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P185 Primary cardiac lymphoma: an unexpected finding. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
Primary cardiac malignancies are rare, with a reported incidence of 0.1%. Up to 10% of cardiac tumors are malignant and primary cardiac lymphoma represents (PCL) a very low proportion of them. The wide variety of clinical manifestations and the inespecificity of them, difficults the diagnosis and delays treatment impacting directly in the prognosis of these patients. Here we present a lady with diagnosis of PCL treated in our center.
CASE REPORT
We present a 69 year old female with arterial hypertension and paroxismal atrial fibrilation that attended our clinic in april 2013. She referred severe dyspnoea with daily activities and peripheral oedema for the last three weeks. She also complaint of painful swallowing for bothliquids and solids. Physical exploration was unremarkable and observations where within normal limits. Transthoracic echocardiogram (TTE) was performed which showed an hipoechogenic mass invading the right ventricle, both atria and left ventricle outflow tract. She underwent cardiac MRI which revealed a myocardial isointense mass, with marked signal enhancement in T2 and heterogeneity in late gadolinium enhancement sequences, that was consistent with primary cardiac lymphoma. For histologycal characterization, biopsy of the mass guided with endoscopic ultrasonography was performed, confirming B-cell lymphoma. Positron emmision tomography (PET) scan showed bulky hypercaptant mass invading both atria, superior vena cava and pericardium, with hypercaptant adenopathies in right pulmonary hilum, subcarinal and phrenic chain. Her case was discussed in multidisciplinary team meeting and prompt initiation of treatment under R-CHOP regime was decided. After three cycles, follow up PET was requested, and revealed complete metabolic response. A repeat TTE showed only minimal infiltration of the right atria without ventricular involvement or hemodynamic compromise.
DISCUSSION
The patient we presented, was sent to Cardiology due to heart failure symptoms. Acute heart failure as well as embolisation and life-threatening arrythmias are typical manifestations of PCL. As reported in the literature, our case was a diffuse large B-cell lymphoma, which is the most frequent subtype. Dysphagia, exertional dyspnoea and constitutional symptoms can be present in early stages, as our patient referred. The main strength of this case is based on the quick diagnosis and early treatment. In contrary to what is reported, the overall survival was excellent, and to date the patient is still alive with no signs of relapse. Although TTE sensitivity is 55-60%, it has a key role in the diagnosis, which was supported later on MRI. Right chambers (specially right atria) are more typically involved than the left heart, including right venous drainage. Early systemic chemotherapy can achieve a high response rate and improve survival.
Abstract P185 Figure. Img1
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P677 When to look for wtTTR amyloidosis in heart failure: increasing chances of positive gammagraphic study. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Wild type transtirretin (wtATTR) amyloidosis has become increasingly recognized as a major cause for heart failure (HF). Diagnosis requires complex work up such as DPD scintigraphy (DPDs). Availability of DPDs is limited urging to identify factors to increase its diagnostic rentability.
Methods
Retrospective study of HF patients between 2013 and 2019 with suspected wtATTR and DPDs was performed. Baseline characteristics, biomarkers, EKG findings, TTE parameters (LVEF, LV diastolic function, TAPSE, interventricular septum (IVS), LV mass (LVM), relative LV wall thickness (RWT), indexed LVTD volume and diameter, indexed LA diameter (iAPLAD)) and DPDs results were studied. Two groups were created according to DPDs (SP those with positive results for amyloidosis and SN those with negative results). For statistical SPSS v.21 was used.
Results
37 patients were studied. In our population 54% had positive DPDs for amyloidosis. Among SP patients 50% were classified as grade 2 of Perugini classification meanwhile 50% were grade 3; mean value of heart to contralateral ratio was 2,73 ± 0,8. There were no differences in NYHA classification. Differences among SP and SN patients are reflected in Table 1.
Conclusions
In our population SP was found to have higher biomarkers values and higher IVS, LVM, RWT and iAPLAD with poorer RV function. Further investigation is needed in order to confirm our result and identify prognostic factors.
