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Rodriguez J, Schulz S, Voss A, Herrera S, Benito S, Giraldo BF. Baroreflex activity through the analysis of the cardio-respiratory variability influence over blood pressure in cardiomyopathy patients. Front Physiol 2023; 14:1184293. [PMID: 37637149 PMCID: PMC10456872 DOI: 10.3389/fphys.2023.1184293] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 06/01/2023] [Indexed: 08/29/2023] Open
Abstract
A large portion of the elderly population are affected by cardiovascular diseases. Early prognosis of cardiomyopathies remains a challenge. The aim of this study was to classify cardiomyopathy patients by their etiology based on significant indexes extracted from the characterization of the baroreflex mechanism in function of the influence of the cardio-respiratory activity over the blood pressure. Forty-one cardiomyopathy patients (CMP) classified as ischemic (ICM-24 patients) and dilated (DCM-17 patients) were considered. In addition, thirty-nine control (CON) subjects were used as reference. The beat-to-beat (BBI) time series, from the electrocardiographic (ECG) signal, the systolic (SBP), and diastolic (DBP) time series, from the blood pressure signal (BP), and the respiratory time (TT), from the respiratory flow (RF) signal, were extracted. The three-dimensional representation of the cardiorespiratory and vascular activities was characterized geometrically, by fitting a polygon that contains 95% of data, and by statistical descriptive indices. DCM patients presented specific patterns in the respiratory response to decreasing blood pressure activity. ICM patients presented more stable cardiorespiratory activity in comparison with DCM patients. In general, CMP shown limited ability to regulate changes in blood pressure. In addition, patients also shown a limited ability of their cardiac and respiratory systems response to regulate incremental changes of the vascular variability and a lower heart rate variability. The best classifiers were used to build support vector machine models. The optimal model to classify ICM versus DCM patients achieved 92.7% accuracy, 94.1% sensitivity, and 91.7% specificity. When comparing CMP patients and CON subjects, the best model achieved 86.2% accuracy, 82.9% sensitivity, and 89.7% specificity. When comparing ICM patients and CON subjects, the best model achieved 88.9% accuracy, 87.5% sensitivity, and 89.7% specificity. When comparing DCM patients and CON subjects, the best model achieved 87.5% accuracy, 76.5% sensitivity, and 92.3% specificity. In conclusion, this study introduced a new method for the classification of patients by their etiology based on new indices from the analysis of the baroreflex mechanism.
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Affiliation(s)
- Javier Rodriguez
- Automatic Control Department (ESAII), Barcelona East School of Engineering (EEBE), Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
- Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Steffen Schulz
- Institute of Innovative Health Technologies, Jena, Germany
| | - Andreas Voss
- Institute of Innovative Health Technologies, Jena, Germany
| | | | | | - Beatriz F. Giraldo
- Automatic Control Department (ESAII), Barcelona East School of Engineering (EEBE), Universitat Politècnica de Catalunya (UPC), Barcelona, Spain
- Institute for Bioengineering of Catalonia (IBEC), The Barcelona Institute of Science and Technology, Barcelona, Spain
- CIBER de Bioengenieria, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain
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Herrera S, Torralbo B, Herranz S, Bernal-Maurandi J, Rubio E, Pitart C, Fortes I, Valls S, Rodríguez L, Santana G, Bodro M, Garcia-Vidal C, Hernández-Meneses M, Puerta P, Morata L, Villella A, Bertran MJ, Brey M, Soriano A, Del Río A, Martinez JA. Carriage of multidrug-resistant Gram-negative bacilli: duration and risk factors. Eur J Clin Microbiol Infect Dis 2023; 42:631-638. [PMID: 36964885 DOI: 10.1007/s10096-023-04581-1] [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: 11/24/2022] [Accepted: 02/24/2023] [Indexed: 03/26/2023]
Abstract
Identification of risk factors influencing the duration of carriage of multidrug-resistant Gram-negative bacilli (MDR-GNB) may be useful for infection control. The aim of this study is to estimate the impact of several factors collected for routine hospital surveillance on the duration of carriage of selected MDR-GNB. From January 2015 to July 2021, patients with at least two clinical/surveillance samples positive for MDR-GNB different from ESBL-producing E. coli or AmpC - exclusively producing Enterobacterales were assessed. Microorganisms, age, number of admissions, clinical or rectal sample, sex, and admission service were evaluated as risk factors. Multivariate analysis was performed by a Cox proportional hazard model. A total of 1981 episodes of colonization were included. Involved microorganisms were ESBL-Klebsiella pneumoniae (KP) in 1057 cases (53.4%), other ESBL-non-E. coli Enterobacterales in 91 (4.6%), OXA-48-KP in 263 (13.3%), KPC-KP in 90 (4.5%), VIM-KP in 29 (1.5%), carbapenemase-producing non-KP Enterobacterales (CP-non-KP) in 124 (6.3%), and MDR Pseudomonas aeruginosa (MDR-PAER) in 327 (16.5%). No differences in duration of colonization were observed among ESBL-KP (median colonization time 320 days), ESBL-non-E. coli Enterobacterales (226 days), OXA48-KP (305 days), and MDR-PAER (321 days). For each group, duration of colonization was significantly longer than that of KPC-KP (median colonization time 60 days), VIM-KP (138 days), and CP-non-KP (71 days). Male sex (HR = 0.88; 95% CI 0.78-0.99), detection in Hepatology-Gastroenterology (HR = 0.71; 95% CI 0.54-0.93), clinical sample (HR = 0.61; 95% CI 0.53-0.69), and > 2 admissions after first detection (HR = 0.47; 95% CI 0.42-0.52) were independent predictors of longer carriage, whereas VIM-KP (HR = 1.61; 95% CI 1.04-2.48), KPC-KP (HR = 1.85; 95% CI 1.49-2.3), and CP-non-KP (HR = 1.92; 95% CI 1.49-2.47) were associated with shorter colonization time. Duration of colonization was significantly longer for ESBL-KP, other ESBL-non-E. coli Enterobacterales, OXA-48-KP, and MDR-PAER. For these microorganisms, prolonging surveillance up to 2.5-3 years should be considered. Male sex, clinical sample, multiple readmissions, admission service, and type of microorganism are independent predictors of the duration of carriage.
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Affiliation(s)
- S Herrera
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain
| | - B Torralbo
- Preventive Medicine, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain
| | - S Herranz
- Preventive Medicine, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain
| | - J Bernal-Maurandi
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain
| | - E Rubio
- Department of Microbiology, Hospital Clinic, University of Barcelona, ISGLOBAL, Barcelona, Spain
| | - C Pitart
- Department of Microbiology, Hospital Clinic, University of Barcelona, ISGLOBAL, Barcelona, Spain
| | - I Fortes
- Preventive Medicine, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain
| | - S Valls
- Preventive Medicine, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain
| | - L Rodríguez
- Preventive Medicine, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain
| | - G Santana
- Preventive Medicine, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain
| | - M Bodro
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain
| | - C Garcia-Vidal
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain
| | - M Hernández-Meneses
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain
| | - P Puerta
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain
| | - L Morata
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain
| | - A Villella
- Preventive Medicine, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain
| | - M J Bertran
- Preventive Medicine, Hospital Clinic of Barcelona-IDIBAPS, Barcelona, Spain
| | - M Brey
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain
| | - A Soriano
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain
| | - A Del Río
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain
| | - J A Martinez
- Department of Infectious Diseases, Hospital Clinic of Barcelona-IDIBAPS, C. de Villarroel, 170, 08036, Barcelona, Spain.
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Sánchez-Marcos C, Jacob J, Llorens P, Rodríguez B, Martín-Sánchez F, Herrera S, Castillero-Díaz L, Herrero P, Gil V, Miró Ò. Análisis de la efectividad y seguridad de las unidades de estancia corta en la hospitalización de pacientes con insuficiencia cardíaca aguda. Propensity Score UCE-EAHFE. Rev Clin Esp 2022. [DOI: 10.1016/j.rce.2022.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Sánchez-Marco C, Jacob J, Llorens P, Rodríguez B, Martín-Sánchez FJ, Herrera S, Castillero-Díaz LE, Herrero P, Gil V, Miró Ò. Original articleAnalysis of the effectiveness and safety of short-stay units in the hospitalization of patients with acute heart failure. Propensity Score SSU-EAHFE. Rev Clin Esp 2022; 222:443-457. [PMID: 35842410 DOI: 10.1016/j.rceng.2022.03.009] [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: 02/02/2022] [Accepted: 03/27/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES This work aims to analyze if hospitalization in short-stay units (SSU) of patients diagnosed in the emergency department with acute heart failure (AHF) is effective in terms of the length of hospital stay and if it is associated with differences in short-term progress. METHOD Patients from the EAHFE registry diagnosed with AHF who were admitted to the SSU (SSU group) were included and compared to those hospitalized in other departments (non-SSU group) from all hospitals (comparison A) and, separately, those from hospitals with an SSU (comparison B) and without an SSU (comparison C). For each comparison, patients in the SSU/non-SSU groups were matched by propensity score. The length of hospital stay (efficacy), 30-day mortality, and post-discharge adverse events at 30 days (safety) were compared. RESULTS A total of 2,003 SSU patients and 12,193 non-SSU patients were identified. Of them, 674 pairs of patients were matched for comparison A, 634 for comparison B, and 588 for comparison C. The hospital stay was significantly shorter in the SSU group in all comparisons (A: median 4 days (IQR = 2-5) versus 8 (5-12) days, p < 0.001; B: 4 (2-5) versus 8 (5-12), p < 0.001; C: 4 (2-5) versus 8 (6-12), p < 0.001). Admission to the SSU was not associated with differences in mortality (A: HR = 1.027, 95%CI = 0.681-1.549; B: 0.976, 0.647-1.472; C: 0.818, 0.662-1.010) or post-discharge adverse events (A: HR = 1.002, 95%CI = 0.816-1.232; B: 0.983, 0.796-1.215; C: 1.135, 0.905-1.424). CONCLUSION The hospitalization of patients with AHF in the SSU is associated with shorter hospital stays but there were no differences in short-term progress.
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Affiliation(s)
- C Sánchez-Marco
- Área de Urgencias, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - J Jacob
- Servicio de Urgencias, Hospital Universitari de Bellvitge, IDIBELL, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
| | - P Llorens
- Servicio de Urgencias, Corta Estancia y Hospitalización a Domicilio, Hospital General de Alicante, Instituto de Investigación Sanitaria y Biómedica de Alicante (ISABIAL), Universidad Miguel Hernández, Alicante, Spain
| | - B Rodríguez
- Servicio de Urgencias, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - F J Martín-Sánchez
- Servicio de Urgencias, Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain
| | - S Herrera
- Servicio de Urgencias, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - P Herrero
- Servicio de Urgencias, Hospital Central de Asturias, Oviedo, Spain
| | - V Gil
- Área de Urgencias, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
| | - Ò Miró
- Área de Urgencias, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain.
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Herrera S, Diaz-Coronado JC, Monsalve S, Guerra-Zarama S, Saavedra Chacón MF, Barbosa J, Serna Giraldo JD, Lopez JD, Gutiérrez JM, Vega T, Orozco D, Ocampo D, Zuluaga N, Hernandez-Parra D, Rojas-Gualdrón D, Pineda.Tamayo R. POS0749 ASSOCIATION BETWEEN IMMUNE-SEROLOGICAL PROFILE AND PULMONARY MANIFESTATIONS IN COLOMBIAN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS (LES). Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2577] [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: 11/04/2022]
Abstract
Background:Pulmonary involvement is common in Systemic Lupus Erythematosus (SLE) patients with varying degrees of parenchymal, vascular, and pleural compromise. In GLADEL, pulmonary involvement was reported in 28.4% of the cohort, but its occurrence ranges between 30-90% due to diversity in populations and the methods used to define it.Objectives:To describe the immune-serological profile of a Colombian cohort of SLE patients and to establish its association with pulmonary manifestations.Methods:Retrospective analysis of observational data from the follow-up of a cohort of adult patients with SLE. We included 559 patients that fulfilled the SLICC 2012 classification criteria with at least 6 months of disease history and being treated in a rheumatology specialized medical center between 2015 and 2018. The immuno-serological profile was characterized, and pulmonary involvement was monitored for 1 year. Diagnosis of pulmonary involvement was performed with the rheumatologist report in the clinical chart. Prevalence of pulmonary manifestations and immune-serological profile was determined, and logistic regression was performed afterward adjusted by age, sex, and level of education to establish the association between pulmonary manifestations and a positive auto-antibodies profile.Results:The median age of the cohort was 45 years, 96.5% were female. Pulmonary involvement was documented in 113 patients (20.5%) at the beginning of the study. Their frequency was: pleuritis (14.3%), lupus pneumonitis (3.6%), pulmonary hypertension (3.2%), interstitial lung disease (ILD) (2.3%), pulmonary embolism (2.3%), lung fibrosis (2.14%), alveolar hemorrhage (1.4%), shrinking lung (0.2%). At 1 year of follow up. there were no statistically significant differences in the frequency of pulmonary manifestations. As for the immune-serological profile, there were positive ANA in 92%, anti-dsDNA in 53.1%, anti-B2GP IgM 15.2%, anti- B2GP IgG in 17.2%, and ENA in 97.2%; as for the ENA 41.7% had positive anti-RNP, 40.2% anti-Ro, 36.4% anti-SM and 16.5% anti-La. Low complement levels was characterized as follows: C3 53.1% and C4 29.2%. In the logistic regression adjusted by age, sex and level of education, there was an association between anti-SM and pulmonary manifestations with an adjusted OR of 1.85; 95% CI 1.13-3.01.Conclusion:An association between anti-SM positivity and pleuro-pulmonary manifestations was found. In other cohorts with a greater size, anti-La and anti-RNP have been associated with pulmonary involvement (OR 2.51; 95% CI 1.39-4.57 and OR 1.32; 95% CI 1-1.75 respectively). Anti-RNP positivity has been associated in particular with ILD, pulmonary hypertension and shrinking lung. Although these manifestations prevalence was similar in our cohort, an association with this antibody was not found (OR 1.01, 95% CI: 0.2-4.9). This could be explained by the smaller sample size. As for anti-La positivity, its prevalence in our cohort was less than what was found in the GLADEL cohort (16.5% vs 24.3% respectively). It is possible that this could explain the poor association between anti-La positivity with the presence of pulmonary manifestations in our study compared with those of the GLADEL cohort. There are data that indicates that anti-SM and anti-RNP simultaneous positivity is related mainly to pleuritis OR 1.98 (95% CI: 1.31-3); and this kind of involvement was found to be more frequent in our study. Our results suggest an association between positive anti-SM and pulmonary manifestations in Colombian patients with SLE, pleuritis in particular.References:[1]Haye Salinas MJ, Caeiro F, Saurit V et al. Pleuropulmonary involvement in patients with systemic lupus erythematosus from a Latin American inception cohort (GLADEL). Lupus. 2017;26(13):1368–77.[2]Emad Y, Gheita T, Darweesh H, Klooster P, et al. Antibodies to extractable nuclear antigens (ENAS) in systemic lupus erythematosus patients: Correlations with clinical manifestations and disease activity. Reumatismo. 2018;70(2):85–91.Disclosure of Interests:None declared
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Herrera S, Diaz-Coronado JC, Monsalve S, Guerra-Zarama S, Saavedra Chacón MF, Barbosa J, Serna Giraldo JD, Lopez JD, Gutiérrez JM, Vega T, Orozco D, Ocampo D, Zuluaga N, Hernandez-Parra D, Rojas-Gualdrón D, Pineda.Tamayo R. AB0336 PULMONARY MANIFESTATIONS IN A COLOMBIAN COHORT OF PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3452] [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: 11/04/2022]
Abstract
