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Sanchez R, Maus TM. Training Model for Special Competency in Echocardiographic Guidance of Structural Heart Disease Interventions: The Value of High-Volume Institutions. J Cardiothorac Vasc Anesth 2023; 37:2204-2206. [PMID: 37596100 DOI: 10.1053/j.jvca.2023.07.024] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 08/20/2023]
Affiliation(s)
- Ramon Sanchez
- Sulpizio Cardiovascular Center, University of California, San Diego, La Jolla, CA
| | - Timothy Michael Maus
- Sulpizio Cardiovascular Center, University of California, San Diego, La Jolla, CA.
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Brubaker AL, Bensard C, MacConmara M, Elbetanony A, Attia M, Sanchez R, Schnickel G. Extended duration of machine perfusion: Maximizing organ utilization. Liver Transpl 2023; 29:1242-1244. [PMID: 37432896 DOI: 10.1097/lvt.0000000000000212] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 06/11/2023] [Indexed: 07/13/2023]
Affiliation(s)
- Aleah L Brubaker
- Department of Surgery, Division of Transplant and Hepatobiliary Surgery, UC San Diego, San Diego, California, USA
| | - Claire Bensard
- Department of Surgery, Division of Transplant and Hepatobiliary Surgery, UC San Diego, San Diego, California, USA
| | | | | | | | - Ramon Sanchez
- Department of Anesthesia, UC San Diego, San Diego, California, USA
| | - Gabriel Schnickel
- Department of Surgery, Division of Transplant and Hepatobiliary Surgery, UC San Diego, San Diego, California, USA
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Jurado CA, Villalobos-Tinoco J, Mekled S, Sanchez R, Afrashtehfar KI. Printed Digital Wax-up Model as a Blueprint for Layered Pressed-ceramic Laminate Veneers: Technique Description and Case Report. Oper Dent 2023; 48:618-626. [PMID: 37881104 DOI: 10.2341/22-144-s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2023] [Indexed: 10/27/2023]
Abstract
This article presents a clinical technique for transferring Digital Smile Design (DSD) information and a digital wax-up to fabricate highly personalized ceramic laminate veneers. The hybrid workflow of digitally designed wax-up and conventional hand-crafted veneers is showcased in a female adult who sought to improve her smile due to maxillary anterior incisal wear. The ceramic veneers, layered by feldspathic porcelain, followed the contours and shade blueprint planned with the digital wax-up. The DSD improved the harmony of the facial-and-smile relationship, and the ceramic restorations fulfilled the patient's esthetic and functional demands. Guides based on the printed model with the digitally designed wax-up can provide a reference for pressed lithium disilicate veneers layered with feldspathic porcelain.
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Affiliation(s)
- C A Jurado
- Carlos Alberto Jurado, DDS, MS, associate professor, Department of Prosthodontics, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
| | - J Villalobos-Tinoco
- Jose Villalobos-Tinoco, DDS, MS, visiting faculty, Specialty Program in Periodontics, National University of Rosario School of Dentistry, Rosario, Argentina
| | - S Mekled
- Salwa Mekled, DDS, MBA, associate professor, Department of Restorative Dentistry, Temple University Kornberg School of Dentistry, Philadelphia, PA, USA
| | - R Sanchez
- Ramon Sanchez, MDT, dental technician, private practice, San Felipe, BC, Mexico
| | - K I Afrashtehfar
- *Kelvin I. Afrashtehfar, DDS, MSc, Dr, FDS RCS, FRCDC, assistant professor, Division of Restorative Dental Sciences, Clinical Sciences Department, College of Dentistry, Ajman University, AE, UAE; adjunct research associate professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, BE, Switzerland
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Sanchez R, Duncker D, Colley B, Doering M, Gummadi S, Perings C, Robertson M, Shroff G, Veltmann
C. The Heart Failure Optimization Study (HF-OPT): rationale and design. Herzschrittmacherther Elektrophysiol 2023; 34:52-58. [PMID: 36695885 PMCID: PMC9950163 DOI: 10.1007/s00399-022-00920-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND According to the current guidelines, implantable cardioverter-defibrillators (ICD) for primary prevention in patients with heart failure and reduced ejection fraction (HFrEF) should not be considered until optimal guideline-directed medical therapy (GDMT) has been achieved for a minimum of 3 months. Optimization of GDMT often needs time beyond 3 months after diagnosis. The aim of the Heart Failure Optimization Study (HF-OPT) is to evaluate the recovery of left ventricular function beyond 3 months after diagnosis of newly diagnosed HFrEF. METHODS The HF-OPT multicenter study is comprised of two non-randomized phases (registry and study). During the first 90 days a wearable cardioverter-defibrillator (WCD) is prescribed and patients are enrolled in an observational pre-study registry. Registry subjects meeting inclusion criteria for the study portion at day 90 have ongoing left ventricular ejection fraction (LVEF) reassessment at 90, 180 and 360 days after the index hospital discharge, regardless of continued WCD use. Approximately 600 subjects will be enrolled in the study portion. Of those, one-third are anticipated to start the study phase at day 90 with reduced LVEF. The primary objective of this study is to observe the rate of recovery of LVEF > 35% between 90 and 180 days, while key secondary endpoints include mortality and WCD recorded arrhythmias and shocks. DISCUSSION The HF-OPT study will provide important information on the rate of additional recovery of LVEF > 35%, between 90 and 180 days, in newly diagnosed HF with reduced LVEF patients being titrated with GDMT. The results of the study may impact indications for primary prophylactic ICD implantation.
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Affiliation(s)
- R. Sanchez
- HCA Florida Heart Institute, St. Petersburg, FL USA
| | - D. Duncker
- Hannover Heart Rhythm Center, Hannover Medical School, Hannover, Germany
| | - B. Colley
- Jackson Heart Clinic, Jackson, MS USA
| | - M. Doering
- Heart Center Leipzig, University of Leipzig, Leipzig, Germany
| | | | - C. Perings
- Katholisches Klinikum Luenen, Luenen, Germany
| | | | - G. Shroff
- Baptist Heart Specialists, Jacksonville, FL USA
| | - C. Veltmann
- Hannover Heart Rhythm Center, Hannover Medical School, Hannover, Germany
- Center for Electrophysiology Bremen, Klinikum Links der Weser, Senator-Wessling-Str. 1, 28277 Bremen, Germany
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Brubaker AL, Urey MA, Taj R, Parekh JR, Berumen J, Kearns M, Shah M, Khan A, Kono Y, Ajmera V, Barman P, Tran H, Adler ED, Silva Enciso J, Asimakopoulos F, Costello C, Bower R, Sanchez R, Pretorius V, Schnickel GT. Heart-liver-kidney transplantation for AL amyloidosis using normothermic recovery and storage from a donor following circulatory death: Short-term outcome in a first-in-world experience. Am J Transplant 2023; 23:291-293. [PMID: 36804136 DOI: 10.1016/j.ajt.2022.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 08/10/2022] [Revised: 10/18/2022] [Accepted: 11/10/2022] [Indexed: 01/13/2023]
Abstract
AL amyloidosis is a rare condition characterized by the overproduction of an unstable free light chain, protein misfolding and aggregation, and extracellular deposition that can progress to multiorgan involvement and failure. To our knowledge, this is the first worldwide report to describe triple organ transplantation for AL amyloidosis and triple organ transplantation using thoracoabdominal normothermic regional perfusion recovery with a donation from a circulatory death (DCD) donor. The recipient was a 40-year-old man with multiorgan AL amyloidosis with a terminal prognosis without multiorgan transplantation. An appropriate DCD donor was selected for sequential heart, liver, and kidney transplants via our center's thoracoabdominal normothermic regional perfusion pathway. The liver was additionally placed on an ex vivo normothermic machine perfusion, and the kidney was maintained on hypothermic machine perfusion while awaiting implantation. The heart transplant was completed first (cold ischemic time [CIT]: 131 minutes), followed by the liver transplant (CIT: 87 minutes, normothermic machine perfusion: 301 minutes). Kidney transplantation was performed the following day (CIT: 1833 minutes). He is 8 months posttransplant without evidence of heart, liver, or kidney graft dysfunction or rejection. This case highlights the feasibility of normothermic recovery and storage modalities for DCD donors, which can expand transplant opportunities for allografts previously not considered for multiorgan transplantations.
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Affiliation(s)
- Aleah L Brubaker
- Department of Surgery, Division of Transplant and Hepatobiliary Surgery, University of California San Diego, San Diego, California, USA.
