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Monedero-Sánchez I, Robles-Velasco P, Pérez-Fernández E, Rubio-Caballero A, Marco-Quirós C, Espejo-Bares V, Artiaga-de-la-Barrera V, Jiménez-Martínez C, García-Jiménez C, González-Alirangues P. [Prognostic impact of prior cardiopathy in patients hospitalized with COVID-19 pneumonia]. Arch Cardiol Mex 2022; 93:50-57. [PMID: 35443127 DOI: 10.24875/acm.21000401] [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: 12/19/2021] [Accepted: 01/14/2022] [Indexed: 11/17/2022] Open
Abstract
Objective From the onset of COVID-19 pandemic, the presence of previous cardiopathy was thought to be related with a worse prognosis of the disease. We aimed to analyse that theoretical adverse impact in a large cohort of patients. Method We selected 1065 patients admitted for SARS-CoV-2 pneumonia between March and June 2020, divided in three groups according to (1) absence of cardiopathy, (2) presence of valvular heart disease or ischemic heart disease, or (3) presence of heart failure. We analysed the differences between groups regarding the need for admission in intensive care unit for mechanical ventilation or mortality during admission, or mortality during admission or in the next 6 months. Results The factors that were associated with a worse prognosis both in acute phase and in the next 6 months were age, male gender, obesity and oncologic disease. The presence of previous cardiopathy did not have an adverse prognostic impact neither initially nor in the short term, in our study. Conclusions We did not obtain significative association of the presence of cardiopathy with a worse medical evolution, neither in acute phase nor in the short term, of patients admitted for SARS-CoV-2 pneumonia.
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Affiliation(s)
| | - Pablo Robles-Velasco
- Unidad de Cardiología, Hospital Universitario Fundación Alcorcón, Madrid, España
| | - Elia Pérez-Fernández
- Unidad de Investigación. Hospital Universitario Fundación Alcorcón, Madrid, España
| | | | - Cecilia Marco-Quirós
- Unidad de Cardiología, Hospital Universitario Fundación Alcorcón, Madrid, España
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Martos Pérez F, Luque Del Pino J, Jiménez García N, Mora Ruiz E, Asencio Méndez C, García Jiménez JM, Navarro Romero F, Núñez Rodríguez MV. Comorbidity and prognostic factors on admission in a COVID-19 cohort of a general hospital. Rev Clin Esp 2021; 221:529-535. [PMID: 34752264 PMCID: PMC7437480 DOI: 10.1016/j.rceng.2020.05.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 05/24/2020] [Indexed: 02/07/2023]
Abstract
ANTECEDENTS AND OBJECTIVE To describe clinical features, comorbidity, and prognostic factors associated with in-hospital mortality in a cohort of COVID-19 admitted to a general hospital. MATERIAL AND METHODS Retrospective cohort study of patients with COVID-19 admitted from 26th February 2020, who had been discharged or died up to 29th April 2020. A descriptive study and an analysis of factors associated with intrahospital mortality were performed. RESULTS Out of the 101 patients, 96 were analysed. Of these, 79 (82%) recovered and were discharged, and 17 (18%) died in the hospital. Diagnosis of COVID-19 was confirmed by polymerase chain reaction to SARS-CoV2 in 92 (92.5%). The mean age was 63 years, and 66% were male. The most frequent comorbidities were hypertension (40%), diabetes mellitus (16%) y cardiopathy (14%). Patients who died were older (mean 77 vs 60 years), had higher prevalence of hypertension (71% vs 33%), and cardiopathy (47% vs 6%), and higher levels of lactate dehydrogenase (LDH) and reactive C protein (mean 662 vs 335 UI/L, and 193 vs 121mg/L respectively) on admission. In a multivariant analysis the variables significantly associated to mortality were the presence of cardiopathy (CI 95% OR 2,58-67,07), levels of LDH≥345 IU/L (CI 95% OR 1,52-46,00), and age≥65 years (CI 95% OR 1,23-44,62). CONCLUSIONS The presence of cardiopathy, levels of LDH≥345 IU/L and age≥65 years, are associated with a higher risk of death during hospital stay for COVID-19. This model should be validated in prospective cohorts.
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Affiliation(s)
- F Martos Pérez
- Servicio de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, Spain.
| | - J Luque Del Pino
- Servicio de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, Spain
| | - N Jiménez García
- Servicio de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, Spain
| | - E Mora Ruiz
- Servicio de Neumología, Hospital Costa del Sol, Marbella, Málaga, Spain
| | - C Asencio Méndez
- Servicio de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, Spain
| | | | - F Navarro Romero
- Servicio de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, Spain
| | - M V Núñez Rodríguez
- Servicio de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, Spain
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Borgia F, Cirillo P, Riccio MP, Raimondi F, Franco D, Scippa L, Franzese A, Esposito G, De Luca N, Bravaccio C. Anorexia nervosa-related cardiopathy in children with physical instability: prevalence, echocardiographic characteristics and reversibility at mid-term follow-up. Eur J Pediatr 2021; 180:3379-3389. [PMID: 34050378 DOI: 10.1007/s00431-021-04130-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 05/17/2021] [Accepted: 05/20/2021] [Indexed: 10/21/2022]
Abstract
Prompt detection of cardiovascular abnormalities in children with anorexia nervosa and physical instability requiring hospitalization is essential to identify patients at higher cardiovascular risk. We studied all anorexia nervosa children requiring admission at Paediatric Institute in the period 2015-2019. Anorexia nervosa cardiopathy at admission was defined by the presence of at least two of the following clinical findings: pericardial effusion, mitral regurgitation, bradycardia, mitral billowing, aortic regurgitation, altered LV morphology and ECG abnormalities. Echocardiographic data were compared with those registered at 3-8-month follow-up and with data from a healthy population. Thirty-eight anorexia nervosa children were examined. Prevalence of anorexia nervosa cardiopathy at admission was 63% (24 patients). Pericardial effusion, bradycardia and mitral regurgitation were present together in 26% of patients. Most cardiovascular changes recovered at follow-up. Anorexia nervosa cardiopathy was associated with significantly lower left ventricle end-diastolic diameters and mass, and higher E wave, E/A and E/e' ratios and left ventricle sphericity index values vs healthy population and vs anorexia nervosa children without cardiopathy (p<0.05). Left ventricle global longitudinal strain was significantly reduced only in anorexia nervosa cardiopathy patients but recovered, whereas end-diastolic diameters, E/A ratio and sphericity index values remained impaired.Conclusion: Among anorexia nervosa children requiring hospitalization, those presenting several cardiac findings together express an acute anorexia nervosa cardiopathy which is characterized by worse LV filling, geometry and subclinical myocardial deformation impairment. Despite treatment, in those patients, some alterations persist at mid-term follow-up. What is Known: • Cardiac and electrocardiographic changes are present in anorexia nervosa children at diagnosis or during stable disease, and most recover after body-weight treatment. • It is unknown if anorexia nervosa children with more severe cardiac impairment during hospitalization present higher cardiovascular-risk profile despite treatment. What is New: • In anorexia nervosa children needing hospitalization for physical reasons, prevalence of acute anorexia nervosa cardiopathy at admission is high, around 60%. • By advanced echocardiography, children with anorexia nervosa cardiopathy at admission have a worse cardiac filling, impaired cardiac geometry and systolic deformation that only partially recover at mid-term follow-up.
