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Pham T, Heunks L, Bellani G, Madotto F, Aragao I, Beduneau G, Goligher EC, Grasselli G, Laake JH, Mancebo J, Peñuelas O, Piquilloud L, Pesenti A, Wunsch H, van Haren F, Brochard L, Laffey JG, Acharya SP, Amin P, Arabi Y, Aragao I, Bauer P, Beduneau G, Beitler J, Berkius J, Bugedo G, Camporota L, Cerny V, Cho YJ, Clarkson K, Estenssoro E, Goligher E, Grasselli G, Gritsan A, Hashemian SM, Hermans G, Heunks LM, Jovanovic B, Kurahashi K, Laake JH, Matamis D, Moerer O, Molnar Z, Ozyilmaz E, Panka B, Papali A, Peñuelas Ó, Perbet S, Piquilloud L, Qiu H, Razek AA, Rittayamai N, Roldan R, Serpa Neto A, Szuldrzynski K, Talmor D, Tomescu D, Van Haren F, Villagomez A, Zeggwagh AA, Abe T, Aboshady A, Acampo-de Jong M, Acharya S, Adderley J, Adiguzel N, Agrawal VK, Aguilar G, Aguirre G, Aguirre-Bermeo H, Ahlström B, Akbas T, Akker M, Al Sadeh G, Alamri S, Algaba A, Ali M, Aliberti A, Allegue JM, Alvarez D, Amador J, Andersen FH, Ansari S, Apichatbutr Y, Apostolopoulou O, Arabi Y, Arellano D, Arica M, Arikan H, Arinaga K, Arnal JM, Asano K, Asín-Corrochano M, Avalos Cabrera JM, Avila Fuentes S, Aydemir S, Aygencel G, Azevedo L, Bacakoglu F, Badie J, Baedorf Kassis E, Bai G, Balaraj G, Ballico B, Banner-Goodspeed V, Banwarie P, Barbieri R, Baronia A, Barrett J, Barrot L, Barrueco-Francioni JE, Barry J, Bauer P, Bawangade H, Beavis S, Beck E, Beehre N, Belenguer Muncharaz A, Bellani G, Belliato M, Bellissima A, Beltramelli R, Ben Souissi A, Benitez-Cano A, Benlamin M, Benslama A, Bento L, Benvenuti D, Berkius J, Bernabe L, Bersten A, Berta G, Bertini P, Bertram-Ralph E, Besbes M, Bettini LR, Beuret P, Bewley J, Bezzi M, Bhakhtiani L, Bhandary R, Bhowmick K, Bihari S, Bissett B, Blythe D, Bocher S, Boedjawan N, Bojanowski CM, Boni E, Boraso S, Borelli M, Borello S, Borislavova M, Bosma KJ, Bottiroli M, Boyd O, Bozbay S, Briva A, Brochard L, Bruel C, Bruni A, Buehner U, Bugedo G, Bulpa P, Burt K, Buscot M, Buttera S, Cabrera J, Caccese R, Caironi P, Canchos Gutierrez I, Canedo N, Cani A, Cappellini I, Carazo J, Cardonnet LP, Carpio D, Carriedo D, Carrillo R, Carvalho J, Caser E, Castelli A, Castillo Quintero M, Castro H, Catorze N, Cengiz M, Cereijo E, Ceunen H, Chaintoutis C, Chang Y, Chaparro G, Chapman C, Chau S, Chavez CE, Chelazzi C, Chelly J, Chemouni F, Chen K, Chena A, Chiarandini P, Chilton P, Chiumello D, Cho YJ, Chou-Lie Y, Chudeau N, Cinel I, Cinnella G, Clark M, Clark T, Clarkson K, Clementi S, Coaguila L, Codecido AJ, Collins A, Colombo R, Conde J, Consales G, Cook T, Coppadoro A, Cornejo R, Cortegiani A, Coxo C, Cracchiolo AN, Crespo Ramirez M, Crova P, Cruz J, Cubattoli L, Çukurova Z, Curto F, Czempik P, D'Andrea R, da Silva Ramos F, Dangers L, Danguy des Déserts M, Danin PE, Dantas F, Daubin C, Dawei W, de Haro C, de Jesus Montelongo F, De Mendoza D, de Pablo R, De Pascale G, De Rosa S, Decavèle M, Declercq PL, Deicas A, del Carmen Campos Moreno M, Dellamonica J, Delmas B, Demirkiran O, Demirkiran H, Dendane T, di Mussi R, Diakaki C, Diaz A, Diaz W, Dikmen Y, Dimoula A, Doble P, Doha N, Domingos G, Dres M, Dries D, Duggal A, Duke G, Dunts P, Dybwik K, Dykyy M, Eckert P, Efe S, Elatrous S, Elay G, Elmaryul AS, Elsaadany M, Elsayed H, Elsayed S, Emery M, Ena S, Eng K, Englert JA, Erdogan E, Ergin Ozcan P, Eroglu E, Escobar M, Esen F, Esen Tekeli A, Esquivel A, Esquivel Gallegos H, Ezzouine H, Facchini A, Faheem M, Fanelli V, Farina MF, Fartoukh M, Fehrle L, Feng F, Feng Y, Fernandez I, Fernandez B, Fernandez-Rodriguez ML, Ferrando C, Ferreira da Silva MJ, Ferreruela M, Ferrier J, Flamm Zamorano MJ, Flood L, Floris L, Fluckiger M, Forteza C, Fortunato A, Frans E, Frattari A, Fredes S, Frenzel T, Fumagalli R, Furche MA, Fusari M, Fysh E, Galeas-Lopez JL, Galerneau LM, Garcia A, Garcia MF, Garcia E, Garcia Olivares P, Garlicki J, Garnero A, Garofalo E, Gautam P, Gazenkampf A, Gelinotte S, Gelormini D, Ghrenassia E, Giacomucci A, Giannoni R, Gigante A, Glober N, Gnesin P, Gollo Y, Gomaa D, Gomero Paredes R, Gomes R, Gomez RA, Gomez O, Gomez A, Gondim L, Gonzalez M, Gonzalez I, Gonzalez-Castro A, Gordillo Romero O, Gordo F, Gouin P, Graf Santos J, Grainne R, Grando M, Granov Grabovica S, Grasselli G, Grasso S, Grasso R, Grimmer L, Grissom C, Gritsan A, Gu Q, Guan XD, Guarracino F, Guasch N, Guatteri L, Gueret R, Guérin C, Guerot E, Guitard PG, Gül F, Gumus A, Gurjar M, Gutierrez P, Hachimi A, Hadzibegovic A, Hagan S, Hammel C, Han Song J, Hanlon G, Hashemian SM, Heines S, Henriksson J, Herbrecht JE, Heredia Orbegoso GO, Hermans G, Hermon A, Hernandez R, Hernandez C, Herrera L, Herrera-Gutierrez M, Heunks L, Hidalgo J, Hill D, Holmquist D, Homez M, Hongtao X, Hormis A, Horner D, Hornos MC, Hou M, House S, Housni B, Hugill K, Humphreys S, Humbert L, Hunter S, Hwa Young L, Iezzi N, Ilutovich S, Inal V, Innes R, Ioannides P, Iotti GA, Ippolito M, Irie H, Iriyama H, Itagaki T, Izura J, Izza S, Jabeen R, Jamaati H, Jamadarkhana S, Jamoussi A, Jankowski M, Jaramillo LA, Jeon K, Jeong Lee S, Jeswani D, Jha S, Jiang L, Jing C, Jochmans S, Johnstad BA, Jongmin L, Joret A, Jovanovic B, Junhasavasdikul D, Jurado MT, Kam E, Kamohara H, Kane C, Kara I, Karakurt S, Karnjanarachata C, Kataoka J, Katayama S, Kaushik S, Kelebek Girgin N, Kerr K, Kerslake I, Khairnar P, Khalid A, Khan A, Khanna AK, Khorasanee R, Kienhorst D, Kirakli C, Knafelj R, Kol MK, Kongpolprom N, Kopitko C, Korkmaz Ekren P, Kubisz-Pudelko A, Kulcsar Z, Kumasawa J, Kurahashi K, Kuriyama A, Kutchak F, Laake JH, Labarca E, Labat F, Laborda C, Laca Barrera MA, Lagache L, Landaverde Lopez A, Lanspa M, Lascari V, Le Meur M, Lee SH, Lee YJ, Lee J, Lee WY, Lee J, Legernaes T, Leiner T, Lemiale V, Leonor T, Lepper PM, Li D, Li H, Li O, Lima AR, Lind D, Litton E, Liu N, Liu L, Liu J, Llitjos JF, Llorente B, Lopez R, Lopez CE, Lopez Nava C, Lovazzano P, Lu M, Lucchese F, Lugano M, Lugo Goytia G, Luo H, Lynch C, Macheda S, Madrigal Robles VH, Maggiore SM, Magret Iglesias M, Malaga P, Mallapura Maheswarappa H, Malpartida G, Malyarchikov A, Mansson H, Manzano A, Marey I, Marin N, Marin MDC, Markman E, Martin F, Martin A, Martin Dal Gesso C, Martinez F, Martínez-Fidalgo C, Martin-Loeches I, Mas A, Masaaki S, Maseda E, Massa E, Mattsson A, Maugeri J, McCredie V, McCullough J, McGuinness S, McKown A, Medve L, Mei C, Mellado Artigas R, Mendes V, Mervat MKE, Michaux I, Mikhaeil M, Milagros O, Milet I, Millan MT, Minwei Z, Mirabella L, Mishra S, Mistraletti G, Mochizuki K, Moerer O, Moghal A, Mojoli F, Molin A, Molnar Z, Montiel R, Montini L, Monza G, Mora Aznar M, Morakul S, Morales M, Moreno Torres D, Morocho Tutillo DR, Motherway C, Mouhssine D, Mouloudi E, Muñoz T, Munoz de Cabo C, Mustafa M, Muthuchellappan R, Muthukrishnan M, Muttini S, Nagata I, Nahar D, Nakanishi M, Nakayama I, Namendys-Silva SA, Nanchal R, Nandakumar S, Nasi A, Nasir K, Navalesi P, Naz Aslam T, Nga Phan T, Nichol A, Niiyama S, Nikolakopoulou S, Nikolic E, Nitta K, Noc M, Nonas S, Nseir S, Nur Soyturk A, Obata Y, Oeckler R, Oguchi M, Ohshimo S, Oikonomou M, Ojados A, Oliveira MT, Oliveira Filho W, Oliveri C, Olmos A, Omura K, Orlandi MC, Orsenigo F, Ortiz-Ruiz De Gordoa L, Ota K, Ovalle Olmos R, Öveges N, Oziemski P, Ozkan Kuscu O, Özyilmaz E, Pachas Alvarado F, Pagella G, Palaniswamy V, Palazon Sanchez EL, Palmese S, Pan G, Pan W, Panka B, Papanikolaou M, Papavasilopoulou T, Parekh A, Parke R, Parrilla FJ, Parrilla D, Pasha T, Pasin L, Patão L, Patel M, Patel G, Pati BK, Patil J, Pattnaik S, Paul D, Pavesi M, Pavlotsky VA, Paz G, Paz E, Pecci E, Pellegrini C, Peña Padilla AG, Perchiazzi G, Pereira T, Pereira V, Perez M, Perez Calvo C, Perez Cheng M, Perez Maita R, Pérez-Araos R, Perez-Teran P, Perez-Torres D, Perkins G, Persona P, Petnak T, Petrova M, Pham T, Philippart F, Picetti E, Pierucci E, Piervincenzi E, Pinciroli R, Pintado MC, Piquilloud L, Piraino T, Piras S, Piras C, Pirompanich P, Pisani L, Platas E, Plotnikow G, Porras W, Porta V, Portilla M, Portugal J, Povoa P, Prat G, Pratto R, Preda G, Prieto I, Prol-Silva E, Pugh R, Qi Y, Qian C, Qin T, Qiu H, Qu H, Quintana T, Quispe Sierra R, Quispe Soto R, Rabbani R, Rabee M, Rabie A, Rahe Pereira MA, Rai A, Raj Ashok S, Rajab M, Ramdhani N, Ramey E, Ranieri M, Rathod D, Ray B, Redwanul Huq SM, Regli A, Reina R, Resano Sarmiento N, Reynaud F, Rialp G, Ricart P, Rice T, Richardson A, Rieder M, Rinket M, Rios F, Rios F, Risso Vazquez A, Rittayamai N, Riva I, Rivette M, Roca O, Roche-Campo F, Rodriguez C, Rodriguez G, Rodriguez Gonzalez D, Rodriguez Tucto XY, Rogers A, Romano ME, Rørtveit L, Rose A, Roux D, Rouze A, Rubatto Birri PN, Ruilan W, Ruiz Robledo A, Ruiz-Aguilar AL, Sadahiro T, Saez I, Sagardia J, Saha R, Saha R, Saiphoklang N, Saito S, Salem M, Sales G, Salgado P, Samavedam S, Sami Mebazaa M, Samuelsson L, San Juan Roman N, Sanchez P, Sanchez-Ballesteros J, Sandoval Y, Sani E, Santos M, Santos C, Sanui M, Saravanabavan L, Sari S, Sarkany A, Sauneuf B, Savioli M, Sazak H, Scano R, Schneider F, Schortgen F, Schultz MJ, Schwarz GL, Seçkin Yücesoy F, Seely A, Seiler F, Seker Tekdos Y, Seok Chan K, Serano L, Serednicki W, Serpa Neto A, Setten M, Shah A, Shah B, Shang Y, Shanmugasundaram P, Shapovalov K, Shebl E, Shiga T, Shime N, Shin P, Short J, Shuhua C, Siddiqui S, Silesky Jimenez JI, Silva D, Silva Sales B, Simons K, Sjøbø BÅ, Slessor D, Smiechowicz J, Smischney N, Smith P, Smith T, Smith M, Snape S, Snyman L, Soetens F, Sook Hong K, Sosa Medellin MÁ, Soto G, Souloy X, Sousa E, Sovatzis S, Sozutek D, Spadaro S, Spagnoli M, Spångfors M, Spittle N, Spivey M, Stapleton A, Stefanovic B, Stephenson L, Stevenson E, Strand K, Strano MT, Straus S, Sun C, Sun R, Sundaram V, SunPark T, Surlemont E, Sutherasan Y, Szabo Z, Szuldrzynski K, Tainter C, Takaba A, Tallott M, Tamasato T, Tang Z, Tangsujaritvijit V, Taniguchi L, Taniguchi D, Tarantino F, Teerapuncharoen K, Temprano S, Terragni P, Terzi N, Thakur A, Theerawit P, Thille AW, Thomas M, Thungtitigul P, Thyrault M, Tilouch N, Timenetsky K, Tirapu J, Todeschini M, Tomas R, Tomaszewski C, Tonetti T, Tonnelier A, Trinder J, Trongtrakul K, Truwit J, Tsuei B, Tulaimat A, Turan S, Turkoglu M, Tyagi S, Ubeda A, Vagginelli F, Valenti MF, Vallverdu I, Van Axel A, van den Hul I, van der Hoeven H, Van Der Meer N, Van Haren F, Vanhoof M, Vargas-Ordoñez M, Vaschetto R, Vascotto E, Vatsik M, Vaz A, Vazquez-Sanchez A, Ventura S, Vermeijden JW, Vidal A, Vieira J, Vilela Costa Pinto B, Villagomez A, Villagra A, Villegas Succar C, Vinorum OG, Vitale G, Vj R, Vochin A, Voiriot G, Volta CA, von Seth M, Wajdi M, Walsh D, Wang S, Wardi G, Ween-Velken NC, Wei BL, Weller D, Welsh D, Welters I, Wert M, Whiteley S, Wilby E, Williams E, Williams K, Wilson A, Wojtas J, Won Huh J, Wrathall D, Wright C, Wu JF, Xi G, Xing ZJ, Xu H, Yamamoto K, Yan J, Yáñez J, Yang X, Yates E, Yazicioglu Mocin O, Ye Z, Yildirim F, Yoshida N, Yoshido HHL, Young Lee B, Yu R, Yu G, Yu T, Yuan B, Yuangtrakul N, Yumoto T, Yun X, Zakalik G, Zaki A, Zalba-Etayo B, Zambon M, Zang B, Zani G, Zarka J, Zerbi SM, Zerman A, Zetterquist H, Zhang J, Zhang H, Zhang W, Zhang G, Zhang W, Zhao H, Zheng J, Zhu B, Zumaran R. Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study. Lancet Respir Med 2023; 11:465-476. [PMID: 36693401 DOI: 10.1016/s2213-2600(22)00449-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/07/2022] [Accepted: 11/10/2022] [Indexed: 01/23/2023]