| | - Marcus A Urey
- Department of Medicine, Division of Cardiology, University of California San Diego, San Diego, California, USA
| | - Raeda Taj
- Department of Surgery, Division of Transplant and Hepatobiliary Surgery, University of California San Diego, San Diego, California, USA
| | - Justin R Parekh
- Department of Surgery, Division of Transplant and Hepatobiliary Surgery, University of California San Diego, San Diego, California, USA
| | - Jennifer Berumen
- Department of Surgery, Division of Transplant and Hepatobiliary Surgery, University of California San Diego, San Diego, California, USA
| | - Mark Kearns
- Department of Surgery, Division of Cardiothoracic Surgery, University of California San Diego, San Diego, California, USA
| | - Mita Shah
- Department of Medicine, Division of Nephrology, University of California San Diego, San Diego, California, USA
| | - Adnan Khan
- Department of Medicine, Division of Nephrology, University of California San Diego, San Diego, California, USA
| | - Yuko Kono
- Department of Medicine, Division of Hepatology, University of California San Diego, San Diego, California, USA
| | - Veeral Ajmera
- Department of Medicine, Division of Hepatology, University of California San Diego, San Diego, California, USA
| | - Pranab Barman
- Department of Medicine, Division of Hepatology, University of California San Diego, San Diego, California, USA
| | - Hao Tran
- Department of Medicine, Division of Cardiology, University of California San Diego, San Diego, California, USA
| | - Eric D Adler
- Department of Medicine, Division of Cardiology, University of California San Diego, San Diego, California, USA
| | - Jorge Silva Enciso
- Department of Medicine, Division of Cardiology, University of California San Diego, San Diego, California, USA
| | - Fotis Asimakopoulos
- Department of Medicine, Division of Bone Marrow Transplant, University of California San Diego, San Diego, California, USA
| | - Caitlin Costello
- Department of Medicine, Division of Bone Marrow Transplant, University of California San Diego, San Diego, California, USA
| | - Richard Bower
- Department of Gastroenterology, Naval Medical Center San Diego, California, USA
| | - Ramon Sanchez
- Department of Anesthesia, University of California San Diego, San Diego, California, USA
| | - Victor Pretorius
- Department of Surgery, Division of Cardiothoracic Surgery, University of California San Diego, San Diego, California, USA
| | - Gabriel T Schnickel
- Department of Surgery, Division of Transplant and Hepatobiliary Surgery, University of California San Diego, San Diego, California, USA
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Sanchez R, Duncker D, Colley B, Doering M, Gummadi S, Perings C, Robertson M, Shroff G, Veltmann C. Publisher Erratum: The Heart Failure Optimization Study (HF‑OPT): rationale and design. Herzschrittmacherther Elektrophysiol 2023; 34:91. [PMID: 36786850 PMCID: PMC9950152 DOI: 10.1007/s00399-023-00928-5] [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: 02/15/2023]
Affiliation(s)
- R. Sanchez
- HCA Florida Heart Institute, St. Petersburg, FL USA
| | - D. Duncker
- Hannover Heart Rhythm Center, Hannover Medical School, Hannover, Germany
| | - B. Colley
- Jackson Heart Clinic, Jackson, MS USA
| | - M. Doering
- Heart Center Leipzig, University of Leipzig, Leipzig, Germany
| | | | - C. Perings
- Katholisches Klinikum Luenen, Luenen, Germany
| | | | - G. Shroff
- Baptist Heart Specialists, Jacksonville, FL USA
| | - C. Veltmann
- Hannover Heart Rhythm Center, Hannover Medical School, Hannover, Germany ,Center for Electrophysiology Bremen, Klinikum Links der Weser, Senator-Wessling-Str. 1, 28277 Bremen, Germany
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Teixido Tura G, Martinez D, Calvo F, Garcia-Orta R, Sanchez R, Larranaga JM, Hernandiz A, Diaz E, Montanes E, Cabrera F, Sabate A, Nistal F, Forteza A, Evangelista A. Aortic and vascular involvement in Loeys-Dietz Syndrome. Results from the REPAG registry (Spanish network of genetic aortic diseases). Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
LDS is a rare disease due to genetic variants in the TGFB pathway. Limited information is available regarding the overall aortic and vascular outcome of these patients
Purpose
To evaluate aortic and vascular complications of patients with mutations in the TGFB pathway.
Methods
Retrospective longitudinal study including patients with (likely) pathogenic (LP/P) variants in the TGFbeta pathway from 10 tertiary centers. Clinical and imaging data were reviewed and data on aortic and vascular outcome included.
Results
A total of 163 patients were included (47.9% women, 38.6% index cases), mean age at first evaluation 32.3±20.4 years, 27.0% with age <16 years. 70 TGFBR1, 43 TGFBR2, 29 SMAD3, 9 TGFB2 and 12 TGFB3 (Table1)
During a mean follow-up of 4.7±3.7 years, 54 (33.1%) patients had at least 1 aortic surgery (max 6). Mean age at first aortic surgery was 37.2±16.8 years (Range 1.2–72.9). First surgery was elective in 42 (77.8%), and included aortic root or ascending aorta in 40 (95.2%) and isolated descending aorta in 2 (4.8%). Emergent surgery included aortic root or ascending aorta in 11 (92.7%). Ascending aorta-root diameter previous to elective surgery was 48.9±4.9mm (range 41–65). 7 patients died during follow-up (2 intracranial bleeding, 1 SD, 2 aortic ruptures, 1post aortic surgery, 1 non-CV). Furthermore, 19 acute aortic syndromes (AAS) were reported (17 dissections, 2 haematomas) in 18 patients, 10 type A (52.6%). Mean age at first AAS was 42.3±11.1 years (min 19.7 years to 62.9 years)
Median survival free of intervention, dissection or death was 57.1 years, being worst for men than women (44.7 yrs vs 69.1 years, p<0.001) (Figure 1), these gender-difference only remained significant in the TGFBR1 and SMAD3 groups (p=0.005 and p=0.008) Regarding aortic branch and intracranial aneurysms, a total of 383 imaging studies of aortic branches and 223 cranial imaging studies were performed during the clinical follow-up. 21 cranial aneurysms and 73 aortic branch aneurisms were reported. 14 (11.5%) patients suffered 19 aneurysms-related events (3 dissections, 3 ruptures, 13 interventions).
Conclusions
In patients with Loeys-Dietz Syndrome, there's a high prevalence of aortic surgeries and acute aortic events, with high numbers of peripheral and intracranial aneurysms. A worst prognosis in men than in women is observed in TGFBR1 and SMAD3 variants. Thus, specialized clinical and imaging follow-up is crucial in the management of these patients
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- G Teixido Tura
- University Hospital Vall d'Hebron, Cardiology , Barcelona , Spain
| | - D Martinez
- Puerta de Hierro Majadahonda University Hospital, Cardiac Surgery, Majadahonda , Madrid , Spain
| | - F Calvo
- Hospital Universitario Alvaro Cunqueiro, Cardiology , Vigo , Spain
| | - R Garcia-Orta
- Virgen de las Nieves University Hospital, Cardiology , Granada , Spain
| | - R Sanchez
- General University Hospital of Alicante , Alicante , Spain
| | - J M Larranaga
- Hospital General A Coruna, Cardiology , A Coruna , Spain
| | - A Hernandiz
- Hospital Universitario y Politecnico La Fe , Valencia , Spain
| | - E Diaz
- Hospital Clinico Universitario, Cardiology , Salamanca , Spain
| | - E Montanes
- University Hospital 12 de Octubre , Madrid , Spain
| | - F Cabrera
- University Hospital Virgen de la Victoria, Cardiology , Malaga , Spain
| | - A Sabate
- University Hospital Vall d'Hebron, Pediatric Cardiology , Barcelona , Spain
| | - F Nistal
- University Hospital Marques de Valdecilla, Cardiac Surgery , Santander , Spain
| | - A Forteza
- Puerta de Hierro Majadahonda University Hospital, Cardiac Surgery, Majadahonda , Madrid , Spain
| | - A Evangelista
- University Hospital Vall d'Hebron, Cardiology , Barcelona , Spain
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Rocamora-Horrach M, Peiro O, Serrano I, Rodriguez J, Carrasquer A, Ferrero-Guillem M, Romeu A, Lal-Trehan N, Sanchez R, Del Moral V, Delgado JR, Bardaji A. Profile and prognosis of patients with heart failure with recovered ejection fraction. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Patients with heart failure (HF) and reduced ejection fraction (rEF) have a poor prognosis. Nevertheless, in the subgroup of patients with recovered ejection fraction (recEF) prognosis is unknown.
Purpose
To analyze characteristics and prognosis in patients with HFrEF (initial EF and at one year <40%) and HFrecEF (initial EF <40% and at one year ≥40% with ≥10% absolute improvement from the initial value).
Methods
Retrospective observational study of outpatients referred to the HF unit within March/2006 and November/2021. Baseline characteristics, ecocardiographic data and follow-up were collected, discerning between patients with HFrEF and HFrecEF.
Results
A total of 346 patients (76.0% men) were analyzed with a mean of age 66.3 (IQR 57.8–74.4) years, of which 50.6% remained with rEF and 49.4% recEF. Median follow-up was 4.6 (2.8–7.9) years. Both groups had a similar risk profile albeit less prevalence of dyslipidemia in the group with recEF (43.5% vs 56.7%, p=0.015). Ischemic etiology predominated in those with rEF (41.7% vs 25.7%, p=0.002) and enolic in recEF (10.5% vs 3.4%, p=0.009). The incidence of combined event (readmission for HF or death) was lower in HFrecEF (33.6% vs 66.4%, p<0.001), as well as death (33.9% vs 66.1%, p<0.001) and readmission for HF (24.4% vs 75.6%, p<0.001). Prevalence of cardiovascular death was lower in the group with recEF (37.8% vs 61.1%, p=0.021). In the multivariate analysis, rEF was an independent predictor for the combined event (HR 2.17; 95% IC [1.45–3.25], p<0.001), as well as for global mortality and readmission for HF.
Conclusion
Patients with HFrecEF have a similar risk profile than patients with HFrEF although with better long-term prognosis.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Rocamora-Horrach
- University Hospital of Taragona Joan XXIII, Cardiology Department , Tarragona , Spain
| | - O Peiro
- University Hospital of Taragona Joan XXIII, Cardiology Department , Tarragona , Spain
| | - I Serrano
- University Hospital of Taragona Joan XXIII, Cardiology Department , Tarragona , Spain
| | - J Rodriguez
- University Hospital of Taragona Joan XXIII, Cardiology Department , Tarragona , Spain
| | - A Carrasquer
- University Hospital of Taragona Joan XXIII, Cardiology Department , Tarragona , Spain
| | - M Ferrero-Guillem
- University Hospital of Taragona Joan XXIII, Cardiology Department , Tarragona , Spain
| | - A Romeu
- University Hospital of Taragona Joan XXIII, Cardiology Department , Tarragona , Spain
| | - N Lal-Trehan
- University Hospital of Taragona Joan XXIII, Cardiology Department , Tarragona , Spain
| | - R Sanchez
- University Hospital of Taragona Joan XXIII, Cardiology Department , Tarragona , Spain
| | - V Del Moral
- University Hospital of Taragona Joan XXIII, Cardiology Department , Tarragona , Spain
| | - J R Delgado
- University Hospital of Taragona Joan XXIII, Cardiology Department , Tarragona , Spain
| | - A Bardaji
- University Hospital of Taragona Joan XXIII, Cardiology Department , Tarragona , Spain
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Sanchez R, Herrera C, Witkowski M. Effect of the timing of insemination (pre- or post-ovulatory) and type of semen (refrigerated or frozen) on the sex ratio of equine offspring. J Equine Vet Sci 2022. [DOI: 10.1016/j.jevs.2022.103985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Prieto M, Carocca A, Fullerton C, Hidalgo A, Diaz J, San Martin P, Godoy M, Nuño M, De Leon A, Rodriguez J, Sanchez R, Batiz F, Castillo A, Cuellar-Barboza A, Biernacka J, Frye M. Clinical Correlates of Cardiac Conduction in Bipolar Disorder. Eur Psychiatry 2022. [PMCID: PMC9566191 DOI: 10.1192/j.eurpsy.2022.1019] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Patients with bipolar disorder (BD) have an increased risk for cardiovascular morbimortality. Clinical risk factors, specifically for arrhythmias and sudden cardiac death remain understudied. Objectives This study was conducted to assess differences in cardiac conduction among BD patients. Methods We included patients with BD in a cross-sectional design, confirmed by structured interview, age 18 through 80. Clinical characteristics were obtained using a structured questionnaire or medical records review. ECG intervals duration and morphology were manually assessed by cardiologists and compared among clinical subgroups using Chi-square, Mann-Whitney, and Kruskall-Wallis tests. Exploratory multivariable linear and logistic regression models were fitted to adjust for potential confounders. Results We included 117 patients (60.7% women, 76.9% bipolar I, 50% history of psychosis, 22.6% suicide attempts). We found a significantly longer QTc interval in BD patients with hypertension (difference: 9.5 ms, p=0.006), obesity (difference: 25 ms, p=0.001), and metabolic syndrome (difference: 13 ms, p=0.007). Hypertension remained a significant predictor of longer QTc after adjusting for age, gender, and antipsychotic use (estimate 17.718, p=0.018). We observed a significantly shorter PR interval in women (difference: 6 ms, p=0.029), early age of onset (difference 6 ms, p=0.025), non-users of lithium (difference 4 ms, p=0.002), and early trauma (difference 4 ms, p=0.038). Finally, we identified significant correlations between symptom severity, blood glucose and PR interval (r=0.298, p=0.001; r=0.278, p=0.003; respectively). Conclusions Patients with BD and hypertension may have an increased risk for QTc prolongation. Careful cardiovascular monitoring may be warranted. Disclosure No significant relationships.