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Affiliation(s)
- Francesco Borgia
- Pediatric and Growing-up Cardiology Program, Division of Cardiology, Dpt of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
| | - Plinio Cirillo
- Pediatric and Growing-up Cardiology Program, Division of Cardiology, Dpt of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - Maria Pia Riccio
- Child and Adolescent Neuropsychiatric Unit, Divison of Pediatrics, Dpt of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Francesco Raimondi
- Child and Adolescent Neuropsychiatric Unit, Divison of Pediatrics, Dpt of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Danilo Franco
- Pediatric and Growing-up Cardiology Program, Division of Cardiology, Dpt of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - Luigi Scippa
- Child and Adolescent Neuropsychiatric Unit, Divison of Pediatrics, Dpt of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Adriana Franzese
- Child and Adolescent Neuropsychiatric Unit, Divison of Pediatrics, Dpt of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Giovanni Esposito
- Pediatric and Growing-up Cardiology Program, Division of Cardiology, Dpt of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - Nicola De Luca
- Pediatric and Growing-up Cardiology Program, Division of Cardiology, Dpt of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | - Carmela Bravaccio
- Child and Adolescent Neuropsychiatric Unit, Divison of Pediatrics, Dpt of Translational Medical Sciences, Federico II University, Naples, Italy
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Reisin RC, Rozenfeld P, Bonardo P. Fabry disease patients have an increased risk of stroke in the COVID-19 ERA. A hypothesis. Med Hypotheses 2020; 144:110282. [PMID: 33254586 PMCID: PMC7494494 DOI: 10.1016/j.mehy.2020.110282] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 09/13/2020] [Indexed: 01/04/2023]
Abstract
Stroke is a severe and frequent complication of Fabry disease (FD), affecting both males and females. Cerebrovascular complications are the end result of multiple and complex pathophysiology mechanisms involving endothelial dysfunction and activation, development of chronic inflammatory cascades leading to a prothrombotic state in addition to cardioembolic stroke due to cardiomyopathy and arrhythmias. The recent coronavirus disease 2019 outbreak share many overlapping deleterious pathogenic mechanisms with those of FD and therefore we analyze the available information regarding the pathophysiology mechanisms of both disorders and hypothesize that there is a markedly increased risk of ischemic and hemorrhagic cerebrovascular complications in Fabry patients suffering from concomitant SARS-CoV-2 infections.
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Affiliation(s)
- R C Reisin
- Neurology Service Hospital Britanico de Buenos Aires, Argentina; AADELFA Asociación Argentina de Estudio de Enfermedad de Fabry y otras Enfermedades Lisosomales.
| | - P Rozenfeld
- AADELFA Asociación Argentina de Estudio de Enfermedad de Fabry y otras Enfermedades Lisosomales; Instituto de Estudios Inmunológicos y Fisiopatológicos (IIFP), UNLP, CONICET, asociado CIC PBA, Facultad de Ciencias Exactas, Departamento de Ciencias Biológicas, La Plata, Argentina
| | - P Bonardo
- Neurology Service Hospital Britanico de Buenos Aires, Argentina
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Cossío-Aranda JE, Gaspar-Hernández J, Juanico-Enriquez A, Rodríguez-Rosales F, López-Jaramillo AM, A-Becerra-Vázquez D, Pinal-Moreno E, Díaz-Jiménez MJ, Velázquez-Ramírez N, Cortés-Bonilla M, Ruiz-Toral A, Pérez-Leos D, Buendía-Hernández A, Chávez-Domínguez R, Cardona-Pérez JA, Martínez-Ríos M, Reguera GFDL. Pregnancy in teenagers with heart disease. Arch Cardiol Mex 2020; 90:81-85. [PMID: 31996866 DOI: 10.24875/acm.19000184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The prevalence of pregnancy in adolescent women is high in Mexico and represents a public health problem. The pregnant teenager with heart disease has a high probability of complications during pregnancy and the delivery, which carries a risk of death of both the mother and the product. In many cases the pregnancy should have been avoided, planned or interrupted, however the majority at this age is vulnerable and although certain cases must be interrupted by their high risk of maternal-fetal death, prevention and legal aspects should be considered. In some cases the woman wants a pregnancy although her health condition does not allow it, but there are options of adoption or recourse to a surrogate belly. In response to this growing social problem, the National Cardiology Institute Ignacio Chávez and National Institute of Perinatology, with the coordination of Ministry of Health in Mexico, started a pregnancy prevention module within a clinic of follow-up of cardiopathy and pregnancy. This review raises the global problem in our country that occupies the first place in pregnancies in adolescents, with more than 400,000 pregnancies a year and the form of immediate response in a multidisciplinary way.