Table 1: Results Total (37) PS (20) PN (17) p value Age (Y) 78 ± 7,9 80 ± 6,5 75,29 ± 8,7 0,05 Gender (male) (%) 30 (8) 19 (95) 11(64) 0,11 Carpal tunnel sdr (%) 3(8) 3 (15) 0 (0) 0,09 Systolic blood pressure (x ± sd) 127 ± 21 118 ± 18 138,5 ± 19 <0,01 ProBNP (x ± sd) 3596 ± 4002 4615 ± 4538 1761 ± 1927 <0,05 Troponin T (x ± sd) 132 ± 360 66,4 ± 35 43 ± 39 0,09 Pseudoinfarction pattern (%) 26 (70) 17 (85) 9 (52) <0,05 IVS (mm) (x ± sd) 14,6 ± 4,5 16,6 ± 5,3 13 ± 3 <0,01 LVM (g/m2) (x ± sd) 142,5 ± 68 180 ± 80 111 ± 32 <0,01 RWT (x ± sd) 0,68 ± 0,42 0,8 ± 0,24 0,56 ± 0,5 <0,01 LVEF (%) (x ± sd) 57,4 ± 11 54 ± 12 60 ± 10 0,12 iAPLAD (mm/m2) (x ± sd) 25,4 ± 6 28,7 ± 6 22,7 ± 4,3 <0,01 TAPSE (mm) (x ± sd) 18,6 ± 5 16,1 ± 4 20,6 ± 5 <0,05 IVS = interventricular septum; LVM = left ventricular mass; RWT = relative wall thickness; iAPLAD= indexed anteroposterior left atrium diameter.
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P4800Estimated effect of NOACs compared to Vitamin K Antagonists in real-world atrial fibrillation patients: Data from FANTASIA Registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Despite of the effectiveness and safety profile of Non-vitamin K Antagonists Oral Anticoagulants (NOACs) even in real-world (RW) Atrial Fibrillation (AF) patients, Vitamin K Antagonists (VKAs) have remained widely used in clinical practice worldwide but the comparison with acenocoumarol therapy in RW is unknown.
Purpose
To estimate the potential absolute benefit in clinical adverse events if the AF patients anticoagulated with VKA therapy had been treated with NOACs.
Methods
We analyzed anticoagulated AF patients who were prospectively recruited into the multicentre FANTASIIA registry. Patients were treated with VKAs for at least 6 months prior to inclusion. The estimation of clinical adverse events avoided was calculated applying absolute risk reductions, relative risk reductions and hazard ratios from the meta-analysis of RW use of NOACs relative to VKAs.
Results
We analyzed 1,470 patients under VKA therapy (mean age 74.1±9.5 years; 56.4% male). Stroke rate with acenocoumarol treatment was 0.88%/year. The estimated rates for stroke using NOACs would be 0.80%/year for Dabigatran 150 mg; 0.76%/year for Rivaroxaban and 0.74%/year for Apixaban instead of VKA. No significant differences were observed between the different NOACs and VKA in stroke rate. Major bleeding with acenocoumarol was 3.40%/year. The estimated rates for major bleeding using NOACs would be 2.75%/year for Dabigatran 150 mg; 3.37%/year for Rivaroxaban and 2.18%/year for Apixaban instead of VKA. Apixaban was the only NOAC that showed a significant estimated reduction rates (p=0.046). Finally, the all-cause mortality rate with acenocoumarol was 4.69%/year. The estimated rates of all-cause mortality using NOACs would be 3.28%/year for Dabigatran 150mg; 4.88%/year for Rivaroxaban and 2.67%/year for Apixaban. Dabigatran and Apixaban showed significant estimated reduction rates with the highest reduction with Apixaban (Table).
Annual Rate reduction of adverse events
Conclusion
The absolute estimated effect of NOACs in the AF patients anticoagulated with VKA showed a significant reduction in adverse clinical events. Apixaban performed the highest estimated reduction in major bleeding and all-cause mortality in comparison with acenocoumarol.
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P4814Prognostic impact of inappropriate doses of direct oral anticoagulants in clinical practice: a subanalysis of the FANTASIIA registry, a prospective, nationwide, real-world, observational study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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P1001Predictors of stroke and overall mortality in real world patients with atrial fibrillation treated with oral anticoagulants. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p1001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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P1281EHRA functional class is a strong predictor of major events in patients with atrial fibrillation treated with oral anticoagulants. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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P6620Relationship between charlson comorbidity index and risk of adverse outcomes in patients with atrial fibrillation: an analysis from the FANTASIIA registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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P6240Long term cardiovascular risk prediction in Real-World atrial fibrillation patients: Validation of the 2MACE score in the FANTASIIA registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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P6284Effectiveness and safety of direct anticoagulants versus vitamin K antagonists in octogenarians patients with atrial fibrillation in a “real world” nationwide registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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P3509Performance of the Cockcroft-Gault, MDRD and CKD-EPI Formulae in Atrial Fibrillation patients.The FANTASIIA Registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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P982Is there an obesity paradox for adverse outcomes in patients with atrial fibrillation? insights from the FANTASIIA registry. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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P6290Independent predictors of major events in octogenarians patients with atrial fibrillation treated with anticoagulants: data from the FANTASIIA registry, a “real world”, nationwide, prospective study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p6290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
Little is known about environmental exposure to pesticides and the extent to which exposure is affected by drift from agricultural applications and take home exposure from agricultural workers. The study focused on 24 agricultural families in the northwestern United States and measured levels of organophosphate pesticides (OP) in house dust. Pesticide residues were significantly associated with the number of individuals in the home whose work included high exposure pesticide activities. Mean levels of pesticides were higher in the homes of workers who reported waiting more than 2 hours before changing out of their work clothes compared with homes where workers change within 2 hours after returning from work (p < .01). The results of this study provide evidence that workers can inadvertently carry agricultural chemicals from their work into their homes, thereby increasing the risk of pesticide exposure to other family members inside the home.