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Lal-Trehan Estrada N, Carrasquer A, Del Moral V, Sanchez R, Bonet G, Peiro O, Fort I, Bardaji A. Prognostic value of myocardial injury and chronic kidney disease in an emergency unit. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Cardiac troponin is independently associated with cardiovascular events and mortality in patients with chronic kidney disease (CKD). Their joint effect is yet to be clarified.
Purpose
This study aims to evaluate the prognostic implication of myocardial injury and CKD in patients attended in an emergency room.
Methods
Retrospective study carried out between January 2012 and December 2013 with consecutive patients attended in an emergency room with troponin determination, who were distributed into four cohorts according to positive troponin and/or glomerular filtration rate (GFR) <45ml/min/ 1.7. We analysed their baseline characteristics and the four-year prognosis.
Results
3622 patients were included (median age 68.5 years [IQR 55.5–79.5]; 43% were women). Compared to subjects with normal GFR, the 565 subjects with CKD were significantly older (80.5 vs 66.5 years), with worse cardiovascular profile (arterial hypertension: 87% vs 56%; diabetes mellitus: 46% vs 22%) and greater comorbidity (history of myocardial infarction: 29% vs 18%; heart failure: 17% vs 5%; peripheral vascular disease: 16% vs 5%; cerebrovascular disease: 13% vs 7%%). Myocardial injury was also related to elderly and worse cardiovascular profile and comorbidity, especially in normal GFR subjects. 23.5% (718 subjects) of normal GFR subjects presented with myocardial injury. This percentage was much higher in the presence of renal impairment (331 subjects, 58.6%). Troponin was associated with a higher risk of death (both in-hospital and during follow-up) and of readmission due to infarction or heart failure, regardless of GFR. The reference cohort in the multivariate competing risk mode was that with subjects without myocardial injury or kidney disease. This analysis showed the worst MACE (all-cause death, non-fatal myocardial infarction and heart failure admission) in four-year follow-up in patients with renal impairment and positive troponin (HR 3.94, 95% CI 3.317–4.682), second worst MACE in those with myocardial injury and with normal GFR (HR 2.408, 95% CI 2.064–2.811), and then abnormal GFR patients with negative troponin (HR 1.532, 95% CI 1.220–1.923). Patients with both myocardial injury and renal impairment had the highest mortality (HR 4.633, 95% CI 3.829–5.604) and more readmissions for heart failure (HR 2.163, 95% CI 1.647–2.841). The myocardial-injury-and-normal-GFR cohort showed significantly higher mortality than the renal-impairment-with-negative-troponin cohort (HR 2.669 vs HR 1.794), more heart failure (HR 1.951 vs 1.067) and more myocardial infarctions (HR 2.439 vs 1.235) in the follow-up.
Conclusion
The results suggest that myocardial injury has better predictive power than chronic kidney disease for MACE events and also for individually mortality, readmission for heart failure or myocardial infarction.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - A Carrasquer
- University Hospital of Taragona Joan XXIII, Tarragona, Spain
| | - V Del Moral
- University Hospital of Taragona Joan XXIII, Tarragona, Spain
| | - R Sanchez
- University Hospital of Taragona Joan XXIII, Tarragona, Spain
| | - G Bonet
- University Hospital of Taragona Joan XXIII, Tarragona, Spain
| | - O Peiro
- University Hospital of Taragona Joan XXIII, Tarragona, Spain
| | - I Fort
- University Hospital of Taragona Joan XXIII, Tarragona, Spain
| | - A Bardaji
- University Hospital of Taragona Joan XXIII, Tarragona, Spain
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Leroy AG, Lavigne-Quilichini V, Le Turnier P, Loufti B, Le Breton E, Piau C, Kempf M, Pantel A, Amara M, Neuwirth C, Sanchez R, Guinard J, Huon JF, Grégoire M, Corvec S. Accuracy of gradient diffusion method for susceptibility testing of dalbavancin and comparators. Expert Rev Anti Infect Ther 2021; 20:457-461. [PMID: 34469266 DOI: 10.1080/14787210.2021.1976143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This multicenter study aimed to assess the performances of gradient diffusion (GD) method in comparison to broth microdilution (BMD) method for susceptibility testing of dalbavancin, daptomycin, vancomycin, and teicoplanin. METHODS Minimum Inhibitory Concentrations (MICs) were retrospectively determined concomitantly by BMD and GD methods, for 93 staphylococci and enterococci isolated from clinical samples. BMD was considered as the gold standard. Essential (EA) and categorical agreements (CA) were calculated. Discordant categorical results were categorized as major (ME) and very major errors (VME). RESULTS EA and CA were 95.7% and 96.8%, 82.8% and 100%, 97.8% and 96.8%, and 94.6% and 95.7% for dalbavancin, daptomycin, vancomycin, and teicoplanin respectively. Concerning dalbavancin, 3 ME without any VME were observed and discrepancies were low (≤ to 2 two-fold dilutions) between both methods. VME were noted in 1 and 3 cases for vancomycin and teicoplanin, respectively, and resulted from 1 two-fold dilution discrepancy in each case. EA was lower for daptomycin. When they were discrepant, BMD MICs were systematically higher than GD ones. Nevertheless, no categorical discrepancy was noted. CONCLUSIONS GD appears as an acceptable and convenient alternative for dalbavancin, vancomycin, and teicoplanin MICs determination. Our study also emphasizes how achieving accurate daptomycin MICs remains challenging.
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Affiliation(s)
- A G Leroy
- Department of Microbiology, University Hospital of Nantes, Nantes, France
| | | | - P Le Turnier
- Department of Infectious Diseases, University Hospital of Nantes, and CIC 1413, INSERM, Nantes, France
| | - B Loufti
- Department of Microbiology, Centre Hospitalier Layné, Mont de Marsan, France
| | - E Le Breton
- Department of Microbiology, Centre Hospitalier de Cornouaille, Quimper, France
| | - C Piau
- Department of Clinical Microbiology, Rennes University Hospital, Rennes, France
| | - M Kempf
- Department of Microbiology, Angers University Hospital, Angers, France
| | - A Pantel
- Department of Microbiology, Nîmes University Hospital, Nîmes, France
| | - M Amara
- Department of Microbiology, Centre Hospitalier de Versailles, Le Chesnay, France
| | - C Neuwirth
- Department of Microbiology, University Hospital of Dijon, Dijon, France
| | - R Sanchez
- Department of Microbiology, Centre Hospitalier de Périgueux, Périgueux, France
| | - J Guinard
- Department of Microbiology, CHR Orléans, Orléans, France
| | - J F Huon
- Clinical Pharmacy Unit, Nantes University Hospital, Nantes, France
| | - M Grégoire
- Clinical Pharmacology Department, Nantes University Hospital, Nantes, France.,UMR INSERM 1235, The Enteric Nervous System in Gut and Brain Disorders, University of Nantes, Nantes, France
| | - S Corvec
- Department of Microbiology, University Hospital of Nantes, Nantes, France.,CRCINA, INSERM U1232, University Hospital of Nantes, Nantes, France
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Metzger G, Cooper JN, Kabre RS, Mak GZ, Halleran DR, Boyd K, Chan S, Corea D, Dydynski P, Gill K, Kraus S, Sanchez R, Afrazi A, Calkins C, Linden AF, Downard C, Ehrlich PF, Fraser JD, Landman M, Leys CM, Rymeski B, Wood RJ, Levitt MA, Deans KJ, Bates DG, Minneci PC. Inter-rater Reliability of Sacral Ratio Measurements in Patients with Anorectal Malformations. J Surg Res 2020; 256:272-281. [DOI: 10.1016/j.jss.2020.06.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/27/2020] [Accepted: 06/16/2020] [Indexed: 01/19/2023]
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Burch A, Sears S, Doring M, Gummadi S, Robertson M, Sanchez R, Shroff G, Veltmann C. Change in health-related quality of life among patients with a reduced ejection fraction initiating guideline-directed medical therapy. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Management of patients with heart failure (HF) should include patient reported outcomes (PROs). The Kansas City Cardiomyopathy Questionnaire is self-administered with subscales to evaluate HF symptom burden, physical limitations, social limitations (recreational participation), and quality of life (QoL). Change in PROs among newly diagnosed patients with HF and reduced ejection fraction (HFrEF) prescribed a wearable cardioverter defibrillator (WCD) and initiating guideline-directed medical therapy (GDMT) has not been assessed.
Purpose
Examine PROs over 180 days of receiving GDMT for newly diagnosed HFrEF.
Methods
Patients (n=93, 75.3% male) were enrolled ≤10 days post-hospitalization for new onset HF; all patients had an EF ≤35% and were prescribed a WCD. Health status, as measured by PRO was assessed at baseline, day 90, and day 180. Controlling for age and EF at baseline, changes in PROs over the 180-day study period were evaluated using repeated measures modeling. Pairwise comparisons with Bonferroni adjustments were used to compare adjacent timepoints. Higher scores reflect better health status.