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Affiliation(s)
- Jorge E Cossío-Aranda
- Departamento de Consulta Externa, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | - Jorge Gaspar-Hernández
- Dirección Médica, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | - Antonio Juanico-Enriquez
- Terapia Intensiva Postquirúrgica Pediátrica, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | - Fernando Rodríguez-Rosales
- Departamento de Consulta Externa, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | - Ana M López-Jaramillo
- Departamento de Consulta Externa, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | - David A-Becerra-Vázquez
- Departamento de Consulta Externa, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | - Ernestina Pinal-Moreno
- Departamento de Consulta Externa, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | - María J Díaz-Jiménez
- Comisión Coordinadora de los Institutos Nacionales de Salud y Hospitales de Alta Especialidad, Ciudad de México, México
| | - Norma Velázquez-Ramírez
- Departamento de Salud Sexual y Reproductiva, Instituto Nacional de Perinotología, Ciudad de México, México
| | - Manuel Cortés-Bonilla
- Asesoría de Dirección General, Instituto Nacional de Perinotología, Ciudad de México, México
| | - Alejandro Ruiz-Toral
- Departamento de Asuntos Jurídicos, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | - Daniel Pérez-Leos
- Departamento de Asuntos Jurídicos, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | - Alfonso Buendía-Hernández
- Departamento de Cardiología Pediátrica, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | - Rafael Chávez-Domínguez
- Departamento de Epidemiología, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
| | | | - Marco Martínez-Ríos
- Dirección General, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
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Jaffuel D, Rabec C, Philippe C, Mallet JP, Georges M, Redolfi S, Palot A, Suehs CM, Nogue E, Molinari N, Bourdin A. Patterns of adaptive servo-ventilation settings in a real-life multicenter study: pay attention to volume! : Adaptive servo-ventilation settings in real-life conditions. Respir Res 2020; 21:243. [PMID: 32957983 DOI: 10.1186/s12931-020-01509-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 09/13/2020] [Indexed: 01/03/2023] Open
Abstract
Backgrounds To explain the excess cardiovascular mortality observed in the SERVE-HF study, it was hypothesized that the high-pressure ASV default settings used lead to inappropriate ventilation, cascading negative consequences (i.e. not only pro-arrythmogenic effects through metabolic/electrolyte abnormalities, but also lower cardiac output). The aims of this study are: i) to describe ASV-settings for long-term ASV-populations in real-life conditions; ii) to describe the associated minute-ventilations (MV) and therapeutic pressures for servo-controlled-flow versus servo-controlled-volume devices (ASV-F Philips®-devices versus ASV-V ResMed®-devices). Methods The OTRLASV-study is a cross-sectional, 5-centre study including patients who underwent ASV-treatment for at least 1 year. The eight participating clinicians were free to adjust ASV settings, which were compared among i) initial diagnosed sleep-disordered-breathing (SBD) groups (Obstructive-Sleep-Apnea (OSA), Central-Sleep-Apnea (CSA), Treatment-Emergent-Central-Sleep-Apnea (TECSA)), and ii) unsupervised groups (k-means clusters). To generate these clusters, baseline and follow-up variables were used (age, sex, body mass index (BMI), initial diagnosed Obstructive-Apnea-Index, initial diagnosed Central-Apnea-Index, Continuous-Positive-Airway-Pressure used before ASV treatment, presence of cardiopathy, and presence of a reduced left-ventricular-ejection-fraction (LVEF)). ASV-data were collected using the manufacturer’s software for 6 months. Results One hundred seventy-seven patients (87.57% male) were analysed with a median (IQ25–75) initial Apnea-Hypopnea-Index of 50 (38–62)/h, an ASV-treatment duration of 2.88 (1.76–4.96) years, 61.58% treated with an ASV-V. SDB groups did not differ in ASV settings, MV or therapeutic pressures. In contrast, the five generated k-means clusters did (generally described as follows: (C1) male-TECSA-cardiopathy, (C2) male-mostly-CSA-cardiopathy, (C3) male-mostly-TECSA-no cardiopathy, (C4) female-mostly-elevated BMI-TECSA-cardiopathy, (C5) male-mostly-OSA-low-LVEF). Of note, the male-mostly-OSA-low-LVEF-cluster-5 had significantly lower fixed end-expiratory-airway-pressure (EPAP) settings versus C1 (p = 0.029) and C4 (p = 0.007). Auto-EPAP usage was higher in the male-mostly-TECSA-no cardiopathy-cluster-3 versus C1 (p = 0.006) and C2 (p < 0.001). MV differences between ASV-F (p = 0.002) and ASV-V (p < 0.001) were not homogenously distributed across clusters, suggesting specific cluster and ASV-algorithm interactions. Individual ASV-data suggest that the hyperventilation risk is not related to the cluster nor the ASV-monitoring type. Conclusions Real-life ASV settings are associated with combinations of baseline and follow-up variables wherein cardiological variables remain clinically meaningful. At the patient level, a hyperventilation risk exists regardless of cluster or ASV-monitoring type, spotlighting a future role of MV-telemonitoring in the interest of patient-safety. Trial registration The OTRLASV study was registered on ClinicalTrials.gov (Identifier: NCT02429986). 1 April 2015.
