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Medina-Cáliz I, Sanabria-Cabrera J, Villanueva-Paz M, Aukštikalnė L, Stephens C, Robles-Díaz M, Pinazo-Bandera JM, García-Cortes M, Conde I, Soriano G, Bessone F, Hernandez N, Nunes V, Paraná R, Lucena MI, Andrade RJ, Niu H, Alvarez-Alvarez I. Characterization of drug-induced liver injury associated with drug reaction with eosinophilia and systemic symptoms in two prospective DILI registries. Arch Toxicol 2024; 98:303-325. [PMID: 38051367 PMCID: PMC10761448 DOI: 10.1007/s00204-023-03630-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/07/2023] [Indexed: 12/07/2023]
Abstract
Idiosyncratic drug-induced liver injury (DILI) associated with drug reactions with eosinophilia and systemic symptoms (DRESS) is poorly characterized among patients of Western countries. We aimed to comprehensively assess the clinical characteristics, outcomes, and causative agents in a prospective, well-vetted cohort of DILI patients with DRESS (DILI-DRESS). We identified 53 DILI-DRESS cases from the Spanish DILI Registry and the Latin American DILI Network. For comparison purposes, we defined a group of DILI patients (n = 881). DILI-DRESS cases were younger (47 vs. 53 years, respectively; p = 0.042) and presented more frequently with cholestatic/mixed damage (p = 0.018). Most DILI-DRESS patients showed moderate liver injury, 13% developed severe damage, and only one patient (with hepatocellular injury due to anti-tuberculosis drugs) progressed to acute liver failure and died. DILI-DRESS cases showed a distinctive causative drug pattern compared to DILI cases. The most frequent drugs were carbamazepine (13%), anti-tuberculosis drugs (13%), amoxicillin-clavulanate (11%), and allopurinol and lamotrigine (7.6% each). Among all cases of DILI due to allopurinol and lamotrigine, 67% presented with a DILI-DRESS phenotype, respectively. Higher total bilirubin (TBL) levels at DILI recognition (odds ratio [OR] 1.23; 95% confidence interval [CI] 1.04-1.45) and absence of eosinophilia (OR 8.77; 95% CI 1.11-69.20) increased the risk for developing a severe-fatal injury in DILI-DRESS patients. DILI-DRESS patients have a more frequent cholestasis/mixed pattern of injury at presentation, with antiepileptics as distinctive causative drug class. Most of the lamotrigine and allopurinol cases present with this phenotype. Higher TBL levels and absence of eosinophilia at DILI recognition are markers of poor outcomes.
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Affiliation(s)
- Inmaculada Medina-Cáliz
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de La Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain
| | - Judith Sanabria-Cabrera
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de La Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain
- Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
- Plataforma de Investigación Clínica y Ensayos Clínicos, Plataforma ISCIII de Investigación Clínica, UICEC-IBIMA, Madrid, Spain
| | - Marina Villanueva-Paz
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de La Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain
- Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Lauryna Aukštikalnė
- Institute of Physiology and Pharmacology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Camilla Stephens
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de La Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain
- Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Mercedes Robles-Díaz
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de La Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain
- Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - José M Pinazo-Bandera
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de La Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain
- Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Miren García-Cortes
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de La Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain
- Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Isabel Conde
- Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
- Unidad de Hepatología, Hospital Universitari I Politècnic La Fe, Servicio de Aparato Digestivo, Valencia, Spain
| | - German Soriano
- Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
- Servicio de Gastroenterología, Hospital de La Santa Creu I Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | | | - Vinicius Nunes
- Hospital Universitário Prof. Edgard Santos-UFBA, Salvador, Brazil
| | - Raymundo Paraná
- Hospital Universitário Prof. Edgard Santos-UFBA, Salvador, Brazil
| | - M Isabel Lucena
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de La Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain.
- Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain.
- Plataforma de Investigación Clínica y Ensayos Clínicos, Plataforma ISCIII de Investigación Clínica, UICEC-IBIMA, Madrid, Spain.
- Departamento de Farmacología, Facultad de Medicina, Universidad de Málaga, Boulevard Louis, Pasteur 32, 29010, Málaga, Spain.
| | - Raúl J Andrade
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de La Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain
- Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
- Plataforma de Investigación Clínica y Ensayos Clínicos, Plataforma ISCIII de Investigación Clínica, UICEC-IBIMA, Madrid, Spain
| | - Hao Niu
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de La Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain
- Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
- Plataforma de Investigación Clínica y Ensayos Clínicos, Plataforma ISCIII de Investigación Clínica, UICEC-IBIMA, Madrid, Spain
| | - Ismael Alvarez-Alvarez
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de La Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain
- Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
- Plataforma de Investigación Clínica y Ensayos Clínicos, Plataforma ISCIII de Investigación Clínica, UICEC-IBIMA, Madrid, Spain
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Niu H, Solis-Muñoz P, García-Cortés M, Sanabria-Cabrera J, Robles-Diaz M, Romero-Flores R, Bonilla-Toyos E, Ortega-Alonso A, Pinazo-Bandera JM, Cabello MR, Bessone F, Hernandez N, Lucena MI, Andrade RJ, Medina-Caliz I, Alvarez-Alvarez I. Prior drug allergies are associated with worse outcome in patients with idiosyncratic drug-induced liver injury: A machine learning approach for risk stratification. Pharmacol Res 2024; 199:107030. [PMID: 38072217 DOI: 10.1016/j.phrs.2023.107030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/30/2023] [Accepted: 12/03/2023] [Indexed: 01/13/2024]
Abstract
The impact of prior drug allergies (PDA) on the clinical features and outcomes of patients who develop idiosyncratic drug-induced liver injury (DILI) is largely unknown. We aimed to assess the clinical presentation and outcomes of DILI patients based on the presence or absence of PDA and explore the association between culprit drugs responsible for DILI and allergy. We analysed a well-vetted cohort of DILI cases enrolled from the Spanish DILI Registry. Bootstrap-enhanced least absolute shrinkage operator procedure was used in variable selection, and a multivariable logistic model was fitted to predict poor outcomes in DILI. Of 912 cases with a first episode of DILI, 61 (6.7%) had documented PDA. Patients with PDA were older (p = 0.009), had higher aspartate aminotransferase (AST) levels (p = 0.047), lower platelet count (p = 0.011) and higher liver-related mortality than those without a history of drug allergies (11% vs. 1.6%, p < 0.001). Penicillin was the most common drug associated with PDA in DILI patients (32%). A model including PDA, nR-based type of liver injury, female sex, AST, total bilirubin, and platelet count showed an excellent performance in predicting poor outcome in patients from the Spanish DILI Registry (area under the ROC curve [AUC] 0.887; 95% confidence interval [CI] 0.794 - 0.981) and the LATINDILI Network (AUC 0.932; 95% CI 0.884 - 0.981). Patients with suspected DILI should be screened for PDA as they would require a close monitoring for early detection of worsening clinical course.
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Affiliation(s)
- Hao Niu
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Plataforma de Investigación Clínica y Ensayos Clínicos IBIMA, Plataforma ISCIII de Investigación Clínica, Madrid, Spain
| | - Pablo Solis-Muñoz
- Servicio de Aparato Digestivo, Hospital Universitario de Cáceres, Cáceres, Spain
| | - Miren García-Cortés
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Judith Sanabria-Cabrera
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain; Plataforma de Investigación Clínica y Ensayos Clínicos IBIMA, Plataforma ISCIII de Investigación Clínica, Madrid, Spain
| | - Mercedes Robles-Diaz
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Rocío Romero-Flores
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain
| | - Elvira Bonilla-Toyos
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain; Plataforma de Investigación Clínica y Ensayos Clínicos IBIMA, Plataforma ISCIII de Investigación Clínica, Madrid, Spain
| | - Aida Ortega-Alonso
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - José M Pinazo-Bandera
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - María R Cabello
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain
| | - Fernando Bessone
- Hospital Provincial del Centenario, Facultad de Medicina, Universidad Nacional de Rosario, Rosario, Argentina
| | - Nelia Hernandez
- Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | - M Isabel Lucena
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Plataforma de Investigación Clínica y Ensayos Clínicos IBIMA, Plataforma ISCIII de Investigación Clínica, Madrid, Spain.
| | - Raúl J Andrade
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Inmaculada Medina-Caliz
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain
| | - Ismael Alvarez-Alvarez
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Plataforma de Investigación Clínica y Ensayos Clínicos IBIMA, Plataforma ISCIII de Investigación Clínica, Madrid, Spain
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Kwater A, Sen S, de Haan J, Ge M, Kim A, Hernandez N. Ultrasound-guided percutaneous cryoneurolysis for management of acute sternal fracture pain. Trauma Case Rep 2023; 43:100751. [PMID: 36636466 PMCID: PMC9829744 DOI: 10.1016/j.tcr.2022.100751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2022] [Indexed: 01/05/2023] Open
Abstract
Background Establishing adequate analgesia for rib and sternal fractures remains a challenge due to the prolonged nature of the associated pain. Historically, cryoneurolysis has demonstrated beneficial in treating chronic pain, and the recent development of hand-held devices has allowed its functionality to expand into the management of acute pain. Case We present a polytrauma patient with sternal and multiple rib fractures that underwent ultrasound-guided intercostal cryoneurolysis at bedside, resulting in significant analgesia lasting several weeks and improving mobilization. This is the first report of the utilization of cryoneurolysis to treat acute sternal fracture pain. Conclusion The most common sternal fracture pattern is transverse which only requires treatment of four intercostal nerves, making cryoneurolysis feasible in trauma centers. This portable, minimally invasive, and low risk technique has the added benefits of reducing opioid requirements, decreasing length of hospital stay, and improving mobility in polytrauma patients.
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Affiliation(s)
- A.P. Kwater
- University of Texas MD Anderson Cancer Center, Department of Anesthesiology & Perioperative Medicine, 1400 Holcombe Blvd., Unit 409, Houston, TX 77030, United States of America
| | - S. Sen
- McGovern School of Medicine at UTHealth, Department of Anesthesiology & Perioperative Medicine, 6431 Fannin Street, MSB 5.020, Houston, TX 77030, United States of America
| | - J.B. de Haan
- McGovern School of Medicine at UTHealth, Department of Anesthesiology & Perioperative Medicine, 6431 Fannin Street, MSB 5.020, Houston, TX 77030, United States of America
| | - M.A. Ge
- McGovern School of Medicine at UTHealth, Department of Anesthesiology & Perioperative Medicine, 6431 Fannin Street, MSB 5.020, Houston, TX 77030, United States of America
| | - A.M. Kim
- McGovern School of Medicine at UTHealth, 6431 Fannin Street, Houston, TX 77030, United States of America,Corresponding author.
| | - N. Hernandez
- McGovern School of Medicine at UTHealth, 6431 Fannin Street, MSB 5.020, Houston, TX 77030, United States of America
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Bessone F, Ferrari A, Hernandez N, Mendizabal M, Ridruejo E, Zerega A, Tanno F, Reggiardo MV, Vorobioff J, Tanno H, Arrese M, Nunes V, Tagle M, Medina-Caliz I, Robles-Diaz M, Niu H, Alvarez-Alvarez I, Stephens C, Lucena MI, Andrade RJ. Nitrofurantoin-induced liver injury: long-term follow-up in two prospective DILI registries. Arch Toxicol 2023; 97:593-602. [PMID: 36416910 PMCID: PMC9859893 DOI: 10.1007/s00204-022-03419-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/09/2022] [Indexed: 11/24/2022]
Abstract
Nitrofurantoin is a synthetic antibiotic that is recommended as first-choice treatment for uncomplicated urinary tract infections. The prescription of this drug has increased dramatically, especially in Latin American countries. We described the demographics, clinical characteristics, biochemical features, and outcome of nitrofurantoin-induced liver injury. We analyzed 23 cases from the Latin American DILI Network (LATINDILI) and the Spanish DILI Registry. Causality was assessed with the RUCAM and RECAM scale. Of the 23 DILI cases included in our series, 96% patients were women, and the mean age of the whole cohort was 61 years. The median time of drug exposure was 175 days (interquartile range [IQR] 96-760), with 11 patients who were prescribed nitrofurantoin for more than six months. Hepatocellular damage was the most frequent pattern of liver injury (83%), and nearly half of the patients had an asymptomatic presentation (52%). Neither death nor liver transplantation was documented in this series. Overall, 65% of the patients (n = 15) presented with positive autoantibody titres. The median time to resolution was 81 days (IQR 57-141), and 15 patients (83%) recovered within six months. Five patients (22%) developed nitrofurantoin-induced autoimmune-like hepatitis (NI-AILH), of whom two were characterized by a persistent increase in transaminases that required immunosuppressive treatment to achieve normalization of liver enzymes. Clinicians who prescribe nitrofurantoin should be aware that patients who had taken nitrofurantoin for a long term may be at risk of developing nitrofurantoin-induced autoimmune-like hepatitis.
