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Green CE, Tyson JE, Heyne RJ, Hintz SR, Vohr BR, Bann CM, Das A, Bell EF, Debsareea SB, Stephens E, Gantz MG, Petrie Huitema CM, Johnson KJ, Watterberg KL, Mosquera R, Peralta-Carcelen M, Wilson-Costello DE, Colaizy TT, Maitre NL, Merhar SL, Adams-Chapman I, Fuller J, Hartley-McAndrew ME, Malcolm WF, Winter S, Duncan AF, Myer GJ, Kicklighter SD, Wyckoff MH, DeMauro SB, Hibbs AM, Stoll BJ, Carlo WA, Van Meurs KP, Rysavy MA, Patel RM, Sánchez PJ, Laptook AR, Cotten CM, D'Angio CT, Walsh MC. Use of term reference infants in assessing the developmental outcome of extremely preterm infants: lessons learned in a multicenter study. J Perinatol 2023; 43:1398-1405. [PMID: 37542155 PMCID: PMC10615749 DOI: 10.1038/s41372-023-01729-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 07/27/2022] [Revised: 03/17/2023] [Accepted: 07/10/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVE Extremely preterm (EP) impairment rates are likely underestimated using the Bayley III norm-based thresholds scores and may be better assessed relative to concurrent healthy term reference (TR) infants born in the same hospital. STUDY DESIGN Blinded, certified examiners in the Neonatal Research Network (NRN) evaluated EP survivors and a sample of healthy TR infants recruited near the 2-year assessment age. RESULTS We assessed 1452 EP infants and 183 TR infants. TR-based thresholds showed higher overall EP impairment than Bayley norm-based thresholds (O.R. = 1.86; [95% CI 1.56-2.23], especially for severe impairment (36% vs. 24%; p ≤ 0.001). Difficulty recruiting TR patients at 2 years extended the study by 14 months and affected their demographics. CONCLUSION Impairment rates among EP infants appear to be substantially underestimated from Bayley III norms. These rates may be best assessed by comparison with healthy term infants followed with minimal attrition from birth in the same centers. CLINICALTRIALS GOV ID Term Reference (under the Generic Database Study): NCT00063063.
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Affiliation(s)
- Charles E Green
- Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - Jon E Tyson
- Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Roy J Heyne
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Susan R Hintz
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA
| | - Betty R Vohr
- Department of Pediatrics, Women & Infants Hospital, Brown University, Providence, RI, USA
| | - Carla M Bann
- Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, Greensboro, NC, USA
| | - Abhik Das
- Social, Statistical and Environmental Sciences Unit, RTI International, Rockville, MD, USA
| | - Edward F Bell
- Department of Pediatrics, University of Iowa, Iowa City, IA, USA
| | - Sana Boral Debsareea
- Center for Clinical Research and Evidence-Based Medicine, University of Texas Houston McGovern Medical School, Houston, TX, USA
| | - Emily Stephens
- Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Marie G Gantz
- Social, Statistical and Environmental Sciences Unit, RTI International, Research Triangle Park, Greensboro, NC, USA
| | | | - Karen J Johnson
- Department of Pediatrics, University of Iowa, Iowa City, IA, USA
| | | | | | | | - Deanne E Wilson-Costello
- Department of Pediatrics, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, OH, USA
| | - Tarah T Colaizy
- Department of Pediatrics, University of Iowa, Iowa City, IA, USA
| | - Nathalie L Maitre
- Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Stephanie L Merhar
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Ira Adams-Chapman
- Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Janell Fuller
- Department of Pediatrics, University of New Mexico, Albuquerque, NM, USA
| | | | | | - Sarah Winter
- Department of Pediatrics, Division of Neonatology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Andrea F Duncan
- Department of Pediatrics, Pennsylvania Hospital, Philadelphia, PA, USA
| | - Gary J Myer
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | | | - Myra H Wyckoff
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Sara B DeMauro
- Department of Pediatrics, University of Pennsylvania, Philadelphia, PA, USA
| | - Anna Maria Hibbs
- Department of Pediatrics, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, OH, USA
| | - Barbara J Stoll
- Department of Pediatrics, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Waldemar A Carlo
- Division of Neonatology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Krisa P Van Meurs
- Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine and Lucile Packard Children's Hospital, Palo Alto, CA, USA
| | - Matthew A Rysavy
- Department of Pediatrics, University of Iowa, Iowa City, IA, USA
| | - Ravi M Patel
- Emory University School of Medicine, Department of Pediatrics, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Pablo J Sánchez
- Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Abbot R Laptook
- Department of Pediatrics, Women & Infants Hospital, Brown University, Providence, RI, USA
| | | | - Carl T D'Angio
- Department of Pediatrics, Wake Medical Center, Raleigh, NC, USA
| | - Michele C Walsh
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
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Alí-Munive A, Leidy P, Proaños NJ, Pedrozo-Pupo J, Giraldo A, Cano D, Diaz-Bossa C, Mosquera R, Paul H, Gonzalez-García M, Aguirre-Franco C, López-Campos JL, Casas-Herrera A. Prevalence of genetic mutations in alpha-1 antitrypsin deficiency (aatd) in patients with chronic obstructive pulmonary disease in Colombia. BMC Pulm Med 2023; 23:156. [PMID: 37143026 PMCID: PMC10158008 DOI: 10.1186/s12890-023-02453-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/26/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Alpha-1 antitrypsin deficiency (AATD) is an underrecognized genetic disorder associated mainly with pulmonary emphysema and Chronic Obstructive Pulmonary Disease (COPD). All individuals with COPD regardless of age or ethnicity should be tested for AATD, but in Colombia its prevalence in unknown. MAIN OBJECTIVE To determine the prevalence of the genetic mutations, present in AATD in adult patients with COPD in Colombia, using a genotyping test on cells from the oral mucosa. METHODS This was a multicentre, observational, cross-sectional study which included adult patients attending seven COPD care centres in Colombia. Demographic data, medical history, including history of exposure to smoking and biomass smoke, most recent spirometry, pharmacological and non-pharmacological treatment received, serum AAT levels, and mutations detected by the genotyping test were recorded for all the recruited patients. For the comparison of variables between the groups with and without mutation, we used the X2 test for the qualitative variables and the Student's t-test or Mann-Whitney U test according to their distribution. MAIN FINDINGS We collected a sample of 1,107 patients, the median age was 73.8 years (87.6-79.9). Mutations were documented in 144 patients (13.01%), the majority had the M/S mutation (78.50%), followed by M/Z (9.72%). One patient had a ZZ mutation and two patients had null alleles. In total, 23 patients had mutations associated with serum AAT deficiency (levels below 60 mg/dl). CONCLUSIONS Genetic mutations were documented in 13.01% of patients with COPD in Colombia and 2.07% were AATD-related, showing that there is a significant number of underdiagnosed patients.
