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Singh CK, Fernandez S, Chhabra G, Zaemisch GR, Nihal A, Swanlund J, Ansari N, Said Z, Chang H, Ahmad N. The role of collagen triple helix repeat containing 1 (CTHRC1) in cancer development and progression. Expert Opin Ther Targets 2024:1-17. [PMID: 38686865 DOI: 10.1080/14728222.2024.2349686] [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: 12/27/2023] [Accepted: 04/26/2024] [Indexed: 05/02/2024]
Abstract
INTRODUCTION Collagen triple helix repeat containing 1 (CTHRC1) is a protein that has been implicated in pro-migratory pathways, arterial tissue-repair processes, and inhibition of collagen deposition via the regulation of multiple signaling cascades. Studies have also demonstrated an upregulation of CTHRC1 in multiple cancers where it has been linked to enhanced proliferation, invasion, and metastasis. However, the understanding of the exact role and mechanisms of CTHRC1 in cancer is far from complete. AREAS COVERED This review focuses on analyzing the role of CTHRC1 in cancer as well as its associations with clinicopathologies and cancer-related processes and signaling. We have also summarized the available literature information regarding the role of CTHRC1 in tumor microenvironment and immune signaling. Finally, we have discussed the mechanisms associated with CTHRC1 regulations, and opportunities and challenges regarding the development of CTHRC1 as a potential target for cancer management. EXPERT OPINION CTHRC1 is a multifaceted protein with critical roles in cancer progression and other pathological conditions. Its association with lower overall survival in various cancers, and impact on the tumor immune microenvironment make it an intriguing target for further research and potential therapeutic interventions in cancer.
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Affiliation(s)
- Chandra K Singh
- Department of Dermatology, University of Wisconsin, Madison, WI, USA
| | - Sofia Fernandez
- Department of Dermatology, University of Wisconsin, Madison, WI, USA
| | - Gagan Chhabra
- Department of Dermatology, University of Wisconsin, Madison, WI, USA
| | | | - Ayaan Nihal
- Department of Dermatology, University of Wisconsin, Madison, WI, USA
| | - Jenna Swanlund
- Department of Dermatology, University of Wisconsin, Madison, WI, USA
| | - Naveed Ansari
- Department of Dermatology, University of Wisconsin, Madison, WI, USA
| | - Zan Said
- Department of Dermatology, University of Wisconsin, Madison, WI, USA
| | - Hao Chang
- Department of Dermatology, University of Wisconsin, Madison, WI, USA
- William S. Middleton VA Medical Center, Madison, WI, USA
| | - Nihal Ahmad
- Department of Dermatology, University of Wisconsin, Madison, WI, USA
- William S. Middleton VA Medical Center, Madison, WI, USA
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Knight JM, Ward MK, Fernandez S, Genberg BL, Beach MC, Ladner RA, Trepka MJ. Perceptions and Current Practices in Patient-Centered Care: A Qualitative Study of Ryan White HIV Providers in South Florida. J Int Assoc Provid AIDS Care 2024; 23:23259582241244684. [PMID: 38651291 PMCID: PMC11036924 DOI: 10.1177/23259582241244684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 02/12/2024] [Accepted: 03/07/2024] [Indexed: 04/25/2024] Open
Abstract
Background: Patient-centered care (PCC) improves HIV adherence and retention, though lack of consensus on its conceptualization and understanding how it is interpreted has hindered implementation. Methods: We recruited 20 HIV providers at Ryan White Programs in FL for in-depth interviews. Thematic analysis identified core consistencies pertaining to: 1) provider perceptions, 2) current practices promoting PCC. Results: Provider perceptions of PCC emerged under four domains: 1) holistic, 2) individualized care, 3) respect for comfort and security, and 4) patient engagement and partnership. PCC practices occurred at multiple levels: 1) individual psychosocial and logistical support, 2) interpersonal support within patient-provider relationships through respectful communication and active engagement, and 3) institutional practices including feedback mechanisms, service integration, patient convenience, and diverse staffing. Conclusions: Our findings highlight the central tenets of PCC as respectful, holistic, individualized, and engaging care. We offer an HIV-adapted framework of PCC as a multilevel construct to guide future intervention.
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Affiliation(s)
- Jennifer M. Knight
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Melissa K. Ward
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
- Research Center in Minority Institutions (RCMI), Florida International University, Miami, FL, USA
| | - Sofia Fernandez
- Research Center in Minority Institutions (RCMI), Florida International University, Miami, FL, USA
- School of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Becky L. Genberg
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | | | | | - Mary Jo Trepka
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
- Research Center in Minority Institutions (RCMI), Florida International University, Miami, FL, USA
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Llorente-Ortega M, Polo R, Chiva S, Martín-Calvo N, Sáenz-Santa-María E, Diez-Caballero F, Fernandez S. The development and validation of a new simulator for endourology. Actas Urol Esp 2023; 47:236-243. [PMID: 36731822 DOI: 10.1016/j.acuroe.2023.01.004] [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: 11/02/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Simulation in medicine has developed a lot in the last few decades. There is a broad range of simulators available, above all for training in surgical procedures. Endourology can benefit much from simulation because the minimally-invasive procedures of endourology frequently have long learning curves, which can be reduced by training with simulators. MATERIALS AND METHODS A low-fidelity simulator was designed for practicing endourology techniques that use cystoscopy. The process of validation involved 5 experts and 19 non-experts. Experts comprised medical professionals working in a department of urology who had performed at least 100 flexible cystoscopy procedures. Non-experts were residents in internal medicine without experience in any type of endoscopy. Information about face and content validity was collected by means of Likert scales from 1 to 5. To evaluate construct validity, we measured the time to complete two tasks, for which the procedure was evaluated by means of the OSATS global evaluation scale. RESULTS New simulator was successfully built according to its design. For all evaluated aspects of construct validity, there was a significant difference (p<0.05) between the group of experts and the group of non-experts. Content validity was scored 4.66 (standard deviation ±0.56) by the experts and 4.41 (±0.71) by the non-experts. In the face validity questionnaire, the average score was 4.14 (±0.94), the question receiving the highest score: 4.6 (±0.84) concerned immersion in the procedure. CONCLUSION The simulator presented is valid both for training up new urologists in endourology technique and for experts seeking to perfect their skills.
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Affiliation(s)
- M Llorente-Ortega
- Medical Engineering Laboratory, School of Medicine, Universidad de Navarra, Pamplona, Spain
| | - R Polo
- Faculty of Medicine, Universidad de Navarra, Pamplona, Spain
| | - S Chiva
- Department of Urology, Clínica Universidad de Navarra, Pamplona, Spain
| | - N Martín-Calvo
- Faculty of Medicine, Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona, Spain, CIBER-obn, Instituto Salud Carlos III, IdiSNA, Institute of Health Research of Navarra, Madrid, Spain
| | - E Sáenz-Santa-María
- Medical Engineering Laboratory, School of Medicine, Universidad de Navarra, Pamplona, Spain
| | - F Diez-Caballero
- Department of Urology, Clínica Universidad de Navarra, Pamplona, Spain
| | - S Fernandez
- Medical Engineering Laboratory, School of Medicine, Universidad de Navarra, Pamplona, Spain.
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Fatania K, Fernandez S, Shaw GC, Salvatore D, Teh I, Schneider JE, Murray L, Scarsbrook AF, Short SC, Currie S. P15.04.B Serial18F-fluciclovine PET-CT and multiparametric MRI during chemoradiation for glioblastoma - an exploratory clinical study with pre-clinical correlation. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Positron emission tomography (PET) using anti-1-amino-3-18fluorine-fluorocyclobutane-1-carboxylic acid (18F-fluciclovine) shows preferential glioma cell uptake with low activity in normal brain. Dynamic contrast-enhanced (DCE) MRI may also be used to investigate regions of glioma that do not show gadolinium-enhancement on post-contrast T1-weighted MR sequences (Gd-T1) and may reflect tumour infiltration beyond the Gd-T1 enhancing margin. There is a paucity of data on how 18F-fluciclovine uptake correlates with Gd-T1 and DCE-MRI activity, how it correlates with tumour biology and whether significant changes in uptake occur during treatment. The aims of this pilot study were: 1 To compare 18F-fluciclovine PET, DCE-MRI and Gd-T1 in patients undergoing chemoradiotherapy for glioblastoma (GBM) 2 To investigate correlation between 18F-fluciclovine uptake, MRI findings, and tumour biology in a pre-clinical glioma model.
Material and Methods
18F-fluciclovine-PET-CT and MRI including DCE-MRI were acquired before, during and after adjuvant chemoradiotherapy (60 Gy in 30 fractions with temozolomide) in GBM patients. DCE-MRI and Gd-T1 volumes were manually contoured, and PET volumes defined using semi-automatic thresholding. Gd-T1 was subtracted from PET and DCE-MRI volumes to identify areas beyond the Gd-T1 volume boundary and similarity of the PET and DCE-MRI volumes outside the Gd-T1 volume boundary were measured using the Dice similarity coefficient (DSC). CT-2A tumour cells were stereotactically injected into the right striatum of 8 to 10-week-old C57BL6J mice and they underwent MRI and 18F-fluciclovine PET-CT. Post-mortem mice brains underwent immunohistochemistry staining for ASCT2 (amino acid transporter), nestin (stemness) and Ki-67 (proliferation) to assess for biologically active tumour.
Results
6 patients were recruited (GBM 1-6). For GBM 1-3: PET volumes were greater than DCE-MRI, in turn greater than Gd-T1. For GBM 4-6, Gd-T1 volumes were similar to DCE-MRI and both were greater than PET volumes. GBM 1-3 had lower overall survival than GBM 4-6: median 249 vs. 903 days. 18F-fluciclovine uptake and Gd uptake (on DCE-MRI) was seen beyond the margins of the standard Gd-T1 volume. Comparing these regions beyond the Gd-T1 margins, the PET and DCE-MRI had low DSC, suggesting distinct areas of fluciclovine and DCE-MRI uptake. Pre-clinical PET-CT demonstrated tumour-specific 18F-fluciclovine uptake which corresponded to biologically active tumour based on immunostaining for Ki-67, nestin and ASCT2.