Abstract
BACKGROUND Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. METHODS WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. FINDINGS Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2-6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. INTERPRETATION In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. FUNDING European Society of Intensive Care Medicine, European Respiratory Society.
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Affiliation(s)
- Tài Pham
- Service de Médecine Intensive-Réanimation, AP-HP, Hôpital de Bicêtre, DMU CORREVE, FHU SEPSIS, Groupe de Recherche CARMAS, Hôpitaux Universitaires Paris-Saclay, Le Kremlin-Bicêtre, France; Université Paris-Saclay, UVSQ, Université Paris-Sud, Inserm U1018, Equipe d'Epidémiologie Respiratoire Intégrative, CESP, 94807, Villejuif, France
| | - Leo Heunks
- Department of Intensive Care Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Giacomo Bellani
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy; Department of Emergency and Intensive Care, University Hospital San Gerardo, Monza, Italy
| | - Fabiana Madotto
- Department of Anaesthesia, Intensive Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Irene Aragao
- Department of Intensive Care Medicine, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Gaëtan Beduneau
- Normandie University, UNIROUEN, UR 3830, CHU Rouen, Department of Medical Intensive Care, F-76000 Rouen, France
| | - Ewan C Goligher
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada; Department of Medicine, Division of Respirology, Toronto General Hospital Research Institute University Health Network, Toronto, Canada
| | - Giacomo Grasselli
- Department of Anaesthesia, Intensive Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Jon Henrik Laake
- Department of Anaesthesiology and Department of Research and Development, Division of Critical Care and Emergencies, Oslo University Hospital, Oslo, Norway
| | - Jordi Mancebo
- Department of Intensive Care Medicine, Hospital Universitari Sant Pau, Barcelona, Spain
| | - Oscar Peñuelas
- Intensive Care Unit, Hospital Universitario de Getafe, Madrid, Spain; Centro de Investigación Biomédica en Red, CIBER de Enfermedades Respiratorias, CIBERES, Madrid, Spain
| | - Lise Piquilloud
- Adult Intensive Care Unit, University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Antonio Pesenti
- Department of Anaesthesia, Intensive Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Hannah Wunsch
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada; Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Frank van Haren
- College of Health and Medicine, Australian National University, Canberra, ACT, Australia; Intensive Care Unit, St George Hospital, Sydney, NSW, Australia
| | - Laurent Brochard
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada; Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - John G Laffey
- Anaesthesia and Intensive Care Medicine, School of Medicine, Clinical Sciences Institute, Galway University Hospitals, Galway, Ireland; School of Medicine, Regenerative Medicine Institute (REMEDI) at CÚRAM Centre for Research in Medical Devices, National University of Ireland Galway, Galway, Ireland.
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Villamil-Gomez W, Torres JR, Rojas-Hernández J, Reston TJ, Vergara-Corena J, Salgado P, Viloria-Ruiz J, Castro A, Cabrera Lasso AM, Gotuzzo E. HTLV-1 uveitis in Colombia, an underrecognized complication of a hitherto neglected condition: a case series. Ther Adv Infect Dis 2023; 10:20499361231165864. [PMID: 37114190 PMCID: PMC10126695 DOI: 10.1177/20499361231165864] [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] [Received: 07/21/2022] [Accepted: 03/09/2023] [Indexed: 04/29/2023] Open
Abstract
Three Colombian patients with chronic HTLV-1 infection and severe intermediate and/or posterior uveitis are described. In one case, retinal ablation was necessary due to extensive peripheral degeneration, while the other two were successfully managed with local anti-inflammatory therapy. Gradual resolution of ocular findings was observed in all three patients on follow-up. Uveitis is a rarely recognized late complication of this infection, which represents a diagnostic and therapeutic challenge for clinicians in endemic countries. The real extension of HTLV-1 prevalence in Colombia and the frequency of its ophthalmologic complications remain to be determined.
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Affiliation(s)
| | - Jaime R. Torres
- Infectious Diseases Section, Tropical Medicine Institute, Universidad Central de Venezuela, Caracas, Venezuela
| | | | - Torés Jose Reston
- Dirección Científica, Clinica Oftalmologica de la Costa, Sincelejo, Colombia
| | | | - Patricia Salgado
- Infectious Diseases and Infection Control Research Group, Hospital Universitario de Sincelejo, Sincelejo, Colombia
| | | | - Alvaro Castro
- Departamento de Patología, Universidad de Sucre, Sincelejo, Colombia
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Yacobitti A, Otero L, Arrubarrena VD, Arano J, Lage S, Silberman M, Zubieta M, Erbetta I, Danei P, Baeck G, Vallejos V, Cavalli F, Calderón N, Di Gregorio M, Hernandez V, Bruno D, Rodera B, Macherett I, Parisi M, Gallastegui M, Paz A, Bernardi R, Azcárate S, Hraste A, Caridi I, Boechi L, Salgado P, Kochen S. Publisher Correction: Clinical characteristics of vulnerable populations hospitalized and diagnosed with COVID-19 in Buenos Aires, Argentina. Sci Rep 2021; 11:17554. [PMID: 34453078 PMCID: PMC8390981 DOI: 10.1038/s41598-021-96120-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- A Yacobitti
- Network Patient Management, Hospital El Cruce N Kirchner, F. Varela, Pcia Buenos Aires, Argentina
| | - L Otero
- Planning Area, Hospital El Cruce N Kirchner, F. Varela, Pcia Buenos Aires, Argentina
| | - V Doldan Arrubarrena
- Planning Area, Hospital El Cruce N Kirchner, F. Varela, Pcia Buenos Aires, Argentina
| | - J Arano
- General Ward, Hospital El Cruce N Kirchner, F. Varela, Pcia Buenos Aires, Argentina
| | - S Lage
- Intensive Therapy Unit, Hospital El Cruce N Kirchner, F. Varela, Pcia Buenos Aires, Argentina
| | - M Silberman
- Planning Area, Hospital El Cruce N Kirchner, F. Varela, Pcia Buenos Aires, Argentina
| | - M Zubieta
- Laboratory, Hospital El Cruce, F. Varela, Pcia Buenos Aires, Argentina
| | - I Erbetta
- Administrative Area, Hospital Module N° 11, F. Varela, Pcia Buenos Aires, Argentina
| | - P Danei
- Administrative Area, UPA N° 11, F. Varela, Pcia Buenos Aires, Argentina
| | - G Baeck
- Patient Admission, Hospital Mi Pueblo, F. Varela, Pcia Buenos Aires, Argentina
| | - V Vallejos
- Prompt Attention Unit, UPA N° 5, A. Brown, Pcia Buenos Aires, Argentina
| | - F Cavalli
- Administrative Area, UPA N°, 5 and Module N° 9, A. Brown, Pcia Buenos Aires, Argentina
| | - N Calderón
- Administrative Area, Hospital L. Meléndez, A. Brown, Pcia Buenos Aires, Argentina
| | - M Di Gregorio
- Administrative Area, Hospital L. Meléndez, A. Brown, Pcia Buenos Aires, Argentina
| | - V Hernandez
- Statistics, Hospital Oñativia, A. Brown, Pcia Buenos Aires, Argentina
| | - D Bruno
- Administrative Area, Hospital Oñativia, A. Brown, Pcia Buenos Aires, Argentina
| | - B Rodera
- Medical Clinic, Iriarte Hospital, Quilmes, Pcia Buenos Aires, Argentina
| | - I Macherett
- Intensive Therapy Unit, Iriarte Hospital, Quilmes, Pcia Buenos Aires, Argentina
| | - M Parisi
- Intensive Therapy Unit, Iriarte Hospital, Quilmes, Pcia Buenos Aires, Argentina
| | - M Gallastegui
- Intensive Therapy Unit, Iriarte Hospital, Quilmes, Pcia Buenos Aires, Argentina
| | - A Paz
- Oller HospitalOller Hospital, Quilmes, Pcia Buenos Aires, Argentina
| | - R Bernardi
- Administrative Area, UPA N° 17, Quilmes, Pcia Buenos Aires, Argentina
| | - S Azcárate
- Intensive Therapy Unit, Evita Pueblo Hospital, Berazategui, Pcia Buenos Aires, Argentina
| | - A Hraste
- Patient Management, Evita Pueblo Hospital, Berazategui, Pcia Buenos Aires, Argentina
| | - I Caridi
- Institute of Calculation, FCEN, UBA and CONICET, Ciudad de Buenos Aires, Argentina
| | - L Boechi
- Institute of Calculation, FCEN, UBA and CONICET, Ciudad de Buenos Aires, Argentina
| | - P Salgado
- Public Health Research Institute, University of Buenos Aires, Caba, Argentina
| | - S Kochen
- Neurosciences and Complex Systems Unit (EnyS), CONICET‑ Hosp. El Cruce "N. Kirchner" ‑ Univ. National A. Jauretche, Fac. Med, Univ. Buenos Aires, Av Calchaqui 5401, CP B1888AAE, F. Varela, Province Buenos Aires, Argentina.