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P6210Relation of renal dysfunction to quality of anticoagulation control in patients with atrial fibrillation: The FANTASIIA registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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5743Clinical determinants of time in therapeutic range and the role of SAMe-TT2R2 score in atrial fibrillation patients receiving oral anticoagulation: data from FANTASIIA registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.5743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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P5342The 2MACE score predicts cardiovascular events in real-world patients with atrial fibrillation: The FANTASIIA registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
This quasi-experimental study investigated the impact of visual art making on the cortisol levels of 39 healthy adults. Participants provided saliva samples to assess cortisol levels before and after 45 minutes of art making. Participants also provided written responses about the experience at the end of the session. Results indicate that art making resulted in statistically significant lowering of cortisol levels. Participants' written responses indicated that they found the art-making session to be relaxing, enjoyable, helpful for learning about new aspects of self, freeing from constraints, an evolving process of initial struggle to later resolution, and about flow/losing themselves in the work. They also reflected that the session evoked a desire to make art in the future. There were weak associations between changes in cortisol level and age, time of day, and participant responses related to learning about one's self and references to an evolving process in art making. There were no significant differences in outcomes based on prior experiences with art making, media choice, or gender.
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Fructose as a novel photosensitizer: Characterization of reactive oxygen species and an application in degradation of diuron and chlorpyrifos. CHEMOSPHERE 2016; 144:1690-1697. [PMID: 26519800 DOI: 10.1016/j.chemosphere.2015.10.074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 09/25/2015] [Accepted: 10/18/2015] [Indexed: 06/05/2023]
Abstract
The objective of this study was to identify reactive oxygen species (ROS) generated from the exposure of fructose solution to the 254 nm ultraviolet (UV) light and evaluate whether fructose can be used as a photosensitizer for accelerated photo-degradation of diuron and chlorpyrifos. We demonstrated that hydrogen peroxide, singlet oxygen ((1)O2) and acidic photolysis products were generated upon UV exposure of fructose. Consistent with these findings, UV induced degradation of chlorpyrifos and diuron was accelerated by the presence of 500 mM fructose. The average first order photo-degradation rate constants in the absence and presence of 500 mM fructose were 0.92 and 2.07 min(-1) respectively for diuron and 0.04 and 0.07 min(-1) for chlorpyrifos. The quantum yields (ɸ) for direct photo-degradation of diuron and chlorpyrifos were 0.003 and 0.001 respectively. In the presence of 500 mM fructose, these values increased to 0.006 and 0.002 respectively. Thus, fructose may be an effective photosensitizer.
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Differential effects of pregnancy on contractile behavior of rat fast and slow skeletal muscles. BRATISL MED J 2014; 115:389-94. [PMID: 25077359 DOI: 10.4149/bll_2014_077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The effect of pregnancy on skeletal muscle still has not been clearly established. The aim of the present study was to investigate the effect of pregnancy on muscle weight and contractile properties of soleus and plantaris muscles. METHODS The female Sprague-Dawley rats were divided into two groups: nonpregnant (NP, 250 ± 4 g, n = 8) and late-pregnant (LP, 305 ± 13 g, n = 8). The right plantaris and soleus muscles were liberated from the surrounding tissues. Each muscle was placed on setup to mechanical recording with electric stimulation. In the optimum length of each muscle were recorded single twitches, tetani and fatigue. RESULTS The weight and cross-sectional area of soleus and plantaris muscles from pregnant rats was increased respect to nonpregnant rats. The maximal twitch tension decreased in both muscles during pregnancy respect to nonpregnant group. The soleus muscle of LP group developed lesser tetanic tension than NP group. However, the plantaris muscle showed a different behavior: to lower frequencies (5-30 Hz) the NP group developed greater tetanic tension than LP group, and for higher frequencies (40-100 Hz), the LP group developed greater tetanic tension than NP group. Finally, the soleus muscle was more resistance to fatigue than plantaris muscle in pregnant rats. CONCLUSION The fast and slow skeletal muscles show a differential contractile response during pregnancy, in tetanic tension and fatigue (Fig. 4, Ref. 48).