Conclusion
Results from this joint pre-clinical and clinical pilot study suggest volumes of 18F-fluciclovine-PET activity beyond that depicted by MRI-DCE and Gd-T1 are associated with a poorer prognosis in patients undergoing chemoradiotherapy for GBM. The pre-clinical model confirmed 18F-fluciclovine uptake reflected biologically active tumour.
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Affiliation(s)
- K Fatania
- Department of Radiology, Leeds Teaching Hospitals Trust , Leeds , United Kingdom
- Leeds Institute of Medical Research, University of Leeds , Leeds , United Kingdom
| | - S Fernandez
- Department of Clinical Oncology, Leeds Teaching Hospitals Trust , Leeds , United Kingdom
| | - G C Shaw
- Leeds Institute of Medical Research, University of Leeds , Leeds , United Kingdom
| | - D Salvatore
- Department of Pathophysiology and Transplantation, University of Milan , Segrate , Italy
| | - I Teh
- Biomedical Imaging Science Department, and Discovery & Translational Science Department , Leeds , United Kingdom
| | - J E Schneider
- Biomedical Imaging Science Department, and Discovery & Translational Science Department , Leeds , United Kingdom
| | - L Murray
- Leeds Institute of Medical Research, University of Leeds , Leeds , United Kingdom
- Department of Clinical Oncology, Leeds Teaching Hospitals Trust , Leeds , United Kingdom
| | - A F Scarsbrook
- Department of Radiology, Leeds Teaching Hospitals Trust , Leeds , United Kingdom
- Leeds Institute of Medical Research, University of Leeds , Leeds , United Kingdom
| | - S C Short
- Leeds Institute of Medical Research, University of Leeds , Leeds , United Kingdom
- Department of Clinical Oncology, Leeds Teaching Hospitals Trust , Leeds , United Kingdom
| | - S Currie
- Department of Radiology, Leeds Teaching Hospitals Trust , Leeds , United Kingdom
- Leeds Institute of Medical Research, University of Leeds , Leeds , United Kingdom
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Sandoval E, Moreno-Castaño A, Pino M, Pereda D, Samanbar S, Pruna-Guillen R, Fernandez S, Roman J, Gomez V, Muro A, Castro P, Escolar G, Diaz-Ricart M. Primary Hemostasis Defect Due to Acquired Von Willebrand Disease and Platelet Activation During Extracorporeal Life Support. In Vitro Correction by Purified VWF. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1529] [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: 11/30/2022] Open
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Espejo C, Mejia-Renteria H, Travieso A, Gonzalo N, Fernandez S, Capote ML, Vedia O, Wang L, Nunez-Gil I, Grande Ingelmo JM, Fernandez Rozas I, Olmos C, Vivas D, Escaned J. Myocardial ischaemia of non-obstructive origin as a cause of new onset anginal chest pain in the long COVID syndrome. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1078] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
New-onset chest pain occurs in around 20% of patients with long COVID syndrome (LCS). Being the vascular endothelium one of the targets of the SARS-CoV-2 virus, we hypothesized that new onset anginal symptoms in LCS could be due to endothelium dysfunction and other non-obstructive causes of myocardial ischaemia.
Methods
We investigated 11 consecutive patients who developed new onset anginal chest pain, suggestive of myocardial ischaemia, after documented SARS-CoV-2 infection. Intracoronary assessment included endothelium-dependent evaluation with acetylcholine testing (Ach), and endothelium-independent assessment with coronary flow reserve (CFR) and microcirculatory resistance (MR). Criteria for positiveness of these tests and medical treatment recommendation were obtained from 2019 ESC guidelines and 2020 EAPCI consensus document on ischaemia with non-obstructive coronary arteries (INOCA).
Results
Mean patient age was 56 years (SD ± 15); 10 (91%) were female. In the acute COVID-19 phase, 4 patients (36%) had had pulmonary infiltrates and 2 (18%) required hospitalization. Conclusive non-invasive tests were obtained in 7 (64%), showing exercise-related myocardial ischaemia in 6 (86%). Coronary angiography ruled out obstructive epicardial stenoses in all the patients. Ach testing revealed abnormal endothelium-dependent responses in 9 (82%) patients: 5 (56%) had epicardial vessel and 4 (44%) microvascular spasm. Endothelium-independent assessment was abnormal in 6 (54%) cases, with abnormal CFR in 2 (33%), abnormal MR in 2 (33) and both abnormal CFR and MR in 2 (33%) patients. The most frequent endotype was combined endothelium dependent- and independent abnormalities (6/9, 67%). Stratified medical treatment according to endotype led to significant improvement in Seattle Angina Scores for angina frequency (+22 points, p=0.013) and a notable trend towards angina stability (+25 points, p=0.093) at a mean follow-up time of 222 days.
Conclusions
Myocardial ischaemia of non-obstructive origin is common in patients with chest pain and LCS. Vasomotor abnormalities related to endothelial dysfunction occurred in 82% of patients, frequently associated to impaired microvascular vasodilation or high microvascular resistance. Stratified medical treatment led to significant improvement in angina stability and frequency.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- C Espejo
- Hospital Clinico San Carlos, Madrid, Spain
| | | | - A Travieso
- Hospital Clinico San Carlos, Madrid, Spain
| | - N Gonzalo
- Hospital Clinico San Carlos, Madrid, Spain
| | | | - M L Capote
- Hospital Clinico San Carlos, Madrid, Spain
| | - O Vedia
- Hospital Clinico San Carlos, Madrid, Spain
| | - L Wang
- Hospital Clinico San Carlos, Madrid, Spain
| | | | | | | | - C Olmos
- Hospital Clinico San Carlos, Madrid, Spain
| | - D Vivas
- Hospital Clinico San Carlos, Madrid, Spain
| | - J Escaned
- Hospital Clinico San Carlos, Madrid, Spain
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Eguibar A, Portilla MA, Mainez JA, Lopez-Tello J, Cansino R, Fernandez S. Penile granulomas after BCG instillations. A case report and review of literature. Urol Case Rep 2021; 38:101716. [PMID: 34040990 PMCID: PMC8144351 DOI: 10.1016/j.eucr.2021.101716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 05/05/2021] [Accepted: 05/11/2021] [Indexed: 11/25/2022] Open
Abstract
Penile granulomas has been rarely reported in the setting of BCG instillations. We present a 70 year-old male with multiple penile granulomas during BCG instillations due a high-grade urothelial bladder cancer. Histopathological study revealed granulomatous structures with central necrosis as seen after BCG therapy. Local treatment with cryotherapy has been shown to be effective. This case emphasizes the importance to suspect this adverse effect in patients under BCG treatment.
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Affiliation(s)
- A Eguibar
- Department of Urology, Quironsalud, Madrid, Spain
| | - M A Portilla
- Department of Urology, Quironsalud, Madrid, Spain
| | - J A Mainez
- Department of Urology, Quironsalud, Madrid, Spain
| | | | - R Cansino
- Department of Urology, Quironsalud, Madrid, Spain
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Pandey K, Dumre SP, Dhimal M, Pun SB, Shah Y, Fernandez S, Morita K, Pandey BD. The Double Burden of COVID-19 and Dengue in Nepal: The challenges ahead. Kathmandu Univ Med J (KUMJ) 2021; 19:140-142. [PMID: 34812173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Coronavirus disease 2019 (COVID-19) pandemic has caused significant impact on the health care system. As a consequence, diagnosis and treatment of vector borne diseases including dengue has been equally affected. Nepal is no exception to this, where COVID-19 cases is exponentially increased and all resources are concentrated on its prevention, control and management. Dengue, one of the major vector-borne diseases in Nepal, is apparently overlooked despite approaching the peak season of the disease. The aim of this paper is to describe the double burden of COVID-19 and dengue in Nepal, particularly highlighting the co-circulation and possible coinfections. This has posed higher risk of increased severity, more severe cases and deaths in Nepal. Moreover, potential misdiagnosis of these viral diseases may lead to delayed or, inappropriate treatment and poor allocation of resources.
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Affiliation(s)
- K Pandey
- Central Department of Zoology, Tribhuvan University, Kirtipur, Nepal
| | - S P Dumre
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Nepal
| | - M Dhimal
- Nepal Health Research Council, Kathmandu, Nepal
| | - S B Pun
- Sukraraj Tropical and Infectious Diseases Hospital, Kathmandu, Nepal
| | - Y Shah
- Everest International Clinic and Research Center, Kathmandu, Nepal
| | - S Fernandez
- Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand
| | - K Morita
- Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan
| | - B D Pandey
- Ministry of Health and Population, Government of Nepal, Kathmandu, Nepal
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Fernandez S, Beasley M, Lilley J, Murray L, Short SC. Establishing a Link Between Commonly Reported Toxicities and Tumour Location in Brain Tumour Patients Treated With Volumetric-modulated Arc Radiotherapy. Clin Oncol (R Coll Radiol) 2021; 33:e97-e98. [PMID: 33020010 DOI: 10.1016/j.clon.2020.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 09/18/2020] [Indexed: 11/28/2022]
Affiliation(s)
- S Fernandez
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - M Beasley
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - J Lilley
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - L Murray
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - S C Short
- Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Karwal L, Nascimento E, Demaso C, Sharma M, Fernandez S, de Silva D, Dean H. Impact of dengue virus genetic diversity on breadth of neutralization by a tetravalent dengue vaccine. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.1265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Wilbanks T, Zimmerman R, Julius S, Kirshen P, Smith J, Moss R, Solecki W, Ruth M, Conrad S, Fernandez S, Matthews M, Savonis M, Scarlett L, Schwartz H, Toole L. Toward indicators of the performance of US Infrastructures under climate change risks. Clim Change 2020; 163:1795-1813. [PMID: 33867603 PMCID: PMC8048114 DOI: 10.1007/s10584-020-02942-9] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 11/05/2020] [Indexed: 06/12/2023]
Abstract
Built infrastructures are increasingly disrupted by climate-related extreme events. Being able to monitor what climate change implies for US infrastructures is of considerable importance to all levels of decision-makers. A capacity to develop cross-cutting, widely applicable indicators for more than a dozen different kinds of infrastructure, however, is severely limited at present. The development of such indicators must be considered an ongoing activity that will require expansion and refinement. A number of recent consensus reports suggest four priorities for indicators that portray the impacts of climate change, climate-related extreme events, and other driving forces on infrastructure. These are changes in the reliability of infrastructure services and the implications for costs; changes in the resilience of infrastructures to climate and other stresses; impacts due to the interdependencies of infrastructures; and ongoing adaptation in infrastructures.