Background:Pulmonary manifestations are frequent in systemic lupus erythematosus (SLE) with a frequency of 30-90% that depends on the cohort and the methods used for their identification. The association of this compromise with mortality highlights its importance and the need for biomarkers to adequately predict this complication. We describe the prevalence of pulmonary manifestations, and the clinic and immunoserological characteristics of 551 Colombian patients with SLEObjectives:We performed an observational and analytic study of a retrospective cohort with adult SLE patients who fulfilled the 2012 SLICC classification criteria and that had a history of at least 6 months of the disease. These patients were treated in a specialized center of rheumatology with presence in six cities of Colombia between 2015 and 2018. We excluded pregnant patients and those with incomplete data for our survey. The first clinic consult occurred between 2015 and 2018, being defined as moment one. The follow up one year later was defined as moment two. We obtained 710 registries that were potentially eligible and analyzed 465 patients at moment two after applying the exclusion criteriaMethods:In 465 eligible patients, 20,5% had pulmonary compromise (93.8% female) with a median age of 42,4 years. The average SLICC Damage Index of 551 patients with SLE was 0,9 in women and 1.05 in men, while the average SDI of patients with pulmonary compromise was 1. The most frequent manifestation was pleural (14.3%), followed by Lupus pneumonitis (3.6%) and pulmonary hypertension (3.2%). Other manifestations and serological characteristics are recorded in Table 1. Of note, ANA homogeneous pattern was the most common (34.5%), anti-RNP positivity was 41.7%, anti-dsDNA positivity was 53.1% and 53.1% had hypocomplementemia.Results:The prevalence of pulmonary manifestations in our cohort was 20,5%, which is lower that in the previous described GLADEL cohort (28,4%). This could be explained by the regional differences of ethnicities in Latin America and in immune-serological profiles. Anti-RNP positivity was frequent (41.7%) and new pulmonary compromise for one year follow-up was rare. Of not, the mean damage index for our patients with pulmonary manifestations was 1, this could highlight the importance of this organ as a causa of higher damage accrual and mortality, which we will explore in the futureConclusion:The prevalence of pulmonary manifestations in our cohort was 20,5%, which is lower that in the previous described GLADEL cohort (28,4%). This could be explained by the regional differences of ethnicities in Latin America and in immune-serological profiles. Anti-RNP positivity was frequent (41.7%) and new pulmonary compromise for one year follow-up was rare. Of not, the mean damage index for our patients with pulmonary manifestations was 1, this could highlight the importance of this organ as a causa of higher damage accrual and mortality, which we will explore in the futureReferences:[1]G. Aguilera-Pickens, C. Abud-Mendoza. Pulmonary Manifestations in Systemic Lupus Erythematosus: Pleural Involvement, Acute Pneumonitis, Chronic Interstitial Lung Disease and Diffuse Alveolar Hemorrhage. Reumatol Clin. 2018;14(5):294–300.[2]Haye Salinas MJ, Caeiro F, Saurit V. Pleuropulmonary involvement in patients with systemic lupus erythematosus from a Latin American inception cohort (GLADEL). Lupus (2017) 0, 1–10.[3]Santamaria-Alza Y, Sanchez-Bautista J, Fajardo-Rivero J. Acute respiratory involvement in Colombian patients with systemic lupus erythematosus undergoing chest computed tomography. Int J Rheum Dis. 2019;00:1–7.Table 1.clinical and immunoserological characteristicsn%Women10693,8Global mortality468,3Pulmonary compromise mortality87,1ANA10492Anti-DNA6053,1ENAS97,2Ro35/8740,2La14/8516,5SM32/8836,4RNP35/8441,7Follow up 1 %Follow up 2 %P Value *Pulmonary hypertension3,22,80,28Pulmonary fibrosis2,142,61Shrunken lung0,20,21Pleuritis14,315,050,42Lupus pneumonitis3,63,010,85Alveolar hemorrhage1,41,30,76Pulmonary embolism2,31,930,72Disclosure of Interests:None declared
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Herrera S, Marenco Maldonado J, Diaz-Coronado JC, Rojas-Gualdrón D, Hernandez-Parra D, Pineda.Tamayo R. AB0351 PROGRESSION TO SEVERE LUPUS NEPHRITIS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOUS: UPDATE FROM A COLOMBIAN COHORT. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.4284] [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: 11/03/2022]
Abstract
Background:Continuous monitoring of patients with Systemic lupus erythematosus (SLE) provides relevant informationObjectives:To update the analysis of clinical and immunological characteristics associated with time to severe renal involvement in patients with Systemic Lupus Erythematous in a Colombian cohort followed from January 2015 to October 2020Methods:A retrospective follow-up study based on clinical records. Patients with SLE diagnosis fulfilled either 1987 American College of Rheumatology Classification Criteria for SLE or 2011 Systemic Lupus International Collaborating Clinics (SLICC) classification criteria for SLE. We included patients with the diagnosis of lupus nephritis according to Wallace and Dubois criteria. Patients who did not have at least two follow-up measurements or had a cause of nephritis other than lupus were excluded. The primary outcome was defined as the time from diagnosis to severe renal involvement defined as creatinine clearance ≤50ml/min, 24-hour proteinuria ≥3.5 grams o end-stage renal disease. Updated age and sex-adjusted survival functions and Hazard ratios (HR) with 95% confidence intervals and p-values were estimated using parametric Weibull models for interval-censored data. P values <0.05 were considered statistically significant. Descriptive statistics were previously reported in EULAR 2020 (1)Results:548 patients were analyzed: 67 were left-censored as they presented renal involvement at entry, 25 were interval censored as outcome occurred between study visits (19 new events), and 456 were right-censored as involvement was not registered during follow-up. In this cohort update Age and sex-adjusted Hazard Ratios for high blood pressure were HR = 3.1 (95%CI 1.5-6.3; p-value = 0.003) and Anti-RO (per unit increase) HR = 1.003 (95%CI 1.001-1.005; p-value = 0.029). Figure 1 shows the updated age and sex-adjusted survival functionConclusion:In this cohort update, we found similar clinical and immunological characteristics associated with time to severe renal involvement in SLE patients to those reported in (1). However, continuous follow-up allows us to deepen our understanding of the progression to severe renal involvement in SLE patientsReferences:[1]Herrera S, Diaz-Coronado JC, Rojas-Gualdrón D, Betancur-Vasquez L, Gonzalez-Hurtado D, Gonzalez-Arango J, et al. SAT0210 factors associated with time to severe lupus nephritis in a cohort of colombian patients. Ann Rheum Dis. junio de 2020;79(Suppl 1):1048.2-1048Disclosure of Interests:None declared
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Herrera S, Diaz-Coronado JC, Monsalve S, Guerra-Zarama S, Saavedra Chacón MF, Barbosa J, Serna Giraldo JD, Lopez JD, Gutiérrez JM, Vega T, Orozco D, Ocampo D, Zuluaga N, Hernandez-Parra D, Rojas-Gualdrón D, Pineda.Tamayo R. AB0335 SURVIVAL ASSESSMENT IN PATIENTS WITH SLE AND PULMONARY MANIFESTATIONS IN A COLOMBIAN COHORT WITH 2-YEAR FOLLOW-UP. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3428] [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: 11/04/2022]
Abstract
Background:Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease with heterogenous and variable behavior. The frequency of pulmonary involvement ranges from 10-90%, with this variability in occurrence attributed to differences in populations and heterogeneity in detection methods and study designs.Objectives:To analyze survival in patients with SLE and the presence of pulmonary manifestations according to clinical and demographic characteristics in a cohort of patients in ColombiaMethods:Observational-analytical, retrospective, follow-up study of a cohort of adult patients with SLE. We included 559 adult patients who fulfilled the 2012 SLICC SLE classification criteria and with at least 6 months of disease evolution, treated in a medical center specialized in rheumatology with locations in 6 cities in Colombia between 2015 and 2018. Pregnant patients and those who had incomplete data or visits were excluded. Immunoserological profile was characterized and pulmonary involvement was followed for 1 year. The diagnosis of pulmonary involvement was obtained from the rheumatology report in the clinical chart. The prevalence of pulmonary manifestations and the immunoserological profile were determined and subsequently a logistic regression adjusted for age, sex and level of education was performed to establish the association between pulmonary manifestations and a positive autoantibody profileResults:Median age was 44.5 ± 14 years, 96.6% were women. In patients with pulmonary compromise 9.7% were smokers, 12.4% had an active alcohol intake, 58.4% had a low socioeconomic status, 38.1% medium and 4.7% high. Pulmonary involvement was present in 20% of patients, the most common manifestations were pleuritis (14.3%), lupus pneumonitis (3.6%), pulmonary hypertension (3.2%), interstitial lung disease (2.3%), pulmonary embolism (2.3%), pulmonary fibrosis (2.14%), alveolar hemorrhage (1.4%), shrinking lung (0.2%). there was no significant difference in the follow up at one year. Immunoserological characteristics shows ANA positivity in 92%, anti-DNA in 53%, ENAS in 97%, with anti-RNP being the most common (41.7%), and low complement levels in 53%. Mortality for pulmonary compromise was 1.4%, and survival at 2 years did not have a statistically significant difference (p=0.155)Conclusion:Survival was not found to be lower in patients with SLE and pulmonary involvement (p=0.155) when compared to SLE patients without pulmonary involvement after 2-year follow-up. This finding was independent of age, gender, and educational level. Previous large cohorts like GLADEL and RELESSER describe an association between pulmonary involvement and lower survival HR 2,79 (95% CI: 1,80-4,31), p <0,001 and HR 3.13, (95% IC: 1.56– 6.28, P = 0.00 respectively. In the RELESSER cohort pleural involvement and pulmonary embolism was found to have low to minimal impact on survival.In our cohort pleuritis was the most common finding whereas the other pulmonary manifestations were reported in less than 4% of patients. This difference could explain our differences with other cohorts. Other causes for this difference are a smaller sample size and a short follow-up.The results of our study do not suggest that there is an association between pulmonary involvement and mortality in Colombian patients with SLE during a 2-year follow-up. We will continue to monitor and report in this regardReferences:[1]Narváez J, Borrell H, Sánchez-Alonso F, Rúa-Figueroa I, López-Longo FJ, Galindo-Izquierdo M, et al. Primary respiratory disease in patients with systemic lupus erythematosus. (RELESSER) cohort. Arthritis Res Ther. 2018;20(1):1–10.[2]Keane MP, Lynch JP. Pleuropulmonary manifestations of systemic lupus erythematosus. Vol. 55, Thorax. Thorax; 2000. p. 159–66.[3]Haye Salinas MJ, Caeiro F, Saurit V, Alvarellos A, Wojdyla D, Scherbarth HR, et al. Pleuropulmonary involvement in patients with systemic lupus erythematosus from a Latin American inception cohort (GLADEL). Lupus. 2017;26(13):1368–77Disclosure of Interests:None declared
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Goren A, Wambier CG, McCoy J, Shapiro J, Vaño-Galván S, Herrera S, Glode LM. Clock genes may drive seasonal variation in SARS-CoV-2 infectivity: are we due for a second wave of COVID-19 in the fall? J BIOL REG HOMEOS AG 2020; 34:1455-1457. [PMID: 32700513 DOI: 10.23812/20-359-l-35] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- A Goren
- Applied Biology, Inc. Irvine, CA, United States
| | - C G Wambier
- Department of Dermatology, Alpert Medical School of Brown University, Providence, RI, United States
| | - J McCoy
- Applied Biology, Inc. Irvine, CA, United States
| | - J Shapiro
- Ronald O. Perelman Department of Dermatology at the New York University School of Medicine, NY, USA
| | - S Vaño-Galván
- Dermatology Department, Ramón y Cajal Hospital, Madrid, Spain
| | - S Herrera
- Infectious Diseases Unit, Ramón y Cajal Hospital, Madrid, Spain
| | - L M Glode
- University of Colorado Cancer Center, Golden, CO., USA
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McCoy J, Cadegiani FA, Wambier CG, Herrera S, Vaño-Galván S, Mesinkovska NA, Ramos PM, Shapiro J, Sinclair R, Tosti A, Goren A. 5-alpha-reductase inhibitors are associated with reduced frequency of COVID-19 symptoms in males with androgenetic alopecia. J Eur Acad Dermatol Venereol 2020; 35:e243-e246. [PMID: 33135263 DOI: 10.1111/jdv.17021] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- J McCoy
- Applied Biology, Inc., Irvine, CA, USA
| | - F A Cadegiani
- Department of Clinical Endocrinology, Federal University of São Paulo Medical School, Sao Paulo, Brazil
| | - C G Wambier
- Department of Dermatology, Alpert Medical School of Brown University, Providence, RI, USA
| | - S Herrera
- Infectious Diseases Unit, Ramón y Cajal Hospital, Madrid, Spain
| | - S Vaño-Galván
- Dermatology Department, Ramón y Cajal Hospital, Madrid, Spain
| | - N A Mesinkovska
- Department of Dermatology, University of Claifornia, Irvine, CA, USA
| | - P M Ramos
- Department of Dermatology, São Paulo State University - UNESP, São Paulo, Brazil
| | - J Shapiro
- Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY, USA
| | - R Sinclair
- Sinclair Dermatology, Melbourne, Vic., Australia
| | - A Tosti
- Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - A Goren
- Applied Biology, Inc., Irvine, CA, USA
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Goren A, Wambier CG, Herrera S, McCoy J, Vaño-Galván S, Gioia F, Comeche B, Ron R, Serrano-Villar S, Ramos PM, Cadegiani FA, Kovacevic M, Tosti A, Shapiro J, Sinclair R. Anti-androgens may protect against severe COVID-19 outcomes: results from a prospective cohort study of 77 hospitalized men. J Eur Acad Dermatol Venereol 2020; 35:e13-e15. [PMID: 32977363 PMCID: PMC7536996 DOI: 10.1111/jdv.16953] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 11/30/2022]
Affiliation(s)
- A Goren
- Applied Biology, Inc., Irvine, CA, USA
| | - C G Wambier
- Department of Dermatology, Alpert Medical School of Brown University, Providence, RI, USA
| | - S Herrera
- Infectious Diseases Unit, Ramón y Cajal Hospital, Madrid, Spain
| | - J McCoy
- Applied Biology, Inc., Irvine, CA, USA
| | - S Vaño-Galván
- Dermatology Department, Ramón y Cajal Hospital, Madrid, Spain
| | - F Gioia
- Infectious Diseases Unit, Ramón y Cajal Hospital, Madrid, Spain
| | - B Comeche
- Infectious Diseases Unit, Ramón y Cajal Hospital, Madrid, Spain
| | - R Ron
- Infectious Diseases Unit, Ramón y Cajal Hospital, Madrid, Spain
| | | | - P M Ramos
- Department of Dermatology, São Paulo State University, Botucatu, Brazil
| | - F A Cadegiani
- Department of Clinical Endocrinology, Federal University of São Paulo Medical School, Sao Paulo, Brazil
| | - M Kovacevic
- Department of Dermatology and Venereology, Hospital Sestre Milosrdnice, Zagreb, Croatia
| | - A Tosti
- Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - J Shapiro
- Ronald O. Perelman Department of Dermatology at the New York University School of Medicine, New York, NY, USA
| | - R Sinclair
- Sinclair Dermatology, Melbourne, VIC, Australia
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McCoy J, Wambier CG, Herrera S, Vaño-Galván S, Gioia F, Comeche B, Ron R, Serrano-Villar S, Iwasiow RM, Tayeb MA, Cadegiani FA, Mesinkovska NA, Shapiro J, Sinclair R, Goren A. Androgen receptor genetic variant predicts COVID-19 disease severity: a prospective longitudinal study of hospitalized COVID-19 male patients. J Eur Acad Dermatol Venereol 2020; 35:e15-e17. [PMID: 32977355 PMCID: PMC7536899 DOI: 10.1111/jdv.16956] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- J McCoy
- Applied Biology, Inc., Irvine, CA, USA
| | - C G Wambier
- Department of Dermatology, Alpert Medical School of Brown University, Providence, RI, USA
| | - S Herrera
- Infectious Diseases Unit, Ramón y Cajal Hospital, Madrid, Spain
| | - S Vaño-Galván
- Dermatology Department, Ramón y Cajal Hospital, Madrid, Spain
| | - F Gioia
- Infectious Diseases Unit, Ramón y Cajal Hospital, Madrid, Spain
| | - B Comeche
- Infectious Diseases Unit, Ramón y Cajal Hospital, Madrid, Spain
| | - R Ron
- Infectious Diseases Unit, Ramón y Cajal Hospital, Madrid, Spain
| | | | | | - M A Tayeb
- DNA Genotek Inc., Ottawa, ON, Canada
| | - F A Cadegiani
- Department of Clinical Endocrinology, Federal University of São Paulo Medical School, Sao Paulo, Brazil
| | - N A Mesinkovska
- Department of Dermatology, University of Claifornia, Irvine, CA, USA
| | - J Shapiro
- Ronald O. Perelman Department of Dermatology, New York University School of Medicine, NY, USA
| | - R Sinclair
- Sinclair Dermatology, Melbourne, VIC, Australia
| | - A Goren
- Applied Biology, Inc., Irvine, CA, USA
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Rezaei Talarposhti M, Asset T, Garcia ST, Chen Y, Herrera S, Dai S, Peterson EJ, Artyushkova K, Zenyuk I, Atanassov P. Kinetic Isotope Effect as a Tool To Investigate the Oxygen Reduction Reaction on Pt-based Electrocatalysts - Part II: Effect of Platinum Dispersion. Chemphyschem 2020; 21:1331-1339. [PMID: 32337815 DOI: 10.1002/cphc.201901092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 04/19/2020] [Indexed: 11/10/2022]
Abstract
We investigated the oxygen reduction reaction (ORR) mechanism on Pt nanoparticles (NPs) dispersed on several carbon blacks with various physicochemical properties (i. e. specific surface ranging from 80 to 900 m2 g-1 , different graphitization degree, etc.). Using the kinetic isotope effect (KIE) along with various electrochemical characterizations, we determined that the rate determining step (RDS) of the ORR is a proton-independent step when the density of Pt NPs on the surface of the carbon support is high. Upon decrease of the density of Pt NPs on the surface, the RDS of the ORR starts involving a proton, as denoted by an increase of the KIE >1. This underlined the critical role played by the carbon support in the oxygen reduction reaction electrocatalysis by Pt supported on high surface area carbon.