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Martos Pérez F, Luque Del Pino J, Jiménez García N, Mora Ruiz E, Asencio Méndez C, García Jiménez JM, Navarro Romero F, Núñez Rodríguez MV. Comorbidity and prognostic factors on admission in a COVID-19 cohort of a general hospital. Rev Clin Esp 2020; 221:S0014-2565(20)30179-X. [PMID: 32680592 PMCID: PMC7318985 DOI: 10.1016/j.rce.2020.05.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 05/13/2020] [Revised: 05/21/2020] [Accepted: 05/24/2020] [Indexed: 01/15/2023]
Abstract
ANTECEDENTS AND OBJECTIVE To describe clinical features, comorbidity, and prognostic factors associated with in-hospital mortality in a cohort of COVID-19 admitted to a general hospital. MATERIAL AND METHODS Retrospective cohort study of patients with COVID-19 admitted from 26th February, who had been discharged or died, up to 29th April, 2020. A descriptive study and an analysis of factors associated with intrahospital mortality were performed. RESULTS Out of the 101 patients, 96 were analysed. Of these, 79 (82%) recovered and were discharged, and 17 (18%) died in the hospital. Diagnosis of COVID-19 was confirmed by polymerase chain reaction to SARS-CoV-2 in 92 (92.5%). The mean age was 63 years, and 66% were male. The most frequent comorbidities were hypertension (40%), diabetes mellitus (16%) and cardiopathy (14%). Patients who died were older (mean 77 vs 60 years), had higher prevalence of hypertension (71% vs 33%), and cardiopathy (47% vs 6%), and higher levels of lactate dehydrogenase (LDH) and reactive C protein (mean 662 vs 335UI/L, and 193 vs 121mg/L respectively) on admission. In a multivariant analysis the variables significantly associated to mortality were the presence of cardiopathy (CI 95% OR 2,58-67,07), levels of LDH≥345IU/L (CI 95% OR 1,52-46,00), and age≥65 years (CI 95% OR 1,23-44,62). CONCLUSIONS The presence of cardiopathy, levels of LDH≥345IU/L and age ≥65 years are associated with a higher risk of death during hospital stay for COVID-19. This model should be validated in prospective cohorts.
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Affiliation(s)
- F Martos Pérez
- Servicio de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, España.
| | - J Luque Del Pino
- Servicio de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, España
| | - N Jiménez García
- Servicio de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, España
| | - E Mora Ruiz
- Servicio de Neumología, Hospital Costa del Sol, Marbella, Málaga, España
| | - C Asencio Méndez
- Servicio de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, España
| | - J M García Jiménez
- Servicio de Neumología, Hospital Costa del Sol, Marbella, Málaga, España
| | - F Navarro Romero
- Servicio de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, España
| | - M V Núñez Rodríguez
- Servicio de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, España
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Apt W, Carrasco D, Fuentealba C, Canals M, Muñoz G, Saavedra M, Castillo JP, Zulantay I. Chronic Chagas disease: Quantification of Trypanosoma cruzi in peripheral blood and dejections of Triatoma infestans fed by xenodiagnosis in patients with and without cardiopathy. Acta Trop 2019; 200:105167. [PMID: 31513762 DOI: 10.1016/j.actatropica.2019.105167] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/30/2019] [Accepted: 09/07/2019] [Indexed: 01/27/2023]
Abstract
It is not currently known which individuals with chronic Chagas disease (ChD) will develop cardiopathy in a determined period and which will be maintained asymptomatic with normal routine laboratory tests all their lives. The parasite burden is a factor that could explain this different evolution. The objective of this study was to quantify Trypanosoma cruzi burden by real-time PCR in blood (qPCR-B) and dejections of triatomines fed by xenodiagnosis (qPCR-XD) in 90 individuals with chronic ChD untreated, classified according to XD results and the presence or absence of cardiopathy. All individuals came from hyperendemic areas of Chile and participated in the study under Informed Consent. The standard qPCR curves for qPCR-B and qPCR-XD were elaborated with a mixture of known concentrations of T. cruzi strains, performing DNA serial dilutions (1/10) with a dynamic range between 105 and 10-1 parasite equivalents/mL. The TaqManⓇ detection system was applied in a Stratagene Mx3000P thermocycler (Agilent Technologies, USA) with cruzi 1 and cruzi 2 satellite primers. 22.2% and 15.6% of cases with cardiopathy or without cardiopathy were XD positive. There was no significant difference between the groups. The positivity of qPCR-B and qPCR-XD in the positive XD group was 82.35% and 100%, respectively, while in the negative XD group was 55.26% and 42.10%, respectively. A superior qPCR value in chronic ChD patients with and without cardiopathy was determined for qPCR in cases with positive XD and positive qPCR-XD. The receiver operating characteristic (ROC) curve analyses show better accuracy for detecting parasite burden (area under the curve, AUC) for qPCR-XD in comparison to qPCR-B. That is to say, major performance in DNA samples obtained of positive XD (gold standard for viable T. cruzi) detected and quantified by qPCR-XD. A high percentage of cases with XD and qPCR-XD positive (80-100%) have result concordant with qPCR-B. In absence of XD, future challenges are especially related to the low parasitic load of chronic ChD patients treated with trypanocidal drugs and post-therapy parasitological evaluations by qPCR-B. Finally, no statistically significant differences were found between presence or absence of cardiopathy and XD, qPCR-B or qPCR-XD.
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Affiliation(s)
- Werner Apt
- Laboratorio de Parasitología Básico-Clínico, Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Daniela Carrasco
- Laboratorio de Parasitología Básico-Clínico, Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile; Escuela de Tecnología Médica, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Cristian Fuentealba
- Laboratorio de Parasitología Básico-Clínico, Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile; Escuela de Tecnología Médica, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Mauricio Canals
- Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Gabriela Muñoz
- Laboratorio de Parasitología Básico-Clínico, Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Miguel Saavedra
- Laboratorio de Parasitología Básico-Clínico, Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Juan-Paul Castillo
- Laboratorio de Parasitología Básico-Clínico, Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Inés Zulantay
- Laboratorio de Parasitología Básico-Clínico, Programa de Biología Celular y Molecular, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
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Lucena Delgado J, Sanabria Carretero P, Durán la Fuente P, Gónzalez Rocafort A, Castro Parga L, Reinoso Barbero F. Cardiac arrest related to anaesthesia in Williams-Beuren syndrome. Rev Esp Anestesiol Reanim (Engl Ed) 2018; 65:234-237. [PMID: 29246395 DOI: 10.1016/j.redar.2017.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 10/31/2017] [Accepted: 11/13/2017] [Indexed: 06/07/2023]
Abstract
Williams-Beuren syndrome is the clinical manifestation of a congenital genetic disorder in the elastin gene, among others. There is a history of cardiac arrest refractory to resuscitation manoeuvres in anaesthesia. The incidence of myocardial ischaemia is high during anaesthetic induction, but there are patients who do not have this condition yet also have had very serious cardiac events, and issues that are still to be resolved. Case descriptions will enable the common pathophysiological factors to be defined, and decrease morbidity and mortality. We report the case of a 3-year-old boy with cardiac arrest at induction, rescued with circulatory assistance with extracorporeal membrane oxygenation and hypothermia induced for cerebral protection.
