tascon CD, González AL, Castañón C, De Sande L, Rodriguez Á, Pedraza M, Mangudo BN, García-Palomo A, Diz P. EP1.16-18 EGFR Mutation Positive Non-Small Cell Lung Cancer: Management Approach and Survival Outcomes from the Hospital of Leon. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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22
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Amor A, Vinagre I, Valverde M, Pané A, Urquizu X, Meler E, López E, Quirós C, Giménez M, Codina L, Alonso N, Conget I, Barahona M, Perea V. Preeclampsia: A Risk Factor On Preclinical Carotid Atherosclerosis With Similar Impact To Type 1 Diabetes. Atherosclerosis 2019. [DOI: 10.1016/j.atherosclerosis.2019.06.255] [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: 11/16/2022]
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23
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Giménez G, Alonso N, Vera G, Pedrozo R. SEROPREVALENCE OF NEOSPOROSIS AND ITS EFFECT ON THE INTERVAL BETWEEN BIRTHS IN DAIRY COWS OF THE CENTRAL DEPARTMENT, PARAGUAY - YEAR 2018. Compend cienc vet 2019. [DOI: 10.18004/compend.cienc.vet.2019.09.01.30-34] [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: 10/26/2022] Open
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24
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Lu X, Forte A, Sawh-Martinez R, Wu R, Cabrejo R, Steinbacher D, Alperovich M, Alonso N, Persing J. Orbit, zygoma, and maxilla growth patterns in Crouzon syndrome. Int J Oral Maxillofac Surg 2019; 48:309-321. [DOI: 10.1016/j.ijom.2018.10.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 10/12/2018] [Accepted: 10/17/2018] [Indexed: 10/28/2022]
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25
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Alonso N, Cañueto J, Ciria S, Bueno E, Palacios‐Alvarez I, Alegre M, Badenas C, Barreiro A, Pena L, Maldonado C, Nespeira‐Jato M, Peña‐Penabad C, Azon A, Gavrilova M, Ferrer I, Sanmartin O, Robles L, Hernandez‐Martin A, Urioste M, Puig S, Puig L, Gonzalez‐Sarmiento R. Novel clinical and molecular findings in Spanish patients with nevoid basal cell carcinoma syndrome. Br J Dermatol 2018. [DOI: 10.1111/bjd.16207] [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]
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26
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Alonso N, Cañueto J, Ciria S, Bueno E, Palacios‐Alvarez I, Alegre M, Badenas C, Barreiro A, Pena L, Maldonado C, Nespeira‐Jato M, Peña‐Penabad C, Azon A, Gavrilova M, Ferrer I, Sanmartin O, Robles L, Hernandez A, Urioste M, Puig S, Puig L, Gonzalez‐Sarmiento R. 针对西班牙痣样基底细胞癌综合征患者的最新临床及分子研究结果. Br J Dermatol 2018. [DOI: 10.1111/bjd.16211] [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: 10/18/2022]
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27
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Alonso N, Cañueto J, Ciria S, Bueno E, Palacios-Alvarez I, Alegre M, Badenas C, Barreiro A, Pena L, Maldonado C, Nespeira-Jato MV, Peña-Penabad C, Azon A, Gavrilova M, Ferrer I, Sanmartin O, Robles L, Hernandez-Martin A, Urioste M, Puig S, Puig L, Gonzalez-Sarmiento R. Novel clinical and molecular findings in Spanish patients with naevoid basal cell carcinoma syndrome. Br J Dermatol 2017; 178:198-206. [PMID: 28733979 DOI: 10.1111/bjd.15835] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Naevoid basal cell carcinoma syndrome (NBCCS) is an autosomal dominant disorder characterized by developmental alterations and multiple basal cell carcinomas. Mutations in PTCH1, which encodes a membrane receptor for Sonic Hedgehog, are associated with the development of the disease. Most of them produce a truncated protein, which is unable to suppress Smoothened protein and continuously activates the downstream pathway. OBJECTIVES We aimed to characterize 22 unrelated Spanish patients with NBCCS, the largest cohort with Gorlin syndrome reported to date in Spain. METHODS Genomic analysis of PTCH1 was performed in patients with NBCCS and controls, and mutations were analysed using bioinformatics tools. RESULTS We report for the first time two young patients, one each with uterus didelphys and ganglioneuroma, within the context of NBCCS. One patient showing a severe phenotype of the disease had developed basal cell carcinomas since childhood. Sanger sequencing of PTCH1 in this cohort identified 17 novel truncating mutations (11 frameshift, five nonsense and one mutation affecting an exon-intron splice site) and two novel missense mutations that were predicted to be pathogenic. The patients showed great clinical variability and inconsistent genotype-phenotype correlation, as seen in relatives carrying similar mutations. CONCLUSIONS This study contributes to increase the pool of clinical manifestations of NBCCS, as well as increasing the number of pathogenic mutations identified in PTCH1 predisposing to the condition. The inconsistencies found between phenotype and genotype suggest the involvement of other modifying factors, genetic, epigenetic or environmental.