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Yacobitti A, Otero L, Doldan Arrubarrena V, Arano J, Lage S, Silberman M, Zubieta M, Erbetta I, Danei P, Baeck G, Vallejos V, Cavalli F, Calderón N, Di Gregorio M, Hernandez V, Bruno D, Rodera B, Macherett I, Parisi M, Gallastegui M, Paz A, Bernardi R, Azcárate S, Hraste A, Caridi I, Boechi L, Salgado P, Kochen S. Clinical characteristics of vulnerable populations hospitalized and diagnosed with COVID-19 in Buenos Aires, Argentina. Sci Rep 2021; 11:9679. [PMID: 33958604 PMCID: PMC8102488 DOI: 10.1038/s41598-021-87552-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 03/23/2021] [Indexed: 12/19/2022] Open
Abstract
There is not in Argentina publications regarding the presentation of patients with COVID-19 requiring hospitalized and emergency care in vulnerable populations (lower incomes and less education tend at greater risk for poor health status and healthcare access), and it has few reports in developing countries. The objective is to determine whether in the care of vulnerable patients, to succeed against COVID-19, multiple public health tools and interventions will be needed to minimize morbidity and mortality. The study is a prospective cohort investigation of patients with lab-confirmed COVID-19, who required to any of the Health Centers response from April 8, 2020, to August 18, 2020. In Buenos Aires Metropolitan Area (AMBA), April 8, 2020 the virus was identified in patients hospitalized in the "Southeast Network" (SN), AMBA. SN covering an area of 661 square kilometers, with 1.8 million inhabitants residing in urban, and rural areas. A total of 14 health centers with different levels of care complexity provide care to patients in the region. The information of each patient with COVID-19 evaluated by SN, was incorporated in an Epidemiological Dashboard. The investigation was designed and reported with consideration of observational studies in epidemiology. We describe the hospitals presentation and care of persons who required SN response and were ultimately diagnosed with COVID-19. From April 8, 2020, to August 18, 2020, were included 1495 patients with lab-confirmed COVID-19 in SN. A total of 58% patients were men, and the mean age (SD) was 48.9 (15.59) years. Eighty one percent patients with pre-existing diseases, most frequent hypertension and diabetes, but hypertension, chronic lung disease, and cardiovascular disease presented higher risk. A total of 13% were hospitalized in Intensive Therapy Unit. The mortality of the cohort was 9.77%. Mortality was higher for patients aged 65 or more (OR 5.09), and for those had some pre-existing disease (OR 2.61). Our observations are consistent with reports demonstrating older persons, and those with comorbidities have the highest risk of mortality related to COVID-19. However, unlike other reports from developed or some developing countries, the mortality in our study is lower. This finding may be related to age of our cohort is younger than other published. Also, the health system was able to respond to the demand.
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Affiliation(s)
- A Yacobitti
- Network Patient Management, Hospital El Cruce N Kirchner, F. Varela, Pcia Buenos Aires, Argentina
| | - L Otero
- Planning Area, Hospital El Cruce N Kirchner, F. Varela, Pcia Buenos Aires, Argentina
| | - V Doldan Arrubarrena
- Planning Area, Hospital El Cruce N Kirchner, F. Varela, Pcia Buenos Aires, Argentina
| | - J Arano
- General Ward, Hospital El Cruce N Kirchner, F. Varela, Pcia Buenos Aires, Argentina
| | - S Lage
- Intensive Therapy Unit, Hospital El Cruce N Kirchner, F. Varela, Pcia Buenos Aires, Argentina
| | - M Silberman
- Planning Area, Hospital El Cruce N Kirchner, F. Varela, Pcia Buenos Aires, Argentina
| | - M Zubieta
- Laboratory, Hospital El Cruce, F. Varela, Pcia Buenos Aires, Argentina
| | - I Erbetta
- Administrative Area, Hospital Module N° 11, F. Varela, Pcia Buenos Aires, Argentina
| | - P Danei
- Administrative Area, UPA N° 11, F. Varela, Pcia Buenos Aires, Argentina
| | - G Baeck
- Patient Admission, Hospital Mi Pueblo, F. Varela, Pcia Buenos Aires, Argentina
| | - V Vallejos
- Prompt Attention Unit, UPA N° 5, A. Brown, Pcia Buenos Aires, Argentina
| | - F Cavalli
- Administrative Area, UPA N° 5 and Module N° 9, A. Brown, Pcia Buenos Aires, Argentina
| | - N Calderón
- Administrative Area, Hospital L. Meléndez, A. Brown, Pcia Buenos Aires, Argentina
| | - M Di Gregorio
- Administrative Area, Hospital L. Meléndez, A. Brown, Pcia Buenos Aires, Argentina
| | - V Hernandez
- Statistics, Hospital Oñativia, A. Brown, Pcia Buenos Aires, Argentina
| | - D Bruno
- Administrative Area, Hospital Oñativia, A. Brown, Pcia Buenos Aires, Argentina
| | - B Rodera
- Medical Clinic, Iriarte Hospital, Quilmes, Pcia Buenos Aires, Argentina
| | - I Macherett
- Intensive Therapy Unit, Iriarte Hospital, Quilmes, Pcia Buenos Aires, Argentina
| | - M Parisi
- Intensive Therapy Unit, Iriarte Hospital, Quilmes, Pcia Buenos Aires, Argentina
| | - M Gallastegui
- Intensive Therapy Unit, Iriarte Hospital, Quilmes, Pcia Buenos Aires, Argentina
| | - A Paz
- Oller HospitalOller Hospital, Quilmes, Pcia Buenos Aires, Argentina
| | - R Bernardi
- Administrative Area, UPA N° 17, Quilmes, Pcia Buenos Aires, Argentina
| | - S Azcárate
- Intensive Therapy Unit, Evita Pueblo Hospital, Berazategui, Pcia Buenos Aires, Argentina
| | - A Hraste
- Patient Management, Evita Pueblo Hospital, Berazategui, Pcia Buenos Aires, Argentina
| | - I Caridi
- Institute of Calculation, FCEN, UBA and CONICET, Ciudad de Buenos Aires, Argentina
| | - L Boechi
- Institute of Calculation, FCEN, UBA and CONICET, Ciudad de Buenos Aires, Argentina
| | - P Salgado
- Public Health Research Institute, University of Buenos Aires, Caba, Argentina
| | - S Kochen
- Neurosciences and Complex Systems Unit (EnyS), CONICET- Hosp. El Cruce "N. Kirchner" - Univ. National A. Jauretche, Fac. Med, Univ. Buenos Aires, Av Calchaqui 5401, CP B1888AAE, F. Varela, Province Buenos Aires, Argentina.
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Andriarimalala H, Dubeux J, Jaramillo D, Rakotozandriny J, Salgado P. Using n-alkanes to estimate herbage intake and diet composition of cattle fed with natural forages in Madagascar. Anim Feed Sci Technol 2021. [DOI: 10.1016/j.anifeedsci.2020.114795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Maseda E, Grau S, Luque S, Castillo-Mafla MP, Suárez-de-la-Rica A, Montero-Feijoo A, Salgado P, Gimenez MJ, García-Bernedo CA, Gilsanz F, Roberts JA. Population pharmacokinetics/pharmacodynamics of micafungin against Candida species in obese, critically ill, and morbidly obese critically ill patients. Crit Care 2018; 22:94. [PMID: 29655372 PMCID: PMC5899833 DOI: 10.1186/s13054-018-2019-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 03/26/2018] [Indexed: 01/05/2023]
Abstract
Background Dosing in obese critically ill patients is challenging due to pathophysiological changes derived from obesity and/or critical illness, and it remains fully unexplored. This study estimated the micafungin probability of reaching adequate 24-h area under the curve (AUC0–24h)/minimum inhibitory concentration (MIC) values against Candida spp. for an obese/nonobese, critically ill/noncritically ill, large population. Methods Blood samples for pharmacokinetic analyses were collected from 10 critically ill nonobese patients, 10 noncritically ill obese patients, and 11 critically ill morbidly obese patients under empirical/directed micafungin treatment. Patients received once daily 100–150 mg micafungin at the discretion of the treating physician following the prescribing information and hospital guidelines. Total micafungin concentrations were determined by high-performance liquid chromatography (HPLC). Monte-Carlo simulations were performed and the probability of target attainment (PTA) was calculated using the AUC0–24/MIC cut-offs 285 (C. parapsilosis), 3000 (all Candida spp.), and 5000 (nonparapsilosis Candida spp.). Intravenous once-daily 100-mg, 150-mg, and 200-mg doses were simulated at different body weights (45, 80, 115, 150, and 185 kg) and age (30, 50, 70 and 90 years old). PTAs ≥ 90% were considered optimal. Fractional target attainment (FTA) was calculated using published MIC distributions. A dosing regimen was considered successful if the FTA was ≥ 90%. Results Overall, 100 mg of micafungin was once-daily administered for nonobese and obese patients with body mass index (BMI) ≤ 45 kg/m2 and 150 mg for morbidly obese patients with BMI > 45 kg/m2 (except two noncritically ill obese patients with BMI ~ 35 kg/m2 receiving 150 mg, and one critically ill patient with BMI > 45 kg/m2 receiving 100 mg). Micafungin concentrations in plasma were best described using a two-compartment model. Weight and age (but not severity score) were significant covariates and improved the model. FTAs > 90% were obtained against C. albicans with the 200 mg/24 h dose for all body weights (up to 185 kg), and with the 150 mg/24 h for body weights < 115 kg, and against C. glabrata with the 200 mg/24 h dose for body weights < 115 kg. Conclusion The lack of adequacy for the 100 mg/24 h dose suggested the need to increase the dose to 150 mg/24 h for C. albicans infections. Further pharmacokinetic/pharmacodynamic studies should address optimization of micafungin dosing for nonalbicans Candida infections.