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Affiliation(s)
- Abraham Alí-Munive
- Fundación Neumológica Colombiana, Cra. 13 B # 161 - 85, Bogota, Colombia.
| | - Prada Leidy
- Universidad de La Sabana, Campus del puente del común, Km 7 Autopista Norte de Bogotá, Chía, Chía- Cundinamarca, Colombia
| | - Nadia Juliana Proaños
- Universidad de La Sabana, Campus del puente del común, Km 7 Autopista Norte de Bogotá, Chía, Chía- Cundinamarca, Colombia
| | - John Pedrozo-Pupo
- Respire Instituto para el Cuidado Respiratorio (Previcare Ltda), Cra 21 # 18 - 27., Santa Marta, Colombia
| | - Angela Giraldo
- CardioSalud Eje Cafetero SAS, Cra. 13 # 3B ? 12, Pereira, Colombia
| | - Diana Cano
- Instituto Neumologico del Oriente S.A. Calle, 53 No. 31 - 30. Bucaramanga, Santander, Spain
| | | | - Ricardo Mosquera
- , Clínica Neumológica del Pacífico S.A.S. Calle 5 A No. 42A - 18. Cali, Valle, Barranquilla, Colombia
| | - Hector Paul
- , Promotores de la salud de la costa S.A.S. Cra 54 No 54 ? 01, Barranquilla, Colombia
| | | | | | - José Luis López-Campos
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Hospital Universitario Virgen del Rocío, Avda de Manuel Siurot s/n, Sevilla, 41013, España
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Kuo DZ, Lail J, Comeau M, Chesnut E, Meyers A, Mosquera R. Research Agenda for Implementation of Principles of Care for Children and Youth With Special Health Care Needs. Acad Pediatr 2022; 22:S41-S46. [PMID: 35248247 DOI: 10.1016/j.acap.2021.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 06/02/2021] [Accepted: 06/09/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Children and youth with special health care needs (CYSHCN) have a range of medical, educational, and support service needs to achieve optimal health and wellness. Principles of care for CYSHCN have been well described, but the literature is lacking particularly on implementation and integration of care across different settings and systems. The objective of this manuscript is to define a research agenda for principles of care for CYSHCN. METHODS Literature review examined principles of care for CYSHCN. Existing research gaps and priorities for principles of care were drawn from the literature review, a recently developed national research agenda for CYSHCN, and stakeholder consensus. RESULTS Specific implementation areas of inquiry include family partner roles within and across systems; life course approach for CYSHCN; roles and training of interdisciplinary team members; and implementation, spread, and sustainability studies. Proposed methods include implementation science-based and comparative effectiveness research. A common set of metrics including health care utilization, clinical outcomes, and family and provider needs should be considered to evaluate implementation of principles of care. CONCLUSIONS Implementation science and comparative effectiveness methods are needed to further understanding about how to adopt and spread principles of care for CYSHCN. The evolving demographics of CYSHCN add relevance and urgency for research findings.
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Affiliation(s)
- Dennis Z Kuo
- Department of Pediatrics, University at Buffalo (DZ Kuo), Buffalo, NY.