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Affiliation(s)
- Morteza Rezaei Talarposhti
- Department of Chemical & Biomolecular Engineering, National Fuel Cell Research Center (NFCRC), University of California, Irvine, CA 92697, USA
| | - Tristan Asset
- Department of Chemical & Biomolecular Engineering, National Fuel Cell Research Center (NFCRC), University of California, Irvine, CA 92697, USA
| | - Samuel T Garcia
- Department of Chemical & Biological Engineering, Center for Micro-Engineered Materials (CMEM), University of New Mexico, Albuquerque, NM 87131, USA
| | - Yechuan Chen
- Department of Chemical & Biomolecular Engineering, National Fuel Cell Research Center (NFCRC), University of California, Irvine, CA 92697, USA
| | - Sergio Herrera
- Department of Chemical & Biological Engineering, Center for Micro-Engineered Materials (CMEM), University of New Mexico, Albuquerque, NM 87131, USA
| | - Sheng Dai
- Department of Materials Science & Engineering, Irvine Materials Research Institute (IMRI), University of California, Irvine, CA 92697, USA
| | - Eric J Peterson
- Department of Chemical & Biological Engineering, Center for Micro-Engineered Materials (CMEM), University of New Mexico, Albuquerque, NM 87131, USA
| | - Kateryna Artyushkova
- Department of Chemical & Biological Engineering, Center for Micro-Engineered Materials (CMEM), University of New Mexico, Albuquerque, NM 87131, USA
| | - Iryna Zenyuk
- Department of Chemical & Biomolecular Engineering, National Fuel Cell Research Center (NFCRC), University of California, Irvine, CA 92697, USA
| | - Plamen Atanassov
- Department of Chemical & Biomolecular Engineering, National Fuel Cell Research Center (NFCRC), University of California, Irvine, CA 92697, USA
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Herrera S, Diaz-Coronado JC, Rojas-Gualdrón D, Betancur-Vasquez L, Gonzalez-Hurtado D, Gonzalez-Arango J, Uribe-Arango L, Saavedra Chacón MF, Lacouture-Fierro J, Monsalve S, Guerra-Zarama S, Lopez JD, Serna JD, Barbosa J, Sierra A, Hernandez-Parra D, Pineda-Tamayo R. SAT0210 FACTORS ASSOCIATED WITH TIME TO SEVERE LUPUS NEPHRITIS IN A COHORT OF COLOMBIAN PATIENTS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6282] [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: 11/03/2022]
Abstract
Background:Systemic lupus erythematosus (SLE) clinical manifestations, and their severity, vary according to age, ethnicity and socioeconomic status. Both Hispanic and Afro-Americans have a higher incidence and more sever presentation when compared to Caucasian patients with SLEObjectives:To analyze clinical and immunological characteristics associated with time to severe renal involvement in patients with Systemic Lupus Erythematous in a Colombian cohort followed for one year, between January 2015 and December 2018Methods:Retrospective follow-up study based in clinical records. Patients with SLE diagnosis that fulfilled either 1987 American College of Rheumatology Classification Criteria for SLE or 2011 Systemic Lupus International Collaborating Clinics (SLICC) classification criteria for SLE. We included patients with diagnosis of lupus nephritis according to Wallace and Dubois criteria. Patients who did not have at least two follow-up measurements or had a cause of nephritis other than lupus were excluded. The main outcome was defined as time from diagnosis to sever renal involvement defined as creatinine clearance ≤50 ml/min, 24-hour proteinuria ≥3.5 grams o end stage renal disease.We analyzed clinical and immunological characteristics. Descriptive statistical analyses of participant data during the first evaluation are reported as frequencies and percentages for categorical variables, and as medians and interquartile ranges (IQR) for quantitative variables. Age and sex adjusted survival functions and Hazard ratios (HR) with 95% confidence intervals and p-values were estimated using parametric Weibull models por interval-censored data. P values < 0.05 were considered statistically significantResults:548 patients were analyzed: 67 were left-censored as they presented renal involvement at entry, 6 were interval censored as outcome occurred between study visits, and 475 were right-censored as involvement was not registered during follow-up. 529 (96.5%) patients were female, median age at entry was 46 (IQR = 23) and median age to diagnosis was 29.5 (IQR = 20.6). 67% were mestizo, 13% Caucasian and 0.3% Afro-Colombian. Age and sex adjusted variables associated with time to severe lupus nephritis were high blood pressure HR = 3.5 (95%CI 2.2-5.6; p-value <0.001) and Anti-RO (per unit increase) HR = 1.002 (95%CI 1.001-1.004; p-value = 0.04). Figure 1 shows age and sex adjusted survival function.Conclusion:In our cohort the appearance of severe lupus nephritis occurs in less than 15% of patients at 10 years. Both high blood pressure and elevated anti-Ro titers were associated with a higher rate of onset in the presentation of severe lupus nephritis, as seen in some polymorphs of anti Ro.References:Disclosure of Interests:Sebastian Herrera Speakers bureau: academic conference, Juan camilo Diaz-Coronado: None declared, Diego Rojas-Gualdrón: None declared, Laura Betancur-Vasquez: None declared, Daniel Gonzalez-Hurtado: None declared, Juanita Gonzalez-Arango: None declared, laura Uribe-Arango: None declared, Maria Fernanda Saavedra Chacón: None declared, Jorge Lacouture-Fierro: None declared, Santiago Monsalve: None declared, Sebastian Guerra-Zarama: None declared, Juan david Lopez: None declared, Juan david Serna: None declared, Julian Barbosa: None declared, Ana Sierra: None declared, Deicy Hernandez-Parra: None declared, Ricardo Pineda.Tamayo: None declared
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Herrera S, Diaz-Coronado JC, Hernandez-Parra D, Durango-Durango Y, Perez-Rios C, Posada-Velásquez M, Rojas-Londoño J, Vallejo-Patiño M, Marín K, Guerrero-Calderón C, Jaramillo S, Usuga-Graciano V, López-Flórez MI, Restrepo-Raigosa C, Restrepo-Hincapié JP, Carvajal-Naranjo C, Restrepo-Upegui S, Pineda Tamayo R. THU0269 CLINICAL COMPARISON OF NEW CRITERIA FOR SYSTEMIC LUPUS ERYTHEMATOSUS IN A COLOMBIAN COHORT. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6527] [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: 11/04/2022]
Abstract
Background:Due to heterogeneity of the disease, there has been several classification criteria for Systemic Lupus Erythematosus (SLE). These have considered the knowledge obtained through the years and have strived for increased sensibility and specificity. Recently, both EULAR and ACR have proposed new criteria for disease classification that mandate a positive ANA result to apply the criteria.Objectives:To compare the 2019 EULAR/ACR classification criteria (1) with the Systemic Lupus International Collaborating Clinics (SLICC) 2012 classification criteria (2) and the American College of Rheumatology (ACR) 1997 classification criteria in a Colombian cohort (3).Methods:A cross-section retrospective study was done with data collected between 2014 and 2018 from a population diagnosed with SLE by a group of rheumatology in an autoimmunity referral centre and followed for one year. The new 2019 EULAR/ACR classification criteria were applied to the information collected from the clinical records. Three sets of criteria were compared using Cohen´s kappa coefficient and concordance was evaluatedResults:We obtained information for 480 patients, in this analysis were mostly females (96%). Anti-nuclear antibody (ANA) results were available for 95% of the patients. According to SLICC classification criteria the diagnosis of SLE was definite in 92% of patients, 81% by ACR 1997 and 89% using ACR/EULAR 2019. The sensibility was 93% and 97% for ACR/EULAR 2019 and SLICC 2012, and the specificity was 67% and 48% respectively. The concordance analysis between the two sets of criteria showed agreement of 92% (kappa 0.52 p <0.001) in the whole group.Conclusion:We found good agreement between SLICC 2012 criteria and EULAR/ACR 2019 classification criteria. In contrast with previous studies, where the new criteria had a sensitivity of 96.1% and specificity of 93.4%, in our cohort the sensitivity was maintained in 93% but the specificity decreased to 67%. A possible explanation could be the ANA negativity that was seen in 5% of the patients and would force to discard patients with false negative results. Despite this, the agreement of the criteria is good and should continue to be applied in our population, without abandoning the expert’s clinical criteria.References:[1]Aringer M, Costenbader K, Daikh D, et al. 2019 European League against Rheumatism/American College of rheumatology classification criteria for systemic lupus erythematosus. Ann Rheum Dis2019;78:1151–9[2]Petri M, Orbai A-M, Alarcón GS, et al. Derivation and validation of the systemic lupus international collaborating clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum2012;64:2677–86.[3]Hochberg MC. Updating the American College of rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum1997;40:1725.Disclosure of Interests:Sebastian Herrera Speakers bureau: academic conference, Juan camilo Diaz-Coronado: None declared, Deicy Hernandez-Parra: None declared, Yecenia Durango-Durango: None declared, Carolina Perez-Rios: None declared, Marcela Posada-Velásquez: None declared, Jennifer Rojas-Londoño: None declared, Manuela Vallejo-Patiño: None declared, Katherine Marín: None declared, Carlos Guerrero-Calderón: None declared, Sara jaramillo: None declared, Veronica Usuga-Graciano: None declared, Martha Isabel López-Flórez: None declared, Camilo Restrepo-Raigosa: None declared, Juan Pablo Restrepo-Hincapié: None declared, Catalina Carvajal-Naranjo: None declared, Sarita Restrepo-Upegui: None declared, Ricardo Pineda.Tamayo: None declared
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Magallares López BP, Park H, Cerda D, Betancourt J, Fraga G, Boronat S, Gich I, Marín AM, Herrera S, Malouf J, Casademont J, García-Guillén A, Corominas H. AB0997 IS HEIGHT ADJUSTMENT NECESSARY IN PEDIATRIC DENSITOMETRY IN ALL CHILDREN? Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.861] [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: 11/03/2022]
Abstract
Background:The current guidelines of the International Society for Clinical Densitometry (1) recommend that in children with linear growth or maturational delay, Z score results should be adjusted. Height for age Z score (HAZ) adjustment is valid and can be calculated using the formula the formula proposed by Zemmel et al(2).It is possible that pediatric populations without linear growth or maturational delay, also benefit from HAZ, to prevent bone size from influencing the final Z score.Objectives:To evaluate Z score variability adjusted and without adjusting for height for age.Methods:We analysed data from densitometry performed on patients 2-20 years of age, from 2016 to 2018, assessed in the pediatric rheumatology office of our hospital for presenting risk factors for low bone mass/osteoporosis. The HAZ was calculated according to Zemel’s formula.Results:Data from 103 patients are presented. Its characteristics are summarized in Table 1Table 1.Mean age9,8 yearsFemale52,4%Height Percentil ≤ 36,8%Height Percentil ≥ 974,9%LBM (Z score ≤ -2) spine8,2%LBM HAZ spine6,4%LBM whole body10,5%LBM HAZ whole body7,2%The table shows that the proportion of patients with BMD decreases in both the spine region and the whole body when adjusting for HAZ.When evaluating the relationship between densitometric measurements we found that spine Z score (ZsS) and whole body Z score (ZsWB) had a correlation coefficient of 0,73 (p<0,001). There were no differences between their averages (p=0,170).At the LBM cut-off point (Z score ≤ -2) there were discrepancies in 7%, where 5% presented LBM in ZsWB but not in ZsS. The concordance index at this point was 0,557.When comparing these measures with their HAZ adjusted equivalents, we observe:HAZ adjusted ZsS vs ZsS without adjusting: There were no differences between their averages (p=0,913) with a correlation coefficient of 0,78 (p<0,001). Concordance index at cut-off point for LBM was 0,498, with a discrepancy of7%, where2%had LBM according to HAZ adjusted ZsS, but not to ZsS without adjusting.HAZ adjusted ZsWB vs ZsWB without adjusting: There were no differences between their averages (p=0, 367) with a correlation coefficient of 0,82 (p<0,001). Concordance index at cut-off point for LBM was 0,557, with a discrepancy of7%, where2%had LBM according to HAZ adjusted ZsWB, but not to ZsWB without adjusting.Conclusion:There are discrepancies at the LBM cut-off point depending on the HAZ adjustment.The pediatric population without linear growth or maturational delay, can also benefit from HAZ adjustment, especially those with high height percentiles in which their size can hide a diagnosis of LBM.References:[1]Weber DR, Boyce A, Gordon C, Hogler W, Kecskemethy HH, Misra M, et al. The Utility of DXA Assessment at the Forearm, Proximal Femur, and Lateral Distal Femur, and Vertebral Fracture Assessment in the Pediatric Population: 2019 ISCD Official Position. Journal of clinical densitometry: the official journal of the International Society for Clinical Densitometry. 2019;22(4):567-89.[2]Zemel BS, Leonard MB, Kelly A, Lappe JM, Gilsanz V, Oberfield S, et al. Height adjustment in assessing dual energy x-ray absorptiometry measurements of bone mass and density in children. The Journal of clinical endocrinology and metabolism. 2010;95(3):1265-73.Disclosure of Interests:None declared
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Diaz-Coronado JC, Herrera S, Hernandez-Parra D, Betancur-Vasquez L, Gonzalez-Hurtado D, Gonzalez-Arango J, Uribe-Arango L, Saavedra Chacón MF, Lacouture-Fierro J, Guerra-Zarama S, Monsalve S, Serna Giraldo JD, Serna JD, Barbosa J, Pineda Tamayo R. SAT0463 SEVERE OSTEOPOROSIS IN COLOMBIAN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6582] [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: 11/04/2022]
Abstract
Background:Osteoporosis predominantly affects post-menopausal women. There is an important percentage of the population that have additional risk factors that decrease bone mineral density. Patients with Systemic Lupus Erythematosus (SLE) have an increased risk for osteoporosis due to corticosteroid use and chronic inflammation. This population could have a higher prevalence of osteoporosis when compared to post-menopausal women of equal or older age. There is a paucity of information regarding bone mineral density and SLE in Latin America.Objectives:To describe the prevalence and incidence of osteoporosis and osteoporotic fractures in a Colombian population with Systemic Lupus ErythematosusMethods:We collected 464 clinical records of patients who met either the American College of Rheumatology 1997 or Systemic Lupus International Collaborating Clinics (SLICC) 2012 classification criteria for systemic lupus erythematosus between January 2015 and June 2019. The clinical and immunoserological characteristics, and damage accrual were monitored for one year. The diagnosis of osteoporosis was confirmed with densitometry by energy x-ray absorptiometry (DXA) and the presence of fragility fractures according to the rheumatologist’s report in the clinical history. The description of proportions and incidence rate of osteoporosis and fragility fracture is performed.Results:The mean age was 45 years, 96.5% were women and the mean disease duration was 12 years. Others clinical characteristics in table 1. The prevalence of osteoporosis was 13.8% with an incidence of 1.1 fractures / 100 person-months in the general population with SLE. In postmenopausal women, over 50 years the prevalence of osteoporosis was 28.4% with an incidence of 0.8 fractures / 100 months person. In the densitometric characteristics, the mean bone mineral density was 0.772 gr / cm2, T-score spine -2.9 and T-score femoral -2.6. SLEDAI mean 1.5 (SD 2.92) and SLICC mean 1.Table 1.clinical characteristicsn%Active Smoking8317.9Premature gonadal failure81.7Lupic Nephritis17838.4Proteinuria >2.5grams/24hours347.3End Stage Renal Disease163.4Anti-dsDNA14631.4Anti-Sm11023.7Anti-Ro13829.7Prednisone Cumulative Dose2.8grAntimalarial5712Conclusion:Low bone mineral density and severe osteoporosis are prevalent in our cohort with SLE. We have found a fracture rate of 1080 per 100.000 people, which is well over what has been reported in the general population (53-443 per 100.000 people in women). Osteoporotic fractures are part of damage accrual and thus have an association with morbidity and mortality. Data regarding osteoporotic fractures are necessary in order to develop guidance and health policy in the region. SLE is an important risk factor for severe osteoporosis and must be kept in mind when developing guidance and health policyReferences:[1]Jumei Xia, Ran Luo, Shuiming Guo, et al. Prevalence and Risk Factors of Reduced Bone Mineral Density in Systemic Lupus Erythematosus Patients: A Meta-Analysis. BioMed Research International. Volume 2019, Article ID 3731648, 10 pages.[2]Irene E.M. Bultinka, Willem F. Lemsa. Lupus and fractures. Curr Opin Rheumatol 2016, 28:426–432.Disclosure of Interests:Juan camilo Diaz-Coronado: None declared, Sebastian Herrera Speakers bureau: academic conference, Deicy Hernandez-Parra: None declared, Laura Betancur-Vasquez: None declared, Daniel Gonzalez-Hurtado: None declared, Juanita Gonzalez-Arango: None declared, laura Uribe-Arango: None declared, Maria Fernanda Saavedra Chacón: None declared, Jorge Lacouture-Fierro: None declared, Sebastian Guerra-Zarama: None declared, Santiago Monsalve: None declared, Jose David Serna Giraldo: None declared, Juan david Serna: None declared, Julian Barbosa: None declared, Ricardo Pineda.Tamayo: None declared