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Serum 25(OH) vitamin D concentration changes after Roux-en-Y gastric bypass surgery. Obesity (Silver Spring) 2013; 21:E599-606. [PMID: 23526677 PMCID: PMC3731401 DOI: 10.1002/oby.20464] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Accepted: 03/09/2013] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To describe serum 25(OH)D changes after Roux-en-Y gastric bypass (RYGB) and to determine if fat mass (FM) loss and vitamin D intake are associated with changes in serum levels. DESIGN AND METHODS The relationship between serum 25(OH)D and 1) FM, 2) weight, 3) % excess weight loss (EWL), and 4) BMI was investigated after controlling for potential confounders using a mixed effects linear model in 20 women before and up to 1-year post-RYGB. Subcutaneous (SAT) and visceral adipose tissue (VAT) vitamin D concentrations at time of RYGB were also evaluated. RESULTS Weight and FM decreased 1-year after surgery by 45 ± 1 kg and 37 ± 1 kg, respectively while 25(OH)D increased by 10 ± 2 ng mL(-1) . Weight, FM, BMI, and %EWL changes were associated with 25(OH)D change. VAT had an average 21% more vitamin D per gram than SAT and concentrations were highly correlated. CONCLUSIONS Although weight loss may lead to increased serum 25(OH)D after RYGB, low levels remain a concern in some patients 1-year postsurgery. Additional research is needed to clarify the relationship between adipose storage of vitamin D and serum 25(OH)D in obesity, and how that relationship might change after surgery. This could lead to improved clinical management of vitamin D in this ever-growing clinical population.
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102 oral PERIPHERAL GAMMA DOSE AND THERMAL NEUTRON FLUENCIES EVALUATION IN DIFFERENT MATERIALS FOR IMRT. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70225-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Thematic stream: co-morbidity: BPP7. Effect of Anti Tnf-Alpha Therapies on Insulin Resistance, Body Composition and Adipokines in Rheumatoid Arthritis Patients. Rheumatology (Oxford) 2011. [DOI: 10.1093/rheumatology/ker096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Repeating video/EEG monitoring: why and with what results? Epilepsy Behav 2010; 18:472-3. [PMID: 20634145 DOI: 10.1016/j.yebeh.2010.06.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2010] [Revised: 06/10/2010] [Accepted: 06/11/2010] [Indexed: 11/25/2022]
Abstract
Prolonged video/EEG monitoring is the main activity of referral tertiary epilepsy centers. Occasionally, monitoring is repeated in the same patient, but this subgroup has not been specifically studied. The purpose of this study was to analyze repeated video/EEG monitoring. We reviewed all sessions of inpatient video/EEG monitoring performed over 3 years (2005-2008), and selected the ones that were repeated in the same patient. A total of 1063 video/EEG monitoring sessions were performed. Of these, 43 (4.0%) were "redos." The most common indication for repeat video/EEG monitoring was evidence of focal epilepsy with no recorded seizures, followed by normal interictal EEG with no recorded episodes. The second session answered the question in 35 (81%) cases, whereas the question remained unanswered in 8 (19%). The repeated session was useful in 35 (81%) cases.
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Cryptococcal meningitis misdiagnosed as Alzheimer's disease: complete neurological and cognitive recovery with treatment. J Alzheimers Dis 2009; 16:517-20. [PMID: 19276545 DOI: 10.3233/jad-2009-0985] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A sixty-two year old man, with a background of Alzheimer's disease for the past three years, acutely presented with imbalance, headaches, and dizziness. Examination revealed a profound frontal disinhibited and dysexecutive syndrome and brain imaging notable for leptomeningeal enhancement; laboratory data confirmed cryptococcal meningitis. Four months after treatment, the patient was normal neurologically, cognitively and neuroradiologically. The specific cognitive impairment and neuroradiological findings may be clues to differing dementia etiologies.
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571: Prevalence and Severity of Renal Dysfunction among 1059 Heart Transplant Patients According to Criteria Based on Serum Creatinine and Estimated Glomerular Filtration Rate: A Cross-Sectional Study. J Heart Lung Transplant 2009. [DOI: 10.1016/j.healun.2008.11.578] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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567: Risk Factors Associated with Moderate to Severe Renal Failure in Heart Transplant Patients. CAPRI Study. J Heart Lung Transplant 2009. [DOI: 10.1016/j.healun.2008.11.574] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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33: Fever in Recipients Waiting for an Urgent Heart Transplantation. Should Be Heart Transplantation Contraindicated? J Heart Lung Transplant 2008. [DOI: 10.1016/j.healun.2007.11.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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181: Pre-existing neoplasms and risk for malignancy after heart transplantation. Data from the Spanish Post-Heart Transplant Tumors Registry. J Heart Lung Transplant 2007. [DOI: 10.1016/j.healun.2006.11.198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Abstract
The deposition of agricultural pesticides in the homes of agricultural workers and residents of agricultural communities is a major environmental health concern. The effectiveness of home cleaning activities in removing pesticides from home surfaces has not been tested. An intervention study was conducted to assess the effectiveness of cleaning windowsills, floors and carpets in a sample of 10 farmworker homes. Baseline measures of organophosphorus (OP) pesticide residues were obtained, a standardized cleaning intervention was applied and follow-up measures of pesticide residues were obtained within 24-48 hours after the cleaning and 12 months later. House dust was analyzed for six OP pesticides. All homes had detectable baseline levels of OP pesticides on floors and windowsills. Cleaning of linoleum floors was ineffective in removing total pesticide residues and cleaning effectiveness varied among the pesticides. The cleaning of total OP pesticides on the windowsills was effective (median decrease was 0.0029 microg/cm(2), 1-sided p-value = 0.01). Steam cleaning carpets essentially reduced the amounts to non-detectable levels. In 12 months the levels in carpets had accumulated to one-third of the baseline levels. These results provide evidence that cleaning practices can reduce the amount of pesticides in agricultural homes; however the type of surface being cleaned and the pesticides present in the home may influence results.