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Affiliation(s)
- N Alonso
- Molecular Medicine Unit, Department of Medicine, University of Salamanca, Salamanca, Spain.,Rheumatology and Bone Disease Unit, Centre for Genomic and Experimental Medicine, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, U.K
| | - J Cañueto
- Department of Dermatology, Salamanca University Hospital, Salamanca, Spain.,Biomedical Research Institute of Salamanca (IBSAL), Institute of Molecular and Cellular Biology of Cancer (IBMCC), University Hospital of Salamanca, University of Salamanca-CSIC, Salamanca, Spain
| | - S Ciria
- Molecular Medicine Unit, Department of Medicine, University of Salamanca, Salamanca, Spain
| | - E Bueno
- Molecular Medicine Unit, Department of Medicine, University of Salamanca, Salamanca, Spain.,Biomedical Research Institute of Salamanca (IBSAL), Institute of Molecular and Cellular Biology of Cancer (IBMCC), University Hospital of Salamanca, University of Salamanca-CSIC, Salamanca, Spain
| | | | - M Alegre
- Department of Dermatology, Hospital Santa Creu i San Pau, Barcelona, Spain
| | - C Badenas
- Biochemistry and Molecular Genetics, Melanoma Unit, Hospital Clinic i Provincial, Barcelona, Spain.,Institut de Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras, Barcelona, Spain
| | - A Barreiro
- Department of Dermatology, Melanoma Unit, Hospital Clinic i Provincial, Barcelona, Spain
| | - L Pena
- Familial Cancer Clinical Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - C Maldonado
- Department of Dermatology, Hospital Central de Asturias, Oviedo, Spain
| | - M V Nespeira-Jato
- Department of Dermatology, Hospital Universitario de La Coruña, La Coruña, Spain
| | - C Peña-Penabad
- Department of Dermatology, Hospital Universitario de La Coruña, La Coruña, Spain
| | - A Azon
- Department of Dermatology, Hospital San Joan de Reus, Reus, Spain
| | - M Gavrilova
- Department of Dermatology, Hospital Clínico de Valencia, Valencia, Spain
| | - I Ferrer
- Department of Dermatology, Hospital General Universitario de Valencia, Valencia, Spain
| | - O Sanmartin
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - L Robles
- Hereditary Cancer Unit, Hospital 12 de Octubre, Madrid, Spain
| | | | - M Urioste
- Familial Cancer Clinical Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - S Puig
- Institut de Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras, Barcelona, Spain.,Department of Dermatology, Melanoma Unit, Hospital Clinic i Provincial, Barcelona, Spain
| | - L Puig
- Department of Dermatology, Hospital Santa Creu i San Pau, Barcelona, Spain
| | - R Gonzalez-Sarmiento
- Molecular Medicine Unit, Department of Medicine, University of Salamanca, Salamanca, Spain.,Biomedical Research Institute of Salamanca (IBSAL), Institute of Molecular and Cellular Biology of Cancer (IBMCC), University Hospital of Salamanca, University of Salamanca-CSIC, Salamanca, Spain
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28
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Fernández VC, Alonso N, Melamud L, Villa AM. Psychiatric comorbidities and suicidality among patients with neuromyelitis optica spectrum disorders in Argentina. Mult Scler Relat Disord 2017; 19:40-43. [PMID: 29125969 DOI: 10.1016/j.msard.2017.11.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 07/19/2017] [Revised: 10/31/2017] [Accepted: 11/02/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Neuromyelitis optica is a relapsing inflammatory, secondarily demyelinating astrocytopathy that most commonly affects the optic nerves and the spinal cord. OBJECTIVE This study aimed to evaluate the psychopathological profile, presence of current depression, and suicidality in patients with neuromyelitis optica spectrum disorders (NMOSD) in an Argentinean cohort, and compare these parameters to those in patients with multiple sclerosis (MS) and in healthy controls (HCs). METHODS Twenty patients with NMOSD, 18 with MS, and 20 healthy controls were included. The presence and grade of current depression were assessed using Beck's depression inventory (BDI), while psychiatric disease and suicidality were assessed using the Mini-International Neuropsychiatric Interview. RESULTS The prevalence of psychiatric disease in the NMOSD group was 45%, significantly higher than in the MS group (16%, p = 0.06) and the HCs (5%, p = 0.008). Recurrent major depressive disorder was the most frequent psychiatric disease and was diagnosed in four (20%) patients in the NMOSD group and in two (11%) patients in the MS group. In the NMOSD group, two (10%) patients were diagnosed with past manic episodes, one (5%) with current dysthymic disorder, one (5%) with lifetime psychotic disorder, and one (5%) with bulimia nervosa. One patient (5.5%) in the MS group and one in the HC (5%) were diagnosed with current generalized anxiety disorder. Ten patients (50%) in the NMOSD group had current depressive symptoms versus five (28%) patients in the MS group (p = 0.16) and two (10%) in the HC group (p = 0.02). Six (30%) patients with NMOSD versus only one (5.5%) patient with MS had attempted suicide at least once, this difference was statistically significant (p = 0.05). Current suicide risk was high in patients with NMOSD (8, 40%) and moderate in patients with MS (4, 22%). CONCLUSIONS Our study shows that the prevalence of psychiatric comorbidities in patients with NMOSD is significantly higher than in patients with MS and healthy controls. Given the high frequency of suicidality, assessment of pertinent psychiatric disorders in such patients to optimize monitoring and comprehensive treatment is required.
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Affiliation(s)
- V C Fernández
- Neuroimmunology Section, Neurology Department, Ramos Mejia Hospital, Buenos Aires University, Argentina.
| | - N Alonso
- Psychiatry Department, Ramos Mejia Hospital, Buenos Aires, Argentina
| | - L Melamud
- Neuroimmunology Section, Neurology Department, Ramos Mejia Hospital, Buenos Aires University, Argentina
| | - A M Villa
- Neuroimmunology Section, Neurology Department, Ramos Mejia Hospital, Buenos Aires University, Argentina
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29
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Masotti C, Brito L, Nica A, Ludwig K, Nunes K, Savastano C, Malcher C, Ferreira S, Kobayashi G, Bueno D, Alonso N, Franco D, Rojas-Martinez A, dos Santos S, Galante P, Meyer D, Hünemeier T, Mangold E, Dermitzakis E, Passos-Bueno M. MRPL53, a New Candidate Gene for Orofacial Clefting, Identified Using an eQTL Approach. J Dent Res 2017; 97:33-40. [DOI: 10.1177/0022034517735805] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
A valuable approach to understand how individual and population genetic differences can predispose to disease is to assess the impact of genetic variants on cellular functions (e.g., gene expression) of cell and tissue types related to pathological states. To understand the genetic basis of nonsyndromic cleft lip with or without cleft palate (NSCL/P) susceptibility, a complex and highly prevalent congenital malformation, we searched for genetic variants with a regulatory role in a disease-related tissue, the lip muscle (orbicularis oris muscle [OOM]), of affected individuals. From 46 OOM samples, which are frequently discarded during routine corrective surgeries on patients with orofacial clefts, we derived mesenchymal stem cells and correlated the individual genetic variants with gene expression from these cultured cells. Through this strategy, we detected significant cis-eQTLs (i.e., DNA variants affecting gene expression) and selected a few candidates to conduct an association study in a large Brazilian cohort (624 patients and 668 controls). This resulted in the discovery of a novel susceptibility locus for NSCL/P, rs1063588, the best eQTL for the MRPL53 gene, where evidence for association was mostly driven by the Native American ancestry component of our Brazilian sample. MRPL53 (2p13.1) encodes a 39S protein subunit of mitochondrial ribosomes and interacts with MYC, a transcription factor required for normal facial morphogenesis. Our study illustrates not only the importance of sampling admixed populations but also the relevance of measuring the functional effects of genetic variants over gene expression to dissect the complexity of disease phenotypes.