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Affiliation(s)
| | | | | | | | - Ezequiel Ridruejo
- Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
| | | | | | | | | | - Hugo Tanno
- Hospital Provincial del Centenario, Rosario, Argentina
| | - Marco Arrese
- Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Vinicius Nunes
- Hospital Universitário Prof. Edgard Santos-UFBA, Salvador, Brazil
| | | | - Inmaculada Medina-Caliz
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain
| | - Mercedes Robles-Diaz
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain ,Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Hao Niu
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain ,Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Ismael Alvarez-Alvarez
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain ,Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Camilla Stephens
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain ,Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - M. Isabel Lucena
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain ,Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Raul J. Andrade
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Universidad de Málaga, Málaga, Spain ,Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
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5
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Efe C, Taşçılar K, Gerussi A, Bolis F, Lammert C, Ebik B, Stättermayer AF, Cengiz M, Gökçe DT, Cristoferi L, Peralta M, Massoumi H, Montes P, Cerda E, Rigamonti C, Yapalı S, Adali G, Çalışkan AR, Balaban Y, Eren F, Eşkazan T, Barutçu S, Lytvyak E, Zazueta GM, Kayhan MA, Heurgue-Berlot A, De Martin E, Yavuz A, Bıyık M, Narro GC, Duman S, Hernandez N, Gatselis NK, Aguirre J, Idilman R, Silva M, Mendizabal M, Atay K, Güzelbulut F, Dhanasekaran R, Montano-Loza AJ, Dalekos GN, Ridruejo E, Invernizzi P, Wahlin S. SARS-CoV-2 vaccination and risk of severe COVID-19 outcomes in patients with autoimmune hepatitis. J Autoimmun 2022; 132:102906. [PMID: 36088883 PMCID: PMC9448709 DOI: 10.1016/j.jaut.2022.102906] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 02/06/2023]
Abstract
Background Data regarding outcome of Coronavirus disease 2019 (COVID-19) in vaccinated patients with autoimmune hepatitis (AIH) are lacking. We evaluated the outcome of COVID-19 in AIH patients who received at least one dose of Pfizer- BioNTech (BNT162b2), Moderna (mRNA-1273) or AstraZeneca (ChAdOx1-S) vaccine. Patients and methods We performed a retrospective study on AIH patients with COVID-19. The outcomes of AIH patients who had acute respiratory syndrome coronavirus 2 (SARS-CoV-2) breakthrough infection after at least one dose of COVID-19 vaccine were compared to unvaccinated patients with AIH. COVID-19 outcome was classified according to clinical state during the disease course as: (i) no hospitalization, (ii) hospitalization without oxygen supplementation, (iii) hospitalization with oxygen supplementation by nasal cannula or mask, (iv) intensive care unit (ICU) admission with non-invasive mechanical ventilation, (v) ICU admission with invasive mechanical ventilation or (vi) death, and data was analyzed using ordinal logistic regression. Results We included 413 (258 unvaccinated and 155 vaccinated) patients (81%, female) with a median age of 52 (range: 17–85) years at COVID-19 diagnosis. The rates of hospitalization were (36.4% vs. 14.2%), need for any supplemental oxygen (29.5% vs. 9%) and mortality (7% vs. 0.6%) in unvaccinated and vaccinated AIH patients with COVID-19. Having received at least one dose of SARS-CoV-2 vaccine was associated with a significantly lower risk of worse COVID-19 severity, after adjusting for age, sex, comorbidities and presence of cirrhosis (adjusted odds ratio [aOR] 0.18, 95% confidence interval [CI], 0.10–0.31). Overall, vaccination against SARS-CoV-2 was associated with a significantly lower risk of mortality from COVID-19 (aOR 0.20, 95% CI 0.11–0.35). Conclusions SARS-CoV-2 vaccination significantly reduced the risk of COVID-19 severity and mortality in patients with AIH.
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Affiliation(s)
- Cumali Efe
- Department of Gastroenterology, Harran University Hospital, Şanlıurfa, Turkey.
| | - Koray Taşçılar
- Department of Medicine 3-Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Alessio Gerussi
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza, Italy
| | - Francesca Bolis
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Craig Lammert
- Department of Medicine Indiana, University School of Medicine, Indianapolis, IN, USA
| | - Berat Ebik
- Department of Gastroenterology, Gazi Yaşargil Education and Research Hospital, Diyarbakir, Turkey
| | - Albert Friedrich Stättermayer
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Mustafa Cengiz
- Department of Gastroenterology, Gülhane Training and Research Hospital, Ankara, Turkey
| | | | - Laura Cristoferi
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza, Italy
| | - Mirta Peralta
- Hepatology Section, Hospital Francisco J Muñiz, Ciudad Autónoma de Buenos Aires, Argentina; Latin American Liver Research Educational and Awareness Network (LALREAN), Pilar, Argentina
| | - Hatef Massoumi
- Department of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Pedro Montes
- Gastroenterology and Hepatology Unit, Hospital Nacional Daniel A. Carrión, Callao, Peru
| | - Eira Cerda
- Hepatology Unit, Hospital Militar Central de México, Ciudad de México, Mexico
| | - Cristina Rigamonti
- Department of Translational Medicine, Università del Piemonte Orientale UPO, Novara, Italy; Division of Internal Medicine, "AOU Maggiore della Carità", Novara, Italy
| | - Suna Yapalı
- Department of Gastroenterology, Acıbadem University School of Medicine, İstanbul, Turkey
| | - Gupse Adali
- Department of Gastroenterology, Umraniye Education and Research Hospital, Istanbul, Turkey
| | - Ali Rıza Çalışkan
- Department of Gastroenterology, Adıyaman University, Adıyaman, Turkey
| | - Yasemin Balaban
- Department of Gastroenterology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Fatih Eren
- Department of Gastroenterology, Medical Faculty, Uludag University, Bursa, Turkey
| | - Tuğçe Eşkazan
- Department of Gastroenterology, Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Sezgin Barutçu
- Department of Gastroenterology, University of Gaziantep Medical Faculty, Gaziantep, Turkey
| | - Ellina Lytvyak
- University of Alberta Division of Gastroenterology and Liver Unit, Edmonton, AB, Canada
| | - Godolfino Miranda Zazueta
- Gastroenterology Unit, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Ciudad de México, Mexico
| | - Meral Akdogan Kayhan
- Department of Gastroenterology, Gülhane Training and Research Hospital, Ankara, Turkey
| | | | - Eleonora De Martin
- Centre Hepato-Biliaire, Hôpital Paul-Brousse, FHU Hepatinov, INSERM Unit UMR 1193, Univ Paris-Saclay, France
| | - Ahmet Yavuz
- Division of Gastroenterology, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Murat Bıyık
- Division of Gastroenterology, Necmettin Erbakan University, Meram School of Medicine, Konya, Turkey
| | - Graciela Castro Narro
- Gastroenterology Unit, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Ciudad de México, Mexico
| | - Serkan Duman
- Department of Gastroenterology, Ankara University Medical Faculty, Ankara, Turkey
| | - Nelia Hernandez
- Gastroenterology and Hepatology Unit, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Nikolaos K Gatselis
- Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa, Greece; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), General University Hospital of Larissa, Larissa, Greece
| | - Jonathan Aguirre
- Hepatology Unit, Hospital Ángeles Pedregal, Ciudad de México, Mexico
| | - Ramazan Idilman
- Department of Gastroenterology, Ankara University Medical Faculty, Ankara, Turkey
| | - Marcelo Silva
- Latin American Liver Research Educational and Awareness Network (LALREAN), Pilar, Argentina; Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
| | - Manuel Mendizabal
- Latin American Liver Research Educational and Awareness Network (LALREAN), Pilar, Argentina; Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
| | - Kadri Atay
- Department of Gastroenterology, Mardin State Hospital, Mardin, Turkey
| | - Fatih Güzelbulut
- Department of Gastroenterology, Haydarpaşa Numune Education and Research Hospital, İstanbul, Turkey
| | | | - Aldo J Montano-Loza
- University of Alberta Division of Gastroenterology and Liver Unit, Edmonton, AB, Canada
| | - George N Dalekos
- Department of Medicine and Research Laboratory of Internal Medicine, National Expertise Center of Greece in Autoimmune Liver Diseases, General University Hospital of Larissa, Greece; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), General University Hospital of Larissa, Larissa, Greece
| | - Ezequiel Ridruejo
- Latin American Liver Research Educational and Awareness Network (LALREAN), Pilar, Argentina; Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina; Hepatology Section, Department of Medicine, Centro de Educación Médica e Investigaciones Clínicas, CEMIC, Ciudad Autónoma de Buenos Aires, Argentina
| | - Pietro Invernizzi
- Division of Gastroenterology and Center for Autoimmune Liver Diseases, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy; European Reference Network on Hepatological Diseases (ERN RARE-LIVER), San Gerardo Hospital, Monza, Italy
| | - Staffan Wahlin
- Hepatology Division, Department of Upper GI Diseases, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
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Hernandez N, Bessone F. Hepatotoxicity Induced by Biological Agents: Clinical Features and Current Controversies. J Clin Transl Hepatol 2022; 10:486-495. [PMID: 35836762 PMCID: PMC9240255 DOI: 10.14218/jcth.2021.00243] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 10/24/2021] [Accepted: 12/15/2021] [Indexed: 12/13/2022] Open
Abstract
Novel biological agents including cytokines and recombinant fusion proteins are increasingly prescribed for cancer, rheumatologic, autoimmune, and inflammatory diseases, and are currently being evaluated in hepatocellular carcinoma (HCC). They are classified by their mechanism of action and include tumor necrosis factor-alpha (TNF-α) antagonists, T cell mediated antitumor inhibitors, interleukin receptor antagonists, and immune checkpoint inhibitors (ICIs). Some ICIs cause frequent hepatotoxicity with a variable clinical, biochemical, and serological presentation, especially in patients receiving another immunomodulatory agent. Half of the cases of liver damage induced by biological agents spontaneously regress after drug withdrawal, but the others require steroid therapy. Unfortunately, there are no widely accepted recommendation for the use of corticosteroids in these patients, even though international cancer societies have their own guidelines. Differentiating drug-induced autoimmune hepatitis (DIAIH) from classic AIH is challenging for pathologists, but liver biopsy is valuable, particularly in cases with unclear clinical presentation. Interesting, novel histological patterns have been described in liver damage induced by these agents (i.e., endothelitis, ring granuloma and secundary sclerosing cholangitis associated with lymphocytic infiltration of cytotoxic CD8+T cells). Here, we describe the clinical and biochemical characteristics of patients with hepatotoxicity induced by TNF-α antagonists and ICIs. Controversial issues involved in the administration of corticosteroid therapy, and hepatitis B virus (HBV) reactivation induced by immunosuppressive therapy are also discussed.
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Affiliation(s)
- Nelia Hernandez
- Hospital de Clinicas, Universidad de la Republica, Montevideo, Uruguay
| | - Fernando Bessone
- Hospital Provincial del Centenario, University of Rosario School of Medicine, Rosario, Argentina
- Correspondence to: Fernando Bessone, Facultad de Ciencias Médicas, Hospital Provincial del Centenario, University of Rosario School of Medicine, Rosario, Argentina. ORCID: https://orcid.org/0000-0002-8569-8123. Tel: +54-341-5026969, Fax: +54-341-4387014, E-mail:
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7
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Bessone F, García-Cortés M, Medina-Caliz I, Hernandez N, Parana R, Mendizabal M, Schinoni MI, Ridruejo E, Nunes V, Peralta M, Santos G, Anders M, Chiodi D, Tagle M, Montes P, Carrera E, Arrese M, Lizarzabal MI, Alvarez-Alvarez I, Caballano-Infantes E, Niu H, Pinazo J, Cabello MR, Lucena MI, Andrade RJ. Herbal and Dietary Supplements-Induced Liver Injury in Latin America: Experience From the LATINDILI Network. Clin Gastroenterol Hepatol 2022; 20:e548-e563. [PMID: 33434654 DOI: 10.1016/j.cgh.2021.01.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/04/2021] [Accepted: 01/06/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Herbal and dietary supplements (HDS) consumption, a growing cause of hepatotoxicity, is a common practice among Latin-American populations. OBJECTIVES To evaluate clinical, laboratory features and outcome in HDS-hepatotoxicity included in the Latin America-Drug Induced Liver Injury (LATINDILI) Network. METHODS A total of 29 adjudicated cases of HDS hepatotoxicity reported to the LATINDILI Network from October 2011 through December 2019 were compared with 322 DILI cases due to conventional drugs and 16 due to anabolic steroids as well as with other series of HDS-hepatotoxicity. RESULTS From 367 DILI cases, 8% were attributed to HDS. An increasing trend in HDS-hepatotoxicity was noted over time (p = .04). Camellia sinensis, Herbalife® products, and Garcinia cambogia, mostly used for weight loss, were the most frequently adjudicated causative agents. Mean age was 45 years (66% female). Median time to onset was 31 days. Patients presented typically with hepatocellular injury (83%) and jaundice (66%). Five cases (17%) developed acute liver failure. Compared to conventional medications and anabolic steroids, HDS hepatotoxicity cases had the highest levels of aspartate and alanine transaminase (p = .008 and p = .021, respectively), had more re-exposure events to the culprit HDS (14% vs 3% vs 0%; p = .026), and had more severe and fatal/liver transplantation outcomes (21% vs 12% vs 13%; p = .005). Compared to other DILI cohorts, less HDS hepatotoxicity cases in Latin America were hospitalized (41%). CONCLUSIONS HDS-hepatotoxicity in Latin-America affects mainly young women, manifests mostly with hepatocellular injury and is associated with higher frequency of accidental re-exposure. HDS hepatotoxicity is more serious with a higher chance of death/liver transplantation than DILI related to conventional drugs.
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Affiliation(s)
- Fernando Bessone
- Hospital Provincial del Centenario, Universidad Nacional de Rosario, Rosario, Argentina; Centro de Investigación Biomédica en Red: Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Miren García-Cortés
- UGC de Aparato Digestivo, Instituto de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red: Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Inmaculada Medina-Caliz
- Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red: Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | | | - Raymundo Parana
- Hospital Universitário Prof. Edgard Santos-UFBA, Salvador, Brazil
| | - Manuel Mendizabal
- Hospital Universitario Austral, Pilar Centro, Provincia de Buenos Aires, Argentina
| | - Maria I Schinoni
- Hospital Universitário Prof. Edgard Santos-UFBA, Salvador, Brazil
| | - Ezequiel Ridruejo
- Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina
| | - Vinicius Nunes
- Hospital Universitário Prof. Edgard Santos-UFBA, Salvador, Brazil
| | - Mirta Peralta
- Hospital de infecciosas F. J. Muñiz, CABA, Buenos Aires, Argentina
| | - Genario Santos
- Hospital Universitario Austral, Pilar Centro, Provincia de Buenos Aires, Argentina
| | | | | | | | - Pedro Montes
- Hospital Nacional Daniel Alcides Carrion, Callao, Perú
| | | | - Marco Arrese
- Departamento de Gastroenterología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Ismael Alvarez-Alvarez
- Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain
| | - Estefania Caballano-Infantes
- Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain
| | - Hao Niu
- Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain
| | - Jose Pinazo
- UGC de Aparato Digestivo, Instituto de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain
| | - Maria R Cabello
- Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain
| | - M Isabel Lucena
- Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red: Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain.
| | - Raúl J Andrade
- UGC de Aparato Digestivo, Instituto de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red: Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
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8
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Bessone F, Hernandez N, Tagle M, Arrese M, Parana R, Méndez-Sánchez N, Ridruejo E, Mendizabal M, Dagher L, Contreras F, Fassio E, Pessoa M, Brahm J, Silva M. Drug-induced liver injury: A management position paper from the Latin American Association for Study of the liver. Ann Hepatol 2022; 24:100321. [PMID: 33609753 DOI: 10.1016/j.aohep.2021.100321] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 01/18/2021] [Accepted: 01/18/2021] [Indexed: 02/06/2023]
Abstract
Idiosyncratic drug-induced liver injury (DILI) caused by xenobiotics (drugs, herbals and dietary supplements) is an uncommon cause of liver disease presenting with a wide range of phenotypes and disease severity, acute hepatitis mimicking viral hepatitis to autoimmune hepatitis, steatosis, fibrosis or rare chronic vascular syndromes. Disease severity ranges from asymptomatic liver test abnormalities to acute liver failure. DILI has been traditionally classified in predictable or intrinsic (dose-related) or unpredictable (not dose-related) mechanisms. Few prospective studies are assessing the real prevalence and incidence of hepatotoxicity in the general population. DILI registries represent useful networks used for the study of liver toxicity, aimed at improving the understanding of causes, phenotypes, natural history, and standardized definitions of hepatotoxicity. Although most of the registries do not carry out population-based studies, they may provide important data related to the prevalence of DILI, and also may be useful to compare features from different countries. With the support of the Spanish Registry of Hepatotoxicity, our Latin American Registry (LATINDILI) was created in 2011, and more than 350 DILI patients have been recruited to date. This position paper describes the more frequent drugs and herbs-induced DILI in Latin America, mainly focusing on several features of responsible medicaments. Also, we highlighted the most critical points on the management of hepatotoxicity in general and those based on findings from our Latin American experience in particular.
