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van Dissel AC, Opotowsky AR, Burchill LJ, Aboulhosn J, Grewal J, Lubert AM, Antonova P, Shah S, Cotts T, John AS, Kay WA, DeZorzi C, Magalski A, Han F, Baker D, Kay J, Yeung E, Vonder Muhll I, Pylypchuk S, Kuo MC, Nicolarsen J, Sarubbi B, Fusco F, Jameson SM, Cramer J, Gupta T, Gallego P, O’Donnell C, Hannah J, Dellborg M, Kauling RM, Ginde S, Krieger EV, Rodriguez F, Dehghani P, Kutty S, Wong J, Wilson WM, Rodriguez-Monserrate CP, Roos-Hesselink J, Celermajer DS, Khairy P, Broberg CS. End-stage heart failure in congenitally corrected transposition of the great arteries: a multicentre study. Eur Heart J 2023; 44:3278-3291. [PMID: 37592821 PMCID: PMC10482567 DOI: 10.1093/eurheartj/ehad511] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 05/19/2023] [Accepted: 07/25/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND AND AIMS For patients with congenitally corrected transposition of the great arteries (ccTGA), factors associated with progression to end-stage congestive heart failure (CHF) remain largely unclear. METHODS This multicentre, retrospective cohort study included adults with ccTGA seen at a congenital heart disease centre. Clinical data from initial and most recent visits were obtained. The composite primary outcome was mechanical circulatory support, heart transplantation, or death. RESULTS From 558 patients (48% female, age at first visit 36 ± 14.2 years, median follow-up 8.7 years), the event rate of the primary outcome was 15.4 per 1000 person-years (11 mechanical circulatory support implantations, 12 transplantations, and 52 deaths). Patients experiencing the primary outcome were older and more likely to have a history of atrial arrhythmia. The primary outcome was highest in those with both moderate/severe right ventricular (RV) dysfunction and tricuspid regurgitation (n = 110, 31 events) and uncommon in those with mild/less RV dysfunction and tricuspid regurgitation (n = 181, 13 events, P < .001). Outcomes were not different based on anatomic complexity and history of tricuspid valve surgery or of subpulmonic obstruction. New CHF admission or ventricular arrhythmia was associated with the primary outcome. Individuals who underwent childhood surgery had more adverse outcomes than age- and sex-matched controls. Multivariable Cox regression analysis identified older age, prior CHF admission, and severe RV dysfunction as independent predictors for the primary outcome. CONCLUSIONS Patients with ccTGA have variable deterioration to end-stage heart failure or death over time, commonly between their fifth and sixth decades. Predictors include arrhythmic and CHF events and severe RV dysfunction but not anatomy or need for tricuspid valve surgery.
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Affiliation(s)
- Alexandra C van Dissel
- Department of Clinical and Experimental Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Knight Cardiovascular Institute, Oregon Health and Science University, 3181 SW Sam Jackson Pk Rd, Portland, OR 97221, USA
| | - Alexander R Opotowsky
- Department of Paediatrics, Cincinnati Children’s Hospital Medical Centre, Heart Institute, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Luke J Burchill
- Department of Medicine, Royal Melbourne Hospital, Melbourne, Australia
| | | | - Jasmine Grewal
- Division of Cardiology, St Paul’s Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Adam M Lubert
- Department of Paediatrics, Cincinnati Children’s Hospital Medical Centre, Heart Institute, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | | | | - Timothy Cotts
- University of Michigan Medical Centre, Ann Arbor, MI, USA
| | | | | | - Christopher DeZorzi
- University of Missouri–Kansas City and Saint Luke’s Hospital, Kansas City, MO, USA
| | - Anthony Magalski
- University of Missouri–Kansas City and Saint Luke’s Hospital, Kansas City, MO, USA
| | - Frank Han
- University of Illinois, Chicago, IL, USA
| | - David Baker
- The University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia
| | - Joseph Kay
- Colorado University School of Medicine, Denver, CO, USA
| | | | | | | | - Marissa C Kuo
- Emory University School of Medicine, Atlanta, GA, USA
| | | | | | | | - Susan M Jameson
- Departments of Paediatrics and Cardiovascular Medicine, School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Jonathan Cramer
- Children’s Hospital, University of Nebraska Medical Centre, Omaha, NE, USA
| | | | - Pastora Gallego
- Hospital Universitario Virgen Del Rocio, Sevilla, Spain
- European Reference Network for Rare, Low Prevalence and Complex Disease of the Heart—ERN GUARD Heart
| | - Clare O’Donnell
- Green Lane Paediatric and Congenital Cardiac Service, Auckland City Hospital, Auckland, New Zealand
| | - Jane Hannah
- Green Lane Paediatric and Congenital Cardiac Service, Auckland City Hospital, Auckland, New Zealand
| | - Mikael Dellborg
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Salil Ginde
- Children’s Hospital of Wisconsin, Milwaukee, WI, USA
| | - Eric V Krieger
- University of Washington Medical Centre and Seattle Children’s Hospital, Seattle, WA, USA
| | | | | | | | - Joshua Wong
- Department of Medicine, Royal Melbourne Hospital, Melbourne, Australia
| | - William M Wilson
- Department of Medicine, Royal Melbourne Hospital, Melbourne, Australia
| | | | - Jolien Roos-Hesselink
- European Reference Network for Rare, Low Prevalence and Complex Disease of the Heart—ERN GUARD Heart
- Erasmus Medical Centre, Rotterdam, The Netherlands
| | - David S Celermajer
- The University of Sydney and Royal Prince Alfred Hospital, Sydney, Australia
| | - Paul Khairy
- Montreal Heart Institute, Université de Montréal, Montreal, Canada
| | - Craig S Broberg
- Knight Cardiovascular Institute, Oregon Health and Science University, 3181 SW Sam Jackson Pk Rd, Portland, OR 97221, USA
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2
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Koncina E, Nurmik M, Pozdeev VI, Gilson C, Tsenkova M, Begaj R, Stang S, Gaigneaux A, Weindorfer C, Rodriguez F, Schmoetten M, Klein E, Karta J, Atanasova VS, Grzyb K, Ullmann P, Halder R, Hengstschläger M, Graas J, Augendre V, Karapetyan YE, Kerger L, Zuegel N, Skupin A, Haan S, Meiser J, Dolznig H, Letellier E. IL1R1 + cancer-associated fibroblasts drive tumor development and immunosuppression in colorectal cancer. Nat Commun 2023; 14:4251. [PMID: 37460545 DOI: 10.1038/s41467-023-39953-w] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 07/05/2023] [Indexed: 07/20/2023] Open
Abstract
Fibroblasts have a considerable functional and molecular heterogeneity and can play various roles in the tumor microenvironment. Here we identify a pro-tumorigenic IL1R1+, IL-1-high-signaling subtype of fibroblasts, using multiple colorectal cancer (CRC) patient single cell sequencing datasets. This subtype of fibroblasts is linked to T cell and macrophage suppression and leads to increased cancer cell growth in 3D co-culture assays. Furthermore, both a fibroblast-specific IL1R1 knockout and IL-1 receptor antagonist Anakinra administration reduce tumor growth in vivo. This is accompanied by reduced intratumoral Th17 cell infiltration. Accordingly, CRC patients who present with IL1R1-expressing cancer-associated-fibroblasts (CAFs), also display elevated levels of immune exhaustion markers, as well as an increased Th17 score and an overall worse survival. Altogether, this study underlines the therapeutic value of targeting IL1R1-expressing CAFs in the context of CRC.
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Affiliation(s)
- E Koncina
- Molecular Disease Mechanisms Group, Department of Life Sciences and Medicine, University of Luxembourg, Belval, Luxembourg
| | - M Nurmik
- Molecular Disease Mechanisms Group, Department of Life Sciences and Medicine, University of Luxembourg, Belval, Luxembourg
| | - V I Pozdeev
- Molecular Disease Mechanisms Group, Department of Life Sciences and Medicine, University of Luxembourg, Belval, Luxembourg
| | - C Gilson
- Molecular Disease Mechanisms Group, Department of Life Sciences and Medicine, University of Luxembourg, Belval, Luxembourg
| | - M Tsenkova
- Molecular Disease Mechanisms Group, Department of Life Sciences and Medicine, University of Luxembourg, Belval, Luxembourg
| | - R Begaj
- Molecular Disease Mechanisms Group, Department of Life Sciences and Medicine, University of Luxembourg, Belval, Luxembourg
| | - S Stang
- Center for Pathobiochemistry and Genetics, Institute of Medical Genetics, Medical University of Vienna, Vienna, Austria
| | - A Gaigneaux
- Molecular Disease Mechanisms Group, Department of Life Sciences and Medicine, University of Luxembourg, Belval, Luxembourg
| | - C Weindorfer
- Center for Pathobiochemistry and Genetics, Institute of Medical Genetics, Medical University of Vienna, Vienna, Austria
| | - F Rodriguez
- Molecular Disease Mechanisms Group, Department of Life Sciences and Medicine, University of Luxembourg, Belval, Luxembourg
| | - M Schmoetten
- Molecular Disease Mechanisms Group, Department of Life Sciences and Medicine, University of Luxembourg, Belval, Luxembourg
| | - E Klein
- Molecular Disease Mechanisms Group, Department of Life Sciences and Medicine, University of Luxembourg, Belval, Luxembourg
| | - J Karta
- Molecular Disease Mechanisms Group, Department of Life Sciences and Medicine, University of Luxembourg, Belval, Luxembourg
| | - V S Atanasova
- Center for Pathobiochemistry and Genetics, Institute of Medical Genetics, Medical University of Vienna, Vienna, Austria
| | - K Grzyb
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Belval, Luxembourg
| | - P Ullmann
- Molecular Disease Mechanisms Group, Department of Life Sciences and Medicine, University of Luxembourg, Belval, Luxembourg
| | - R Halder
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Belval, Luxembourg
| | - M Hengstschläger
- Center for Pathobiochemistry and Genetics, Institute of Medical Genetics, Medical University of Vienna, Vienna, Austria
| | - J Graas
- Clinical and Epidemiological Investigation Center, Department of Population Health, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - V Augendre
- National Center of Pathology, Laboratoire National de Santé, Dudelange, Luxembourg
| | | | - L Kerger
- Department of Surgery, Centre Hospitalier Emile Mayrisch, Esch-sur-Alzette, Luxembourg
| | - N Zuegel
- Department of Surgery, Centre Hospitalier Emile Mayrisch, Esch-sur-Alzette, Luxembourg
| | - A Skupin
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Belval, Luxembourg
| | - S Haan
- Molecular Disease Mechanisms Group, Department of Life Sciences and Medicine, University of Luxembourg, Belval, Luxembourg
| | - J Meiser
- Cancer Metabolism Group, Department of Cancer Research, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - H Dolznig
- Center for Pathobiochemistry and Genetics, Institute of Medical Genetics, Medical University of Vienna, Vienna, Austria.
| | - E Letellier
- Molecular Disease Mechanisms Group, Department of Life Sciences and Medicine, University of Luxembourg, Belval, Luxembourg.
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3
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Lewis MJ, Reardon LC, Aboulhosn J, Haeffele C, Chen S, Kim Y, Fuller S, Forbess L, Alshawabkeh L, Urey MA, Book WM, Rodriguez F, Menachem JN, Clark DE, Valente AM, Carazo M, Egbe A, Connolly HM, Krieger EV, Angiulo J, Cedars A, Ko J, Jacobsen RM, Earing MG, Cramer JW, Ermis P, Broda C, Nugaeva N, Ross H, Awerbach JD, Krasuski RA, Rosenbaum M. Clinical Outcomes of Adult Fontan-Associated Liver Disease and Combined Heart-Liver Transplantation. J Am Coll Cardiol 2023; 81:2149-2160. [PMID: 37257950 DOI: 10.1016/j.jacc.2023.03.421] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/02/2023] [Accepted: 03/27/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND The impact of Fontan-associated liver disease (FALD) on post-transplant mortality and indications for combined heart-liver transplant (CHLT) in adult Fontan patients remains unknown. OBJECTIVES The purpose of this study was to assess the impact of FALD on post-transplant outcomes and compare HT vs CHLT in adult Fontan patients. METHODS We performed a retrospective-cohort study of adult Fontan patients who underwent HT or CHLT across 15 centers. Inclusion criteria were as follows: 1) Fontan; 2) HT/CHLT referral; and 3) age ≥16 years at referral. Pretransplant FALD score was calculated using the following: 1) cirrhosis; 2) varices; 3) splenomegaly; or 4) ≥2 paracenteses. RESULTS A total of 131 patients (91 HT and 40 CHLT) were included. CHLT recipients were more likely to be older (P = 0.016), have a lower hemoglobin (P = 0.025), require ≥2 diuretic agents pretransplant (P = 0.051), or be transplanted in more recent decades (P = 0.001). Postmatching, CHLT demonstrated a trend toward improved survival at 1 year (93% vs 74%; P = 0.097) and improved survival at 5 years (86% vs 52%; P = 0.041) compared with HT alone. In patients with a FALD score ≥2, CHLT was associated with improved survival (1 year: 85% vs 62%; P = 0.044; 5 years: 77% vs 42%; P = 0.019). In a model with transplant decade and FALD score, CHLT was associated with improved survival (HR: 0.33; P = 0.044) and increasing FALD score was associated with worse survival (FALD score: 2 [HR: 14.6; P = 0.015], 3 [HR: 22.2; P = 0.007], and 4 [HR: 27.8; P = 0.011]). CONCLUSIONS Higher FALD scores were associated with post-transplant mortality. Although prospective confirmation of our findings is necessary, compared with HT alone, CHLT recipients were older with higher FALD scores, but had similar survival overall and superior survival in patients with a FALD score ≥2.