| | | | - Meg Comeau
- Center for Innovation in Social Work & Health, Boston University School of Social Work (M Comeau), Boston, Mass
| | - Emily Chesnut
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center (E Chesnut), Cincinnati, Ohio
| | - Alissa Meyers
- Department of Pediatrics, University of Texas at Houston (A Meyers and R Mosquera), Houston, Tex
| | - Ricardo Mosquera
- Department of Pediatrics, University of Texas at Houston (A Meyers and R Mosquera), Houston, Tex
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Rivera J, Mosquera R, Orozco L, Geraldine N, Gomez A, Benavides-Cordoba V. FROM HEALTH-RELATED QUALITY OF LIFE TO FUNCTIONAL AEROBIC CAPACITY: THE BENEFITS OF PULMONARY REHABILITATION IN COLOMBIAN PATIENTS WITH SEQUELAE OF PULMONARY TUBERCULOSIS. Chest 2020. [DOI: 10.1016/j.chest.2020.05.431] [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: 11/29/2022] Open
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Rivera J, Orozco L, Mosquera R, Benavides-Cordoba V. SHRINKING LUNG SYNDROME AND PULMONARY REHABILITATION: A CASE REPORT. Chest 2020. [DOI: 10.1016/j.chest.2020.05.432] [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: 10/24/2022] Open
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Oliver AC, Riva E, Mosquera R, Galeano S, Pierri S, Bello L, Caneiro A, Gai R, Miller A, Muxi P. Comparison of two different anti-infectious approaches after high-dose chemotherapy and autologous stem cell transplantation for hematologic malignancies in a 12-year period in British Hospital, Uruguay. Ann Hematol 2020; 99:877-884. [PMID: 32062742 DOI: 10.1007/s00277-020-03947-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 01/30/2020] [Indexed: 12/25/2022]
Abstract
Autologous stem cell transplant (ASCT) is a widely used and safe procedure to treat mostly hematologic diseases. These patients are at risk of infectious complications, which represents a major cause of morbidity and it is the second cause of mortality. This retrospective 12-year analysis of the incidence, type, and severity of infections in 266 consecutive unselected ASCT patients at our institution provides novel information addressing this issue. We included 266 ASCT procedures. Patients included in the 2006-2013 period are referred to as group 1 (ciprofloxacin prophylaxis and ceftazidime-amikacin as empirical antibiotics), and those in the 2013-2017 period are group 2 (levofloxacin prophylaxis and meropenem as empirical antibiotics). The incidence of febrile neutropenia was 72% in group 1 and 86.2% in group 2 (p = 0.004). The majority of infectious episodes were associated with fever of unknown origin: 55% in group 1 and 59% in group 2. Febrile of unknown origin episodes were 82.6% in group 1 and 80% in group 2. Significant differences between both groups were found in age, hypogammaglobulinemia, and advanced disease at ASCT. No differences were found between groups regarding the most common agent documented in positive blood cultures (Gram+ were 66.6% in group 1 and 69% in group 2 (p = 0.68)). Mortality within 100 days of transplant was low, 1.87%. Regardless of the prophylactic regimen used, most patients experience febrile episodes in the ASCT setting, fever of unknown origin is the most common infection complication, and Gram+ agents are prevalent in both groups. Mortality rates were low. According to our results, ASCT is a safe procedure and there is no clear benefit in favor of levofloxacin versus ciprofloxacin prophylaxis. Both anti-infectious approaches are acceptable, yielding similar outcomes.
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Affiliation(s)
- Ana Carolina Oliver
- Department: Hematology, Hospital Britanico, Av Italia 2420, 11300, Montevideo, Uruguay.
| | - Eloisa Riva
- Department: Hematology, Hospital Britanico, Av Italia 2420, 11300, Montevideo, Uruguay
| | - Ricardo Mosquera
- Department: Hematology, Hospital Britanico, Av Italia 2420, 11300, Montevideo, Uruguay
| | - Sebastian Galeano
- Department: Hematology, Hospital Britanico, Av Italia 2420, 11300, Montevideo, Uruguay
| | - Silvia Pierri
- Department: Hematology, Hospital Britanico, Av Italia 2420, 11300, Montevideo, Uruguay
| | - Laura Bello
- Department: Hematology, Hospital Britanico, Av Italia 2420, 11300, Montevideo, Uruguay
| | - Ada Caneiro
- Department: Hematology, Hospital Britanico, Av Italia 2420, 11300, Montevideo, Uruguay
| | - Regis Gai
- Department: Hematology, Hospital Britanico, Av Italia 2420, 11300, Montevideo, Uruguay
| | - Andrew Miller
- Department: Hematology, Hospital Britanico, Av Italia 2420, 11300, Montevideo, Uruguay
| | - Pablo Muxi
- Department: Hematology, Hospital Britanico, Av Italia 2420, 11300, Montevideo, Uruguay
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Benavides-Cordoba V, Aviles S, Ascuntar C, Orozco L, Mosquera R, Rivera J. Dual use of bronchodilators versus monotherapy, and its impact on pulmonary rehabilitation in COPD patients. Pulm Pharmacol Ther 2020; 61:101898. [PMID: 31978547 DOI: 10.1016/j.pupt.2020.101898] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 01/13/2020] [Accepted: 01/16/2020] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Long-acting bronchodilators are the therapy with the best evidence for treating stable chronic obstructive pulmonary disease (COPD). Long-acting combinations of β2 agonists and anticholinergics (LABA-LAMA) are recommended in advanced stages when monotherapy has not generated the desired effects. Pulmonary Rehabilitation (PR) is an effective non-pharmacological strategy. The aim of this study was to compare the results obtained in patients with COPD who received monotherapy versus dual bronchodilator therapy in terms of functional aerobic capacity, symptoms and quality of life. MATERIALS AND METHODS Prospective non randomized intervention study; the patients were divided into two groups: in one group patients were treated with LAMA (Tiotropium Bromide, 5 μg every 24 h) and in the other group patients were treated with LABA + LAMA (Indacaterol/Glycopyrronium, 110/50 μg once a day). After receiving the concept of pulmonology, patients were intervened with 8 weeks of PR. The study was approved by the committee of the Clinica Neumológica del Pacifico in Cali and the Institución Universitaria Escuela Nacional del Deporte, Colombia. To determine the differences, t pair test for intragroup, and t-test was performed for intergroup analysis. For all tests, a p-value <0.05 was considered as statistically significant. RESULTS 53 patients participated in this study, of which 20 were assigned to the LAMA group and 33 to the LAMA + LABA group. Patients in both groups presented changes in the distance of the 6MWT, in the VO2e, dyspnea and in all the SGRQ domains. Regarding the comparison between groups, there were found no differences in the variables at the beginning of the PR and significant differences (p < 0.05) at the end of the 8 week-period in favor of the LABA + LAMA group, in symptoms with the mMRC scale, functional aerobic capacity with the 6 min walking test and in health related quality of life specifically in the symptoms domain, where the dual therapy group obtained better results. CONCLUSION The addition of LABA to the treatment with LAMA showed better response results compared with the monotherapy in patients with COPD who attended PR.