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Genotoxicants target distinct molecular networks in neonatal neurons. ENVIRONMENTAL HEALTH PERSPECTIVES 2006; 114:1703-12. [PMID: 17107856 PMCID: PMC1665395 DOI: 10.1289/ehp.9073] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND Exposure of the brain to environmental agents during critical periods of neuronal development is considered a key factor underlying many neurologic disorders. OBJECTIVES In this study we examined the influence of genotoxicants on cerebellar function during early development by measuring global gene expression changes. METHODS We measured global gene expression in immature cerebellar neurons (i.e., granule cells) after treatment with two distinct alkylating agents, methylazoxymethanol (MAM) and nitrogen mustard (HN2). Granule cell cultures were treated for 24 hr with MAM (10-1,000 microM) or HN2 (0.1-20 microM) and examined for cell viability, DNA damage, and markers of apoptosis. RESULTS Neuronal viability was significantly reduced (p < 0.01) at concentrations > 500 microM for MAM and > 1.0 microM for HN2; this correlated with an increase in both DNA damage and markers of apoptosis. Neuronal cultures treated with sublethal concentrations of MAM (100 microM) or HN2 (1.0 microM) were then examined for gene expression using large-scale mouse cDNA microarrays (27,648). Gene expression results revealed that a) global gene expression was predominantly up-regulated by both genotoxicants; b) the number of down-regulated genes was approximately 3-fold greater for HN2 than for MAM; and c) distinct classes of molecules were influenced by MAM (i.e, neuronal differentiation, the stress and immune response, and signal transduction) and HN2 (i.e, protein synthesis and apoptosis). CONCLUSIONS These studies demonstrate that individual genotoxicants induce distinct gene expression signatures. Further study of these molecular networks may explain the variable response of the developing brain to different types of environmental genotoxicants.
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Organophosphate pesticide exposure and neurobehavioral performance in agricultural and non-agricultural Hispanic workers. ENVIRONMENTAL HEALTH PERSPECTIVES 2006; 114:691-6. [PMID: 16675422 PMCID: PMC1459921 DOI: 10.1289/ehp.8182] [Citation(s) in RCA: 85] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Our understanding of the health risks of farmworkers exposed to pesticides in their work and home environments is rapidly increasing, although studies designed to examine the possible neurobehavioral effects of low-level chronic pesticide exposure are limited. We measured dialkyl phosphate urinary metabolite levels, collected environmental dust samples from a subset of homes, obtained information on work practices, and conducted neurobehavioral tests on a sample of farmworkers in Oregon. Significant correlations between urinary methyl metabolite levels and total methyl organophosphate (azinphos-methyl, phosmet, malathion) house dust levels were observed. We found the neurobehavioral performance of Hispanic immigrant farmworkers to be lower than that observed in a nonagricultural Hispanic immigrant population, and within the sample of agricultural workers there was a positive correlation between urinary organophosphate metabolite levels and poorer performance on some neurobehavioral tests. These findings add to an increasing body of evidence of the association between low levels of pesticide exposure and deficits in neurobehavioral performance.