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Affiliation(s)
- Matthew J Lewis
- Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, New York, USA.
| | - Leigh C Reardon
- Department of Medicine, Division of Cardiology, Ahmason/UCLA Adult Congenital Heart Disease Center, University of California Los Angeles, Los Angeles, California, USA
| | - Jamil Aboulhosn
- Department of Medicine, Division of Cardiology, Ahmason/UCLA Adult Congenital Heart Disease Center, University of California Los Angeles, Los Angeles, California, USA
| | - Christiane Haeffele
- Division of Pediatric Cardiology, Department of Pediatrics, Stanford University, Palo Alto, California, USA
| | - Sharon Chen
- Division of Pediatric Cardiology, Department of Pediatrics, Stanford University, Palo Alto, California, USA
| | - Yuli Kim
- Division of Cardiology, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Stephanie Fuller
- Division of Cardiothoracic Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Lisa Forbess
- Division of Pediatric Cardiology, Department of Pediatrics, Northwestern University, Ann and Robert Lurie Children's Hospital, Chicago, Illinois, USA
| | - Laith Alshawabkeh
- Division of Cardiology, Department of Medicine, University of California, San Diego, California, USA
| | - Marcus A Urey
- Division of Cardiology, Department of Medicine, University of California, San Diego, California, USA
| | - Wendy M Book
- Division of Cardiology, Department of Medicine, Emory University, Atlanta, Georgia, USA
| | - Fred Rodriguez
- Division of Cardiology, Department of Medicine, Emory University, Atlanta, Georgia, USA
| | - Jonathan N Menachem
- Division of Cardiology, Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA
| | - Daniel E Clark
- Division of Cardiology, Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA
| | - Anne Marie Valente
- Department of Cardiology, Boston Children's Hospital, Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Harvard University, Boston, Massachusetts, USA
| | - Matthew Carazo
- Department of Cardiology, Boston Children's Hospital, Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Harvard University, Boston, Massachusetts, USA
| | - Alexander Egbe
- Division of Cardiology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Heidi M Connolly
- Division of Cardiology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Eric V Krieger
- Division of Cardiology, Department of Medicine, University of Washington and Seattle Children's Hospital, Seattle, Washington, USA
| | - Jilian Angiulo
- Division of Cardiology, Department of Medicine, University of Washington and Seattle Children's Hospital, Seattle, Washington, USA
| | - Ari Cedars
- Division of Cardiology, Department of Medicine, UT Southwestern, Dallas, Texas, USA
| | - Jong Ko
- Division of Cardiology, Department of Medicine, UT Southwestern, Dallas, Texas, USA
| | - Roni M Jacobsen
- Division of Cardiology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Michael G Earing
- Division of Cardiology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jonathan W Cramer
- Department of Pediatrics and Internal Medicine, Division of Cardiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Peter Ermis
- Division of Pediatric Cardiology and Adult Congenital Heart Disease, Department of Pediatrics, Texas Children's Hospital/Baylor College of Medicine, Houston, Texas, USA
| | - Christopher Broda
- Division of Pediatric Cardiology and Adult Congenital Heart Disease, Department of Pediatrics, Texas Children's Hospital/Baylor College of Medicine, Houston, Texas, USA
| | - Natalia Nugaeva
- Division of Cardiology, Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Heather Ross
- Division of Cardiology, Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Jordan D Awerbach
- Division of Cardiology, Phoenix Children's, Phoenix, AZ, Divisions of Child Health and Internal Medicine, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA
| | - Richard A Krasuski
- Division of Cardiology, Department of Medicine, Duke University, Raleigh Durham, North Carolina, USA
| | - Marlon Rosenbaum
- Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, New York, USA
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4
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Lewis MJ, Reardon LC, Aboulhosn J, Haeffele C, Chen S, Kim Y, Fuller S, Forbess L, Alshawabkeh L, Urey MA, Book WM, Rodriguez F, Menachem JN, Clark DE, Valente AM, Carazo M, Egbe A, Connolly HM, Krieger EV, Angiulo J, Cedars A, Ko J, Jacobsen RM, Earing MG, Cramer JW, Ermis P, Broda C, Nugaeva N, Ross H, Awerbach JD, Krasuski RA, Rosenbaum M. Morbidity and Mortality in Adult Fontan Patients After Heart or Combined Heart-Liver Transplantation. J Am Coll Cardiol 2023; 81:2161-2171. [PMID: 37257951 DOI: 10.1016/j.jacc.2023.03.422] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/07/2023] [Accepted: 03/27/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND An increasing number of adult Fontan patients require heart transplantation (HT) or combined heart-liver transplant (CHLT); however, data regarding outcomes and optimal referral time remain limited. OBJECTIVES The purpose of this study was to define survivorship post-HT/CHLT and predictors of post-transplant mortality, including timing of referral, in the adult Fontan population. METHODS A retrospective cohort study of adult Fontan patients who underwent HT or CHLT across 15 centers in the United States and Canada was performed. Inclusion criteria included the following: 1) Fontan; 2) HT/CHLT referral; and 3) age ≥16 years at the time of referral. Date of "failing" Fontan was defined as the earliest of the following: worsening fluid retention, new ascites, refractory arrhythmia, "failing Fontan" diagnosis by treating cardiologist, or admission for heart failure. RESULTS A total of 131 patients underwent transplant, including 40 CHLT, from 1995 to 2021 with a median post-transplant follow-up time of 1.6 years (Q1 0.35 years, Q3 4.3 years). Survival was 79% at 1 year and 66% at 5 years. Survival differed by decade of transplantation and was 87% at 1 year and 76% at 5 years after 2010. Time from Fontan failure to evaluation (HR/year: 1.23 [95% CI: 1.11-1.36]; P < 0.001) and markers of failure, including NYHA functional class IV (HR: 2.29 [95% CI: 1.10-5.28]; P = 0.050), lower extremity varicosities (HR: 3.92 [95% CI: 1.68-9.14]; P = 0.002), and venovenous collaterals (HR: 2.70 [95% CI: 1.17-6.20]; P = 0.019), were associated with decreased post-transplant survival at 1 year in a bivariate model that included transplant decade. CONCLUSIONS In our multicenter cohort, post-transplant survival improved over time. Late referral after Fontan failure and markers of failing Fontan physiology, including worse functional status, lower extremity varicosities, and venovenous collaterals, were associated with post-transplant mortality.
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Affiliation(s)
- Matthew J Lewis
- Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, New York, USA.
| | - Leigh C Reardon
- Department of Medicine, Division of Cardiology, Ahmason/UCLA Adult Congenital Heart Disease Center, University of California Los Angeles, Los Angeles, California, USA
| | - Jamil Aboulhosn
- Department of Medicine, Division of Cardiology, Ahmason/UCLA Adult Congenital Heart Disease Center, University of California Los Angeles, Los Angeles, California, USA
| | - Christiane Haeffele
- Division of Pediatric Cardiology, Department of Pediatrics, Stanford University, Palo Alto, California, USA
| | - Sharon Chen
- Division of Pediatric Cardiology, Department of Pediatrics, Stanford University, Palo Alto, California, USA
| | - Yuli Kim
- Division of Cardiology, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Stephanie Fuller
- Division of Cardiothoracic Surgery, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Lisa Forbess
- Division of Pediatric Cardiology, Department of Pediatrics, Northwestern University, Ann and Robert Lurie Children's Hospital, Chicago, Illinois, USA
| | - Laith Alshawabkeh
- Division of Cardiology, Department of Medicine, University of California, San Diego, California, USA
| | - Marcus A Urey
- Division of Cardiology, Department of Medicine, University of California, San Diego, California, USA
| | - Wendy M Book
- Division of Cardiology, Department of Medicine, Emory University, Atlanta, Georgia, USA
| | - Fred Rodriguez
- Division of Cardiology, Department of Medicine, Emory University, Atlanta, Georgia, USA
| | - Jonathan N Menachem
- Division of Cardiology, Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA
| | - Daniel E Clark
- Division of Cardiology, Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA
| | - Anne Marie Valente
- Department of Cardiology, Boston Children's Hospital, Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Harvard University, Boston, Massachusetts, USA
| | - Matthew Carazo
- Department of Cardiology, Boston Children's Hospital, Division of Cardiology, Department of Medicine, Brigham and Women's Hospital, Harvard University, Boston, Massachusetts, USA
| | - Alexander Egbe
- Division of Cardiology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Heidi M Connolly
- Division of Cardiology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Eric V Krieger
- Division of Cardiology, Department of Medicine University of Washington and Seattle Children's Hospital, Seattle, Washington, USA
| | - Jilian Angiulo
- Division of Cardiology, Department of Medicine University of Washington and Seattle Children's Hospital, Seattle, Washington, USA
| | - Ari Cedars
- Division of Cardiology, Department of Medicine, UT Southwestern, Dallas, Texas, USA
| | - Jong Ko
- Division of Cardiology, Department of Medicine, UT Southwestern, Dallas, Texas, USA
| | - Roni M Jacobsen
- Division of Cardiology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Michael G Earing
- Division of Cardiology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jonathan W Cramer
- Department of Pediatrics and Internal Medicine, Division of Cardiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Peter Ermis
- Division of Pediatric Cardiology and Adult Congenital Heart Disease, Department of Pediatrics, Texas Children's Hospital/Baylor College of Medicine, Houston, Texas, USA
| | - Christopher Broda
- Division of Pediatric Cardiology and Adult Congenital Heart Disease, Department of Pediatrics, Texas Children's Hospital/Baylor College of Medicine, Houston, Texas, USA
| | - Natalia Nugaeva
- Division of Cardiology, Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Heather Ross
- Division of Cardiology, Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Jordan D Awerbach
- Division of Cardiology, Phoenix Children's, Phoenix, AZ, Divisions of Child Health and Internal Medicine, University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA
| | - Richard A Krasuski
- Division of Cardiology, Department of Medicine, Duke University, Raleigh Durham, North Carolina, USA
| | - Marlon Rosenbaum
- Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, New York, USA
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5
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Rodriguez F, Nin N, Fajardo A, Aunchayna M, Guerendiaín R, Hurtado J. [Early lung autopsy in deceased patients with acute respiratory distress syndrome due to infection by SARS-CoV-2]. Med Intensiva 2023; 47:173-175. [PMID: 35935246 PMCID: PMC9339975 DOI: 10.1016/j.medin.2022.07.001] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 07/12/2022] [Indexed: 11/23/2022]
Affiliation(s)
- F. Rodriguez
- Unidad de Medicina Intensiva, Hospital Español «Juan J. Crottogini» ASSE, Montevideo, Uruguay,Autor para correspondencia
| | - N. Nin
- Unidad de Medicina Intensiva, Hospital Español «Juan J. Crottogini» ASSE, Montevideo, Uruguay
| | - A. Fajardo
- Laboratorio de Virología Molecular, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay
| | - M. Aunchayna
- Laboratorio de Anatomía Patológica, Hospital Maciel ASSE, Montevideo, Uruguay
| | - R. Guerendiaín
- Unidad de Medicina Intensiva, Hospital Español «Juan J. Crottogini» ASSE, Montevideo, Uruguay
| | - J. Hurtado
- Unidad de Medicina Intensiva, Hospital Español «Juan J. Crottogini» ASSE, Montevideo, Uruguay
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6
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Rodriguez F, Nin N, Fajardo A, Auchayna M, Guerendiaín R, Hurtado J. Early lung autopsy in deceased patients with acute respiratory distress syndrome due to infection by SARS-CoV-2. Med Intensiva 2023; 47:173-175. [PMID: 36272904 PMCID: PMC9579894 DOI: 10.1016/j.medine.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- F Rodriguez
- Unidad de Medicina Intensiva, Hospital Español "Juan J Crottogini" ASSE, Montevideo, Uruguay.
| | - N Nin
- Unidad de Medicina Intensiva, Hospital Español "Juan J Crottogini" ASSE, Montevideo, Uruguay
| | - A Fajardo
- Laboratorio de Virología Molecular, Facultad de Ciencias. Universidad de la República, Montevideo, Uruguay
| | - M Auchayna
- Laboratorio de Anatomía Patológica, Hospital Maciel ASSE, Montevideo, Uruguay
| | - R Guerendiaín
- Unidad de Medicina Intensiva, Hospital Español "Juan J Crottogini" ASSE, Montevideo, Uruguay
| | - J Hurtado
- Unidad de Medicina Intensiva, Hospital Español "Juan J Crottogini" ASSE, Montevideo, Uruguay
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Villacis-Nunez DS, West Z, Khan AY, Rodriguez F, Shane AL, Rytting H, Shashidharan S, Clifton MS, Woods G, Clabby M, Prahalad S. Successful Medical-Surgical Management of Intracardiac Thrombosis and Pulmonary Pseudoaneurysms in an Adolescent With Hughes-Stovin Syndrome. J Investig Med High Impact Case Rep 2023; 11:23247096231166672. [PMID: 37032536 PMCID: PMC10101212 DOI: 10.1177/23247096231166672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 03/06/2023] [Accepted: 03/12/2023] [Indexed: 04/11/2023] Open
Abstract
We present an adolescent male with a single intracardiac mass and pulmonary emboli, complicated by peripheral venous thrombosis and subsequent development of pulmonary pseudoaneurysms, leading to diagnosis of Hughes-Stovin syndrome. Remission was achieved with cyclophosphamide, corticosteroids, and pseudoaneurysm resection and maintained with infliximab and methotrexate.