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Affiliation(s)
- T Wilbanks
- Oak Ridge National Laboratory, Oak Ridge, USA
| | | | - S Julius
- US Environmental Protection Agency, Washington, DC, USA
| | - P Kirshen
- University of Massachusetts, Boston, MA, USA
| | - J Smith
- Abt Associates, Boulder, CO USA
| | - R Moss
- Princeton University, Princeton, NJ, USA
| | - W Solecki
- Hunter College, CUNY, New York, NY, USA
| | - M Ruth
- University of York, York, United Kingdom
| | - S Conrad
- Sandia National Laboratories, Albuquerque, NM, USA
| | | | - M Matthews
- US Department of Homeland Security, Washington, DC, USA
| | - M Savonis
- ICF International, Washington, DC, USA
| | - L Scarlett
- The Nature Conservancy, Arlington, VA, USA
| | - H Schwartz
- HGS Consultants LLC, Saint Louis, MO, USA
| | - L Toole
- Los Alamos National Laboratory, Los Alamos, NM, USA
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Garrido-Torres N, Fernandez S, Rodríguez A, Reina M, Prieto I, Viedma A, González C, Hernandez L. Antipsychotics and women: Yes, prolactin is important. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2016.01.2331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
IntroductionThe hormonal imbalance produced by antipsychotics can be detected by symptoms, such as: infertility, acne, hirsutism, sexual dysfunction and galactorrhea. We consider especially important the study of women's diseases, which may develop due to hyperprolactinemia, specifically: breast cancer, endometrial cancer and osteoporosis.ObjectiveTo undertake a systematic review about the relationship between hyperprolactinemia as a result of the treatment with antipsychoticsand endometrial and breast cancer.MethodAn exhaustive search was performed on PUBMED and COCHRANE (from 2006 to 2015).Fifteen papers were selected including comparative studies, clinical trials and clinical reviews.ResultsWith respect to endometrial carcinoma, there is no direct relationship with the use of antipsychotics. However, most papers have suggested that the blood prolactin elevation is a risk factor in the development of endometrial engrossment, which could lead to endometrial hyperplasia, polyps and endometrial cancer. Related to the use of antipsychotics as a treatment for schizophrenic women and breast carcinoma, a significant association was found and this association is strengthened through the interaction of other factors like the fact that women with schizophrenia are less worried about going to the clinical screening reviews in their health centre, smoking, and lower physical activity than healthy women.ConclusionsAripiprazolis associated with a low prevalence of hyperprolactinemia. Menopausal women, the obese, and women who smoke receiving antipsychotics that produce hyperprolactinemia have the greatest risk of developing endometrial pathology. Schizophrenic women with hyperprolactinemia due to antipsychotics and loss of motivation to go to screening activities have a greater risk of breast cancer. Sexual dysfunction could be a non-adherence treatment factor.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Fernandez S, Fernández P, Fernandez S, Fernández C. SUN-449 PATIENT WITH FABRY DISEASE IN CHRONIC HEMODIALYSIS FOR 7 YEARS AND 9 YEARS OF ENZYME REPLACEMENT THERAPY (ERT) IN TOTAL. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.990] [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: 11/30/2022] Open
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Banda A, Cohen E, Lynskey G, Fernandez S, Hsu C, Kim A. 4:12 PM Abstract No. 325 Transjugular intrahepatic portosystemic shunt improves liver function in patients with alcohol-induced cirrhosis. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Powell JR, Murray L, Burnet NG, Fernandez S, Lingard Z, McParland L, O'Hara DJ, Whitfield GA, Short SC. Patient Involvement in the Design of a Randomised Trial of Proton Beam Radiotherapy Versus Standard Radiotherapy for Good Prognosis Glioma. Clin Oncol (R Coll Radiol) 2019; 32:89-92. [PMID: 31607613 DOI: 10.1016/j.clon.2019.09.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/02/2019] [Accepted: 08/14/2019] [Indexed: 11/12/2022]
Affiliation(s)
- J R Powell
- Department of Oncology, Velindre University NHS Trust, Cardiff, UK.
| | - L Murray
- St James's Hospital and Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - N G Burnet
- Division of Cancer Sciences, Manchester Cancer Research Centre, University of Manchester, Manchester, UK; Department of Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - S Fernandez
- Clinical Trials Research Unit, Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Z Lingard
- Division of Cancer Sciences, Manchester Cancer Research Centre, University of Manchester, Manchester, UK
| | - L McParland
- Department of Oncology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - D J O'Hara
- Clinical and Health Psychology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - G A Whitfield
- Division of Cancer Sciences, Manchester Cancer Research Centre, University of Manchester, Manchester, UK; Department of Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | - S C Short
- St James's Hospital and Leeds Institute of Medical Research, University of Leeds, Leeds, UK
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Abstract
Abstract
Introduction
Traditional risk factors for coronary heart disease have been reported in around 85% patients who present with myocardial infarction. More recently, inflammation and immune mediated diseases have been associated with ischemic heart disease.
Inflammatory Bowel Disease (IBD) is an immune mediated disorder which comprises of ulcerative colitis and Crohn's disease. Estimated prevalence of IBD in the United States in 2004 was 1.4 million people. These patients have an overall increased risk of thrombotic complications with microvascular thrombosis hypothesized to contribute in disease pathogenesis.
Results from a recent meta-analysis were consistent with increased risk of ischemic heart disease among IBD patients, with risk greater in females and younger patients, although heterogeneity was considerable in overall data. Also, in a recent study, IBD was found to be associated with an increased risk of acute myocardial infarction and heart failure despite lower prevalence of coronary risk factors in IBD patients.
IBD pathogenesis involves sustained activation of immune responses with upregulation of cytokines including but not limited to IL-1 beta, IL-6 and TNF-alpha. Upregulation of these cytokines has also been reported in coronary atherosclerosis.
Based on above information, we explored incidence of MACE (Major Adverse Cardiac Event) in this patient population from our health system data-base.
Methods
Propensity scores were estimated for all 15,292 (0.4%) patients with inflammatory bowel disease from a total patient pool of 3,917,894 patients in our health system to assemble a 1:1 matched cohort balanced for age, gender, race and known cardiovascular risk factors including hypertension, hyperlipidemia, diabetes mellitus and smoking (current and former). ICD-9 and ICD-10 codes were used to identify cardiovascular risk factors and outcomes.
Results
Matched patients (n=30,584) had a mean age of 51 years, with 58% of all being women, and 63% Caucasian. During the median follow up of 4.4 years all-cause mortality was observed in 1.7% and 1.2% of patients from IBD and non-IBD groups respectively (hazard ratio {HR}, 1.31; 95% confidence interval {CI}, 1.08–1.58; p=0.005). Combined outcome for myocardial infarction or all-cause mortality was noted in 4.1% and 3.4% from IBD and non-IBD groups respectively (HR, 1.16; 95% CI, 1.03–1.30; p=0.014) while HRs for cardiovascular mortality, myocardial infarction and unstable angina independently were 1.04 (0.74–1.47; p=0.833), 1.05 (0.89–1.23; p=0.591) and 1.10 (0.83–1.46; p=0.524) respectively.
Conclusion
Inflammatory bowel disease did not show association with myocardial infarction, cardiovascular mortality or unstable angina when matched for known cardiovascular risk factors, but was associated with increased all-cause mortality and combined end-point of all-cause mortality or myocardial infarction.
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Affiliation(s)
- G Gill
- Washington Hospital Center, Washington, United States of America
| | - S Fernandez
- Medstar Research Institute, Washington, United States of America
| | - M Soud
- Washington Hospital Center, Washington, United States of America
| | - M Mete
- Medstar Research Institute, Washington, United States of America
| | - N Malhotra
- Washington Hospital Center, Washington, United States of America
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Rincon LM, Sanmartin M, Alonso GL, Rodriguez JA, Muriel A, Casas E, Navarro M, Carbonell A, Lazaro C, Fernandez S, Jimenez Mena M, Fernandez Golfin C, Esteban A, Garcia Bermejo ML, Zamorano JL. P1551A genetic risk score predicts recurrent events after myocardial infarction in young adults. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
To evaluate whether a genetic risk score (GRS) improves the prediction of recurrent events in young non-diabetic patients presenting with an acute myocardial infarction and identifies a more aggressive form of atherosclerosis in this population.
Methods and results
We performed a prospective study including 81 consecutive non-diabetic patients aged below 55 y.o. presenting with an acute myocardial infarction (48±6 y.o., 89% male). A comprehensive study including serum biomarkers, genetic testing and cardiac CT was performed. We studied the association of a GRS composed of 11 genetic variants with a primary composite end-point (all-cause mortality, recurrent acute coronary syndrome, and cardiac re-hospitalisation). After a median follow-up of 4.1 (3.5 - 4.4) years 24 recurrent events were documented. A significantly higher prevalence of 9 out of 11 risk alleles was noted compared with general population. The GRS was significantly associated with recurrent events, especially when baseline LDL-cholesterol levels were elevated. Compared with the low-risk GRS category, the multivariate-adjusted hazard ratio for recurrent events for the intermediate-risk GRS category was 10.2 (95% CI 1.1–100.3, p=0.04) and for the high-risk GRS was 20.7 (2.4–181.0, p=0.006) when LDL-C ≥2.8 mmol/L. Inclusion of the GRS improved the C statistic (ΔC statistic =0.086), the continuous Net Reclassification Index (30%) and the Integrated Discrimination Improvement (0.05) compared with a multivariate clinical risk model. Cardiac CT detected coronary calcified atherosclerosis and numerous plaques but it had a limited value for prediction of recurrences. No association was observed between extracellular matrix metabolism biomarkers and GRS or recurrent events in this population.