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Affiliation(s)
- Emilio Maseda
- Department of Anesthesia and Surgical Intensive Care, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain. .,Universidad Autónoma de Madrid, Madrid, Spain.
| | - Santiago Grau
- Pharmacy Department, Hospital del Mar, Barcelona, Spain.,Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
| | - Sonia Luque
- Pharmacy Department, Hospital del Mar, Barcelona, Spain.,Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Maria-Pilar Castillo-Mafla
- Department of Anesthesia and Surgical Intensive Care, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Alejandro Suárez-de-la-Rica
- Department of Anesthesia and Surgical Intensive Care, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Ana Montero-Feijoo
- Department of Anesthesia and Surgical Intensive Care, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain
| | - Patricia Salgado
- Department of Anesthesia and Surgical Intensive Care, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain
| | | | | | - Fernando Gilsanz
- Department of Anesthesia and Surgical Intensive Care, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain.,Universidad Autónoma de Madrid, Madrid, Spain
| | - Jason A Roberts
- Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK.,Burns, Trauma and Critical Care Research Centre, The University of Queensland, Brisbane, Australia.,Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia.,Pharmacy Department, Royal Brisbane and Women's Hospital, Brisbane, Australia
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Caviglia H, Landro ME, Daffunchio C, Galatro G, Douglas Price AL, Salgado P, Neme D. Platelet Rich Plasma for Chronic Synovitis Treatment in Patients with Haemophilia. Haemophilia 2017; 23:613-619. [DOI: 10.1111/hae.13212] [Citation(s) in RCA: 15] [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] [Accepted: 02/02/2017] [Indexed: 12/24/2022]
Affiliation(s)
- H. Caviglia
- Department of Orthopaedic Surgery and Traumatology; Dr. Juan A. Fernández General Hospital; Buenos Aires Argentina
- Haemophilia Foundation; Buenos Aires Argentina
| | - M. E. Landro
- Department of Orthopaedic Surgery and Traumatology; Dr. Juan A. Fernández General Hospital; Buenos Aires Argentina
| | - C. Daffunchio
- Department of Orthopaedic Surgery and Traumatology; Dr. Juan A. Fernández General Hospital; Buenos Aires Argentina
- Haemophilia Foundation; Buenos Aires Argentina
| | - G. Galatro
- Department of Orthopaedic Surgery and Traumatology; Dr. Juan A. Fernández General Hospital; Buenos Aires Argentina
- Haemophilia Foundation; Buenos Aires Argentina
| | - A. L. Douglas Price
- Department of Orthopaedic Surgery and Traumatology; Dr. Juan A. Fernández General Hospital; Buenos Aires Argentina
| | - P. Salgado
- Department of Orthopaedic Surgery and Traumatology; Dr. Juan A. Fernández General Hospital; Buenos Aires Argentina
| | - D. Neme
- Haemophilia Foundation; Buenos Aires Argentina
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Ribera E, Martínez L, Pujol L, Angelats M, Ezquiaga I, Grifell M, Palma Á, Belmonte E, Pérez L, Pérez-Solá V, Salgado P. Is there a relationship between morbid obesity and depression? Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.02.250] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionA considerable proportion of patients with morbid obesity require treatment with antidepressants.ObjectivesThe aim of this study is to determine the incidence of patients who are in antidepressant treatment and identify risk factors for the need of this treatment in patients with morbid obesity.Materials and methodsRetrospective cohort study of 292 patients with morbid obesity who underwent bariatric surgery at Hospital del Mar from January 2010 to November 2015. The incidence of antidepressant treatment was analyzed, and also its possible relationship with the following variables: age, sex, BMI, tobacco smoking, alcohol consumption and age of onset of obesity. Chi2 test for categorical variables and Student t-test for quantitative variables were applied. Afterwards, a multivariate analysis was performed using logistic regression.ResultsThe mean age is 43.1 years. Most of the patients (76.4%) are women. Seventy-seven patients (26.4%) are receiving treatment with antidepressants. There is a statistically significant relationship between age and the need of treatment with antidepressants (P < 0.001). This relationship is still present when the variables are analyzed using logistic regression (P < 0.005, OR 1.049). We have not found any significant relationship with the rest of the variables.ConclusionsDespite the large number of patients in the study, there are limitations, such as being a retrospective study and not being adjusted for confounding factors. From all the variables that have been analyzed we have found that as the age of the patients increase, there is a higher number of patients that receive treatment with antidepressants.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Martínez L, Mané A, Cortizo R, Cáceres I, Treen D, Galindo L, Salgado P, Berge D. Insight and Social Cognition in First Episode of Psychosis. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.02.102] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
IntroductionImpairment of insight in psychotic disorder is associated with adverse impact in treatment compliance, outcome and social functioning although its underlying mechanisms are still unknown. Social cognition and more specifically Theory of mind have been proposed to be correlated to insight. However, the relationship between both factors is still not well defined.AimsTo study the association between social cognition and insight into mental illness in individuals with early psychosis included in the first episode of psychosis program of Hospital del Mar.MethodsFrom the 94 patients included in the first psychotic episode program between January 2011 and January 2016, thirty-eight patients were evaluated six months after the episode. The three initial items of SUMD (Scale Unawareness of Mental Disorder) were used to measure insight and MSCEIT (Mayer-Salovey-Caruso Emotional Intelligence Test) was used to assess social cognition. Linear correlation analysis by Pearson correlation was conducted.ResultsInsight results of SUMD six months after the first episode of psychosis were significantly associated with several subsections of MSCEIT, such as experiential area total punctuation (r = –0.574; P = 0.025), emotional facilitation section (r = –0.633; P = 0.011) and the facial emotion perception task (r = –0.572; P = 0.026).ConclusionsResults suggest an association between insight and emotional perception and facilitation performance in first episode patients, which may suggest a role of social cognition in psychosis insight impairment. Further research to better define the participation of social cognition in insight into psychosis alteration is mandatory to understand the etiology of insight, define treatment targets and consequently improve the disorder prognosis.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Galindo L, Robledo P, Guinart D, Pérez E, Cuenca-Royo A, Menoyo E, Fernandez C, García J, Moreno E, Casadó V, de la Torre R, Perez-Solá V, Salgado P, Oller S, Campillo M, Orejas O. CB1-5-HT2A heteromers in schizophrenia patients: Human studies in pro-neurons of the olfactory epithelium. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1572] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
IntroductionDespite multiple clinical and preclinical studies investigating schizophrenia, the neurobiological basis of this disease is still unknown. The dysregulation of the serotonergic system, in particular the 5-HT2A receptor and the endocannabinoid system have been postulated as possible causes of schizophrenia.ObjectivesThe aim of this study is to evaluate the expression of CB1-5-HT2A receptor heteromers in primary cultures of pro-neurons from the olfactory epithelium in schizophrenia patients and control subjects.MethodsWe recruited a group of 10 healthy volunteers and 10 patients diagnosed with schizophrenia, who were treated with atypical antipsychotics, were clinically stable and had an illness duration range from 1 up to 15 years. The patients were diagnosed with schizophrenia from the medical record and confirmed by the structured clinical interview for DSM disorders. The expression of CB1-5-HT2A receptor heteromers in primary cultures of pro-neurons from the olfactory epithelium was quantified using proximity ligation assays and confocal microscopy.ResultsOlfactory epithelium pro-neurons were viable and expressed the neuronal marker, III-β tubulin. We also established the presence and the functionality of CB1-5-HT2A receptor heteromers in these cells using the proximity ligation and cAMP activity assays, respectively. Heteromer expression was significantly increased in schizophrenia patients with respect to controls.ConclusionsThis highly innovative methodology will allow the noninvasive, low-cost study of new biomarkers for schizophrenia in a model closely related to the central nervous system.Disclosure of interestThe authors have not supplied their declaration of competing interest.AcknowledgmentsThis work was supported by grants from DIUE-Generalitat-de Catalunya (2014SGR 680), Instituto de Salud Carlos III (PI14/00210) and (PI10/01708) FIS-FEDER-Funds. LG is supported by the Instituto-de Salud Carlos III through a “Río Hortega” (CM14/00111).
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Del Brutto OH, Nash TE, White AC, Rajshekhar V, Wilkins PP, Singh G, Vasquez CM, Salgado P, Gilman RH, Garcia HH. Revised set of diagnostic criteria for neurocysticercosis (in reply to Garg and Malhotra). J Neurol Sci 2016; 373:350-351. [PMID: 28011076 DOI: 10.1016/j.jns.2016.12.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Accepted: 12/12/2016] [Indexed: 11/25/2022]
Affiliation(s)
- O H Del Brutto
- School of Medicine, Universidad Espíritu Santo - Ecuador, Guayaquil, Ecuador.
| | - T E Nash
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institute of Health, Bethesda, MD, United States
| | - A C White
- Infectious Disease Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, United States
| | - V Rajshekhar
- Department of Neurological Sciences, Christian Medical College Hospital, Vellore, India
| | - P P Wilkins
- Parasitology Services, Marathon, Fl, United States
| | - G Singh
- Department of Neurology, Dayanand Medical College, Ludhiana, India
| | - C M Vasquez
- Department of Neurosurgery, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - P Salgado
- Neuroimaging Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Mexico City, Mexico
| | - R H Gilman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - H H Garcia
- Center for Global Health, Tumbes and the Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Peru; Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
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Del Brutto OH, Nash TE, White AC, Rajshekhar V, Wilkins PP, Singh G, Vasquez CM, Salgado P, Gilman RH, Garcia HH. Revised diagnostic criteria for neurocysticercosis. J Neurol Sci 2016; 372:202-210. [PMID: 28017213 DOI: 10.1016/j.jns.2016.11.045] [Citation(s) in RCA: 169] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 10/29/2016] [Accepted: 11/20/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND A unified set of criteria for neurocysticercosis (NCC) has helped to standardize its diagnosis in different settings. METHODS Cysticercosis experts were convened to update current diagnostic criteria for NCC according to two principles: neuroimaging studies are essential for diagnosis, and all other information provides indirect evidence favoring the diagnosis. Recent diagnostic advances were incorporated to this revised set. RESULTS This revised set is structured in absolute, neuroimaging and clinical/exposure criteria. Absolute criteria include: histological confirmation of parasites, evidence of subretinal cysts, and demonstration of the scolex within a cyst. Neuroimaging criteria are categorized as major (cystic lesions without scolex, enhancing lesions, multilobulated cysts, and calcifications), confirmative (resolution of cysts after cysticidal drug therapy, spontaneous resolution of single enhancing lesions, and migrating ventricular cysts on sequential neuroimaging studies) and minor (hydrocephalus and leptomeningeal enhancement). Clinical/exposure criteria include: detection of anticysticercal antibodies or cysticercal antigens by well-standardized tests, systemic cysticercosis, evidence of a household Taenia carrier, suggestive clinical manifestations, and residency in endemic areas. Besides patients having absolute criteria, definitive diagnosis can be made in those having two major neuroimaging criteria (or one major plus one confirmative criteria) plus exposure. For patients presenting with one major and one minor neuroimaging criteria plus exposure, definitive diagnosis of NCC requires the exclusion of confounding pathologies. Probable diagnosis is reserved for individuals presenting with one neuroimaging criteria plus strong evidence of exposure. CONCLUSIONS This revised set of diagnostic criteria provides simpler definitions and may facilitate its more uniform and widespread applicability in different scenarios.
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Affiliation(s)
- O H Del Brutto
- School of Medicine, Universidad Espíritu Santo - Ecuador, Guayaquil, Ecuador
| | - T E Nash
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institute of Health, Bethesda, MD, United States
| | - A C White
- Infectious Disease Division, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX, United States
| | - V Rajshekhar
- Department of Neurological Sciences, Christian Medical College Hospital, Vellore, India
| | - P P Wilkins
- Parasitology Services, Marathon, FL, United States
| | - G Singh
- Department of Neurology, Dayanand Medical College, Ludhiana, India
| | - C M Vasquez
- Department of Neurosurgery, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
| | - P Salgado
- Neuroimaging Unit, National Institute of Neurology and Neurosurgery Manuel Velasco Suarez, Mexico City, Mexico
| | - R H Gilman
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - H H Garcia
- Center for Global Health, Tumbes, Peru; Department of Microbiology, School of Sciences, Universidad Peruana Cayetano Heredia, Peru; Cysticercosis Unit, Instituto Nacional de Ciencias Neurológicas, Lima, Peru.
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Salgado P, Gilsanz F, Maseda E. [Resistant gram-negative bacteria. Therapeutic approach and risk factors]. Rev Esp Quimioter 2016; 29 Suppl 1:26-30. [PMID: 27608309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The rapid spread of multidrug-resistant bacteria has become a serious threat, especially in critical care units, thereby prolonging the hospital stay. Enterobacteriaceae have a high capacity to adapt to any environment. Plasmids are the reason behind their expansion. The choice of empiric therapy for intra-abdominal or urinary infections requires knowledge of the intrinsic microbiological variability of each hospital or critical care unit, as well as the source of infection, safety or antibiotic toxicity, interaction with other drugs, the dosage regimen and the presence of risk factors. Carbapenems are the drug of choice in the case of suspected infection by ESBL-producing Enterobacteriaceae. The new ceftazidime/avibactam and ceftolozane/tazobactam drugs are opening up promising new horizons in the treatment of multidrug-resistant Enterobacteriaceae.