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Affiliation(s)
- D. Sofia Villacis-Nunez
- Division of Pediatric Rheumatology,
Department of Pediatrics, Emory University School of Medicine, Atlanta, GA,
USA
- Children’s Healthcare of Atlanta,
Atlanta, GA, USA
| | - Zachary West
- Children’s Healthcare of Atlanta,
Atlanta, GA, USA
- Division of Pediatric Hospital
Medicine, Department of Pediatrics, Emory University School of Medicine, Atlanta,
GA, USA
| | - Adil Y. Khan
- Children’s Healthcare of Atlanta,
Atlanta, GA, USA
- Division of Pediatric Hospital
Medicine, Department of Pediatrics, Emory University School of Medicine, Atlanta,
GA, USA
| | - Fred Rodriguez
- Children’s Healthcare of Atlanta,
Atlanta, GA, USA
- Sibley Heart Center, Atlanta, GA,
USA
| | - Andi L. Shane
- Children’s Healthcare of Atlanta,
Atlanta, GA, USA
- Division of Pediatric Infectious
Diseases, Department of Pediatrics, Emory University School of Medicine, Atlanta,
GA, USA
| | - Heather Rytting
- Department of Pathology, Children’s
Healthcare of Atlanta, Atlanta, GA, USA
| | - Subhadra Shashidharan
- Children’s Healthcare of Atlanta,
Atlanta, GA, USA
- Department of Congenital Cardiac
Surgery, Emory University School of Medicine, Atlanta, GA, USA
| | - Matthew S. Clifton
- Children’s Healthcare of Atlanta,
Atlanta, GA, USA
- Department of Surgery, Emory University
School of Medicine, Atlanta, GA, USA
| | - Gary Woods
- Children’s Healthcare of Atlanta,
Atlanta, GA, USA
- Department of Pediatrics, Emory
University School of Medicine, Atlanta, GA, USA
| | - Martha Clabby
- Children’s Healthcare of Atlanta,
Atlanta, GA, USA
- Sibley Heart Center, Atlanta, GA,
USA
| | - Sampath Prahalad
- Division of Pediatric Rheumatology,
Department of Pediatrics, Emory University School of Medicine, Atlanta, GA,
USA
- Children’s Healthcare of Atlanta,
Atlanta, GA, USA
- Department of Human Genetics, Emory
University School of Medicine, Atlanta, GA, USA
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Broberg CS, van Dissel A, Minnier J, Aboulhosn J, Kauling RM, Ginde S, Krieger EV, Rodriguez F, Gupta T, Shah S, John AS, Cotts T, Kay WA, Kuo M, Dwight C, Woods P, Nicolarsen J, Sarubbi B, Fusco F, Antonova P, Fernandes S, Grewal J, Cramer J, Khairy P, Gallego P, O'Donnell C, Hannah J, Dellborg M, Rodriguez-Monserrate CP, Muhll IV, Pylypchuk S, Magalski A, Han F, Lubert AM, Kay J, Yeung E, Roos-Hesselink J, Baker D, Celermajer DS, Burchill LJ, Wilson WM, Wong J, Kutty S, Opotowsky AR. Long-Term Outcomes After Atrial Switch Operation for Transposition of the Great Arteries. J Am Coll Cardiol 2022; 80:951-963. [PMID: 36049802 DOI: 10.1016/j.jacc.2022.06.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [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: 02/07/2022] [Revised: 05/02/2022] [Accepted: 06/07/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND For patients with d-loop transposition of the great arteries (d-TGA) with a systemic right ventricle after an atrial switch operation, there is a need to identify risks for end-stage heart failure outcomes. OBJECTIVES The authors aimed to determine factors associated with survival in a large cohort of such individuals. METHODS This multicenter, retrospective cohort study included adults with d-TGA and prior atrial switch surgery seen at a congenital heart center. Clinical data from initial and most recent visits were obtained. The composite primary outcome was death, transplantation, or mechanical circulatory support (MCS). RESULTS From 1,168 patients (38% female, age at first visit 29 ± 7.2 years) during a median 9.2 years of follow-up, 91 (8.8% per 10 person-years) met the outcome (66 deaths, 19 transplantations, 6 MCS). Patients experiencing sudden/arrhythmic death were younger than those dying of other causes (32.6 ± 6.4 years vs 42.4 ± 6.8 years; P < 0.001). There was a long duration between sentinel clinical events and end-stage heart failure. Age, atrial arrhythmia, pacemaker, biventricular enlargement, systolic dysfunction, and tricuspid regurgitation were all associated with the primary outcome. Independent 5-year predictors of primary outcome were prior ventricular arrhythmia, heart failure admission, complex anatomy, QRS duration >120 ms, and severe right ventricle dysfunction based on echocardiography. CONCLUSIONS For most adults with d-TGA after atrial switch, progress to end-stage heart failure or death is slow. A simplified prediction score for 5-year adverse outcome is derived to help identify those at greatest risk.
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Affiliation(s)
- Craig S Broberg
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA.
| | - Alexandra van Dissel
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA; Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Jessica Minnier
- School of Public Health, Oregon Health and Science University, Portland, Oregon, USA
| | | | | | - Salil Ginde
- Children's Hospital of Wisconsin, Milwaukee, Wisconsin, USA
| | - Eric V Krieger
- University of Washington Medical Center and Seattle Children's Hospital, Seattle, Washington, USA
| | | | - Tripti Gupta
- Ochsner Medical Center, New Orleans, Louisiana, USA
| | | | | | - Timothy Cotts
- University of Michigan Medical Center, Ann Arbor, Michigan, USA
| | - W Aaron Kay
- Krannert Institute of Cardiology, Indianapolis, Indiana, USA
| | - Marissa Kuo
- Ochsner Medical Center, New Orleans, Louisiana, USA
| | - Cindy Dwight
- Krannert Institute of Cardiology, Indianapolis, Indiana, USA
| | - Patricia Woods
- Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
| | | | | | | | | | - Susan Fernandes
- Stanford University, School of Medicine, Departments of Pediatrics and Medicine, Palo Alto, California, USA
| | - Jasmine Grewal
- St. Paul's Hospital, Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jonathan Cramer
- Children's Hospital, Omaha & University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Paul Khairy
- Montreal Heart Institute, Montreal, Quebec, Canada
| | | | - Clare O'Donnell
- Green Lane Paediatric and Congenital Cardiac Service, Auckland City Hospital, Auckland, New Zealand
| | - Jane Hannah
- Green Lane Paediatric and Congenital Cardiac Service, Auckland City Hospital, Auckland, New Zealand
| | - Mikael Dellborg
- Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Carla P Rodriguez-Monserrate
- Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA; Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | | | - Frank Han
- University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Adam M Lubert
- Cincinnati Children's Hospital Medical Center, Heart Institute, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Joseph Kay
- Colorado University School of Medicine, Denver, Colorado, USA
| | - Elizabeth Yeung
- Colorado University School of Medicine, Denver, Colorado, USA
| | | | - David Baker
- University of Sydney and Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - David S Celermajer
- University of Sydney and Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Luke J Burchill
- Royal Melbourne Hospital, Department of Medicine, Melbourne, Victoria, Australia
| | - William M Wilson
- Royal Melbourne Hospital, Department of Medicine, Melbourne, Victoria, Australia
| | - Joshua Wong
- Royal Melbourne Hospital, Department of Medicine, Melbourne, Victoria, Australia
| | - Shelby Kutty
- Johns Hopkins University, Baltimore, Maryland, USA
| | - Alexander R Opotowsky
- Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA; Department of Medicine, Division of Cardiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; Cincinnati Children's Hospital Medical Center, Heart Institute, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Savio V, Maldini C, Alba P, Saurit V, Berbotto G, Pisoni C, Tissera Y, Nieto R, Maldonado F, Ornella S, Gobbi C, Baños AR, Vivero F, Exeni IE, Cusa A, Bellomio VI, Perez Alamino R, Gomez G, Zelaya D, Risueño F, Quaglia MI, Correa MDLA, Rojas Tessel R, Delavega M, Lazaro MA, Mercé AL, Finucci P, Matellan CE, Romeo C, Martire V, Moyano S, Martin ML, Picco E, Goizueta C, Tralice ER, Tamborenea MN, Subils GC, Gallo R, Pineda Vidal SI, Velasco Zamora JL, Lloves Schenone N, Cosentino V, Rodriguez F, Diaz MP, Viola M, Mamani Ortega ML, Buschiazzo E, Gómez G, Roberts K, Quintana R, Isnardi CA, Pons-Estel G. POS1199 IS PSORIATIC ARTHRITIS A RISK FACTOR FOR SEVERE COVID -19 INFECTION? DATA FROM THE ARGENTINIAN REGISTRY SAR-COVID. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundComorbidities, particularly cardio-metabolic disorders, are highly prevalent in patients with psoriatic arthritis (PsA) and they were associated with an increased risk of atherosclerotic cardiovascular disease, which have been associated with higher morbidity and mortality. Whether PsA enhances the risk of SARS-CoV-2 infection or affects the disease outcome remains to be ascertained.ObjectivesTo describe the sociodemographic, clinical and treatment characteristics of patients with PsA with confirmed SARS-CoV-2 infection from the SAR-COVID registry and to identify the variables associated with poor COVID-19 outcomes, comparing them with those with rheumatoid arthritis (RA).MethodsCross-sectional observational study including patients ≥18 years old, with diagnosis of PsA (CASPAR criteria) and RA (ACR / EULAR 2010 criteria), who had confirmed SARS-CoV-2 infection (RT-PCR or serology) from the SAR-COVID registry. Recruitment period was between August 13, 2020 and July 31, 2021. Sociodemographic variables, comorbidities, and treatments were analyzed. To assess the severity of the infection, the ordinal scale of the National Institute of Allergy and Infectious Diseases (NIAID)1 was used, and it was considered that a patient met the primary outcome, if they presented criteria of categories 5 or higher on the severity scale. For this analysis, Chi2 test, Fisher’s test, Student’s test or Wilcoxon test, and binomial logistic regression using NIAID>=5 as dependent variable were performed.ResultsA total of 129 PsA patients and 808 with RA were included. Clinical characteristics are shown in Table 1. Regarding PsA treatment, 12.4% of PsA were receiving IL-17 inhibitors, 5.4% IL12-23 inhibitors, one patient apremilast and one abatacept. The frequency of NIAID≥5 was comparable between groups (PsA 19.5% vs RA 20.1%; p=0.976). (Figure 1).Table 1.Characteristics of patients with PsA and RA who presented COVID-19 in the SAR-COVID registry.Psoriatic arthritis (n=129)Rheumatoid arthritis (n=808)P valueTotal (n=937)Age (years), mean (SD)51.7 (12.7)53.1 (12.9)0.23952.9 (12.9)Female72 (55.8)684 (84.7)<0.001756 (80.7)Comorbidities65 (50.4)355 (43.9)0.203420 (44.8) Obesity (BMI ≥30)19 (15.2)102 (13.4)0.692121 (13.7) Morbid obesity (BMI ≥40)1 (0.8)10 (1.3)111 (1.25) Hypertension35 (28.5)205 (26.8)0.783240 (27.0) Diabetes16 (13.0)67 (8.8)0.18883 (9.39) Dyslipidemia24 (19.5)102 (13.5)0.106126 (14.4) Cardiovascular or cerebrovascular disease5 (11.4)32 (3.9)0.03337 (4.2)Two or more comorbidities55 (42.6)219 (27.1)<0.001274 (29.2)Current smoking4 (3.6)60 (8.4)0.7964 (7.7)High disease activity0 (0)29 (3.8)0.02729 (3.23)Glucocorticoids treatment5 (20.0)95 (60.1)<0.001100 (54.6)Conventional DMARDs47 (36.4)443 (54.8)<0.001490 (52.3)Biologic DMARDs60 (46.5)193 (23.9)<0.001253 (27.0)JAK inhibitors4 (3.10)72 (8.9)0.03876 (8.1)Full recovery of COVID-19105 (84.0)644 (81.7)0.127749 (82.0)COVID-19 complications16 (12.5)68 (8.7)0.22784 (9.2)Death due to COVID-191 (0.8)34 (4.3)0.07435 (3.8)Notes=values n (%) unless otherwise indicated; BMI: Body Mass Index; DMARDs: disease-modifying antirheumatic drugs; JAK inhibitors: Janus kinase inhibitors.PsA patients with NIAID≥5 in comparison with NIAID<5 were older (58.6±11.4 vs 50±12.5; p=0.002), had more frequently hypertension (52.2% vs 23%; p=0.011) and dyslipidemia (39.1% vs 15%; p=0.017). In the multivariate analysis, age (OR 1.06; 95% CI 1.02–1.11) was associated with a worse outcome of the COVID-19 (NIAID≥5) in patients with PsA, while those who received methotrexate (OR 0.34; 95% CI 0.11–0.92) and biological DMARDs (OR 0.28; 95% CI 0.09–0.78) had a better outcome.ConclusionAlthough PsA patients have a higher frequency of cardiovascular and metabolic comorbidities than those with RA, the COVID-19 severity was similar. Most of the patients had mild SARS-CoV-2 infection and a low death rate.References[1]Beigel JH, et al. Remdesivir for the Treatment of Covid-19 - Final Report. N Engl J Med. 2020 Nov 5;383(19):1813-1826.Disclosure of InterestsNone declared