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224. J Heart Lung Transplant 2006. [DOI: 10.1016/j.healun.2005.11.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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The Solaar HIV prevention program for gay and bisexual Latino men: using social marketing to build capacity for service provision and evaluation. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2005; 17:361-74. [PMID: 16178705 DOI: 10.1521/aeap.2005.17.4.361] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Community-researcher partnerships can be powerful mechanisms to understand and effectively address health and social problems such as HIV/AIDS prevention. When the partnership is a positive, productive one, the combined expertise and energy of both parties result in a more effective program and a better evaluation of its effects. This article describes one such partnership and how a program challenge provided the opportunity for both partners to develop new capacities and strengthen others. The program is Proyecto SOLAAR, a community-based and culturally-sensitive HIV prevention program for gay and bisexual Latino men. The program is an experiential, daylong retreat focused on personal aspects of the men (e.g., self-concept), ideas about and aspects of their relationship behavior (e.g., cultural misunderstandings, dating behavior), and HIV prevention; there is a follow-up reunion a month later to share experiences with other participants about new dating and HIV prevention behaviors. The article focuses in particular on how the partners built new capacity in the area of social marketing to address the challenge of participant recruitment and describes the components of the new campaign. These components included distinctive images in ads in publications read by the target population, a toll-free telephone number and Web site for easy initial contact with the program, phone cards and postcards featuring the specially created program image to reinforce a connection to the program, and other aspects. The article describes the partnership between the HIV service providers and the researchers and how the collaborative effort was key to understanding and addressing the recruitment problem, identifying potential solutions, and implementing the new social marketing strategy. This process resulted in four kinds of capacities that were built or strengthened, including program recruitment, program content and implementation, program evaluation, and the partnership itself. The article concludes with a discussion of the unexpected benefits of the capacity-building experience and of the antecedent conditions that fostered the positive partnership outcomes.
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Molecular networks perturbed in a developmental animal model of brain injury. Neurobiol Dis 2005; 19:108-18. [PMID: 15837566 DOI: 10.1016/j.nbd.2004.11.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2004] [Revised: 11/16/2004] [Accepted: 11/23/2004] [Indexed: 11/29/2022] Open
Abstract
Methylazoxymethanol (MAM) is widely used as a developmental neurotoxin and exposure to its glucoside (i.e., cycasin) is associated with the prototypical neurological disorder western Pacific ALS/PDC. However, the specific molecular targets that play a key role in MAM-induced brain injury remain unclear. To reveal potential molecular networks targeted by MAM in the developing nervous system, we examined characteristic phenotypic changes (DNA damage, cytoarchitecture) induced by MAM and their correlation with gene expression differences using microarray assays (27,648 genes). Three day-old postnatal C57BL/6 mice (PND3) received a single injection of MAM and the cerebellum and cerebral cortex of PND4, 8, 15, and 22 mice were analyzed. DNA damage was detected in both the cerebellum (N7-mGua, TUNEL labeling) and cerebral cortex (N7-mGua) of PND4 mice, but progressive disruption of the cytoarchitecture was restricted to the cerebellum. A majority (>75%) of the genes affected (cerebellum 636 genes, cortex 1080 genes) by MAM were developmentally regulated, with a predominant response early (PND4) in the cerebellum and delayed (PND8 and 15) in the cerebral cortex. The genes and pathways (e.g., proteasome) affected by MAM in the cerebellum are distinct from cortex. The genes perturbed in the cerebellum reflect critical cellular processes such as development (17%), cell cycle (7%), protein metabolism (12%), and transcriptional regulation (9%) that could contribute to the observed cytoarchitectural disruption of the cerebellum. This study demonstrates for the first time that specific genes and molecular networks are affected by MAM during CNS development. Further investigation of these targets will help to understand how disruption of these developmental programs could contribute to chronic brain injury or neurodegenerative disease.
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Variation in organophosphate pesticide metabolites in urine of children living in agricultural communities. ENVIRONMENTAL HEALTH PERSPECTIVES 2005; 113:504-8. [PMID: 15811843 PMCID: PMC1278494 DOI: 10.1289/ehp.6890] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2003] [Accepted: 01/10/2005] [Indexed: 05/19/2023]
Abstract
Children of migrant farmworkers are at increased risk of exposure to organophosphate pesticides because of "carry-home" transport processes and residential location. Although this at-risk status is generally recognized, few available reports describe the extent of this exposure among agricultural communities. We quantified dialkyl phosphate (DAP) levels in serial samples of urine from 176 children, 2-6 years of age, in three Oregon communities hosting differing agricultural industries: pears, cherries, and fruit berries. Up to three spot samples of urine were collected from children at the beginning, mid-point, and end of their parents' work seasons. The median levels of dimethylthiophosphate (DMTP), the most commonly detected metabolite, was significantly higher in urine samples from children in each of the three agricultural communities (17.5, 19.0, and 41.0 ng/mL) relative to a reference group of children who lived in an urban community and whose parents did not work in agriculture (6.5 ng/mL; Kruskal-Wallis, p < 0.001). After controlling for age, sex, and weight, the median level of DMTP in children in the pear community was 1.92 times higher than the level in children of the berry community [95% confidence interval (CI), 1.14-3.23] and 1.75 times higher than the level in children of the cherry community (95% CI, 0.95-3.23). We observed increasing levels of DMTP across the work season only within the berry community. Levels decreased in the cherry community and remained constant in the pear community. Substantial temporal variation within the children followed demonstrates the need for multiple urine samples to most accurately characterize longer term and/or cumulative exposure. The observed variability in urinary DAP levels, between communities and over time, could be attributed to the types and amounts of organophosphate pesticides used, the timing of applications and degradation of residues in the environment, work operations and hygiene practices, the proximity of housing to orchards and fields, or the movement of these working families. Additional studies of variation in pesticide exposure across agricultural regions are needed.