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Affiliation(s)
- Fernando Bessone
- Hospital Provincial del Centenario, Facultad de Medicina, Universidad Nacional de Rosario, Rosario, Argentina.
| | | | - Martin Tagle
- Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Marco Arrese
- Pontificia Universidad Católica de chile, Santiago de Chile, Chile
| | | | - Nahum Méndez-Sánchez
- Liver Research Unit, Medica Sur Clinic & Foundation, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico; Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico
| | - Ezequiel Ridruejo
- Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno "CEMIC", Buenos Aires, Argentina
| | | | - Lucy Dagher
- Policlínica Metropolitana y CMDLT, Caracas, Venezuela
| | | | - Eduardo Fassio
- Hospital Nacional Prof. Alejandro Posadas, Provincia de Buenos Aires, Argentina
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9
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Loirec CL, Hernandez N. Technical Note: Development of a generalized source model for flux estimation in nuclear reactors. ANN NUCL ENERGY 2022. [DOI: 10.1016/j.anucene.2021.108776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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10
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Díaz LA, Idalsoaga F, Fuentes-López E, Márquez-Lomas A, Ramírez CA, Roblero JP, Araujo RC, Higuera-de-la-Tijera F, Toro LG, Pazmiño G, Montes P, Hernandez N, Mendizabal M, Corsi O, Ferreccio C, Lazo M, Brahmania M, Singal AK, Bataller R, Arrese M, Arab JP. Impact of Public Health Policies on Alcohol-Associated Liver Disease in Latin America: An Ecological Multinational Study. Hepatology 2021; 74:2478-2490. [PMID: 34134172 DOI: 10.1002/hep.32016] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [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] [Received: 03/16/2021] [Revised: 06/05/2021] [Accepted: 06/08/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS Alcohol-associated liver disease (ALD) is the leading cause of liver-related mortality in Latin America, yet the impact of public health policies (PHP) on liver disease is unknown. We aimed to assess the association between alcohol PHP and deaths due to ALD in Latin American countries. APPROACH AND RESULTS We performed an ecological multinational study including 20 countries in Latin America (628,466,088 inhabitants). We obtained country-level sociodemographic information from the World Bank Open Data source. Alcohol-related PHP data for countries were obtained from the World Health Organization Global Information System of Alcohol and Health. We constructed generalized linear models to assess the association between the number of PHP (in 2010) and health outcomes (in 2016). In Latin America, the prevalence of obesity was 27% and 26.1% among male and female populations, respectively. The estimated alcohol per capita consumption among the population at 15 years old or older was 6.8 L of pure alcohol (5.6 recorded and 1.2 unrecorded). The overall prevalence of alcohol use disorders (AUD) was 4.9%. ALD was the main cause of cirrhosis in 64.7% of male and 40.0% of female populations. A total of 19 (95%) countries have at least one alcohol-related PHP on alcohol. The most frequent PHP were limiting drinking age (95%), tax regulations (90%), drunk-driving policies and countermeasures (90%), and government monitoring systems and community support (90%). A higher number of PHP was associated with a lower ALD mortality (PR, 0.76; 95% CI, 0.61-0.93; P = 0.009), lower AUD prevalence (PR, 0.80; 95% CI, 0.65-0.99; P = 0.045), and lower alcohol-attributable road traffic deaths (PR, 0.81; 95% CI, 0.65-1.00; P = 0.051). CONCLUSIONS Our study indicates that in Latin America, countries with higher number of PHP have lower mortality due to ALD, lower prevalence of AUD, and lower alcohol-attributable road traffic mortality.
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Affiliation(s)
- Luis Antonio Díaz
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Idalsoaga
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Eduardo Fuentes-López
- Departamento de Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | | | - Juan Pablo Roblero
- Sección Gastroenterología, Hospital Clínico Universidad de Chile, Escuela de Medicina Universidad de Chile, Santiago, Chile
| | - Roberta C Araujo
- Gastroenterology Division, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | - Luis Guillermo Toro
- Hepatology and Liver Transplant Unit, Hospitales de San Vicente Fundación de Medellín y Rionegro, Medellin, Colombia
| | - Galo Pazmiño
- Department of Gastroenterology, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Pedro Montes
- Department of Gastroenterology, Hospital Nacional Daniel A. Carrión, Callao, Perú
| | - Nelia Hernandez
- Clínica de Gastroenterología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República Uruguay, Montevideo, Uruguay
| | - Manuel Mendizabal
- Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Buenos Aires, Argentina
| | - Oscar Corsi
- Departamento de Medicina Interna, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Catterina Ferreccio
- Public Health Department, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.,Advanced Center for Chronic Diseases, ACCDis, Santiago, Chile
| | - Mariana Lazo
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA.,Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA.,Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Mayur Brahmania
- Department of Medicine, Division of Gastroenterology, Western University, London Health Sciences Center, London, ON, Canada
| | - Ashwani K Singal
- Division of Transplant Hepatology, Department of Medicine, Avera Transplant Institute, University of South Dakota Sanford School of Medicine, Sioux Falls, SD
| | - Ramon Bataller
- Center for Liver Diseases, Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Marco Arrese
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Juan Pablo Arab
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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11
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Dorelo R, Barcelos ST, Barros M, Elustondo V, Pérez YY, Oricchio M, Uribe ND, Hernandez N, Joveleviths D, Alvares-da-Silva MR. Potentially hepatotoxic drugs are still being prescribed to liver disease patients under tertiary care: it is time to say enough. Rev Peru Investig Salud 2021. [DOI: 10.35839/repis.5.4.1104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction and aim: Drug-induced liver injury (DILI) manifests as a spectrum of clinical presentations that carries morbidity and mortality. Patients with chronic liver disease (CLD), particularly hospitalized, are at high risk for developing DILI. We aimed to investigate the use of potentially hepatotoxic drugs (PHD) in patients with CLD in a tertiary university hospital. Materials and methods: Adult (≥ 18 years-old) with CLD admitted to the hospital from January 2016 to December 2018 were evaluated regarding PHD, assessing the risk of DILI and liver enzymes behavior after exposure. Results: From 931 hospitalized patients with CLD, 291 (31.3%) were exposed to hepatotoxic drugs during their hospitalization. Of those, 244 (83.8%) were cirrhotic. The most frequent causes of liver disease were hepatitis C (41.2%), followed by alcohol (13.2%), hepatitis C/alcohol (11.7%) and non-alcoholic fatty liver disease (5.8%). Decompensated cirrhosis (46.7%) was the main reason for hospital admission. The most often prescribed PHD were antibiotics (67.7%), cardiovascular drugs (34.4%), neuromodulators (26.1%) and anesthetics (19.9%). After exposure, 113 patients (38.8%) presented significant elevated liver enzymes. Surprisingly, PHD were more often prescribed in GI/Liver unit (48.8%) followed by emergency/intensive care unit (28.5%). A total of 65 patients (22%) died, however in neither case was it possible to safely infer causal relationship among PHD, liver enzymes and death. Conclusion: PHD prescription is frequent in patients with CLD even in a tertiary university hospital and in the gastroenterology and hepatology department, exposing these patients to an additional risk.
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Arab JP, Dirchwolf M, Álvares-da-Silva MR, Barrera F, Benítez C, Castellanos-Fernandez M, Castro-Narro G, Chavez-Tapia N, Chiodi D, Cotrim H, Cusi K, de Oliveira CPMS, Díaz J, Fassio E, Gerona S, Girala M, Hernandez N, Marciano S, Masson W, Méndez-Sánchez N, Leite N, Lozano A, Padilla M, Panduro A, Paraná R, Parise E, Perez M, Poniachik J, Restrepo JC, Ruf A, Silva M, Tagle M, Tapias M, Torres K, Vilar-Gomez E, Costa Gil JE, Gadano A, Arrese M. Latin American Association for the study of the liver (ALEH) practice guidance for the diagnosis and treatment of non-alcoholic fatty liver disease. Ann Hepatol 2021; 19:674-690. [PMID: 33031970 DOI: 10.1016/j.aohep.2020.09.006] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [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: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 02/07/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) currently represents an epidemic worldwide. NAFLD is the most frequently diagnosed chronic liver disease, affecting 20-30% of the general population. Furthermore, its prevalence is predicted to increase exponentially in the next decades, concomitantly with the global epidemic of obesity, type 2 diabetes mellitus (T2DM), and sedentary lifestyle. NAFLD is a clinical syndrome that encompasses a wide spectrum of associated diseases and hepatic complications such as hepatocellular carcinoma (HCC). Moreover, this disease is believed to become the main indication for liver transplantation in the near future. Since NAFLD management represents a growing challenge for primary care physicians, the Asociación Latinoamericana para el Estudio del Hígado (ALEH) has decided to organize this Practice Guidance for the Diagnosis and Treatment of Non-Alcoholic Fatty Liver Disease, written by Latin-American specialists in different clinical areas, and destined to general practitioners, internal medicine specialists, endocrinologists, diabetologists, gastroenterologists, and hepatologists. The main purpose of this document is to improve patient care and awareness of NAFLD. The information provided in this guidance may also be useful in assisting stakeholders in the decision-making process related to NAFLD. Since new evidence is constantly emerging on different aspects of the disease, updates to this guideline will be required in future.
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Affiliation(s)
- Juan Pablo Arab
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
| | - Melisa Dirchwolf
- Unidad de Trasplante Hepático, Servicio de Hepatología, Hospital Privado de Rosario, Rosario, Argentina.
| | - Mário Reis Álvares-da-Silva
- Hepatology Division, Hospital de Clinicas de Porto Alegre, Brazil; School of Medicine, Universidade Federal do Rio Grande do Sul, Brazil; Graduate Program in Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Francisco Barrera
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
| | - Carlos Benítez
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
| | | | - Graciela Castro-Narro
- Gastroenterology Department, National Institute of Medical Sciences and Nutrition "Salvador Zubirán", Mexico City, Mexico.
| | | | - Daniela Chiodi
- Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
| | - Helma Cotrim
- School of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil.
| | - Kenneth Cusi
- Division of Endocrinology, Diabetes and Metabolism, University of Florida, Gainesville, FL, USA.
| | | | - Javier Díaz
- Departamento del Aparato Digestivo, Hospital Edgardo Rebagliati Martins, EsSalud, Lima, Peru.
| | - Eduardo Fassio
- Sección Hígado, Vías Biliares y Páncreas, Servicio de Gastroenterología, Hospital Nacional Profesor Alejandro Posadas, El Palomar, Buenos Aires, Argentina.
| | - Solange Gerona
- Liver Unit, Hospital de Fuerzas Armadas, Montevideo, Uruguay.
| | | | - Nelia Hernandez
- Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay.
| | | | - Walter Masson
- Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
| | | | - Nathalie Leite
- School of Medicine, Internal Medicine Department and Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Adelina Lozano
- Unidad de Hígado, Servicio de Gastroenterología, Hospital Nacional Arzobispo Loayza, Lima, Peru; Universidad Peruana Cayetano Heredia, Lima, Peru.
| | | | - Arturo Panduro
- Department of Molecular Biology in Medicine, Civil Hospital of Guadalajara, Fray Antonio Alcalde, Guadalajara, Jalisco, Mexico.
| | - Raymundo Paraná
- School of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil.
| | - Edison Parise
- Department of Gastroenterology, Federal University of Sao Paulo, Sao Paulo, Brazil.
| | - Marlene Perez
- Hospital General de la Plaza de la Salud, Santo Domingo, Dominican Republic.
| | - Jaime Poniachik
- Sección de Gastroenterología, Hospital Clínico Universidad de Chile, Santiago, Chile.
| | - Juan Carlos Restrepo
- Hepatobiliary and Liver Transplant Program, Hospital Pablo Tobon Uribe-Universidad de Antioquia, Medellín, Colombia; Grupo Gastrohepatologia, Facultad de Medicina, Universidad of Antioquía UdeA, Medellin, Colombia.
| | - Andrés Ruf
- Unidad de Trasplante Hepático, Servicio de Hepatología, Hospital Privado de Rosario, Rosario, Argentina.
| | - Marcelo Silva
- Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina.
| | - Martín Tagle
- Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia, Lima, Peru.
| | - Monica Tapias
- Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia.
| | - Kenia Torres
- Hospital General de la Plaza de la Salud, Santo Domingo, Dominican Republic.
| | - Eduardo Vilar-Gomez
- Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, IN, USA.
| | | | - Adrian Gadano
- Liver Unit, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
| | - Marco Arrese
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
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Bessone F, Hernandez N, Mendizabal M, Ridruejo E, Gualano G, Fassio E, Peralta M, Fainboim H, Anders M, Tanno H, Tanno F, Parana R, Medina-Caliz I, Robles-Diaz M, Alvarez-Alvarez I, Niu H, Stephens C, Colombato L, Arrese M, Reggiardo MV, Ono SK, Carrilho F, Lucena MI, Andrade RJ. Serious liver injury induced by Nimesulide: an international collaborative study. Arch Toxicol 2021; 95:1475-1487. [PMID: 33759010 DOI: 10.1007/s00204-021-03000-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 02/02/2021] [Indexed: 12/19/2022]
Abstract
Nimesulide is a non-steroidal anti-inflammatory drug still marketed in many countries. We aim to analyze the clinical phenotype, outcome, and histological features of nimesulide-induced liver injury (nimesulide-DILI). We analyzed 57 cases recruited from the Spanish and Latin American DILI registries. Causality was assessed by the RUCAM scale. Mean age of the whole case series was 59 years (86% women) with a median time to onset of 40 days. A total of 46 patients (81%) were jaundiced. Nimesulide-DILI pattern was hepatocellular in 38 (67%), mixed in 12 (21%), and cholestatic in 7 (12%) cases. Transaminases were elevated with a mean of nearly 20-fold the upper limit of normality (ULN), while alkaline phosphatase showed a twofold mean elevation above ULN. Total bilirubin showed a mean elevation of 13-fold the ULN. Liver histology was obtained in 14 cases (25%), most of them with a hepatocellular pattern. Median time to recovery was 60 days. Overall, 12 patients (21%) developed acute liver failure (ALF), five (8.8%) died, three underwent liver transplantation (5.3%), and the remaining four resolved. Latency was ≤ 15 days in 12 patients (21%) and one patient developed ALF within 7 days from treatment initiation. Increased total bilirubin and aspartate transaminase levels were independently associated with the development of ALF. In summary, nimesulide-DILI affects mainly women and presents typically with a hepatocellular pattern. It is associated with ALF and death in a high proportion of patients. Shorter (≤ 15 days) duration of therapy does not prevent serious nimesulide hepatotoxicity, making its risk/benefit ratio clearly unfavorable.