Results
After controlling for age (mean 56±13.4) and baseline EF (mean 22±7.7) improvements in health status were observed. From baseline to day 90, physical limitation, symptom frequency, QoL, and the summary score all increased (Δ: 17.8, 23.7, 28.4, 23.7, respectively; all p's <0.05). From day 90 to day 180, only QoL continued to improve (Δ 7.5, p=0.001). Change in social limitations over time was not significant (p=0.42).
Conclusion
Patients report improved health status in the months following a new diagnosis of HFrEF when prescribed a WCD and GDMT.
Change in Quality of Life
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Burch
- East Carolina University, Greenville, United States of America
| | - S.F Sears
- East Carolina University, Greenville, United States of America
| | - M Doring
- Leipzig Heart Institute GmbH, Leipzig, Germany
| | - S Gummadi
- Cardiovascular Institute of Central Florida, Ocala, United States of America
| | - M Robertson
- Trinity Medical, Buffalo, United States of America
| | - R Sanchez
- The Heart Institute, Saint Petersburg, United States of America
| | - G Shroff
- Baptist Heart Specialists, Jacksonville, United States of America
| | - C Veltmann
- Medizinische Hochschule Hannover, Hannover, Germany
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15
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Phan M, Sou E, Al Sannaa G, Erwin M, Sanchez R. Dermal Hemorrhage: A Clue to Lichen Sclerosus et Atrophicus. Cureus 2020; 12:e9343. [PMID: 32850217 PMCID: PMC7444889 DOI: 10.7759/cureus.9343] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Lichen sclerosus et atrophicus (LSA) may present in a rare bullous and hemorrhagic form that is often difficult to recognize both clinically and histopathologically. Clinically, the lesions may be characterized by atrophic and ivory-white sclerotic plaques in both genital and extragenital regions. Histologically, fully developed lesions of LSA are characterized by a thinned, effaced epidermis with interface change, a wide band of hyalinization in the upper dermis, and a lymphohistiocytic infiltrate below the hyalinized area. Extensive vacuolar degeneration weakens the integrity of the dermoepidermal junction, which contributes to the development of marked edema in the papillary dermis and subepidermal vesiculation. With increased fragility of dermal capillaries, hemorrhage can accumulate within the bullae. Recognizing prominent upper dermal hemorrhage as a secondary change may lead to a prompt diagnosis of LSA. We present a case of extragenital LSA that mimics a dermal hemorrhage clinically and histologically in a 71-year-old Caucasian woman.
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16
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Abbar M, Khan A, Rollin L, Sanchez R, Carson W, Morris B, Timko K, Marcus R. Efficacy of adjunctive aripiprazole to lithium or valproate in the long-term treatment of mania in subjects with bipolar i disorder (CN138–189). Eur Psychiatry 2020. [DOI: 10.1016/s0924-9338(11)71897-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
ObjectivesTo evaluate the long-term safety and efficacy of adjunctive aripiprazole (ARI) to lithium (LI) or valproate (VAL) in delaying time to relapse in bipolar I disorder.MethodsBipolar I disorder subjects with a current manic or mixed episode received LI or VAL for at least 2 weeks; inadequate responders (YMRS score ≥ 16 and ≤35% decrease from baseline at 2 weeks) received adjunctive ARI. Subjects maintaining mood stability (YMRS and MADRS ≤ 12 for 12 consecutive weeks) were randomised 1:1 to double-blind ARI (10 to 30 mg/day) or placebo (PBO) plus LI or VAL. Relapse was monitored up to 52 weeks.Results337 subjects were randomised to continuation of mood stabiliser plus adjunctive ARI or PBO; 61.3% and 52.7%, respectively, completed the study. Adjunctive ARI significantly delayed the time to any relapse, hazard ratio = 0.544 (95% CI: 0.33, 0.89, log-rank p = 0.014). Overall relapse rates at 52 weeks were 14.9% and 25.4% in ARI vs PBO subjects. A superior reduction in CGI-BP Mania Severity of Illness from baseline at 52 weeks was also observed (0.3 vs. 0.0, respectively, p = 0.01). Adverse events generally were as expected per known drug and illness profiles with no significant difference in mean change in body weight between adjunctive PBO (0.60 kg) and adjunctive ARI (1.07 kg) (p = 0.49 Week 52, LOCF).ConclusionContinuation of aripiprazole treatment increased time to relapse to any mood episode compared with placebo plus LI/VAL over 1 year, indicating a long-term benefit in continuing adjunctive aripiprazole to a mood stabiliser after sustained remission is achieved.
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Hurtado G, Mateu G, Martinez R, Farre A, Marti J, Sanchez R, Diaz L, Campillo M. Personality dimensions and drug of choice: A descriptive study using Cloninger's temperament and character inventory revised. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2016.01.1016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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
Personality dimensions related with drug use are novelty seeking, impulsivity and harm avoidance. Studies predicting drug of choice over personality variables are controversial.ObjectiveTo describe personality profile of drug users in relation to substance of choice.AimsTo know personality dimension differences according to drug used.MethodsCloninger's TCI-R was administered to 218 patients in a dual diagnosis unit.SPSS was applied.ResultsOf the patients, 33.94% had personality disorder. Principal substances used were alcohol, cocaine and cannabis.Most of drug users had normal scores in each dimension. No high scores were found in reward dependence, self-directedness and cooperativeness with any drug.High scores were observed for novelty seeking in 42.9% of timulants users; for arm avoidance in a quarter of cocaine, alcohol and methadone users and for persistence in 18.2% of hypnotics users.Low scores were observed for reward dependence in 45% of heroine and hypnotics users; for persistence in 50% of methadone and 32% of cocaine users; for self-directedness in most of types of drug users and for cooperativeness in up to 50% in heroine, hypnotics, stimulants and cocaine users.Statistical significant differences were observed for cocaine use and high novelty seeking and low cooperation; for non cannabis use and high harm avoidance; for non anfetamine use and low scores in reward dependence; for opiate use and low self-directedness.ConclusionsMost of patients had normal scores in the different dimensions.Presence of comorbid personality disorder led us to consider the results with caution.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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18
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Nadimpalli A, Tsung JW, Sanchez R, Shah S, Zelikova E, Umphrey L, Hurtado N, Gonzalez A, Teicher C. Feasibility of Training Clinical Officers in Point-of-Care Ultrasound for Pediatric Respiratory Diseases in Aweil, South Sudan. Am J Trop Med Hyg 2020; 101:689-695. [PMID: 31287049 PMCID: PMC6726960 DOI: 10.4269/ajtmh.18-0745] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Lower respiratory tract infections (LRTIs) are the leading cause of deaths in children < 5 years old worldwide, particularly affecting low-resource settings such as Aweil, South Sudan. In these settings, diagnosis can be difficult because of either lack of access to radiography or clinical algorithms that overtreat children with antibiotics who only have viral LRTIs. Point-of-care ultrasound (POCUS) has been applied to LRTIs, but not by nonphysician clinicians, and with limited data from low-resource settings. Our goal was to examine the feasibility of training the mid-level provider cadre clinical officers (COs) in a Médecins Sans Frontières project in South Sudan to perform a POCUS algorithm to differentiate among causes of LRTI. Six COs underwent POCUS training, and each subsequently performed 60 lung POCUS studies on hospitalized pediatric patients < 5 years old with criteria for pneumonia. Two blinded experts, with a tiebreaker expert adjudicating discordant results, served as a reference standard to calculate test performance characteristics, assessed image quality and CO interpretation. The COs performed 360 studies. Reviewers rated 99.1% of the images acceptable and 86.0% CO interpretations appropriate. The inter-rater agreement (κ) between COs and experts for lung consolidation with air bronchograms was 0.73 (0.63–0.82) and for viral LRTI/bronchiolitis was 0.81 (0.74–0.87). It is feasible to train COs in South Sudan to use a POCUS algorithm to diagnose pneumonia and other pulmonary diseases in children < 5 years old.
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Affiliation(s)
| | - James W Tsung
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York.,Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Ramon Sanchez
- Department of Radiology, University of Michigan School of Medicine, Ann Arbor, Michigan
| | - Sachita Shah
- Department of Emergency Medicine, University of Washington, Seattle, Washington
| | | | - Lisa Umphrey
- Médecins Sans Frontières Medical Department, Sydney, Australia
| | - Northan Hurtado
- Médecins Sans Frontières Medical Department, New York, New York
| | - Alan Gonzalez
- Médecins Sans Frontières Medical Department, New York, New York
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Abstract
The spectrum of ovarian tumors in the pediatric population differs significantly from that in adults. Germ cell tumors are the predominant class of ovarian tumors in children, whereas epithelial tumors are the most common in adults. Ultrasonography is the modality of choice for the initial evaluation of pediatric ovarian tumors. Determining the diagnosis based on imaging may prove difficult, and combining the imaging findings with the clinical scenario is very helpful in reaching a differential diagnosis during clinical practice. We will discuss the spectrum of ovarian neoplasms in the pediatric population and describe their clinical, pathologic, and imaging characteristics. A few unique entities related to ovarian tumors, such as growing teratoma syndrome, anti-N-methyl-D-aspartate receptor encephalitis, and hereditary ovarian tumor syndromes, are also discussed. In addition, we will review several entities that may mimic ovarian neoplasms as well as their distinct imaging features.
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Affiliation(s)
- Abdelrahman K Hanafy
- Diagnostic Radiology, The University of Texas Health Science Centre at San Antonio, San Antonio, TX, 78229, USA
| | - Bilal Mujtaba
- Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holocombe Blvd, Houston, TX, 77030, USA
| | - Sireesha Yedururi
- Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holocombe Blvd, Houston, TX, 77030, USA
| | - Corey T Jensen
- Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holocombe Blvd, Houston, TX, 77030, USA
| | - Ramon Sanchez
- Radiology, Children's National Health System, 111 Michigan Avenue NW, Washington, DC, 20010, USA
| | - Mary T Austin
- Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holocombe Blvd, Houston, TX, 77030, USA
| | - Ajaykumar C Morani
- Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holocombe Blvd, Houston, TX, 77030, USA.