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Rivero W, Sánchez G, Rodriguez F, Villarreal L, Buitrago-Garcia D, Castro C, Santos-Moreno P. POS1489-HPR ASSESSMENT OF TREATMENT ADHERENCE IN A COHORT OF RHEUMATOID ARTHRITIS PATIENTS TREATED WITH SUBCUTANEOUS ANTI-TNF WHO WERE EXPOSED TO A COMPREHENSIVE CARE MODEL. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundRheumatoid arthritis (RA) is an autoimmune, chronic, and inflammatory disease, which can be treated with effective medications, but requires a high level of adherence to treatment. Offering a comprehensive care model by a multidisciplinary team could increase the adherence levels of these patients and improves disease outcomes.ObjectivesCompare the level of adherence to treatment before and after the implementation of a comprehensive care model in a cohort of patients with RA, treated with subcutaneous anti-TNF, in a reference center in Bogotá-Colombia.MethodsAn analytical study was conducted before and after the implementation of a comprehensive care model on a cohort of patients over 18 years of age, diagnosed with RA, who have been prescribed management with a subcutaneous anti-TNF by their doctor during the last 12 months. Convenience sequential sampling was performed to reach a defined sample size of 130 patients to estimate a baseline versus final adherence difference of 20%, at an alpha value of 5% and a beta value of 20%. The comprehensive care model (CCM) consisted of the approach by a multidisciplinary team, offering a comprehensive care not fragmented, based on evidence (guidelines and protocols) and proposing a treatment by objectives (T2T). Adherence was measured using the CQR-19 scale, with a cut-off point ≥80.7 to consider an adherent patient.ResultsThe cohort consisted of 131 patients who were followed semiannually for 24 months, and who were incorporated into the CCM. 83.9% were women (n=110), in an age range between 30 and 84 years (Average: 62; DS: 9.9 years). 37.4% of patients were treated with etanercept (n=49), 29% with golimumab (n=38) and 33.6% with adalimumab (n=44). The median baseline of CQR-19 was 87.7 points (RIQ:84.2-91.2); while at month 24 it reached 91.2 points (RIQ: 87.7-94.7). The difference between the distributions was statistically significant (p<0.00). According to the cut-off point for CQR-19, the baseline percentage of adherent patients was 87.8% (n=115) and increased to a percentage of 96.2% at 24 months of follow-up (n=126). The difference between these two percentages of adherence was 8.39% (95% CI: 1.9-14.9%) (p: 0.012). The results of a generalized linear model binomial family, for the outcome of difference in proportions (PD) of basal and final adherence, are presented in Table 1. The estimator is adjusted for activity level (DAS28), disability level (HAQ) and anti-TNF. Golimumab appears to have an effect that increases adherence by 4.5% compared to adalimumab and etanercept, adjusting for the other predictors.Table 1.Model of the effect of MAI on adherence to treatment.Dependent variable: Adhesion according to cut-off point CQR-19(≥80.7). Proportion Difference (DP) EstimatorVariableDPCI 95%P-valueIntervention: MAI9,4%3,2-15,5%0,003Golimumab vs. Etanercept-Adalimumab4,5%0,5-8,5%0,024DAS28(-)0,85%(-)3.2% to 14.9%0,47HAQ0,00(-)0.03% to 0.045%0,85MLG-Binomial family. Identity function.ConclusionThe CCM, after a follow-up of 24 months in patients with RA in treatment with subcutaneous anti-TNF increases the percentage of adherence by 9.4%, adjusting for treatment, activity level and degree of disability. Golimumab appears to have an effect that increases adherence by 4.5% compared to adalimumab and etanercept, adjusting for the other predictors.Disclosure of InterestsWilberto Rivero: None declared, GUILLERMO SÁNCHEZ: None declared, Fernando Rodriguez: None declared, Laura Villarreal: None declared, Diana Buitrago-Garcia: None declared, CARLOS CASTRO: None declared, Pedro Santos-Moreno Speakers bureau: Pfizer, Janssen, Abbvie, Biopas-UCB, Bristol, Roche, Novartis, Lilly, Consultant of: Pfizer, Janssen, Abbvie, Biopas-UCB, Bristol, Roche, Novartis, Lilly, Grant/research support from: Pfizer, Janssen, Abbvie, Biopas-UCB, Bristol, Roche, Novartis, Lilly
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Gonzalez Gomez CA, Cosatti M, Castro Coello VV, Haye M, Tissera Y, Reyes AA, Albiero JA, Ornella S, Alba P, Gobbi C, Gamba MJ, Exeni IE, Cusa A, Gallino Yanzi J, Bellomio VI, Gomez G, Zelaya D, Takashima L, Carlevaris L, Correa MDLA, Rojas Tessel R, García M, German N, Mercé AL, Bertoli A, Aguero SE, Calvo ME, Martire V, Mauri M, Martin ML, Picco E, Castrillon Bustamante D, Ibañez Zurlo L, Tamborenea MN, Subils GC, Vasquez DL, Soares de Souza S, Herscovich N, Raiti L, Cosentino V, Rodriguez F, Ledesma C, Diaz MP, Mamani Ortega ML, Castaño MS, Gómez G, Roberts K, Quintana R, Isnardi CA, Pons-Estel G, Pisoni C. AB1101 PREVALENCE OF LONG COVID IN RHEUMATIC DISEASE PATIENTS: ANALYSIS OF SAR COVID REGISTRY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundPersistent symptoms after acute COVID have been described previously. Main symptoms reported are fatigue, arthralgias, myalgias and mental sickness. Definition and methods vary widely.1ObjectivesTo asses prevalence and related factors to long COVID in a retrospective cohort of patients with rheumatic diseases from Argentina.MethodsA total of 1915 patients were registered from August 18th, 2020 to July 29th, 2021. Patients > 18 years old, with rheumatic disease and confirmed infection by SARS-CoV-2 (antigen or RT-PCR) were included. Those dead, with unknown outcome, wrong date or missing data were excluded. Demographic data, comorbidities, rheumatic disease, and characteristics of SARS-CoV-2 infection were recorded.Long COVID was defined according to NICE guidelines (persistent symptoms for more than 4 weeks, without alternative diagnosis). Long COVID symptoms were defined by rheumatologist. Severity of infection was classified according to WHO ordinal scale.We used descriptive statistics, univariate model (Student’s test, chi square test, ANOVA) and multivariate logistic regression analysis.Results230 (12%) had long COVID. Median age was 51 (IQR 40-61]) years, 82% were females, 51% were not caucasian. Median of education was 13.3 years (IQR 12 – 16), 79 % had private health insurance and 55 % were employed. Nearly half (n=762, 46%) had comorbidities, the most prevalent was hypertension (n=396, 24%).The most frequent rheumatic diseases were rheumatoid arthritis (n=719, 42%) and systemic lupus erythematosus (n=280, 16 %). Most were in low activity/remission (79%), used Conventional DMARD (n=773 patients, 45%) and steroids (n=588, 34%) at low dose (n=415, 71%).Main laboratory findings were abnormal D-dimer (n=94, 28%) and leukopenia (n=93, 26%). Most patients had a WHO ordinal scale < 5 (n=1472, 86%). Median of hospitalization at intensive care unit (ICU) was 8 days [IQR 5, 13]. Treatment for SARS-CoV-2 infection (steroids, anticoagulation, azithromycin, convalescent plasma) was used in 461 (27%) patients.Most of long COVID (n= 152, 69%) reported 1 symptom, the most frequent was fatigue (n= 55, 22%). Figure 1.Univariate analysis is presented in Table 1. In multivariate logistic regression analysis non-caucasian ethnicity OR 1.44 (1.07-1.95), years of education OR 1.05 (1-1.09), treatment with cyclophosphamide OR 11.35 (1.56-112.97), symptoms of COVID – 19 OR 13.26 (2.75-242.08), severity scale WHO ≥ 5 OR 2.46 (1.68-3.57), and ICU hospitalization days OR 1.09 (1.05-1.14) were factors associated to long COVID.Table 1.Univariate analysis of long COVID syndrome in SAR – COVID registryVariableAcute COVID n=1486Long COVID n=221P valueAge, years, median [IQR]51 [40, 60]54 [42, 62]0.032Caucasian, n (%)744 (48)132 (53)0.227Female sex, n (%)1242 (80)215 (86)0.066Education, years, median [IQR]12 [10, 17]13 [12, 16]-Private health insurance, n (%)1161 (79)181 (82)0.325Smoking, n (%)381 (25)71 (29)0.224Comorbidities, n (%)650 (45)108 (52)0.066Dyslipidemia, n (%)173 (12)39 (19)0.008Hypertension, n (%)332 (23)60 (29)0.053Low activity/remission disease, n (%)1140 (80)179 (77)1Rheumatoid arthritis, n (%)623 (42)96 (42)1Systemic lupus erythematosus, n (%)243 (16)37 (16)0.996DMARD, n (%)664 (45)109 (47)0.486Cyclophosphamide, n (%)3 (0.2)3 (1)0.035Rituximab, n (%)19 (1)9 (34)0.008Lymphocyte66 (23)19 (30)0.011<1.500 / mm3, n (%)Ferritin > 2000 ng/ml, n (%)32 (11)16 (25)0.011ICU hospitalization, days,7 [4, 10]10 [8, 24]<0.001median [IQR]Treatment for COVID-19, n (%)394 (27)91 (41)<0.001ConclusionPrevalence of long COVID was 12%. Non-caucasian ethnicity, higher education, treatment with cyclophosphamide, symptoms of COVID – 19, severe disease and ICU hospitalization days were related to long COVID.References[1]Cabrera Martimbianco AL, Pacheco RL, Bagattini ÂM, Riera R. Frequency, signs and symptoms, and criteria adopted for long COVID-19: A systematic review. Int J Clin Pract.Disclosure of InterestsNone declared
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Rodriguez F, Buitrago-Garcia D, Sánchez G, Santos-Moreno P. POS1491-HPR THE USEFULNESS OF THE PATIENT ACTIVITY SCORE-PASS-II TO ASSESS DISEASE ACTIVITY DURING THE COVID-19 LOCKDOWN IN PATIENTS WITH RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.5108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundMany measurement tools are designed to assess disease activity for Rheumatoid Arthritis (RA) patients. One of the most used tools is the Disease Activity Score- DAS28 which assesses the number of painful joints, erythrocyte sedimentation, and a patient’s global assessment. The assessment is performed by a clinician and requires laboratory exams. Unfortunately, from March to August 2019, Colombia had one of the strictest responses to the COVID-19 pandemic according to the COVID-19 stringency Index(1). One of the main restrictions was the preventive isolation of older populations, especially those with comorbidities. These restrictions challenged the rheumatology practice because face-to-face consultations were not possible. Due to the above, measurements like the PAS-II score should be used to assess disease activity during the pandemic.ObjectivesTo describe disease activity according to the Patient Activity Score- PAS-II score patients with RA and compare its results to the most recent DAS28 assessment before the COVID-19 pandemic.MethodsWe conducted a descriptive study; patients were followed during the COVID-19- lockdown in a video consultation. The PAS-II score was applied to assess disease activity as an alternative to the DAS28 assessment. The patients were part of an educational program, clinical charts were reviewed to collect the study variables. We collected demographic data and DAS28 before the pandemic started. We present a descriptive analysis of DAS28 severity and the results obtained by the PASS-II score.ResultsThe educational program enrolled 250 participants; 196 patients had complete data. 93% of participants were women, mean age was 64 years IQR (54-67). 43% of participants were married or had a civil union, 26% were single, 20% divorced, and 11% were widowed. Regarding educational level, 25% had finished elementary school and 39% high school; the remaining 36% had higher education. When we compared the last DAS28 assessed by a rheumatologist between January, and March 2019, 67% of patients were in remission, while in July 2019, the PASS-II score reported that 7% of patients were in remission and 75% had low or minimal activity. Figure 1- Table 1.Figure 1.Table 1.DISEASE ACTIVITIYDAS28PASS-IIRemission67%6%Low (Minimal)14%75%Moderate15%18.5%High/Severe4%0.5%ConclusionThe PASS score is a helpful tool to assess disease activity in patients with RA, especially in situations where the patient cannot see a rheumatologist in a face-to-face consultation; however, patients in severe disease activity should not delay the consultation with a clinician. As other studies have demonstrated, patient-reported outcome measures should be adopted in clinical practice as an alternative for treat- to- targe strategies(2). Further studies should be conducted to assess the impact of the pandemic in countries with high levels of restrictions in the course of RA.References[1]Hale T, Angrist N, Goldszmidt R, Kira B, Petherick A, Phillips T, et al. A global panel database of pandemic policies (Oxford COVID-19 Government Response Tracker). Nature Human Behaviour. 2021;5(4):529-38.[2]Salaffi F, Di Carlo M, Farah S, Marotto D, Atzeni F, Sarzi-Puttini P. Rheumatoid Arthritis disease activity assessment in routine care: performance of the most widely used composite disease activity indices and patient-reported outcome measures: Comparison of disease activity indices in RA. Acta Biomedica Atenei Parmensis. 2021;92(4):e2021238.AcknowledgementsThis project was funded by the Ministry of Science, Technology and Innovation MINCIENCIAS. Grant number: 695180763684Disclosure of InterestsFernando Rodriguez: None declared, Diana Buitrago-Garcia: None declared, GUILLERMO SÁNCHEZ: None declared, Pedro Santos-Moreno Speakers bureau: Pfizer, Janssen, Abbvie, Biopas-UCB, Bristol, Roche, Novartis, Lilly, Consultant of: Pfizer, Janssen, Abbvie, Biopas-UCB, Bristol, Roche, Novartis, Lilly, Grant/research support from: Pfizer, Janssen, Abbvie, Biopas-UCB, Bristol, Roche, Novartis, Lilly