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Affiliation(s)
- C. Masotti
- Department of Genetics and Evolutionary Biology, University of São Paulo, São Paulo, SP, Brazil
- Molecular Oncology Center, Hospital Sírio Libanês, São Paulo, SP, Brazil
| | - L.A. Brito
- Department of Genetics and Evolutionary Biology, University of São Paulo, São Paulo, SP, Brazil
| | - A.C. Nica
- Department of Genetic Medicine and Development, University of Geneva Medical School, Geneva, Switzerland
- Institute for Genetics and Genomics in Geneva (iGE3), University of Geneva, Geneva, Switzerland
- Swiss Institute of Bioinformatics, Geneva, Switzerland
| | - K.U. Ludwig
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Department of Genomics, Life&Brain Center, University of Bonn, Bonn, Germany
| | - K. Nunes
- Department of Genetics and Evolutionary Biology, University of São Paulo, São Paulo, SP, Brazil
| | - C.P. Savastano
- Department of Genetics and Evolutionary Biology, University of São Paulo, São Paulo, SP, Brazil
| | - C. Malcher
- Department of Genetics and Evolutionary Biology, University of São Paulo, São Paulo, SP, Brazil
| | - S.G. Ferreira
- Department of Genetics and Evolutionary Biology, University of São Paulo, São Paulo, SP, Brazil
| | - G.S. Kobayashi
- Department of Genetics and Evolutionary Biology, University of São Paulo, São Paulo, SP, Brazil
| | - D.F. Bueno
- Department of Genetics and Evolutionary Biology, University of São Paulo, São Paulo, SP, Brazil
| | - N. Alonso
- Department of Plastic Surgery, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - D. Franco
- Department of Plastic Surgery, Hospital Clementino Braga Filho, Federal University of Rio de Janeiro Medical School, Rio de Janeiro, RJ, Brazil
| | - A. Rojas-Martinez
- Department of Biochemistry and Molecular Medicine, School of Medicine, and Centro de Investigación y Desarrollo en Ciencias de la Salud, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
| | - S.E. dos Santos
- Institute of Biological Sciences, Federal University of Pará, Belém, PA, Brazil
| | - P.A. Galante
- Molecular Oncology Center, Hospital Sírio Libanês, São Paulo, SP, Brazil
| | - D. Meyer
- Department of Genetics and Evolutionary Biology, University of São Paulo, São Paulo, SP, Brazil
| | - T. Hünemeier
- Department of Genetics and Evolutionary Biology, University of São Paulo, São Paulo, SP, Brazil
| | - E. Mangold
- Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - E.T. Dermitzakis
- Department of Genetic Medicine and Development, University of Geneva Medical School, Geneva, Switzerland
- Institute for Genetics and Genomics in Geneva (iGE3), University of Geneva, Geneva, Switzerland
- Swiss Institute of Bioinformatics, Geneva, Switzerland
| | - M.R. Passos-Bueno
- Department of Genetics and Evolutionary Biology, University of São Paulo, São Paulo, SP, Brazil
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Castañeda-García A, Prieto AI, Rodríguez-Beltrán J, Alonso N, Cantillon D, Costas C, Pérez-Lago L, Zegeye ED, Herranz M, Plociński P, Tonjum T, García de Viedma D, Paget M, Waddell SJ, Rojas AM, Doherty AJ, Blázquez J. A non-canonical mismatch repair pathway in prokaryotes. Nat Commun 2017; 8:14246. [PMID: 28128207 PMCID: PMC5290159 DOI: 10.1038/ncomms14246] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [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: 06/29/2016] [Accepted: 12/12/2016] [Indexed: 12/18/2022] Open
Abstract
Mismatch repair (MMR) is a near ubiquitous pathway, essential for the maintenance of genome stability. Members of the MutS and MutL protein families perform key steps in mismatch correction. Despite the major importance of this repair pathway, MutS-MutL are absent in almost all Actinobacteria and many Archaea. However, these organisms exhibit rates and spectra of spontaneous mutations similar to MMR-bearing species, suggesting the existence of an alternative to the canonical MutS-MutL-based MMR. Here we report that Mycobacterium smegmatis NucS/EndoMS, a putative endonuclease with no structural homology to known MMR factors, is required for mutation avoidance and anti-recombination, hallmarks of the canonical MMR. Furthermore, phenotypic analysis of naturally occurring polymorphic NucS in a M. smegmatis surrogate model, suggests the existence of M. tuberculosis mutator strains. The phylogenetic analysis of NucS indicates a complex evolutionary process leading to a disperse distribution pattern in prokaryotes. Together, these findings indicate that distinct pathways for MMR have evolved at least twice in nature.
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Affiliation(s)
- A Castañeda-García
- Stress and Bacterial Evolution Group, Instituto de Biomedicina de Sevilla. Avda. Manuel Siurot S/N, 41013-Sevilla, Spain.,Genome Damage and Stability Centre, School of Life Sciences, University of Sussex, Brighton BN1 9RQ, UK
| | - A I Prieto
- Stress and Bacterial Evolution Group, Instituto de Biomedicina de Sevilla. Avda. Manuel Siurot S/N, 41013-Sevilla, Spain
| | - J Rodríguez-Beltrán
- Stress and Bacterial Evolution Group, Instituto de Biomedicina de Sevilla. Avda. Manuel Siurot S/N, 41013-Sevilla, Spain
| | - N Alonso
- Centro Nacional de Biotecnología-CSIC. C/ Darwin 3, 28049-Madrid, Spain
| | - D Cantillon
- Brighton and Sussex Medical School, University of Sussex, Brighton BN1 9PX, UK
| | - C Costas
- Stress and Bacterial Evolution Group, Instituto de Biomedicina de Sevilla. Avda. Manuel Siurot S/N, 41013-Sevilla, Spain
| | - L Pérez-Lago
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital Gregorio Marañón and Instituto de Investigación Sanitaria Gregorio Marañón. Dr. Esquerdo 46, 28007-Madrid, Spain
| | - E D Zegeye
- Department of Microbiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway and Department of Microbiology, University of Oslo, P.O. Box 1072 Blindern, 0316 Oslo, Norway
| | - M Herranz
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital Gregorio Marañón and Instituto de Investigación Sanitaria Gregorio Marañón. Dr. Esquerdo 46, 28007-Madrid, Spain
| | - P Plociński
- Genome Damage and Stability Centre, School of Life Sciences, University of Sussex, Brighton BN1 9RQ, UK
| | - T Tonjum
- Department of Microbiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway and Department of Microbiology, University of Oslo, P.O. Box 1072 Blindern, 0316 Oslo, Norway
| | - D García de Viedma
- Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital Gregorio Marañón and Instituto de Investigación Sanitaria Gregorio Marañón. Dr. Esquerdo 46, 28007-Madrid, Spain
| | - M Paget