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Affiliation(s)
| | | | - E Maseda
- Emilio Maseda, Servicio de Anestesia y Reanimación, Hospital Universitario La Paz. Paseo de la Castellana 261; 28046, Madrid, Spain.
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Maseda E, Salgado P, Anillo V, Ruiz-Carrascoso G, Gómez-Gil R, Martín-Funke C, Gimenez MJ, Granizo JJ, Aguilar L, Gilsanz F. Risk factors for colonization by carbapenemase-producing enterobacteria at admission to a Surgical ICU: A retrospective study. Enferm Infecc Microbiol Clin 2016; 35:333-337. [PMID: 27016135 DOI: 10.1016/j.eimc.2016.02.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 02/11/2016] [Accepted: 02/21/2016] [Indexed: 12/28/2022]
Abstract
INTRODUCTION In 2011, a hospital-wide outbreak of OXA-48 producing Klebsiella pneumoniae occurred in our hospital, an epidemiological setting of high ESBL-producing K. pneumoniae rates. This study identifies risk factors for colonization with carbapenemase-producing enterobacteria (CPE) at Surgical Intensive Care Unit (SICU) admission. METHODS A 2-year retrospective study was performed in all patients admitted to the SICU that following routine had a rectal swab collected upon admission. RESULTS Of 254 patients admitted, 41 (16.1%) harbored CPE (five showing two carbapenemase-producing isolates). Most frequent carbapenemase-producing isolates and carbapenemases were K. pneumoniae (39/46, 84.8%) and OXA-48 (31/46; 76.1%), respectively. Carriers significantly had higher rates of chronic renal disease, previous digestive/biliary endoscopy, hospitalization, ICU/SICU admission, intraabdominal surgery, and antibiotic intake, as well as higher median values of clinical scores (SOFA, SAPS II and APACHE II). In the multivariate analysis (R2=0.309, p<0.001), CPE carriage was associated with prior administration of 3rd-4th generation cephalosporins (OR=27.96, 95%CI=6.88, 113.58, p<0.001), β-lactam/β-lactamase inhibitor (OR=11.71, 95%CI=4.51, 30.43, p<0.001), abdominal surgery (OR=6.33, 95%CI=2.12, 18.89, p=0.001), and prior digestive/biliary endoscopy (OR=3.88, 95%CI=1.56, 9.67, p=0.004). CONCLUSIONS A strong association between production of ESBLs and carriage of CPE (mainly OXA-48 producing K. pneumoniae) was found. According to the model, the co-selection of β-lactamases by previous exposure to broad-spectrum cephalosporins and β-lactam/β-lactamase inhibitors (with lower relative risk), abdominal surgery and prior digestive/biliary endoscopy were factors associated with CPE carriage.
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Affiliation(s)
- Emilio Maseda
- Anesthesiology and Surgical Critical Care Dpt., Hospital Universitario La Paz, Madrid, Spain.
| | - Patricia Salgado
- Anesthesiology and Surgical Critical Care Dpt., Hospital Universitario La Paz, Madrid, Spain
| | - Víctor Anillo
- Anesthesiology and Surgical Critical Care Dpt., Hospital Universitario La Paz, Madrid, Spain
| | | | - Rosa Gómez-Gil
- Microbiology Dpt., Hospital Universitario La Paz, Madrid, Spain
| | - Carmen Martín-Funke
- General Medicine Dpt., Hospital Universitario Gregorio Marañón, Madrid, Spain
| | | | | | | | - Fernando Gilsanz
- Anesthesiology and Surgical Critical Care Dpt., Hospital Universitario La Paz, Madrid, Spain
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Galindo L, Grifell M, Peréz E, Dinamarca F, Chavarria V, Salgado P, Pérez V. Are there more mechanical restraint in patients admitted for substance use disorder? Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.1013] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Introduction and objectivesMechanical restraint is a therapeutic procedure commonly applied in acute units in response to psychomotor agitation. Its frequency is between 21 and 59% of patients admitted. These patients represent a risk to both themselves and for health workers. There is a myth that patients with substance use disorder (SUD) are more aggressive and require more forceful measures. There are not clinical studies that compared if there are differences of the frequency of mechanical restrain in patients with SUD.The aim of this study is to explore the differences of frequency of mechanical restraint on patients with SUD in the psychiatry acute and dual pathology units and others psychiatric diagnostics.Material and methodsWe reviewed retrospectively the informatics record of all the mechanical restraints made and the total discharges of the three acute care units and dual disorders of Neuropsychiatry and Addictions Institute (INAD) of the Parc de Salut Mar de Barcelona, between January 2012 and January 2015. For every discharge the presence of at least one mechanical restraint and the DSM-IV diagnostic were coded. Then was calculated the frequency and proportion of mechanical retrains in every diagnostic group.ResultsThe number of discharges analyzed was 4659 from which 838 had an episode of mechanical restraint. The 37% of patients with SUD of cocaine had an episode of mechanical restrain. The patients with SUD of alcohol only the 4%, and there no one case on patients with SUD of Cannabis. Thirty percent of patients with schizophrenia and 28% of bipolar disorder.AcknowledgementsL. Galindo is a Rio-Hortega-fellowship-(ISC-III;CM14/00111).Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Dinamarca F, Galindo L, Grifell M, Perez E, Chavarria V, Salgado P, Perez S. The agitated patient; need for mechanical restraint and prevention measures in relation to psychiatric diagnosis. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.754] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
IntroductionPsychomotor agitation is a common psychiatric emergency in our environment that can occur in a wide clinical spectrum. Both the agitation itself as the procedures for their control, carry an implicit risk to patient safety and health workers.ObjectiveTo describe the prevention measures used in patients requiring mechanical restraint in relation to diagnosis of psychiatric disorders.Material and methodsThis is a naturalistic descriptive study. Mechanical restraints made in brief psychiatric hospitalization units of “Hospital del Mar” between January of 2013 to March of 2015, were analyzed by diagnosis. Proportions of the prevention intervention performed by nurses in each episode were compared. The groups of prevention interventions done were: “verbal approach”, “environmental measures”, “psychopharmacological intervention”, “observation increase” and “inability for applying any measure because unpredictability”.ResultsA total of 2986 mechanical restraints were done in brief hospitalization units. Among the results, we find that verbal approach measure was use in 77.23% of patient with personality disorders. Environmental measures were used in 40% of the total of restraints. The most of psychopharmacological intervention was done in alcohol intoxication (50%) and then in psychotic spectrum (42.01%). The inability for applying measures was greater in alcohol intoxication (45.4%).ConclusionSome of the results of this study are interesting and consistent with clinical practice (for example, effectivity of pharmacological intervention in psychosis and bipolar disorders, as well verbal approach in anxiety, etc.), we can predict the usefulness of measures applied to prevent a mechanical restraint. Further research is needed in this topic.Disclosure of interestL. Galindo is a Rio-Hortega-fellowship – (ISC-III; CM14/00111).
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Salgado P, Gilsanz F, Maseda E. [Therapeutic options for carbapenemase-producing Enterobacteriaceae]. Rev Esp Quimioter 2015; 28 Suppl 1:12-15. [PMID: 26365727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Carbapenemase-producing Enterobacteriaceae (CPE) has spread worldwide becoming a threat to public health. However, no randomized clinical trials about the efficacy of optimizing antibiotic treatment have been published. Experimental studies have been designed to find combinations of antibiotics with synergistic activity. Their main aim has been increasing the speed of bacterial destruction and decreasing resistance. The latest guidelines recommend combination therapy. The carbapenems has been chosen as the basis of such therapy. We face limited therapeutic options. Polymyxins, fosfomycin and gentamicin have reemerged in this context, becoming the basis of multiple combination regimens, with beneficial effects both in vitro and in murine models of infection.
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Affiliation(s)
| | | | - Emilio Maseda
- Emilio Maseda, Servicio de Anestesia y Reanimación, Hospital Universitario La Paz; Paseo de la Castellana 261, 2846, Madrid, Spain.
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Salgado P, Visnevschi-Necrasov T, Kiene RP, Azevedo I, Rocha ACS, Almeida CMR, Magalhães C. Determination of 3-mercaptopropionic acid by HPLC: A sensitive method for environmental applications. J Chromatogr B Analyt Technol Biomed Life Sci 2015; 992:103-8. [PMID: 25966653 DOI: 10.1016/j.jchromb.2015.04.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 04/04/2015] [Accepted: 04/06/2015] [Indexed: 11/25/2022]
Abstract
The organic sulfur compound 3-mercaptopropionic acid (3-MPA) is an important thiol intermediate in organic sulfur metabolism in natural environments. It is generated during degradation of sulfur-containing amino acids (e.g. methionine) and from demethylation of dimethylsulfoniopropionate (DMSP). This pathway is an alternative enzymatic process in the DMSP catabolism that routes sulfur away from the climatically-active dimethyl sulfide (DMS). 3-MPA detection and subsequent quantification in different matrices is difficult due to its extreme reactivity. We therefore developed a sensitive method for determination of 3-MPA based on pre-column derivatization with monobromobimane and analysis by high-performance liquid chromatography (HPLC) with fluorescence detection. This methodology was first tested with 3-MPA standards under low (0.005-0.2μmolL(-1)) and high (1-25μmolL(-1)) concentrations. For the optimization of the reaction, CHES and, alternatively, Tris-HCl buffers were evaluated in the derivatization step, with Tris-HCl showing more effective separation of thiol derivatives and a better 3-MPA peak shape. The detection limit was 4.3nmolL(-1) with a 10μL sample injection, and mean recoveries of 3-MPA ranged from 97 to 105% in estuarine waters with different salinities (0.17 and 35.9ppt). The linearity (r>0.99) and repeatability of detector response, with intra- and inter-day precision (% CV) of 2.68-7.01% and 4.86-12.5%, respectively, confirmed the reliability of the method. Previous 3-MPA analytical methods required immediate analysis due to unstable derivatives, but in this method we achieved high stability of the derivatized samples when stored at 4°C, with only a 3-5% loss after more than one year of storage. This method was successfully applied to measure 3-MPA concentrations and rates of 3-MPA production in a variety of intertidal estuarine sediment slurries. Dissolved 3-MPA concentrations in these sediment slurries varied between 2 and 237μmolL(-1) and, 3-MPA net fluxes ranged in wet sediments between -3.6±1.7 and 30±5μmolL(-1)g(-1)h(-1). Thus, the application of this optimized methodology showed an efficient performance for measuring 3-MPA in environmental samples, with a straightforward sample derivatization and a simple analysis of stable 3-MPA derivatives.