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Santos-Moreno P, Buitrago-Garcia D, Rodriguez F, Sánchez G. POS1459 THE IMPLEMENTATION OF AN EDUCATIONAL PROGRAM TO IMPROVE PHARMACOLOGICAL ADHERENCE IN PATIENTS WITH RHEUMATOID ARTHRITIS. RESULTS FROM A QUASI-EXPERIMENTAL STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundPharmacological therapy is the principal intervention in rheumatoid arthritis (RA) patients. Currently, adherence to DMARDs therapy is a challenge that needs to be addressed[1]. On the other hand, educational programs have shown an improvement in the health status of RA patients[2].ObjectivesThis study aimed to determine if a 12-month educational program developed for patients with RA can improve medication adherence.MethodsA quasi-experimental design was conducted. Patients who attend a specialized center in RA were invited to participate in an educational program. The program was called UNIVERSITAR: PATIENT UNIVERSITY. An interdisciplinary team provided educational workshops for the patients; we included coaching sessions and leisure activities such as yoga and art lessons to avoid a conventional classroom program and provide a dynamic program. A rheumatologist with experience in centers of excellence for RA led the team. Patients attended during a year. Follow-up was planned at 6 and 12 months after enrollment. Medication adherence was assessed using the self-reported 8-item Morisky Medication Adherence Scale (MMAS-8). Patients were considered adherent when they scored 8 points, moderately adherent with a score of 6 or 7, and non-adherent with less than 6 points. The Wilcoxon signed-rank test was used to evaluate differences in MMAS-8 scores between baseline and 16 and 12-months. We also assessed if there were changes in DAS 28 in the participants who improved the level of adherence.ResultsIn total, 252 patients were enrolled in the study, and 206 completed the follow-up at 6 and 12 months (82%). The median age was 60 years IQR (54-67), 94% were female. In our study, 54% of patients received conventional and 46% Biological therapy. The proportion of patients with high adherence at baseline was 11%, at 6-months was 17% and at 12-month was 19%. At the end of the follow-up, 49% of the participants moved from being non-adherent to a moderate or high adherence level. When we compared the MMAS scores at baseline and follow-up, they showed a significant improvement (P<0.05) Figures 1-2. The majority of participants (65%) were in remission at baseline, according to DAS28. Therefore, we found no differences between the level of adherence and DAS28.ConclusionOur educational program improved medication adherence among patients with RA. Educational interventions are helpful to sustain remission in patients with RA. Further studies focused only on patients with moderate and high disease activity are necessary to assess the impact on clinical outcomes.References[1]Monchablon C, Gondé H, Pouplin S, Varin R, Vittecoq O, Lequerré T. Assessment of adherence to disease-modifying anti-rheumatic drugs in rheumatoid arthritis. Clin Rheumatol. 2020;39(1):207-16.[2]Tan YK, Teo P, Saffari SE, Xin X, Chakraborty B, Ng CT, et al. A musculoskeletal ultrasound program as an intervention to improve disease modifying anti-rheumatic drugs adherence in rheumatoid arthritis: a randomized controlled trial. Scand J Rheumatol. 2022;51(1):1-9.AcknowledgementsThis project was funded by the Ministry of Science, Technology and Innovation MINCIENCIAS. Grant number: 695180763684Disclosure of InterestsPedro Santos-Moreno Speakers bureau: Pfizer, Janssen, Abbvie, Biopas-UCB, Bristol, Roche, Novartis, Lilly, Consultant of: Pfizer, Janssen, Abbvie, Biopas-UCB, Bristol, Roche, Novartis, Lilly, Grant/research support from: Pfizer, Janssen, Abbvie, Biopas-UCB, Bristol, Roche, Novartis, Lilly, Diana Buitrago-Garcia: None declared, Fernando Rodriguez: None declared, GUILLERMO SÁNCHEZ: None declared
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de Las Vecillas L, López J, Morchón E, Rodriguez F, Drake M, Martino M. Viral-like reaction or hypersensitivity? Erythema multiforme minor reaction and moderate eosinophilia after receiving Pfizer-BioNTech BNT162b2 (mRNA-based SARS-CoV-2 vaccine). J Investig Allergol Clin Immunol 2021; 32:77-78. [PMID: 34588156 DOI: 10.18176/jiaci.0757] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- L de Las Vecillas
- Department of Allergy, Marqués de Valdecilla University Hospital, Instituto de Investigación Marques de Valdecilla (IDIVAL), Santander, Spain
| | - J López
- Department of Allergy, Marqués de Valdecilla University Hospital, Instituto de Investigación Marques de Valdecilla (IDIVAL), Santander, Spain
| | - E Morchón
- Department of Allergy, Marqués de Valdecilla University Hospital, Instituto de Investigación Marques de Valdecilla (IDIVAL), Santander, Spain
| | - F Rodriguez
- Department of Allergy, Marqués de Valdecilla University Hospital, Instituto de Investigación Marques de Valdecilla (IDIVAL), Santander, Spain
| | - M Drake
- Department of Dermatology, Marqués de Valdecilla University Hospital, Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain
| | - M Martino
- Department of Pathology, Marqués de Valdecilla University Hospital, Instituto de Investigación Marqués de Valdecilla (IDIVAL), Santander, Spain
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Hussenoeder F, Conrad I, Riedel-Heller SG, Rodriguez F. Der Protective-Mental-Work-Demands Questionnaire – Entwicklung eines Instruments zur Messung von mentalen Anforderungen am Arbeitsplatz, welche protektiv gegen Demenz und kognitiven Abbau im Alter wirken. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732003] [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: 10/20/2022]
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Ross S, Rodriguez F. Self-perceived problems in daily activities and strategy building in people without, with mild and severe dementia. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732184] [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: 10/20/2022]
Affiliation(s)
- S Ross
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V., Psychosoziale Epidemiologie und Versorgungsforschung
| | - F Rodriguez
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V., Psychosoziale Epidemiologie und Versorgungsforschung
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Rodriguez F, Pabst A, Riedel-Heller SG. Risk for disorientation: Longitudinal evidence from three old age cohorts in Germany (AgeDifferent.de platform). Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732021] [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: 10/20/2022]
Affiliation(s)
- F Rodriguez
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), RG Psychosoziale Epidemiologie & Public Health
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Universität Leipzig
| | - A Pabst
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Universität Leipzig
| | - SG Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Universität Leipzig
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Rodriguez F, Hussenoeder F, Spilski J, Conrad I, SG RH. Multidisciplinary Approach to Explain the Association between Mental Demands at Work on Cognitive Functioning in Old Age. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732022] [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: 10/20/2022]
Affiliation(s)
- F Rodriguez
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), RG Psychosoziale Epidemiologie & Versorgungsforschung
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig
| | - F Hussenoeder
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig
| | - J Spilski
- Center for Cognitive Science, TU Kaiserslautern
| | - I Conrad
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig
| | - Riedel-Heller SG
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig
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Hofbauer L, Rodriguez F. Association of social deprivation with cognitive status and decline in older adults. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732130] [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: 10/20/2022]
Affiliation(s)
- L Hofbauer
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE)
| | - F Rodriguez
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE)
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Van Staalduinen WH, Ganzarain JG, Dantas C, Rodriguez F, Stiehr K, Schulze J, Fernandez-Rivera C, Kelly P, McGrory J, Pritchard C, Berry D, Zallio M, Ciesla A, Ulanicka M, Renaux S, Guzy M. Learning to implement Smart Healthy Age-Friendly Environments. Transl Med UniSa 2021; 23:1-5. [PMID: 34447703 PMCID: PMC8370529 DOI: 10.37825/2239-9747.1021] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
To develop trainings on the implementation of smart healthy age-friendly environments for people who aim to support, for example, their parents, their neighbours or local community, there are precautionary measures that have to be taken into account: the role of the facilitator (volunteer or self-employed), the level of skills, the needs of the end-users, training content and methodologies together with the sustainability of the learning. This article examines these aspects, based on desk research and expert interviews in the Smart Healthy Age-Friendly Environments (SHAFE) fields.
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Rink D, Book W, Raskind-Hood C, Kancherla V, Hoffman T, Rodriguez F. ASSOCIATION BETWEEN COMBINED ANATOMIC AND PHYSIOLOGIC CLASSIFICATION OF ADULTS WITH CONGENITAL HEART DISEASE (ACHD) AND SELECTED HEALTHCARE UTILIZATION AND CLINICAL OUTCOMES. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)01806-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Egbe AC, Miranda WR, Devara J, Shaik L, Iftikhar M, Goda Sakr A, John A, Cedars A, Rodriguez F, Moore JP, Russell M, Grewal J, Ginde S, Lubert AM, Connolly HM. Recurrent sustained atrial arrhythmias and thromboembolism in Fontan patients with total cavopulmonary connection. Int J Cardiol Heart Vasc 2021; 33:100754. [PMID: 33786365 PMCID: PMC7988316 DOI: 10.1016/j.ijcha.2021.100754] [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: 01/02/2021] [Revised: 02/25/2021] [Accepted: 02/27/2021] [Indexed: 11/29/2022]
Abstract
Background Total cavopulmonary connection (TCPC) is associated with a lower risk of incident atrial arrhythmias as compared to atriopulmonary Fontan, but the risk of recurrent atrial arrhythmias is unknown in this population. The purpose of this study was to determine the incidence and risk factors for recurrent atrial arrhythmias and thromboembolic complications in patients with TCPC. Methods This is a retrospective multicenter study conducted by the Alliance for Adult Research in Congenital Cardiology (AARCC), 2000-2018. The inclusion criteria were TCPC patients (age > 15 years) with prior history of atrial arrhythmia. Results A total of 103 patients (age 26 ± 7 years; male 58 [56%]) met inclusion criteria. The mean age at initial arrhythmia diagnosis was 13 ± 5 years, and atrial arrhythmias were classified as atrial flutter/tachycardia in 85 (83%) and atrial fibrillation in 18 (17%). The median duration of follow-up from the first episode of atrial arrhythmia was 14.9 (12.1-17.3) years, and during this period 64 (62%) patients had recurrent atrial arrhythmias (atrial flutter/tachycardia 51 [80%] and atrial fibrillation 13 [20%]) with annual incidence of 4.4%. Older age was a risk factor for arrhythmia recurrence while the use of a class III anti-arrhythmic drug was associated with a lower risk of recurrent arrhythmias. The incidence of thromboembolic complication was 0.6% per year, and the cumulative incidence was 4% and 7% at 5 and 10 years respectively from the time of first atrial arrhythmia diagnosis. There were no identifiable risk factors for thromboembolic complications in this cohort. Conclusions Although TCPC provides superior flow dynamics and lower risk of incident atrial arrhythmias, there is a significant risk of recurrent arrhythmias among TCPC patients with a prior history of atrial arrhythmias. These patients may require more intensive arrhythmia surveillance as compared to other TCPC patients.