- School of Life Sciences, University of Sussex, Brighton BN1 9QG, UK
| | - S J Waddell
- Brighton and Sussex Medical School, University of Sussex, Brighton BN1 9PX, UK
| | - A M Rojas
- Computational Biology and Bioinformatics, Instituto de Biomedicina de Sevilla (IBIS)-CSIC. Avda. Manuel Siurot S/N, 41013-Sevilla Spain
| | - A J Doherty
- Genome Damage and Stability Centre, School of Life Sciences, University of Sussex, Brighton BN1 9RQ, UK
| | - J Blázquez
- Stress and Bacterial Evolution Group, Instituto de Biomedicina de Sevilla. Avda. Manuel Siurot S/N, 41013-Sevilla, Spain.,Centro Nacional de Biotecnología-CSIC. C/ Darwin 3, 28049-Madrid, Spain.,Unit of Infectious Diseases, Microbiology, and Preventive Medicine. University Hospital Virgen del Rocio, Avda. Manuel Siurot S/N, 41013-Sevilla, Spain
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Valiente OL, Álvarez R, Alonso N, Corrales MP. EVALUATION OF PERFORMANCE, BROMATOLOGICAL COMPOSITION AND DIGESTIBILITY IN VITRO GREEN WHEAT HYDROPONIC FORAGE HARVESTED (Triticum spp) AT 8 AND 10 DAYS. Compend cienc vet 2016. [DOI: 10.18004/compend.cienc.vet.2016.06.02.42-46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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32
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Albert G, Alonso N, Cabrera A, Rojas L, Rosthoj S. PRODUCTIVE EVALUATION OF GREEN FODDER HYDROPONICS CORN, OATS AND WHEAT. Compend cienc vet 2016. [DOI: 10.18004/compend.cienc.vet.2016.06.01.7-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Palmer SC, Ruospo M, Wong G, Craig JC, Petruzzi M, De Benedittis M, Ford P, Johnson DW, Tonelli M, Natale P, Saglimbene V, Pellegrini F, Celia E, Gelfman R, Leal MR, Torok M, Stroumza P, Bednarek-Skublewska A, Dulawa J, Frantzen L, Ferrari JN, del Castillo D, Bernat AG, Hegbrant J, Wollheim C, Gargano L, Bots CP, Strippoli GF, Raña S, Serrano M, Claros S, Arias M, Petracci L, Arana M, De Rosa P, Gutierrez A, Simon M, Vergara V, Tosi M, Cernadas M, Vilamajó I, Gravac D, Paulón M, Penayo L, Carrizo G, Ghiani M, Perez G, Da Cruz O, Galarce D, Gravielle M, Vescovo E, Paparone R, Mato Mira C, Mojico E, Hermida O, Florio D, Yucoswky M, Labonia W, Rubio D, Di Napoli G, Fernandez A, Altman H, Rodriguez J, Serrano S, Valle G, Lobos M, Acosta V, Corpacci G, Jofre M, Gianoni L, Chiesura G, Capdevila M, Montenegro J, Bequi J, Dayer J, Gómez A, Calderón C, Abrego E, Cechín C, García J, Corral J, Natiello M, Coronel A, Muñiz M, Muñiz V, Bonelli A, Sanchez F, Maestre S, Olivera S, Camargo M, Avalos V, Geandet E, Canteli M, Escobar A, Sena E, Tirado S, Peñalba A, Neme G, Cisneros M, Oliszewski R, Nascar V, Daud M, Mansilla S, Paredes Álvarez A, Gamín L, Arijón M, Coombes M, Zapata M, Boriceanu C, Frantzen-Trendel S, Albert K, Csaszar I, Kiss E, Kosa D, Orosz A, Redl J, Kovacs L, Varga E, Szabo M, Magyar K, Kriza G, Zajko E, Bereczki A, Csikos J, Kuti A, Mike A, Steiner K, Nemeth E, Tolnai K, Toth A, Vinczene J, Szummer S, Tanyi E, Toth R, Szilvia M, Dambrosio N, Paparella G, Sambati M, Donatelli C, Pedone F, Cagnazzo V, Antinoro R, Torsello F, Saturno C, Giannoccaro G, Maldera S, Boccia E, Mantuano M, Di Toro Mammarella R, Meconizzi M, Steri P, Riccardi C, Flammini A, Moscardelli L, Murgo M, San Filippo N, Pagano S, Marino G, Montalto G, Cantarella S, Salamone B, Randazzo G, Rallo D, Maniscalco A, Fici M, Lupo A, Pellegrino P, Fichera R, D’Angelo A, Falsitta N, Bochenska-Nowacka E, Jaroszynski A, Drabik J, Birecka M, Daniewska D, Drobisz M, Doskocz K, Wyrwicz G, Inchaustegui L, Outerelo C, Sousa Mendes D, Mendes A, Lopes J, Barbas J, Madeira C, Fortes A, Vizinho R, Cortesão A, Almeida E, Bernat A, De la Torre B, Lopez A, Martín J, Cuesta G, Rodriguez R, Ros F, Garcia M, Orero E, Ros E, Caetano A, MacGregor K, Santos M, Silva Pinheiro S, Martins L, Leitão D, Izidoro C, Bava G, Bora A, Gorena H, Calderón T, Dupuy R, Alonso N, Siciliano V, Frantzen-Trendel S, Nagy K, Bajusz Ö, Pinke I, Decsi G, Gyergyoi L, Jobba Z, Zalai Z, Zsedenyi Á, Kiss G, Pinter M, Kereszturi M, Petruzzi M, De Benedittis M, Szkutnik J, Sieczkarek J, Capelo A, Garcia Gallart M, Mendieta C. Dental Health and Mortality in People With End-Stage Kidney Disease Treated With Hemodialysis: A Multinational Cohort Study. Am J Kidney Dis 2015; 66:666-76. [DOI: 10.1053/j.ajkd.2015.04.051] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 04/29/2015] [Indexed: 01/28/2023]
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Scévola L, Lombardi N, Alonso N, Fernández L, Korman G, Oddo S, Kochen S, D’Alessio L. Clinical recognition and differential semiology during video-eeg in patients with temporal lobe epilepsy and psychogenic none epileptic seizures. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.156] [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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Lopez E, Bermejo N, Berna-Erro A, Alonso N, Salido GM, Redondo PC, Rosado JA. Relationship between calcium mobilization and platelet α- and δ-granule secretion. A role for TRPC6 in thrombin-evoked δ-granule exocytosis. Arch Biochem Biophys 2015; 585:75-81. [PMID: 26386308 DOI: 10.1016/j.abb.2015.09.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 09/14/2015] [Accepted: 09/15/2015] [Indexed: 11/25/2022]
Abstract
Changes in cytosolic Ca(2+) concentration ([Ca(2+)]c) regulate granule secretion in different cell types. Thrombin activates PAR1 and PAR4 receptors and promotes release of Ca(2+) from distinct intracellular stores, which, in turn, activates store-operated Ca(2+) entry (SOCE). A crucial step during platelet function is the release of physiological agonists stored in secretory granules to the extracellular compartment during activation. We aim to study the role of Ca(2+) mobilization from the extracellular compartment or from different intracellular stores in platelet granule secretion. By using flow cytometry, we have found that α- and δ-granules are secreted in thrombin-stimulated platelets in the absence of extracellular Ca(2+), and in a concentration-dependent manner. Our findings show that thrombin-stimulated granule secretion depends on Ca(2+) mobilization from intracellular stores. Analysis of the kinetics of granule secretion reveals that platelet stimulation with thrombin results in rapid release of α-granules which precedes the secretion of δ-granules. Incubation of platelets with a specific antibody, which recognizes the extracellular amino acid sequence 573-586 of TRPC6, inhibited thrombin-evoked δ-granule exocytosis. Our results indicate that the mechanisms underlying thrombin-induced α- and δ-granule secretion show differences in dependency on Ca(2+) mobilization.
