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Chen Q, Perales C, Soria ME, García-Cehic D, Gregori J, Rodríguez-Frías F, Buti M, Crespo J, Calleja JL, Tabernero D, Vila M, Lázaro F, Rando-Segura A, Nieto-Aponte L, Llorens-Revull M, Cortese MF, Fernandez-Alonso I, Castellote J, Niubó J, Imaz A, Xiol X, Castells L, Riveiro-Barciela M, Llaneras J, Navarro J, Vargas-Blasco V, Augustin S, Conde I, Rubín Á, Prieto M, Torras X, Margall N, Forns X, Mariño Z, Lens S, Bonacci M, Pérez-Del-Pulgar S, Londoño MC, García-Buey ML, Sanz-Cameno P, Morillas R, Martró E, Saludes V, Masnou-Ridaura H, Salmerón J, Quíles R, Carrión JA, Forné M, Rosinach M, Fernández I, García-Samaniego J, Madejón A, Castillo-Grau P, López-Núñez C, Ferri MJ, Durández R, Sáez-Royuela F, Diago M, Gimeno C, Medina R, Buenestado J, Bernet A, Turnes J, Trigo-Daporta M, Hernández-Guerra M, Delgado-Blanco M, Cañizares A, Arenas JI, Gomez-Alonso MJ, Rodríguez M, Deig E, Olivé G, Río OD, Cabezas J, Quiñones I, Roget M, Montoliu S, García-Costa J, Force L, Blanch S, Miralbés M, López-de-Goicoechea MJ, García-Flores A, Saumoy M, Casanovas T, Baliellas C, Gilabert P, Martin-Cardona A, Roca R, Barenys M, Villaverde J, Salord S, Camps B, Silvan di Yacovo M, Ocaña I, Sauleda S, Bes M, Carbonell J, Vargas-Accarino E, Ruzo SP, Guerrero-Murillo M, Von Massow G, Costafreda MI, López RM, González-Moreno L, Real Y, Acero-Fernández D, Viroles S, Pamplona X, Cairó M, Ocete MD, Macías-Sánchez JF, Estébanez A, Quer JC, Mena-de-Cea Á, Otero A, Castro-Iglesias Á, Suárez F, Vázquez Á, Vieito D, López-Calvo S, Vázquez-Rodríguez P, Martínez-Cerezo FJ, Rodríguez R, Macenlle R, Cachero A, Mereish G, Mora-Moruny C, Fábregas S, Sacristán B, Albillos A, Sánchez-Ruano JJ, Baluja-Pino R, Fernández-Fernández J, González-Portela C, García-Martin C, Sánchez-Antolín G, Andrade RJ, Simón MA, Pascasio JM, Romero-Gómez M, Antonio Del-Campo J, Domingo E, Esteban R, Esteban JI, Quer J. Deep-sequencing reveals broad subtype-specific HCV resistance mutations associated with treatment failure. Antiviral Res 2020; 174:104694. [PMID: 31857134 DOI: 10.1016/j.antiviral.2019.104694] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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: 04/15/2019] [Revised: 10/24/2019] [Accepted: 12/11/2019] [Indexed: 02/07/2023]
Abstract
A percentage of hepatitis C virus (HCV)-infected patients fail direct acting antiviral (DAA)-based treatment regimens, often because of drug resistance-associated substitutions (RAS). The aim of this study was to characterize the resistance profile of a large cohort of patients failing DAA-based treatments, and investigate the relationship between HCV subtype and failure, as an aid to optimizing management of these patients. A new, standardized HCV-RAS testing protocol based on deep sequencing was designed and applied to 220 previously subtyped samples from patients failing DAA treatment, collected in 39 Spanish hospitals. The majority had received DAA-based interferon (IFN) α-free regimens; 79% had failed sofosbuvir-containing therapy. Genomic regions encoding the nonstructural protein (NS) 3, NS5A, and NS5B (DAA target regions) were analyzed using subtype-specific primers. Viral subtype distribution was as follows: genotype (G) 1, 62.7%; G3a, 21.4%; G4d, 12.3%; G2, 1.8%; and mixed infections 1.8%. Overall, 88.6% of patients carried at least 1 RAS, and 19% carried RAS at frequencies below 20% in the mutant spectrum. There were no differences in RAS selection between treatments with and without ribavirin. Regardless of the treatment received, each HCV subtype showed specific types of RAS. Of note, no RAS were detected in the target proteins of 18.6% of patients failing treatment, and 30.4% of patients had RAS in proteins that were not targets of the inhibitors they received. HCV patients failing DAA therapy showed a high diversity of RAS. Ribavirin use did not influence the type or number of RAS at failure. The subtype-specific pattern of RAS emergence underscores the importance of accurate HCV subtyping. The frequency of "extra-target" RAS suggests the need for RAS screening in all three DAA target regions.