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Affiliation(s)
| | - Sebastian Aviles
- Institución Universitaria Escuela Nacional del Deporte, Colombia
| | - Camila Ascuntar
- Institución Universitaria Escuela Nacional del Deporte, Colombia
| | - Lina Orozco
- Clínica Neumologica del Pacifico, Universidad Santiago de Cali, Colombia
| | | | - Julian Rivera
- Clinica Neumológica del Pacifico, Institución universitaria Escuela Nacional del deporte, Colombia
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Coller RJ, Rodean J, Linares DE, Chung PJ, Pulcini C, Hall M, Alpern E, Mosquera R, Casto E, Berry JG. Variation in Hospitalization Rates Following Emergency Department Visits in Children with Medical Complexity. J Pediatr 2019; 214:113-120.e1. [PMID: 31540760 DOI: 10.1016/j.jpeds.2019.07.034] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 06/21/2019] [Accepted: 07/11/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To evaluate factors associated with admission from emergency department (ED) encounters for children with medical complexity (CMC) and to quantify the hospital admission rate as well as variation in adjusted hospital admission rates across EDs. STUDY DESIGN Retrospective study of 271 806 visits to 37 EDs in freestanding children's hospitals from January 1, 2014, to June 30, 2017, for patients of all ages with a complex chronic condition. Associations between patient demographic, clinical, and health services characteristics and the likelihood of hospital admission were identified using generalized linear models, which were then used to calculate adjusted hospital admission rates. RESULTS Hospital admission occurred with 25.7% of ED visits. Characteristics with the greatest aOR of hospitalization were ≥3 compared with 0 prior hospitalizations in 365 days (4.7; 95% CI, 4.5-4.9), ED arrival overnight compared with during workday 3.2 (95% CI, 3.1-3.3)], and ≥6 vs 0-1 chronic conditions (1.6; 95% CI, 1.5-1.6). Adjusted hospital admission rates varied significantly (P < .001) across EDs (21.1% [10th percentile]) and 30.0% [90th percentile]). Significant variation remained when excluding low-intensity ED visits, excluding hospitalizations requiring surgery and/or intensive care, or restricting the cohort to overnight ED arrival and to children with ≥3 prior hospitalizations. CONCLUSIONS CMC are frequently admitted from the ED. Substantial variation in CMC hospital admission rates across EDs exists after case-mix adjustment.
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Affiliation(s)
- Ryan J Coller
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | | | - Deborah E Linares
- Health Resources and Services Administration, Maternal and Child Health Bureau, Office of Epidemiology and Research, Division of Research, Rockville, MD
| | - Paul J Chung
- Health Systems Science, Kaiser Permanente School of Medicine, Departments of Pediatrics and Health Policy & Management, UCLA RAND Health, RAND Corporation, Los Angeles, CA
| | - Christian Pulcini
- Emergency Medicine, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Matt Hall
- Children's Hospital Association, Lenexa, KS; Department of Pediatrics, Children's Mercy Kansas City, University of Missouri-Kansas City School of Medicine, Kansas City, MO
| | - Elizabeth Alpern
- Emergency Medicine, Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL
| | - Ricardo Mosquera
- Department of Pediatrics, University of Texas Medical School, Houston, TX
| | - Elizabeth Casto
- Division of General Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Jay G Berry
- Division of General Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA.
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Causey J, Gonzales T, Yadav A, Hashmi S, De Jesus-Rojas W, Jon C, Haque I, Johnston R, Stark J, McBeth K, Colasurdo G, Mosquera R. Characteristics and Outcomes of Children with Clinical History of Atopic Versus Non-atopic Asthma Admitted to a Tertiary Pediatric Intensive Care Unit. Open Respir Med J 2018; 12:21-28. [PMID: 30008967 PMCID: PMC6008982 DOI: 10.2174/1874306401812010021] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 04/24/2018] [Accepted: 05/05/2018] [Indexed: 11/22/2022] Open
Abstract
Background: Children admitted to the Pediatric Intensive Care Unit (PICU) with status asthmaticus have variable clinical courses, and predicting their outcomes is challenging. Identifying characteristics in these patients that may require more intense intervention is important for clinical decision-making. Objective: This study sought to determine the characteristics and outcomes, specifically length of stay and mortality, of atopic versus non-atopic asthmatics admitted to a PICU with status asthmaticus. Methods: A retrospective study was conducted at a children’s hospital from November 1, 2008 to October 31, 2013. A total of 90 children admitted to the PICU were included in the analysis. Patients were divided into two groups based on the presence of specific historical data indicative of a clinical history of atopy. Children were considered to be atopic if they had a parental history of asthma, a personal history of eczema, or a combined history of wheezing (apart from colds) and allergic rhinitis (diagnosed by a medical provider). The median hospital Length Of Stay (LOS), PICU LOS, cardiopulmonary arrest, and mortality were compared between atopic and non-atopic asthma groups. Regression models were used to estimate the LOS stratified by atopic or non-atopic and by history of intubation in present hospitalization. Results: Median hospital LOS for atopic children was 5.9 days (IQR of 3.8-8.7) and 3.5 days (IQR of 2.2-5.5) for non-atopic asthmatics (z = 2.9, p = 0.0042). The median PICU LOS was 2.5 days (IQR 1.4-6.1) for atopic asthmatics and 1.6 days (IQR 1.1-2.4) for non-atopic asthmatics (z = 2.5, p = 0.0141). The median LOS was significantly higher for atopic intubated patients compared to non-atopic intubated patients (p=0.021). Although there was an increased tendency towards intubation in the atopic group, the difference was not significant. There was no significant difference in cardiopulmonary arrest or mortality. Conclusion: A clinical history of atopic asthma in children admitted to the PICU with status asthmaticus was associated with longer length of stays The longest LOS was observed when atopic patients required intubation.