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Magallares López BP, Park H, Cerda D, Betancourt J, Fraga G, Boronat S, Herrera S, Marín AM, Gich I, Malouf J, Casademont J, García-Guillén A, Corominas H. AB0998 TRABECULAR BONE SCORE IN PEDIATRICS, IS IT USEFUL? Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.866] [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: 11/04/2022]
Abstract
Background:Bone fragility depends not only on bone mineral density (BMD), but also on bone microarchitecture. In adults, Trabecular Bone Score (TBS) is being used as an indirect marker of bone microarchitectureIt is a software that applicated to the vertebral image obtained by conventional densitometry, informs about the thickness of the trabeculae, the trabecular connectivity and the space between them. A high score indicates a better bone microstructure. In adults, a TBS equal to or greater than 1,350 is considered to represent a normal microarchitectureObjectives:To evaluate the usefulness of TBS in pediatric population with risk factors for Low Bone Mass (LBM)Methods:TBS was assessed by analyzing vertebral densitometries performed on patients from 4 to 20 years of age, assessed in the pediatric rheumatology office of our hospital for presenting risk factors for LBM, consecutively from 2016 until 2018Data were compared with normal pediatric populationResults:Data from 83 patients are shown, with an average age of 11.2 years, 62% female, 80% CaucasianThe main risk factors for LBM were (%): Insufficient calcium intake (84,5), medications with osteopenizing potential (31), corticosteroids (39), sedentary lifestyle (13,6), fractures of long or vertebral bones (12,6) and hypovitaminosis D (8,1)Table 1.TBS por age groups and in patients with and without LBMAge groupsnMeanSDMinimum-MaximumScholars (4-9a)221,3210,0931,119-1,502Adolescence (10-17a)541,3090,0881,073-1,493Youth (18-20a)61,3590,0851,258-1,460Spine Z scorenMean (SD)pMinimum-Maximum ≤-281,270 (0,075)0,1261,419-1,162 >-2741,321 (0,090)1,502-1,073Whole Body Z score ≤-291,246 (0,060)0,0121,323-1,145 >-2731,324 (0,089)1,502-1,073Table 2.TBS in healthy population and study population for ageHealthy girls (n=2535)Healthy boys (n=1459)Study girls (n=47)Study boys (n=36)Age (y)Spine BMDTBSSpine BMDTBSTBSTBS1-20,401,3250,371,2722-30,511,3630,461,2671,1273-40,521,3460,511,2641,2044-50,601,3460,601,2671,2371,2435-60,601,2880,561,2691,3301,3686-70,651,2800,601,2321,3181,4227-80,671,2680,641,2441,3391,3458-90,711,2660,681,2281,2449-100,751,2780,701,2081,2531,34110-110,81,2850,731,2311,2291,29211-120,841,3370,761,2501,3031,31512-130,991,3550,811,2481,3811,36813-141,061,3860,891,2731,3941,33814-151,101,3980,991,3031,4741,28515-161,141,4051,081,3111,3681,40616-171,171,4051,151,3341,3321,37117-181,171,4041,201,3281,3741,28518-191,171,4041,161,314Conclusion:TBS was lower in the patients with LBM by whole body Z score, but not in those with LBM by spine Z score. We observed a decrease in TBS in adolescence, not corresponding with a decrease in BMD, and that should not be interpreted as a pathological findingSimilar results have been described in other pediatric populations (1, 2), but larger studies are needed to evaluate this phenomenon. We hypothesize that it may be due to a higher rate of growth in adolescence, with a lower rate of calcium apposition into the osteoid materialReferences:[1]Del Rio DS, Winthenrieth R. BONE MICROARCHITECTURE (TBS) AND BONE MASS DEVELOPMENT DURING CHILDHOOD AND ADOLESCENCE IN A SPANISH POPULATION GROUP. . WCO-IOF-ESCEO; Seville2014.[2]Shawwa K, Arabi A, Nabulsi M, et al. Predictors of trabecular bone score in school children. Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 2016;27(2):703-10.Disclosure of Interests:None declared
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Herrera S, Diaz-Coronado JC, Rojas-Gualdrón D, Betancur-Vasquez L, Gonzalez-Hurtado D, Gonzalez-Arango J, Uribe-Arango L, Saavedra Chacón MF, Lacouture-Fierro J, Monsalve S, Guerra-Zarama S, Serna JD, Barbosa J, Hernandez-Parra D, Sierra A, Pined R, Tamayo A. AB0246 FACTORS ASSOCIATED WITH THE TIME OF PRESENTATION OF CARDIOVASCULAR EVENTS IN A COHORT OF COLOMBIAN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6421] [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: 11/04/2022]
Abstract
Background:Systemic lupus erythematosus is a systemic disease characterized by a compromise of vital organs. The autoimmune activity has been linked to accelerated endothelial damage and increased cardiovascular risk and its outcomes such as heart attack, stroke, and peripheral arterial disease(1). Patients with Lupic nephritis have been characterized by requiring aggressive immunosuppressive therapies apart from prolonged and progressive use of corticosteroids, what you have shown can accelerate these outcomes(2). Other factors such as secondary arterial hypertension, dyslipidemia among others are factors to consider (3).Objectives:To analyze clinical and immunological characteristics associated with time to severe renal involvement in patients with Systemic Lupus Erythematous in a Colombian cohort followed for one year, between January 2015 and December 2018.Methods:Retrospective follow-up study based on clinical records of patients with SLE diagnosis that fulfilled either 1987 American College of Rheumatology Classification Criteria for SLE or 2011 Systemic Lupus International Collaborating Clinics (SLICC) classification criteria for SLE. Patients with cardiovascular disease outcomes such as angina, acute myocardial infarction, stroke, transient cerebral ischemia and chronic arterial occlusive disease were included. Patients who did not have at least two follow-up measurements or had structural heart disease, valvulopathies, arrhythmias, myocarditis, pericarditis were excluded. The main outcome was defined as the time from diagnosis to cardiovascular diseases.Clinical and immunological characteristics were analyzed. Descriptive statistical analyses of participant data during the first evaluation are reported as frequencies and percentages for categorical variables, and as medians and interquartile ranges for quantitative variables. Age and sex adjusted survival functions and Hazard Ratios (HR) with 95% confidence intervals and p-values were estimated using parametric Weibull models for interval-censored data. P values < 0.05 were considered statistically significantResults:547 patients were analyzed: 29 were left-censored as they presented renal involvement at entry, 22 were interval censored as outcome occurred between study visits, and 496 were right-censored as involvement was not registered during follow-up. 528 (96.5%) patients were female, median age at entry was 46 (IQR = 23) and median age to diagnosis was 29.4 (IQR = 20.9). Statistically significant age and sex adjusted variables were High Blood Pressure (HBP) HR = 2.0 (95%CI 1.1-3.6; p-value <0.018) and cumulative prednisolone dose (>10 gr vs <2 gr) HR = 2.4 (95%CI 1. 1-5.1; p-value = 0.023). Figure 1 shows the age and sex adjusted survival function for HBPConclusion:HBP and cumulative steroid doses accelerate the onset of cardiovascular diseases in patients with lupus more than two times. Maintaining blood pressure in goals and performing early clearance of glucocorticoids could improve outcomes in these patients who are already considered a high cardiovascular riskReferences:[1]Hans-Joachim Anders, Ramesh Saxena, Ming-Hui Zhao. Lupus Nephritis. Nat Rev Dis Primers. 2020 Jan 23;6(1):7.[2]Shanthini Kasturi, Lisa R Sammaritano. Corticosteroids in Lupus. Rheum Dis Clin North Am, 42 (1), 47-62, viii[3]César Magro-Checa, Juan Salvatierra, José Luis Rosales-Alexander, et al. Cardiovascular risk in systemic lupus erythematosus: implicated factors and assessment methods. Semin Fund Esp Reumatol. 2012;13(3):95–102Disclosure of Interests:Sebastian Herrera Speakers bureau: academic conference, Juan camilo Diaz-Coronado: None declared, Diego Rojas-Gualdrón: None declared, Laura Betancur-Vasquez: None declared, Daniel Gonzalez-Hurtado: None declared, Juanita Gonzalez-Arango: None declared, laura Uribe-Arango: None declared, Maria Fernanda Saavedra Chacón: None declared, Jorge Lacouture-Fierro: None declared, Santiago Monsalve: None declared, Sebastian Guerra-Zarama: None declared, Juan david Serna: None declared, Julian Barbosa: None declared, Deicy Hernandez-Parra: None declared, Ana Sierra: None declared, Ricardo Pineda.Tamayo: None declared
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Herrera S, Diaz-Coronado JC, Hernandez-Parra D, Perez-Rios C, Durango-Durango Y, Pineda.Tamayo R. AB0245 RHEUMATOID ARTHRITIS DISEASE ACTIVITY AND VITAMIN D LEVELS IN A COLOMBIAN COHORT. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4764] [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: 11/04/2022]
Abstract
Background:There seems to be a relationship between 25-hydroxyvitamin D [25(OH)D] level and rheumatoid arthritis (RA)(1). It has been proposed that susceptibility for RA exists in selected patients with low 25(OH) with conflicting results (2,3) Regarding disease activity, most of the evidence suggests an inverse relationship of disease activity with 25(OH)D levels(4). To our knowledge, there is only a small study that suggests low 25(oh) D levels as a predictor of disease activity (5) in our regionObjectives:We aimed to evaluate the possible association of low 25(OH) D levels and disease activity in a large cohort of patients with Rheumatoid Arthritis in ColombiaMethods:We evaluated the clinical records of 3576 patients with RA that fulfilled the 2010 EULAR Classification Criteria for Rheumatoid Arthritis and that were managed in our autoimmunity center between 2014 and 2017. Registries that contained both the measurement of 25(OH)D levels and DAS28 VSG with no more than 6 months apart and that also had at least a mean 12-month follow-up were included. We classified 25(OH) D insufficiency as levels ≤ 20ng/ml. We evaluated differences in achieving disease control depending on the 25(OH) D levels with McNemar’s test. Disease control was defined as DAS28VSG≤3.2Results:A total of 880 patients were included, 90% were female and their mean age was 63 years and 24.3% had 25(OH) D insufficiency. The vast majority were seropositive and only 13% were on biologics (Table 1). A 25% of patients who 25(OH)D insufficiency had DAS28 3.2 and a year of follow-up decreased to 24% with medical intervention (p=0,1), while patients without 25(OH)D insufficiency at the beginning of follow-up, 27% had DAS28 3.2 and after one year follow-up decreased to 17% (p=0.001)Table 1Mean (SD)Age (years)63.3 (10.6)Disease Duration14.7 (10.8)Age at diagnosis48.6(13.5)N%Sex (Feminine)79390.1Rheumatoid Factor (Positive)N=81769985.6ACPA (Positive)N=36632.377.6Actual Steroid use61169.4Actual Biologic Therapy12313.9DMARD Methotrexate57064.8 Leflunomide68277.5 Sulfasalazine21824.8 Azathioprine50.6 Antimalarials14716.7Conclusion:In Colombian patients with rheumatoid arthritis low 25(OH) D status has an inverse correlation with disease control. Even in an equatorial country, up to 24% of RA patients had low vitamin levels. A strategy of active detection of 25(OH) D insufficiency could have an impact on disease activity and health statusReferences:[1]Ishikawa LLW, Colavite PM, Fraga-Silva TF de C, Mimura LAN, França TGD, Zorzella-Pezavento SFG, et al. Vitamin D Deficiency and Rheumatoid Arthritis. Vol. 52, Clinical Reviews in Allergy and Immunology. Humana Press Inc.; 2017. p. 373–88.[2]Bragazzi NL, Watad A, Neumann SG, Simon M, Brown SB, Abu Much A, et al. Vitamin D and rheumatoid arthritis: An ongoing mystery. Vol. 29, Current Opinion in Rheumatology. Lippincott Williams and Wilkins; 2017. p. 378–88.[3]Bae SC, Lee YH. Vitamin D level and risk of systemic lupus erythematosus and rheumatoid arthritis: a Mendelian randomization. Clin Rheumatol. 2018 Sep 1;37(9):2415–21.[4]Lee YH, Bae SC. Vitamin D level in rheumatoid arthritis and its correlation with the disease activity: A meta-analysis. Clin Exp Rheumatol. 2016;34(5):827–33.[5]Quintana-Duque MA, Caminos JE, Varela-Nariño A, Calvo-Paramo E, Yunis JJ, Iglesias-Gamarra A. The role of 25-hydroxyvitamin D as a predictor of clinical and radiological outcomes in early onset rheumatoid arthritis. J Clin Rheumatol. 2017;23(1):33–9.Disclosure of Interests:Sebastian Herrera Speakers bureau: academic conference, Juan camilo Diaz-Coronado: None declared, Deicy Hernandez-Parra: None declared, Carolina Perez-Rios: None declared, Yecenia Durango-Durango: None declared, Ricardo Pineda.Tamayo: None declared
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Ballesta S, Güerri-Fernández RC, Chillarón JJ, Güell A, Herrera S, Torres E, Ascoeta NG, Flores Le-Roux JA, Díez A. The use of microindentation for the study of bone properties in type 1 diabetes mellitus patients. Osteoporos Int 2020; 31:175-180. [PMID: 31641800 DOI: 10.1007/s00198-019-05178-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 09/24/2019] [Indexed: 11/27/2022]
Abstract
UNLABELLED Diabetes mellitus is associated with a higher risk of fracture. In this study, we analysed the bone quality of premenopausal women with type 1 diabetes mellitus by microindentation. No differences in bone quality were identified between patients and healthy controls, suggesting that intensive insulin therapy can preserve bone health. PURPOSE To compare the bone quality of women with type 1 diabetes mellitus (T1DM) and healthy controls, and to determine the relationship with bone mineral density (BMD). METHODS This was a cross-sectional study of 45 premenopausal women with T1DM and 21 healthy controls, matched according to age and BMI. Clinical parameters, BMD and bone tissue mechanical properties (assessed using the bone material strength index [BMSi]) were evaluated in each group using microindentation. In T1DM patients, glycosylated haemoglobin (HbA1c), the number of hypoglycaemic events and the status of chronic complications were also analysed. RESULTS No differences in BMSi or BMD between T1DM patients and healthy controls were identified. In the T1DM patients, the mean HbA1c was 7.52% ± 1.00% and the mean time elapsed since diagnosis was 22.6 ± 12.2 years. Eight patients (17.7%) met the criteria for metabolic syndrome (MetS), and microvascular complications were present in 12 patients (26.7%). Neither the number of features of MetS present nor the presence of microangiopathy was found to be associated with BMSi. CONCLUSIONS T1DM premenopausal patients showed bone tissue properties comparable to those shown by controls. Further larger-scale studies should be conducted to confirm these results.