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Affiliation(s)
- Qian Chen
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Celia Perales
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - María Eugenia Soria
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain
| | - Damir García-Cehic
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Josep Gregori
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Roche Diagnostics SL, Sant Cugat del Valles, Barcelona, Spain
| | - Francisco Rodríguez-Frías
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Biochemistry and Microbiology Department, VHIR-HUVH, Barcelona, Spain
| | - María Buti
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Javier Crespo
- Gastroenterology and Hepatology Department, Instituto de Investigación (IDIVAL), Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | | | - David Tabernero
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Biochemistry and Microbiology Department, VHIR-HUVH, Barcelona, Spain
| | - Marta Vila
- Biochemistry and Microbiology Department, VHIR-HUVH, Barcelona, Spain
| | - Fernando Lázaro
- Microbiology Department, Hospital Universitario La Paz, Madrid, Spain
| | | | | | - Meritxell Llorens-Revull
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Irati Fernandez-Alonso
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain
| | - José Castellote
- Liver Unit, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Jordi Niubó
- Microbiology Department, Hospital Universitari de Bellvitge, Barcelona
| | - Arkaitz Imaz
- HIV and STI Unit, Infectious Diseases Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Xavier Xiol
- Liver Unit, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Lluís Castells
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Mar Riveiro-Barciela
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Jordi Llaneras
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Víctor Vargas-Blasco
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Salvador Augustin
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Isabel Conde
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Hospital Universitario La Fe, Valencia, Spain
| | - Ángel Rubín
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Hospital Universitario La Fe, Valencia, Spain
| | - Martín Prieto
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Hospital Universitario La Fe, Valencia, Spain
| | - Xavier Torras
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Microbiology Department, Hospital Universitari Santa Creu i Sant Pau, Barcelona, Spain
| | - Nuria Margall
- Digestive Pathology Unit, Hospital Universitari Santa Creu i Sant Pau, Barcelona, Spain
| | - Xavier Forns
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) - Hospital Clínic de Barcelona, Barcelona, Spain
| | - Zoe Mariño
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) - Hospital Clínic de Barcelona, Barcelona, Spain
| | - Sabela Lens
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) - Hospital Clínic de Barcelona, Barcelona, Spain
| | - Martin Bonacci
- Liver Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) - Hospital Clínic de Barcelona, Barcelona, Spain
| | - Sofía Pérez-Del-Pulgar
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) - Hospital Clínic de Barcelona, Barcelona, Spain
| | - Maria Carlota Londoño
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) - Hospital Clínic de Barcelona, Barcelona, Spain
| | | | | | - Rosa Morillas
- Liver Unit, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Elisa Martró
- Microbiology Department, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Institut de Recerca Germans Trias i Pujol (IGTP), Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Verónica Saludes
- Microbiology Department, Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Institut de Recerca Germans Trias i Pujol (IGTP), Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | | | - Javier Salmerón
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Complejo Hospitalario de Granada, Granada, Spain