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20
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Ankringa N, Sanchez R, Kammergruber E, Grinwis G, Gröne A. Bilateral Retrobulbar Extramedullary Haemopoiesis in a Feline Leukaemia Virus and Feline Immunodeficiency Virus-Negative Cat. J Comp Pathol 2020. [DOI: 10.1016/j.jcpa.2019.10.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Fukushima M, Goda J, Oizumi A, Bounds J, Cutler T, Grove T, Hayes D, Hutchinson J, McKenzie G, McSpaden A, Sanchez R, Walker J, Tsujimoto K. Systematic Measurements and Analyses for Lead Void Reactivity Worth in a Plutonium Core and Two Uranium Cores with Different Enrichments. NUCL SCI ENG 2019. [DOI: 10.1080/00295639.2019.1663089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- M. Fukushima
- Japan Atomic Energy Agency, Nuclear Science and Engineering Center, 2-4 Shirane, Shirakata, Tokai-mura, Naka-gun, Ibaraki 319-1195, Japan
| | - J. Goda
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - A. Oizumi
- Japan Atomic Energy Agency, Nuclear Science and Engineering Center, 2-4 Shirane, Shirakata, Tokai-mura, Naka-gun, Ibaraki 319-1195, Japan
| | - J. Bounds
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - T. Cutler
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - T. Grove
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - D. Hayes
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - J. Hutchinson
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - G. McKenzie
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - A. McSpaden
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - R. Sanchez
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - J. Walker
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - K. Tsujimoto
- Japan Atomic Energy Agency, Nuclear Science and Engineering Center, 2-4 Shirane, Shirakata, Tokai-mura, Naka-gun, Ibaraki 319-1195, Japan
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22
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Danforth D, Gabriel RA, Clark AI, Newhouse B, Khoche S, Vig S, Sanchez R, Schmidt UH. Preoperative risk factors for massive transfusion, prolonged ventilation requirements, and mortality in patients undergoing liver transplantation. Korean J Anesthesiol 2019; 73:30-35. [PMID: 31378055 PMCID: PMC7000286 DOI: 10.4097/kja.19108] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 07/30/2019] [Indexed: 01/21/2023] Open
Abstract
Background Despite improvements in techniques and management of liver transplant patients, numerous perioperative complications that contribute to perioperative mortality remain. Models to predict intraoperative massive blood transfusion, prolonged mechanical ventilation, or in-hospital mortality in liver transplant recipients have not been identified. In this study we aim to identify preoperative factors associated with the above mentioned complications. Methods A retrospective observational analysis was conducted on data collected from 124 orthotopic liver transplants performed at a single institution between 2014 and 2017. A multivariable logistic regression using backwards elimination was performed for three defined outcomes (massive transfusion ≥ 10 units packed red blood cells (PRBC), prolonged mechanical ventilation > 24 h, and in-hospital mortality) to identify associations with preoperative characteristics. Results Statistically significant (P < 0.05) associations with massive transfusion ≥ 10 units PRBC were hepatocellular carcinoma and preoperative transfusion of PRBC. Significant associations with prolonged mechanical ventilation > 24 h were hepatitis C, alcoholic hepatitis, elevated preoperative alanine aminotransferase, and hepatorenal syndrome. Male gender was protective for requiring prolonged mechanical ventilation. End-stage renal disease and hepatitis B were significantly associated with increased in-hospital mortality. Conclusions This study identified risk factors associated with common perioperative complications of liver transplantation. These factors may assist practitioners in risk stratification and may form the basis for further investigations of potential interventions to mitigate these risks.
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Affiliation(s)
- Dennis Danforth
- Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA
| | - Rodney A Gabriel
- Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA.,Department of Biomedical Informatics, University of California San Diego, La Jolla, CA, USA
| | - Anthony I Clark
- Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA
| | - Beverly Newhouse
- Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA
| | - Swapnil Khoche
- Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA
| | - Sanjana Vig
- Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA
| | - Ramon Sanchez
- Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA
| | - Ulrich H Schmidt
- Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA
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Doval HC, Mariani J, Gómez GC, Vulcano L, Parlanti L, Gavranovic MA, Iemma M, Sanchez R, Macchia A. Cardiovascular and other risk factors among people who live in slums in Buenos Aires, Argentina. Public Health 2019; 170:38-44. [PMID: 30921654 DOI: 10.1016/j.puhe.2019.02.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 07/16/2018] [Revised: 01/24/2019] [Accepted: 02/06/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Effective planning of health policies requires the availability of accurate data, representing the burden of disease and risks to the diverse components of society. In Argentina, health information comes from the national risk factors survey (NRFS), which characterises the distribution of different risk factors. However, the NRFS has never collected information from residents living in slums, despite slums representing 10% of the population. The objective of this survey was to characterise the prevalence of cardiovascular and other risk factors among the inhabitants of one of the largest slums in Buenos Aires (Villa 31) and compare it to data from the NRFS. STUDY DESIGN This was a cross-sectional study. METHODS A cross-sectional study was carried out in 400 slum households, using the same data structure as the NRFS. The survey obtained information about economic aspects, reproductive health, addictions and risk factors. All participants had their blood pressure, weight and height measured. A total of 406 people were interviewed and their data were compared with data from 32,365 people in the NRFS. All comparisons were made on the basis of age group. RESULTS A fair/poor self-perceived level of health (odds ratio [OR] 3.19, 95% confidence interval [CI]: 2.60-3.91), anxiety and moderate to severe depression (OR 5.44, 95% CI: 4.43-6.69), problem drinking (OR 10.01, 95% CI 8.08-12.40), self-reported hypertension (OR 1.26, 95% CI: 1.01-1.57), overweight (OR 1.26, 95% CI: 1.03-1.55) and obesity (OR 1.72, 95% CI: 1.38-2.15) were significantly higher in the slum population. In people aged 18-24 years, the prevalence of diabetes was triple the national average (OR 3.17, 95% CI: 1.26-7.98). For all evaluated conditions in this study, the inhabitants of the slum received significantly less treatment compared with participants from the NRFS. CONCLUSIONS The prevalence of cardiovascular and other risk factors in the slum population has a different distribution to that reported in the NRFS. These data suggest the need to establish specific policies for slum populations.
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Affiliation(s)
- H C Doval
- Fundación GESICA, Buenos Aires, Argentina
| | - J Mariani
- Fundación GESICA, Buenos Aires, Argentina
| | - G C Gómez
- Pichón Riviere School of Social Psychology, Buenos Aires, Argentina
| | - L Vulcano
- Pichón Riviere School of Social Psychology, Buenos Aires, Argentina
| | - L Parlanti
- Pichón Riviere School of Social Psychology, Buenos Aires, Argentina
| | - M A Gavranovic
- Pichón Riviere School of Social Psychology, Buenos Aires, Argentina
| | - M Iemma
- Pichón Riviere School of Social Psychology, Buenos Aires, Argentina
| | - R Sanchez
- Pichón Riviere School of Social Psychology, Buenos Aires, Argentina
| | - A Macchia
- Fundación GESICA, Buenos Aires, Argentina.
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24
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Triolo TM, Fouts A, Pyle L, Yu L, Gottlieb PA, Steck AK, Greenbaum CJ, Atkinson M, Baidal D, Battaglia M, Becker D, Bingley P, Bosi E, Buckner J, Clements M, Colman P, DiMeglio L, Gitelman S, Goland R, Gottlieb P, Herold K, Knip M, Krischer J, Lernmark A, Moore W, Moran A, Muir A, Palmer J, Peakman M, Philipson L, Raskin P, Redondo M, Rodriguez H, Russell W, Spain L, Schatz D, Sosenko J, Wentworth J, Wherrett D, Wilson D, Winter W, Ziegler A, Anderson M, Antinozzi P, Benoist C, Blum J, Bourcier K, Chase P, Clare-Salzler M, Clynes R, Eisenbarth G, Fathman C, Grave G, Hering B, Insel R, Kaufman F, Kay T, Leschek E, Mahon J, Marks J, Nanto-Salonen K, Nepom G, Orban T, Parkman R, Pescovitz M, Peyman J, Pugliese A, Roep B, Roncarolo M, Savage P, Simell O, Sherwin R, Siegelman M, Skyler J, Steck A, Thomas J, Trucco M, Wagner J, Krischer JP, Leschek E, Rafkin L, Bourcier K, Cowie C, Foulkes M, Insel R, Krause-Steinrauf H, Lachin JM, Malozowski S, Peyman J, Ridge J, Savage P, Skyler JS, 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Manning G, Hendry B, Taylor S, Jones W, Strader M, Bencomo T, Bailey L, Bedolla C, Roldan C, Moudiotis B, Vaidya C, Anning S, Bunce S, Estcourt E, Folland E, Gordon C, Harrill J, Ireland J, Piper L, Scaife K, Sutton S, Wilkins M, Costelloe J, Palmer L, Casas C, Miller M, Burgard C, Erickson J, Hallanger-Johnson P, Clark W, Taylor A, Lafferty S, Gillett C, Nolan M, Pathak L, Sondrol T, Hjelle S, Hafner J, Kotrba R, Hendrickson A, Cemeroglu T, Symington M, Daniel Y, Appiagyei-Dankah D, Postellon M, Racine L, Kleis K, Barnes S, Godwin H, McCullough K, Shaheen G, Buck L, Noel M, Warren S, Weber S, Parker I, Gillespie B, Nelson C, Frost J, Amrhein E, Moreland A, Hayes J, Peggram J, Aisenberg M, Riordan J, Zasa E, Cummings K, Scott T, Pinto A, Mokashi K, McAssey E, Helden P, Hammond L, Dinning S, Rahman S, Ray C, Dimicri S, Guppy H, Nielsen C, Vogel C, Ariza L, Morales Y, Chang R, Gabbay L, Ambrocio L, Manley R, Nemery W, Charlton P, Smith L, Kerr B, Steindel-Kopp M, Alamaguer D, Liljenquist G, Browning T, Coughenour M, Sulk E, Tsalikan M, Tansey J, Cabbage N. Identical and Nonidentical Twins: Risk and Factors Involved in Development of Islet Autoimmunity and Type 1 Diabetes. Diabetes Care 2019; 42:192-199. [PMID: 30061316 PMCID: PMC6341285 DOI: 10.2337/dc18-0288] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/28/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE There are variable reports of risk of concordance for progression to islet autoantibodies and type 1 diabetes in identical twins after one twin is diagnosed. We examined development of positive autoantibodies and type 1 diabetes and the effects of genetic factors and common environment on autoantibody positivity in identical twins, nonidentical twins, and full siblings. RESEARCH DESIGN AND METHODS Subjects from the TrialNet Pathway to Prevention Study (N = 48,026) were screened from 2004 to 2015 for islet autoantibodies (GAD antibody [GADA], insulinoma-associated antigen 2 [IA-2A], and autoantibodies against insulin [IAA]). Of these subjects, 17,226 (157 identical twins, 283 nonidentical twins, and 16,786 full siblings) were followed for autoantibody positivity or type 1 diabetes for a median of 2.1 years. RESULTS At screening, identical twins were more likely to have positive GADA, IA-2A, and IAA than nonidentical twins or full siblings (all P < 0.0001). Younger age, male sex, and genetic factors were significant factors for expression of IA-2A, IAA, one or more positive autoantibodies, and two or more positive autoantibodies (all P ≤ 0.03). Initially autoantibody-positive identical twins had a 69% risk of diabetes by 3 years compared with 1.5% for initially autoantibody-negative identical twins. In nonidentical twins, type 1 diabetes risk by 3 years was 72% for initially multiple autoantibody-positive, 13% for single autoantibody-positive, and 0% for initially autoantibody-negative nonidentical twins. Full siblings had a 3-year type 1 diabetes risk of 47% for multiple autoantibody-positive, 12% for single autoantibody-positive, and 0.5% for initially autoantibody-negative subjects. CONCLUSIONS Risk of type 1 diabetes at 3 years is high for initially multiple and single autoantibody-positive identical twins and multiple autoantibody-positive nonidentical twins. Genetic predisposition, age, and male sex are significant risk factors for development of positive autoantibodies in twins.