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Affiliation(s)
- Alexander C Egbe
- Department of Cardiovascular Medicine, Mayo Clinic Rochester, MN, United States
| | - William R Miranda
- Department of Cardiovascular Medicine, Mayo Clinic Rochester, MN, United States
| | - Janaki Devara
- Department of Cardiovascular Medicine, Mayo Clinic Rochester, MN, United States
| | - Likhita Shaik
- Department of Cardiovascular Medicine, Mayo Clinic Rochester, MN, United States
| | - Momina Iftikhar
- Department of Cardiovascular Medicine, Mayo Clinic Rochester, MN, United States
| | - Ahmed Goda Sakr
- Department of Cardiovascular Medicine, Mayo Clinic Rochester, MN, United States
| | - Anitha John
- Children's National Hospital, Washington DC, United States
| | - Ari Cedars
- University of Texas, Southwestern Medical Center, United States
| | - Fred Rodriguez
- Emory University Hospital and Children's Healthcare of Atlanta, GA, United States
| | - Jeremy P Moore
- Ahmanson/UCLA Adult Congenital Heart Disease Center, UCLA Medical Center, Los Angeles, CA, United States
| | - Matthew Russell
- Ahmanson/UCLA Adult Congenital Heart Disease Center, UCLA Medical Center, Los Angeles, CA, United States
| | - Jasmine Grewal
- University of British Columbia, Vancouver, United States
| | - Salil Ginde
- Children's Hospital Wisconsin, United States
| | | | - Heidi M Connolly
- Department of Cardiovascular Medicine, Mayo Clinic Rochester, MN, United States
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Nieto-Calvache AJ, Rodriguez F, Ordoñez CA. Re: Vascular control by infrarenal aortic cross-clamping in placenta accreta spectrum disorders: description of technique. BJOG 2021; 128:1101-1102. [PMID: 33624926 DOI: 10.1111/1471-0528.16656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2020] [Indexed: 01/25/2023]
Affiliation(s)
- A J Nieto-Calvache
- Placenta Accreta Spectrum Clinic, Fundación Valle de Lili, Cali, Colombia
| | - F Rodriguez
- Placenta Accreta Spectrum Clinic, Fundación Valle de Lili, Cali, Colombia.,Trauma and Emergency Surgery Department, Fundación Valle del Lili, Cali, Colombia
| | - C A Ordoñez
- Placenta Accreta Spectrum Clinic, Fundación Valle de Lili, Cali, Colombia.,Trauma and Emergency Surgery Department, Fundación Valle del Lili, Cali, Colombia
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Mahtta D, Ahmed S, Ramsey D, Akeroyd J, Lee M, Rodriguez F. Statin Prescription Rates, Adherence, and Associated Clinical Outcomes Among Women With PAD and ICVD. J Vasc Surg 2020. [DOI: 10.1016/j.jvs.2020.09.005] [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]
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Valencia O, Cabrera M, Rodriguez F, Santos-Moreno P. AB1305-HPR IS BETTER AND SAFER TOFACITINIB AS A FIRST LINE OF TREATMENT IN PATIENTS WITH RHEUMATOID ARTHRITIS? – A COHORT STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Tofacitinib is the first oral Janus Kinasa inhibitor approved for the treatment of rheumatoid arthritis (RA); and although it is approved both after conventional treatment and after biological therapy, it is not well known its real-life effectiveness in both cases and if it is preferable to use it after cDMARDs or biologics.Objectives:We compare the effectiveness and safety of Tofacitinib in patients with RA analyzing if better and safer Tofacitinib after cDMARDs or biologics.Methods:A retrospective analysis of a real-world cohort of patients with RA, who were treated with Tofacitinib in last 3 years, as first line of treatment (T1) after failure with cDMARDS and second line of treatment after biologic drug failure (T2). The therapy was considered effective with the change from moderate-high disease activity to low disease activity or remission measured by DAS28, in those who met criteria of high adherence, without change or addition of other conventional DMARDs, without new dose or increase of dose of oral glucocorticoids. A logistic model of regression was performed to evaluate de differences between T1 and T2, using as covariates sex, age, comorbidities, time of disease evolution, adverse events and other causes of discontinuation. Medication survival time and the main causes of suspension were measured. Mixed model regression and least-squared means were used to estimate the baseline changes and a Kaplan-Meyer survival analysis to estimate time to remission and drug survival.Results:105 patients with RA were included (median age: 56.1 ± 11.7 years; 80.9% female, median disease duration 11.48 ± 10.1 years); 43% (45/105) of patients with positive rheumatoid factor and 73% (77/105) positive anti-citrulline antibodies. Regarding treatment 51% (54/105) used Tofacitinib as 1T, after failure to cDMARDs; on the other hand, Tofacitinib was used as 2T, after failure to biologics in 49% (51/105) of patients. DAS28 levels were reduced at 8, 16 and 24 weeks with statistical difference (p value 0.004, <0.0001, and <0.001, respectively). HAQ-DI also reported reduction but without statistical difference. The use of Tofacitinib was more effective after failure to cDMARDs (p value 0.014) and patients with more than 3 years of disease (p value 0.04), a statistically better response. Also, corticoids use, positive RF, extended release tablet of tofacitinib reported better changes of DAS28 but without statistical significance. Patients with high disease activity treated with Tofacitinib 1T decreased from 30% at baseline to 19% at the last follow-up; patients in 2T way were in moderate activity of the disease in 57% at baseline and went to 37% in the last follow-up. There was an increase in patients who achieved remission in both groups, but higher in 1T where they went from 9% to 41%, while in 2T they went from 22% to 33% (p < 0.05). The survival rate of the medication was 1.7 years in 1T and 2.1 in 2T; in terms of time to remission, the use of Tofacitinib monotherapy presented statistical difference (p value <0.001). The main cause of suspension of treatment was therapeutic failure 12% (13/105), 9% in 1T (5/54) and 16% (8/51) in 2T (p <0.005). 6% of patients (6/105) presented suspension due to the occurrence of adverse events, 4% (2/54) in 1T and 8% (4/51) in 2T (p <0.005).Conclusion:In patients with RA, the use of Tofacitinib as the first line of treatment (after failure to cDMARDs) is better in effectiveness and safer in comparison with its use as a second line of treatment (after biologics), with significant differences in the rates of therapeutic failure and occurrence of adverse events/reactions. On the other hand, concomitant corticoids use, positive RF, extended release tablet of Tofacitinib seem to increase the effectiveness of Tofacitinib in terms of DAS28 and HAQ-DI.Disclosure of Interests:Omaira Valencia: None declared, Michael Cabrera: None declared, Fernando Rodriguez: None declared, Pedro Santos-Moreno Grant/research support from: I have received research grants from Abbvie, Biopas-UCB, Janssen, Novartis, Pfizer., Speakers bureau: I have been a speaker for Abbvie, Biopas-UCB, Janssen, Lilly, Novartis, Pfizer, Roche, Sanofi.
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Cabrera M, Rodriguez F, Buitrago-Garcia D, Sánchez G, Santos-Moreno P. AB1296-HPR PREVALENCE OF COMORBIDITIES IN A COHORT OF PATIENTS IN AN EDUCATIONAL MULTIDISCIPLINARY PROGRAM. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Rheumatoid arthritis (RA) is a chronic inflammatory and complex disease. Patients with RA face other diseases that might lead to increase morbidity. In patients with RA it has been stablished a high prevalence of comorbidities and their risk factors (1).Objectives:The aim of this study was to evaluate the prevalence of comorbidities in Colombian patients with RA enrolled in an educational multidisciplinary program and possible correlation with disease activityMethods:We performed a cross-sectional study; we included patients with confirmed diagnosis of rheumatoid arthritis in a specialized RA center. We collected sociodemographic data, and markers of disease activity DAS28. We collected data regarding the history of comorbidities such as hypertension, dyslipidemia, osteoporosis, type 2 diabetes mellitus, hypothyroidism, malignancies, among others. We performed a descriptive analysis, variables with a normal distribution were described using mean and standard deviation (SD), and non- normal distributed variables were described using median and interquartile range. Categorical variables were presented as rates. We evaluated the relationship between disease activity and comorbidities.Results:We included 251 patients; mean age was 59 ± 9.8 years old, with a high proportion of women 93%; median disease duration was 15 years RIQ (8-20); in this study, 145 (65%) of patients were in remission; 35 (11%) had low, 44 (20%) moderate and 10 (4%) high disease activity. Regarding pharmacological therapy, 55% were receiving conventional DMARDs. The prevalence of comorbidities was 85%, the most common were high blood pressure 25% followed by hypothyroidism 12% and diabetes 10%, 0.7% of patients had malignancies such as thyroid cancer or breast cancer, 1.29% of patients had renal comorbidities. Among comorbidities related to RA 30% had osteoporosis and 20% arthrosis. We did not find a statistical association between DAS28 and comorbidities.Conclusion:As other studies have shown, there is a high prevalence of comorbidities among RA patients, mainly high blood pressure. Due to the above, it is relevant to evaluate the risks factors of patients with RA, especially cardiovascular risks. We consider that a multidisciplinary program represents an opportunity not only to educate patients about healthy life styles and the management of RA, but also other diseases in order to increase the empowering of the health status in these poly pathological patients(2).References:[1]Gullick NJ, Scott DL. Co-morbidities in established rheumatoid arthritis. Best practice & research Clinical rheumatology. 2011;25(4):469-83.[2]Galarza-Delgado DA, Azpiri-Lopez JR, Colunga-Pedraza IJ, Cardenas-de la Garza JA, Vera-Pineda R, Wah-Suarez M, et al. Prevalence of comorbidities in Mexican mestizo patients with rheumatoid arthritis. Rheumatology international. 2017;37(9):1507-11.Acknowledgments:This project has been funded by a collaboration between the Ministry of Science, Technology and Innovation COLCIENCIAS (contract 746-2018), the Fundación Universitaria de Ciencias de la Salud and Biomab - Center for Rheumatoid ArthrtitisDisclosure of Interests:Michael Cabrera: None declared, Fernando Rodriguez: None declared, Diana Buitrago-Garcia: None declared, GUILLERMO SÁNCHEZ: None declared, Pedro Santos-Moreno Grant/research support from: I have received research grants from Abbvie, Biopas-UCB, Janssen, Novartis, Pfizer., Speakers bureau: I have been a speaker for Abbvie, Biopas-UCB, Janssen, Lilly, Novartis, Pfizer, Roche, Sanofi.