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Affiliation(s)
- J Lucena Delgado
- Departamento de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario La Paz, Madrid, España.
| | - P Sanabria Carretero
- Departamento de Anestesiología Pediátrica, Reanimación y Terapéutica del Dolor, Hospital Universitario La Paz, Madrid, España
| | - P Durán la Fuente
- Departamento de Anestesiología Pediátrica, Reanimación y Terapéutica del Dolor, Hospital Universitario La Paz, Madrid, España
| | - A Gónzalez Rocafort
- Departamento de Cirugía Cardíaca Pediátrica, Hospital Universitario La Paz, Madrid, España
| | - L Castro Parga
- Departamento de Anestesiología Pediátrica, Reanimación y Terapéutica del Dolor, Hospital Universitario La Paz, Madrid, España
| | - F Reinoso Barbero
- Departamento de Anestesiología Pediátrica, Reanimación y Terapéutica del Dolor, Hospital Universitario La Paz, Madrid, España
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10
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Smol T, Petit F, Piton A, Keren B, Sanlaville D, Afenjar A, Baker S, Bedoukian EC, Bhoj EJ, Bonneau D, Boudry-Labis E, Bouquillon S, Boute-Benejean O, Caumes R, Chatron N, Colson C, Coubes C, Coutton C, Devillard F, Dieux-Coeslier A, Doco-Fenzy M, Ewans LJ, Faivre L, Fassi E, Field M, Fournier C, Francannet C, Genevieve D, Giurgea I, Goldenberg A, Green AK, Guerrot AM, Heron D, Isidor B, Keena BA, Krock BL, Kuentz P, Lapi E, Le Meur N, Lesca G, Li D, Marey I, Mignot C, Nava C, Nesbitt A, Nicolas G, Roche-Lestienne C, Roscioli T, Satre V, Santani A, Stefanova M, Steinwall Larsen S, Saugier-Veber P, Picker-Minh S, Thuillier C, Verloes A, Vieville G, Wenzel M, Willems M, Whalen S, Zarate YA, Ziegler A, Manouvrier-Hanu S, Kalscheuer VM, Gerard B, Ghoumid J. MED13L-related intellectual disability: involvement of missense variants and delineation of the phenotype. Neurogenetics 2018; 19:93-103. [PMID: 29511999 DOI: 10.1007/s10048-018-0541-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 11/28/2017] [Accepted: 02/17/2018] [Indexed: 12/30/2022]
Abstract
Molecular anomalies in MED13L, leading to haploinsufficiency, have been reported in patients with moderate to severe intellectual disability (ID) and distinct facial features, with or without congenital heart defects. Phenotype of the patients was referred to "MED13L haploinsufficiency syndrome." Missense variants in MED13L were already previously described to cause the MED13L-related syndrome, but only in a limited number of patients. Here we report 36 patients with MED13L molecular anomaly, recruited through an international collaboration between centers of expertise for developmental anomalies. All patients presented with intellectual disability and severe language impairment. Hypotonia, ataxia, and recognizable facial gestalt were frequent findings, but not congenital heart defects. We identified seven de novo missense variations, in addition to protein-truncating variants and intragenic deletions. Missense variants clustered in two mutation hot-spots, i.e., exons 15-17 and 25-31. We found that patients carrying missense mutations had more frequently epilepsy and showed a more severe phenotype. This study ascertains missense variations in MED13L as a cause for MED13L-related intellectual disability and improves the clinical delineation of the condition.
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Affiliation(s)
- T Smol
- Institut de Génétique Médicale, Hôpital Jeanne de Flandre, CHU Lille, Lille, France.,University of Lille, EA 7364-RADEME, Lille, France
| | - F Petit
- University of Lille, EA 7364-RADEME, Lille, France.,Service de Génétique Clinique, Hôpital Jeanne de Flandre, CHU Lille, avenue Eugène Avinée, Lille, France
| | - A Piton
- Laboratoire de diagnostic génétique, Institut de Génétique Médicale d'Alsace, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - B Keren
- Département de Génétique, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
| | - D Sanlaville
- Service de Génétique, Hospices Civils de Lyon, Lyon, France
| | - A Afenjar
- Service de Génétique, Hôpital d'Enfants Armand-Trousseau, AP-HP, Paris, France
| | - S Baker
- Department of Pathology Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - E C Bedoukian
- Roberts Individualized Medical Genetics Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - E J Bhoj
- Department of Pathology Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - D Bonneau
- Service de Génétique, CHU d'Angers, Angers, France
| | - E Boudry-Labis
- Institut de Génétique Médicale, Hôpital Jeanne de Flandre, CHU Lille, Lille, France
| | - S Bouquillon
- Institut de Génétique Médicale, Hôpital Jeanne de Flandre, CHU Lille, Lille, France
| | - O Boute-Benejean
- University of Lille, EA 7364-RADEME, Lille, France.,Service de Génétique Clinique, Hôpital Jeanne de Flandre, CHU Lille, avenue Eugène Avinée, Lille, France
| | - R Caumes
- Service de Génétique Clinique, Hôpital Jeanne de Flandre, CHU Lille, avenue Eugène Avinée, Lille, France
| | - N Chatron
- Service de Génétique, Hospices Civils de Lyon, Lyon, France
| | - C Colson
- University of Lille, EA 7364-RADEME, Lille, France.,Service de Génétique Clinique, Hôpital Jeanne de Flandre, CHU Lille, avenue Eugène Avinée, Lille, France
| | - C Coubes
- Département de Génétique Médicale, CHU Montpellier, Montpellier, France
| | - C Coutton
- Laboratoire de Génétique Chromosomique, CHU Grenoble Alpes, Grenoble, France