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Affiliation(s)
- S Ballesta
- Department of Endocrinology and Nutrition, Hospital del Mar, PasseigMarítim, 25-29, 08003, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - R C Güerri-Fernández
- Department of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
- Department of Internal Medicine, Hospital del Mar, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - J J Chillarón
- Department of Endocrinology and Nutrition, Hospital del Mar, PasseigMarítim, 25-29, 08003, Barcelona, Spain.
- Department of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
| | - A Güell
- Department of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
- Department of Medicine, Universitat Pompeu Fabra, Barcelona, Spain
| | - S Herrera
- Department of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
- Department of Internal Medicine, Hospital del Mar, Barcelona, Spain
| | - E Torres
- Department of Internal Medicine, Hospital del Mar, Barcelona, Spain
| | - N G Ascoeta
- Department of Endocrinology and Nutrition, Hospital del Mar, PasseigMarítim, 25-29, 08003, Barcelona, Spain
| | - J A Flores Le-Roux
- Department of Endocrinology and Nutrition, Hospital del Mar, PasseigMarítim, 25-29, 08003, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - A Díez
- Department of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
- Department of Internal Medicine, Hospital del Mar, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
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Barriga X, Rodriguez J, Herrera S, Pacheco V, Fernandez F, Reategui R. EVALUACION DE LIPOPROTEINAS DE BAJA DENSIDAD Y YEMA DE HUEVO COMO CRIOPROTECTORES NO PENETRANTES EN SEMEN DE CABALLO PERUANO DE PASO. SPERMOVA 2019. [DOI: 10.18548/aspe/0007.11] [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: 11/19/2022] Open
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Miró Ò, Padrosa J, Takagi K, Gayat É, Gil V, Llorens P, Martín-Sánchez FJ, Herrero-Puente P, Jacob J, Montero MM, Tost J, Díez MPL, Traveria L, Torres-Gárate R, Alonso MI, Agüera C, Valero A, Javaloyes P, Peacock WF, Bueno H, Mebazaa A, Fuentes M, Gil C, Alonso H, Garmila P, García GL, Yáñez-Palma MC, López SI, Escoda R, Xipell C, Sánchez C, Gaytan JM, Pérez-Durá MJ, Salvo E, Pavón J, Noval A, Torres JM, López-Grima ML, Valero A, Juan MÁ, Aguirre A, Morales JE, Masó SM, Alonso MI, Ruiz F, Franco JM, Mecina AB, Tost J, Sánchez S, Carbajosa V, Piñera P, Nicolás JAS, Garate RT, Alquezar A, Rizzi MA, Herrera S, Roset A, Cabello I, Richard F, Pérez JMÁ, Diez MPL, Álvarez JV, García BP, Sánchez González MGGYM, Javaloyes P, Marquina V, Jiménez I, Hernández N, Brouzet B, Ramos S, López A, Andueza JA, Romero R, Ruíz M, Calvache R, Lorca MT, Calderón L, Arriaga BA, Sierra B, Mojarro EM, Bécquer LT, Burillo G, García LL, LaSalle GC, Urbano CA, Soto ABG, Padial ED, Ferrer ES, Garrido M, Lucas FJ, Gaya R, Bibiano C, Mir M, Rodríguez B, Sánchez N, Carballo JL, Rodríguez-Adrada E, Rodríguez B. Influence of the length of hospitalisation in post-discharge outcomes in patients with acute heart failure: Results of the LOHRCA study. Eur J Intern Med 2019; 70:24-32. [PMID: 31451322 DOI: 10.1016/j.ejim.2019.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 06/18/2019] [Revised: 08/04/2019] [Accepted: 08/09/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the relationship between length of hospitalisation (LOH) and post-discharge outcomes in acute heart failure (AHF) patients and to ascertain whether there are different patterns according to department of initial hospitalisation. METHODS Consecutive AHF patients hospitalised in 41 Spanish centres were grouped based on the LOH (<6/6-10/11-15/>15 days). Outcomes were defined as 90-day post-discharge all-cause mortality, AHF readmissions, and the combination of both. Hazard ratios (HRs), adjusted by chronic conditions and severity of decompensation, were calculated for groups with LOH >6 days vs. LOH <6 days (reference), and stratified by hospitalisation in cardiology, internal medicine, geriatrics, or short-stay units. RESULTS We included 8563 patients (mean age: 80 (SD = 10) years, 55.5% women), with a median LOH of 7 days (IQR 4-11): 2934 (34.3%) had a LOH <6 days, 3184 (37.2%) 6-10 days, 1287 (15.0%) 11-15 days, and 1158 (13.5%) >15 days. The 90-day post-discharge mortality was 11.4%, readmission 32.2%, and combined endpoint 37.4%. Mortality was increased by 36.5% (95%CI = 13.0-64.9) when LOH was 11-15 days, and by 72.0% (95%CI = 42.6-107.5) when >15 days. Conversely, no differences were found in readmission risk, and the combined endpoint only increased 21.6% (95%CI = 8.4-36.4) for LOH >15 days. Stratified analysis by hospitalisation departments rendered similar post-discharge outcomes, with all exhibiting increased mortality for LOH >15 days and no significant increments in readmission risk. CONCLUSIONS Short hospitalisations are not associated with worse outcomes. While post-discharge readmissions are not affected by LOH, mortality risk increases as the LOH lengthens. These findings were similar across hospitalisation departments.
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Affiliation(s)
- Òscar Miró
- Emergency Department, Hospital Clínic, Barcelona; "Emergencies: processes and pathologies" Research Group, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain; The GREAT (Global REsearch in Acute Cardiovascular Conditions Team) Network, Rome, Italy.
| | - Joan Padrosa
- Emergency Department, Hospital Clínic, Barcelona; "Emergencies: processes and pathologies" Research Group, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
| | - Koji Takagi
- Department of Anesthesiology and Critical Care Medicine, Saint Louis Lariboisière University Hospital, Université Paris Diderot, Paris, France
| | - Étienne Gayat
- Department of Anesthesiology and Critical Care Medicine, Saint Louis Lariboisière University Hospital, Université Paris Diderot, Paris, France
| | - Víctor Gil
- Emergency Department, Hospital Clínic, Barcelona; "Emergencies: processes and pathologies" Research Group, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
| | - Pere Llorens
- Emergency Department, Home Hospitalization and Short Stay Unit, Hospital General de Alicante, Alicante, Spain
| | - Francisco Javier Martín-Sánchez
- Emergency Department, Hospital Clínico San Carlos, Madrid, Instituto de Investigación Sanitaria San Carlos (IdISSC), Universidad Complutense de Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | | | - Javier Jacob
- Emergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Catalonia, Spain
| | - María Mir Montero
- Emergency Department, Hospital Universitario Infanta Leonor, Madrid, Spain
| | - Josep Tost
- Emergency Department, Hospital de Terrassa, Barcelona, Catalonia, Spain
| | | | - Lissete Traveria
- Emergency Department, Hospital Universitario de Canarias, Tenerife, Spain
| | - Raquel Torres-Gárate
- Emergency Department, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | | | - Carmen Agüera
- Emergency Department, Hospital Costa del Sol, Marbella, Málaga, Spain
| | - Amparo Valero
- Emergency Department, Hospital Doctor Peset, València, Spain
| | - Patricia Javaloyes
- Emergency Department, Home Hospitalization and Short Stay Unit, Hospital General de Alicante, Alicante, Spain
| | - W Frank Peacock
- The GREAT (Global REsearch in Acute Cardiovascular Conditions Team) Network, Rome, Italy; Emergency Department, Baylor College of Medicine, Ben Taub General Hospital, Houston, USA
| | - Héctor Bueno
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Cardiology Department, Universidad Complutense, Hospital 12 de Octubre, Madrid, Spain
| | - Alexandre Mebazaa
- The GREAT (Global REsearch in Acute Cardiovascular Conditions Team) Network, Rome, Italy; Department of Anesthesiology and Critical Care Medicine, Saint Louis Lariboisière University Hospital, Université Paris Diderot, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | - Eva Salvo
- Hospital Politénic La Fe de Valencia, Spain
| | - José Pavón
- Hospital Dr. Negrín de Las Palmas de Gran Canaria, Spain
| | - Antonio Noval
- Hospital Insular de Las Palmas de Gran Canaria, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Aitor Alquezar
- Hospital de la Santa Creu y Sant Pau de Barcelona, Spain
| | | | - Sergio Herrera
- Hospital de la Santa Creu y Sant Pau de Barcelona, Spain
| | - Alex Roset
- Hospital Universitari de Bellvitge de Barcelona, Spain
| | - Irene Cabello
- Hospital Universitari de Bellvitge de Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Rut Gaya
- Hospital Juan XXIII de Tarragona, Spain
| | | | - María Mir
- Hospital Infanta Leonor de Madrid, Spain
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Caballero F, Puig M, Leal J, Trejo O, Díaz I, Herrera S, Turbau M, Ris J, Benito S. Successful organ donation for transplantation: Targeted actions in the emergency department. Am J Transplant 2019; 19:2960-2961. [PMID: 31246336 DOI: 10.1111/ajt.15516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Francisco Caballero
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mireia Puig
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jesus Leal
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Olga Trejo
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Iván Díaz
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sergio Herrera
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Miquel Turbau
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Josep Ris
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Salvador Benito
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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Miró Ò, García Sarasola A, Fuenzalida C, Calderón S, Jacob J, Aguirre A, Wu DM, Rizzi MA, Malchair P, Haro A, Herrera S, Gil V, Martín-Sánchez FJ, Llorens P, Herrero Puente P, Bueno H, Domínguez Rodríguez A, Müller CE, Mebazaa A, Chioncel O, Alquézar-Arbé A. Departments involved during the first episode of acute heart failure and subsequent emergency department revisits and rehospitalisations: an outlook through the NOVICA cohort. Eur J Heart Fail 2019; 21:1231-1244. [PMID: 31389111 DOI: 10.1002/ejhf.1567] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 06/02/2019] [Accepted: 06/30/2019] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES We investigated the natural history of patients after a first episode of acute heart failure (FEAHF) requiring emergency department (ED) consultation, focusing on: the frequency of ED visits and hospitalisations, departments admitting patients during the first and subsequent hospitalisations, and factors associated with difficult disease control. METHODS AND RESULTS We included consecutive patients diagnosed with FEAHF (either with or without previous heart failure diagnosis) in four EDs during 5 months in three different time periods (2009, 2011, 2014). Diagnosis was adjudicated by local principal investigators. The clinical characteristics of the index event were prospectively recorded, and all post-discharge ED visits and hospitalisations [related/unrelated to acute heart failure (AHF)], as well as departments involved in subsequent hospitalisations were retrospectively ascertained. 'Uncontrolled disease' during the first year after FEAHF was considered if patients were attended at ED (≥ 3 times) or hospitalised (≥ 2 times) for AHF or died. Overall, 505 patients with FEAHF were included and followed for a mean of 2.4 years. In-hospital mortality was 7.5%. Among 467 patients discharged alive, 288 died [median survival 3.9 years, 95% confidence interval (CI) 3.5-4.4], 421 (90%) revisited the ED (2342 ED visits; 42.4% requiring hospitalisation, 34.0% AHF-related) and 357 (77%) were hospitalised (1054 hospitalisations; 94.1% through ED, 51.4% AHF-related). AHF-related hospitalisations were mainly in internal medicine (28.0%), short-stay unit (26.3%), cardiology (20.8%), and geriatrics (14.1%). Only 47.4% of AHF-related hospitalisations were in the same department as the FEAHF, and internal medicine involvement significantly increased with subsequent hospitalisations (P = 0.01). Uncontrolled disease was observed in 31% of patients, which was independently related to age > 80 years [odds ratio (OR) 1.80, 95% CI 1.17-2.77], systolic blood pressure < 110 mmHg at ED arrival (OR 2.61, 95% CI 1.26-5.38) and anaemia (OR 2.39, 95% CI 1.51-3.78). CONCLUSION In the present aged cohort of AHF patients from Barcelona, Spain, the natural history after FEAHF showed different patterns of hospital department involvement. Advanced age, low systolic blood pressure and anaemia were factors related to uncontrolled disease during the year after debut.