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Affiliation(s)
- P Salgado
- CIMAR/CIIMAR - Centre of Marine and Environmental Research, University of Porto, Rua dos Bragas, n° 289, 4050-123 Porto, Portugal.
| | - T Visnevschi-Necrasov
- CIMAR/CIIMAR - Centre of Marine and Environmental Research, University of Porto, Rua dos Bragas, n° 289, 4050-123 Porto, Portugal
| | - R P Kiene
- Department of Marine Sciences, University of South Alabama, LSCB 25, Mobile, AL 36688, USA; Dauphin Island Sea Lab, Dauphin Island, AL 36528, USA
| | - I Azevedo
- CIMAR/CIIMAR - Centre of Marine and Environmental Research, University of Porto, Rua dos Bragas, n° 289, 4050-123 Porto, Portugal
| | - A C S Rocha
- CIMAR/CIIMAR - Centre of Marine and Environmental Research, University of Porto, Rua dos Bragas, n° 289, 4050-123 Porto, Portugal
| | - C M R Almeida
- CIMAR/CIIMAR - Centre of Marine and Environmental Research, University of Porto, Rua dos Bragas, n° 289, 4050-123 Porto, Portugal
| | - C Magalhães
- CIMAR/CIIMAR - Centre of Marine and Environmental Research, University of Porto, Rua dos Bragas, n° 289, 4050-123 Porto, Portugal
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Maseda E, Suárez-de-la-Rica A, Anillo V, Salgado P, Tamayo E, García-Bernedo CA, Ramasco F, Villagrán MJ, López-Tofiño A, Giménez MJ, Granizo JJ, Hernández-Gancedo C, Aguilar L, Gilsanz F. A practice-based observational study identifying factors associated with the use of high-dose tigecycline in the treatment of secondary peritonitis in severely ill patients. Rev Esp Quimioter 2015; 28:47-53. [PMID: 25690145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
INTRODUCTION Based on tigecycline linear pharmacokinetic/pharmacodynamics, dose increases have been advocated to maximise activity especially when severe infections with high bacterial load and/or multidrug resistance are suspected. This practice-based observational study explored factors associated with tigecycline administration (100 mg/12h, 200 mg loading dose) in severely ill patients with complicated intra-abdominal infection (cIAI) admitted to four Surgical Critical Care Units (SCCUs). METHODS Medical records of all consecutive adult patients with cIAI and controlled infection source requiring surgery and admission for ≥ 48 h to SCCU were reviewed and divided into patients treated with a regimen including tigecycline (tigecycline group) and those that not (control group). A logistic regression model was performed using "tigecycline administration" (dependent variable) and variables showing differences (p ≤ 0.1) in bivariate analyses (independent variables). RESULTS One hundred and twenty one patients were included. In the tigecycline group, higher percentage of patients (vs. controls) presented colon as surgical site (66.7% vs. 41.8%, p = 0.006), nosocomial infection (55.6% vs. 26.9%, p = 0.001), mechanical ventilation (48.1% vs. 28.4%, p = 0.025), chronic renal replacement therapy (40.7% vs. 19.4%, p =0.008), septic shock (72.2% vs. 46.3%, p = 0.004), and higher values of SAPS II (48.0 ± 15.0 vs. 39.6 ± 15.5, p = 0.003), SOFA at admission (7.0 ± 3.3 vs. 5.5 ± 3.7, p = 0.020), lactate-24h (2.5 ± 2.8 vs. 1.6 ± 0.9, p = 0.029) and CRP-72 h (207.4 ± 87.9 vs. 163.7 ± 76.8, p = 0.021). In the multivariate analysis (R2 = 0.187, p < 0.001) nosocomial infection (OR = 7.721; 95%CI = 2.193, 27.179; p = 0.001), colon as infection site (OR = 4.338; 95%CI = 1.432, 13.145; p = 0.009) and CRP-72 h (OR = 1.009 per-unit; 95%CI = 1.002, 1.016; p = 0.012) were associated with tigecycline administration. CONCLUSIONS In severely ill patients with cIAI, high-dose tigecycline administration was associated with nosocomial origin of cIAI and colon as source infection site.
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Affiliation(s)
- Emilio Maseda
- Emilio Maseda, Anesthesiology and Surgical Critical Care Department. Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain.
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Salgado P, Suarez-de-la-Rica A, Maseda E, Maggi G, Hernández-Gancedo C, Lopez-Tofiño A, Palacios E, Ruiz E, Gilsanz F. Severe Mucor necrotizing fasciitis associated to dipyrone-induced agranulocytosis. Rev Esp Quimioter 2015; 28:58-60. [PMID: 25690148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Patricia Salgado
- Emilio Maseda, Anesthesiology and Surgical Critical Care Department. Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain.
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Santos J, Salgado P, Santos C, Mendes P, Saavedra J, Baldaque P, Monteiro L, Costa E. Effect of bariatric surgery on weight loss, inflammation, iron metabolism, and lipid profile. Scand J Surg 2013; 103:21-5. [PMID: 24177986 DOI: 10.1177/1457496913490467] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Accumulating evidence indicates that a state of chronic inflammation has a crucial role in the pathogenesis of obesity-related metabolic dysfunction. This study aims to evaluate changes in inflammatory process, iron metabolism, erythropoiesis, and lipid profile associated with weight loss after gastric banding surgery. MATERIAL AND METHODS A total of 46 patients were evaluated before and 3 months after gastric banding surgery. A survey was conducted to record demographic data, body mass index, and presence of comorbidities. Moreover, complete blood cell counts and serum levels of iron, ferritin, transferrin, high-sensitivity C-reactive protein, total cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, and triglycerides were performed. RESULTS At a follow-up 3 months after surgery, our patients presented a significant decrease in weight and body mass index, associated with a decreased inflammatory process (decreased high-sensitivity C-reactive protein, neutrophil counts, and neutrophil:lymphocyte ratio), increased iron availability (increased transferrin saturation and a trend to higher iron serum levels), and significant decreased triglycerides and triglycerides:high-density lipoprotein-cholesterol ratio. CONCLUSIONS Our results showed a significant decrease in the inflammation process 3 months after gastric banding surgery, associated with adipose tissue loss. This decrease in the inflammatory process is associated with more efficient iron absorption and increased iron availability for erythropoiesis. Moreover, we also found decreased triglyceride serum levels. These changes suggest benefits of weight loss, including decreased risk of cardiovascular disease.
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Affiliation(s)
- J Santos
- Hospital da Prelada-Dr. Domingos Braga da Cruz, Porto, Portugal
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Bermejo C, Maseda E, Salgado P, Gabilondo G, Gilsanz F. [Septic shock due to a community acquired Clostridium difficile infection. A case study and a review of the literature]. ACTA ACUST UNITED AC 2013; 61:219-22. [PMID: 23735318 DOI: 10.1016/j.redar.2013.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 04/07/2013] [Accepted: 04/10/2013] [Indexed: 10/26/2022]
Abstract
The epidemiology of Clostridium difficile infection has changed in the past decade. The incidence rate of community acquired cases has increased in patients with no typical risk factors. We present a patient who was diagnosed with community-acquired Clostridium difficile infection who presented with acute abdominal pain, and subsequently developed acute renal failure and septic shock. We describe the diagnosis, treatment and outcome and brief review of the literature.
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Affiliation(s)
- C Bermejo
- Servicio de Anestesiología y Reanimación, Hospital Universitario La Paz, Madrid, España
| | - E Maseda
- Servicio de Anestesiología y Reanimación, Hospital Universitario La Paz, Madrid, España.
| | - P Salgado
- Servicio de Anestesiología y Reanimación, Hospital Universitario La Paz, Madrid, España
| | - G Gabilondo
- Servicio de Anestesiología y Reanimación, Hospital Universitario La Paz, Madrid, España
| | - F Gilsanz
- Servicio de Anestesiología y Reanimación, Hospital Universitario La Paz, Madrid, España
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Durbán A, Abellán JJ, Jiménez-Hernández N, Salgado P, Ponce M, Ponce J, Garrigues V, Latorre A, Moya A. Structural alterations of faecal and mucosa-associated bacterial communities in irritable bowel syndrome. Environ Microbiol Rep 2012; 4:242-7. [PMID: 23757279 DOI: 10.1111/j.1758-2229.2012.00327.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder in western countries. Previous studies on IBS, mostly based on faecal samples, suggest alterations in the intestinal microbiota. However, no consensus has been reached regarding the association between specific bacteria and IBS. We explore the alterations of intestinal bacterial communities in IBS using massive sequencing of amplified 16S rRNA genes. Mucosal biopsies of the ascending and descending colon and faeces from 16 IBS patients and 9 healthy controls were analysed. Strong inter-individual variation was observed in the composition of the bacterial communities in both patients and controls. These communities showed less diversity in IBS cases. There were larger differences in the microbiota composition between biopsies and faeces than between patients and controls. We found a few over-represented and under-represented taxa in IBS cases with respect to controls. The detected alterations varied by site, with no changes being consistent across sample types.
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Affiliation(s)
- Ana Durbán
- Centro Superior de Investigación en Salud Pública (CSISP), Avenida de Cataluña 21, 46020, Valencia, Spain. Instituto Cavanilles de Biodiversidad y Biología Evolutiva, Universitat de València, Apartado Postal 22085, 46071 Valencia, Spain. CIBER en Epidemiología y Salud Pública (CIBEResp), Spain. School of Biological Sciences, University of California, Irvine and Minority Health and Health Disparities International Research Training (MHIRT), Irvine, California, USA. Servicio de Medicina Digestiva, Hospital Universitario La Fe, Avenida de Campanar 21, 46009 Valencia, Spain. Centro de Investigación Biomédica en Enfermedades Hepáticas y Digestivas (CIBER-EHD), Spain
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Mozo JD, Carbajo J, Sturm JC, Núñez-Vergara LJ, Salgado P, Squella JA. Determination of Nifuroxazide by Flow Injection Linear Adsorptive Stripping Voltammetry on a Screen-Printed Carbon Nanofiber Modified Electrode. ELECTROANAL 2012. [DOI: 10.1002/elan.201100612] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Alvarez P, Puente VM, Blasco MJ, Salgado P, Merino A, Bulbena A. Concurrent Koro and Cotard syndromes in a Spanish male patient with a psychotic depression and cerebrovascular disease. Psychopathology 2012; 45:126-9. [PMID: 22310658 DOI: 10.1159/000329739] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [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: 01/25/2011] [Accepted: 05/30/2011] [Indexed: 11/19/2022]
Abstract
Koro and Cotard syndromes are uncommon conditions described in a variety of psychiatric and medical disorders. The authors report the third case of a simultaneous presentation of both syndromes, in a 62-year-old inpatient Spanish male with major depressive disorder with psychotic features, parkinsonism and cognitive impairment. A discussion of the literature and the possible relationship between both syndromes and other neuropsychiatric disorders are presented.
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Affiliation(s)
- P Alvarez
- Department of Psychiatry, Centre Fòrum, INAD, Parc de Salut Mar, Barcelona, Spain.
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Bergé D, Carmona S, Rovira M, Bulbena A, Salgado P, Vilarroya O. Gray matter volume deficits and correlation with insight and negative symptoms in first-psychotic-episode subjects. Acta Psychiatr Scand 2011; 123:431-9. [PMID: 21054282 DOI: 10.1111/j.1600-0447.2010.01635.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To determine brain areas reduced in first episode of psychotic subjects and its association with lack of insight and negative symptoms. METHOD Twenty-one drug naive first-episode subjects and 20 controls underwent a structural MRI scan and were clinically assessed. Optimized voxel-based-morphometry analysis (VBM) was implemented to find between-group differences and correlations between GM volume and: (i) lack of insight and (ii) negative symptoms. RESULTS Patients showed GM reduction in prefrontal and left temporal areas. A significant correlation was found between insight and GM volume in the cerebellum (corrected P = 0.01), inferior temporal gyrus (corrected P = 0.022), medial superior frontal gyrus (corrected P < 0.001), and inferior frontal gyrus (corrected P = 0.012), as the insight decreased, the volume decreased. Negative symptoms correlated with decreased GM volume at cerebellum (corrected P = 0.037) and frontal inferior regions (corrected P < 0.001), the more negative symptoms, the less volume. CONCLUSION Our findings support an association between prefrontal, temporal, and cerebellar deficits and lack of insight in schizophrenia and confirm previous findings of GM deficits in patients since the first episode of psychosis.
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Affiliation(s)
- D Bergé
- Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Barcelona, Spain.