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Buitrago-Garcia D, Rodriguez F, Sánchez G, Santos-Moreno P. AB1279-HPR A DESCRIPTIVE STUDY RELATED TO THE ADHERENCE BEFORE AND AFTER ENROLLING IN A MULTIDISCIPLINARY EDUCATIONAL PROGRAM. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Rheumatoid arthritis (RA) is an inflammatory, chronic disease. It leads to deformity and destruction of joints through the erosion of cartilage and bone. Patients with RA report to suffer symptoms in hands, joints, swelling, loss of motion, muscle weakness among others.(1).Centers of excellence in RA have proposed a multidisciplinary model of care with an initial diagnosis, treatment prescription and follow-up with a rheumatologist, periodic consultations with a physiatrist, psychologist, physiotherapist, occupational therapy, nutrition and a patient focused program(2). With this model of care, the patient is seen as a whole, and the expectation is to achieve the best results in the management of RA. However, if the patient does adhere the model becomes ineffective.Objectives:The aim of this to report the attendance to a multidisciplinary model of care for patients with RA that attend to a specialized center in Colombia, before and after enrolling in a educational program.Methods:We performed a descriptive study. Patients enrolled our educational program in July 2019. In our institution patients are followed-up under T2T standards and a multidisciplinary approach, as part of our model of care they have periodic consultations with a rheumatology, physiatrist, psychologist, physiotherapist, occupational therapy and nutrition. We collected sociodemographic data, DAS28, and compare the attendance to each specialty at the beginning and at 6-month follow-up. Descriptive epidemiology was done, we calculated means, and standard deviations for continuous variables and categorical variables were presented as rates. We compared disease activity and adherence at the beginning of the program and after six months of attendance.Results:We included 229 patients; mean age was 59 years ±10; 93% were female. At the beginning of our program, mean DAS28 was 2.57 ± 1.19, from all patients 65% were at remission, 11% at low disease activity 19% at moderate disease activity and, 5% at severe disease activity. Regarding adherence to our model, the medical specialty with the highest attendance was rheumatology (30%) followed by, physical therapy (16%) physiatrist consultation (15%) psychology (13%) and, occupational therapy (11%); the specialty with the lowest attendance was nutrition (8%). After six months of attendance to the educational program, we found an increasing number of patients in remission 67%, low disease activity 15%, moderate disease activity 18%, we did not have patients with severe DA28. Regarding the medical specialties, we found a 3% rise in the attendance to the nutrition consultation and psychology consultation. We did not find statistical association between disease activity and adherence to the model.Conclusion:These results are a clear example of how an educational program is capable of increasing awareness and improving the clinical outcomes and adherence to a multidisciplinary model for approaching RA. As other studies have shown(3), patient education interventions improve adherence to medication and to attendance to health care specialists.References:[1]Santos-Moreno P, Castaneda O, Garro B, Flores D, Sanchez G, Castro C. From the model of integral attention to the creation of centers of excellence in rheumatoid arthritis. Clinical rheumatology. 2015;34 Suppl 1:S71-7.[2]Taibanguay N, Chaiamnuay S, Asavatanabodee P, Narongroeknawin P. Effect of patient education on medication adherence of patients with rheumatoid arthritis: a randomized controlled trial. Patient preference and adherence. 2019;13:119-29.Acknowledgments:This project has been funded by a collaboration between the Ministry of Science, Technology and Innovation COLCIENCIAS (contract 746-2018), the Fundación Universitaria de Ciencias de la Salud and Biomab - Center for Rheumatoid ArthritisDisclosure of Interests:Diana Buitrago-Garcia: None declared, Fernando Rodriguez: None declared, GUILLERMO SÁNCHEZ: None declared, Pedro Santos-Moreno Grant/research support from: I have received research grants from Abbvie, Biopas-UCB, Janssen, Novartis, Pfizer., Speakers bureau: I have been a speaker for Abbvie, Biopas-UCB, Janssen, Lilly, Novartis, Pfizer, Roche, Sanofi.
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Buitrago-Garcia D, Rodriguez F, Sánchez G, Santos-Moreno P. AB1340-HPR PATIENTS’ OUT-OF-POCKET EXPENSES ANALYSIS IN PATIENTS WITH RHEUMATOID ARTHRITIS ENROLLED IN A EDUCATIONAL PROGRAM. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.5526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:The increasing health and economic burdens of deaths and disabilities from non-communicable diseases (NCDs) are emerging as major concerns worldwide, particularly for low- and middle-income countries (LMICs)(1). Rheumatoid arthritis (RA) NCD is considered as one of the most common causes of disability. RA affects from 0.5% to 1% of the worldwide population. Little is known about the out-of-pocket (OOP) expenditures for prescription of pharmacological treatment for patients with RA, including drugs, diagnostic tests, mobility aids among others.Objectives:To describe the out of pocket costs in patients with rheumatoid arthritisMethods:We performed a cross-sectional study among patients who are participating in an educational program in a specialized center for RA. We collected sociodemographic variables; in addition, we collected data related to the expenditures in drugs, diagnostic tests and mobility aids that were not covered by the health system. Descriptive epidemiology was done, we calculated means, and standard deviations for continuous variables and categorical variables were presented as rates. The costs are presented in the US dollars with the average exchange rate for 2019Results:We included 181 patients, 92% were female. Mean age was 59 years ±9.5. Regarding occupation, 24% were employees, 40% were economically inactive, and 36% were pensioners. Most of patients 45% had a low income, 43 % middle income and only 12% high income according to the Colombian socioeconomic classification. Most of out of pocket expenses (47%) were associated to the acquisition of medical devices such as reading glasses or orthopedic braces. Secondly, the OOP expenses were related to medications (38%) such as antibiotics prednisone or pain control medications. Finally, 25% of patients reported that they had pay for their diagnostic tests such as x rays or laboratory tests. When assessed the costs patients expended between 30-100 USD purchasing aid devices, medications or laboratory tests.Conclusion:In the Colombian context OPP are relevant and represent an important expenditure for patients with RA especially for those who have low or middle income. Due to the above, it is important to find alternatives in order to help vulnerable segments of the population. Additionally, OPP needed to be taken into account due to its association with treatment adherence(2).References:Datta BK, Husain MJ, Fatehin S. The crowding out effect of out-of-pocket medication expenses of two major non-communicable diseases in Pakistan. International health. 2020;12(1):50-9.Acknowledgments:This project has been funded by a collaboration between the Ministry of Science, Technology and Innovation COLCIENCIAS (contract 746-2018), the Fundación Universitaria de Ciencias de la Salud and Biomab - Center for Rheumatoid ArthritisDisclosure of Interests:Diana Buitrago-Garcia: None declared, Fernando Rodriguez: None declared, GUILLERMO SÁNCHEZ: None declared, Pedro Santos-Moreno Grant/research support from: I have received research grants from Abbvie, Biopas-UCB, Janssen, Novartis, Pfizer., Speakers bureau: I have been a speaker for Abbvie, Biopas-UCB, Janssen, Lilly, Novartis, Pfizer, Roche, Sanofi.
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Lewis MJ, Reardon L, Aboulhosn JA, Haeffele C, Chen S, Kim Y, Book W, Rodriguez F, Valente AM, Carazo M, Krieger E, Angiulo J, Egbe A, Cedars AM, Ko J, Jacobson R, Earing M, Ermis P, Broda C, Cramer JW, Nugaeva N, Ross HJ, Krasuski RA, Rosenbaum M. MORBIDITY AND MORTALITY IN ADULT FONTAN PATIENTS AFTER HEART OR COMBINED HEART LIVER TRANSPLANT: A REPORT FROM THE FOSTER STUDY. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)31280-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Lewis MJ, Haeffele C, Chen S, Reardon L, Aboulhosn JA, Nugaeva N, Ross HJ, Kim Y, Krasuski RA, Valente AM, Carazo M, Krieger E, Angiulo J, Book W, Rodriguez F, Egbe A, Jacobson R, Earing M, Cramer JW, Cedars AM, Ko J, Broda C, Ermis P, Rosenbaum M. MORBIDITY AND MORTALITY IN ADULT FONTAN PATIENTS REFERRED FOR TRANSPLANT: A REPORT FROM THE FOSTER STUDY. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)31173-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Camarillo R, Jimenez I, Guzman A, Rosales AM, Rodriguez F, Perez-Rivero JJ, Herrera JA. Oviductal Proteins Effect in Rooster Spermatic Cryopreservation. Cryo Letters 2019; 40:352-356. [PMID: 33966062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Cryopreservation induces spermatic cryo capacitation, which can decrease thawed sperm fertilizing capability. OBJECTIVE To evaluate the effect of uterus-vaginal union protein factors to inhibit sperm cryo capacitation and maintain viability and fertilizing capability of rooster spermatozoa. MATERIALS AND METHODS Rooster spermatozoa was cryopreserved using Lake extender supplemented with different hen's uterus-vaginal junction protein concentrations, to determine spermatic viability, sperm physiological condition and fertilizing capability in vivo. RESULTS It was possible to induce spermatic decapacitation in vitro, inhibiting cryo capacitation and allowing fertility results comparable to those obtained with fresh semen. CONCLUSION Uterus-vaginal protein extracts induce spermatic decapacitation in vitro.
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Affiliation(s)
- R Camarillo
- Mastery in the Animal Reproduction Biology, Metropolitan Autonomous University, San Rafael Atlixco, CDMX, Mexico
| | - I Jimenez
- Department of Health Sciences, UAM-I, Metropolitan Autonomous University, San Rafael Atlixco, CDMX, Mexico
| | - A Guzman
- Department of Agricultural and Animal Production, UAM-X, Metropolitan Autonomous University, Villa Quietud, Coyoacan, CDMX., Mexico
| | - A M Rosales
- Department of Agricultural and Animal Production, UAM-X, Metropolitan Autonomous University, Villa Quietud, Coyoacan, CDMX., Mexico
| | - F Rodriguez
- Department of Agricultural and Animal Production, UAM-X, Metropolitan Autonomous University, Villa Quietud, Coyoacan, CDMX., Mexico
| | - J J Perez-Rivero
- Department of Agricultural and Animal Production, UAM-X, Metropolitan Autonomous University, Villa Quietud, Coyoacan, CDMX., Mexico
| | - J A Herrera
- Department of Agricultural and Animal Production, UAM-X, Metropolitan Autonomous University, Villa Quietud, Coyoacan, CDMX., Mexico.
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Kamioka N, Lisko J, Maidman S, Kim D, Sahu A, Dong A, Shashidharan S, Jokhadar M, Rodriguez F, Book W, Gleason P, Block P, Babaliaros V. TCT-770 Outcomes After Endograft Facilitated Transcatheter Pulmonary Valve Replacement for Failed Repair: Surgical vs. Transcatheter Procedures. J Am Coll Cardiol 2019. [DOI: 10.1016/j.jacc.2019.08.911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sun YW, Liu W, Hernandez I, Gonzalez J, Rodriguez F, Dunstan DJ, Humphreys CJ. 3D Strain in 2D Materials: To What Extent is Monolayer Graphene Graphite? Phys Rev Lett 2019; 123:135501. [PMID: 31697529 DOI: 10.1103/physrevlett.123.135501] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 05/28/2019] [Indexed: 06/10/2023]
Abstract
This work addresses a fundamental question: To what extent is graphene graphite? In particular does 2D graphene have many of the same 3D mechanical properties as graphite, such as the bulk modulus and elastic constant c_{33}? We have obtained, for the first time, unambiguous Raman spectra from unsupported monolayer graphene under pressure. We have used these data to quantify the out-of-plane stiffness of monolayer graphene, which is hard to define due to its 2D nature. Our data indicate a first physically meaningful out-of-plane stiffness of monolayer graphene, and find it to be consistent with that of graphite. We also report a shift rate of the in-plane phonon frequency of unsupported monolayer graphene to be 5.4 cm^{-1} GPa^{-1}, very close to that of graphite (4.7 cm^{-1} GPa^{-1}), contrary to the previous value for supported graphene. Our results imply that monolayer graphene has similar in-plane and out-of-plane stiffnesses, and anharmonicities to graphite.