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Affiliation(s)
- E Lopez
- Department of Physiology, University of Extremadura, Phycell, 10003, Spain
| | - N Bermejo
- Department of Hematology, Hospital San Pedro de Alcantara, 10003 Cáceres, Spain
| | - A Berna-Erro
- Department of Physiology, University of Extremadura, Phycell, 10003, Spain
| | - N Alonso
- Department of Hematology, Hospital Infanta Cristina, 06006 Badajoz, Spain
| | - G M Salido
- Department of Physiology, University of Extremadura, Phycell, 10003, Spain
| | - P C Redondo
- Department of Physiology, University of Extremadura, Phycell, 10003, Spain
| | - J A Rosado
- Department of Physiology, University of Extremadura, Phycell, 10003, Spain.
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Ortiz V, Poppele G, Alonso N, Castellano C, Garrigues V. Evaluation of esophagogastric junction relaxation by 4-second Integrated Relaxation Pressure in achalasia using High Resolution Manometry with water-perfused catheters. Neurogastroenterol Motil 2014; 26:1551-6. [PMID: 25124837 DOI: 10.1111/nmo.12415] [Citation(s) in RCA: 9] [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: 03/06/2014] [Accepted: 07/21/2014] [Indexed: 02/08/2023]
Abstract
BACKGROUND Relaxation of the esophagogastric junction (EGJ) is now evaluated calculating 4-second integrated relaxation pressure (4-s IRP) by high resolution manometry (HREPT). Solid-state catheters have been used to define abnormal values. Our aim was to evaluate 4-s IRP in esophageal achalasia using HREPT with perfused catheters. METHODS From June 2009 to June 2013, 936 HREPT studies have been performed in our unit. Of these, 194 patients having treated achalasia were excluded. Control group was constituted by 695 patients without achalasia, and 47 patients with untreated achalasia constituted the study group. HREPT was performed with water-perfused catheters. To establish the cut-off value for 4-s IRP that better discriminate patients with achalasia from all other patients, a receiver operating characteristic (ROC) analysis was performed. KEY RESULTS Twenty three of 47 achalasia patients (49%) showed a 4-s IRP under 15 mmHg; and seven (15%) had a value under modified Chicago criteria. A cut-off value for 4-s IRP of 6.5 mmHg, calculated by ROC analysis, highly discriminates achalasia from the rest of the patients and especially from scleroderma patients (area under the curve: 0.997, 95% CI: 0.995-1.000; p < 0.001). CONCLUSIONS & INFERENCES Cut-off values for 4-s IRP defined using HREPT with solid-state catheters are not adequate for diagnosing esophageal achalasia with water-perfused systems. A lower value, i.e., 6.5 mmHg, is suggested for this equipment. The diagnostic criteria of esophageal achalasia should be modified for HREPT performed with water-perfused systems.
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Affiliation(s)
- V Ortiz
- Digestive Functional Disorders Unit, Gastroenterology Department, Hospital Universitari i Politècnic La Fe, Valencia, Spain
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Abstract
INTRODUCTION Osteoporosis is a common disease characterised by low bone mineral density and an increased risk of fragility fractures. METHODS We conducted a literature review of relevant studies relating to the genetics of osteoporosis. RESULTS Family studies have revealed that bone density and fractures have a strong heritable component but environmental factors also play an important role. This makes identification of the causative genetic variants challenging. Linkage analysis has been successful in identifying the genes responsible for rare inherited diseases associated with abnormalities of bone mass but has been of limited value in osteoporosis. In contrast, genome-wide association studies in large cohort studies have identified 56 loci with robust evidence of association with bone density and 14 loci that predispose to fractures. Although the effect size of the implicated variants is small, many of the loci contain genes known to be involved in regulating bone cell activity through the RANK and Wnt signalling pathways, whereas others contain novel genes not previously implicated in bone metabolism. In a few instances, whole genome and exome sequencing have been successfully used to identify rare variants of large effect size that influence susceptibility to osteoporosis. CONCLUSION A future challenge will be to conduct fine mapping and functional analysis of the loci implicated in osteoporosis in order to identify the causal genetic variants and examine the mechanisms by which they influence bone cell function and bone mass. Ultimately this may lead to the identification of biomarkers for susceptibility to osteoporosis and fractures or new therapeutic targets.