Cox regression analysis between GRS terciles and LDL-C Univariate analysis Multivariate analysis* HR (95% CI) p-value HR (95% CI) p-value* Low GRS 1 1 Intermediate GRS 2.0 (0.7–5.8) 0.21 LDL-C≤110 mg/dL (≤2.8 mmol/L) 1.0 (0.3–4.0) >110 mg/dL (>2.8 mmol/L) 10.2 (1.1–100.3) 0.04 High GRS 3.0 (1.0–9.2) 0.05 LDL-C≤110 mg/dL (≤2.8 mmol/L) 0.3 (0.1–1.9) >110 mg/dL (>2.8 mmol/L) 20.7 (2.4–181.0) 0.006 *Multivariate model adjusted for GRACE risk score and LDL-C and interaction. There was a strong interaction between GRS terciles and LDL-C (p<0.01).
Recurrent events based on genetic risk
Conclusions
A multilocus genetic risk score identified non-diabetic young patients at increased risk for recurrent events after a myocardial infarction. The significance of LDL-cholesterol in relation to genetic predisposition for recurrences merits further evaluation.
Acknowledgement/Funding
Instituto de Salud Carlos III (PI12/0564, PI14/01152 and PI15/00667), the CIBERCV and the Spanish Society of Cardiology (2015/CC)
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Affiliation(s)
- L M Rincon
- University Hospital Ramon y Cajal, Madrid, Spain
| | - M Sanmartin
- University Hospital Ramon y Cajal, Madrid, Spain
| | - G L Alonso
- University Hospital Ramon y Cajal, Madrid, Spain
| | - J A Rodriguez
- Center for Applied Medical Research, Pamplona, Spain
| | - A Muriel
- Instituto Ramon y Cajal de Investigacion Sanitaria (IRYCIS), Madrid, Spain
| | - E Casas
- University Hospital Ramon y Cajal, Madrid, Spain
| | - M Navarro
- University Hospital Ramon y Cajal, Madrid, Spain
| | - A Carbonell
- University Hospital 12 de Octubre, Madrid, Spain
| | - C Lazaro
- Hospital Torrejόn, Madrid, Spain
| | - S Fernandez
- University Hospital Ramon y Cajal, Madrid, Spain
| | | | | | - A Esteban
- University Hospital Ramon y Cajal, Madrid, Spain
| | - M L Garcia Bermejo
- Instituto Ramon y Cajal de Investigacion Sanitaria (IRYCIS), Madrid, Spain
| | - J L Zamorano
- University Hospital Ramon y Cajal, Madrid, Spain
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18
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Sillero I, lopetegui lia N, Gonzalez P, Sánchez-Cousido L, López Flores M, Rojas Piedra M, Medina S, López González A, Pedraza Lorenzo M, Rodríguez Sánchez Á, Nieto Mangudo B, Castañón González C, De Sande L, Diz Tain P, García-Palomo A, Fernandez S, Ramos F, Escalante F. Diffuse large B cell lymphoma in the elderly. A retrospective analysis of standard versus alternative treatments. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz251.012] [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: 11/14/2022] Open
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Garcia Torralba E, Castellano Gauna D, Sobrevilla N, Guma J, Luengo M, Aparicio J, Sanchez-Muñoz A, Mellado B, Saenz A, Valverde C, Fernández A, Margeli M, Duran I, Fernandez S, Sastre J, Ros S, Maroto P, Aguilar J, Garcia del Muro X, Gonzalez Billalabeitia E. Prognosis of anaemia in disseminated testicular germ cell tumours. On behalf of the Spanish Germ Cell Cancer Group (SGCCG). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz249.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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20
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Bobot M, Hache G, Fernandez S, Balasse L, Brige P, Chopinet S, Thomas L, Mckay N, Burtey S, Guillet B. L’atteinte cognitive est associée à une rupture de la barrière hémato-encéphalique et aux concentrations d’indoxyl sulfate dans deux modèles de maladie rénale chronique chez le rat. Nephrol Ther 2019. [DOI: 10.1016/j.nephro.2019.07.298] [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: 10/26/2022]
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21
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Fernandez S. 7ESSENTIAL PHARMACY ROLE IN POLYPHARMACY REVIEW AND DEPRESCRIBING FOR FRAIL OLDER PATIENTS. Age Ageing 2019. [DOI: 10.1093/ageing/afz055.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S Fernandez
- Royal Gwent Hospital Pharmacy Department, Newport
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22
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Benito J, Fernandez S, Gendive M, Santiago P, Perez-Garay R, Arana-Arri E, Mintegi S. A new clinical score to identify children at low risk for appendicitis. Am J Emerg Med 2019; 38:554-561. [PMID: 31171439 DOI: 10.1016/j.ajem.2019.05.050] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 05/17/2019] [Accepted: 05/27/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Besides clinical signs and imaging, in recent years, biomarkers have proven to be a viable diagnostic resource for acute appendicitis (AA). OBJECTIVE The objective of this study was to develop a clinical score including clinical signs and a combination of biomarkers to identify children with abdominal pain at low risk of AA. DESIGN/METHODS We prospectively included children 2 to 14 years of age with abdominal pain suggestive of AA who presented to the emergency department between July 2016 and September 2017. A new score, the Pediatric Appendicitis Laboratory Score (PALabS) including clinical signs, leucocyte (WBC) and neutrophil (ANC) counts and plasma C-reactive protein (CRP) and calprotectin (CP) levels was developed and validated through secondary analyses of two distinct cohorts The validation sample included visits to a single pediatric emergency department from 2012 to 2013 and 2016 to 2017. RESULTS The derivation sample included 278 children, 35.9% of whom had AA and the validation sample included 255 children, 49% of whom had AA. Using logistic regression, we created a 6-part score that consisted of nausea (3 points), history of focal right lower quadrant pain (4 points), ANC of ≥7500/μL (7 points), WBC of ≥10,000/μL (4 points), CRP ≥ 10.0 mg/L (2 points) and CP ≥ 0.50 ≥ ng/mL (3 points). This score exhibited a high discriminatory power (area under the curve: 0.88; 95% confidence interval: 0.84 to 0.92) and outperformed the PAS and Kharbanda scores (area under the curve: 0.76; 95% confidence interval: 0.71 to 0.82 and 0.82; 95% confidence interval: 0.77 to 0.87, respectively). A PALabS ≤6 had a sensitivity of 99.2% (95% confidence interval [CI]: 95.6-99.9), negative predictive value of 97.6% (95% CI: 87.7-99.6), and negative likelihood ratio of 0.03 (95% CI: 0.00-0.18) in the validation set. CONCLUSION In our validation cohort of patients with acute abdominal pain, the new score can accurately predict which children are at low risk of appendicitis and could be safely managed with close observation.
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Affiliation(s)
- J Benito
- Pediatric Emergency Department, BioCruces Bizkaia Health Research Institute, Bilbao, Basque Country, Spain.
| | - S Fernandez
- Pediatric Emergency Department, BioCruces Bizkaia Health Research Institute, Bilbao, Basque Country, Spain
| | - M Gendive
- Pediatric Emergency Department, BioCruces Bizkaia Health Research Institute, Bilbao, Basque Country, Spain
| | - P Santiago
- Pediatric Emergency Department, BioCruces Bizkaia Health Research Institute, Bilbao, Basque Country, Spain
| | - R Perez-Garay
- Department, Laboratory, BioCruces Bizkaia Health Research Institute, Bilbao, Basque Country, Spain
| | - E Arana-Arri
- Department of Epidemiologic Unit, Cruces University Hospital, BioCruces Bizkaia Health Research Institute, Bilbao, Basque Country, Spain
| | - S Mintegi
- Pediatric Emergency Department, BioCruces Bizkaia Health Research Institute, Bilbao, Basque Country, Spain
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Fernandez S, Garcia A, Vethencourt A, Vazquez S, Petit A, Pla MJ, Ortega R, Pérez J, Gil M, Ponce J, Pernas S, Lopez A, Falo C. Abstract P2-08-58: Prognostic factors of survival in node positive breast cancer patients after neoadjuvant chemotherapy in a large series after 5y follow-up: Can response overcome the poor prognosis of nodal stage? Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-08-58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Status of the axilla is one of the most significant prognostic factors in breast cancer (BC) patients. On the other hand, response to neoadjuvant chemotherapy (NACT) is related to survival. The aim of the present study is to analyze which prognostic factors impact most on Node positive (N+) BC patient survival after NATC. Material and methods: Retrospective analyses on a series of N+ BC patients treated with NATC based on anthracyclines and taxanes +/- trastuzumab if HER2 positive tumors, between June 2008 and December 2016. Clinical, radiological and pathological outcomes have been evaluated. Residual cancer burden (RCB) 1 and the neoadjuvant response index (INR) 2 have been recorded. Survival was calculated with Kaplan-Meier survival curve since the start of NATC to the first documented disease recurrence (DFS) or death (OS). Hazard ratios (HRs) with 95% CIs were estimated with cox proportional hazards regression analysis and subgroups were compared with a two-sided log-rank test. Results: A total of 345 N+ BC patients were included. Pathological complete response was achieved in 72 (20.8%) patients. After NACT, 137 (39.6%) become ypN0, 9 (2.6%) ypN1 mic, 113 (32.7%) ypN1, 60 (17.3%) ypN2 and 26 (7.6%) N3. Those independent predictive factor of ypN0 were molecular subtype (TN and Her2+) with OR: 7.7, p<0.001 and clinical response with OR 6.88, p: 0.04. At a mean follow-up of 58 months there have been 73 (21.1%) recurrences: 9 (2.3%) local, 45 (13%) systemic, 15 (4.3%) systemic+ local, 3 (0.9%) axilla, 1 (0.3%) supraclavicular. The estimated 5y OS was 87.8%. The univariate analysis according to DSF is detailed in Table1.
Adjusted univariate anaalysis cox regression of clinical and pathological factors of desease free survivalBMI10.989-1.010.963AGE0.9960.953-1.0420.876Dose NATC0.9940.979-1.0080.402Clinical Stage1.4021.077-1.8260.012Rx Image1.260.803-1.9940.311Rx size1.0090.995-1.0240.217Number suspicious ALN1.0950.801-1.4970.57Molecular subtype TN,HER20.8800.534-1.450.616Nottinghan grade1.0460.753-1.4530.789Histological subtype1.4651.044-2.0570.27MOlecular subtype1.1510.956-1.3850.137Vascular invasion1.6761.137-24710.009Clinical response2.3691.709-3.284<0.001Fibrosis tumor bed0.980.972-0.989<0.001Nodal fibrosis>50%1.7950.874-3.6860.111Pathological tumoral response1.6861.175-2.4180.005ypN03.561.853-6.838<0.001NRI0.330.192-0.565<0.001RCB1.2741.106-1.4680.001
In the multivariate model those parameters that were independently prognostic were clinical response HR: 5.44 (IC95% 2.275-13.042, p<0.001) and clinical stage HR: 2.364 (IC95% 1.018-5.490, p: 0.045). Conclusions: The most significant prognostic factor in our N+ series was response to NATC, followed by clinical stage. Those independently predictive factors of axillar response (ypN0) were molecular subtype (TN and Her2+) and clinical response. In conclusion, in those patients with chemo sensitive tumors, lymphadenectomy could be safely spared with a more selective axillary approach.