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Pesticide exposure and self reported home hygiene: practices in agricultural families. AAOHN JOURNAL : OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION OF OCCUPATIONAL HEALTH NURSES 2003; 51:113-9. [PMID: 12670098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Little is known about environmental exposure to pesticides and the extent to which exposure is affected by drift from agricultural applications and take home exposure from agricultural workers. The study focused on 24 agricultural families in the northwestern United States and measured levels of organophosphate pesticides (OP) in house dust. Pesticide residues were significantly associated with the number of individuals in the home whose work included high exposure pesticide activities. Mean levels of pesticides were higher in the homes of workers who reported waiting more than 2 hours before changing out of their work clothes compared with homes where workers change within 2 hours after returning from work (p < .01). The results of this study provide evidence that workers can inadvertently carry agricultural chemicals from their work into their homes, thereby increasing the risk of pesticide exposure to other family members inside the home.
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Route-of-entry and brain tissue partition coefficients for common superfund contaminants. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2002; 65:2075-2086. [PMID: 12515587 DOI: 10.1080/00984100290071838] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Various organic solvents may be encountered in contaminated water supplies at U.S. Environmental Protection Agency-designated Superfund sites. Human exposure to these environmental contaminants may occur by oral, dermal, or inhalation routes. The estimation of human health risk associated with exposure to these solvents can be improved through the use of physiologically based pharmacokinetic (PBPK) models to describe the absorption, tissue distribution, metabolism, and elimination of the compounds following any route of exposure. However, development of these PBPK models requires information on the relative solubility, or partition coefficient, of each compound in blood and various tissues. A number of investigators have provided partition coefficient information on different tissues in various species; however, the data for route of entry organs (i.e., skin, lung, stomach) and brain tissue are not complete. Therefore, the objective of this work was to replicate partition coefficient studies for several commonly encountered environmental contaminants using an in vitro gas-phase vial equilibration technique and to include tissues to evaluate brain, lung, stomach, and skin. A comparison of the partition coefficient values determined here with values reported in the literature, where available, showed good agreement in nearly all cases. An additional study was conducted to compare the liver-to-air partition coefficient values for toluene, benzene, and o-xylene introduced as single chemicals to partition coefficient values determined with the chemicals introduced as a mixture of all three compounds. The similarities of the resulting values suggest that both labor and laboratory resources may be reduced when partition coefficients are determined as chemical mixtures.
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Work characteristics and pesticide exposures among migrant agricultural families: a community-based research approach. ENVIRONMENTAL HEALTH PERSPECTIVES 2001; 109:533-8. [PMID: 11401767 PMCID: PMC1240315 DOI: 10.1289/ehp.01109533] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
There are few data on pesticide exposures of migrant Latino farmworker children, and access to this vulnerable population is often difficult. In this paper we describe a community-based approach to implement culturally appropriate research methods with a migrant Latino farmworker community in Oregon. Assessments were conducted in 96 farmworker homes and 24 grower homes in two agricultural communities in Oregon. Measurements included surveys of pesticide use and work protection practices and analyses of home-dust samples for pesticide residues of major organophosphates used in area crops. Results indicate that migrant farmworker housing is diverse, and the amounts and types of pesticide residues found in homes differ. Azinphos-methyl (AZM) was the pesticide residue found most often in both farmworker and grower homes. The median level of AZM in farmworker homes was 1.45 ppm compared to 1.64 ppm in the entry area of grower homes. The median level of AZM in the play areas of grower homes was 0.71 ppm. The levels of AZM in migrant farmworker homes were most associated with the distance from fields and the number of agricultural workers in the home. Although the levels of AZM in growers and farmworker homes were comparable in certain areas, potential for disproportionate exposures occur in areas of the homes where children are most likely to play. The relationship between home resident density, levels of pesticide residues, and play behaviors of children merit further attention.