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Affiliation(s)
- N Alonso
- Rheumatic Diseases Unit, Centre for Genomic and Experimental Medicine, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Crewe Road South, Edinburgh, EH4 2XU, UK
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Alonso N, Traveset A, Rubinat E, Arcidiacono M, Ortega E, Betriu A, Hernández M, Fernández E, Mauricio D. Type 2 diabetic patients with diabetic retinopathy without previous cardiovascular disease show an increased carotid plaque burden. Atherosclerosis 2014. [DOI: 10.1016/j.atherosclerosis.2014.05.725] [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: 11/27/2022]
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Martínez-Ramonde T, Alonso N, Cordido F, Cervelló E, Cañizares A, Martínez-Peinado P, Sempere J, Roche E. Importance of Exercise in the Control of Metabolic and Inflammatory Parameters at the Moment of Onset in Type 1 Diabetic Subjects. Exp Clin Endocrinol Diabetes 2014; 122:334-40. [DOI: 10.1055/s-0034-1372581] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [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: 10/25/2022]
Affiliation(s)
| | - N. Alonso
- Applied Biology Department and Institute of Bioengineering, University Miguel Hernandez, Elche (Alicante) Spain
| | - F. Cordido
- Endocrinology Service, University Hospital A Coruña (Spain)
| | - E. Cervelló
- Sport Research Centre, University Miguel Hernandez, Elche (Alicante) Spain
| | - A. Cañizares
- Microbiology Department, University Hospital Complex, A Coruña (Spain)
| | | | - J. Sempere
- Biotechnology Department, University of Alicante (Spain)
| | - E. Roche
- Applied Biology Department and Institute of Bioengineering, University Miguel Hernandez, Elche (Alicante) Spain
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Pérez-Garrido R, Alonso N, Jiménez-Yuste V, Haya S, Zúñiga P, Baques A, Candela M, Dávoli M, Rescia V. Efficacy of factor IX Grifols® in surgery: experience of an international multicentre retrospective study. Haemophilia 2012; 18:e372-3. [DOI: 10.1111/j.1365-2516.2012.02919.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2012] [Indexed: 11/28/2022]
Affiliation(s)
| | - N. Alonso
- Hospital Infanta Cristina; Badajoz; Spain
| | | | - S. Haya
- Hospital Universitario y Politécnico La Fe; Valencia; Spain
| | - P. Zúñiga
- Hospital de la Universidad Católica de Chile; Santiago; Chile
| | - A. Baques
- Fundación de la Hemofilia; Buenos Aires; Argentina
| | - M. Candela
- Fundación de la Hemofilia; Buenos Aires; Argentina
| | - M. Dávoli
- Sanatorio Americano; Rosario; Argentina
| | - V. Rescia
- Sanatorio Americano; Rosario; Argentina
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Ruiz-Riol M, Martínez-Arconada MJ, Alonso N, Soldevila B, Marchena D, Armengol MP, Sanmartí A, Pujol-Borrell R, Martínez-Cáceres EM. Overexpression of metallothionein I/II: a new feature of thyroid follicular cells in Graves' disease. J Clin Endocrinol Metab 2012; 97:446-54. [PMID: 22090273 DOI: 10.1210/jc.2011-1429] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [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: 02/12/2023]
Abstract
CONTEXT One salient feature of autoimmune thyroid disease is the inappropriate expression of human leukocyte antigen (HLA) class II molecules by thyroid follicular cells. Metallothioneins (MT) are small proteins induced by tissue stress that can contribute to restoring homeostasis of tissue inflammation and have been found to be increased in a transcriptomic analysis of Graves' disease (GD) glands. METHODOLOGY To assess the role of MT in the pathogenesis of GD, we analyzed MT-I and -II expression and distribution in GD-affected thyroid glands (n = 14) compared with other thyroid diseases (n = 20) and normal thyroid glands (n = 5). Two-color indirect immunofluorescence and semiquantitative morphometry were applied. The relationship between MT and HLA class II expression was analyzed by their degree of colocalization in GD sections, and in vitro induction kinetics and expression of these molecules on the HT93 thyroid cell line were compared by quantitative RT-PCR and flow cytometry using interferon-γ and zinc as stimuli. RESULTS MT were clearly overexpressed in nine of 14 GD glands. MT expression distribution in GD was almost reciprocal to that of HLA class II. In vitro analysis of MT and HLA class II demonstrated that MT is induced more slowly and at a lower level than HLA. Moreover, the main MT inducer, zinc, reduces interferon-γ-induced class II expression. CONCLUSIONS These findings show that MT and HLA class II play very different roles in the autoimmune process by affecting the thyroid gland, thereby pointing to the possible role of MT as a marker of cell stress and homeostasis restoration in GD.
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Affiliation(s)
- M Ruiz-Riol
- Laboratory of Immunobiology for Research and Applications to Diagnosis, Universitat Autònoma de Barcelona, 08916 Badalona, Spain
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Alonso N, Buey RM, Urien H, Sonnenberg A, de Pereda JM. Structure of the second pair of fibronectin type III repeats of the integrin β4. Acta Crystallogr A 2011. [DOI: 10.1107/s0108767311086028] [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: 11/10/2022] Open
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Soldevila B, Alonso N, Martínez-Arconada MJ, Morillas RM, Planas R, Sanmartí AM, Martínez-Cáceres EM. A prospective study of T- and B-lymphocyte subpopulations, CD81 expression levels on B cells and regulatory CD4(+) CD25(+) CD127(low/-) FoxP3(+) T cells in patients with chronic HCV infection during pegylated interferon-alpha2a plus ribavirin treatment. J Viral Hepat 2011; 18:384-92. [PMID: 20487258 DOI: 10.1111/j.1365-2893.2010.01317.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [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: 12/12/2022]
Abstract
Resolution of hepatitis C virus (HCV) infection requires a complex interplay between innate and adaptative immune responses. The role of lymphocyte subpopulations during combined antiviral treatment remains to be defined. This study was conducted to assess the effect of pegylated interferon-alpha2a (pegIFN-α2a) and ribavirin treatment on peripheral blood lymphocytes, mainly on CD81 expression on B cells and CD4(+) CD25(+) CD127(low/-) FoxP3(+) regulatory T cells (Tregs) in patients with chronic HCV infection. Thirty-five patients with chronic HCV infection who started pegIFN-α2a and ribavirin treatment were enrolled. Peripheral blood mononuclear cells (PBMC) were obtained at baseline before treatment (BT), mid-treatment (MT), the end of treatment (ET) and 24weeks post-treatment (PT). During combined antiviral treatment, a significant decrease in the percentage of CD3(+) , CD8(+) , CD3(+) gamma/delta (γδ)(+) , CD19(+) lymphocyte subpopulations and Tregs was observed. There was also a significant increase in the percentage of the CD4(+) lymphocyte subpopulation and in CD81 expression levels on CD19(+) B cells when BT was compared with ET (all P<0.05). Seventeen patients were nonresponders (NR) and 18 had a sustained virological response (SVR). At baseline, NR patients had higher CD81 expression levels on CD19(+) B cells (P=0.017) and a higher Tregs percentage (P=0.025) than SVR patients. Our results suggest that immunomodulation fluctuates during antiviral treatment and that percentage CD81 expression levels on B cells and Tregs might be useful as an immunological prognostic factor for pegIFN-α2a and ribavirin treatment response in chronic HCV infection.