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Affiliation(s)
- Fernando Bessone
- Department of Gastroenterology and Hepatology, Hospital Provincial del Centenario, University of Rosario School of Medicine, Urquiza 3101, 200, Rosario, Argentina.
| | - Nelia Hernandez
- Facultad de Medicina, Hospital de Clínicas, Montevideo, Uruguay
| | | | - Ezequiel Ridruejo
- Centro de Educación Médica e Investigaciones Clínicas, Buenos Aires, Argentina
| | | | | | | | | | | | - Hugo Tanno
- Department of Gastroenterology and Hepatology, Hospital Provincial del Centenario, University of Rosario School of Medicine, Urquiza 3101, 200, Rosario, Argentina
| | - Federico Tanno
- Department of Gastroenterology and Hepatology, Hospital Provincial del Centenario, University of Rosario School of Medicine, Urquiza 3101, 200, Rosario, Argentina
| | - Raymundo Parana
- Facultad de Medicina, Universidad Nacional de Bahia, Salvador de Bahia, Brazil
| | - Inmaculada Medina-Caliz
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga-IBIMA, Universidad de Málaga, Málaga, Spain. CIBERehd, Madrid, Spain
| | - Mercedes Robles-Diaz
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga-IBIMA, Universidad de Málaga, Málaga, Spain. CIBERehd, Madrid, Spain
| | - Ismael Alvarez-Alvarez
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga-IBIMA, Universidad de Málaga, Málaga, Spain. CIBERehd, Madrid, Spain
| | - Hao Niu
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga-IBIMA, Universidad de Málaga, Málaga, Spain. CIBERehd, Madrid, Spain
| | - Camilla Stephens
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga-IBIMA, Universidad de Málaga, Málaga, Spain. CIBERehd, Madrid, Spain
| | | | - Marco Arrese
- Pontificia Universidad Catolica de Chile, Santiago de Chile, Chile
| | - M Virginia Reggiardo
- Department of Gastroenterology and Hepatology, Hospital Provincial del Centenario, University of Rosario School of Medicine, Urquiza 3101, 200, Rosario, Argentina
| | | | | | - M Isabel Lucena
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga-IBIMA, Universidad de Málaga, Málaga, Spain. CIBERehd, Madrid, Spain.
| | - Raul J Andrade
- Servicios de Aparato Digestivo y Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Instituto de Investigación Biomédica de Málaga-IBIMA, Universidad de Málaga, Málaga, Spain. CIBERehd, Madrid, Spain
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Hernandez N, Castro L, Medina-Quero J, Favela J, Michan L, Mortenson WB. Scoping Review of Healthcare Literature on Mobile, Wearable, and Textile Sensing Technology for Continuous Monitoring. J Healthc Inform Res 2021; 5:270-299. [PMID: 33554008 PMCID: PMC7849621 DOI: 10.1007/s41666-020-00087-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 07/30/2020] [Accepted: 12/02/2020] [Indexed: 12/01/2022]
Abstract
Remote monitoring of health can reduce frequent hospitalisations, diminishing the burden on the healthcare system and cost to the community. Patient monitoring helps identify symptoms associated with diseases or disease-driven disorders, which makes it an essential element of medical diagnoses, clinical interventions, and rehabilitation treatments for severe medical conditions. This monitoring can be expensive and time-consuming and provide an incomplete picture of the state of the patient. In the last decade, there has been a significant increase in the adoption of mobile and wearable devices, along with the introduction of smart textile solutions that offer the possibility of continuous monitoring. These alternatives fuel a technology shift in healthcare, one that involves the continuous tracking and monitoring of individuals. This scoping review examines how mobile, wearable, and textile sensing technology have been permeating healthcare by offering alternate solutions to challenging issues, such as personalised prescriptions or home-based secondary prevention. To do so, we have selected 222 healthcare literature articles published from 2007 to 2019 and reviewed them following the PRISMA process under the schema of a scoping review framework. Overall, our findings show a recent increase in research on mobile sensing technology to address patient monitoring, reflected by 128 articles published in journals and 19 articles in conference proceedings between 2014 and 2019, which represents 57.65% and 8.55% respectively of all included articles.
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Affiliation(s)
- N Hernandez
- School of Computing, Campus Jordanstown, Ulster University, Newtownabbey, BT37-0QB UK
| | - L Castro
- Department of Computing and Design, Sonora Institute of Technology (ITSON), Ciudad Obregón, 85000 Mexico
| | - J Medina-Quero
- Department of Computer Science, Campus Las Lagunillas, University of Jaen, Jaén, 23071 Spain
| | - J Favela
- Department of Computer Science, Ensenada Centre for Scientific Research and Higher Education, Ensenada, 22860 Mexico
| | - L Michan
- Department of Comparative Biology, National Autonomous University of Mexico, Mexico City, 04510 Mexico
| | - W Ben Mortenson
- International Collaboration on Repair Discoveries and GF Strong Rehabilitation Research Program, University of British Columbia, Vancouver, V6T-1Z4 Canada
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Molinero D, Cabeza P, Hernandez N, Silva E, Delgado W. P334 Heart model method: could it be a new echocardiographic gold-standard for the assessment of the left ventricular systolic function in a population under chemotherapy treatment? Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.187] [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
Echocardiographic assessment of the left ventricular systolic function is essential in diagnosis and during the follow up of cardiovascular diseases. Although subjective visual approach method is easily applied, quantitative systems give more objective information about systolic function analyses. The purpose of this study is to evaluate the different quantitative methods of estimating systolic function basal in non-invasive techniques
Methods
We used a group of 40 patients, prospectively collected, under chemotherapy treatment with preserved systolic function. Same echocardiography device (Philips EPIQ-7) has been used in all studies (acquiring apical 4 and 2 chambers and 3 D of apical volume by an experimented operator). We compare three standard methods with impact in the literature (Speckle tracking and 3D Heartmodel system) to the echocardiographic gold-standard (Simpson’s biplane method). The Bland-Altman method has been used for the graphic comparison of the values of the resulting measures while the statistical comparison was made by a T-student method.
Results
Three quantitative methods were used to compare left ventricular systolic function assessment (Heart Model 3D (60.4% ± 5.2%), Strain (60.50% ± 7.1%), global longitudinal strain (-19.7 ± 3.15%) to Simpson’s biplane (mean 62.10% ± 5.75%). Values of differential means (2.73 with Heart model 3D and 2.08 with Strain) compared to Simpson’s biplane were translated to a Bland-Altman plot and means were compared with a T-student method. A statistically significant difference was found in case of the Heartmodel method compared with Simpson’s biplane (p < 0.05), though it does not imply any clinical difference. Less time consuming and better segmentation of the cardiac cavities in just one beat with the 3D-Heart Model technique was a magnificent point compared to the Strain method that needed a postprocessing modification
Conclusions
Heartmodel method is probably the most time-saving and with a good accuracy of left ventricular systolic function assesment and it is not inferior compared to the echocardiographic gold-standard Simpson’s biplane method.
Abstract P334 Figure 1. Bland-Altman analysis
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Affiliation(s)
- D Molinero
- University Hospital Puerta del Mar, Cadiz, Spain
| | - P Cabeza
- University Hospital Puerta del Mar, Cardiology, Cadiz, Spain
| | - N Hernandez
- University Hospital Puerta del Mar, Cardiology, Cadiz, Spain
| | - E Silva
- University Hospital Puerta del Mar, Cardiology, Cadiz, Spain
| | - W Delgado
- University Hospital Puerta del Mar, Cardiology, Cadiz, Spain
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Molinero D, Cabeza P, Hernandez N, Delgado W, Silva E. P923 Ultrasound follow-up of left atrial appendage occlusion devices. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.558] [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
Left atrial appendage (LAA) occlusion devices represent an important alternative to anticoagulation in patients with atrial fibrillation (AF) with high risk of bleeding and who have suffered any hemorrhagic event. At first, a transesophageal ultrasound is performed to examine cardiac cavities, take measures of LAA and discharge the presence of thrombi. We redo a new transesophageal ultrasound as a control three months later after having installed the device. The purpose of this article is to show our experience in ultrasound follow up of LAA occlusion.
Methodology
All measures of LAA were taken with the transoesophageal ultrasound device by the same operator. According to the size acquired from the appendage of each patient, they were divided into a first group with the implementation of the Watchman device (23 patients) and Amplatzer (6 patients). A transthoracic echocardiography control was performed on each patient to rule out the presence of complications after the intervention, before to be discharged from hospital. After three months, a new transoesophageal study was repeated to assess the correct position of the device and to rule out the presence of any disfunctions or clot formation.
Results
A total of 29 patients with AF (CHADSVASC 4.09 HASBLED 2.96) with a high risk of bleeding and after having suffered any complications (41% brain bleeding, 31% major gastrointestinal bleeding, 27% advanced chronic kidney disease) were presented for the implantation of a LAA closure device. Firstly, LAA size was confirm and the presence of a thrombi was rule out. No patient suffered complications during the procedure that was confirmed with transthoracic echocardiography (discharging the presence of perforation, pericardial effusion or tamponade). At three months later, we performed a new transoesophageal as a control for the assessment of the place and presence of GAPs, if any (80% correct-placed, 15% placed with a gap of 2-4 mm with passage of flow throughout). In a 10-month follow-up, it was found that practically 93% of patients were still without anticoagulation, except two patients, one of them (CHADSVASC 4 HASBLED 2) had to reintroduce oral anticoagulation due to the fact of the clot formation on the device. The second one (CHADSVASC 4 HASBLED 2) had to reintroduce temporarily fractionated heparin due to stent thrombosis in the femoral artery. None of them presented any ischemic complications or new haemorrhagic events.
Conclusions
LAA occlusion devices are an effective and safe alternative to anticoagulation in patients with atrial fibrillation with predisposition to bleeding where ultrasound techniques play an essential role in all stages of procedure (prior to implantation of the device, during and at the follow-up).
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Affiliation(s)
- D Molinero
- University Hospital Puerta del Mar, Cardiology, Cadiz, Spain
| | - P Cabeza
- University Hospital Puerta del Mar, Cardiology, Cadiz, Spain
| | - N Hernandez
- University Hospital Puerta del Mar, Cardiology, Cadiz, Spain
| | - W Delgado
- University Hospital Puerta del Mar, Cardiology, Cadiz, Spain
| | - E Silva
- University Hospital Puerta del Mar, Cardiology, Cadiz, Spain
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Hernandez N, Perez D, Wilson T. A Novel Technique for Atraumatic, Fiberoptic Nasal Intubation: Pilot Study and Preliminary Results. J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.joms.2019.06.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hernandez N, Pontet Y, Bessone F. Translating new knowledge on drug-induced liver injury into clinical practice. Frontline Gastroenterol 2019; 11:303-310. [PMID: 32587673 PMCID: PMC7307039 DOI: 10.1136/flgastro-2018-101120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 08/03/2019] [Accepted: 08/11/2019] [Indexed: 02/04/2023] Open
Abstract
Drug-induced liver injury (DILI) is one of the main reasons for drug withdrawal from the market, and a cause of worldwide morbidity. Although several issues on DILI are still unsolved, there have been significant advances in new definitions and diagnosis tools. DILI is the result of a complex interaction between genetic and environmental factors, and constitutes an expanding area of investigation. DILI can mimic virtually all known hepatopathies, including vascular disorders and liver tumours. As part of this broad spectrum of clinical presentations, DILI severity ranges from asymptomatic elevations of aminotransferases to acute liver failure. Although biomarkers are emerging as valuable diagnostic tools, they are not available in clinical practice. Accurate DILI diagnosis is a challenging issue, particularly the establishing of causal relationships with the culprit agent and the exclusion of competing causes of liver injury. Given that the understanding of the mechanisms inducing DILI is growing, and both DILI causality assessment scales and the performance of international DILI networks have been improved, hepatotoxicity may be recognised earlier in clinical practice. In this review, advances and results obtained by DILI registries around the world, case characterisations, particularly those relevant to newer definitions in DILI, and the behaviour of chronic liver disease induced by drugs will be updated. In addition, recently published data on herbal and dietary supplements and new predictive scores for acute liver failure assessment will also be discussed.