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Affiliation(s)
- Òscar Miró
- Emergency Department, Hospital Clínic, 'Emergencies: Processes and Pathologies' Research Group, IDIBAPS, University of Barcelona, Barcelona, Spain.,The GREAT (Global REsearch in Acute cardiovascular conditions Team) Network
| | - Ana García Sarasola
- Emergency Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - Carolina Fuenzalida
- Emergency Department, Hospital Clínic, 'Emergencies: Processes and Pathologies' Research Group, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Sofía Calderón
- Emergency Department, Hospital Clínic, 'Emergencies: Processes and Pathologies' Research Group, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Javier Jacob
- Emergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Alfons Aguirre
- Emergency Department, Hospital del Mar, Barcelona, Spain
| | - Da M Wu
- Emergency Department, Hospital Clínic, 'Emergencies: Processes and Pathologies' Research Group, IDIBAPS, University of Barcelona, Barcelona, Spain.,San Juan Bautista School of Medicine, San Juan de Puerto Rico, Puerto Rico
| | - Miguel A Rizzi
- Emergency Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - Pierre Malchair
- Emergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Antonio Haro
- Emergency Department, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Sergio Herrera
- The GREAT (Global REsearch in Acute cardiovascular conditions Team) Network
| | - Víctor Gil
- Emergency Department, Hospital Clínic, 'Emergencies: Processes and Pathologies' Research Group, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Francisco J Martín-Sánchez
- Emergency Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC), Universidad Complutense de Madrid, Madrid, Spain.,Centro Nacionalde Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - Pere Llorens
- Emergency Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Pablo Herrero Puente
- Emergency Department, Home Hospitalization and Short Stay Unit, Hospital General de Alicante, Alicante, Spain
| | - Héctor Bueno
- Centro Nacionalde Investigaciones Cardiovasculares (CNIC), Madrid, Spain.,Cardiology Department, Hospital 12 de Octubre, Universidad Complutense, Madrid, Spain
| | | | - Christian E Müller
- The GREAT (Global REsearch in Acute cardiovascular conditions Team) Network.,Cardiology Department, University Hospital of Basel, Basel, Switzerland
| | - Alexandre Mebazaa
- The GREAT (Global REsearch in Acute cardiovascular conditions Team) Network.,Department of Anesthesiology and Critical Care Medicine, Saint Louis Lariboisière University Hospital, Université Paris Diderot, Paris, France
| | - Ovidiu Chioncel
- Emergency Institute for Cardiovascular Diseases, Prof. C. C. Iliescu, University of Medicine Carol Davila, Bucharest, Romania
| | - Aitor Alquézar-Arbé
- Emergency Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
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Asset T, Garcia ST, Herrera S, Andersen N, Chen Y, Peterson EJ, Matanovic I, Artyushkova K, Lee J, Minteer SD, Dai S, Pan X, Chavan K, Calabrese Barton S, Atanassov P. Investigating the Nature of the Active Sites for the CO2 Reduction Reaction on Carbon-Based Electrocatalysts. ACS Catal 2019. [DOI: 10.1021/acscatal.9b01513] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Tristan Asset
- Department of Chemical & Biomolecular Engineering, National Fuel Cell Research Center (NFCRC), University of California, Irvine, California 92697, United States
| | - Samuel T. Garcia
- Department of Chemical & Biological Engineering, Center for Micro-Engineered Materials (CMEM), University of New Mexico, Albuquerque, New Mexico 87131, United States
| | - Sergio Herrera
- Department of Chemical & Biological Engineering, Center for Micro-Engineered Materials (CMEM), University of New Mexico, Albuquerque, New Mexico 87131, United States
| | - Nalin Andersen
- Department of Chemical & Biological Engineering, Center for Micro-Engineered Materials (CMEM), University of New Mexico, Albuquerque, New Mexico 87131, United States
| | - Yechuan Chen
- Department of Chemical & Biomolecular Engineering, National Fuel Cell Research Center (NFCRC), University of California, Irvine, California 92697, United States
| | - Eric J. Peterson
- Department of Chemical & Biological Engineering, Center for Micro-Engineered Materials (CMEM), University of New Mexico, Albuquerque, New Mexico 87131, United States
| | - Ivana Matanovic
- Department of Chemical & Biological Engineering, Center for Micro-Engineered Materials (CMEM), University of New Mexico, Albuquerque, New Mexico 87131, United States
- Theoretical Division, Los Alamos National Laboratory, Los Alamos, New Mexico 87545, United States
| | - Kateryna Artyushkova
- Department of Chemical & Biological Engineering, Center for Micro-Engineered Materials (CMEM), University of New Mexico, Albuquerque, New Mexico 87131, United States
| | - Jack Lee
- Department of Chemistry, University of Utah, Salt Lake City, Utah 84112, United States
| | - Shelley D. Minteer
- Department of Chemistry, University of Utah, Salt Lake City, Utah 84112, United States
| | - Sheng Dai
- Department of Materials Science & Engineering, Irvine Materials Research Institute (IMRI), University of California, Irvine, California 92697, United States
| | - Xiaoqing Pan
- Department of Materials Science & Engineering, Irvine Materials Research Institute (IMRI), University of California, Irvine, California 92697, United States
- Department of Physics and Astronomy, University of California, Irvine, California 92697, United States
- Irvine Materials Research Institute (IMRI), University of California, Irvine, California 92697, United States
| | - Kanchan Chavan
- Department of Chemical & Materials Engineering, Michigan State University, East Lansing, Michigan 48824, United States
| | - Scott Calabrese Barton
- Department of Chemical & Materials Engineering, Michigan State University, East Lansing, Michigan 48824, United States
| | - Plamen Atanassov
- Department of Chemical & Biomolecular Engineering, National Fuel Cell Research Center (NFCRC), University of California, Irvine, California 92697, United States
- Department of Chemical & Biological Engineering, Center for Micro-Engineered Materials (CMEM), University of New Mexico, Albuquerque, New Mexico 87131, United States
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Veeraraghavan J, De Angelis C, Mao R, Wang T, Herrera S, Pavlick AC, Contreras A, Nuciforo P, Mayer IA, Forero A, Nanda R, Goetz MP, Chang JC, Wolff AC, Krop IE, Fuqua SAW, Prat A, Hilsenbeck SG, Weigelt B, Reis-Filho JS, Gutierrez C, Osborne CK, Rimawi MF, Schiff R. A combinatorial biomarker predicts pathologic complete response to neoadjuvant lapatinib and trastuzumab without chemotherapy in patients with HER2+ breast cancer. Ann Oncol 2019; 30:927-933. [PMID: 30903140 PMCID: PMC6594453 DOI: 10.1093/annonc/mdz076] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND HER2-positive (+) breast cancers, defined by HER2 overexpression and/or amplification, are often addicted to HER2 to maintain their malignant phenotype. Yet, some HER2+ tumors do not benefit from anti-HER2 therapy. We hypothesize that HER2 amplification levels and PI3K pathway activation are key determinants of response to HER2-targeted treatments without chemotherapy. PATIENTS AND METHODS Baseline HER2+ tumors from patients treated with neoadjuvant lapatinib plus trastuzumab [with endocrine therapy for estrogen receptor (ER)+ tumors] in TBCRC006 (NCT00548184) were evaluated in a central laboratory for HER2 amplification by fluorescence in situ hybridization (FISH) (n = 56). HER2 copy number (CN) and FISH ratios, and PI3K pathway status, defined by PIK3CA mutations or PTEN levels by immunohistochemistry were available for 41 tumors. Results were correlated with pathologic complete response (pCR; no residual invasive tumor in breast). RESULTS Thirteen of the 56 patients (23%) achieved pCR. None of the 11 patients with HER2 ratio <4 and/or CN <10 achieved pCR, whereas 13/45 patients (29%) with HER2 ratio ≥4 and/or CN ≥10 attained pCR (P = 0.0513). Of the 18 patients with tumors expressing high PTEN or wild-type (WT) PIK3CA (intact PI3K pathway), 7 (39%) achieved pCR, compared with 1/23 (4%) with PI3K pathway alterations (P = 0.0133). Seven of the 16 patients (44%) with HER2 ratio ≥4 and intact PI3K pathway achieved pCR, whereas only 1/25 (4%) patients not meeting these criteria achieved pCR (P = 0.0031). CONCLUSIONS Our findings suggest that there is a clinical subtype in breast cancer with high HER2 amplification and intact PI3K pathway that is especially sensitive to HER2-targeted therapies without chemotherapy. A combination of HER2 FISH ratio and PI3K pathway status warrants validation to identify patients who may be treated with HER2-targeted therapy without chemotherapy.
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Affiliation(s)
- J Veeraraghavan
- Lester and Sue Smith Breast Center; Dan L. Duncan Comprehensive Cancer Center
| | - C De Angelis
- Lester and Sue Smith Breast Center; Dan L. Duncan Comprehensive Cancer Center
| | - R Mao
- Lester and Sue Smith Breast Center; Dan L. Duncan Comprehensive Cancer Center
| | - T Wang
- Lester and Sue Smith Breast Center; Dan L. Duncan Comprehensive Cancer Center; Departments of Medicine
| | - S Herrera
- Lester and Sue Smith Breast Center; Dan L. Duncan Comprehensive Cancer Center; Pathology, Baylor College of Medicine, Houston, USA
| | - A C Pavlick
- Lester and Sue Smith Breast Center; Dan L. Duncan Comprehensive Cancer Center
| | - A Contreras
- Lester and Sue Smith Breast Center; Dan L. Duncan Comprehensive Cancer Center; Pathology, Baylor College of Medicine, Houston, USA
| | - P Nuciforo
- Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Hospital Clinic de Barcelona, Barcelona, Spain
| | - I A Mayer
- Medicine, Hematology/Oncology, Vanderbilt University, Nashville
| | - A Forero
- Medicine, University of Alabama at Birmingham, Birmingham
| | - R Nanda
- Medicine, University of Chicago, Chicago
| | - M P Goetz
- Department of Oncology, Mayo Clinic, Rochester
| | - J C Chang
- Houston Methodist Cancer Center, Houston Methodist Hospital, Houston
| | - A C Wolff
- Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore
| | - I E Krop
- Department of Medicine, Dana-Farber Cancer Institute, Boston
| | - S A W Fuqua
- Lester and Sue Smith Breast Center; Dan L. Duncan Comprehensive Cancer Center
| | - A Prat
- Translational Genomics and Targeted Therapeutics in Solid Tumors, IDIBAPS, Hospital Clinic de Barcelona, Barcelona, Spain
| | - S G Hilsenbeck
- Lester and Sue Smith Breast Center; Dan L. Duncan Comprehensive Cancer Center; Departments of Medicine
| | - B Weigelt
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York
| | - J S Reis-Filho
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York
| | - C Gutierrez
- Lester and Sue Smith Breast Center; Dan L. Duncan Comprehensive Cancer Center; Pathology, Baylor College of Medicine, Houston, USA
| | - C K Osborne
- Lester and Sue Smith Breast Center; Dan L. Duncan Comprehensive Cancer Center; Departments of Medicine; Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, USA
| | - M F Rimawi
- Lester and Sue Smith Breast Center; Dan L. Duncan Comprehensive Cancer Center; Departments of Medicine
| | - R Schiff
- Lester and Sue Smith Breast Center; Dan L. Duncan Comprehensive Cancer Center; Departments of Medicine; Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, USA.
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28
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Rossello X, Miró Ò, Llorens P, Jacob J, Herrero-Puente P, Gil V, Rizzi MA, Pérez-Durá MJ, Espiga FR, Romero R, Sevillano JA, Vidán MT, Bueno H, Pocock SJ, Martín-Sánchez FJ, Fuentes M, Gil C, Alonso H, Garmila P, Rodríguez Adrada E, Llopis García G, Yáñez-Palma MC, López SI, Escoda R, Xipell C, Sánchez C, Gaytan JM, Pérez-Durá MJ, Salvo E, Pavón J, Noval A, Torres JM, López-Grima ML, Valero A, Juan MÁ, Aguirre A, Morales JE, Mínguez Masó S, Isabel Alonso M, Ruiz F, Miguel Franco J, Díaz E, Belén Mecina A, Tost J, Sánchez S, Carbajosa V, Piñera P, Sánchez Nicolás JA, Torres Garate R, Alquezar A, Alberto Rizzi M, Herrera S, Roset A, Cabello I, Richard F, Álvarez Pérez JM, Pilar López Diez M, Vázquez Álvarez J, Alonso Morilla A, Irimia A, Javaloyes P, Marquina V, Jiménez I, Hernández N, Brouzet B, Ramos S, López A, Antonio Andueza J, Antonio Sevillano J, Romero R, Calvache R, Lorca MT, Calderón L, Amores Arriaga B, Sierra B, Martín Mojarro E, Travería Bécquer L, Burillo G, Llauger García L, Corominas LaSalle G, Agüera Urbano C, Belén García A, Elisa Delgado Padial S, Soy Ferrer E, Garrido M, Javier Lucas F, Gaya R. Effect of Barthel Index on the Risk of Thirty-Day Mortality in Patients With Acute Heart Failure Attending the Emergency Department: A Cohort Study of Nine Thousand Ninety-Eight Patients From the Epidemiology of Acute Heart Failure in Emergency Departments Registry. Ann Emerg Med 2019; 73:589-598. [DOI: 10.1016/j.annemergmed.2018.12.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 11/09/2018] [Accepted: 12/04/2018] [Indexed: 01/14/2023]
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Barajas A, Pelaez T, González O, Usall J, Iniesta R, Arteaga M, Jackson C, Baños I, Sánchez B, Dolz M, Obiols JE, Haro JM, Ochoa S, Arranz B, Arteaga M, Asensio R, Autonell J, Baños I, Bañuelos M, Barajas A, Barceló M, Blanc M, Borrás M, Busquets E, Carlson J, Carral V, Castro M, Corbacho C, Coromina M, Dachs I, De Miquel L, Dolz M, Domenech MD, Elias M, Espezel I, Falo E, Fargas A, Foix A, Fusté M, Godrid M, Gómez D, González O, Granell L, Gumà L, Haro JM, Herrera S, Huerta E, Lacasa F, Mas N, Martí L, Martínez R, Matalí J, Miñambres A, Muñoz D, Muñoz V, Nogueroles R, Ochoa S, Ortiz J, Pardo M, Planella M, Pelaez T, Peruzzi S, Rivero S, Rodriguez MJ, Rubio E, Sammut S, Sánchez M, Sánchez B, Serrano E, Solís C, Stephanotto C, Tabuenca P, Teba S, Torres A, Urbano D, Usall J, Vilaplana M, Villalta V. Predictive capacity of prodromal symptoms in first-episode psychosis of recent onset. Early Interv Psychiatry 2019; 13:414-424. [PMID: 29116670 DOI: 10.1111/eip.12498] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 02/16/2017] [Revised: 07/16/2017] [Accepted: 08/20/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Both the nature and number of a wide range of prodromal symptoms have been related to the severity and type of psychopathology in the psychotic phase. However, at present there is an incomplete picture focused mainly on the positive pre-psychotic dimension. AIM To characterize the prodromal phase retrospectively, examining the number and nature of prodromal symptoms as well as their relationship with psychopathology at the onset of first-episode psychosis. METHODS Retrospective study of 79 patients experiencing a first-episode psychosis of less than 1 year from the onset of full-blown psychosis. All patients were evaluated with a comprehensive battery of instruments including socio-demographic and clinical questionnaire, IRAOS interview, PANSS, stressful life events scale (PERI) and WAIS/WISC (vocabulary subtest). Bivariate associations and multiple regression analysis were performed. RESULTS Regression models revealed that several prodromal dimensions of IRAOS (delusions, affect, language, behaviour and non-hallucinatory disturbances of perception) predicted the onset of psychosis, with positive (22.4% of the variance) and disorganized (25.6% of the variance) dimensions being the most widely explained. CONCLUSION In addition to attenuated positive symptoms, other symptoms such as affective, behavioural and language disturbances should also be considered in the definitions criteria of at-high-risk people.