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Affiliation(s)
- Jamie Causey
- Department of Pediatrics Division of Pediatric Critical Care Medicine, University of Texas Health Science Center at Houston, Houston, USA
| | - Traci Gonzales
- Department of Pediatrics Division of Pulmonary Medicine, University of Texas Health Science Center at Houston, Houston, USA
| | - Aravind Yadav
- Department of Pediatrics Division of Pulmonary Medicine, University of Texas Health Science Center at Houston, Houston, USA
| | - Syed Hashmi
- Department of Pediatrics, University of Texas Health Science Center at Houston, Houston, USA
| | - Wilfredo De Jesus-Rojas
- Department of Pediatrics Division of Pulmonary Medicine, University of Texas Health Science Center at Houston, Houston, USA
| | - Cindy Jon
- Department of Pediatrics Division of Pulmonary Medicine, University of Texas Health Science Center at Houston, Houston, USA
| | - Ikram Haque
- Department of Pediatrics Division of Pediatric Critical Care Medicine, University of Texas Health Science Center at Houston, Houston, USA
| | - Richard Johnston
- Department of Pediatrics Division of Pediatric Critical Care Medicine, University of Texas Health Science Center at Houston, Houston, USA
| | - James Stark
- Department of Pediatrics Division of Pulmonary Medicine, University of Texas Health Science Center at Houston, Houston, USA
| | - Katrina McBeth
- Department of Pediatrics Division of Pulmonary Medicine, University of Texas Health Science Center at Houston, Houston, USA
| | - Giuseppe Colasurdo
- Department of Pediatrics Division of Pulmonary Medicine, University of Texas Health Science Center at Houston, Houston, USA
| | - Ricardo Mosquera
- Department of Pediatrics Division of Pulmonary Medicine, University of Texas Health Science Center at Houston, Houston, USA
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Abstract
In order to better understand the epoxide-formation step of the Sharpless epoxidation process, a set of 263 oxygen-transfer reactions reflecting the complexity of the Sharpless epoxidation process were studied using density functional theory (DFT) and Bader's quantum theory of atoms in molecules (QTAIM). The diversity within these reactions reflects the different ligands in the coordination sphere of vanadium and also different substrates (alkene and an allylic alcohol both free and in the form of an alcoxo ligand). The transition states for 76 of these reactions were also characterized using DFT and QTAIM, allowing for an estimation of the impact of the different ligands and substrates on the activation barriers. A smaller subset of the latter was further subjected to an ab initio molecular dynamics (AIMD) simulation coupled to QTAIM analysis. The results show that the type of active catalyst plays an important role in the thermodinamic outcome of these reactions, with vanadium(V) tert-butylhydroperoxide adducts being responsible for the most exoenergetic reactions. On the other hand, the different ligands tested play only a limited role in modulating the thermodynamics and kinetics of these reactions. Moreover, no evidence was found to support a thermodynamic or kinetic preference for the epoxidation of an allylic alcohol over that of an unfunctionalized alkene. However, the results suggest that the reaction path is strongly influenced by the orientation of the substrate upon approximation to the active catalyst, confirming the well-known regioselectivity of the Sharpless epoxidation process.
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Affiliation(s)
- Filipe Teixeira
- LAQV-REQUIMTE, Departamento de Química e Bioquímica, Faculdade de Ciências, Universidade do Porto , Rua do Campo Alegre, 4169-007 Porto, Portugal
| | - Ricardo Mosquera
- Departamento de Química Física, Facultade de Química, Universidade de Vigo , 36310 Vigo, Galicia, Spain
| | - André Melo
- LAQV-REQUIMTE, Departamento de Química e Bioquímica, Faculdade de Ciências, Universidade do Porto , Rua do Campo Alegre, 4169-007 Porto, Portugal
| | - Cristina Freire
- LAQV-REQUIMTE, Departamento de Química e Bioquímica, Faculdade de Ciências, Universidade do Porto , Rua do Campo Alegre, 4169-007 Porto, Portugal
| | - M Natália D S Cordeiro
- LAQV-REQUIMTE, Departamento de Química e Bioquímica, Faculdade de Ciências, Universidade do Porto , Rua do Campo Alegre, 4169-007 Porto, Portugal
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11
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Abstract
The possibility of linkage isomerism in a number of vanadium(IV) and vanadium(V) complexes with acetate was surveyed using Density Functional Theory (DFT) and Bader's Quantum Theory of Atoms in Molecules (QTAIM). The results show that vanadium-acetate linkages may be classified as bidentate symmetrical, bidentate asymmetrical, or monodentate, the latter being observed in about 40% of the cases. These latter ones correspond to situations where the two oxygen atoms of the acetate moiety are not equivalent. They are associated with an energy penalty of about 263 kJ·mol(-1), as determined by the distribution of the scaled kinetic energy of the atomic basins forming the acetate ligand. In the presence of bidentate symmetrical vanadium-acetate linkages, the inner valence-shell charge concentrations on the vanadium atom deviate from the traditional VSEPR-derived arrangement, with an energy penalty of about 780 kJ·mol(-1). A compromise situation is partially accomplished in the case of bidentate asymmetrical linkages, which allow a Gillespiean-like arrangement of the inner valence-shell charge concentrations. In this case, one of these local charge concentrations lies close to a V-OAcO bond, which slightly disrupts the equivalence between the two oxygen atoms in the acetate ligand.