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Tran H, Salgado P, Tillard E, Dardenne P, Nguyen X, Lecomte P. “Global” and “local” predictions of dairy diet nutritional quality using near infrared reflectance spectroscopy. J Dairy Sci 2010; 93:4961-75. [DOI: 10.3168/jds.2008-1893] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2008] [Accepted: 03/25/2010] [Indexed: 11/19/2022]
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Dao JM, Salgado P, Lee JH, Loughlin SE, Belluzzi JD, Leslie FM. Serotonergic mechanisms underlying nicotine induced alterations in the dopamine system. FASEB J 2010. [DOI: 10.1096/fasebj.24.1_supplement.766.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | | | | | - France M Leslie
- Anatomy and Neurobiology
- PharmacologyUniversity of California, IrvineIrvineCA
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Salazar-Hernández C, Alquiza MJP, Salgado P, Cervantes J. TEOS-colloidal silica-PDMS-OH hybrid formulation used for stone consolidation. Appl Organomet Chem 2010. [DOI: 10.1002/aoc.1646] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Abstract
BACKGROUND This short report presents the case of a man with chronic anergy and mild depressive symptoms probably due to obstructive sleep apnea (OAS). METHOD The patient was treated with continuous positive airway pressure (CPAP). RESULT He developed a first manic episode at an atypical age simultaneously with the beginning of treatment. DISCUSSION Several possible connections between affective syndromes, OAS, and CPAP treatment are proposed and discussed relating to current literature.
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Affiliation(s)
- D Bergé
- Centre Forum Hospital del Mar, Institut d'Atenció Psiquiàtrica Salut Mental i Toxicomanies (IAPS), Barcelona, Spain.
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Berge D, Mane A, Salgado P, Vilarroya O, Merino A, Bulbena A. Diagnostic Stability and Clinical Characteristics in First-episode Psychosis. Eur Psychiatry 2009. [DOI: 10.1016/s0924-9338(09)71352-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Introduction:Diagnostic stability in first-episode psychosis shows a wide variability between studies. Amini and cols reported a 50% rate of patients schizophreniform disorder shifting to schizophrenia during the first 12 months period. We report the preliminary follow-up results of our recently ongoing first- episode psychosis unit.Methods:Forty-six patients admitted for a first-episode psichosis to our Inpatient Psychiatric Unit from January 2006 to January 2008 were recruited. Clinical and socio-demographic characteristics were registered during admission period and during the follow-up period.Results:At admission 52% of the first-episode subjects had a diagnosis of psychosis NOS and 32% a schizophreniform disorder diagnosis. after discharge, most of the patients (72%) had a diagnosis of schizophreniform disorder, 16% psychosis NOS and 8% brief psychotic disorder. Six months later, half of the followed-up patients had a schizophreniform disorder diagnosis, and 23% had a diagnosis of schizophrenia. 30% of the patients were drop-outs, mainly referred to other out-patient services. Patients shifting to schizophrenia were younger, predominantly male (75% vs 50% in non-schizophrenia shift), had a lower proportion of university studies and presented a longer hospitalization period at admission. No differences in familial history of psychosis and cannabis use were found. after one-year follow-up period, 50% preserved a schizophreniform disorder diagnosis and 30% were diagnosed as schizophrenia.Conclusions:Schizophrenia spectrum disorders have a high stability in first-episode psychosis during first year follow-up. as in previous studies, male gender is one of the factors that best predicts the shift to schizophrenia.
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Estrada G, González-Maya L, Celis-López M, Gavito J, Lárraga-Gutiérrez J, Salgado P, Altamirano J. Diagnostic approach in suspected recurrent primary brain tumors using 18FDG-PET/MRI, perfusion MRI, visual and quantitative analysis, and three dimensional stereotactic surface projections. First experience in Mexico. ACTA ACUST UNITED AC 2008; 27:329-39. [DOI: 10.1157/13126189] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Romero G, Kravetz D, Argonz J, Vulcano C, Suarez A, Fassio E, Dominguez N, Bosco A, Muñoz A, Salgado P, Terg R. Comparative study between nadolol and 5-isosorbide mononitrate vs. endoscopic band ligation plus sclerotherapy in the prevention of variceal rebleeding in cirrhotic patients: a randomized controlled trial. Aliment Pharmacol Ther 2006; 24:601-11. [PMID: 16827811 DOI: 10.1111/j.1365-2036.2006.03007.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND After variceal bleeding, cirrhotic patients should receive secondary prophylaxis. AIM To compare nadolol plus 5-isosorbide mononitrate (5-ISMN) with endoscopic band ligation. The end points were rebleeding, treatment failure and death. METHODS One hundred and nine cirrhotic patients with a recent variceal bleeding were randomized: nadolol plus 5-ISMN in 57 patients and endoscopic band ligation in 52 patients. RESULTS The mean follow-up was 17 and 19 months in nadolol plus 5-ISMN and endoscopic band ligation groups, respectively. No differences were observed between groups in upper rebleeding (47% vs. 46%), variceal rebleeding (40% vs. 36%), failure (32% vs. 22%), major complications (7% vs. 13.5%) and death (19% vs. 20%), respectively. The actuarial probability of remaining free of rebleeding, failure and deaths were similar in both groups. Time to rebleeding shows that endoscopic band ligation patients had an early rebleed, with a median of 0.5 month (95% CI: 0.0-4.2) compared with patients from nadolol plus 5-ISMN, 7.6 months (95% CI: 2.9-12.3, P < 0.013). Multivariate analysis indicated that outcome-specific predictive factor(s) for rebleeding was Child A vs. B + C (P < 0.01); for failure was Child A vs. B + C (P < 0.02); and for death ascites (P < 0.01) and rebleeding (P < 0.02). CONCLUSION This trial suggests no superiority of endoscopic band ligation over nadolol plus 5-ISMN mononitrate for the prevention of rebleeding in cirrhotic patients.
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Affiliation(s)
- G Romero
- Liver Unit, Hospital de Gastroenterologia Prof. Bonorino Udaondo, Buenos Aires, Argentina
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Mangone CA, Grillo R, Saavedra I, Pallo V, Salgado P. [New assessment variables in the Clock Drawing Test (CDT) allow an early and easy diagnosis of degrees of cognitive impairment]. Vertex 2005; 16:13-9. [PMID: 15785784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
OBJECTIVE We developed new subroutines and scoring procedures of the CDT to detect markers of early cognitive impairment. SUBJECTS AND METHODS We compared the performance of 41 mild Alzheimer's patients (AD) (MMSE 22.7+/-3.2); and 18 mild cognitive impairment patients (MCI) (MMSE 28.3+/-1.4), with 33 age and education matched normal controls (NC) regarding their ability in drawing a clock on command, copying a printed clock, setting hands and reading the time. We search for differences in the placement of the hands using a colloquial hour code ("a quarter to ten") and a formal numeric code ("10:45"). We focused our attention on placement and clock hands size. The drawing of hands pointing at 2:50 hs and 8:40 hs were of particular interest. RESULTS Planning strategies, placement of clock hands using a formal numeric code, clock hands size and hands drawing pointing at 2:50 hs. and 8:40 hs. were the variables that best discriminated AD, MCI and NC ( p<0.01). A stepwise regression analysis using as dependent variables (AD - NC ) and (MCI - NC) showed in both cases that the best predictor model was that formed by: planning strategies, clock hands pointing to 8:40, clock hands size, reading hours and set up clock hands following a formal numeric code (p<.001). CONCLUSIONS Our proposed modifications in this test convert it in an appropriate tool for cognitive impairment screening because they do not only detect visuoconstructional abilities but also frontal planning, contents and processing of the hour memory code and transcodification of semantic memory processes.
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Affiliation(s)
- Carlos A Mangone
- Centro de asistencia, investigación tratamiento y prevención de las enfermedades de la memoria CAITPEM-Servico de Neurología Hospital D.F. Santojanni-Cons, Bs As, Argentina.
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Papiol S, Rosa A, Gutiérrez B, Martín B, Salgado P, Catalán R, Arias B, Fañanás L. Interleukin-1 cluster is associated with genetic risk for schizophrenia and bipolar disorder. J Med Genet 2004; 41:219-23. [PMID: 14985387 PMCID: PMC1735684 DOI: 10.1136/jmg.2003.012914] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Giagante B, Oddo S, Silva W, Consalvo D, Centurion E, D'Alessio L, Solis P, Salgado P, Seoane E, Saidon P, Kochen S. Clinical-electroencephalogram patterns at seizure onset in patients with hippocampal sclerosis. Clin Neurophysiol 2004; 114:2286-93. [PMID: 14652088 DOI: 10.1016/s1388-2457(03)00284-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The purpose of this study is to identify specific clinical-electroencephalogram (EEG) patterns at seizure onset in patients with hippocampal sclerosis (HS). METHODS Sixty-six ictal video-EEG recordings corresponding to 26 patients with HS have been reviewed, focusing on the EEG features found during the first 30 ictal s. The EEG activity has been classified into the following groups: (A) according to spatial distribution: type 1: temporal electrodes on one side; type 2: temporal and adjacent frontal electrodes on one side; and type 3: non-lateralizing electrographic activity; and (B) according to morphology; subtype (a): regular 5-9 Hz rhythmic activity (RA); subtype (b): low-voltage rapid activity, followed by a 5-9 Hz RA; and subtype (c): irregular EEG sharp waves. We analyzed the clinical symptoms sequence and established the relationship with the ictal EEG patterns. RESULTS Considering spatial distribution and morphology, the most frequent ictal EEG patterns were type 1 (57%), type 2 (37%), and subtype (a): 62%; subtype (b): 27%; and subtype (c): 11%. The sequence of clinical symptoms observed was: aura-->behavioral arrest-->oro-alimentary automatisms-->unilateral hand automatisms. All seizures with aura and including two or more symptoms of the clinical sequence (65%) were associated with a 1a, 1b, 2a or 2b EEG pattern. CONCLUSIONS The identification of a specific clinical-EEG pattern provides a useful tool for the epileptogenic zone localization in non-invasive pre-surgical assessment of patients with hippocampal sclerosis. SIGNIFICANCE The identification of a specific clinical-EEG pattern associated to neuroimaging findings and neuropsychological testing allows indicating surgery for the treatment of epilepsy in patients with hippocampal sclerosis, without performing any further complementary studies.
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Affiliation(s)
- B Giagante
- Centro de Epilepsia, División Neurología, Hospital 'JM. Ramos Mejia Instituto de Biología Celular y Neurociencias, Dr. Eduardo De Robertis, Facultad de Medicina, Universidad de Buenos Aires, Argentina.
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López-Gentili LI, Kremenchutzky M, Salgado P. [Data base for patients with balance disorders]. Rev Neurol 2003; 36:960-5. [PMID: 12766872] [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: 03/02/2023]
Abstract
INTRODUCTION With the aim of integrating clinical thinking and obtaining epidemiological and biostatistical results in long series of patients who present balance disorders, we have developed a neuro otological protocol and its corresponding database. This offers answers to the questions of how to assess the patient, how to conduct a clinical interview correctly, and which complementary studies should be requested and how. RESULTS The information from the protocol is stored and analysed in our database, which was designed in the Epi Info software application, produced by CDC (NIH, USA), in collaboration with the WHO Global Program on AIDS. The application, which we call ENO LK, has already been used to store data concerning 1,100 patients whose average age is 54.5 years old and 62.8% of which were females (SD 18, range 4 93). 69.1% were diagnosed as suffering from vertigo, 12.7% displayed instability, 1.9% syncope and 16.3% had other causes (37% psychogenic and 28% disorders affecting the central integrator). Of the 760 patients with vertigo, in 55% it was positional (60% of these were idiopathic benign), 6.3% were sustained (peripheral causes accounted for 74% and a vascular aetiology was predominant in the central causes), 26.6% were recurring and 12.1% otolithic (in this series the vertigos all had a central aetiology). CONCLUSIONS With this application the user has the possibility of obtaining epidemiological and diagnostic conclusions efficiently and effectively, as well as aiding to follow up all patients who present balance disorders.
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Affiliation(s)
- L I López-Gentili
- Sector Neuro-Otología, División Neurología, Hospital Ramos Mejía, Buenos Aires, Argentina.