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Short report. Effect of the application of the new diagnostic criteria of diabetes mellitus in the prevalence estimates and diagnostic level in the general population. Eur J Public Health 1999. [DOI: 10.1093/eurpub/9.2.149] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Assessing the effects of low boron diets on embryonic and fetal development in rodents using in vitro and in vivo model systems. Biol Trace Elem Res 1998; 66:271-98. [PMID: 10050925 DOI: 10.1007/bf02783143] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
To date, boron (B) essentiality has not been conclusively shown in mammals. This article summarizes the results of a series of in vitro and in vivo experiments designed to investigate the role of B in mammalian reproduction. In the first study, rat dams were fed either a low (0.04 microg B/g) or an adequate (2.00 microg B/g) B diet for 6 wk before breeding and through pregnancy; reproductive outcome was monitored on gestation day 20. Although low dietary B significantly lowered maternal blood, liver, and bone B concentrations, it had no marked effects on fetal growth or development. The goal of the second study was to assess the effects of B on the in vitro development of rat postimplantation embryos. Day 10 embryos collected from dams fed either the low or adequate B diets for at least 12 wk were cultured in serum collected from male rats exposed to one of the two dietary B treatments. Dams fed the low B diet had a significantly reduced number of implantation sites compared to dams fed the B-adequate diet. However, embryonic growth in vitro was not affected by B treatment. The aim of study 3 was to define the limits of boric acid (BA) toxicity on mouse preimplantation development in vitro. Two-cell mouse embryos were cultured in media containing graded levels of BA (from 6 to 10,000 microM). Impaired embryonic differentiation and proliferation were observed only when embryos were exposed to high levels of BA (>2000 microM), reflecting a very low level of toxicity of BA on early mouse embryonic development. Study 4 tested the effects of low (0.04 microg B/g) and adequate (2.00 microg B/g) dietary B on the in vitro development of mouse preimplantation embryos. Two-cell embryos obtained from the dams were cultured in vitro for 72 h. Maternal exposure to the low B diet for 10, 12, and 16 wk was associated with a reduction in blastocyst formation, a reduction in blastocyst cell number, and an increased number of degenerates. Collectively, these studies support the concept that B deficiency impairs early embryonic development in rodents.
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Abstract
A cross-sectional study of the prevalence and distribution of diabetes among 40- to 69-year olds in Galicia (NW Spain) is presented. A (R)Reflotron system was used to measure the capillary fasting glucaemia in 1275 subjects randomly chosen from the electoral roll, who also answered a short questionnaire and were weighed and measured. The prevalence of diabetes was 7.5% regardless of sex or habitat (urban or rural), and increased significantly with age. These data are in keeping with the scant available information from other parts of Spain and the world in general. The lack of difference between urban and rural habitats was unexpected in view of previously reported dietary differences between both areas.
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Liquid Chromatographic Method for Determination of Oxythioquinox in Technical and Formulated Products: Collaborative Study. J AOAC Int 1986. [DOI: 10.1093/jaoac/69.3.490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
A liquid chromatographic method for determination of oxythioquinox (Morestan®) in oxythioquinox technical and formulated products has been developed and collaboratively studied in 14 laboratories. Samples are dissolved in chloroform containing n-valerophenone as an internal standard, diluted with acetonitrile, and analyzed by reverse phase chromatography. Collaborators analyzed blind duplicate samples of oxythioquinox technical and 25 WP. Coefficients of variation were 1.06 and 1.72% for the technical and 25 WP samples, respectively. The method has been adopted official first action.
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[Long bone growth changes in thymectomized rats in the pre-puberal stage (author's transl)]. REVISTA BRASILEIRA DE PESQUISAS MEDICAS E BIOLOGICAS 1978; 11:1-7. [PMID: 653012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The authors studied the relationship between thymus and growth of long bones in rats in the pre-puberal stage. 150 rats of both sexes were divided in 3 groups: thymectomized, sham-thymectomized and controls. The animals were sacrificed 15 days after surgery, the femurs were collected and measured, in length and breadth. Thymectomized animals have a bone growth significantly lesser in length and breadth when compared to the sham-thymectomized animals. The latter ones also presented a lesser bone growth when compared to the controls. The average body weight was also significantly lesser in thymectomized rats than in controls, the same happening with the shamthymectomized rats. It is suggested that the thymus probably presents some kind of relation with the hypothalamus through a positive feed-back, simulating secretion of substances that would act on the adenohypophysis rising the secretion of growth hormone and the thymus playing a role in maintaining the serum levels of growth hormone and thyroxine necessary for the growth and development of bones.
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[American trypanosomiasis (Chagas' disease in the immunopathology concept)]. REVISTA BRASILEIRA DE MALARIOLOGIA E DOENCAS TROPICAIS. PUBLICACOES AVULSAS 1970; 22:355-410. [PMID: 4998330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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[Contribution to a better understanding of the pathological effect of S. cruzi on the human organism]. HOSPITAL (RIO DE JANEIRO, BRAZIL) 1967; 72:675-700. [PMID: 4974912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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[On the use of the double diffusion tube technic (Oakley and Fulthorp) for analysis of cultrues of developing Schizotrypanum cruzi]. COMPTES RENDUS DES SEANCES DE LA SOCIETE DE BIOLOGIE ET DE SES FILIALES 1967; 161:493-5. [PMID: 4229168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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