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Affiliation(s)
- Taylor M. Triolo
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Alexandra Fouts
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Laura Pyle
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Liping Yu
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Peter A. Gottlieb
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
| | - Andrea K. Steck
- Barbara Davis Center for Diabetes, University of Colorado School of Medicine, Aurora, CO
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Rojas-Bracho L, Gulland FMD, Smith CR, Taylor B, Wells RS, Thomas PO, Bauer B, Heide-Jørgensen MP, Teilmann J, Dietz R, Balle JD, Jensen MV, Sinding MHS, Jaramillo-Legorreta A, Abel G, Read AJ, Westgate AJ, Colegrove K, Gomez F, Martz K, Rebolledo R, Ridgway S, Rowles T, van Elk CE, Boehm J, Cardenas-Hinojosa G, Constandse R, Nieto-Garcia E, Phillips W, Sabio D, Sanchez R, Sweeney J, Townsend F, Vivanco J, Vivanco JC, Walker S. A field effort to capture critically endangered vaquitas Phocoena sinus for protection from entanglement in illegal gillnets. ENDANGER SPECIES RES 2019. [DOI: 10.3354/esr00931] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Sanchez R, Nofrarias M, Wali N, Valle R, Pérez M, Majó N, Ramis A. Comparison of the pathobiology of two different highly pathogenic avian influenza strains of different origin in geese. J Comp Pathol 2019. [DOI: 10.1016/j.jcpa.2018.10.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Cuya R, Huanca W, Medina G, Sanchez R, Huanca WF. 99 Effect of application of seminal plasma on Day 0, 5, or 7 postmating on pregnancy rate and embryonic survival in alpacas (Lama pacos). Reprod Fertil Dev 2019. [DOI: 10.1071/rdv31n1ab99] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Alpacas, similar to other camelids, are classified as induced ovulators, as an external stimulus is required for the occurrence of ovulation. A protein identified as β-nerve growth factor, present in the seminal plasma (SP), has the capacity to induce ovulation and corpus luteum formation. Alpacas exhibit poor reproductive efficiency, with birth rates below 50% due in part to high embryo mortality before 35 days post-mating. A study was carried out to evaluate the effect of the application of SP on Day 0, 5, or 7 post-mating on pregnancy rate and embryo survival, defined as the difference in the numbers of pregnant females between Day 35 and 25. Nonpregnant adult alpaca females (n=124) between 5 to 6 years old were evaluated by transrectal ultrasonography to determine presence of a follicle ≥7mm, and then 2 days later to confirm permanence of the follicle. Alpacas were then bred by natural mating and assigned randomly to 1 of 4 treatments: 1mL of SP IM at mating; 1mL of SP IM Day 5 post-mating; 1mL of SP IM Day 7 post-mating; and control. Semen was collected from adults male and ejaculates were diluted 1:1 with PBS and then centrifuged for 30min at 3000 rpm. Supernatant was separated and a drop evaluated to determine absence of spermatozoa and SP-free sperm was stored at −20°C. Twenty adult males with optimal reproductive performance were used for mating with females assigned to the different treatments. Animals were evaluated by ultrasound with an Aloka SSD 500 (Aloka, Tokyo, Japan) and 5.0-MHz linear transducer on Day 25 and 35 to determine pregnancy rate and embryonic survival. Data were analysed by chi-square. Results are present in Table 1. The results differ from our initial hypothesis and a possible explanations may be that additional application of SP IM could saturate receptors and block the action of the seminal plasma present in the ejaculate of males.
Table 1.Pregnancy rate and embryonic survival in alpacas with application of seminal plasma on Day 0, 5, or 7
Study was supported by project no. 405-PNICP-PIAP-UNMSM.
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Abstract
Solid tumors are inherently difficult to treat because of large regions of hypoxia and are often chemotherapy- or radiotherapy-resistant. It seems that cancer stem cells reside in hypoxic and adjacent necrotic tumor areas. Therefore, new treatments that are highly selective for tumors and can eradicate cells in both hypoxic and necrotic tumor regions are desirable. Antibody α-radioconjugates couple an α-emitting radionuclide with the specificity of a tumor-targeting monoclonal antibody. The large mass and energy of α-particles result in radiation dose delivery within a smaller area independent of oxygen concentration, thus matching key criteria for killing hypoxic tumor cells. With advances in radionuclide production and chelation chemistry, α-radioconjugate therapy is regaining interest as a cancer therapy. Here, we will review current literature examining radioconjugate therapy specifically targeting necrotic and hypoxic tumor cells and outline how α-radioconjugate therapy could be used to treat tumor regions harboring more resistant cancer cell types. Statement of Significance Tumor-targeting antibodies are excellent vehicles for the delivery of toxic payloads directly to the tumor site. Tumor hypoxia and necrosis promote treatment recurrence, resistance, and metastasis. Targeting these areas with antibody α-radioconjugates would aid in overcoming treatment resistance.
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Affiliation(s)
- Tyler Lopez
- Department of Chemical and Environmental Engineering, Bourns College of Engineering, University of California Riverside, Riverside, CA, USA
| | - Aaron Ramirez
- Department of Chemical and Environmental Engineering, Bourns College of Engineering, University of California Riverside, Riverside, CA, USA
| | - Chris Benitez
- Department of Chemical and Environmental Engineering, Bourns College of Engineering, University of California Riverside, Riverside, CA, USA
| | - Zahid Mustafa
- Department of Chemical and Environmental Engineering, Bourns College of Engineering, University of California Riverside, Riverside, CA, USA
| | - Henry Pham
- Department of Chemical and Environmental Engineering, Bourns College of Engineering, University of California Riverside, Riverside, CA, USA
| | - Ramon Sanchez
- Department of Chemical and Environmental Engineering, Bourns College of Engineering, University of California Riverside, Riverside, CA, USA
| | - Xin Ge
- Department of Chemical and Environmental Engineering, Bourns College of Engineering, University of California Riverside, Riverside, CA, USA
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Siiskonen T, Ciraj-Bjelac O, Dabin J, Diklic A, Domienik-Andrzejewska J, Farah J, Fernandez J, Gallagher A, Hourdakis C, Jurkovic S, Järvinen H, Järvinen J, Knežević Ž, Koukorava C, Maccia C, Majer M, Malchair F, Riccardi L, Rizk C, Sanchez R, Sandborg M, Merce MS, Segota D, Sierpowska J, Simantirakis G, Sukupova L, Thrapsanioti Z, Vano E. Establishing the European diagnostic reference levels for interventional cardiology. Phys Med 2018; 54:42-48. [DOI: 10.1016/j.ejmp.2018.09.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 09/19/2018] [Accepted: 09/23/2018] [Indexed: 11/29/2022] Open
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Lopez T, Chuan C, Ramirez A, Chen KHE, Lorenson MY, Benitez C, Mustafa Z, Pham H, Sanchez R, Walker AM, Ge X. Epitope-specific affinity maturation improved stability of potent protease inhibitory antibodies. Biotechnol Bioeng 2018; 115:2673-2682. [PMID: 30102763 DOI: 10.1002/bit.26814] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 07/31/2018] [Accepted: 08/08/2018] [Indexed: 12/26/2022]
Abstract
Targeting effectual epitopes is essential for therapeutic antibodies to accomplish their desired biological functions. This study developed a competitive dual color fluorescence-activated cell sorting (FACS) to maturate a matrix metalloprotease 14 (MMP-14) inhibitory antibody. Epitope-specific screening was achieved by selection on MMP-14 during competition with N-terminal domain of tissue inhibitor of metalloproteinase-2 (TIMP-2) (nTIMP-2), a native inhibitor of MMP-14 binding strongly to its catalytic cleft. 3A2 variants with high potency, selectivity, and improved affinity and proteolytic stability were isolated from a random mutagenesis library. Binding kinetics indicated that the affinity improvements were mainly from slower dissociation rates. In vitro degradation tests suggested the isolated variants had half lives 6-11-fold longer than the wt. Inhibition kinetics suggested they were competitive inhibitors which showed excellent selectivity toward MMP-14 over highly homologous MMP-9. Alanine scanning revealed that they bound to the vicinity of MMP-14 catalytic cleft especially residues F204 and F260, suggesting that the desired epitope was maintained during maturation. When converted to immunoglobulin G, B3 showed 5.0 nM binding affinity and 6.5 nM inhibition potency with in vivo half-life of 4.6 days in mice. In addition to protease inhibitory antibodies, the competitive FACS described here can be applied for discovery and engineering biosimilars, and in general for other circumstances where epitope-specific modulation is needed.