Citation Format: Fernandez S, Garcia A, Vethencourt A, Vazquez S, Petit A, Pla MJ, Ortega R, Pérez J, Gil M, Ponce J, Pernas S, Lopez A, Falo C. Prognostic factors of survival in node positive breast cancer patients after neoadjuvant chemotherapy in a large series after 5y follow-up: Can response overcome the poor prognosis of nodal stage? [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-58.
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Affiliation(s)
- S Fernandez
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - A Garcia
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - A Vethencourt
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - S Vazquez
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - A Petit
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - MJ Pla
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - R Ortega
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - J Pérez
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - M Gil
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - J Ponce
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - S Pernas
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - A Lopez
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
| | - C Falo
- Hospital Universitari de Bellvitge, Hospitalet, Barcelona, Spain; Institut Català d'Oncologia, Hospitalet, Barcelona, Spain
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Hunsawong T, Suthangkornkul R, Ong-Ajchaowlerd P, Thaisomboonsuk B, Klungtong C, Poolpanichupatam Y, Phonpakobsin T, Macareo L, Srikiatkhachorn A, Fernandez S, Ellison D. Potential immune-mediated genes expression induced by dengue antibodies enhance zika virus infection in THP-1 cell line. Int J Infect Dis 2019. [DOI: 10.1016/j.ijid.2018.11.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Demircioglu G, Mirza A, Fernandez S, Morgenstern J, Murray A, Haas J, Oliveri M, Aime S, Blacksburg S. Addressing Billing Errors: Results of a Prospective Quality Assurance Initiative to Optimize the Accuracy of Radiation Oncology Patient Charges. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Martín M, de la Torre-Montero JC, López-Tarruella S, Pinilla K, Casado A, Fernandez S, Jerez Y, Puente J, Palomero I, González Del Val R, Del Monte-Millan M, Massarrah T, Vila C, García-Paredes B, García-Sáenz JA, Lluch A. Persistent major alopecia following adjuvant docetaxel for breast cancer: incidence, characteristics, and prevention with scalp cooling. Breast Cancer Res Treat 2018; 171:627-634. [PMID: 29923063 PMCID: PMC6133184 DOI: 10.1007/s10549-018-4855-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 06/13/2018] [Indexed: 11/29/2022]
Abstract
Background Persistent alopecia (PA) after docetaxel has been recently described. The aim of our study is to establish the incidence and characteristics of PA following adjuvant docetaxel for breast cancer (BC) and to test the ability of scalp cooling in prevention. Patients and methods BC patients receiving adjuvant chemotherapy followed or not by endocrine therapy (and a control group receiving only endocrine therapy) were interviewed in a single institution at 1.5 to 5 years following primary diagnosis searching for PA. A confirmatory prevalence study was later performed in other two institutions. Finally, a prevention study using prophylactic scalp cooling (PSC) with ELASTO-GEL hypothermia caps in patients receiving adjuvant docetaxel was performed. Results In the initial prevalence study (492 patients), minor forms of PA (grade 1) were recorded with all chemotherapy regimens and aromatase inhibitors. Patients receiving docetaxel regimens at cumulative dose (CD) ≥ 400 mmg/m2 presented a significantly higher prevalence of grades 1 PA (33–52%) and 2 PA (5–12%). Prevalence of grade 2 PA with docetaxel CD ≥ 400 mmg/m2 was confirmed in two other institutions. Overall, grade 2 PA was seen in 10.06% (95% CI 7.36–13.61) of 358 patients with docetaxel regimens reaching CD ≥ 400 mmg/m2, but not in patients with lower docetaxel CD, other chemotherapy regimens, or endocrine therapy alone. In prevention trial, no grade 2 PA occurred among 116 patients receiving adjuvant docetaxel (≥ 400 mmg/m2) and PSC followed-up after a 96 months median time. PSC was well tolerated. No scalp relapses were seen among 30 patients (22% of all inclusions) having disease relapse. Conclusion Adjuvant treatment with docetaxel (CD ≥ 400 mmg/m2) is associated with a significant rate of grade 2 PA, leading to wearing a wig, in around 10% of patients. This toxicity was completely prevented with scalp cooling. Clinical Trial Reference: NCT00515762. Electronic supplementary material The online version of this article (10.1007/s10549-018-4855-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- M Martín
- Medical Oncology Service, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, GEICAM, Universidad Complutense, Madrid, Spain. .,Hospital General Universitario Gregorio Marañón, Medical Oncology Service, Calle Maiquez, no. 9, 28007, Madrid, Spain.
| | - J C de la Torre-Montero
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), CIBERONC, Madrid, Spain.,Universidad Pontificia Comillas, Madrid, Spain
| | - S López-Tarruella
- Medical Oncology Service, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, Madrid, Spain
| | - K Pinilla
- Medical Oncology Department, Hospital Clínico Universitario, CIBERONC, Valencia, Spain
| | - A Casado
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), CIBERONC, Madrid, Spain
| | - S Fernandez
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), CIBERONC, Madrid, Spain.,Medical Oncology Service, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, Madrid, Spain
| | - Y Jerez
- Medical Oncology Service, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, Madrid, Spain
| | - J Puente
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), CIBERONC, Madrid, Spain
| | - I Palomero
- Medical Oncology Service, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, Madrid, Spain
| | - R González Del Val
- Medical Oncology Service, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, Madrid, Spain
| | - M Del Monte-Millan
- Medical Oncology Service, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, Madrid, Spain
| | - T Massarrah
- Medical Oncology Service, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERONC, Madrid, Spain
| | - C Vila
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), CIBERONC, Madrid, Spain
| | - B García-Paredes
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), CIBERONC, Madrid, Spain
| | - J A García-Sáenz
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), CIBERONC, Madrid, Spain
| | - A Lluch
- Medical Oncology Department, Hospital Clínico Universitario, CIBERONC, Valencia, Spain
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Rivero Viera Y, Esparza Martin N, Suria Gonzalez S, Bosch Benitez-Parodi E, Guerra Rodriguez R, Ramirez Puga A, Rodenas Galvez AC, Fernandez S, Perez Suarez G, Garcia-Canton C. P382Factors related to cardiovascular event after two years of follow-up of stage 3 chronic kidney disease patient's. Cardiovasc Res 2018. [DOI: 10.1093/cvr/cvy060.291] [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: 11/14/2022] Open
Affiliation(s)
- Y Rivero Viera
- University Hospital Insular of Gran Canaria, Nephrology, Las Palmas De Gran Canaria, Spain
| | - N Esparza Martin
- University Hospital Insular of Gran Canaria, Nephrology, Las Palmas De Gran Canaria, Spain
| | - S Suria Gonzalez
- University Hospital Insular of Gran Canaria, Nephrology, Las Palmas De Gran Canaria, Spain
| | - E Bosch Benitez-Parodi
- University Hospital Insular of Gran Canaria, Nephrology, Las Palmas De Gran Canaria, Spain
| | - R Guerra Rodriguez
- University Hospital Insular of Gran Canaria, Nephrology, Las Palmas De Gran Canaria, Spain
| | - A Ramirez Puga
- University Hospital Insular of Gran Canaria, Nephrology, Las Palmas De Gran Canaria, Spain
| | - A C Rodenas Galvez
- University Hospital Insular of Gran Canaria, Nephrology, Las Palmas De Gran Canaria, Spain
| | - S Fernandez
- University Hospital Insular of Gran Canaria, Nephrology, Las Palmas De Gran Canaria, Spain
| | - G Perez Suarez
- University Hospital Insular of Gran Canaria, Nephrology, Las Palmas De Gran Canaria, Spain
| | - C Garcia-Canton
- University Hospital Insular of Gran Canaria, Nephrology, Las Palmas De Gran Canaria, Spain
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Cordero RR, Damiani A, Jorquera J, Sepúlveda E, Caballero M, Fernandez S, Feron S, Llanillo PJ, Carrasco J, Laroze D, Labbe F. Ultraviolet radiation in the Atacama Desert. Antonie Van Leeuwenhoek 2018; 111:1301-1313. [PMID: 29605897 DOI: 10.1007/s10482-018-1075-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 03/21/2018] [Indexed: 10/17/2022]
Abstract
The world's highest levels of surface ultraviolet (UV) irradiance have been measured in the Atacama Desert. This area is characterized by its high altitude, prevalent cloudless conditions, and a relatively low total ozone column. In this paper, we provide estimates of the surface UV (monthly UV index at noon and annual doses of UV-B and UV-A) for all sky conditions in the Atacama Desert. We found that the UV index at noon during the austral summer is expected to be greater than 11 in the whole desert. The annual UV-B (UV-A) doses were found to range from about 3.5 kWh/m2 (130 kWh/m2) in coastal areas to 5 kWh/m2 (160 kWh/m2) on the Andean plateau. Our results confirm significant interhemispherical differences. Typical annual UV-B doses in the Atacama Desert are about 40% greater than typical annual UV-B doses in northern Africa. Mostly due to seasonal changes in the ozone, the differences between the Atacama Desert and northern Africa are expected to be about 60% in the case of peak UV-B levels (i.e. the UV-B irradiances at noon close to the summer solstice in each hemisphere). Interhemispherical differences in the UV-A are significantly lower since the effect of the ozone in this part of the spectrum is minor.