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Affiliation(s)
- Y W Sun
- School of Engineering and Materials Science, Queen Mary University of London, London E1 4NS, United Kingdom
| | - W Liu
- College of Information Science and Electronic Engineering, Zhejiang University, Hangzhou 310027, China
| | - I Hernandez
- Departamento CITIMAC, Universidad de Cantabria, Santander 39005, Spain
| | - J Gonzalez
- Departamento CITIMAC, Universidad de Cantabria, Santander 39005, Spain
| | - F Rodriguez
- Departamento CITIMAC, Universidad de Cantabria, Santander 39005, Spain
| | - D J Dunstan
- School of Physics and Astronomy, Queen Mary University of London, London E1 4NS, United Kingdom
| | - C J Humphreys
- School of Engineering and Materials Science, Queen Mary University of London, London E1 4NS, United Kingdom
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Everitt I, Hoffman T, Raskind-Hood C, Saraf A, Rodriguez F, Hogue C, Book W. WHO WILL BOUNCE BACK? PREDICTING REHOSPITALIZATION AFTER CONGENITAL HEART SURGERY. J Am Coll Cardiol 2019. [DOI: 10.1016/s0735-1097(19)31249-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Rodriguez F, Kress J, Arevalo S. VALIDITY OF INSTRUMENTS MEASURING COGNITIVE FUNCTIONING IN OLDER ADULT HISPANICS: A SYSTEMATIC REVIEW. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1888] [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: 11/13/2022] Open
Affiliation(s)
- F Rodriguez
- Center for Cognitive Science, University of Kaiserslautern
| | - J Kress
- University of Southern California
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Lloyd D, Aranda M, Rodriguez F. HEALTH AND SOCIAL PREDICTORS OF FRAILTY ONSET IN A U.S. NATIONAL SAMPLE. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.3086] [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: 11/14/2022] Open
Affiliation(s)
- D Lloyd
- University of Southern California
| | - M Aranda
- University of Southern California
| | - F Rodriguez
- Center for Cognitive Science, University of Kaiserslautern
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Saenz J, Rodriguez F. Cognitive Functioning I. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.173] [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: 11/14/2022] Open
Affiliation(s)
- J Saenz
- University of Southern California
| | - F Rodriguez
- Center for Cognitive Science, University of Kaiserslautern
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Rodriguez F, Riedel-Heller SG. EXPOSURE-DEPENDENT IMPACT OF SPECIFIC MENTAL WORK DEMANDS ON COGNITIVE FUNCTIONING IN OLD AGE. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1587] [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: 11/13/2022] Open
Affiliation(s)
- F Rodriguez
- University of Kaiserslautern, Kaiserslautern, Rheinland-Pfalz, Germany
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Rodriguez F, Spilski J, Lachmann T. Technology. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2072] [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)
- F Rodriguez
- Center for Cognitive Science, University of Kaiserslautern
| | - J Spilski
- Center for Cognitive Science, University of Kaiserslautern
| | - T Lachmann
- Center for Cognitive Science, University of Kaiserslautern
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Arevalo S, Rodriguez F, Falcon L, Tucker K. COGNITIVE FUNCTION TRAJECTORIES AND ENRICHED ENVIRONMENT AT WORK AMONG OLDER LATINO ADULTS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1485] [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: 11/14/2022] Open
Affiliation(s)
| | - F Rodriguez
- Center for Cognitive Science, University of Kaiserslautern
| | - L Falcon
- University of Massachusetts, Lowell
| | - K Tucker
- Zuckerberg College of Health Sciences, Biomedical & Nutritional Sciences Department
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Ephrem G, Hebson C, John A, Moore E, Jokhadar M, Ford R, Veldtman G, Dori Y, Gurvitz M, Kogon B, Kovacs A, Roswick M, McConnell M, Book WM, Rodriguez F. Frontiers in Fontan failure: Innovation and improving outcomes: A conference summary. CONGENIT HEART DIS 2018; 14:128-137. [PMID: 30343507 DOI: 10.1111/chd.12685] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 07/10/2018] [Accepted: 09/14/2018] [Indexed: 12/24/2022]
Abstract
The initial "Frontiers in Fontan Failure" conference in 2015 in Atlanta, GA, provided an opportunity for experts in the field of pediatric cardiology and adult congenital heart disease to focus on the etiology, physiology, and potential interventions for patients with "Failing Fontan" physiology. Four types of "Fontan Failure" were described and then published by Dr Book et al. The acknowledgment that even Dr Fontan himself realized that the Fontan procedure "imposed a gradually declining functional capacity and premature late death after an initial period of often excellent palliation." The purpose of the second "Frontiers in Fontan Failure" was to further the discussion regarding new data and technologies as well as novel interventions. The 2017 "Frontiers in Fontan Failure: Innovation and Improving Outcomes" was sponsored by Children's Healthcare of Atlanta, Sibley Heart Center Cardiology, and Emory University School of Medicine. Future directions in the management of Fontan failure include further investigations into the risk of sudden cardiac death and how to properly prevent it, achievable interventions in modifying the Fontan physiology to treat or prevent late complications, and improved and refined algorithms in Fontan surveillance. Finally, further research into the interventional treatment of lymphatic-related complications hold the promise of marked improvement in the quality of life of advanced Fontan failure patients and as such should be encouraged and contributed to.
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Affiliation(s)
- Georges Ephrem
- Peter Munk Cardiac Centre, University Health Network, Toronto, Canada
| | - Camden Hebson
- Division of Cardiology, Department of Pediatrics, Children's of Alabama, Birmingham, Alabama
| | - Anitha John
- Division of Pediatric Cardiology, Children's National Health System, Washington, District of Columbia
| | - Estella Moore
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Maan Jokhadar
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Ryan Ford
- Division of Gastroenterology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Gruschen Veldtman
- Department of Cardiology, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Yoav Dori
- Division of Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Michelle Gurvitz
- Boston Children's Hospital, Boston, Massachusetts.,Brigham and Women's Hospital, Boston, Massachusetts
| | - Brian Kogon
- Division of Pediatric Cardiothoracic Surgery, University of Mississippi Medical Center, Jackson, Mississippi
| | - Adrienne Kovacs
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, Oregon
| | | | - Michael McConnell
- Sibley Heart Center Cardiology, Emory University School of Medicine, Atlanta, Georgia
| | - Wendy M Book
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Fred Rodriguez
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.,Sibley Heart Center Cardiology, Emory University School of Medicine, Atlanta, Georgia
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Ulloa PA, Vidal J, Dicastillo C, Rodriguez F, Guarda A, Cruz RMS, Galotto MJ. Development of poly(lactic acid) films with propolis as a source of active compounds: Biodegradability, physical, and functional properties. J Appl Polym Sci 2018. [DOI: 10.1002/app.47090] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- P. A. Ulloa
- Escuela AlimentosPontificia Universidad Católica de Valparaíso, Avenida Waddington 716 2360100 Valparaíso Chile
| | - J. Vidal
- Escuela AlimentosPontificia Universidad Católica de Valparaíso, Avenida Waddington 716 2360100 Valparaíso Chile
| | - C. Dicastillo
- Food Packaging Laboratory (LABEN‐Chile), Food Science and Technology DepartmentCenter for the Development of Nanoscience and Nanotechnology (CEDENNA), Universidad de Santiago de Chile, Obispo Manuel Umaña 050 Santiago Chile
| | - F. Rodriguez
- Food Packaging Laboratory (LABEN‐Chile), Food Science and Technology DepartmentCenter for the Development of Nanoscience and Nanotechnology (CEDENNA), Universidad de Santiago de Chile, Obispo Manuel Umaña 050 Santiago Chile
| | - A. Guarda
- Food Packaging Laboratory (LABEN‐Chile), Food Science and Technology DepartmentCenter for the Development of Nanoscience and Nanotechnology (CEDENNA), Universidad de Santiago de Chile, Obispo Manuel Umaña 050 Santiago Chile
| | - R. M. S. Cruz
- Department of Food EngineeringInstitute of Engineering, University of Algarve Faro Portugal
- MeditBio‐Center for Mediterranean Bioresources and Food, Faculty of Sciences and TechnologyUniversity of Algarve Faro Portugal
| | - M. J. Galotto
- Food Packaging Laboratory (LABEN‐Chile), Food Science and Technology DepartmentCenter for the Development of Nanoscience and Nanotechnology (CEDENNA), Universidad de Santiago de Chile, Obispo Manuel Umaña 050 Santiago Chile
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Roehr S, Luck T, Rodriguez F, Thiery J, Loeffler M, Villringer A, Riedel-Heller S. The mediating effect of cognitive reserve between social isolation and cognitive function – Results of the population-based LIFE-Adult-Study. Das Gesundheitswesen 2018. [DOI: 10.1055/s-0038-1667712] [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 Roehr
- Universitaet Leipzig, Institut fuer Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Leipzig, Deutschland
| | - T Luck
- HS Nordhausen, Nordhausen, Deutschland
| | - F Rodriguez
- Universitaet Kaiserlautern, Kaiserslautern, Deutschland
- University of Southern California, Edward R. Royal Institute on Aging, Los Angeles, Deutschland
| | - J Thiery
- Universität Leipzig, Institut für Laboratoriumsmedizin, Klinische Chemie und Molekulare Diagnostik, Leipzig, Deutschland
| | - M Loeffler
- LIFE – Leipziger Forschungszentrum fuer Zivilisationskrankheiten, Leipzig, Deutschland
- Universitaet Leipzig, Institut für Medizinische Informatik, Statistik und Epidemiologie, Leipzig, Deutschland
| | - A Villringer
- Max-Planck-Instituts für Kognitions- und Neurowissenschaften, Leipzig, Deutschland
| | - S Riedel-Heller
- Universitaet Leipzig, Institut fuer Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Leipzig, Deutschland
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Cossio-Aranda J, Soto ME, Berrios Barcenas EA, Fajardo E, Avila Vanzzini N, Araiza Garaygordobil D, Rodriguez F. P4547Non-invasive measurement of central blood pressure and vascular stiffness in aortopathies. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4547] [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: 11/13/2022] Open
Affiliation(s)
- J Cossio-Aranda
- National Institute of Cardiology Ignacio Chavez, Outpatient Clinics, Mexico City, Mexico
| | - M E Soto
- National Institute of Cardiology Ignacio Chavez, Outpatient Clinics, Mexico City, Mexico
| | - E A Berrios Barcenas
- National Institute of Cardiology Ignacio Chavez, Outpatient Clinics, Mexico City, Mexico
| | - E Fajardo
- National Institute of Cardiology Ignacio Chavez, Outpatient Clinics, Mexico City, Mexico
| | - N Avila Vanzzini
- National Institute of Cardiology Ignacio Chavez, Outpatient Clinics, Mexico City, Mexico
| | - D Araiza Garaygordobil
- National Institute of Cardiology Ignacio Chavez, Outpatient Clinics, Mexico City, Mexico
| | - F Rodriguez
- National Institute of Cardiology Ignacio Chavez, Outpatient Clinics, Mexico City, Mexico
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Hussenoeder F, Riedel-Heller SG, Rodriguez F. Mentale Anforderungen im Beruf als Schutzfaktor gegen Demenz und kognitiven Abbau im Alter. Psychother Psychosom Med Psychol 2018. [DOI: 10.1055/s-0038-1667925] [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)
- F Hussenoeder
- Universität Leipzig, Medizinische Fakultät, Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Leipzig, Deutschland
| | - SG Riedel-Heller
- Universität Leipzig, Medizinische Fakultät, Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Leipzig, Deutschland
| | - F Rodriguez
- Universität Leipzig, Medizinische Fakultät, Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Leipzig, Deutschland
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Blanco-García S, Aguado F, González J, Rodriguez F. A Raman study of the pressure-induced densification of SiO 2-based glass-ceramics. J Phys Condens Matter 2018; 30:304002. [PMID: 29877865 DOI: 10.1088/1361-648x/aacb1a] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Here we report a structural characterization study of glass-ceramics as a function of pressure by Raman spectroscopy. We selected a glass-ceramics of Li2O-Al2O3-nSiO2 (n ≈ 8) doped with ZrO2 and TiO2. This composition induces slight structural modification in Si-O and Si-O-Si bonds in the glass matrix that are crucial to stabilize metastable hexagonal SiO2 (β-quartz) solid-solution nano crystals corresponding to γ-LiAlSi2O6. This structure yields a more compact β-quartz-type phase that eventually stabilizes it in wider pressure range than pure SiO2. Raman spectroscopy allows to unravel at least two pressure-induced structural phase transitions at about 6 and 15 GPa that could not be previously revealed by x-ray diffraction. We show that the phase-transition sequence can tentatively be described in terms of SiO2-type structure as: β-quartz → Coesite I → Coesite II. The measured transition pressures are consistent with the larger cell volume attained in the γ-LiAlSi2O6 yielding a wider metastability pressure range of the β-quartz-type phase.
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Affiliation(s)
- S Blanco-García
- MALTA-Consolider team, DCITIMAC, Facultad de Ciencias, University of Cantabria, Santander, 39005, Spain
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Gunasekaran M, Sharma M, Rodriguez F, Elnahas S, Hachem R, Walia R, Smith M, Bremner R, Mohanakumar T. Distinct Phenotypic, Molecular and Immune Characteristics of Circulating Exosomes From Lung Transplant Recipients With Bronchiolitis Obliterans Syndrome versus Stable Patients. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Abstract
Although laboratories may be able to rely on a comprehensive Hurricane Plan during a hurricane, alarming and unanticipated events frequently occur. To minimize disruption of lab operations, it is important to try to mitigate the impact of these unexpected events as quickly as possible, in the quest to minimize negative outcomes. In this article, we discuss approaches to dealing with unanticipated events during and after hurricanes, based on our personal experiences.
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Affiliation(s)
| | | | - Peggy Mann
- University of Texas Medical Branch, Galveston, TX
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Kendsersky P, Book W, Rodriguez F, Lloyd M. CLINICAL OUTCOMES OF NOVEL ANTICOAGULANT VERSUS VITAMIN K ANTAGONIST USE IN ADULTS WITH FONTAN CIRCULATION. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)31079-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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50
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Saraf A, De Stearcke C, Gerardin J, Pernetz M, Ephrem G, Adjei S, Jennings S, Abdelhadi N, Kim J, Rodriguez F, Book W. FONTAN PHENOTYPES HAVE SIGNATURE BIOMARKER EXPRESSION PROFILES. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)31168-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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