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Affiliation(s)
- Tyler Lopez
- Department of Chemical and Environmental Engineering, Bourns College of Engineering, University of California Riverside, Riverside, California
| | - Chen Chuan
- Department of Chemical and Environmental Engineering, Bourns College of Engineering, University of California Riverside, Riverside, California
| | - Aaron Ramirez
- Department of Chemical and Environmental Engineering, Bourns College of Engineering, University of California Riverside, Riverside, California
| | - Kuan-Hui E Chen
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, California
| | - Mary Y Lorenson
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, California
| | - Chris Benitez
- Department of Chemical and Environmental Engineering, Bourns College of Engineering, University of California Riverside, Riverside, California
| | - Zahid Mustafa
- Department of Chemical and Environmental Engineering, Bourns College of Engineering, University of California Riverside, Riverside, California
| | - Henry Pham
- Department of Chemical and Environmental Engineering, Bourns College of Engineering, University of California Riverside, Riverside, California
| | - Ramon Sanchez
- Department of Chemical and Environmental Engineering, Bourns College of Engineering, University of California Riverside, Riverside, California
| | - Ameae M Walker
- Division of Biomedical Sciences, School of Medicine, University of California Riverside, Riverside, California
| | - Xin Ge
- Department of Chemical and Environmental Engineering, Bourns College of Engineering, University of California Riverside, Riverside, California
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Hidalgo M, Consuegra C, Dorado J, Diaz-Jimenez M, Ortiz I, Pereira B, Sanchez R, Crespo F. Concentrations of non-permeable cryoprotectants and equilibration temperatures are key factors for stallion sperm vitrification success. Anim Reprod Sci 2018; 196:91-98. [DOI: 10.1016/j.anireprosci.2018.06.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 06/12/2018] [Accepted: 06/28/2018] [Indexed: 10/28/2022]
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Sanchez R, Nasir K, Klimchak A, Kuznik A, Joulain F, Briggs A. Modeling the population health benefits of LDL-C reduction with alirocumab among cardiovascular disease/heterozygous familial hypercholesterolemia patients with elevated LDL-C. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.273] [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: 11/26/2022]
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Silva P, Fernandes-Lima F, Gallo C, Sampaio F, Sanchez R. 344 Human spermatozoa function is positively influenced by Vitamin D. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.04.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Herrera C, Jeannerat E, Sanchez R, Burger D, Wyck S, Janett F, Bollwein H. Blastocoele Fluid vs. Embryonic Cells for Sex Determination in Equine Embryos. J Equine Vet Sci 2018. [DOI: 10.1016/j.jevs.2018.05.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Goret J, Blanchi J, Floch P, Peuchant O, Chrisment D, Sanchez R, Biessy H, Lemarié R, Leyssene D, Loutfi B, Mimouni S, Flao T, Bébéar C, Mégraud F. Impact of the introduction of a nucleic acid amplification test for Clostridium difficile diagnosis on stool rejection policies. Gut Pathog 2018; 10:19. [PMID: 29854009 PMCID: PMC5975266 DOI: 10.1186/s13099-018-0245-x] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/19/2018] [Indexed: 12/02/2022] Open
Abstract
Background The change from non-molecular to nucleic acid amplification tests (NAATs) is known to increase the detection of Clostridium difficile infection (CDI); however, the impact on stool rejection policies in clinical laboratories is unclear. The current guidelines have reinforced the importance of respecting strict conditions for performing tests on stool samples for CDI diagnosis. The purpose of this study was to estimate whether the implementation of molecular tests has resulted in changes in stool rejection policies between clinical laboratories that introduced NAATs and those that did not. Results A survey was conducted to evaluate the change in the number of stool samples rejected and the rejection criteria among 12 hospital laboratories in southwestern France before and after the switch from non-molecular tests to NAATs using retrospective data from June 1 till September 30, 2013 and the same period 2014. Four laboratories introduced NAATs as a second or third step in the process. A total of 1378 and 1297 stools samples were collected in 2013 and 2014, respectively. The mean number of rejected stool samples significantly increased (p < 0.001, Chi square test), with a total of 99 (7.1%) and 147 (11.3%) specimens rejected in 2013 and 2014, respectively. Notably, these laboratories had more stringent criteria and were no longer testing the stool samples of patients with CDI-positive results within 7 days. In contrast, there was a significant decrease in the rate of rejected stool samples (p < 0.001, Chi square test) in the five laboratories that did not adopt NAATs and a less stringent stool rejection policy. Conclusion Nucleic acid amplification test implementation improved compliance with recommended stool rejection policies. Laboratories should follow the recommended laboratory algorithm for the CDI diagnosis combined with the correct stool rejection policy. Electronic supplementary material The online version of this article (10.1186/s13099-018-0245-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- J Goret
- 1Laboratoire de Bactériologie, C.H.U. de Bordeaux, Groupe Hospitalier Pellegrin, Place Amélie Raba Léon, 33076 Bordeaux Cedex, France
| | - J Blanchi
- 1Laboratoire de Bactériologie, C.H.U. de Bordeaux, Groupe Hospitalier Pellegrin, Place Amélie Raba Léon, 33076 Bordeaux Cedex, France
| | - P Floch
- 2C.H.U. de Bordeaux, Hôpital Haut-Lévèque, Pessac, France
| | - O Peuchant
- 2C.H.U. de Bordeaux, Hôpital Haut-Lévèque, Pessac, France
| | | | - R Sanchez
- C.H. de Périgueux, Périgueux, France
| | - H Biessy
- G.H. de La Rochelle-Ré-Aunis, La Rochelle, France
| | - R Lemarié
- G.H. de La Rochelle-Ré-Aunis, La Rochelle, France
| | - D Leyssene
- C. H. de la Côte Basque, Bayonne, France
| | - B Loutfi
- C.H. Mont de Marsan, Mont de Marsan, France
| | | | - T Flao
- C.H.I.C Marmande-Tonneins, Marmande, France
| | - C Bébéar
- 1Laboratoire de Bactériologie, C.H.U. de Bordeaux, Groupe Hospitalier Pellegrin, Place Amélie Raba Léon, 33076 Bordeaux Cedex, France
| | - F Mégraud
- 1Laboratoire de Bactériologie, C.H.U. de Bordeaux, Groupe Hospitalier Pellegrin, Place Amélie Raba Léon, 33076 Bordeaux Cedex, France
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Dugan K, Sanchez R, Zmijarevic I. Cross section homogenization for transient calculations in a spatially heterogeneous geometry. ANN NUCL ENERGY 2018. [DOI: 10.1016/j.anucene.2018.02.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hoffman T, Triebwasser M, Mahani MG, Sanchez R, Richer E, Lee E, Braun T, Duvall A, Magenau JM, Riwes MM, Choi S, Pawarode A, Bloye K, Bulte C, Sekerak K, Paglia D, Yanik GA. Correlation of Radiographic Abnormalities on Computer Tomography (CT) with Broncho-Alveolar Lavage (BAL) Results. What are Our Radiologists Reading? Biol Blood Marrow Transplant 2018. [DOI: 10.1016/j.bbmt.2017.12.676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Jensen EW, Demant L, Sanchez R. A Model for Estimation of the Pulmonary Capillary Pressure. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1634959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Abstract:To estimate the pulmonary capillary pressure, a theory was introduced by Holloway and coworkers. Based upon this, a mathematical model describing the measured data was developed. Because the physiologic data are embedded in noise and the pulmonary capillary pressure cannot be measured directly, we simulated an extensive series of data. The noise properties of the data were as analyzed to design a signal-processing tool, that cancels the noise from the measured data. The signal processing tool developed for the current application consists of pre-processing with a moving time average filter and post-processing with a neural network. After a verification procedure the tool can be applied to measured data, hence a more reliable measurement of the pulmonary capillary pressure is achieved.
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Isachenko V, Rahimi G, Mallmann P, Sanchez R, Isachenko E. Technologies of cryoprotectant-free vitrification of human spermatozoa: asepticity as criterion of effectiveness. Andrology 2017; 5:1055-1063. [DOI: 10.1111/andr.12414] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 06/23/2017] [Accepted: 07/11/2017] [Indexed: 11/30/2022]
Affiliation(s)
- V. Isachenko
- Department of Obstetrics and Gynaecology; University Maternal Hospital; Cologne University; Cologne Germany
| | - G. Rahimi
- Department of Obstetrics and Gynaecology; University Maternal Hospital; Cologne University; Cologne Germany
| | - P. Mallmann
- Department of Obstetrics and Gynaecology; University Maternal Hospital; Cologne University; Cologne Germany
| | - R. Sanchez
- Center of Translational Medicine; Scientific and Technological Bioresource Nucleus (CEMT- BIOREN); Department of Preclinical Science, Faculty of Medicine, University de La Frontera; Temuco Chile
| | - E. Isachenko
- Department of Obstetrics and Gynaecology; University Maternal Hospital; Cologne University; Cologne Germany
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Fukushima M, Goda J, Bounds J, Cutler T, Grove T, Hutchinson J, James M, McKenzie G, Sanchez R, Oizumi A, Iwamoto H, Tsujimoto K. Lead Void Reactivity Worth in Two Critical Assembly Cores with Differing Uranium Enrichments. NUCL SCI ENG 2017. [DOI: 10.1080/00295639.2017.1373520] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- M. Fukushima
- Japan Atomic Energy Agency, Nuclear Science and Engineering Center, 2-4 Shirane, Shirakata, Tokai-mura, Naka-gun, Ibaraki 319-1195, Japan
| | - J. Goda
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - J. Bounds
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - T. Cutler
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - T. Grove
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - J. Hutchinson
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - M. James
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - G. McKenzie
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - R. Sanchez
- Los Alamos National Laboratory, Nuclear Engineering and Non-Proliferation Division, P.O. Box 1663, Los Alamos, New Mexico 87544
| | - A. Oizumi
- Japan Atomic Energy Agency, Nuclear Science and Engineering Center, 2-4 Shirane, Shirakata, Tokai-mura, Naka-gun, Ibaraki 319-1195, Japan
| | - H. Iwamoto
- Japan Atomic Energy Agency, Nuclear Science and Engineering Center, 2-4 Shirane, Shirakata, Tokai-mura, Naka-gun, Ibaraki 319-1195, Japan
| | - K. Tsujimoto
- Japan Atomic Energy Agency, Nuclear Science and Engineering Center, 2-4 Shirane, Shirakata, Tokai-mura, Naka-gun, Ibaraki 319-1195, Japan
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Rouanes N, Sanchez R, Cazanave C. [A case of gonococcal arthritis: Diagnostic difficulties and usefulness of synovial fluid PCR]. Rev Med Interne 2017; 39:54-56. [PMID: 28844395 DOI: 10.1016/j.revmed.2017.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 10/10/2016] [Revised: 05/26/2017] [Accepted: 07/24/2017] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The incidence of Neisseria gonorrhoeae septic arthritis remains low in the general population. Its clinical and microbiological diagnostic remains difficult. CASE REPORT We report a 44-year-old man who presented with a monoarthritis of the right ankle. The diagnosis of gonoccocal septic arthritis was obtained by PCR from the joint fluid. Treatment with ceftriaxone was effective. CONCLUSION In patients with high risk of N. gonorrhoeae infection, PCR for detection of gonorrhea in synovial fluid could potentially facilitate the diagnostic of gonococcal septic arthritis.