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Affiliation(s)
- R R Cordero
- Universidad de Santiago de Chile, Av. Bernardo O'Higgins, 3363, Santiago, Chile.
| | - A Damiani
- Universidad de Santiago de Chile, Av. Bernardo O'Higgins, 3363, Santiago, Chile.,Center for Environmental Remote Sensing, Chiba University, Chiba, Japan
| | - J Jorquera
- Universidad de Santiago de Chile, Av. Bernardo O'Higgins, 3363, Santiago, Chile
| | - E Sepúlveda
- Universidad de Santiago de Chile, Av. Bernardo O'Higgins, 3363, Santiago, Chile
| | - M Caballero
- Universidad de Santiago de Chile, Av. Bernardo O'Higgins, 3363, Santiago, Chile
| | - S Fernandez
- Universidad de Santiago de Chile, Av. Bernardo O'Higgins, 3363, Santiago, Chile
| | - S Feron
- Universidad de Santiago de Chile, Av. Bernardo O'Higgins, 3363, Santiago, Chile
| | - P J Llanillo
- Universidad de Santiago de Chile, Av. Bernardo O'Higgins, 3363, Santiago, Chile
| | - J Carrasco
- Universidad de Magallanes, Av. Bulnes, 01855, Punta Arenas, Chile
| | - D Laroze
- Instituto de Alta Investigación, Universidad de Tarapacá, Casilla 7D, Arica, Chile
| | - F Labbe
- Universidad Técnica Federico Santa María, Av. Espana 1680, Valparaiso, Chile
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Ulrich S, Lehner A, Fernandez S, Birnbaum J, Hakami L, Fischer M, Dalla R, Haas N. Cardiac Allograft Vasculopathy Is Reversible: Also in Higher Stages. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- S. Ulrich
- Department for Pediatric Cardiology and Intensive Care Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - A. Lehner
- Department for Pediatric Cardiology and Intensive Care Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - S. Fernandez
- Department for Pediatric Cardiology and Intensive Care Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - J. Birnbaum
- Department for Pediatric Cardiology and Intensive Care Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - L. Hakami
- Department of Heart Surgery, Ludwig-Maximilians-University Munich, Munich, Germany
| | - M. Fischer
- Department for Pediatric Cardiology and Intensive Care Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - R. Dalla
- Department for Pediatric Cardiology and Intensive Care Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - N. Haas
- Department for Pediatric Cardiology and Intensive Care Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
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Rodriguez-Valero N, Castro P, Martinez G, Marco Hernandez J, Fernandez S, Gascon J, Nicolas JM. Blackwater fever in a non-immune patient with Plasmodium falciparum malaria after intravenous artesunate. J Travel Med 2018; 25:4780174. [PMID: 29394389 DOI: 10.1093/jtm/tax094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 11/28/2017] [Indexed: 11/12/2022]
Abstract
Blackwater fever was typically reported after quinine administration, although it is poor recognized in patients receiving artesunate. This case describes a blackwater fever in a non-immune patient after artesunate for severe malaria. It highlights the importance of monitoring haemolytic parameters in severe malaria to avoid renal impairment or severe anaemia.
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Affiliation(s)
- N Rodriguez-Valero
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic (Department of International Health), Universitat de Barcelona, Barcelona, Spain
| | - P Castro
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic (Department of International Health), Universitat de Barcelona, Barcelona, Spain
| | - G Martinez
- Department of Internal Medicine, Hospital Clinic, Barcelona, Spain
| | | | - S Fernandez
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic (Department of International Health), Universitat de Barcelona, Barcelona, Spain
| | - J Gascon
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic (Department of International Health), Universitat de Barcelona, Barcelona, Spain
| | - J M Nicolas
- ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic (Department of International Health), Universitat de Barcelona, Barcelona, Spain.,Department of Internal Medicine, Hospital Clinic, Barcelona, Spain
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Lehner A, Flaig M, Fernandez S, Ulrich S, Kanaan M, Dalla-Pozza R, Haas N. The Impact of Improved Percutaneous Pulmonary Valve Design on Patient Characteristics: Smaller, Younger, and More Complex. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1628128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A. Lehner
- Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians University, München, Germany
| | - M. Flaig
- Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians University, München, Germany
| | - S. Fernandez
- Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians University, München, Germany
| | - S. Ulrich
- Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians University, München, Germany
| | - M. Kanaan
- Department of Pediatric Cardiology, Heart and Diabetes Center NRW, Bad Oeynhausen, Germany
| | - R. Dalla-Pozza
- Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians University, München, Germany
| | - N.A. Haas
- Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians University, München, Germany
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32
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Fernandez S, Pibarot P, Messika-Zeitoun D, Kasel M, Kahlert P, Chieffo A, Zamorano P. P3273Aortic regurgitation and haemodynamic performance of a third-generation balloon-expandable transcatheter heart valve. Results from the SOURCE 3 registry echocardiographic substudy at 1 year. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3273] [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)
- S. Fernandez
- University Hospital Ramon y Cajal de Madrid, Madrid, Spain
| | - P. Pibarot
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Quebec, Canada
| | | | - M. Kasel
- Deutsches Herzzentrum, Munchen, Germany
| | - P. Kahlert
- University of Duisburg-Essen, West German Heart Center, Essen, Germany
| | - A. Chieffo
- San Raffaele Hospital of Milan (IRCCS), Milan, Italy
| | - P. Zamorano
- University Hospital Ramon y Cajal de Madrid, Madrid, Spain
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Lauque D, Fernandez S, Lecoules N, Charpentier S, Azéma O, Edlow J, Bellou A. Revue de la littérature sur les retours précoces aux urgences pour améliorer la qualité et la sécurité des soins. Ann Fr Med Urgence 2017. [DOI: 10.1007/s13341-017-0737-1] [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: 10/19/2022]
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Fernandez S, Feliciano M, Borin-Crivellenti S, Crivellenti L, Maronezi M, Simões A, Silva P, Uscategui R, Cruz N, Santana A, Vicente W. Acoustic radiation force impulse (ARFI) elastography of adrenal glands in healthy adult dogs. ARQ BRAS MED VET ZOO 2017. [DOI: 10.1590/1678-4162-9131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT To describe the ARFI elastography in the evaluation of the adrenal glands in adult dogs, to evaluate the stiffness of adrenal parenchyma and to determine the qualitative and quantitative standards of the ARFI technique, which have not yet been described in veterinary medicine. Sixty adrenal glands from thirty healthy adult dogs were evaluated by B-mode and qualitative and quantitative ARFI elastography to assess the stiffness of healthy parenchyma and to determine the quality and quantity (shear velocity) standards of ARFI technique in body, cranial and caudal adrenal poles. Findings of ultrasonography evaluations were normal. Qualitative elastography showed that adrenal glands were not deformable and presented homogeneous middle-gray areas. The results of shear wave velocity were similar statically (P = 0.3087): 1) left adrenal - 1.42 m/s for cranial polar, 1.31 m/s for body region, and 1.71 m/s for caudal polar; 2) right adrenal - 1.42 m/s for cranial polar, 1.74 m/s for body region and 1.63 m/s for caudal pole. Quantitative and qualitative ARFI elastography of dogs' adrenal glands is feasible, well tolerated, easily implemented and may provide baseline data in the study of this structure to allow the use of ARFI.
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Affiliation(s)
| | - M.A.R. Feliciano
- UNESP, Brazil; Universidade Federal do Recôncavo da Bahia, Brazil
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Fernandez S, Haas N, Lehner A, Birnbaum J, Fischer M, Schulze-Neick I. Filling the Gap in the Detection and Management of Dysrhythmia: The Life Vest. Thorac Cardiovasc Surg 2017. [DOI: 10.1055/s-0037-1599047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- S. Fernandez
- Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians-University, Campus Großhadern, München, Germany
| | - N. Haas
- Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians-University, Campus Großhadern, München, Germany
| | - A. Lehner
- Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians-University, Campus Großhadern, München, Germany
| | - J. Birnbaum
- Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians-University, Campus Großhadern, München, Germany
| | - M. Fischer
- Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians-University, Campus Großhadern, München, Germany
| | - I. Schulze-Neick
- Department of Pediatric Cardiology and Pediatric Intensive Care, Ludwig-Maximilians-University, Campus Großhadern, München, Germany
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37
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España A, Fernandez S. Exploring beyond the oral mucosa in patients affected with autoimmune blistering diseases: the importance of endoscopic procedures. J Eur Acad Dermatol Venereol 2016; 31:791-797. [PMID: 27624852 DOI: 10.1111/jdv.13889] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 06/17/2016] [Indexed: 11/29/2022]
Abstract
Autoimmune blistering diseases (AIBD) comprise several entities characterized by the presence of autoantibodies targeted against structural proteins either in desmosomes or in the dermoepidermal junction of polystratified squamous epithelium. Patients develop blisters, erosions in cutaneous surfaces or mucosas. Diagnosis is based on the characteristic mucocutaneous lesions, the typical findings on histological studies and direct immunofluorescence assays, and the presence of specific autoantibodies against the epidermal antigens. It may not be possible for dermatologists to appropriately explore the nose and throat (NT). Thus, a clinical exploration by endoscopic procedures of NT may be a useful tool during the conventional dermatological exam. The aims of this review are to draw attention to the most frequent NT manifestations in AIBD patients, and underline the utility of endoscopic procedures to achieve a more successful and rationale management of patients. Additionally, we will provide brief information related to the anatomical structures and type of epithelium in NT areas which may explain the extent and type of NT involvement in AIBD. Endoscopic exploration in AIBD patients is important for several reasons. Firstly, it will allow the real NT mucosal involvement in each patient to be determined, thus making a differential diagnosis during the endoscopic exam possible, based on the localization of mucosal lesions. Secondary mucosal morbidity can also be ruled out. Secondly, the clinical response to treatment may be established, especially in NT mucosa, as these are anatomical areas subjected to important local traumas, and physiological functions such as breathing, swallowing, speech production and phonation may be damaged. Therefore, a multidisciplinary management in AIBD is mandatory by both dermatologists and otorhinolaryngologists, adding the clinical exploration by endoscopic procedures of NT to the conventional dermatological exam in all AIBD patients, irrespective of whether they exhibit associated symptoms.