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López-Gentili LI, Kremenchutzky M, Salgado P. [A statistical analysis of 1300 patients with dizziness-vertigo. Its most frequent causes]. Rev Neurol 2003; 36:417-20. [PMID: 12640592] [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: 03/01/2023]
Abstract
PATIENTS AND METHODS We analysed the records of the individuals who were attended because of dizziness or vertigo in the vestibular sector, with the aim of describing the epidemiological clinical profile of a group of patients with such symptoms. 1300 patients were systematically evaluated according to our neuro otological examination protocol. Diagnoses were ordered, according to the international classification reported by Drachman and later modified by Bahlo, in four categories: 1. Vertigo, 2. Instability, 3. Pre syncope and 4. Miscellaneous. Each of these classes was organised according to the topography of the lesion and these were in turn grouped by aetiologies (viral, vascular, tumoural, demyelinating, post traumatic, idiopathic, autoimmune, etc.). The data were stored and analysed in a computer database, Epi info 6.02 (OMS 1994), which was especially adapted by the researchers for the purpose. RESULTS 63.1% were women. The average age was 55.5 years old (SD: 17.5, interval: 4 93). Vertigo was diagnosed in 68.9%, instability was found in 12.4%, 1.8% presented syncope and miscellaneous disorders occurred in 16.9% (of these, 64.1% had disorders of the central integrator and 16.4% were of a psychogenic origin). Of the 1300 patients, 896 presented vertigo; the positional type was seen in 54%, sustained in 6.5%, recurrent in 27.7% and 11.8% were found to have the otolithic type. CONCLUSIONS The relevance of the epidemiological work based on clinical evaluation and the thorough neuro otological examination in our medium must be highlighted. These findings were similar to those reported in the international literature in more delimited series.
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Salgado P, Martins J, Carvalho F, Abreu M, Freire J, Toullec R, Lallès J, Bento O. Component digestibility of lupin (Lupinus angustifolius) and pea (Pisum sativum) seeds and effects on the small intestine and body organs in anastomosed and intact growing pigs. Anim Feed Sci Technol 2002. [DOI: 10.1016/s0377-8401(02)00027-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Papiol S, Martín B, Rosa A, Gutiérrez B, Salgado P, Catalán R, Gastó C, Fañanas L. Interleukin-1beta gene promoter polymorphism and risk to functional psychosis. Eur Psychiatry 2002. [DOI: 10.1016/s0924-9338(02)80634-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Jurado MA, Junqué C, Vallejo J, Salgado P, Grafman J. Obsessive-compulsive disorder (OCD) patients are impaired in remembering temporal order and in judging their own performance. J Clin Exp Neuropsychol 2002; 24:261-9. [PMID: 11992208 DOI: 10.1076/jcen.24.3.261.986] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Obsessive-compulsive disorder (OCD) has been related to frontostriatal dysfunction, but some inconsistencies between studies and a relative paucity of neuropsychological research still characterizes the study of OCD. We compared 28 patients with OCD and matched healthy controls on two neuropsychological tests sensitive to frontal dysfunction: temporal ordering and a "feeling-of-doing" (FOD) judgment about ordering. The OCD group performed significantly worse than controls in the temporal ordering task despite showing normal recognition memory. Patients were also impaired in "feeling-of-doing" judgments suggesting they have a lack of self-awareness of their performance. Thus, the results of the current study reinforces previous research that indicates that OCD patients fail on tasks that require adequate functioning of the frontal-striatal pathways.
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Affiliation(s)
- M A Jurado
- Dpt. Psiquiatria i Psicobiologia clínica, Universitat de Barcelona, Spain.
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Abstract
The aim of our study was to investigate whether patients with obsessive-compulsive disorder (OCD) have impaired incidental memory for frequency. Fifty-four subjects (27 OCD patients and 27 matched control subjects) performed a task assessing estimation of occurrence of previously heard words. Performance on this task was compared with other intentional verbal memory tasks (recognition, recall and learning of common words). We also correlated memory for frequency with frontal lobe tests (Wisconsin Card Sorting Test, Trail Making Tests A and B, and verbal fluency). Performance on incidental learning of frequency was significantly worse in the OCD group than in control subjects. Other verbal memory measures did not show significant differences. Performance in the frequency task correlated with verbal fluency. Although intentional verbal memories are normal in OCD patients, incidental memory for frequency is impaired, suggesting that prefrontal systems are involved in OCD.
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Affiliation(s)
- M A Jurado
- Departament de Psiquiatria i Psicobiologia Clínica, Universitat de Barcelona, Passeig de la Vall d'Hebron 171, E-08035 Barcelona, Spain.
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Alonso P, Menchon JM, Pifarre J, Mataix-Cols D, Torres L, Salgado P, Vallejo J. Long-term follow-up and predictors of clinical outcome in obsessive-compulsive patients treated with serotonin reuptake inhibitors and behavioral therapy. J Clin Psychiatry 2001; 62:535-40. [PMID: 11488364 DOI: 10.4088/jcp.v62n07a06] [Citation(s) in RCA: 141] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The objective of this study was to examine the long-term course of obsessive-compulsive disorder (OCD) in patients treated with serotonin reuptake inhibitors (SRIs) and behavioral therapy and to identify predictors of clinical outcome. METHOD Sixty outpatients meeting DSM-II-R or DSM-IV criteria for OCD were followed up for 1 to 5 years (mean = 2.5 years). All of them received prolonged pharmacologic therapy with an SRI. RESULTS Thirty-seven patients (61.7%) completed an adequate behavioral treatment. At long-term assessment, 22 patients (36.7%) exhibited a global Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score greater than 16 or a final reduction in Y-BOCS global score of less than 35% and were considered nonresponders. Patients who completed behavioral therapy showed a significant decrease in Y-BOCS compulsions subscale score (p = .01), whereas no significant differences in either Y-BOCS global or obsessions subscale scores between those who did and those who did not undergo behavioral therapy were detected. Obsessions of sexual/religious content were the unique factor related to a poorer long-term outcome. CONCLUSION A substantial number of OCD patients showed persistent disabling symptoms at the long-term follow-up in spite of combined pharmacologic and behavioral treatment. Major benefits from behavioral therapy appeared to be the improvement of ritualistic behaviors. Sexual/religious obsessions predicted poorer long-term outcome, whereas short-term response to SRI treatment failed to achieve predictive value in the long-term course of OCD.
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Affiliation(s)
- P Alonso
- Department of Psychiatry, Hospital Principes de España, Ciudad Sanitaria y Universitaria de Bellvitge, Barcelona, Spain
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Salgado P, Lallès J, Toullec R, Mourato M, Cabral F, Freire J. Nutrient digestibility of chickpea (Cicer arietinum L.) seeds and effects on the small intestine of weaned piglets. Anim Feed Sci Technol 2001. [DOI: 10.1016/s0377-8401(01)00236-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Condés-Lara M, Barrios FA, Romo JR, Rojas R, Salgado P, Sánchez-Cortazar J. Brain somatic representation of phantom and intact limb: a fMRI study case report. Eur J Pain 2001; 4:239-45. [PMID: 10985867 DOI: 10.1053/eujp.2000.0176] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Reports on phantom limb patients concerning neuronal reorganization using non-invasive methods have focused mainly on the cortical regions and suggest the presence of pain as the cause of this reorganization. The phantom limb, however, includes other somatic and motor sensations other than pain. Here we describe the results of non-painful stimulation in cortical and subcortical lateralization and reorganization and also examine the involvement of subcortical structures in phantom limb telescoping perception. We describe an enlarged contralateral cortical representation of the stump, a cortical and thalamic bilateral representation of the remaining leg, and a neuronal correlate of a telescoping perception of the phantom limb. The missing leg produces an enlarged cortical representation due to abnormal information and the remaining leg has a bilateral SII representation, which could be related to new, compensatory functions. The telescoping perception of a phantom limb by the stimulation of misallocation points was correlated with lenticular nuclei, thalamic and cingulate gyrus activation. We therefore propose that the reorganization concept of a phantom limb, applied mainly to the cortex, must extend to the thalamic and the somatosensory and motor systems (pathways and relay nuclei).
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Affiliation(s)
- M Condés-Lara
- Departamento de Neurofisiología, Centro de Neurobiología, Universidad Nacional Autónoma de México, Juriquilla, Querétaro.
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48
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Cantú C, Pineda C, Barinagarrementeria F, Salgado P, Gurza A, Espinosa R, Martínez-Lavín M. Noninvasive cerebrovascular assessment of Takayasu arteritis. Stroke 2000; 31:2197-202. [PMID: 10978051 DOI: 10.1161/01.str.31.9.2197] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Despite prominent neurological symptoms reported in Takayasu arteritis (TA), a complete evaluation of the cerebral circulation has not been consistently performed. The purpose of this study is to describe MR angiography (MRA), color Doppler flow imaging, and transcranial Doppler (TCD) findings in the extracranial and intracranial cerebral arteries in TA. METHODS MRA, color Doppler flow imaging, and TCD were performed in 21 patients with TA. Intima-media thickness was measured in the common carotid artery. The correlation between noninvasive studies and panaorto-arteriography was examined for supraortic vessels. Cerebral angiography findings were compared with the noninvasive methods in 7 patients. Intracranial hemodynamic changes detected by TCD were compared with extracranial circulation lesions assessed by panaorto-arteriography. RESULTS Noninvasive vascular techniques showed at least 1 abnormality in the extracranial and/or intracranial cerebral arteries in 20 of 21 patients (95%). Both MRA and color Doppler flow imaging showed a substantial correlation in the ability to detect obstructive lesions in supra-aortic vessels compared with panaorto-arteriography. High-resolution ultrasonography displayed common carotid artery wall thickening in 5 vessels that were considered normal by arteriography. In 24% of patients, MRA and TCD showed abnormalities consistent with stenosis of the basal cerebral arteries. In 10 patients with severe extracranial circulation involvement (detected by arteriography), TCD displayed intracranial hemodynamic changes consisting of dampened or blunted waveforms with low pulsatility. CONCLUSIONS The comprehensive assessment of cerebral circulation in TA patients by noninvasive methods allowed the detection of a high rate of diverse vascular abnormalities in both extracranial and intracranial circulation.
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Affiliation(s)
- C Cantú
- Stroke Clinic, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico
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Lallès JP, Tukur HM, Salgado P, Mills EN, Morgan MR, Quillien L, Levieux D, Toullec R. Immunochemical studies on gastric and intestinal digestion of soybean glycinin and beta-conglycinin in vivo. J Agric Food Chem 1999; 47:2797-806. [PMID: 10552568 DOI: 10.1021/jf980882+] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Two experiments were conducted to study gastric and small intestinal digestion of soybean glycinin and beta-conglycinin in preruminant calves fed milk replacers containing a mixture of skim milk powder and antigenic heated soybean flour. In experiment 1, duodenal passage of immunoreactive beta-conglycinin lasted for a much longer time after the morning meal than that of glycinin. Western blotting revealed the early abomasal outflow of glycinin subunits that associated nearly intact basic polypeptides to partially degraded acidic polypeptides. Intact beta-conglycinin was evidenced at most sampling times. In experiment 2, intact basic glycinin (M(r) = 21000) associated with partially digested acidic glycinin (7000 < M(r) < 25000) was demonstrated in ileal digesta up to 8-10 h after the meal. beta-Conglycinin immunoreactivity could not be evidenced by Western blotting in ileal digesta.
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Affiliation(s)
- J P Lallès
- Laboratoire du Jeune Ruminant, INRA, 65 rue de Saint-Brieuc, 35042 Rennes Cedex, France.
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Callén M, Marañón E, Mastral A, Murillo R, Salgado P, Sastre H. Ecotoxicological assessment of ashes and particulate matter from fluidized bed combustion of coal. Ecotoxicol Environ Saf 1998; 41:59-61. [PMID: 9756690 DOI: 10.1006/eesa.1998.1667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Toxicity of ash and particulate matter from the gases generated in coal fluidized bed combustion (FBC) has been determined by the Microtox assay according to the standard leachate procedure. Results are compared with the polycylic aromatic hydrocarbon (PAH) content of the particulate matter, which was determined by fluorescence spectroscopy. Although PAHs are considered highly toxic compounds, the low ecotoxicity values obtained could be explained by the low solubility of the compounds in water. The Microtox assay may underestimate the toxicity of water-insoluble compounds unless they are previously extracted with an organic solvent. Nevertheless, this type of assay can be very useful for measuring the potential toxicity of residues when exposed to water sources such as rain water and the risk of the components being dissolved and transported by runoff water.
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Affiliation(s)
- M Callén
- Instituto de Carboquímica, CSIC, Zaragoza, 50080, Spain
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