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Affiliation(s)
- N Rouanes
- Service de médecine interne et maladies infectieuses, centre hospitalier de Périgueux, 80, avenue G.-Pompidou, CS 61205, 24019 Périgueux cedex, France.
| | - R Sanchez
- Laboratoire de biologie médicale, centre hospitalier de Périgueux, 80, avenue G.-Pompidou, CS 61205, 24019 Périgueux cedex, France
| | - C Cazanave
- Service des maladies infectieuses et tropicales, centre hospitalier universitaire de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France
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Cediel G, Carrasquer A, Gonzalez_Del_Hoyo M, Sanchez R, Boque C, Bardaji A. P6434Early risk stratification of patients with positive troponin and without acute coronary syndrome. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6434] [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: 11/12/2022] Open
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Dillman JR, Dehkordy SF, Smith EA, DiPietro MA, Sanchez R, DeMatos-Maillard V, Adler J, Zhang B, Trout AT. Defining the ultrasound longitudinal natural history of newly diagnosed pediatric small bowel Crohn disease treated with infliximab and infliximab-azathioprine combination therapy. Pediatr Radiol 2017; 47:924-934. [PMID: 28421251 PMCID: PMC5511547 DOI: 10.1007/s00247-017-3848-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 02/07/2017] [Accepted: 03/22/2017] [Indexed: 01/20/2023]
Abstract
BACKGROUND Little is known about changes in the imaging appearances of the bowel and mesentery over time in either pediatric or adult patients with newly diagnosed small bowel Crohn disease treated with anti-tumor necrosis factor-alpha (anti-TNF-α) therapy. OBJECTIVE To define how bowel ultrasound findings change over time and correlate with laboratory inflammatory markers in children who have been newly diagnosed with pediatric small bowel Crohn disease and treated with infliximab. MATERIALS AND METHODS We included 28 pediatric patients treated with infliximab for newly diagnosed ileal Crohn disease who underwent bowel sonography prior to medical therapy and at approximately 2 weeks, 1 month, 3 months and 6 months after treatment initiation; these patients also had laboratory testing at baseline, 1 month and 6 months. We used linear mixed models to compare mean results between visits and evaluate whether ultrasound measurements changed over time. We used Spearman rank correlation to assess bivariate relationships. RESULTS Mean subject age was 15.3±2.2 years; 11 subjects were girls (39%). We observed decreases in mean length of disease involvement (12.0±5.4 vs. 9.1±5.3 cm, P=0.02), maximum bowel wall thickness (5.6±1.8 vs. 4.7±1.7 mm, P=0.02), bowel wall color Doppler signal (1.7±0.9 vs. 1.2±0.8, P=0.002) and mesenteric color Doppler signal (1.1±0.9 vs. 0.6±0.6, P=0.005) at approximately 2 weeks following the initiation of infliximab compared to baseline. All laboratory inflammatory markers decreased at 1 month (P-values<0.0001). There was strong correlation between bowel wall color Doppler signal and fecal calprotectin (ρ=0.710; P<0.0001). Linear mixed models confirmed that maximum bowel wall thickness (P=0.04), length of disease involvement (P=0.0002) and bowel wall color Doppler signal (P<0.0001) change over time in response to infliximab, when adjusted for age, sex, azathioprine therapy, scanning radiologist and baseline short pediatric Crohn's disease activity index score. CONCLUSION The ultrasound appearance of the bowel changes as early as 2 weeks after the initiation of infliximab therapy. There is strong correlation between bowel wall color Doppler signal and fecal calprotectin.
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Affiliation(s)
- Jonathan R Dillman
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., ML5031, Cincinnati, OH, 45229-3039, USA.
| | - Soudabeh Fazeli Dehkordy
- Department of Radiology, Section of Pediatric Radiology, C. S. Mott Children's Hospital, University of Michigan Health System, Ann Arbor, MI, USA
| | - Ethan A Smith
- Department of Radiology, Section of Pediatric Radiology, C. S. Mott Children's Hospital, University of Michigan Health System, Ann Arbor, MI, USA
| | - Michael A DiPietro
- Department of Radiology, Section of Pediatric Radiology, C. S. Mott Children's Hospital, University of Michigan Health System, Ann Arbor, MI, USA
| | - Ramon Sanchez
- Department of Radiology, Section of Pediatric Radiology, C. S. Mott Children's Hospital, University of Michigan Health System, Ann Arbor, MI, USA
| | - Vera DeMatos-Maillard
- Department of Pediatrics, Division of Gastroenterology, C. S. Mott Children's Hospital, University of Michigan Health System, Ann Arbor, MI, USA
| | - Jeremy Adler
- Department of Pediatrics, Division of Gastroenterology, C. S. Mott Children's Hospital, University of Michigan Health System, Ann Arbor, MI, USA
| | - Bin Zhang
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Andrew T Trout
- Department of Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., ML5031, Cincinnati, OH, 45229-3039, USA
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Affiliation(s)
- S. Rauck
- Commissariat à l’Energie Atomique, Direction des Réacteurs Nucléaires Services d’Etudes de Réacteurs et de Mathématiques Appliquées, CEA de Saclay, France
| | - R. Sanchez
- Commissariat à l’Energie Atomique, Direction des Réacteurs Nucléaires Services d’Etudes de Réacteurs et de Mathématiques Appliquées, CEA de Saclay, France
| | - I. Zmijarevic
- Commissariat à l’Energie Atomique, Direction des Réacteurs Nucléaires Services d’Etudes de Réacteurs et de Mathématiques Appliquées, CEA de Saclay, France
| | - M. Nobile
- Commissariat à l’Energie Atomique, Direction des Réacteurs Nucléaires Services d’Etudes de Réacteurs et de Mathématiques Appliquées, CEA de Saclay, France
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Affiliation(s)
- R. Sanchez
- University of Washington, Department of Nuclear Engineering Seattle, Washington 98195
| | - N. J. McCormick
- University of Washington, Department of Nuclear Engineering Seattle, Washington 98195
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Sanchez R, Ganapol BD. Benchmark Values for Monoenergetic Neutron Transport in One-Dimensional Cylindrical Geometry with Linearly Anisotropic Scattering. NUCL SCI ENG 2017. [DOI: 10.13182/nse83-a17458] [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] [Indexed: 11/12/2022]
Affiliation(s)
- R. Sanchez
- University of Washington, Department of Nuclear Engineering, Seattle, Washington 98195
| | - B. D. Ganapol
- University of Arizona, Department of Nuclear Engineering, Tucson, Arizona 85721
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Affiliation(s)
- R. Sanchez
- University of Washington, Department of Nuclear Engineering Seattle, Washington 98195
| | - N. J. McCormick
- University of Washington, Department of Nuclear Engineering Seattle, Washington 98195
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Akherraz B, Fedon-Magnaud C, Lautard JJ, Sanchez R. Anisotropic Scattering Treatment for the Neutron Transport Equation with Primal Finite Elements. NUCL SCI ENG 2017. [DOI: 10.13182/nse95-a24118] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- B. Akherraz
- Commissariat à I’Énergie Atomique Servide d’Études de Réacteurs et de Mathématiques Appliquées Centre d’Études de Saclay, 91191 Gif sur Yvette Cedex, France
| | - C. Fedon-Magnaud
- Commissariat à I’Énergie Atomique Servide d’Études de Réacteurs et de Mathématiques Appliquées Centre d’Études de Saclay, 91191 Gif sur Yvette Cedex, France
| | - J. J. Lautard
- Commissariat à I’Énergie Atomique Servide d’Études de Réacteurs et de Mathématiques Appliquées Centre d’Études de Saclay, 91191 Gif sur Yvette Cedex, France
| | - R. Sanchez
- Commissariat à I’Énergie Atomique Servide d’Études de Réacteurs et de Mathématiques Appliquées Centre d’Études de Saclay, 91191 Gif sur Yvette Cedex, France
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Santandrea S, Sciannandrone D, Sanchez R, Mao L, Graziano L. A Neutron Transport Characteristics Method for 3D Axially Extruded Geometries Coupled with a Fine Group Self-Shielding Environment. NUCL SCI ENG 2017. [DOI: 10.1080/00295639.2016.1273634] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- S. Santandrea
- Université Paris-Saclay, DEN-Service d’études des réacteurs et de mathématiques appliquées (SERMA), CEA, F-91191 Gif-sur-Yvette, France
| | - D. Sciannandrone
- Université Paris-Saclay, DEN-Service d’études des réacteurs et de mathématiques appliquées (SERMA), CEA, F-91191 Gif-sur-Yvette, France
| | - R. Sanchez
- Université Paris-Saclay, DEN-Service d’études des réacteurs et de mathématiques appliquées (SERMA), CEA, F-91191 Gif-sur-Yvette, France
| | - L. Mao
- Université Paris-Saclay, DEN-Service d’études des réacteurs et de mathématiques appliquées (SERMA), CEA, F-91191 Gif-sur-Yvette, France
| | - L. Graziano
- Université Paris-Saclay, DEN-Service d’études des réacteurs et de mathématiques appliquées (SERMA), CEA, F-91191 Gif-sur-Yvette, France
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Affiliation(s)
- S. Santandrea
- Commissariat à l’Energie Atomique, DEN/DANS/DM2S Service d’Etudes de Réacteurs et de Mathématiques Appliquées CEA de Saclay (France), 91191 Gif-sur-Yvette cedex, France
| | - R. Sanchez
- Commissariat à l’Energie Atomique, DEN/DANS/DM2S Service d’Etudes de Réacteurs et de Mathématiques Appliquées CEA de Saclay (France), 91191 Gif-sur-Yvette cedex, France
| | - P. Mosca
- Commissariat à l’Energie Atomique, DEN/DANS/DM2S Service d’Etudes de Réacteurs et de Mathématiques Appliquées CEA de Saclay (France), 91191 Gif-sur-Yvette cedex, France
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