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Affiliation(s)
- Filipe Teixeira
- LAQV-REQUIMTE, Faculty of Sciences of the University of Porto, Rua do Campo Alegre, 4169-007 Porto, Portugal
| | - Ricardo Mosquera
- Departamento de Química Física, Facultade de Química, Universidade de Vigo , 36310 Vigo, Spain
| | - André Melo
- LAQV-REQUIMTE, Faculty of Sciences of the University of Porto, Rua do Campo Alegre, 4169-007 Porto, Portugal
| | - Cristina Freire
- LAQV-REQUIMTE, Faculty of Sciences of the University of Porto, Rua do Campo Alegre, 4169-007 Porto, Portugal
| | - M Natália D S Cordeiro
- LAQV-REQUIMTE, Faculty of Sciences of the University of Porto, Rua do Campo Alegre, 4169-007 Porto, Portugal
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12
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Rivera J, Wilches-Luna E, Mosquera R, Hernandez N, Orobio OH. Pulmonary rehabilitation on aerobic capacity and health-related quality of life in patients with sequelae of pulmonary TB. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1203] [Citation(s) in RCA: 2] [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: 10/23/2022]
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13
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Reverdin AK, Mosquera R, Colasurdo GN, Jon CK, Clements RM. Airway obstruction in congenital central hypoventilation syndrome. BMJ Case Rep 2014; 2014:bcr-2013-200911. [PMID: 24842348 DOI: 10.1136/bcr-2013-200911] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Congenital central hypoventilation syndrome (CCHS) is the failure of the autonomic system to control adequate ventilation while asleep with preserved ventilatory response while awake. We report a case of a patient with CCHS who presented with intrathoracic and extrathoracic airway obstruction after tracheostomy tube decannulation and phrenic nerve pacer placement. Nocturnal polysomnography (NPSG) revealed hypoxia, hypercapnia and obstructive sleep apnoea, which required bilevel positive airway pressure titration. Airway endoscopy demonstrated tracheomalacia and paretic true vocal cords in the paramedian position during diaphragmatic pacing. Laryngeal electromyography demonstrated muscular electrical impulses that correlated with diaphragmatic pacer settings. Thus, we surmise that the patient's upper and lower airway obstruction was secondary to diaphragmatic pacer activity. Thorough airway evaluation, including NPSG and endoscopy, may help identify the side effects of diaphragmatic pacing, such as airway obstruction, in patients with CCHS.
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Affiliation(s)
- Alexandra K Reverdin
- Department of Pediatrics, Division of Pediatric Pulmonary Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Ricardo Mosquera
- Department of Pediatrics, Division of Pediatric Pulmonary Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Giuseppe N Colasurdo
- Department of Pediatrics, Division of Pediatric Pulmonary Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Cindy K Jon
- Department of Pediatrics, Division of Pediatric Pulmonary Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Roya M Clements
- Department of Pediatrics, Division of Pediatric Pulmonary Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, USA
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14
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Puccio FA, Rojas R, Mosquera I, Hernandez A, Mosquera R, Jaua L, Lizarrale M, Cifarrelli D, Reyes R. Food allergy is an important diseases associated to fibromyalgia. Clin Transl Allergy 2013. [PMCID: PMC3723944 DOI: 10.1186/2045-7022-3-s3-p120] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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15
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Latif A, Castriotta R, Majid R, Hashmi S, Mosquera R. Resolution of Obstructive Sleep Apnea-Associated Hypercapnia in Children After Tonsillectomy and Adenoidectomy. Chest 2012. [DOI: 10.1378/chest.1389398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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16
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Palma I, Mosquera R, Demier C, Vay C, Famiglietti A, Luna CM. Impacto de la bacteriemia en una cohorte de pacientes con neumonía neumocócica. J Bras Pneumol 2012; 38:422-30. [DOI: 10.1590/s1806-37132012000400003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Accepted: 11/22/2011] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Bacteriemia es la forma invasiva más común de neumonía adquirida en la comunidad (NAC) por Streptococcus pneumoniae. Investigamos si la bacteriemia en NAC neumocócica empeora los resultados y si ella guarda relación con la vacunación antineumocócica (VAN). MÉTODOS: Análisis secundario de una cohorte de pacientes con NAC neumocócica confirmada por cultivo de sangre o esputo o antígeno urinario. Se registraron datos demográficos, clínicos, radiográficos y de laboratorio, escores Acute Physiology and Chronic Health Evaluation II (APACHE II) y pneumonia severity index (PSI), comorbilidades y antecedente de VAN. Se compararon pacientes con NAC neumocócica bacteriémica (NNB) vs. no bacteriémica (NNNB). RESULTADOS: Cuarenta y siete pacientes tenían NNB y 71 NNNB (45 por cultivo de esputo y 26 por antígeno urinario); 107 tenían alguna indicación de VAN. Ningún paciente con NNB, pero 9 con NNNB, habían recibido VAN (p = 0,043). Los pacientes con NNB eran mayores (76,4 ± 11,5 vs. 67,5 ± 20,9 años), tenían mayor APACHE II (16,4 ± 4,6 vs. 14,1 ± 6,5) y PSI (129,5 ± 36 vs. 105,2 ± 45), más frecuentemente cardiopatía e insuficiencia renal crónica e internación en UTI (42,5% vs. 22,5%) y menor hematocrito (35,7 ± 5,8 vs. 38,6 ± 6,7%) y sodio plasmático (133,9 ± 6,0 vs. 137,1 ± 5,5 mEq/L). La mortalidad fue similar (29,8% vs. 28,2%). CONCLUSIONES: Los niveles de VAN (8,4%) en esta población con alto riesgo de NAC por S. pneumoniae fueron extremadamente bajos. Los pacientes con NNB estaban más graves, pero la mortalidad fue similar entre los dos grupos. La VAN reduce la incidencia de NNB y es razonable incrementar el nivel de vacunación de la población en riesgo.