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Affiliation(s)
- B Soldevila
- Department of Endocrinology and Nutrition, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain.
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Alonso N, Granada ML, Soldevila B, Salinas I, Joaquin C, Reverter JL, Juncà J, Martínez Cáceres EM, Sanmartí A. Serum autoimmune gastritis markers, pepsinogen I and parietal cell antibodies, in patients with type 1 diabetes mellitus: a 5-year prospective study. J Endocrinol Invest 2011; 34:340-4. [PMID: 20530988 DOI: 10.1007/bf03347456] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [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: 02/04/2023]
Abstract
BACKGROUND AND AIM To determine the temporal evolution of serum markers of autoimmune gastritis, mainly pepsinogen I (PI) and parietal cell antibodies (PCA), in patients with Type 1 diabetes mellitus (DM1). MATERIALS AND METHODS A 5-yr prospective follow-up study of 168 DM1 patients (87 men, aged 31 ± 9.3 yr) attending the endocrinology outpatient clinic of a university hospital evaluated in 2001 and 2006. Serum PI, gastrin, hemoglobin, cobalamin concentrations, PCA and antibodies to intrinsic factor were measured. RESULTS In 2001, 11 patients had low PI concentrations and positive PCA (group I), 11 had only low PI concentrations (group II), and 33 had only positive PCA (group III). After 5 yr, PI remained low and PCA positive in all patients from group I. In group II, PI remained low in 4 and normalized in 7. In group III, 4 patients presented low PI concentrations after 5 yr, which remained normal in the other 29 subjects. PCA became negative in 17 patients from group III. In 2001, 3 of the 11 patients of group I had low cobalamin concentrations. In 2006, 2 additional patients from this group presented low cobalamin concentrations. CONCLUSIONS These results show the importance of determining PI together with PCA, since the presence of abnormal results in both tests, that is low PI and positive PCA, is the association that best identifies patients with a higher risk to decrease cobalamin concentrations during follow-up.
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Affiliation(s)
- N Alonso
- Department of Endocrinology and Nutrition, Autonomous University of Barcelona, Hospital Universitari Germans Trias i Pujol, Ctra Canyet s/n, Badalona 08916, Spain.
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Armengol MP, Sabater L, Fernández M, Ruíz M, Alonso N, Otero MJ, Martínez-Cáceres E, Jaraquemada D, Pujol-Borrell R. Influx of recent thymic emigrants into autoimmune thyroid disease glands in humans. Clin Exp Immunol 2008; 153:338-50. [PMID: 18637101 DOI: 10.1111/j.1365-2249.2008.03706.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Autoimmune thyroid diseases (AITD) are considered as prototypic organ-specific autoimmune diseases, yet their underlying aetiology remains poorly understood. Among the various pathophysiological mechanisms considered, a failure of central tolerance has received little attention. Here we present evidence in favour of dysregulated thymic function playing a role in AITD. Flow-cytometric analyses conducted in peripheral blood lymphocytes from 58 AITD patients and 48 age- and-sex-matched controls showed that AITD patients have significantly higher blood levels of CD4(+)CD45RA(+), CD4(+)CD31(+) and CD4/CD8 double-positive T lymphocytes, all markers of recent thymic emigrants (RTE). In addition, the alpha-signal joint T cell receptor excision circles (TRECs) content (a molecular marker of RTEs) was higher in the group of AITD patients older than 35 years than in age-matched controls. This was independent from peripheral T cell expansion as assessed by relative telomere length. Comparisons of TREC levels in peripheral blood lymphocytes and intrathyroidal lymphocytes in paired samples showed higher levels within the thyroid during the initial 30 months of the disease, indicating an influx of RTE into the thyroid during the initial stages of AITD. Additionally, a lack of correlation between TREC levels and forkhead box P3 expression suggests that the intrathyroidal RTE are not natural regulatory T cells. These results uncover a hitherto unknown correlation between altered thymic T cell export, the composition of intrathyroidal T cells and autoimmune pathology.
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Affiliation(s)
- M P Armengol
- Laboratory of Immunobiology for Research and Applications to Diagnosis, Banc de Sang i Teixits, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Spain
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Joaquin C, Aguilera E, Granada ML, Pastor MC, Salinas I, Alonso N, Sanmartí A. Effects of GH treatment in GH-deficient adults on adiponectin, leptin and pregnancy-associated plasma protein-A. Eur J Endocrinol 2008; 158:483-90. [PMID: 18362295 DOI: 10.1530/eje-07-0554] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [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: 11/08/2022]
Abstract
OBJECTIVE GH deficiency (GHD) in adults is associated with adverse effects on metabolism and increased cardiovascular risk. Pregnancy-associated plasma protein-A (PAPP-A) is a protease that promotes IGF-I availability in vascular tissues. PAPP-A levels appear to correlate with carotid intima-media thickness and have been proposed as an early predictor of cardiac events. The aim of our study was to evaluate PAPP-A levels in GHD adults at baseline and after GH replacement and correlate them with changes in body composition, lipid profile, glucose homeostasis, inflammatory markers and in leptin and adiponectin. PATIENTS AND METHODS Fourteen GHD adults were evaluated at baseline and after 1 year of GH therapy. All patients were compared at baseline with 28 age-, sex- and body mass index (BMI)-matched control subjects. RESULTS At baseline, GHD adults showed higher PAPP-A levels (P=0.03) and higher leptin (P=0.04), fibrinogen (P=0.002) and highly sensitive C-reactive protein (P=0.01) values than controls. Therapy with GH reduced PAPP-A (P=0.03) and fibrinogen levels (P=0.002) while increased BMI (P=0.01) and reduced waist-hip ratio (WHR; P=0.05) were observed. Insulin and homeostasis model assessment of insulin resistance index increased after treatment (P<0.004/P=0.007), without changes in leptin or adiponectin levels. PAPP-A values correlated positively with BMI and WHR and negatively with adiponectin before and after treatment, with no correlation with glucose homeostasis parameters, lipid profile or leptin. CONCLUSIONS Our study suggests that PAPP-A expression is increased in GHD adults, and that 1 year of GH replacement therapy is able to reduce PAPP-A levels in this population. However, further studies are required to determine whether this decrease correlates with an improvement in atherosclerosis.