| | - F Devillard
- Laboratoire de Génétique Chromosomique, CHU Grenoble Alpes, Grenoble, France
| | - A Dieux-Coeslier
- University of Lille, EA 7364-RADEME, Lille, France.,Service de Génétique Clinique, Hôpital Jeanne de Flandre, CHU Lille, avenue Eugène Avinée, Lille, France
| | - M Doco-Fenzy
- Service de Génétique, EA3801, SFR-CAP Santé, CHU de Reims, Reims, France
| | - L J Ewans
- St Vincent's Clinical School, University of New South Wales, Darlinghurst, New South Wales, Australia
| | - L Faivre
- Centre de Génétique et Centre de Référence Maladies Rares 'Anomalies du Développement, CHU Dijon, Dijon, France.,Equipe GAD, UMR INSERM 1231, Université de Bourgogne, Dijon, France
| | - E Fassi
- Division of Genetics and Genomic Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - M Field
- The Genetics of Learning Disability Service, Waratah, New South Wales, Australia
| | - C Fournier
- Laboratoire de diagnostic génétique, Institut de Génétique Médicale d'Alsace, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - C Francannet
- Service de Génétique Médicale, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - D Genevieve
- Département de Génétique Médicale, CHU Montpellier, Montpellier, France
| | - I Giurgea
- Service de Génétique, Hôpital Trousseau, AP-HP, Paris, France
| | - A Goldenberg
- Service de Génétique et Inserm U1079, Centre Normand de Génomique Médicale et Médecine Personnalisée, CHU de Rouen, Inserm et Université de Rouen, Rouen, France
| | - A K Green
- Department of Clinical Genetics, University Hospital Linköping, Linköping, Sweden
| | - A M Guerrot
- Service de Génétique et Inserm U1079, Centre Normand de Génomique Médicale et Médecine Personnalisée, CHU de Rouen, Inserm et Université de Rouen, Rouen, France
| | - D Heron
- Département de Génétique, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
| | - B Isidor
- Service de Génétique Médicale, Unité de Génétique Clinique, CHU de Nantes, Nantes, France
| | - B A Keena
- Clinical Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - B L Krock
- Department of Pathology Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - P Kuentz
- Equipe GAD, UMR INSERM 1231, Université de Bourgogne, Dijon, France
| | - E Lapi
- Medical Genetics Unit, Anna Meyer Children's University Hospital, Florence, Italy
| | - N Le Meur
- Service de Génétique et Inserm U1079, Centre Normand de Génomique Médicale et Médecine Personnalisée, CHU de Rouen, Inserm et Université de Rouen, Rouen, France
| | - G Lesca
- Service de Génétique, Hospices Civils de Lyon, Lyon, France
| | - D Li
- Department of Pathology Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - I Marey
- Département de Génétique, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
| | - C Mignot
- Département de Génétique, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
| | - C Nava
- Département de Génétique, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
| | - A Nesbitt
- Department of Pathology Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - G Nicolas
- Service de Génétique et Inserm U1079, Centre Normand de Génomique Médicale et Médecine Personnalisée, CHU de Rouen, Inserm et Université de Rouen, Rouen, France
| | - C Roche-Lestienne
- Institut de Génétique Médicale, Hôpital Jeanne de Flandre, CHU Lille, Lille, France
| | - T Roscioli
- St Vincent's Clinical School, University of New South Wales, Darlinghurst, New South Wales, Australia
| | - V Satre
- Laboratoire de Génétique Chromosomique, CHU Grenoble Alpes, Grenoble, France
| | - A Santani
- Department of Pathology Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - M Stefanova
- Department of Clinical Genetics, University Hospital Linköping, Linköping, Sweden
| | - S Steinwall Larsen
- Department of Clinical Genetics, University Hospital Linköping, Linköping, Sweden
| | - P Saugier-Veber
- Service de Génétique et Inserm U1079, Centre Normand de Génomique Médicale et Médecine Personnalisée, CHU de Rouen, Inserm et Université de Rouen, Rouen, France
| | - S Picker-Minh
- Department of Pediatric Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - C Thuillier
- Institut de Génétique Médicale, Hôpital Jeanne de Flandre, CHU Lille, Lille, France
| | - A Verloes
- Unité Fonctionnelle de Génétique Clinique, Hôpital Robert Debré, AP-HP, Paris, France
| | - G Vieville
- Laboratoire de Génétique Chromosomique, CHU Grenoble Alpes, Grenoble, France
| | - M Wenzel
- Clinical Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - M Willems
- Département de Génétique Médicale, CHU Montpellier, Montpellier, France
| | - S Whalen
- Département de Génétique, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
| | - Y A Zarate
- Section of Genetics and Metabolism, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - A Ziegler
- Service de Génétique, CHU d'Angers, Angers, France
| | - S Manouvrier-Hanu
- University of Lille, EA 7364-RADEME, Lille, France.,Service de Génétique Clinique, Hôpital Jeanne de Flandre, CHU Lille, avenue Eugène Avinée, Lille, France
| | - V M Kalscheuer
- Research Group Development and Disease, Max Planck Institute for Molecular Genetics, Berlin, Germany
| | - B Gerard
- Laboratoire de diagnostic génétique, Institut de Génétique Médicale d'Alsace, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Jamal Ghoumid
- University of Lille, EA 7364-RADEME, Lille, France. .,Service de Génétique Clinique, Hôpital Jeanne de Flandre, CHU Lille, avenue Eugène Avinée, Lille, France.
