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Riva E, Schütz N, Peña C, Ruiz-Argüelles G, Hopkins CR, Bove V, Villano F, Andino L, Suárez L, Martínez H, Navarro J, López-Vidal H, Da Costa O, Pineda MR, Rubio Y, Ramirez J, Choque J, Fantl D. Significant differences in access to tests and treatments for multiple myeloma between public and private systems in Latin America. Results of a Latin American survey. GELAMM (Grupo de Estudio Latino Americano de Mieloma Múltiple). Ann Hematol 2020; 99:1025-1030. [PMID: 32157420 DOI: 10.1007/s00277-020-03983-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 03/01/2020] [Indexed: 12/14/2022]
Abstract
The incidence of multiple myeloma (MM) has increased in the last 20 years, particularly in middle and low-middle income countries. Access to diagnostic and prognostic tests and the availability of effective care is highly variable globally. Latin America represents 10% of the world population, distributed in countries of varied size, population, and socio-economic development. In the last decade, great improvements have been made in the diagnosis and treatment of MM. Applying these advances in real life is a challenge in our region. Local data regarding MM standards of care and outcomes are limited. A survey was carried out among hematologists from 15 Latin American countries to describe access to MM diagnostic and prognostic tests and the availability of effective care options. This study provides real-world data for MM in our region, highlighting striking differences between public and private access to essential analyses and therapeutic options.
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Affiliation(s)
- Eloísa Riva
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay.
| | - N Schütz
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | - C Peña
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | | | - C Rojas Hopkins
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | - V Bove
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | - F Villano
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | - L Andino
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | - L Suárez
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | - H Martínez
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | - J Navarro
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | - H López-Vidal
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | - O Da Costa
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | | | - Y Rubio
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | - J Ramirez
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | - J Choque
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
| | - D Fantl
- Hospital de Clínicas, A Italia sn, 11700, Montevideo, Uruguay
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Rafiei A, Hafez A, Jahromi BR, Kivisaari R, Canato B, Choque J, Colasanti R, Fransua S, Lehto H, Andrade-Barazarte H, Hernesniemi J. Anatomic Features of Paraclinoid Aneurysms: Computed Tomography Angiography Study of 144 Aneurysms in 136 Consecutive Patients. Neurosurgery 2017; 81:949-957. [PMID: 28419295 DOI: 10.1093/neuros/nyx157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 03/17/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Paraclinoid aneurysms are among the most challenging aneurysms to treat. Computed tomography (CT) angiography helps in evaluating the radiological characteristics of these aneurysms next to bony structures. OBJECTIVE To present the CT angiography characteristics of paraclinoid aneurysms in order to better understand such pathology. METHODS The study examined CT angiography-based anatomical characteristics obtained retrospectively from 136 patients with 144 paraclinoid aneurysms selected from single-defined catchment populations in Finland. We examined the diameters of the parent artery (internal carotid artery), the location of the aneurysm, its dimensions (width, height, neck), and aneurysm wall irregularity. RESULTS We analyzed 144 paraclinoid aneurysms in 136 patients admitted to the hospital during 2000-2014. Multivariable analysis reveals that rupture aneurysms have the following radiological features: aneurysm larger than 5 mm in diameter (P = .006), irregular wall (P = .046), superior location, larger aspect ratio (P = .039), and neck wider than parent artery (P < .001). CONCLUSION Smaller diameter of the internal carotid artery and superior location, as well as a large and irregular aneurysm wall, are radiological characteristics of ruptured paraclinoid aneurysms, which CT angiography can measure easily.
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Affiliation(s)
- Ahmadreza Rafiei
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Ahmad Hafez
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Behnam Rezai Jahromi
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Riku Kivisaari
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Bruno Canato
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Joham Choque
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Roberto Colasanti
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Sharafeddin Fransua
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Hanna Lehto
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | | | - Juha Hernesniemi
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
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Crisp R, Vidal-Senmache G, Navarro Cabrera J, Huaman-Garaicoa F, Maldonado B, Undurraga Sutton M, Valladares X, Guillermo C, Grillé S, Choque J, Salinas Viedma V, Royg M, Iastrebner M, Belli C. Access to Diagnostic and Therapeutic Tools for Myelodysplastic Syndromes in General Practice: Survey Among South-American Hematologists. Leuk Res 2017. [DOI: 10.1016/s0145-2126(17)30251-5] [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] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sharafeddin F, Hafez A, Lehecka M, Raj R, Colasanti R, Rafiei A, Choque J, Jahromi BR, Niemelä M, Hernesniemi J. A5 segment aneurysm of the anterior cerebral artery, imbedded into the body of the corpus callosum: A case report. Surg Neurol Int 2017; 8:18. [PMID: 28217397 PMCID: PMC5309442 DOI: 10.4103/2152-7806.199559] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Accepted: 12/07/2016] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The A5 segment aneurysms of the anterior cerebral artery are rare, approximately 0.5% of all intracranial aneurysms. They are small with a wide base located in the midline, with the domes mostly projecting upward or backward. CASE DESCRIPTION The authors describe a unique case of A5 segment aneurysm, with the dome embedded into the body of the corpus callosum. This 41-year-old female was admitted to the neurology department for possible multiple sclerosis investigation. Computed tomography angiogram (CTA) revealed a 4-mm right-sided pericallosal artery aneurysm, with rare configuration, which was caudally projected, embedded into the body of the corpus callosum. Considering the family history, patient underwent a prophylactic ligation surgery. The postoperative CT and CTA showed no complication and successful occlusion of the aneurysm with no ischemia or hemorrhage in the corpus callosum. CONCLUSION To the best of our knowledge, this is the first case of an aneurysm with this configuration. Our rare case of A5 segment aneurysm demonstrates the importance of planning of the surgery, choosing the appropriate approach, and knowing the detailed anatomy of the region, as well as the necessity of microsurgical clipping of small unruptured AdistAs.
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Affiliation(s)
- Fransua Sharafeddin
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Ahmad Hafez
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Martin Lehecka
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Rahul Raj
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Roberto Colasanti
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Ahmadreza Rafiei
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Joham Choque
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Behnam R Jahromi
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Mika Niemelä
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
| | - Juha Hernesniemi
- Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland
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Muñoz V, Sauvain M, Bourdy G, Arrázola S, Callapa J, Ruiz G, Choque J, Deharo E. A search for natural bioactive compounds in Bolivia through a multidisciplinary approach. Part III. Evaluation Of the antimalarial activity of plants used by Alteños Indians. J Ethnopharmacol 2000; 71:123-131. [PMID: 10904155 DOI: 10.1016/s0378-8741(99)00191-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
A total of 40 plant extracts traditionally used by the Alteños Indians, a native community living between the Andean block and the tropical valleys of Bolivia, were screened for antimalarial activity in vitro on Plasmodium falciparum chloroquine resistant (Indo) strain, and in vivo on rodent malaria Plasmodium vinckei petteri. Eleven extracts displayed good or moderate activity in vivo, and ten extracts good or very good antimalarial activity in vitro. Results of the screening are discussed here, in relation with the traditional use of plants.
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Affiliation(s)
- V Muñoz
- Instituto Boliviano de Biologia de Altura (IBBA) CP641, La Paz, Bolivia
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