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17
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Benedetti A, Cabeza M, Castro G, Feijoo I, Mosquera R, Merino P. Surface modification of 7075-T6 aluminium alloy by laser melting. SURF INTERFACE ANAL 2012. [DOI: 10.1002/sia.4840] [Citation(s) in RCA: 5] [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)
- A. Benedetti
- C.A.C.T.I, Vigo University; Campus Universitario; Vigo; Spain
| | - M. Cabeza
- ENCOMAT Group, Vigo University; E.T.S.E.I., Campus Universitario; Vigo; Spain
| | - G. Castro
- Technological Centre AIMEN; Relva 27A Torneiros; Porriño; Pontevedra; Spain
| | - I. Feijoo
- Technological Centre AIMEN; Relva 27A Torneiros; Porriño; Pontevedra; Spain
| | - R. Mosquera
- ENCOMAT Group, Vigo University; E.T.S.E.I., Campus Universitario; Vigo; Spain
| | - P. Merino
- ENCOMAT Group, Vigo University; E.T.S.E.I., Campus Universitario; Vigo; Spain
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18
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Estévez N, Reigosa V, Orraca M, Iturria Y, Ojeda A, Alemán Y, Pentón L, Lage A, Mosquera R, Valdés L, Recio B, González E, Marine R, Rodrı´guez M, Amor V. 69. Volumetric, connective, and morphologic changes in the brains of developmental dyscalculic children with and without a genetic disorder. Clin Neurophysiol 2008. [DOI: 10.1016/j.clinph.2008.04.085] [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: 10/21/2022]
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19
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Terán C, Gonzalez Moa MJ, Mosquera R, Santana L. Synthesis and structural study of pyrimidyl carbocyclic analogues of nucleosides based on cyclopentene rings. Nucleosides Nucleotides Nucleic Acids 2001; 20:999-1002. [PMID: 11563163 DOI: 10.1081/ncn-100002477] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
A series of 1,2-disubstituted carbonucleoside analogues of pyrimidine and 5-halopyrimidines with the unsaturated carbocycle cyclopentene was synthesized. AIM theory was applied to analyse the conformational and electronic effects of 5-halogenation.
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Affiliation(s)
- C Terán
- Vigo University, Vigo, Spain
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20
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Mansilla E, Arrúa J, Salas E, Gardiner C, Marchessi N, Manfredi D, Schreiner A, Mosquera R, Gil MA, Gardenal L, Ball Lima M, Marín G, Drago H, Sturla F, Menna ME, Sorratti C, Piccinelli G. The Derma Project: present and future possibilities of skin procurement for the treatment of large burns in Argentina, Tissue Engineering and the Cadaver Skin Bank. Transplant Proc 2001; 33:637-9. [PMID: 11266994 DOI: 10.1016/s0041-1345(00)02179-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- E Mansilla
- Cell Culture and Tissue Engineering Unit-Immunology Department and Skin Bank-Plastic Surgery and Burns Department, San Martín Hospital Cucaiba, La Plata, Argentina
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21
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Orjales A, Alonso-Cires L, López-Tudanca PL, Tapia I, Labeaga L, Mosquera R. Synthesis and 5-HT3 receptor affinity of new quinolinecarboxylic acid derivatives. Drug Des Discov 2000; 16:271-9. [PMID: 10807033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
A series of quinolinecarboxylic acid amides and an ester with a quinuclidine moiety were synthesized and their in vitro affinities at 5-HT3, 5-HT4, and D2 receptors evaluated by radioligand binding assays. Highest affinity at 5-HT3 receptor corresponded to derivative 5 with Ki = 9.9 nM and with selectivity over 5-HT4 and D2 receptors. Compounds displayed moderate 5-HT3 antagonist activity (ED50 = 10.5-21.5 microg/kg i.v.). The obtained data suggest that the 5-HT3 receptor sites can accommodate the acyl group of the 2-quinoline derivatives. The results indicate the existence of an optimal distance between the lone electron pair of the quinoline nitrogen atom and the azabicyclic nitrogen atom, and a no-pharmacophoric pocket in the 5-HT3 receptor which would hold the fragment at the position 4 of the quinoline ring.
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Affiliation(s)
- A Orjales
- Departamento de Investigación, FAES, Leioa (Vizcaya), Spain
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22
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Tapia I, Alonso-Cires L, López-Tudanca PL, Mosquera R, Labeaga L, Innerárity A, Orjales A. 2,3-Dihydro-2-oxo-1H-benzimidazole-1-carboxamides with selective affinity for the 5-HT(4) receptor: synthesis and structure-affinity and structure-activity relationships of a new series of partial agonist and antagonist derivatives. J Med Chem 1999; 42:2870-80. [PMID: 10425096 DOI: 10.1021/jm981098j] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A series of 2,3-dihydro-2-oxo-1H-benzimidazole-1-carboxamide derivatives bearing a piperazine moiety was synthesized. Their in vitro 5-HT(4), 5-HT(3), and D(2) receptors affinities were evaluated by radioligand binding assay. For selected compounds functional studies at the 5-HT(4) receptor were made by using precontracted (by carbachol) preparations of rat esophageal tunica muscularis mucosae (TMM). The influence of the 3-substituent of the benzimidazole ring, the 4-substituent of the piperazine moiety, and the alkylene spacer was studied. Compounds with an ethyl or a cyclopropyl substituent in the 3-position of the benzimidazole ring showed moderate to high affinity (K(i) = 6.7-75.4 nM) for the 5-HT(4) receptor with selectivity over 5-HT(3) and D(2) receptors and moderate antagonist activity (pK(b) = 6.19-7.73). Compounds with an isopropyl substituent in the 3-benzimidazole position exhibited moderate and selective 5-HT(4) affinity (K(i) >/= 38.9 nM) and a partial agonist activity (5a, i.a. = 0.94) higher than that of the reference compound BIMU 8 (i.a. = 0.70). This reversal of the pharmacological activity due only to a small structural difference might confirm the existence of two binding sites on the 5-HT(4) receptor. In the alkylene spacer, a two-methylene chain is favorable to optimize the affinity and the antagonist or the partial agonist activity. In the ethyl and cyclopropyl series, 5-HT(4) antagonist activity seems to be unrelated to the size of the 4-substituent of the piperazine moiety, whereas a methyl group is optimal for high partial agonist activity in the isopropyl series; however, the presence of a butyl substituent is a favorable pattern for 5-HT(4) antagonism and even causes a reversal of the pharmacological profile in the isopropyl series (5h, pK(b) = 7.94). N-Butyl quaternization of 5a led to an improvement in affinity for the 5-HT(4) receptor and mantained the high partial agonist activity (5r, K(i) = 66.3 nM, i.a. = 0.93).