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11
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Volschan ICM, Kasuki L, Silva CMS, Alcantara ML, Saraiva RM, Xavier SS, Gadelha MR. Two-dimensional speckle tracking echocardiography demonstrates no effect of active acromegaly on left ventricular strain. Pituitary 2017; 20:349-357. [PMID: 28220351 DOI: 10.1007/s11102-017-0795-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Speckle tracking echocardiography (STE) allows for the study of myocardial strain (ε), a marker of early and subclinical ventricular systolic dysfunction. Cardiac disease may be present in patients with acromegaly; however, STE has never been used to evaluate these patients. OBJECTIVE To evaluate left ventricular (LV) global longitudinal strain in patients with active acromegaly with normal LV systolic function. DESIGN Cross-sectional clinical study. METHODS Patients with active acromegaly with no detectable heart disease and a control group were matched for age, gender, arterial hypertension and diabetes mellitus underwent STE. Global LV longitudinal ε (GLS), left ventricular mass index (LVMi), left ventricular ejection fraction (LVEF) and relative wall thickness (RWT) were obtained via two-dimensional (2D) echocardiography using STE. RESULTS Thirty-seven patients with active acromegaly (mean age 45.6 ± 13.8; 48.6% were males) and 48 controls were included. The mean GLS was not significantly different between the acromegaly group and the control group (in %, -20.1 ± 3.1 vs. -19.4 ± 2.2, p = 0.256). Mean LVMi was increased in the acromegaly group (in g/m2, 101.6 ± 27.1 vs. 73.2 ± 18.6, p < 0.01). There was a negative correlation between LVMi and GLS (r = -0.39, p = 0.01). CONCLUSIONS Acromegaly patients, despite presenting with a higher LVMi when analyzed by 2D echocardiography, did not present with impairment in the strain when compared to a control group; this finding indicates a low chance of evolution to systolic dysfunction and agrees with recent studies that show a lower frequency of cardiac disease in these patients.
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Affiliation(s)
- I C M Volschan
- Cardiology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rodolpho Paulo Rocco, 255, 9th floor, Ilha do Fundão, Rio de Janeiro, 21941-913, Brazil.
| | - L Kasuki
- Neuroendocrinology Research Center/ Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Neuroendocrine Unit, Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria Estadual de Saúde do Rio de Janeiro, Rio de Janeiro, Brazil
- Endocrine Section, Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil
| | - C M S Silva
- Neuroendocrinology Research Center/ Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - M L Alcantara
- Echocardiographic Section, Hospital Samaritano e Americas Medical City, Rio de Janeiro, Brazil
| | - R M Saraiva
- Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - S S Xavier
- Cardiology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rodolpho Paulo Rocco, 255, 9th floor, Ilha do Fundão, Rio de Janeiro, 21941-913, Brazil
| | - M R Gadelha
- Neuroendocrinology Research Center/ Endocrinology Section, Medical School and Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Neuroendocrine Unit, Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria Estadual de Saúde do Rio de Janeiro, Rio de Janeiro, Brazil
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12
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Ambonville C, Bouldouyre MA, Laforêt P, Richard P, Benveniste O, Vigouroux C. [A complex case of diabetes due to LMNA mutation]. Rev Med Interne 2017; 38:695-699. [PMID: 28545855 DOI: 10.1016/j.revmed.2017.04.006] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 04/07/2017] [Accepted: 04/20/2017] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Laminopathies (diseases related to A/C mutations of lamines) are rare genetic diseases with an extensive phenotypic spectrum, including lipodystrophic syndromes-characterized by a selective loss of adipose tissue-of which the partial Dunnigan family type is the most frequent. CASE REPORT We report on a 55-year-old woman with diabetes and long-term disabling myalgia. Her cushingoid morphotype, associated with cutaneous lipo-atrophy and muscle hypertrophy in addition to a genetic heritage, led us to the diagnosis of complex partial familial lipodystrophy heterozygous LMNA_c.82C>T, p.Arg28Trp mutation. CONCLUSION Familial partial lipodystrophic syndromes may have varied phenotypes, mainly cardio-metabolic, which could mimic a particularly severe type 2 diabetes. The diagnostic work-up of this disease has to include a careful investigation of gait troubles and paroxysmal conduction that could lead to sudden death, as well as a genetic examination. In some cases, recombinant leptin can be proposed.
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Affiliation(s)
- C Ambonville
- Service d'endocrinologie, diabétologie et maladies métaboliques, centre hospitalier intercommunal Robert-Ballanger, 93603 Aulnay-sous-Bois, France
| | - M-A Bouldouyre
- Service de médecine interne et maladies infectieuses, centre hospitalier intercommunal Robert-Ballanger, 93603 Aulnay-sous-Bois, France.
| | - P Laforêt
- Centre de référence pathologie neuromusculaire Paris Est, groupe hospitalier Pitié-Salpétrière, AH-HP, 43-87, boulevard de l'Hôpital, 75013 Paris, France
| | - P Richard
- Unité fonctionnelle de cardiogénétique et myogénétique moléculaire et cellulaire, service de biochimie métabolique, hôpitaux universitaires Pitié-Salpétrière Charles-Foix, AP-HP, 43-87, boulevard de l'Hôpital, 75013 Paris, France
| | - O Benveniste
- Département de médecine interne et immunologie clinique, centre de référence des maladies rares, pathologies du muscle inflammatoire, groupe hospitalier Pitié-Salpétrière, AP-HP, 43-87, boulevard de l'Hôpital, 75013 Paris, France
| | - C Vigouroux
- Service d'endocrinologie et laboratoire commun de biologie et génétique moléculaires, hôpital Saint-Antoine, AP-HP, 75012 Paris, France; Inserm UMR_S938, centre de recherche Saint-Antoine (CRSA), ICAN, institut de cardio-métabolisme et nutrition, Sorbonne universités, UPMC université Paris 6, 75012 Paris, France
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13
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Abstract
The G-protein-coupled receptor APJ and its endogenous ligand apelin are widely expressed in many peripheral tissues and central nervous system, including adipose tissue, skeletal muscles and hypothalamus. Apelin/APJ system, involved in numerous physiological functions like angiogenesis, fluid homeostasis and energy metabolism regulation, is notably implicated in the development of different pathologies such as diabetes and its complications. Increasing evidence suggests that apelin regulates insulin sensitivity, stimulates glucose utilization and enhances brown adipogenesis in different tissues associated with diabetes. Moreover, apelin is also involved in the regulation of diabetic complications via binding to APJ receptor. Apelin improves diabetes-induced kidney hypertrophia, normalizes obesity-associated cardiac hypertrophy and negatively promotes retinal angiogenesis in diabetic retinopathy. In this review, we provide a comprehensive overview about the role of apelin/APJ system in different tissues related with diabetes. Furthermore, we describe the pathogenesis of diabetic complications associated with apelin/APJ system. Finally, agonists and antagonists targeted to APJ receptor are described in the literature. Thus, we highlight apelin/APJ system as a novel therapeutic target for pharmacological intervention in treating diabetes and its complications.