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Affiliation(s)
- A España
- Department of Dermatology, School of Medicine, University Clinic of Navarra, Navarra, Spain.,Unit of Autoimmune Blistering Skin Disorders, School of Medicine, University Clinic of Navarra, Navarra, Spain
| | - S Fernandez
- Department of Otorhinolaryngology, School of Medicine, University Clinic of Navarra, Navarra, Spain.,Unit of Autoimmune Blistering Skin Disorders, School of Medicine, University Clinic of Navarra, Navarra, Spain
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Fernandez S, Feliciano M, Crivellenti S, Crivellenti L, Simões A, Maronezi M, Uscategui R, Capela C, Gilor C, Santana A, Vicente W. B-mode and Doppler ultrasonography of adrenal glands of healthy dogs. ARQ BRAS MED VET ZOO 2016. [DOI: 10.1590/1678-4162-8644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT The aim of this study was to determine the vascular indices of adrenal blood flow in healthy dogs (systolic velocity - SV; diastolic velocity - DV; resistance index - RI). Eighteen dogs (thirty six adrenal) were studied. Physical examination, biochemical profile and dexamethasone suppression test were performed to determine general health status. Echotexture, size, contours and margins, and overall shape of the adrenal gland (right and left) were assessed via ultrasound. By spectral Doppler of the phrenic-abdominal artery, the SV, DV, and RI were acquired. Animals did not show alterations in clinical and laboratory examination and suppression of cortisol. Normal homogeneous and echotexture, regular contours and margins and normal shape and size were verified via B mode. Spectral Doppler of the phrenic-abdominal artery showed monophasic-patterned waves and low vascular resistance and systolic peak evident with means values: left adrenal - SV = 31.34cm/s, DV = 9.54cm/s and RI = 0.69; and right adrenal - SV = 27.83cm/s, DV = 7.71cm/s and RI = 0.68. Doppler evaluation of adrenal was easily implemented and may provide base line data in the study, allowing for the use of this technique as a diagnostic tool for diseases of the dog's adrenal.
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Affiliation(s)
| | | | | | | | | | | | | | | | - C. Gilor
- The Ohio State University, United States
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Abudulai L, Cha L, Fernandez S, French M. 2 Increased interferon-alpha activity may contribute to defects of B cells and antibody production caused by HIV-1 infection. J Virus Erad 2016. [DOI: 10.1016/s2055-6640(20)30947-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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40
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Portafaix T, Godin-Beekmann S, Payen G, de Mazière M, Langerock B, Fernandez S, Posny F, Cammas J, Metzger JM, Bencherif H, Vigouroux C, Marquestaut N. Ozone profiles obtained by DIAL technique at Maïdo Observatory in La Reunion Island: comparisons with ECC ozone-sondes, ground-based FTIR spectrometer and microwave radiometer measurements. EPJ Web of Conferences 2016. [DOI: 10.1051/epjconf/201611905005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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41
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Sellier P, Ostertag A, Collet C, Trout H, Champion K, Fernandez S, Lopes A, Morgand M, Clevenbergh P, Evans J, Souak S, de Vernejoul MC, Bergmann JF. Disrupted trabecular bone micro-architecture in middle-aged male HIV-infected treated patients. HIV Med 2016; 17:550-6. [PMID: 27186847 DOI: 10.1111/hiv.12380] [Citation(s) in RCA: 6] [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] [Accepted: 01/12/2016] [Indexed: 01/22/2023]
Abstract
OBJECTIVES HIV-infected individuals are at increased risk of incident fractures. Evaluation of trabecular bone micro-architecture is an important tool to assess bone strength, but its use has not yet been reported in middle-aged HIV-infected male individuals. The aim of the study was to compare bone micro-architecture between HIV-infected and HIV-uninfected men. METHODS In this cross-sectional study, 53 HIV-infected male individuals with a mean (± standard deviation) age of 49 ± 9 years who had been receiving antiretroviral therapy including tenofovir disoproxil fumarate (DF) for at least 60 months were compared with 50 HIV-uninfected male controls, matched for age and ethnic origin. We studied the volumetric bone density and micro-architecture of the radius and tibia using high-resolution peripheral quantitative computed tomography (HR-p QCT). RESULTS Volumetric trabecular bone density was 17% lower in the tibia (P < 10(-4) ) and 16% lower in the radius (P < 10(-3) ) in HIV-infected patients compared with controls. By contrast, the cortical bone density was normal at both sites. The tibial trabecular micro-architecture differed markedly between patients and controls: bone volume/total volume (BV/TV) and trabecular number were each 13% lower (P < 10(-4) for both). Trabecular separation and inhomogeneity of the network were 18% and 24% higher in HIV-infected patients than in controls, respectively. The radial BV/TV and trabecular thickness were each 13% lower (P < 10(-3) and 10(-2) , respectively). Cortical thickness was not different between the two groups. CONCLUSIONS The findings of lower volumetric trabecular bone density and disrupted trabecular micro-architectural parameters in middle-aged male HIV-infected treated patients help to explain bone frailty in these patients.
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Affiliation(s)
- P Sellier
- Department of Internal Medicine, Lariboisiere Hospital, Assistance Publique-Hopitaux de Paris, Paris, France
| | - A Ostertag
- INSERM U 606, Department of Rheumatology, Lariboisiere Hospital, Assistance Publique-Hopitaux de Paris, Paris, France
| | - C Collet
- Laboratory of molecular biology, Lariboisiere Hospital, Assistance Publique-Hopitaux de Paris, Paris, France
| | - H Trout
- Pharmacy, Lariboisiere Hospital, Assistance Publique-Hopitaux de Paris, Paris, France
| | - K Champion
- Department of Internal Medicine, Lariboisiere Hospital, Assistance Publique-Hopitaux de Paris, Paris, France
| | - S Fernandez
- INSERM U 606, Department of Rheumatology, Lariboisiere Hospital, Assistance Publique-Hopitaux de Paris, Paris, France
| | - A Lopes
- Department of Internal Medicine, Lariboisiere Hospital, Assistance Publique-Hopitaux de Paris, Paris, France
| | - M Morgand
- Department of Internal Medicine, Lariboisiere Hospital, Assistance Publique-Hopitaux de Paris, Paris, France
| | - P Clevenbergh
- Department of Internal Medicine, Lariboisiere Hospital, Assistance Publique-Hopitaux de Paris, Paris, France
| | - J Evans
- Department of Internal Medicine, Lariboisiere Hospital, Assistance Publique-Hopitaux de Paris, Paris, France
| | - S Souak
- Department of Internal Medicine, Lariboisiere Hospital, Assistance Publique-Hopitaux de Paris, Paris, France
| | - M-C de Vernejoul
- INSERM U 606, Department of Rheumatology, Lariboisiere Hospital, Assistance Publique-Hopitaux de Paris, Paris, France
| | - J-F Bergmann
- Department of Internal Medicine, Lariboisiere Hospital, Assistance Publique-Hopitaux de Paris, Paris, France
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Shaaban AM, Kaptanis S, Danial I, Smith S, Bradley S, Fernandez S, Mitsopoulos G, Ryan D, Winters Z, Jones L. Abstract P6-05-06: Incidence and molecular phenotype of multifocal invasive breast carcinomas; A UK multi institutional series. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p6-05-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Historically, multiple synchronous breast cancers are defined as multifocal (MF) when they aoccur in the same quadrant of the breast, and multicentric (MC) they are in different quadrants; a number of authors continue to use this distinction. Multifocality has been reported to be an independent prognostic factor for survival and local recurrence. The molecular implications of MF and MC versus univocal breast cancers remain to be defined. We sought to investigate the incidence and molecular basis for this phenomenon.
Materials and methods: Following a systematic review of the literature, breast cancer excisions reported by three specialist centers between 2005 and 2014 were investigated (n=4409 cases). Within this cohort, cases identified radiologically and confirmed histologically as mutifocal/multicentric were identified. Data on age at presentation, histological features and molecular profile were collected and compared between MF/MC breast cancer and the unifocal disease. Chi square test was used to compare categorical groups for ER, PR, HER2 and student t-test for mean age comparison. A p-values of ≤ 0.05 was considered significant.
Results: 446 cases (10.12%) were reported as MF/MC invasive breast cancer. Most cases were treated by mastectomy. The majority of these were early breast cancer (Stage 1, 59.1% pT1(m), 72.2% pN0-1). Compared with unifocal breast cancer, patients with multifocal breast cancer were significantly younger (56.6 vs 59 years old, p=0.004) and more likely to have lymph node metastasis on presentation (50% vs 32%, p=0.001). There were differences, some significant, in the molecular profiles of unifocal cancers vs the largest focus of multifocals (ER positive: 80% vs 84% p=0.239, PR positive: 72% vs 76% p=0.301, HER2+ negative: 89% vs 76% p=0.002).
Discussion: A significant proportion (one tenth) of breast cancer presented as multifocal disease. Differences in the immunohistochemical profile, in particular HER2 status, between MF and unifocal breast carcinomas are identified. Both the literature review and analysis of our available cases demonstrated a paucity of data on the incidence, degree of intratumor heterogeneity of multifocal breast cancers and its appropriate management. There are important questions unanswered about the molecular classification of multifocal breast cancer. Future genomic testing of those cases may highlight more pronounced differences. The findings form basis of a biomarker driven trial in set up comparing conservative surgery and mastectomy (MIAMI).
Citation Format: Shaaban AM, Kaptanis S, Danial I, Smith S, Bradley S, Fernandez S, Mitsopoulos G, Ryan D, Winters Z, Jones L. Incidence and molecular phenotype of multifocal invasive breast carcinomas; A UK multi institutional series. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-05-06.