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MESH Headings
- Amides/chemical synthesis
- Amides/chemistry
- Amides/metabolism
- Amides/pharmacology
- Animals
- Benzimidazoles/chemical synthesis
- Benzimidazoles/chemistry
- Benzimidazoles/metabolism
- Benzimidazoles/pharmacology
- Corpus Striatum/metabolism
- Entorhinal Cortex/metabolism
- Esophagus/drug effects
- Esophagus/physiology
- Guinea Pigs
- In Vitro Techniques
- Male
- Muscle, Smooth/drug effects
- Muscle, Smooth/physiology
- Radioligand Assay
- Rats
- Rats, Wistar
- Receptors, Dopamine D2/drug effects
- Receptors, Serotonin/drug effects
- Receptors, Serotonin/metabolism
- Receptors, Serotonin, 5-HT3
- Receptors, Serotonin, 5-HT4
- Serotonin Antagonists/chemical synthesis
- Serotonin Antagonists/chemistry
- Serotonin Antagonists/pharmacology
- Serotonin Receptor Agonists/chemical synthesis
- Serotonin Receptor Agonists/chemistry
- Serotonin Receptor Agonists/pharmacology
- Structure-Activity Relationship
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Affiliation(s)
- I Tapia
- Departamento de Investigación, FAES, S.A., Máximo Aguirre 14, 48940 Leioa, Vizcaya, Spain
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23
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Orjales A, Mosquera R, Labeaga L, Rodes R. New 2-piperazinylbenzimidazole derivatives as 5-HT3 antagonists. Synthesis and pharmacological evaluation. J Med Chem 1997; 40:586-93. [PMID: 9046349 DOI: 10.1021/jm960442e] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A series of 2-piperazinylbenzimidazole derivatives were prepared and evaluated as 5-HT3 receptor antagonists. Their 5-HT3 receptor affinities were evaluated by radioligand binding assays, and their abilities to inhibit the 5-HT-induced Bezold-Jarisch reflex in anesthetized rats were determined. Compound 7e (lerisetron, pKi = 9.2) exhibited higher affinity for the 5-HT3 receptor than did tropisetron and granisetron, while compound 7q (pKi = 7.5) had very low affinity for this receptor, showing that substitution on the N1 atom of the benzimidazole ring is essential for affinity and activity. The effect of substitution on the aromatic ring of benzimidazole by several substituents in different positions is also discussed. A strong correlation between the 5-HT3 antagonistic activity of the studied compounds and the position of substitution on the aromatic ring was established. Thus, while the 4-methoxy derivative 7m showed weak affinity for the 5-HT3 receptor (pKi = 6.7), the 7-methoxy derivative 7n exhibited the highest affinity (pKi = 9.4). Compounds 7e and 7n are now under further investigation as drugs for the treatment of nausea and emesis evoked by cancer chemotherapy and radiation.
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MESH Headings
- Animals
- Benzimidazoles/chemistry
- Guinea Pigs
- Indazoles/metabolism
- Male
- Models, Chemical
- Piperazines/chemistry
- Piperidines
- Rats
- Rats, Wistar
- Receptor, Serotonin, 5-HT2A
- Receptors, Serotonin/metabolism
- Receptors, Serotonin, 5-HT1
- Receptors, Serotonin, 5-HT3
- Receptors, Serotonin, 5-HT4
- Serotonin Antagonists/chemical synthesis
- Serotonin Antagonists/pharmacology
- Tropanes/metabolism
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Affiliation(s)
- A Orjales
- Departamento de Investigación, FAES, S.A. Leioa (Vizcaya), Spain
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24
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Fernández B, Mosquera R, Uriarte E. Structure-activity relationships in verapamil and analogues using molecular mechanics calculations. Int J Pharm 1992. [DOI: 10.1016/0378-5173(92)90111-e] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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25
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Wilches EC, Rivera JA, Mosquera R, Loaiza L, Obando L. Pulmonary rehabilitation in multi-drug resistant tuberculosis (TB MDR): a case report. Colomb Med (Cali) 1969. [DOI: 10.25100/cm.v40i4.675] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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26
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Wilches EC, Rivera JA, Mosquera R, Loaiza L, Obando L. Rehabilitación pulmonar en tuberculosis multirresistente (TB-MDR): informe de un caso. Colomb Med (Cali) 1969. [DOI: 10.25100/cm.v40i4.676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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27
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Pellón A, Mosquera R, Castedo L, Ribas I. Retamine N-oxides. Tetrahedron Lett 1969:129-32. [PMID: 5778487 DOI: 10.1016/s0040-4039(01)87490-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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