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Affiliation(s)
- Ana Barajas
- Department of Research, Centre d'Higiene Mental Les Corts, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain.,Hospital Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Esplugues de Llobregat, Barcelona, Spain.,Fundació Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain.,Department of Clinical and Psychology, School of Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Trinidad Pelaez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Olga González
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Judith Usall
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Raquel Iniesta
- Fundació Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
| | - Maria Arteaga
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Chris Jackson
- Birmingham Early Intervention Service, Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK
| | - Iris Baños
- Fundació Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
| | - Bernardo Sánchez
- Hospital Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Esplugues de Llobregat, Barcelona, Spain
| | - Montserrat Dolz
- Hospital Sant Joan de Déu de Barcelona, Centro de Investigación Biomédica en Red de Salud Mental, Esplugues de Llobregat, Barcelona, Spain
| | - Jordi E Obiols
- Department of Clinical and Psychology, School of Psychology, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain
| | - Josep M Haro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | | | - Susana Ochoa
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
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Herrera S, Farooq A, Davoudi S, Martinu T, Kumar D, Humar A, Rotstein C, Singer L, Keshavjee S, Husain S. Late Onset Invasive Pulmonary Aspergillosis in Lung Transplant Recipients Treated with a Preemptive/ Targeted Antifungal Therapy Strategy: 4 Year Follow Up. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.537] [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] Open
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31
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Gabrielli L, Saavedra R, Herrera S, Vega J, Salinas M, Fernandez R, Contreras F, Vergara L, Yanez F, Jalil J, Ocaranza MP, Lavandero S, Chiong M, Castro P, Sitges M. P653Cardiac remodeling in highly trained athletes is associated with rho kinase activation and increased levels of cardiotrophin-1. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p653] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- L Gabrielli
- Pontifical Catholic University of Chile, Cardiovascular Disease Division, Santiago, Chile
| | - R Saavedra
- Pontifical Catholic University of Chile, Cardiovascular Disease Division, Santiago, Chile
| | - S Herrera
- Pontifical Catholic University of Chile, Cardiovascular Disease Division, Santiago, Chile
| | - J Vega
- Pontifical Catholic University of Chile, Cardiovascular Disease Division, Santiago, Chile
| | - M Salinas
- Pontifical Catholic University of Chile, Cardiovascular Disease Division, Santiago, Chile
| | - R Fernandez
- Pontifical Catholic University of Chile, Cardiovascular Disease Division, Santiago, Chile
| | - F Contreras
- Pontifical Catholic University of Chile, Cardiovascular Disease Division, Santiago, Chile
| | - L Vergara
- Pontifical Catholic University of Chile, Cardiovascular Disease Division, Santiago, Chile
| | - F Yanez
- Pontifical Catholic University of Chile, Cardiovascular Disease Division, Santiago, Chile
| | - J Jalil
- Pontifical Catholic University of Chile, Cardiovascular Disease Division, Santiago, Chile
| | - M P Ocaranza
- Pontifical Catholic University of Chile, Cardiovascular Disease Division, Santiago, Chile
| | - S Lavandero
- University of Chile, Advanced Center for Chronic Diseases (ACCDiS) & CEMC, Facultad Ciencias Químicas y Farmacéuticas y F, Santiago, Chile
| | - M Chiong
- University of Chile, Advanced Center for Chronic Diseases (ACCDiS) & CEMC, Facultad Ciencias Químicas y Farmacéuticas y F, Santiago, Chile
| | - P Castro
- Pontifical Catholic University of Chile, Cardiovascular Disease Division, Santiago, Chile
| | - M Sitges
- Institute of Biomedical Research August Pi Sunyer (IDIBAPS), Cardiology Department, Barcelona, Spain
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Heard J, Pape K, Romanowski K, Liu Y, Herrera S, Granchi T, Wibbenmeyer L. 287 Invasive Fungal Infections in Burns: Case Series and Review of the Literature. J Burn Care Res 2018. [DOI: 10.1093/jbcr/iry006.209] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- J Heard
- University of Iowa Hospitals and Clinics, Iowa City, IA
| | - K Pape
- University of Iowa Hospitals and Clinics, Iowa City, IA
| | - K Romanowski
- University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Y Liu
- University of Iowa Hospitals and Clinics, Iowa City, IA
| | - S Herrera
- University of Iowa Hospitals and Clinics, Iowa City, IA
| | - T Granchi
- University of Iowa Hospitals and Clinics, Iowa City, IA
| | - L Wibbenmeyer
- University of Iowa Hospitals and Clinics, Iowa City, IA
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Herrera S, Gohir W, Aguilar C, Juvet S, Martinu T, Singer L, Keshavjee S, Rotstein C, Kumar D, Humar A, Husain S. Predictive Cytokine Profile for Invasive Aspergillosis in Lung Transplant Recipients in the Setting of Pre-emptive Prophylaxis. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.530] [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: 10/17/2022] Open
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de Frutos M, López-Urrutia L, Berbel C, Allue M, Herrera S, Azcona JM, Beristaín X, Aznar E, Albert M, Ruiz C, Eiros JM. [Monophasic Salmonella Typhimurium outbreak due to the consumption of roast pork meat]. Rev Esp Quimioter 2018; 31:156-159. [PMID: 29564869 PMCID: PMC6159379] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 12/05/2017] [Accepted: 12/05/2017] [Indexed: 10/26/2022]
Abstract
This report presents an outbreak of monophasic Salmonella enteric serovar Typhimurium fagotipe 4, 5, 12: i:-, in a motorcycle concentration in Valladolid. Information was collected to one hundred and twelve affected from seven Spanish Autonomous Communities. The epidemiological investigation associated the outbreak with the consumption of roast pork with sauce sandwiches sold at a street market in that event.
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Affiliation(s)
- M de Frutos
- Mónica de Frutos, Servicio de Microbiología. Hospital Universitario Rio Hortega Calle Dulzaina, 2 47012 Valladolid, Spain.
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Santoro C, Kodali M, Herrera S, Serov A, Ieropoulos I, Atanassov P. Power generation in microbial fuel cells using platinum group metal-free cathode catalyst: Effect of the catalyst loading on performance and costs. J Power Sources 2018; 378:169-175. [PMID: 29527091 PMCID: PMC5840685 DOI: 10.1016/j.jpowsour.2017.12.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 11/22/2017] [Accepted: 12/07/2017] [Indexed: 05/05/2023]
Abstract
Platinum group metal-free (PGM-free) catalyst with different loadings was investigated in air breathing electrodes microbial fuel cells (MFCs). Firstly, the electrocatalytic activity towards oxygen reduction reaction (ORR) of the catalyst was investigated by rotating ring disk electrode (RRDE) setup with different catalyst loadings. The results showed that higher loading led to an increased in the half wave potential and the limiting current and to a further decrease in the peroxide production. The electrons transferred also slightly increased with the catalyst loading up to the value of ≈3.75. This variation probably indicates that the catalyst investigated follow a 2x2e- transfer mechanism. The catalyst was integrated within activated carbon pellet-like air-breathing cathode in eight different loadings varying between 0.1 mgcm-2 and 10 mgcm-2. Performance were enhanced gradually with the increase in catalyst content. Power densities varied between 90 ± 9 μWcm-2 and 262 ± 4 μWcm-2 with catalyst loading of 0.1 mgcm-2 and 10 mgcm-2 respectively. Cost assessments related to the catalyst performance are presented. An increase in catalyst utilization led to an increase in power generated with a substantial increase in the whole costs. Also a decrease in performance due to cathode/catalyst deterioration over time led to a further increase in the costs.
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Affiliation(s)
- Carlo Santoro
- Department of Chemical and Biological Engineering, Center Micro-Engineered Materials (CMEM), MSC01 1120 University of New Mexico Albuquerque, New Mexico 87131, USA
| | - Mounika Kodali
- Department of Chemical and Biological Engineering, Center Micro-Engineered Materials (CMEM), MSC01 1120 University of New Mexico Albuquerque, New Mexico 87131, USA
| | - Sergio Herrera
- Department of Chemical and Biological Engineering, Center Micro-Engineered Materials (CMEM), MSC01 1120 University of New Mexico Albuquerque, New Mexico 87131, USA
| | - Alexey Serov
- Department of Chemical and Biological Engineering, Center Micro-Engineered Materials (CMEM), MSC01 1120 University of New Mexico Albuquerque, New Mexico 87131, USA
| | - Ioannis Ieropoulos
- Bristol BioEnergy Centre, Bristol Robotics Laboratory, T-Block, UWE, Coldharbour Lane, Bristol BS16 1QY, UK
- Biological, Biomedical and Analytical Sciences, UWE, Coldharbour Lane, Bristol BS16 1QY, UK
| | - Plamen Atanassov
- Department of Chemical and Biological Engineering, Center Micro-Engineered Materials (CMEM), MSC01 1120 University of New Mexico Albuquerque, New Mexico 87131, USA
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Caballero F, Puig M, Leal J, Trejo O, Díaz I, Herrera S, Turbau M, Ris J, Benito S. A helpful approach to organ donation: From end-of-life care to effective organ transplantation. Am J Transplant 2018; 18:528-529. [PMID: 28891206 DOI: 10.1111/ajt.14493] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- F Caballero
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Puig
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Leal
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - O Trejo
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Díaz
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Herrera
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Turbau
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Ris
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Benito
- Department of Emergency Medicine and Transplant Coordination, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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Herrera S, Soriano R, Nogués X, Güerri-Fernandez R, Grinberg D, García-Giralt N, Martínez-Gil N, Castejón S, González-Lizarán A, Balcells S, Diez-Perez A. Discrepancy between bone density and bone material strength index in three siblings with Camurati-Engelmann disease. Osteoporos Int 2017; 28:3489-3493. [PMID: 28842728 DOI: 10.1007/s00198-017-4198-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 08/14/2017] [Indexed: 10/19/2022]
Abstract
UNLABELLED Camurati-Engelmann (CE) is a very rare disease affecting one in every million persons worldwide. It is characterized by an enlargement of long bones. We aimed to assess bone characteristics in three siblings with different tools. Even if there was an excess of bone density, quality seemed to be deteriorated. INTRODUCTION CE disease is a rare monogenic disorder affecting approximately one in every million persons worldwide. It is mainly characterized by a progressive hyperostosis of the periosteum and endosteum of the diaphysis of long bones. Limited data are available about bone characteristics in these patients. In three siblings with CE disease, we aimed to assess bone mineral density (BMD) and trabecular bone score (TBS) by dual-energy X-ray absorptiometry (DXA) and material characteristics at tissue level using bone impact reference point indentation. METHODS Clinical data were collected and a general laboratory workup was performed. At the lumbar spine and hip, BMD and TBS were measured using DXA imaging. Bone material strength index (BMSi) was measured by bone impact microindentation using an Osteoprobe instrument. RESULTS All three cases had densitometric values consistent with high bone mass (sum of Z-score at the lumbar spine and hip > 4). Hip BMD was extremely high in all three siblings at both total hip and femoral neck, while at the lumbar spine, two of them had normal values but the third again had very high BMD. TBS values were in the normal range. In contrast, BMSi measurements were at low or very low levels, compared with normal controls. CONCLUSION Despite strikingly increased BMD and normal microarchitecture, BMSi is affected in patients with CE. Microindentation could be an appropriate tool for assessing bone fragility in these patients. Bone disease in this group of patients requires further study to better understand the underlying regulatory mechanisms and their alterations.
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Affiliation(s)
- S Herrera
- Hospital del Mar Institute of Medical Research, Autonomous University of Barcelona and CIBERFES, Instituto Carlos III, Barcelona, Spain
| | - R Soriano
- Hospital del Mar Institute of Medical Research, Autonomous University of Barcelona and CIBERFES, Instituto Carlos III, Barcelona, Spain
| | - X Nogués
- Hospital del Mar Institute of Medical Research, Autonomous University of Barcelona and CIBERFES, Instituto Carlos III, Barcelona, Spain
| | - R Güerri-Fernandez
- Hospital del Mar Institute of Medical Research, Autonomous University of Barcelona and CIBERFES, Instituto Carlos III, Barcelona, Spain
| | - D Grinberg
- Department of Genetics, Microbiology and Statistics, University of Barcelona, IBUB, IDSJD, and CIBERER, Instituto Carlos III, Barcelona, Spain
| | - N García-Giralt
- Hospital del Mar Institute of Medical Research, Autonomous University of Barcelona and CIBERFES, Instituto Carlos III, Barcelona, Spain
| | - N Martínez-Gil
- Department of Genetics, Microbiology and Statistics, University of Barcelona, IBUB, IDSJD, and CIBERER, Instituto Carlos III, Barcelona, Spain
| | - S Castejón
- Hospital del Mar Institute of Medical Research, Autonomous University of Barcelona and CIBERFES, Instituto Carlos III, Barcelona, Spain
| | - A González-Lizarán
- Hospital del Mar Institute of Medical Research, Autonomous University of Barcelona and CIBERFES, Instituto Carlos III, Barcelona, Spain
| | - S Balcells
- Department of Genetics, Microbiology and Statistics, University of Barcelona, IBUB, IDSJD, and CIBERER, Instituto Carlos III, Barcelona, Spain
| | - A Diez-Perez
- Hospital del Mar Institute of Medical Research, Autonomous University of Barcelona and CIBERFES, Instituto Carlos III, Barcelona, Spain.
- Department of Internal Medicine, Hospital del Mar, P. Maritim 25-29, 08003, Barcelona, Spain.
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Kodali M, Santoro C, Herrera S, Serov A, Atanassov P. Bimetallic platinum group metal-free catalysts for high power generating microbial fuel cells. J Power Sources 2017; 366:18-26. [PMID: 29097833 PMCID: PMC5637930 DOI: 10.1016/j.jpowsour.2017.08.110] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 07/26/2017] [Accepted: 08/30/2017] [Indexed: 04/14/2023]
Abstract
M1-M2-N-C bimetallic catalysts with M1 as Fe and Co and M2 as Fe, Co, Ni and Mn were synthesized and investigated as cathode catalysts for oxygen reduction reaction (ORR). The catalysts were prepared by Sacrificial Support Method in which silica was the template and aminoantipyrine (AAPyr) was the organic precursor. The electro-catalytic properties of these catalysts were investigated by using rotating ring disk (RRDE) electrode setup in neutral electrolyte. Fe-Mn-AAPyr outperformed Fe-AAPyr that showed higher performances compared to Fe-Co-AAPyr and Fe-Ni-AAPyr in terms of half-wave potential. In parallel, Fe-Co-AAPyr, Co-Mn-AAPyr and Co-Ni-AAPyr outperformed Co-AAPyr. The presence of Co within the catalyst contributed to high peroxide production not desired for efficient ORR. The catalytic capability of the catalysts integrated in air-breathing cathode was also verified. It was found that Co-based catalysts showed an improvement in performance by the addition of second metal compared to simple Co- AAPyr. Fe-based bimetallic materials didn't show improvement compared to Fe-AAPyr with the exception of Fe-Mn-AAPyr catalyst that had the highest performance recorded in this study with maximum power density of 221.8 ± 6.6 μWcm-2. Activated carbon (AC) was used as control and had the lowest performances in RRDE and achieved only 95.6 ± 5.8 μWcm-2 when tested in MFC.
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Affiliation(s)
| | | | | | | | - Plamen Atanassov
- Department of Chemical and Biological Engineering, Center Micro-Engineered Materials (CMEM), MSC01 1120 University of New Mexico Albuquerque, New Mexico 87131, USA
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Pérez-Sáez MJ, Herrera S, Prieto-Alhambra D, Vilaplana L, Nogués X, Vera M, Redondo-Pachón D, Mir M, Güerri R, Crespo M, Díez-Pérez A, Pascual J. Bone density, microarchitecture, and material strength in chronic kidney disease patients at the time of kidney transplantation. Osteoporos Int 2017; 28:2723-2727. [PMID: 28497224 DOI: 10.1007/s00198-017-4065-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 04/19/2017] [Indexed: 10/19/2022]
Abstract
UNLABELLED Bone health is assessed by bone mineral density (BMD). Other techniques such as trabecular bone score and microindentation could improve the risk of fracture's estimation. Our chronic kidney disease (CKD) patients presented worse bone health (density, microarchitecture, mechanical properties) than controls. More than BMD should be done to evaluate patients at risk of fracture. INTRODUCTION BMD measured by dual-energy X-ray absorptiometry (DXA) is used to assess bone health in end-stage renal disease (ESRD) patients. Recently, trabecular bone score (TBS) and microindentation that can measure microarchitectural and mechanical properties of bone have demonstrated better correlation with fractures than DXA in different populations. We aimed to characterize bone health (BMD, TBS, and strength) and calcium/phosphate metabolism in a cohort of 53 ESRD patients undergoing kidney transplantation (KT) and 94 controls with normal renal function. METHODS Laboratory workout, lumbar spine/hip BMD measurements (using DXA), lumbar spine TBS, and bone strength were carried out. The latter was assessed with an impact microindentation device, standardized as percentage of a reference value, and expressed as bone material strength index (BMSi) units. Multivariable linear regression was used to study differences between cases and controls adjusted by age, gender, and body mass index. RESULTS Among cases, serum calcium was 9.6 ± 0.7 mg/dl, phosphorus 4.4 ± 1.2 mg/dl, and intact parathyroid hormone 214 pg/ml [102-390]. Fourteen patients (26.4%) had prevalent asymptomatic fractures in spinal X-ray. BMD was significantly lower among ESRD patients compared to controls: lumbar 0.966 ± 0.15 vs 0.982 ± 0.15 (adjusted p = 0.037), total hip 0.852 ± 0.15 vs 0.902 ± 0.13 (adjusted p < 0.001), and femoral neck 0.733 ± 0.15 vs 0.775 ± 0.12 (adjusted p < 0.001), as were TBS (1.20 [1.11-1.30] vs 1.31 [1.19-1.43] (adjusted p < 0.001)) and BMSi (79 [71.8-84.2] vs 82. [77.5-88.9] (adjusted p = 0.005)). CONCLUSIONS ESRD patients undergoing transplant surgery have damaged bone health parameters (density, microarchitecture, and mechanical properties) despite acceptably controlled hyperparathyroidism. Detecting these abnormalities may assist in identifying patients at high risk of post-transplantation fractures.