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Affiliation(s)
- Nelia Hernandez
- Gastroenterology and Hepatology, Facultad de Medicina, Hospital de Clínicas, UdelaR, Montevideo, Uruguay
| | - Yessica Pontet
- Gastroenterology and Hepatology, Facultad de Medicina, Hospital de Clínicas, UdelaR, Montevideo, Uruguay
| | - Fernando Bessone
- Gastroenterology and Hepatology, University of Rosario School of Medicine, Rosario, Argentina
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Bessone F, Robles-Diaz M, Hernandez N, Medina-Caliz I, Lucena MI, Andrade RJ. Assessment of Serious Acute and Chronic Idiosyncratic Drug-Induced Liver Injury in Clinical Practice. Semin Liver Dis 2019; 39:381-394. [PMID: 31049898 DOI: 10.1055/s-0039-1685519] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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: 02/01/2023]
Abstract
Drug-induced liver injury (DILI) is the leading cause of acute liver failure (ALF) in developed countries. The extremely variable phenotype of DILI, both in presentation and in severity, is one of the distinctive characteristics of the disease and one of the major challenges that hepatologists face when assessing hepatotoxicity cases. A new Hy's law that more accurately predicts the risk of ALF related to DILI has been proposed and validated. Other prognostic scoring algorithms for the early identification of DILI patients who may go on to develop ALF have been developed as it is of most clinical relevance to stratify patients for closer monitoring. Recent data indicate that acute DILI often presents a more prolonged resolution or evolves into chronicity at a higher frequency than other forms of acute liver injury. Risk factors for chronicity, specific phenotypes, and histological features are discussed in this study. Biomarkers to predict DILI outcome are in need.
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Affiliation(s)
- Fernando Bessone
- Hospital Provincial del Centenario, University of Rosario School of Medicine, Rosario, Argentina
| | - Mercedes Robles-Diaz
- Unidad de Gestión Clínica de Aparato Digestivo, Instituto de Investigación Biomédica de Málaga-IBIMA, Universidad de Málaga, Hospital Universitario Virgen de la Victoria, Málaga, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - Nelia Hernandez
- Facultad de Medicina, Hospital de Clínicas, Universidad de la República, Montevideo, Uruguay
| | - Inmaculada Medina-Caliz
- Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga-IBIMA, Universidad de Málaga, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - M Isabel Lucena
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain.,Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga-IBIMA, Universidad de Málaga, Hospital Universitario Virgen de la Victoria, Málaga, Spain.,Unidad Investigación Clínica y Ensayos Clínicos (UICEC)-IBIMA, Plataforma Spanish Clinical Research Network (SCReN), Málaga, Spain
| | - Raul J Andrade
- Unidad de Gestión Clínica de Aparato Digestivo, Instituto de Investigación Biomédica de Málaga-IBIMA, Universidad de Málaga, Hospital Universitario Virgen de la Victoria, Málaga, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
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Bessone F, Hernandez N, Mendizabal M, Sanchez A, Paraná R, Arrese M, Tagle M, Girala M, Lizarzabal M, Carrera E, Brahm J, Contreras F, Mendez‐Sanchez N, Santos G, Nunes V, Medina‐Caliz I, Parra‐Martinez C, Sanz‐Villanueva L, Isabel Lucena M, Andrade RJ. When the Creation of a Consortium Provides Useful Answers: Experience of The Latin American DILI Network (LATINDILIN). Clin Liver Dis (Hoboken) 2019; 13:51-57. [PMID: 31139356 PMCID: PMC6465791 DOI: 10.1002/cld.778] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 10/29/2018] [Indexed: 02/04/2023] Open
Affiliation(s)
- Fernando Bessone
- Hospital Provincial del Centenario, University of Rosario School of MedicineRosarioArgentina
| | | | | | | | - Raymundo Paraná
- Hospital Universitario Prof. Edgard SantosSalvador de BahiaBrazil
| | - Marco Arrese
- Universidad Católica Pontificia de ChileSantiagoChile
| | | | | | | | | | - Javier Brahm
- Universidad Católica Pontificia de ChileSantiagoChile
| | | | | | - Genario Santos
- Hospital Universitario Prof. Edgard SantosSalvador de BahiaBrazil
| | - Vinicius Nunes
- Hospital Universitario Prof. Edgard SantosSalvador de BahiaBrazil
| | - Inmaculada Medina‐Caliz
- Unidad de Gestión Clínica de Ap Digestivo y Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de MálagaHospital Universitario Virgen de la Victoria, Universidad de MálagaMálagaSpain
| | - Cecilio Parra‐Martinez
- Unidad de Gestión Clínica de Ap Digestivo y Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de MálagaHospital Universitario Virgen de la Victoria, Universidad de MálagaMálagaSpain
| | - Laura Sanz‐Villanueva
- Unidad de Gestión Clínica de Ap Digestivo y Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de MálagaHospital Universitario Virgen de la Victoria, Universidad de MálagaMálagaSpain
| | - Maria Isabel Lucena
- Unidad de Gestión Clínica de Ap Digestivo y Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de MálagaHospital Universitario Virgen de la Victoria, Universidad de MálagaMálagaSpain
| | - Raul J. Andrade
- Unidad de Gestión Clínica de Ap Digestivo y Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de MálagaHospital Universitario Virgen de la Victoria, Universidad de MálagaMálagaSpain
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21
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Gonzalez-Jimenez A, McEuen K, Chen M, Suzuki A, Robles-Diaz M, Medina-Caliz I, Bessone F, Hernandez N, Arrese M, Parana R, Lucena MI, Stephens C, Andrade RJ. The influence of drug properties and host factors on delayed onset of symptoms in drug-induced liver injury. Liver Int 2019; 39:401-410. [PMID: 30195258 DOI: 10.1111/liv.13952] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 08/22/2018] [Accepted: 08/27/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND & AIMS Most patients with drug-induced liver injury (DILI) manifest clinical symptoms while on therapy, while some patients manifest days or weeks after drug cessation (delayed onset). This challenges DILI causality assessment and diagnosis. Factors contributing to the delayed onset phenotype are currently unknown. We explored factors contributing to delayed onset of DILI by analysing culprit drug properties, host factors and their interactions in a large patient population from the Spanish DILI Registry. METHODS Clinical information from 388 patients (69 presented delayed onset) and drug properties of 43 causative drugs (45 active ingredients) were analysed. A two-tier regression-based model was used to assess host/drug interactions affecting the probability of delayed onset. RESULTS Antibacterial and anti-inflammatory drugs accounted for the delayed onset cases. Drug property of <50% hepatic metabolism (odds ratio [OR] 11.06, 95% confidence interval [95% CI]: 4.4-32.2, P = 0.0003), daily dose ≥1000 mg (OR: 2.77, 95% CI: 1.3-6.1, P = 0.0063) and the absence of pre-existing conditions in a patient (OR: 2.55, 95% CI: 1.3-4.9, P = 0.0043) were independently associated with delayed onset. The findings were consistent when externally validated using Latin American DILI Network cases (N = 131). Likewise, drug properties of mitochondrial liability and Pauling electronegativity were associated with delayed onset, but dependent on specific host factors such as age, sex and pre-existing cardiac diseases. CONCLUSIONS This study demonstrated that delayed onset, a specific DILI phenotype, is explained by complex interactions among drug properties and host factors and provided mechanistic hypotheses for future studies. These findings can help improve the diagnostic capability and causality assessment.
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Affiliation(s)
- Andres Gonzalez-Jimenez
- Unidad de Gestión Clínica del Aparato Digestivo, Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, CIBERehd, Málaga, Spain
| | - Kristin McEuen
- Division of Bioinformatics and Biostatistics, National Center for Toxicological Research, US Food and Drug Administration, Jefferson, Arkansas, USA
| | - Minjun Chen
- Division of Bioinformatics and Biostatistics, National Center for Toxicological Research, US Food and Drug Administration, Jefferson, Arkansas, USA
| | - Ayako Suzuki
- Gastroenterology, Duke University, Durham, North Carolina, USA.,Gastroenterology, Durham VA Medical Center, Durham, North Carolina, USA
| | - Mercedes Robles-Diaz
- Unidad de Gestión Clínica del Aparato Digestivo, Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, CIBERehd, Málaga, Spain
| | - Inmaculada Medina-Caliz
- Unidad de Gestión Clínica del Aparato Digestivo, Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, CIBERehd, Málaga, Spain
| | - Fernando Bessone
- Facultad de Medicina, Hospital Provincial del Centenario, Universidad de Rosario, Rosario, Argentina
| | - Nelia Hernandez
- Facultad de Medicina, Hospital de Clínicas, UDELAR, Montevideo, Uruguay
| | - Marco Arrese
- Departamento de Gastroenterología, Facultad de Medicina, Pontificia Universidad Católica de Chile y Centro de Envejecimiento y Regeneración (CARE), Facultad de Ciencias Biológicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Raymundo Parana
- Hospital Universitario Prof. Edgard Santos, Universidad Federal da Bahía, Salvador de Bahía, Brazil
| | - M Isabel Lucena
- Unidad de Gestión Clínica del Aparato Digestivo, Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, CIBERehd, Málaga, Spain.,UICEC IBIMA, Plataforma SCReN (Spanish Clinical Research Network), Servicio de Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Málaga, Spain
| | - Camilla Stephens
- Unidad de Gestión Clínica del Aparato Digestivo, Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, CIBERehd, Málaga, Spain
| | - Raúl J Andrade
- Unidad de Gestión Clínica del Aparato Digestivo, Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, CIBERehd, Málaga, Spain
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22
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Hernandez M, Neninger E, Santiesteban E, Camacho K, Hernandez N, Amador R, Acosta S, Gonzalez Y, Jimenez Y, Corella M, Ortiz R, Bello L, Calana A, Pichs G, Cala M, Flores Y, Viada C, Robaina M, Crombet T. Efficacy of racotumomab or nimotuzumab vs docetaxel as second-line therapy for advanced non-small cell lung cancer patients. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy288.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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23
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Urrutia-Goyes R, Hernandez N, Carrillo-Gamboa O, Nigam KDP, Ornelas-Soto N. Street dust from a heavily-populated and industrialized city: Evaluation of spatial distribution, origins, pollution, ecological risks and human health repercussions. Ecotoxicol Environ Saf 2018; 159:198-204. [PMID: 29753272 DOI: 10.1016/j.ecoenv.2018.04.054] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 04/20/2018] [Accepted: 04/26/2018] [Indexed: 06/08/2023]
Abstract
Emissions from vehicles include particles from tire and brake wearing that can settle down and join industrial discharges into street dust. Metals present in street dust may create ecological and health threats and their analysis is of great environmental relevance. The city of Monterrey, Mexico is an industrial pillar of the country and shows an increasing fleet during the last years, which has yielded higher traffic and emissions. This study analyzes 44 street dust samples taken across the city for total element concentrations by using X-ray fluorescence. Associations and indicators are calculated to define possible origins, levels of pollution, natural or anthropogenic sources, and ecological and human health risks. High concentrations of As, Ba, Cu, Fe, Mo, Ni, Pb, Ti, and Zn were found. Main sources of metals were defined as: tire wearing for Zn and Fe; brake wearing for Ba, Cu, Fe, Pb and Zr; additional industrial sources for Mo, Ni, Pb, and Ti; and other natural sources for As. Ecological risk was found to be moderate across the city and risk due to Pb concentrations was established for children.
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Affiliation(s)
- R Urrutia-Goyes
- Departamento de Ciencias de la Energía y Mecánica, Universidad de las Fuerzas Armadas ESPE, Av. Gral. Rumiñahui s/n, P.O. Box 171-5-231B, Sangolqui 171103, Ecuador.
| | - N Hernandez
- Laboratorio de Nanotecnología Ambiental, Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Ave. Eugenio Garza Sada 2501, Monterrey, N.L. 64849, México
| | - O Carrillo-Gamboa
- Laboratorio de Nanotecnología Ambiental, Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Ave. Eugenio Garza Sada 2501, Monterrey, N.L. 64849, México
| | - K D P Nigam
- Laboratorio de Nanotecnología Ambiental, Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Ave. Eugenio Garza Sada 2501, Monterrey, N.L. 64849, México; Department of Chemical Engineering at Indian Institute of Technology, Delhi, India
| | - N Ornelas-Soto
- Laboratorio de Nanotecnología Ambiental, Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Ave. Eugenio Garza Sada 2501, Monterrey, N.L. 64849, México.
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24
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Echeverría N, Chiodi D, López P, Sanchez Ciceron A, Angulo J, López-Lastra M, Silvera P, Canavesi A, Bianchi C, Colistro V, Cristina J, Hernandez N, Moreno P. IL28B gene polymorphism rs12979860, but not rs8099917, contributes to the occurrence of chronic HCV infection in Uruguayan patients. Virol J 2018; 15:40. [PMID: 29499724 PMCID: PMC5833045 DOI: 10.1186/s12985-018-0946-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 02/05/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Host single-nucleotide polymorphisms (SNPs) near the interleukin 28B (IL28B) locus are associated with sustained virological response to antiviral therapy and with spontaneous Hepatitis C Virus (HCV) clearance. Prevalence of these SNPs varies depending on ethnicity. The impact of IL28B SNPs in HCV-infected patients is currently unknown in Uruguay. Therefore, the aim of this study was to evaluate and compare the distribution of polymorphisms in the IL28B gene (rs12979860 and rs8099917) among HCV-infected patients and healthy individuals in Uruguay and thus assess their possible association with the establishment of HCV infection. METHODS DNA was recovered from 92 non-infected individuals and 78 HCV-infected patients and SNPs were determined by RFLP and allelic discrimination by real-time PCR. RESULTS The distribution of rs12979860 genotypes for the infected population was 29.5%-CC, 47.4%-CT and 23.1%-TT and for the control group 45.7%, 42.4% and 11.9%, respectively. Prevalence in both infected and uninfected individuals is similar to that reported in other countries with admixed populations. The distribution of rs8099917 genotypes for the infected population was 57.7%-TT, 27.2%-TG and 14.1%-GG and for the control group 60.9%, 33.7% and 5.4%, respectively. The comparison of rs12979860 genotype distribution between the two populations evidenced a higher prevalence of the favourable genotype (CC) in the uninfected control group (p < 0.05). Additionally, results generated using logistic regression analysis show that individuals carrying rs12979860-TT or CT genotypes have a higher likelihood of developing chronic hepatitis upon infection with HCV, when compared to CC carriers, considering rs8099917 genotype as constant. CONCLUSION Patients with HCV infection have a statistically significant lower prevalence of the favourable rs12979860 genotype when compared to uninfected individuals; therefore we can establish that only IL28B rs12979860-CT and TT genotypes seem to contribute to the occurrence of chronic HCV infection in the cohort of Uruguayan population studied. Considering that a trend towards a higher frequency of "good" response genotypes was observed in responder patients, we believe that IL28B rs12979860 genotyping could be a useful tool for predicting different therapies outcome, including in the DAA era.