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Affiliation(s)
- AM Shaaban
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom; Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Barts Health NHS Trust, London, London, United Kingdom
| | - S Kaptanis
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom; Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Barts Health NHS Trust, London, London, United Kingdom
| | - I Danial
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom; Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Barts Health NHS Trust, London, London, United Kingdom
| | - S Smith
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom; Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Barts Health NHS Trust, London, London, United Kingdom
| | - S Bradley
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom; Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Barts Health NHS Trust, London, London, United Kingdom
| | - S Fernandez
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom; Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Barts Health NHS Trust, London, London, United Kingdom
| | - G Mitsopoulos
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom; Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Barts Health NHS Trust, London, London, United Kingdom
| | - D Ryan
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom; Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Barts Health NHS Trust, London, London, United Kingdom
| | - Z Winters
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom; Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Barts Health NHS Trust, London, London, United Kingdom
| | - L Jones
- Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom; Barts Cancer Institute, Queen Mary University of London, London, United Kingdom; Barts Health NHS Trust, London, London, United Kingdom
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Vicente BS, Nieto J, Arbide N, Perez-Hoyos M, Arrazubi V, Arevalo A, Arango J, Zumarraga A, Fernandez S, Sala M, Galve E, Novas P, Sande L, Abad T, Prado PMD. 2147 Pathological response as a prognostic factor for disease free survival on colorectal cancer with liver limited disease. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31068-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Novas Vidal P, Fernandez S, Galve E, Arrazubi V, Sala M, Torre I, Arevalo A, Arango J, López de San Vicente B, Pérez C, Zumárraga A, Abad M, Garcia M, Marínez M. 1918 Impact of an osteoporosis unit in the incidence of fractures in early breast cancer patients with aromatase inhibitors. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30867-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Serebrinsky G, Calvo M, Fernandez S, Saito S, Ohno K, Wallace E, Warnock D, Sakuraba H, Politei J. Late onset variants in Fabry disease: Results in high risk population screenings in Argentina. Mol Genet Metab Rep 2015; 4:19-24. [PMID: 26937405 PMCID: PMC4750630 DOI: 10.1016/j.ymgmr.2015.05.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 05/29/2015] [Accepted: 05/29/2015] [Indexed: 01/03/2023] Open
Abstract
Background Screening for Fabry disease (FD) in high risk populations yields a significant number of individuals with novel, ultra rare genetic variants in the GLA gene, largely without classic manifestations of FD. These variants often have significant residual α-galactosidase A activity. The establishment of the pathogenic character of previously unknown or rare variants is challenging but necessary to guide therapeutic decisions. Objectives To present 2 cases of non-classical presentations of FD with renal involvement as well as to discuss the importance of high risk population screenings for FD. Results Our patients with non-classical variants were diagnosed through FD screenings in dialysis units. However, organ damage was not limited to kidneys, since LVH, vertebrobasilar dolichoectasia and cornea verticillata were also present. Lyso-Gb3 concentrations in plasma were in the pathologic range, compatible with late onset FD. Structural studies and in silico analysis of p.(Cys174Gly) and p.(Arg363His), employing different tools, suggest that enzyme destabilization and possibly aggregation could play a role in organ damage. Conclusions Screening programs for FD in high risk populations are important as FD is a treatable multisystemic disease which is frequently overlooked in patients who present without classical manifestations.
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Affiliation(s)
| | - M Calvo
- Nephrology Department, Hospital Zonal General de Agudos Evita, Buenos Aires, Argentina
| | - S Fernandez
- Nephrology Department, Centro Médico CIPERCA, Catamarca, Argentina
| | - S Saito
- Department of Medical Management and Informatics, Hokkaido Information University, Ebetsu, Hokkaido, Japan
| | - K Ohno
- Department of Research, Not-for-Profit Organization for the Promotion of Research on Intellectual Property Tokyo, Chiyoda, Tokyo, Japan
| | - E Wallace
- Department of Medicine, University of Alabama, Birmingham, AL, United States
| | - D Warnock
- Department of Medicine, University of Alabama, Birmingham, AL, United States
| | - H Sakuraba
- Department of Clinical Genetics, Meiji Pharmaceutical University, Kiyose, Tokyo, Japan
| | - J Politei
- Fundación para el Estudio de las Enfermedades Neurometabólicas (FESEN), Buenos Aires, Argentina
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Gaudré N, Moulis G, Fernandez S, Azema O, Cougoul P, Beyne-rauzy O, Adoue D. Tous les patients se présentant aux urgences pour crise vaso-occlusive sont-ils drépanocytaires ? Étude rétrospective au CHU de Toulouse. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.320] [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: 10/23/2022]
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Rutvisuttinunt W, Chinnawirotpisan P, Thaisomboonsuk B, Rodpradit P, Ajariyakhajorn C, Manasatienkij W, Simasathien S, Shrestha SK, Yoon IK, Klungthong C, Fernandez S. Viral subpopulation diversity in influenza virus isolates compared to clinical specimens. J Clin Virol 2015; 68:16-23. [PMID: 26071329 DOI: 10.1016/j.jcv.2015.04.010] [Citation(s) in RCA: 7] [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: 01/03/2015] [Revised: 03/17/2015] [Accepted: 04/09/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Influenza virus (IFV) isolates obtained from mammalian cell cultures are valuable reagents used for vaccine production, antigenic characterization, laboratory assays, and epidemiological and evolutionary studies. Complete genomic comparison of IFV isolates with their original clinical specimens provides insight into cell culture-driven genomic changes which may sequentially alter the virus phenotype. OBJECTIVES The genome of the viral isolates and of the viruses in the clinical specimens was examined by deep sequencing in order to determine nucleotide heterogeneity (measured number of variances or numbers of mixed bases) as a marker for IFV population diversity. STUDY DESIGN Clinical respiratory specimens were collected between July and October 2012 and identified by RT-PCR as positive for influenza A H3N2 or H1N1, or influenza B. The viruses in the clinical specimens were amplified using mammalian cell culture. Next generation sequencing (NGS) was used to investigate genomic differences between IFV isolates and their corresponding clinical specimens. RESULTS There was less nucleotide heterogeneity in 5 of 6 viral isolates compared to the corresponding clinical specimens, especially for influenza B. A phylogenetic analysis of the hemagglutinin (HA) gene consensus sequences obtained from deep and Sanger sequencing showed that the viral isolates and their corresponding clinical specimens contained the same IFV strains with less than 5% pair-wise genetic distance. CONCLUSION The IFV sequence data analysis detected a substantial decrease in nucleotide heterogeneity from clinical specimens to viral cultures in 5 out of 6 investigated cases.
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Affiliation(s)
- W Rutvisuttinunt
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), 315/6 Rajavithi Road, 10400 Bangkok, Thailand.
| | - P Chinnawirotpisan
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), 315/6 Rajavithi Road, 10400 Bangkok, Thailand.
| | - B Thaisomboonsuk
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), 315/6 Rajavithi Road, 10400 Bangkok, Thailand.
| | - P Rodpradit
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), 315/6 Rajavithi Road, 10400 Bangkok, Thailand.
| | - C Ajariyakhajorn
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), 315/6 Rajavithi Road, 10400 Bangkok, Thailand.
| | - W Manasatienkij
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), 315/6 Rajavithi Road, 10400 Bangkok, Thailand.
| | | | - S K Shrestha
- Walter Reed/ AFRIMS Research Unit Nepal, Kathmandu, Nepal.
| | - I K Yoon
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), 315/6 Rajavithi Road, 10400 Bangkok, Thailand.
| | - C Klungthong
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), 315/6 Rajavithi Road, 10400 Bangkok, Thailand.
| | - S Fernandez
- Department of Virology, Armed Forces Research Institute of Medical Sciences (AFRIMS), 315/6 Rajavithi Road, 10400 Bangkok, Thailand.
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Cabezas V, Fernandez S, Garcia L, Fernandez S, Cardaba ME. CP-092 Estimated rate of therapeutic failure with palivizumab in the prophylaxis of respiratory syncytial virus. Eur J Hosp Pharm 2015. [DOI: 10.1136/ejhpharm-2015-000639.88] [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: 11/03/2022] Open
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Ori A, Fiori GG, Fernandez S, Longo D, Simoni L. Cost and Duration Of Regulatory Process in an Observational Study in Europe and USA. Value Health 2014; 17:A453. [PMID: 27201253 DOI: 10.1016/j.jval.2014.08.1229] [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] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- A Ori
- MEDIDATA SRL, MODENA, Italy
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Rajapakse NW, Karim F, Straznicky NE, Fernandez S, Evans RG, Head GA, Kaye DM. Augmented endothelial-specific L-arginine transport prevents obesity-induced hypertension. Acta Physiol (Oxf) 2014; 212:39-48. [PMID: 25041756 DOI: 10.1111/apha.12344] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 05/31/2014] [Accepted: 07/08/2014] [Indexed: 12/27/2022]
Abstract
AIM Hypertension is a major clinical complication of obesity. Our previous studies show that abnormal uptake of the nitric oxide precursor L-arginine, via the cationic amino acid transporter-1 (CAT1), contributes to endothelial dysfunction in cardiovascular disease. In this study, we tested the hypothesis that abnormal L-arginine transport may be a key mediator of obesity-induced hypertension. METHODS Mean arterial pressure (MAP) was monitored by telemetry in conscious wild-type (WT; n = 13) mice, and transgenic mice with endothelial-specific overexpression of CAT1 (CAT+; n = 14) fed a normal or a high fat diet for 20 weeks. Renal angiotensin II (Ang II), CAT1 mRNA and plasma nitrate/nitrite levels were then quantified. In conjunction, plasma nitrate/nitrite levels were assessed in obese normotensive (n = 15) and obese hypertensive subjects (n = 15). RESULTS Both genotypes of mice developed obesity when fed a high fat diet (P ≤ 0.002). Fat fed WT mice had 13% greater MAP and 78% greater renal Ang II content, 42% lesser renal CAT1 mRNA levels and 42% lesser plasma nitrate/nitrite levels, than WT mice fed a normal fat diet (P ≤ 0.02). In contrast, none of these variables were significantly altered by high fat feeding in CAT+ mice (P ≥ 0.36). Plasma nitrate/nitrite levels were 17% less in obese hypertensives compared with obese normotensives (P = 0.02). CONCLUSION Collectively, these data indicate that obesity-induced down-regulation of CAT1 expression and subsequent reduced bioavailability of nitric oxide may contribute to the development of obesity-induced hypertension.
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Affiliation(s)
- N. W. Rajapakse
- Baker IDI Heart and Diabetes Institute; Melbourne Vic. Australia
| | - F. Karim
- Baker IDI Heart and Diabetes Institute; Melbourne Vic. Australia
| | - N. E. Straznicky
- Baker IDI Heart and Diabetes Institute; Melbourne Vic. Australia
| | - S. Fernandez
- Baker IDI Heart and Diabetes Institute; Melbourne Vic. Australia
| | - R. G. Evans
- Department of Physiology; Monash University; Melbourne Vic. Australia
| | - G. A. Head
- Baker IDI Heart and Diabetes Institute; Melbourne Vic. Australia
| | - D. M. Kaye
- Baker IDI Heart and Diabetes Institute; Melbourne Vic. Australia
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