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Affiliation(s)
- M J Pérez-Sáez
- Department of Nephrology, Hospital del Mar, Autonomous University of Barcelona, Passeig Maritim 25-29, 08003, Barcelona, Spain
- Institut Mar d'Investigacions Mediques, Barcelona, Spain
- REDINREN, Instituto Carlos III, Madrid, Spain
| | - S Herrera
- Institut Mar d'Investigacions Mediques, Barcelona, Spain
- Department of Internal Medicine, Hospital del Mar, Autonomous University of Barcelona, Passeig Maritim 25-29, 08003, Barcelona, Spain
- RETICEF, Instituto Carlos III, Madrid, Spain
| | - D Prieto-Alhambra
- Institut Mar d'Investigacions Mediques, Barcelona, Spain
- RETICEF, Instituto Carlos III, Madrid, Spain
- Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Windmill Road, Oxford, OX3 7HE, UK
| | - L Vilaplana
- Institut Mar d'Investigacions Mediques, Barcelona, Spain
- Department of Internal Medicine, Hospital del Mar, Autonomous University of Barcelona, Passeig Maritim 25-29, 08003, Barcelona, Spain
- RETICEF, Instituto Carlos III, Madrid, Spain
| | - X Nogués
- Institut Mar d'Investigacions Mediques, Barcelona, Spain
- Department of Internal Medicine, Hospital del Mar, Autonomous University of Barcelona, Passeig Maritim 25-29, 08003, Barcelona, Spain
- RETICEF, Instituto Carlos III, Madrid, Spain
| | - M Vera
- Department of Nephrology, Hospital del Mar, Autonomous University of Barcelona, Passeig Maritim 25-29, 08003, Barcelona, Spain
- Institut Mar d'Investigacions Mediques, Barcelona, Spain
| | - D Redondo-Pachón
- Department of Nephrology, Hospital del Mar, Autonomous University of Barcelona, Passeig Maritim 25-29, 08003, Barcelona, Spain
- Institut Mar d'Investigacions Mediques, Barcelona, Spain
- REDINREN, Instituto Carlos III, Madrid, Spain
| | - M Mir
- Department of Nephrology, Hospital del Mar, Autonomous University of Barcelona, Passeig Maritim 25-29, 08003, Barcelona, Spain
- Institut Mar d'Investigacions Mediques, Barcelona, Spain
| | - R Güerri
- Institut Mar d'Investigacions Mediques, Barcelona, Spain
- Department of Internal Medicine, Hospital del Mar, Autonomous University of Barcelona, Passeig Maritim 25-29, 08003, Barcelona, Spain
- RETICEF, Instituto Carlos III, Madrid, Spain
| | - M Crespo
- Department of Nephrology, Hospital del Mar, Autonomous University of Barcelona, Passeig Maritim 25-29, 08003, Barcelona, Spain
- Institut Mar d'Investigacions Mediques, Barcelona, Spain
- REDINREN, Instituto Carlos III, Madrid, Spain
| | - A Díez-Pérez
- Institut Mar d'Investigacions Mediques, Barcelona, Spain.
- Department of Internal Medicine, Hospital del Mar, Autonomous University of Barcelona, Passeig Maritim 25-29, 08003, Barcelona, Spain.
- RETICEF, Instituto Carlos III, Madrid, Spain.
| | - J Pascual
- Department of Nephrology, Hospital del Mar, Autonomous University of Barcelona, Passeig Maritim 25-29, 08003, Barcelona, Spain.
- Institut Mar d'Investigacions Mediques, Barcelona, Spain.
- REDINREN, Instituto Carlos III, Madrid, Spain.
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Reátegui J, Herrera S, Boluarte J, Fernández F, Pacheco V, Bernardi S. Comparación de tres técnicas en la preparación de nuestras para la cristalización del flujo cérvical en bovinos lecheros. SPERMOVA 2017. [DOI: 10.18548/aspe/0005.11] [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: 11/19/2022] Open
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Argerich S, Herrera S, Benito S, Giraldo BF. Evaluation of periodic breathing in respiratory flow signal of elderly patients using SVM and linear discriminant analysis. Annu Int Conf IEEE Eng Med Biol Soc 2017; 2016:4276-4279. [PMID: 28269227 DOI: 10.1109/embc.2016.7591672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Aging population is a major concern that is reflected in the increase of chronic diseases. Heart Failure (HF) is one of the most common chronic diseases of elderly people that is punctuated with acute episodes, which result in hospitalization. The periodic modulation of the amplitude of the breathing pattern is proved to be one of the multiple symptoms of an acute episode, and thus, the features extracted from its characterization contribute in the improvement of the first diagnosis of the clinical practice. The main objective of this study is to evaluate if the features extracted from the breathing pattern along with common clinical variables are reliable enough to detect Periodic Breathing (PB). A dataset of 44 elderly patients containing clinical information and a short record of electrocardiogram and respiratory flow signal was used to train two machine learning classification methods: Support Vector Machine (SVM) and Linear Discriminant Analysis (LDA). All the available clinical parameters within the dataset along with the parameters characterizing the respiratory pattern were used to classify the observations into two groups. SVM classification was optimized and performed using a = -8 and C = 10.04 giving an accuracy of 88.2 % sensitivity of 90 % and specificity of 85.7 % Similar results were achieved with LDA classifying with an accuracy of 82.4 %, a sensitivity of 81.8% and specificity of 83.3 % PB has been accurately detected using both classifiers.
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Juanes A, Garin N, Mangues MA, Herrera S, Puig M, Faus MJ, Baena MI. Impact of a pharmaceutical care programme for patients with chronic disease initiated at the emergency department on drug-related negative outcomes: a randomised controlled trial. Eur J Hosp Pharm 2017; 25:274-280. [PMID: 31157039 DOI: 10.1136/ejhpharm-2016-001055] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 01/11/2017] [Accepted: 01/23/2017] [Indexed: 11/04/2022] Open
Abstract
Background The resolution of potential drug-related problems is a priority of pharmaceutical care programmes. Objectives To assess the clinical impact on drug-related negative outcomes of a pharmaceutical care programme focusing on the resolution of potential drug-related problems, initiated in the emergency department for patients with heart failure (HF) and/or chronic obstructive pulmonary disease (COPD). Methods Controlled trials, in which older adults (≥65 years) receiving four or more medications admitted to the emergency department for ≥12 hours for worsening of HF and/or COPD were randomised (1:1) to either a pharmaceutical care programme focusing on resolving potential drug-related problems initiated at the emergency department (intervention group (IG)) or standard care (control group). Comparisons between the groups were made for the proportion of patients with drug-related negative outcomes, number of drug-related negative outcomes per patient, mean stay, patients readmitted within 180 days and 180-day mortality. Results 118 patients were included, 59 in each group. Fewer patients in the IG had drug-related negative outcomes (37 (62.7%) vs 47 (79.7%) in the control group (p=0.042)). Fewer drug-related negative outcomes per patient occurred in the IG (56 (0.95 per patient) vs 85 (1.44 per patient) in the control group (p=0.01)). The mean stay was similar between groups (194.7 hours in the IG vs 242.5 hours in the control group (p=0.186)). No difference in revisits within 180 days was found (32 (54.24%) in the IG vs 22 (37.3%) in the control group (p=0.065)). 180-Day mortality was detected in 11 (18.6%) patients in the IG compared with 13 (22%) in the control group (p=0.647). Conclusion A pharmaceutical care programme focusing on resolving potential drug-related problems initiated at the emergency department has a favourable clinical impact, as it reduces the number and prevalence of drug-related negative outcomes. No difference was found in other outcome variables.Trial registration number NCT02368548.
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Affiliation(s)
- Ana Juanes
- Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Noe Garin
- Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigacin Biomdica en Red de Salud Mental, CIBERSAM, Madrid, Spain
| | - Maria Antonia Mangues
- Pharmacy Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,CIBER de Bioingeniera, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain
| | - Sergio Herrera
- Emergency Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Mireia Puig
- Emergency Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Maria Jose Faus
- Pharmaceutical care Research Group, Universidad de Granada, Granada, Spain
| | - Maria Isabel Baena
- Pharmaceutical care Research Group, Universidad de Granada, Granada, Spain
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González JM, Olano V, Vergara J, Arévalo-Herrera M, Carrasquilla G, Herrera S, López JA. Unstable, low-level transmission of malaria on the Colombian Pacific Coast. Annals of Tropical Medicine & Parasitology 2016. [DOI: 10.1080/00034983.1997.11813149] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Arévalo-Herrera M, Roggero MA, Gonzalez JM, Vergara J, Corradin G, López JA, Herrera S. Mapping and comparison of the B-cell epitopes recognized on thePlasmodium vivaxcircumsporozoite protein by immune Colombians and immunizedAotusmonkeys. Annals of Tropical Medicine & Parasitology 2016. [DOI: 10.1080/00034983.1998.11813311] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Duque S, Montenegro-James S, Arévalo-Herrera M, Praba AD, Villinger F, Herrera S, James MA. Expression of cytokine genes inAotusmonkeys immunized with synthetic and recombinantPlasmodium vivaxandP. falciparumantigens. Annals of Tropical Medicine & Parasitology 2016. [DOI: 10.1080/00034983.1998.11813312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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López JA, González JM, Kettner A, Arévalo-Herrera M, Herrera S, Corradin G, Roggero MA. Synthetic polypeptides corresponding to the non-repeat regions from the circumsporozoite protein ofPlasmodium falciparum: recognition by human T-cells and immunogenicity in owl monkeys. Annals of Tropical Medicine & Parasitology 2016. [DOI: 10.1080/00034983.1997.11813139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Calderón J, Flores P, Aguirre JM, Valdivia G, Padilla O, Barra I, Scoriels L, Herrera S, González A, Massardo L. Impact of cognitive impairment, depression, disease activity, and disease damage on quality of life in women with systemic lupus erythematosus. Scand J Rheumatol 2016; 46:273-280. [PMID: 27701937 DOI: 10.1080/03009742.2016.1206617] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To define the relative role of cognitive impairment, depression, disease activity, and disease damage in the decreased health-related quality of life (HRQoL) frequently observed in systemic lupus erythematosus (SLE) patients. METHOD We studied 101 Chilean female SLE patients and applied the 12-item Medical Outcomes Study (MOS) Short Form Health Survey version 2 (SF-12v2) to assess HRQoL and the Cambridge Neuropsychological Test Automated Battery (CANTAB) to assess cognitive function. Analysis of covariance (ANCOVA) models included demographic and disease-related factors and cognitive function tests of sustained attention, memory, and executive function. RESULTS All measures of HRQoL were lower in the 101 female SLE patients compared to the women from the Chilean general population. HRQoL was associated with the following factors: (i) depression symptoms, which were detrimental to all components of the physical and mental HRQoL scores; (ii) executive dysfunction (spatial planning), which was associated with lower scores on role limitations due to physical health problems and emotional problems, and general health perceptions; (iii) higher activity and organ damage were deleterious to role physical, bodily pain, and physical summary scores; and (iv) higher damage also impacted physical function. Impairments in sustained attention and memory did not decrease the HRQoL. CONCLUSIONS Our results highlight the relevance of executive dysfunction to poor physical and mental health components of HRQoL in SLE together with depression, while disease activity and disease damage are associated with lower HRQoL physical components. The need for cognitive function evaluation and rehabilitation in SLE is indicated.
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Affiliation(s)
- J Calderón
- a Department of Psychiatry, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile
| | - P Flores
- a Department of Psychiatry, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile
| | - J M Aguirre
- a Department of Psychiatry, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile
| | - G Valdivia
- b Department of Public Health, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile
| | - O Padilla
- b Department of Public Health, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile
| | - I Barra
- c School of Medicine, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile
| | - L Scoriels
- d Institute of Biomedical Sciences , Federal University of Rio de Janeiro , Rio de Janeiro , Brazil
| | - S Herrera
- c School of Medicine, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile
| | - A González
- e Department of Clinical Immunology and Rheumatology, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile.,f Centre for Ageing and Regeneration (CARE), Department of Molecular and Cell Biology, Faculty of Biological Sciences , Pontifical Catholic University of Chile , Santiago , Chile
| | - L Massardo
- e Department of Clinical Immunology and Rheumatology, Faculty of Medicine , Pontifical Catholic University of Chile , Santiago , Chile
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Alquézar Arbé A, de Diego Bustillos E, Rizzi M, Herrera S. Diferencias en la supervivencia en pacientes con insuficiencia cardiaca. Aten Primaria 2016; 48:500. [PMID: 27083076 PMCID: PMC6877826 DOI: 10.1016/j.aprim.2015.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 09/15/2015] [Indexed: 11/28/2022] Open
Affiliation(s)
| | | | - Miguel Rizzi
- Hospital de la Santa Creu i Sant Pau, Barcelona, España
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Martínez Bueno MJ, Herrera S, Munaron D, Boillot C, Fenet H, Chiron S, Gómez E. POCIS passive samplers as a monitoring tool for pharmaceutical residues and their transformation products in marine environment. Environ Sci Pollut Res Int 2016; 23:5019-29. [PMID: 25382501 DOI: 10.1007/s11356-014-3796-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 10/29/2014] [Indexed: 05/20/2023]
Abstract
In the last years, several scientific studies have shown that carbamazepine (CBZ) is one of the most frequently detected pharmaceutical in aquatic environment. However, little data is available on its detection and its transformation products (TPs) in marine water. The use of polar organic chemical integrative sampling (POCIS) passive samplers as a semi-quantitative and qualitative tool for screening of pharmaceuticals and TPs in seawater has been studied. Furthermore, the uptake rates of the target compounds were also determined under laboratory experiments to characterize the levels accumulated in devices. The results confirmed the presence of residues of anticonvulsant CBZ as well as some of its main metabolites, over a 1-year monitoring campaign carried out in French coast on the Mediterranean Sea. The work reports for the first time the presence of two TPs (10,11-dihydro-10,11-trans-dihydroxycarbamazepine (TRANS) and 10-hydroxy-10,11-dihydrocarbamazepine (10OH)) in marine water. The results contribute in assessing the environmental and human health risk of pharmaceuticals on coastal areas.
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Affiliation(s)
- M J Martínez Bueno
- Hydrosciences Montpellier UMR 5569, Department of Environmental Sciences and Public Health, University of Montpellier I, 34000, Montpellier, France.
| | - S Herrera
- Pesticide Residues Research Group, Department of Hydrogeology and Analytical Chemistry, University of Almería, 04120, La Cañada de San Urbano, Almería, Spain
| | - D Munaron
- Laboratoire Environnement et Ressources du Languedoc-Roussillon, IFREMER, Avenue Jean Monnet, 34203, Sete, France
| | - C Boillot
- Hydrosciences Montpellier UMR 5569, Department of Environmental Sciences and Public Health, University of Montpellier I, 34000, Montpellier, France
| | - H Fenet
- Hydrosciences Montpellier UMR 5569, Department of Environmental Sciences and Public Health, University of Montpellier I, 34000, Montpellier, France
| | - S Chiron
- Hydrosciences Montpellier UMR 5569, Department of Environmental Sciences and Public Health, University of Montpellier I, 34000, Montpellier, France
| | - E Gómez
- Hydrosciences Montpellier UMR 5569, Department of Environmental Sciences and Public Health, University of Montpellier I, 34000, Montpellier, France
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Téllez JP, Herrera S, Benito S, Giraldo BF. Analysis of the breathing pattern in elderly patients using the Hurst exponent applied to the respiratory flow signal. Annu Int Conf IEEE Eng Med Biol Soc 2015; 2014:3422-5. [PMID: 25570726 DOI: 10.1109/embc.2014.6944358] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Due to the increasing elderly population and the extensive number of comorbidities that affect them, studies are required to determine future increments in admission to emergency departments. Some of these studies could focus on the relation between chronic diseases and breathing pattern in elderly patients. Variations in the fractal properties of respiratory signals can be associated with several diseases. To determine the relationship between these variations and breathing patterns, and to quantify the fractal properties of respiratory flow signals, we estimated the Hurst exponent (H). Detrended fluctuation analysis (DFA) and discrete wavelet transform-based estimation (DWTE) methods were applied. The estimation methods were analyzed using simulated data series generated by fractional Gaussian noise. 43 elderly patients (19 patients with a non-periodic breathing pattern - nPB, and 24 patients with a periodic breathing pattern - PB) were studied. The results were evaluated according to the length of data and the number of averaged data series used to obtain a good estimation. The DWTE method estimated the respiratory flow signals better than the DFA method, and obtained Hurst values clustered by group. We found significant differences in the H exponent (p = 0.002) between PB and nPB patients, which showed different behavior in the fractal properties.
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