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Affiliation(s)
- Natalia Echeverría
- Laboratorio de Virología Molecular, Centro de Investigaciones Nucleares, Facultad de Ciencias, Universidad de la República, 2055 Montevideo, Mataojo Uruguay
| | - Daniela Chiodi
- Clínica de Gastroenterología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, 11600 Montevideo, Uruguay
| | - Pablo López
- Departamento de Laboratorio Clínico, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Adriana Sanchez Ciceron
- Clínica de Gastroenterología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, 11600 Montevideo, Uruguay
| | - Jenniffer Angulo
- Laboratorio de Virología Molecular, Instituto Milenio de Inmunología e Inmunoterapia, Centro de Investigaciones Médicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marcelo López-Lastra
- Laboratorio de Virología Molecular, Instituto Milenio de Inmunología e Inmunoterapia, Centro de Investigaciones Médicas, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Paola Silvera
- Departamento de Laboratorio Clínico, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Adrian Canavesi
- Clínica de Gastroenterología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, 11600 Montevideo, Uruguay
| | | | - Valentina Colistro
- Departamento de Genética, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Juan Cristina
- Laboratorio de Virología Molecular, Centro de Investigaciones Nucleares, Facultad de Ciencias, Universidad de la República, 2055 Montevideo, Mataojo Uruguay
| | - Nelia Hernandez
- Clínica de Gastroenterología, Hospital de Clínicas, Facultad de Medicina, Universidad de la República, 11600 Montevideo, Uruguay
| | - Pilar Moreno
- Laboratorio de Virología Molecular, Centro de Investigaciones Nucleares, Facultad de Ciencias, Universidad de la República, 2055 Montevideo, Mataojo Uruguay
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25
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Zoubek ME, González-Jimenez A, Medina-Cáliz I, Robles-Díaz M, Hernandez N, Romero-Gómez M, Bessone F, Hallal H, Cubero FJ, Lucena MI, Stephens C, Andrade RJ. High Prevalence of Ibuprofen Drug-Induced Liver Injury in Spanish and Latin-American Registries. Clin Gastroenterol Hepatol 2018; 16:292-294. [PMID: 28782674 DOI: 10.1016/j.cgh.2017.07.037] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 07/20/2017] [Accepted: 07/23/2017] [Indexed: 02/07/2023]
Affiliation(s)
- Miguel E Zoubek
- Unidad de Gestión Clínica de Aparato Digestivo, Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga-Instituto de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas, Málaga, Spain
| | - Andres González-Jimenez
- Unidad de Gestión Clínica de Aparato Digestivo, Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga-Instituto de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas, Málaga, Spain
| | - Inmaculada Medina-Cáliz
- Unidad de Gestión Clínica de Aparato Digestivo, Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga-Instituto de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas, Málaga, Spain
| | - Mercedes Robles-Díaz
- Unidad de Gestión Clínica de Aparato Digestivo, Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga-Instituto de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas, Málaga, Spain.
| | - Nelia Hernandez
- Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Manuel Romero-Gómez
- Unidad de Gestión Clínica de Aparato Digestivo Intercentros, Hospitales Universitarios Virgen Macarena-Virgen del Rocio, Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas, Seville, Spain
| | - Fernando Bessone
- Hospital Provincial del Centenario, Facultad de Medicina, Universidad Nacional de Rosario, Rosario, Argentina
| | - Hacibe Hallal
- Servicio de Aparato Digestivo, Hospital Morales Meseguer, Murcia, Spain
| | - Francisco J Cubero
- Department of Immunology, Complutense University School of Medicine, Madrid, Spain; Hospital 12 de Octubre Health Research Institute (i+12), Madrid, Spain
| | - M Isabel Lucena
- Unidad de Gestión Clínica de Aparato Digestivo, Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga-Instituto de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas, Málaga, Spain; Unidad de Investigación Clínica y Ensayos Clínicos Instituto de Investigación Biomédica de Málaga, Plataforma Spanish Clinical Research Network, Servicio de Farmacología Clínica, Hospital Universitario Virgen de la Victoria, Málaga, Spain.
| | - Camilla Stephens
- Unidad de Gestión Clínica de Aparato Digestivo, Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga-Instituto de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas, Málaga, Spain
| | - Raúl J Andrade
- Unidad de Gestión Clínica de Aparato Digestivo, Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga-Instituto de Investigación Biomédica de Málaga, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas, Málaga, Spain
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26
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Debes JD, Chan AJ, Balderramo D, Kikuchi L, Gonzalez Ballerga E, Prieto JE, Tapias M, Idrovo V, Davalos MB, Cairo F, Barreyro FJ, Paredes S, Hernandez N, Avendaño K, Diaz Ferrer J, Yang JD, Carrera E, Garcia JA, Mattos AZ, Hirsch BS, Gonçalves PT, Carrilho FJ, Roberts LR. Hepatocellular carcinoma in South America: Evaluation of risk factors, demographics and therapy. Liver Int 2018. [PMID: 28640517 DOI: 10.1111/liv.13502] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related death worldwide. Most studies addressing the epidemiology of HCC originate from developed countries. This study reports the preliminary findings of a multinational approach to characterize HCC in South America. METHODS We evaluated 1336 HCC patients seen at 14 centres in six South American countries using a retrospective study design with participating centres completing a template chart of patient characteristics. The diagnosis of HCC was made radiographically or histologically for all cases according to institutional standards. Methodology of surveillance for each centre was following AASLD or EASL recommendations. RESULTS Sixty-eight percent of individuals were male with a median age of 64 years at time of diagnosis. The most common risk factor for HCC was hepatitis C infection (HCV, 48%), followed by alcoholic cirrhosis (22%), Hepatitis B infection (HBV, 14%) and NAFLD (9%). We found that among individuals with HBV-related HCC, 38% were diagnosed before age 50. The most commonly provided therapy was transarterial chemoembolization (35% of HCCs) with few individuals being considered for liver transplant (<20%). Only 47% of HCCs were diagnosed during surveillance, and there was no difference in age of diagnosis between those diagnosed incidentally vs by surveillance. Nonetheless, being diagnosed during surveillance was associated with improved overall survival (P = .01). CONCLUSIONS Our study represents the largest cohort to date reporting characteristics and outcomes of HCC across South America. We found an important number of HCCs diagnosed outside of surveillance programmes, with associated increased mortality in those patients.
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Affiliation(s)
- Jose D Debes
- Department of Medicine, University of Minnesota, Hennepin County Medical Center, Minneapolis, MN, USA
| | - Aaron J Chan
- Department of Medicine, University of Minnesota, Hennepin County Medical Center, Minneapolis, MN, USA
| | - Domingo Balderramo
- Departamento de Gastroenterologia, Hospital Privado Universitario de Córdoba, Instituto Universitario de Ciencias Biomédicas de Córdoba, Córdoba, Argentina
| | - Luciana Kikuchi
- Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil
| | | | - Jhon E Prieto
- Department of Gastroenterology, Organización Sanitas Colombia, Centro de enfermedades hepáticas y digestivas (CEHYD), Bogota, Colombia
| | - Monica Tapias
- Department of Gastroenterology, Hospital Universitario Fundación Santa Fe y Organizacion Sánitas, Bogotá, Colombia
| | - Victor Idrovo
- Department of Gastroenterology, Hospital Universitario Fundación Santa Fe y Organizacion Sánitas, Bogotá, Colombia
| | - Milagros B Davalos
- Department of Gastroenterology, Hospital Nacional Edgardo Rebagliati Martins, HNERM, Lima, Peru
| | - Fernando Cairo
- Departamento de Gastroenterologia, Hospital El Cruce, Buenos Aires, Argentina
| | - Fernando J Barreyro
- Consejo Nacional de Investigaciones Científicas y Técnicas, Posadas, Argentina
| | - Sebastian Paredes
- Departamento de Gastroenterologia y Hepatologia, Hospital Presidente Peron, Formosa, Argentina
| | - Nelia Hernandez
- Departamento de Gastroenterologia y Hepatologia, Hospital de Clinicas (UdelaR), Montevideo, Uruguay
| | - Karla Avendaño
- Departamento de Gastroenterologia y Hepatologia, Hospital de Clinicas (UdelaR), Montevideo, Uruguay
| | - Javier Diaz Ferrer
- Department of Gastroenterology, Hospital Nacional Edgardo Rebagliati Martins, HNERM, Lima, Peru
| | - Ju Dong Yang
- Department of Gastroenterology, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Enrique Carrera
- Departamento de Gastroenterologia y Hepatologia, Hospital Eugenio Espejo, Quito, Ecuador
| | | | - Angelo Z Mattos
- Department of Gastroenterology, Hospital Nossa Senhora da Conceição-HNSC, Porto Alegre, Brazil
| | - Bruno S Hirsch
- Department of Gastroenterology, Hospital Nossa Senhora da Conceição-HNSC, Porto Alegre, Brazil
| | - Pablo T Gonçalves
- Department of Gastroenterology, Hospital Nossa Senhora da Conceição-HNSC, Porto Alegre, Brazil
| | - Flair J Carrilho
- Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Lewis R Roberts
- Department of Gastroenterology, Mayo Clinic College of Medicine, Rochester, MN, USA
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Novoa NM, Esteban P, Hernandez N, Hernández MTG, Varela G. F-078RANDOMIZED TRIAL TO EVALUATE THE BENEFICIAL EFFECTS OF AN UNSUPERVISED POSTOPERATIVE PHYSICAL TRAINING PROTOCOL AFTER LUNG RESECTION: NEGATIVE RESULTS. Interact Cardiovasc Thorac Surg 2017. [DOI: 10.1093/icvts/ivx280.090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Chan AJ, Balderramo D, Kikuchi L, Ballerga EG, Prieto JE, Tapias M, Idrovo V, Davalos MB, Cairo F, Barreyro FJ, Paredes S, Hernandez N, Avendaño K, Ferrer JD, Yang JD, Carrera E, Mattos AZ, Hirsch BS, Gonçalves PT, Carrilho FJ, Roberts LR, Debes JD. Early Age Hepatocellular Carcinoma Associated With Hepatitis B Infection in South America. Clin Gastroenterol Hepatol 2017; 15:1631-1632. [PMID: 28532694 DOI: 10.1016/j.cgh.2017.05.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 04/30/2017] [Accepted: 05/13/2017] [Indexed: 02/07/2023]
Affiliation(s)
- Aaron J Chan
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Domingo Balderramo
- Departamento de Gastroenterologia, Hospital Privado Universitario de Córdoba, Instituto Universitario de Ciencias Biomédicas de Córdoba, Córdoba, Argentina
| | - Luciana Kikuchi
- University of São Paulo School of Medicine, São Paulo, Brazil
| | | | - Jhon E Prieto
- Organización Sanitas Colombia, Centro de Enfermedades Hepáticas y Digestivas, Bogota, Colombia
| | - Monica Tapias
- Hospital Universitario Fundación Santa Fe y Organizacion Sánitas, Bogotá, Colombia
| | - Victor Idrovo
- Hospital Universitario Fundación Santa Fe y Organizacion Sánitas, Bogotá, Colombia
| | | | - Fernando Cairo
- Unidad de Hepatologia, Hospital El Cruce, Buenos Aires, Argentina
| | - Fernando J Barreyro
- Consejo Nacional de Investigaciones Científicas y Técnicas, Posadas, Argentina
| | - Sebastian Paredes
- Departmento de Gatroenterologia, Hospital Presidente Peron, Formosa, Argentina
| | - Nelia Hernandez
- Hospital de Clinicas (Universidad de la Republica), Montevideo, Uruguay
| | - Karla Avendaño
- Hospital de Clinicas (Universidad de la Republica), Montevideo, Uruguay
| | | | - Ju Dong Yang
- Department of Gastroenterology, Hospital Nossa Senhora da Conceição-Hospital Nossa Senhora da Conceição (HNSC), Porto Alegre, Brazil
| | - Enrique Carrera
- Department of Gastroenterology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Angelo Z Mattos
- Department of Gastroenterology, Hospital Nossa Senhora da Conceição-HNSC, Porto Alegre, Brazil
| | - Bruno S Hirsch
- Department of Gastroenterology, Hospital Nossa Senhora da Conceição-HNSC, Porto Alegre, Brazil
| | - Pablo T Gonçalves
- Department of Gastroenterology, Hospital Nossa Senhora da Conceição-HNSC, Porto Alegre, Brazil
| | | | - Lewis R Roberts
- Department of Gastroenterology, Hospital Nossa Senhora da Conceição-Hospital Nossa Senhora da Conceição (HNSC), Porto Alegre, Brazil
| | - Jose D Debes
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
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Saavedra J, Hernandez N, Osses A, Castillo A, Cancino A, Grothusen H, Navas E, Henriquez P, Bohle H, Bustamante F, Bustos P, Mancilla M. Prevalence, geographic distribution and phenotypic differences of Piscirickettsia salmonis EM-90-like isolates. J Fish Dis 2017. [PMID: 28075013 DOI: 10.1016/s0044-8486(00)00315-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Early reports accounted for two main genotypes of Piscirickettsia salmonis, a fish pathogen and causative agent of piscirickettsiosis, placing the single isolate EM-90 apart from the prototypic LF-89 and related isolates. In this study, we provide evidence that, contrary to what has been supposed, the EM-90-like isolates are highly prevalent and disseminated across Chilean marine farms. Molecular analysis of 507 P. salmonis field isolates derived from main rearing areas, diverse hosts and collected over 6 years, revealed that nearly 50% of the entire collection were indeed typed as EM-90-like. Interestingly, these isolates showed a marked host preference, being recovered exclusively from Atlantic salmon (Salmo salar) samples. Although both strains produce undistinguishable pathological outcomes, differences regarding growth kinetics and susceptibility to the antibiotics and bactericidal action of serum could be identified. In sum, our results allow to conclude that the EM-90-like isolates represent an epidemiologically relevant group in the current situation of piscirickettsiosis. Based on the consistency between genotype and phenotype exhibited by this strain, we point out the need for genotypic studies that may be as important for the Chilean salmon industry as the continuous surveillance of antimicrobial susceptibility patterns.