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Affiliation(s)
- C Joaquin
- Department of Endocrinology, Hospital Universitari Germans Trias i Pujol, Universitat Autonoma de Barcelona, Carretera del Canyet s/n 08916, Badalona, Barcelona, Spain.
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Ferrio J, Alonso N, Voltas J, Araus J. Grain weight changes over time in ancient cereal crops: Potential roles of climate and genetic improvement. J Cereal Sci 2006. [DOI: 10.1016/j.jcs.2006.07.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Priego P, Lobo E, Moreno I, Sánchez-Picot S, Gil Olarte MA, Alonso N, Fresneda V. Acute appendicitis in an incarcerated crural hernia: analysis of our experience. Rev Esp Enferm Dig 2006; 97:707-15. [PMID: 16351463 DOI: 10.4321/s1130-01082005001000004] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
INTRODUCTION The finding of the vermiform appendix within a crural hernia (Amyand s hernia) is a rare entity whose incidence is not described in the literature. OBJECTIVE The aim of this study was to report our hospital s experience in this kind of pathology. MATERIAL AND METHODS Between 1993 and 2004, 4,572 acute appendicitis and 372 incarcerated crural hernia cases have been operated on in our hospital. We studied 6 cases of incarcerated crural hernia with vermiform appendix inside. We analyzed in retrospect the following parameters: age, sex, personal history, clinical manifestations, preoperative diagnosis, surgical technique, mean hospital stay, and outcome. RESULTS All patients were women with a mean age of 78.8 years. Most frequent clinical manifestations included pain and a mass in the right inguinocrural region, of variable intensity and duration. No clinical, laboratory, or radiographic signs help in reaching a correct preoperative diagnosis. General anesthesia and a crural approach are used in most surgical operations. In all cases an appendectomy was performed via the hernia sac, thus proving the presence of acute appendicitis in four of them (66.67%). A prosthetic mesh was used in 3 cases, and one case of wound infection was found. In the other cases we sutured the hernia ring using prolene. CONCLUSION The finding of the appendix in an incarcerated crural hernia is a rare entity in old women that is difficult to diagnose preoperatively. Treatment includes appendectomy and herniorraphy. The use of prosthetic mesh is controversial.
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Affiliation(s)
- P Priego
- Department of General Digestive Surgery, Hospital Ramón y Cajal, Madrid, Spain.
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Priego P, Lobo E, Alonso N, Gil Olarte MA, Pérez de Oteyza J, Fresneda V. Surgical treatment of esophageal leiomyoma: an analysis of our experience. Rev esp enferm dig 2006; 98:350-8. [PMID: 16944995 DOI: 10.4321/s1130-01082006000500005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
INTRODUCTION leiomyoma is the most common benign esophageal neoplasm. Surgical treatment (enucleation) has traditionally been the therapy of choice. The advent of minimally invasive techniques has produced an increase in endoscopic approaches to the detriment of open surgery. OBJECTIVE the aim of this study was to compare the results obtained with open surgery and with laparoscopic surgery in this kind of pathology. MATERIAL AND METHODS we performed a retrospective study of all leiomyomas operated for in our center between 1986 and 2004, and obtained 9 cases of esophageal leiomyoma. Four were women and five men, between the ages of 40 and 70, with a mean age of 53.5 years. The most frequent symptoms were heartburn (5 cases), dysphagia (3 cases), and retrosternal pain (3 cases). Surgery was in all the cases an enucleation. An open approach was performed in 5 cases (3 thoracotomies and 2 laparotomies), and an endoscopic approach in 4 (2 thoracoscopies and 2 laparoscopies). RESULTS the mean postoperative hospital stay was 5.12 days (range 2-8 days). This was shorter for endoscopic approaches versus open surgery (3.25 vs. 7 days). There was no case of esophageal mucosal perforation or reconversion. No death, intraoperative complication, or tumor relapse was described. Only 2 patients had complications: post-surgical thoracic pain, and intestinal obstruction by adhesions 8 years after surgery. CONCLUSION enucleation is an easier procedure and constitutes the therapy of choice for esophageal leiomyoma. This approach has to be laparoscopic. We think that muscle borders should be closed after enucleation, and that biopsy is not indicated preoperatively.
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Affiliation(s)
- P Priego
- Department of General Digestive Surgery, Hospital Ramón y Cajal, Madrid, Spain.
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Reverter JL, Holgado S, Alonso N, Salinas I, Granada ML, Sanmartí A. Lack of deleterious effect on bone mineral density of long-term thyroxine suppressive therapy for differentiated thyroid carcinoma. Endocr Relat Cancer 2005; 12:973-81. [PMID: 16322336 DOI: 10.1677/erc.1.01072] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.5] [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: 11/27/2022]
Abstract
The effect of subclinical hyperthyroidism on bone mineral density is controversial and could be significant in patients with differentiated thyroid carcinoma who receive suppressive doses of levothyroxine (LT4). To ascertain whether prolonged treatment with LT4 to suppress thyrotropin had a deleterious effect on bone mineral density and/or calcium metabolism in patients thyroidectomized for differentiated thyroid cancer we have performed a cross-sectional study in a group of 88 women (mean +/- SD age: 51 +/- 12 years) treated with LT4 after near-total thyroidectomy and in a control group of 88 healthy women (51 +/- 11 years) matched for body mass index and menopausal status. We determined calcium metabolism parameters, bone turnover marker N-telopeptide and bone mass density by dual-energy X-ray absorptiometry. No differences were found between patients and controls in calcium metabolism parameters or N-telopeptide except for PTH, which was significantly increased in controls. No differences were found between groups in bone mineral density in femoral neck (0.971 +/- 0.148 gr/cm(2) vs 0.956 +/- 0.130 gr/cm(2) in patients and controls respectively, P = 0.5). In lumbar spine, bone mineral density values were lower in controls than in patients (1.058 +/- 0.329 gr/cm(2) vs 1.155 +/- 0.224 gr/cm(2) respectively, P < 0.05). When premenopausal (n = 44) and postmenopausal (n = 44) patients were compared with their respective controls, bone mineral density was similar both in femoral neck and lumbar spine. The proportion of women with normal bone mass density, osteopenia and osteoporosis in patient and control groups was similar in pre- and postmenopausal women. In conclusion, long-term suppressive LT4 treatment does not appear to affect skeletal integrity in women with differentiated thyroid carcinoma.
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Affiliation(s)
- J L Reverter
- Department of Endocrinology and Nutrition, Germans Trias i Pujol Hospital, Barcelona, Spain.
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