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Affiliation(s)
- Haoliang Hu
- Institute of Pharmacy and Pharmacology, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang 421001, China
| | - Lu He
- Institute of Pharmacy and Pharmacology, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang 421001, China; Department of Neurosurgery, The First Affiliated Hospital of University of South China, Hengyang 421001, China
| | - Lanfang Li
- Institute of Pharmacy and Pharmacology, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang 421001, China.
| | - Linxi Chen
- Institute of Pharmacy and Pharmacology, Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang 421001, China.
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14
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Khemiri K, Jenayah AA, Boudaya F, Hamdi A, Meskhi S, Sfar E, Chelli D. [Epidemiological profile of cardiac pregnant women at Tunis maternity center: a service experience]. Pan Afr Med J 2015; 21:140. [PMID: 26327977 PMCID: PMC4546776 DOI: 10.11604/pamj.2015.21.140.5915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 12/09/2014] [Accepted: 06/09/2015] [Indexed: 11/11/2022] Open
Abstract
Nous rapportons dans ce travail, le profil épidémiologique des femmes enceintes porteuses d'une cardiopathie ayant accouché dans le service «A» du centre de maternité de Tunis. Il s'agit d'une étude rétrospective descriptive sur 3 ans, de janvier 2010 à décembre 2012, portant sur les dossiers des parturientes cardiaques suivies et ayant accouché dans notre service, à l'exclusion des cardiopathies hypertensives. Les paramètres analysés étaient la gestité et parité des parturientes, le type de la cardiopathie, le mode d'accouchement et le pronostic foetal. Cinquante six cas sur 19655 accouchements avaient été recrutés, soit une incidence de 1 pour 351 accouchements (0,285%). L’âge moyen de nos parturientes était de 30,89±5,3 ans avec des extrêmes allant de 21 à 42 ans. 23 (41,07%) avaient une cardiopathie congénitale, 35 (62,5%) une valvulopathie, 6 (10,71%) un trouble du rythme, 3 (5,35%) un trouble de la conduction à type de bloc auriculo-ventriculaire et 3 (5,35%) une cardiopathie ischémique. Cinquante deux parturientes (92,85%) avaient accouché à un terme dépassant les 37 semaines d'aménorrhée (SA). L'accouchement s'est déroulé par les voies naturelles chez 22 (39,28%) patientes et par césarienne chez 34 (60,71%). Le poids moyen des nouveaux nés à la naissance était de 3341,25 grammes. 3 transferts néonataux en unité de réanimation étaient réalisés avec un seul cas de décès néonatal. La grossesse et l'accouchement chez la femme cardiaque constituent un haut risque materno-foetal dépendant du type, mais surtout du stade de la cardiopathie, nécessitant une prise en charge précoce et multidisciplinaire de la parturiente.
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Affiliation(s)
- Khaled Khemiri
- Service de Gynécologie Obstétrique A, Centre de Maternité et de Néonatologie de Tunis, Tunisie
| | - Amel Achour Jenayah
- Service de Gynécologie Obstétrique A, Centre de Maternité et de Néonatologie de Tunis, Tunisie
| | - Fethia Boudaya
- Service de Gynécologie Obstétrique A, Centre de Maternité et de Néonatologie de Tunis, Tunisie
| | - Asma Hamdi
- Service de Gynécologie Obstétrique A, Centre de Maternité et de Néonatologie de Tunis, Tunisie
| | - Souad Meskhi
- Service de Gynécologie Obstétrique A, Centre de Maternité et de Néonatologie de Tunis, Tunisie
| | - Ezzeddine Sfar
- Service de Gynécologie Obstétrique A, Centre de Maternité et de Néonatologie de Tunis, Tunisie
| | - Dalenda Chelli
- Service de Gynécologie Obstétrique A, Centre de Maternité et de Néonatologie de Tunis, Tunisie
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15
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Tahiri M, Drighil A, Jalal Y, Ghellab D, Hliwa W, Fouad H, Badre W, Bellabah A, Habbal R, Alaoui R. Chronic permanent hypoxemia predisposes to mild elevation of liver stiffness. World J Gastroenterol 2014; 20:10564-10569. [PMID: 25132776 PMCID: PMC4130867 DOI: 10.3748/wjg.v20.i30.10564] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 10/06/2013] [Accepted: 01/06/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the impact of long term permanent hypoxemia noticed in patients with non operated congenital cyanogenic cyanotic cardiopathy on liver stiffness.
METHODS: We included ten adult patients with non operated inoperate cyanotic cardiopathy and ten matched patients for age and gender admitted to the gastroenterology department for proctologic diseases; Clinical and laboratory data were collected [age, gender, body mass index, oxygen saturation, glutamate oxaloacetate transaminase (GOT), glutamate pyruvate transaminase (GPT), glycemia and cholesterol]. Measurement of hepatic stiffness by transient elastography was carried out in all patients using the Fibroscan device. All patients underwent an echocardiography to eliminate congestive heart failure.
RESULTS: Among the patients with cyanotic cardiopathy, median liver stiffness 5.9 ± 1.3 kPa was greater than control group (4.7 ± 0.4 kPa) (P = 0.008). Median levels of GOT, GPT, gamma-glutamyltransferase, glycemia and cholesterol were comparable in cardiopathy and control group. In regression analysis including age, gender, body mass index, oxygen saturation, GOT, GPT, glycemia, cholesterol showed that only oxygen saturation was related to liver stiffness (r = -0.63 P = 0.002).
CONCLUSION: Chronic permanent hypoxemia can induce mild increase of liver stiffness, but further studies are needed to explore the histological aspects of liver injury induced by chronic permanent hypoxemia.
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