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Affiliation(s)
- J Saavedra
- Laboratorio de Diagnóstico y Biotecnología, ADL Diagnostic Chile Ltda, Puerto Montt, Chile
| | - N Hernandez
- Laboratorio de Diagnóstico y Biotecnología, ADL Diagnostic Chile Ltda, Puerto Montt, Chile
| | - A Osses
- Laboratorio de Diagnóstico y Biotecnología, ADL Diagnostic Chile Ltda, Puerto Montt, Chile
| | - A Castillo
- Laboratorio de Diagnóstico y Biotecnología, ADL Diagnostic Chile Ltda, Puerto Montt, Chile
| | - A Cancino
- Laboratorio de Diagnóstico y Biotecnología, ADL Diagnostic Chile Ltda, Puerto Montt, Chile
| | - H Grothusen
- Laboratorio de Diagnóstico y Biotecnología, ADL Diagnostic Chile Ltda, Puerto Montt, Chile
| | - E Navas
- Laboratorio de Diagnóstico y Biotecnología, ADL Diagnostic Chile Ltda, Puerto Montt, Chile
| | - P Henriquez
- Laboratorio de Diagnóstico y Biotecnología, ADL Diagnostic Chile Ltda, Puerto Montt, Chile
| | - H Bohle
- Laboratorio de Diagnóstico y Biotecnología, ADL Diagnostic Chile Ltda, Puerto Montt, Chile
| | - F Bustamante
- Laboratorio de Diagnóstico y Biotecnología, ADL Diagnostic Chile Ltda, Puerto Montt, Chile
| | - P Bustos
- Laboratorio de Diagnóstico y Biotecnología, ADL Diagnostic Chile Ltda, Puerto Montt, Chile
| | - M Mancilla
- Laboratorio de Diagnóstico y Biotecnología, ADL Diagnostic Chile Ltda, Puerto Montt, Chile
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30
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Saavedra J, Hernandez N, Osses A, Castillo A, Cancino A, Grothusen H, Navas E, Henriquez P, Bohle H, Bustamante F, Bustos P, Mancilla M. Prevalence, geographic distribution and phenotypic differences of Piscirickettsia salmonis EM-90-like isolates. J Fish Dis 2017; 40:1055-1063. [PMID: 28075013 DOI: 10.1111/jfd.12581] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 10/12/2016] [Accepted: 10/13/2016] [Indexed: 06/06/2023]
Abstract
Early reports accounted for two main genotypes of Piscirickettsia salmonis, a fish pathogen and causative agent of piscirickettsiosis, placing the single isolate EM-90 apart from the prototypic LF-89 and related isolates. In this study, we provide evidence that, contrary to what has been supposed, the EM-90-like isolates are highly prevalent and disseminated across Chilean marine farms. Molecular analysis of 507 P. salmonis field isolates derived from main rearing areas, diverse hosts and collected over 6 years, revealed that nearly 50% of the entire collection were indeed typed as EM-90-like. Interestingly, these isolates showed a marked host preference, being recovered exclusively from Atlantic salmon (Salmo salar) samples. Although both strains produce undistinguishable pathological outcomes, differences regarding growth kinetics and susceptibility to the antibiotics and bactericidal action of serum could be identified. In sum, our results allow to conclude that the EM-90-like isolates represent an epidemiologically relevant group in the current situation of piscirickettsiosis. Based on the consistency between genotype and phenotype exhibited by this strain, we point out the need for genotypic studies that may be as important for the Chilean salmon industry as the continuous surveillance of antimicrobial susceptibility patterns.
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Affiliation(s)
- J Saavedra
- Laboratorio de Diagnóstico y Biotecnología, ADL Diagnostic Chile Ltda, Puerto Montt, Chile
| | - N Hernandez
- Laboratorio de Diagnóstico y Biotecnología, ADL Diagnostic Chile Ltda, Puerto Montt, Chile
| | - A Osses
- Laboratorio de Diagnóstico y Biotecnología, ADL Diagnostic Chile Ltda, Puerto Montt, Chile
| | - A Castillo
- Laboratorio de Diagnóstico y Biotecnología, ADL Diagnostic Chile Ltda, Puerto Montt, Chile
| | - A Cancino
- Laboratorio de Diagnóstico y Biotecnología, ADL Diagnostic Chile Ltda, Puerto Montt, Chile
| | - H Grothusen
- Laboratorio de Diagnóstico y Biotecnología, ADL Diagnostic Chile Ltda, Puerto Montt, Chile
| | - E Navas
- Laboratorio de Diagnóstico y Biotecnología, ADL Diagnostic Chile Ltda, Puerto Montt, Chile
| | - P Henriquez
- Laboratorio de Diagnóstico y Biotecnología, ADL Diagnostic Chile Ltda, Puerto Montt, Chile
| | - H Bohle
- Laboratorio de Diagnóstico y Biotecnología, ADL Diagnostic Chile Ltda, Puerto Montt, Chile
| | - F Bustamante
- Laboratorio de Diagnóstico y Biotecnología, ADL Diagnostic Chile Ltda, Puerto Montt, Chile
| | - P Bustos
- Laboratorio de Diagnóstico y Biotecnología, ADL Diagnostic Chile Ltda, Puerto Montt, Chile
| | - M Mancilla
- Laboratorio de Diagnóstico y Biotecnología, ADL Diagnostic Chile Ltda, Puerto Montt, Chile
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Bessone F, Hernandez N, Roma MG, Ridruejo E, Mendizabal M, Medina-Cáliz I, Robles-Díaz M, Lucena MI, Andrade RJ. Hepatotoxicity induced by coxibs: how concerned should we be? Expert Opin Drug Saf 2016; 15:1463-1475. [PMID: 27537326 DOI: 10.1080/14740338.2016.1225719] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Fernando Bessone
- Hospital Provincial del Centenario, University of Rosario School of Medicine, Gastroenterology & Hepatology Department, Rosario, Argentina
| | - Nelia Hernandez
- Hospital de Clínicas, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Marcelo Gabriel Roma
- Instituto de Fisiología Experimental (CONICET-UNR), Facultad de Ciencias Bioquímicas y Farmaceúticas, Universidad de Rosario, Rosario, Argentina
| | - Ezequiel Ridruejo
- Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno ‘CEMIC’, Medicine Department, Hepatology Section, Ciudad Autónoma de Buenos Aires, Argentina
| | - Manuel Mendizabal
- Hospital Universitario Austral, Herpatology & Liver Transplant Unit, Buenos Aires, Argentina
| | - Inmaculada Medina-Cáliz
- UGC de Ap Digestivo y Farmacología Clínica, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga, CIBERehd, Málaga, Spain
| | - Mercedes Robles-Díaz
- UGC de Ap Digestivo y Farmacología Clínica, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga, CIBERehd, Málaga, Spain
| | - M. Isabel Lucena
- UGC de Ap Digestivo y Farmacología Clínica, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga, CIBERehd, Málaga, Spain
| | - Raúl J. Andrade
- UGC de Ap Digestivo y Farmacología Clínica, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga, CIBERehd, Málaga, Spain
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Mehrens H, Lewis B, Lujano C, Nguyen T, Hernandez N, Alvarez P, Molineu A, Followill D. SU-F-T-292: Imaging and Radiation Oncology Core (IROC) Houston QA Center's Anthropomorphic Phantom Program. Med Phys 2016. [DOI: 10.1118/1.4956477] [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: 11/07/2022] Open
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33
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Molineu A, Kry S, Alvarez P, Hernandez N, Nguyen T, Followill D. SU-G-TeP2-12: IROCHouston and MDAPL SRS Anthropomorphic Phantom Results. Med Phys 2016. [DOI: 10.1118/1.4957047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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34
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Followill D, Kry S, Molineu A, Lowenstein J, Alvarez P, Taylor P, Nguyen H, Hernandez N, Nguyen T, Lujano C, Keith T. EP-1916: The IROC Houston QA Center’s international activities outside North America. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)33167-x] [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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35
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Bessone F, Hernandez N, Lucena MI, Andrade RJ. The Latin American DILI Registry Experience: A Successful Ongoing Collaborative Strategic Initiative. Int J Mol Sci 2016; 17:313. [PMID: 26938524 PMCID: PMC4813176 DOI: 10.3390/ijms17030313] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 02/17/2016] [Accepted: 02/19/2016] [Indexed: 02/07/2023] Open
Abstract
Drug induced liver injury (DILI) is a rare but well recognized serious adverse reaction. Pre-marketing studies may not detect liver injury, and DILI becomes very often apparent after the drug is launched to the market. Specific biomarkers for DILI prediction or diagnosis are not available. Toxic liver reactions present with a wide spectrum of phenotypes and severity, and our knowledge on the mechanisms underlying idiosyncratic reactions and individual susceptibility is still limited. To overcome these limitations, country-based registries and multicenter research networks have been created in Europe and North America. Reliable epidemiological data on DILI in Latin America (LA), a region with a large variety of ethnic groups, were however lacking. Fortunately, a LA network of DILI was set up in 2011, with the support of the Spanish DILI Registry from the University of Malaga. The primary aim of the Latin DILI Network (LATINDILIN) Registry was to prospectively identify bona fide DILI cases and to collect biological samples to study genetic biomarkers. Physicians involved in the project must complete a structured report form describing the DILI case presentation and follow-up which is submitted to a Coordinator Center in each country, where it is further assessed for completeness. During the last four years, several LA countries (Argentina, Uruguay, Chile, Mexico, Paraguay, Brazil, Ecuador, Peru, Venezuela and Colombia) have joined the network and committed with this project. At that point, to identify both our strengths and weaknesses was a very important issue. In this review, we will describe how the LATINDILI Registry was created. The aims and methods to achieve these objectives will be discussed in depth. Additionally, both the difficulties we have faced and the strategies to solve them will be also pinpointed. Finally, we will report on our preliminary results, and discuss ideas to expand and to keep running this network.
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Affiliation(s)
- Fernando Bessone
- Hospital Provincial del Centenario, University of Rosario School of Medicine, Urquiza 3101, 2000 Rosario, Argentina.
| | - Nelia Hernandez
- Hospital de Clínicas, Facultad de Medicina, UdelaR, Av Italia s/n, 11600 Montevideo, Uruguay.
| | - M Isabel Lucena
- Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga, CIBERehd, Blvd. L Pasteur 32, 29071 Málaga, Spain.
| | - Raúl J Andrade
- Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga, CIBERehd, Blvd. L Pasteur 32, 29071 Málaga, Spain.
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Kappa S, Marien T, Hernandez N, Eisner B, Miller N. Prevention of infectious complications of percutaneous nephrolithotomy. MINERVA UROL NEFROL 2015; 67:317-323. [PMID: 26364571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Infection and sepsis is a complication of percutaneous nephrolithotomy that can lead to morbidity, mortality, and increased costs. Herein we review the current relevant literature on the topic of prevention of sepsis after percutaneous nephrolithotomy.
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Affiliation(s)
- S Kappa
- Department of Urology, Vanderbilt Medical Center, Nashville, TN, USA -
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37
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Molineu A, Hernandez N, Alvarez P, Followill D. TU-G-BRD-05: Results From Multi-Institutional Measurements with An Anthropomorphic Spine Phantom. Med Phys 2015. [DOI: 10.1118/1.4925740] [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: 11/07/2022] Open
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38
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Lujano C, Hernandez N, Keith T, Nguyen T, Taylor P, Molineu A, Followill D. MO-F-CAMPUS-T-01: IROC Houston QA Center's Anthropomorphic Proton Phantom Program. Med Phys 2015. [DOI: 10.1118/1.4925476] [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: 11/07/2022] Open
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39
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Followill D, Kry S, Molineu A, Lowenstein J, Alvarez P, Taylor P, Nguyen H, Hernandez N, Lujano C, Nguyen T, Keith T, Roll J, Tailor A. TU-G-BRD-06: The Imaging and Radiation Oncology Core Houston (IROC Houston) QA Center International Activities Outside North America. Med Phys 2015. [DOI: 10.1118/1.4925741] [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: 11/07/2022] Open
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40
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Louis ED, Hernandez N, Michalec M. Prevalence and correlates of rest tremor in essential tremor: cross-sectional survey of 831 patients across four distinct cohorts. Eur J Neurol 2015; 22:927-32. [PMID: 25786561 DOI: 10.1111/ene.12683] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [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: 09/30/2014] [Accepted: 12/23/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Essential tremor (ET) is amongst the most commonly encountered neurological disorders. Its hallmark feature is kinetic tremor. However, other tremors may also occur in ET patients, creating considerable diagnostic confusion amongst treating physicians. Hence, characterizing the prevalence and clinical accompaniments of these other tremors is of value. Surprisingly, there are few data on the prevalence of rest tremor in ET patients, and even fewer data on the clinical correlates of such tremor. METHODS Eight hundred and thirty-one patients in four distinct settings (population, genetics study, study of environmental epidemiology, brain bank) underwent a detailed videotaped neurological examination that was reviewed by a senior movement disorders neurologist. Rest tremor was evaluated in several positions (seated, standing, lying down). RESULTS The prevalence of rest tremor whilst seated or standing was lowest in the population-based setting (1.9%), highest in the brain bank study (46.4%) and intermediate in the remaining two settings (9.6% and 14.7%, respectively). Rest tremor was restricted to the arms and was not observed in the legs. Rest tremor was associated with older age, longer disease duration (in some studies), greater tremor severity and, to some extent, the presence of cranial tremors. CONCLUSIONS Rest tremor can be a common clinical feature of ET. Its prevalence is highly dependent on the setting in which patients are evaluated, ranging from as low as 1% to nearly 50%. Rest tremor seems to emerge as a clinical feature with advancing disease. The anatomical substrates for this type of tremor remain unknown at present.
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Affiliation(s)
- E D Louis
- GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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41
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Perez D, Perez L, Mahgoub H, Hernandez N. Subjective and Functional Outcomes Following TMJ Reconstruction with Custom-made Total Joint Prostheses. J Oral Maxillofac Surg 2014. [DOI: 10.1016/j.joms.2014.06.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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42
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Méndez-Sánchez N, Paraná R, Cheinquer H, Alves de Mattos A, Gadano A, Silva M, Pessôa MG, Gomes-Ferraz ML, Soza A, Mendes-Correa MC, Chávez-Tapia NC, Dagher L, Padilla M, Hernandez N, Sánchez-Avila JF, Contreras F, Moraes-Coelho HS, Parise ER, Bessone F, Uribe M. Latin American Association for the Study of the Liver recommendations on treatment of hepatitis C. Ann Hepatol 2014; 13 Suppl 2:s4-66. [PMID: 25185535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
| | - Raymundo Paraná
- School of Medicine, Federal University of Bahia, Gastro-Hepatologist Unit, University Bahia University Hospital, Bahia, Brazil
| | - Hugo Cheinquer
- Gastroenterology and Hepatology, Universidade Federal do Rio Grande do Sul, Fundação Universidade Federal de Ciências da Saude de Porto Alegre, Brazil
| | | | - Adrian Gadano
- Liver Unit, Hospital Italiano, Buenos Aires, Buenos Aires, Argentina
| | - Marcelo Silva
- Hepatology and Liver Transplant Unit Austral University Hospital Buenos Aires, Argentina
| | - Mario G Pessôa
- Department of Gastroenterology. University of São Paulo School of Medicine. São Paulo, Brazil
| | | | - Alejandro Soza
- Department of Gastroenterology, Centro de Investigación Clínica UC (CICUC), School of Medicine, Pontificia Universidad Católica de Chile. Santiago, Chile
| | - M Cassia Mendes-Correa
- São Paulo University Medical School, Department of Infectious and Parasitic Diseases, Brazil
| | | | | | - Martín Padilla
- Liver Transplant Service, Guillermo Almenara National Hospital, Lima, Peru
| | | | - Juan F Sánchez-Avila
- Hepatology and Liver Transplantation Department, National Institute of Nutrition and Medical Sciences "Salvador Zubiran", Mexico City, Mexico
| | | | | | - Edison R Parise
- School of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Fernando Bessone
- Gastroenterology, University of Rosario School of Medicine, Rosario, Argentina
| | - Misael Uribe
- Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico
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Robles-Diaz M, Lucena MI, Kaplowitz N, Stephens C, Medina-Cáliz I, González-Jimenez A, Ulzurrun E, Gonzalez AF, Fernandez MC, Romero-Gómez M, Jimenez-Perez M, Bruguera M, Prieto M, Bessone F, Hernandez N, Arrese M, Andrade RJ. Use of Hy's law and a new composite algorithm to predict acute liver failure in patients with drug-induced liver injury. Gastroenterology 2014; 147:109-118.e5. [PMID: 24704526 DOI: 10.1053/j.gastro.2014.03.050] [Citation(s) in RCA: 210] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 03/20/2014] [Accepted: 03/22/2014] [Indexed: 12/21/2022]
Abstract
BACKGROUND & AIMS Hy's Law, which states that hepatocellular drug-induced liver injury (DILI) with jaundice indicates a serious reaction, is used widely to determine risk for acute liver failure (ALF). We aimed to optimize the definition of Hy's Law and to develop a model for predicting ALF in patients with DILI. METHODS We collected data from 771 patients with DILI (805 episodes) from the Spanish DILI registry, from April 1994 through August 2012. We analyzed data collected at DILI recognition and at the time of peak levels of alanine aminotransferase (ALT) and total bilirubin (TBL). RESULTS Of the 771 patients with DILI, 32 developed ALF. Hepatocellular injury, female sex, high levels of TBL, and a high ratio of aspartate aminotransferase (AST):ALT were independent risk factors for ALF. We compared 3 ways to use Hy's Law to predict which patients would develop ALF; all included TBL greater than 2-fold the upper limit of normal (×ULN) and either ALT level greater than 3 × ULN, a ratio (R) value (ALT × ULN/alkaline phosphatase × ULN) of 5 or greater, or a new ratio (nR) value (ALT or AST, whichever produced the highest ×ULN/ alkaline phosphatase × ULN value) of 5 or greater. At recognition of DILI, the R- and nR-based models identified patients who developed ALF with 67% and 63% specificity, respectively, whereas use of only ALT level identified them with 44% specificity. However, the level of ALT and the nR model each identified patients who developed ALF with 90% sensitivity, whereas the R criteria identified them with 83% sensitivity. An equal number of patients who did and did not develop ALF had alkaline phosphatase levels greater than 2 × ULN. An algorithm based on AST level greater than 17.3 × ULN, TBL greater than 6.6 × ULN, and AST:ALT greater than 1.5 identified patients who developed ALF with 82% specificity and 80% sensitivity. CONCLUSIONS When applied at DILI recognition, the nR criteria for Hy's Law provides the best balance of sensitivity and specificity whereas our new composite algorithm provides additional specificity in predicting the ultimate development of ALF.
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Affiliation(s)
- Mercedes Robles-Diaz
- Unidad de Gestión Clínica de Enfermedades Digestivas, Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain
| | - M Isabel Lucena
- Unidad de Gestión Clínica de Enfermedades Digestivas, Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain.
| | - Neil Kaplowitz
- University of Southern California Research Center for Liver Diseases, Keck School of Medicine, Los Angeles, California
| | - Camilla Stephens
- Unidad de Gestión Clínica de Enfermedades Digestivas, Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain
| | - Inmaculada Medina-Cáliz
- Unidad de Gestión Clínica de Enfermedades Digestivas, Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain
| | - Andres González-Jimenez
- Unidad de Gestión Clínica de Enfermedades Digestivas, Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain
| | - Eugenia Ulzurrun
- Unidad de Gestión Clínica de Enfermedades Digestivas, Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain
| | - Ana F Gonzalez
- Unidad de Gestión Clínica de Enfermedades Digestivas, Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain
| | | | - Manuel Romero-Gómez
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain; Unidad de Gestión Clínica de Enfermedades Digestivas, Hospital Universitario de Valme, Sevilla, Spain
| | - Miguel Jimenez-Perez
- Unidad de Gestión Clínica de Enfermedades Digestivas, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Regional Universitario Carlos Haya, Málaga, Spain
| | - Miguel Bruguera
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain; Instituto de Enfermedades Digestivas y Metabolismo, Hospital Clinic, Barcelona, Spain
| | - Martín Prieto
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain; Unidad de Gestión Clínica de Enfermedades Digestivas, Hospital La Fe, Valencia, Spain
| | - Fernando Bessone
- Facultad de Ciencias Médicas, Servicio de Gastroenterología y Hepatología, Hospital Provincial del Centenario, Universidad Nacional de Rosario, Rosario, Argentina
| | - Nelia Hernandez
- Hospital de Clínicas, Clínica de Gastroenterología, Facultad de Medicina, Universidad de la Republica, Montevideo, Uruguay
| | - Marco Arrese
- Departamento de Gastroenterología, Facultad de Medicina Pontificia, Universidad Católica de Chile, Santiago, Chile
| | - Raúl J Andrade
- Unidad de Gestión Clínica de Enfermedades Digestivas, Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga (IBIMA), Hospital Universitario Virgen de la Victoria, Universidad de Málaga, Málaga, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain
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Clark LN, Liu X, Parmalee NL, Hernandez N, Louis ED. The microtubule associated protein tau H1 haplotype and risk of essential tremor. Eur J Neurol 2013; 21:1044-8. [PMID: 24372973 DOI: 10.1111/ene.12335] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 11/18/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE Two recent studies investigated the association of the microtubule associated protein tau (MAPT) H1 haplotype, a known risk factor for neurodegenerative disease including progressive supranuclear palsy and Parkinson's disease (PD), with essential tremor (ET). METHODS To confirm this association in a different population the distribution of allele and genotype frequencies for the MAPT H1/H2 tagging single-nucleotide polymorphism (SNP) rs1052553 in ET cases and controls enrolled in a clinical-epidemiological study of ET at Columbia University was analyzed. RESULTS Overall, no association was observed between ET and the MAPT H1 haplotype. The analysis was also restricted to clinical subtypes including early-onset (≤40 years of age), Ashkenazi Jewish ancestry, white non-Ashkenazi, or ET cases with a 'definite' or 'probable/possible' diagnosis; none of these stratified analyses showed evidence of association with ET. A meta-analysis of the H1/H2 tagging SNP rs1052553 in published data sets and the H1 haplotype with risk for ET in the current study was also performed and did not find evidence for association. CONCLUSIONS The inconsistent reports of association of MAPT H1 in three emerging studies (our own and two published studies) may reflect sampling issues and/or clinical heterogeneity in these populations.
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Affiliation(s)
- L N Clark
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA; Department of Pathology and Cell Biology, Columbia University, New York, NY, USA; Center for Human Genetics, Columbia University, New York, NY, USA
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Hernandez N, Andersson F, Edjlali M, Hommet C, Cottier JP, Destrieux C, Bonnet-Brilhault F. Cerebral functional asymmetry and phonological performance in dyslexic adults. Psychophysiology 2013; 50:1226-38. [PMID: 24117474 DOI: 10.1111/psyp.12141] [Citation(s) in RCA: 10] [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] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Accepted: 07/23/2013] [Indexed: 11/27/2022]
Abstract
Developmental dyslexia is a frequent language-based learning disorder characterized by difficulty in reading. The predominant etiologic view postulates that reading impairment is related to phonological and orthographic dysfunction. The aim of this fMRI study was to evaluate the neural bases of phonological processing impairment in remediated dyslexic adults (DD). We used a rhyming words judgment task contrasted with an unreadable fonts font-matching judgment task to compare patterns of activation and functional asymmetry in DD and normal-reading young adults. We found evidence of a link between asymmetry in inferior frontal gyrus and performance during the phonological processing. We also observed that DD recruit a network including regions involved in articulatory control in order to achieve rhyme judgment suggesting that, due to a lack of hemispheric specialization, DD recruit the latter network to achieve rhyme judgment.
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Affiliation(s)
- N Hernandez
- U930 INSERM, Tours, France; Team 1 Autism-UMR930 Imaging, Brain University François-Rabelais of Tours, Tours, France
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Roché L, Hernandez N, Blanc R, Bonnet-Brilhault F, Centelles L, Schmitz C, Martineau J. Discrimination between biological motion with and without social intention: a pilot study using visual scanning in healthy adults. Int J Psychophysiol 2013; 88:47-54. [PMID: 23376597 DOI: 10.1016/j.ijpsycho.2013.01.009] [Citation(s) in RCA: 4] [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] [Received: 08/18/2012] [Revised: 01/07/2013] [Accepted: 01/21/2013] [Indexed: 11/28/2022]
Abstract
Human beings have a detailed understanding of others' action and body language allowing them to adapt their behaviour for effective social interaction. A proper selection of human motion deserving a social intention over the many human motion surrounding them may be executed by overt visual-spatial attention. The aim of this study was to characterize eye movements in 32 healthy adults while exploring Social and Non-social human biological motion using an eye tracking method according to two paradigms. The "preferential looking paradigm" revealed that the first fixation is more often on the Non-social Motion than Social Motion but the first fixations duration are longer on Social Motion. Moreover, with the same paradigm, subjects spent a greater looking time percentage on Social Motion than Non-social Motion, no matter whether discrimination between categories was asked for or not. In the "blocks paradigm" the looking time percentage varied by the body parts (chests, pelvis and legs) and its distribution was different between categories. Eye movements revealed a spontaneous, fast and durable bias of overt visual-spatial attention favouring the perception of Social Motion and a different visual scanpath for Social compared to Non-social human biological motion. These findings constitute a basis for the investigation of a 'social intention' bias in perception of human biological motion.
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Affiliation(s)
- L Roché
- Laboratoire Imagerie et Cerveau, U930, Institut National de la Santé et de la Recherche Médicale, Tours, France.
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Mobily M, Tang A, Branco B, Hernandez N, Friese R, Joseph B, Catalano R, Frantz N, Judkins D, Green D, Gries L, Kulvatunyou N, O'Keeffe T, Wynne J, Rhee P. Advanced Trauma Life Support Participant Course: A Critical Review. J Surg Res 2013. [DOI: 10.1016/j.jss.2012.10.869] [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: 10/27/2022]
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Martineau J, Hernandez N, Roché L, Bonnet-Brilhault F. Pupil size and pupil reactivity to faces in children with autism spectrum disorders. Int J Psychophysiol 2012. [DOI: 10.1016/j.ijpsycho.2012.06.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Amador C, Hernandez N, Molineu A, Alvarez P, Followill D. SU-E-T-180: The Radiological Physics Center's Anthropomorphic Quality Assurance Phantom Program. Med Phys 2012; 39:3744. [PMID: 28517794 DOI: 10.1118/1.4735239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To describe the phantoms, program logistics and current results for the Radiological Physics Center's (RPC) anthropomorphic QA phantom program for credentialing institutions for participation in NCI-sponsored advanced technology clinical trials. METHODS The RPC has developed an extensive phantom credentialing program consisting of four different phantoms designs: H&N, pelvis, lung and spine. These QA phantoms are water-filled plastic shells with imageable targets, avoidance structures, and heterogeneities that contain TLD and radiochromic film dosimeters. Institutions wishing to be credentialed request a phantom and are prioritized for delivery. At the institution, the phantom is imaged, a treatment plan is developed, the phantom is positioned on the treatment couch and the treatment is delivered. The phantom is returned and the measured dose distributions are compared to the institution's electronically submitted treatment plan dosimetry data. RESULTS The RPC currently has an inventory of 31 H&N, 10 pelvis, 9 lung, and 8 spine phantoms that are mailed to institutions nationally and internationally. In 2011, 444 of these phantoms were mailed out for credentialing. Once the phantom is sent, it takes the institution an average of 26 days to return it to the RPC. On average the dosimeters are analyzed within 17 days and the report is sent 21 days after receipt of the phantom data. In 2011 the percent of phantoms meeting the acceptance criteria increased by 12, 13 and 6 percentage points for the H&N, spine and lung phantoms, respectively. It fell by 5 percentage points for the pelvis phantom. CONCLUSIONS The RPC's QA phantom program has been an effective and responsive QA tool for assessing the use of advanced technologies in NCI sponsored clinical trials. The RPC has been efficient in its mailing of phantoms, and analyzing and reporting results. Work supported by PHS grant CA10953 and CA081647 (NCI, DHHS).
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Affiliation(s)
- C Amador
- UT MD Anderson Cancer Center, Houston, TX
| | | | - A Molineu
- UT MD Anderson Cancer Center, Houston, TX
| | - P Alvarez
- UT MD Anderson Cancer Center, Houston, TX
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Molineu A, Alvarez P, Hernandez N, Yin F, Followill D. TH-C-BRB-01: Credentialing Results from a Spine Anthropomorphic Phantom. Med Phys 2012. [DOI: 10.1118/1.4736304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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