| | - Rosa Quíles
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Complejo Hospitalario de Granada, Granada, Spain
| | - José Antonio Carrión
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Parc de Salut Mar - Hospital del Mar, Barcelona, Spain
| | - Montserrat Forné
- Gastroenterology Unit, Hospital Universitari Mútua Terrassa, Spain
| | - Mercè Rosinach
- Gastroenterology Unit, Hospital Universitari Mútua Terrassa, Spain
| | | | - Javier García-Samaniego
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ) - Hospital Universitario La Paz, Madrid, Spain
| | - Antonio Madejón
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ) - Hospital Universitario La Paz, Madrid, Spain
| | - Pilar Castillo-Grau
- Liver Unit, Instituto de Investigación Hospital Universitario La Paz (IdiPAZ) - Hospital Universitario La Paz, Madrid, Spain
| | - Carme López-Núñez
- Gastroenterology Department, Hospital Universitari Doctor Josep Trueta, Girona, Spain
| | - María José Ferri
- Clinical Laboratory, Hospital Universitari Doctor Josep Trueta, Girona, Spain
| | - Rosa Durández
- Laboratori Territorial - Hospital Santa Caterina, Girona, Spain
| | - Federico Sáez-Royuela
- Gastroenterology and Hepatology Depart., Hospital Universitario de Burgos, Burgos, Spain
| | - Moisés Diago
- Liver Unit, Hospital General de Valencia, Valencia, Spain
| | | | - Rafael Medina
- Microbiology Unit, Hospital General de Valencia, Valencia, Spain
| | - Juan Buenestado
- Medicine Department-Medical School, Hospital Univ. Arnau de Vilanova, Lleida, Spain
| | - Albert Bernet
- Microbiology Department, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Juan Turnes
- Gastroenterology and Hepatology Department, Instituto de Investigación Sanitaria Galicia Sur (IISGS) - Complejo Hospitalario de Pontevedra, Pontevedra, Spain
| | - Matilde Trigo-Daporta
- Microbiology and Parasitology Department, Complejo Hospitalario de Pontevedra, Pontevedra, Spain
| | | | | | - Angelina Cañizares
- Microbiology Department, Institut de Investigación Biomédica de a Coruña (INIBIC) - Complejo Hospitalario Universitario A Coruña (CHUAC), La Coruña, Spain
| | | | | | - Manuel Rodríguez
- Gastroenterology Depart., Central University Hospital of Asturias (HUCA), Oviedo, Spain
| | | | - Gemma Olivé
- Sant Jaume de Calella County Hospital, Barcelona, Spain
| | - Oscar Del Río
- Sant Jaume de Calella County Hospital, Barcelona, Spain
| | - Joaquín Cabezas
- Gastroenterology and Hepatology Department, Instituto de Investigación (IDIVAL), Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Ildefonso Quiñones
- Gastroenterology Department, Dr Negrin University Hospital of Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Mercè Roget
- Liver Unit, Consorci Sanitari de Terrassa - Hospital de Terrassa, Terrassa, Spain
| | - Silvia Montoliu
- Gastroenterology Unit, Joan XXIII University Hospital, Tarragona, Spain
| | - Juan García-Costa
- Virology and Molecular Biology Unit, Microbiology Department, Complexo Hospitalario Universitario de Ourense (CHUO), Ourense, Spain
| | | | - Silvia Blanch
- Hospital Universitari Sant Pau i Santa Tecla, Tarragona, Spain
| | - Miguel Miralbés
- Gastroenterology Department, Hospital Universitari Santa Maria de Lleida, Lleida, Spain
| | | | | | - María Saumoy
- HIV and STI Unit, Infectious Diseases Department, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Teresa Casanovas
- Liver Unit, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Carme Baliellas
- Liver Unit, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Pau Gilabert
- Liver Unit, Hospital Universitari de Bellvitge, Barcelona, Spain
| | | | - Rosa Roca
- Liver Unit, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Mercè Barenys
- Liver Unit, Hospital de Viladecans, Barcelona, Spain
| | - Joana Villaverde
- Liver Unit, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Silvia Salord
- Liver Unit, Hospital Universitari de Bellvitge, Barcelona, Spain
| | - Blau Camps
- Liver Unit, Hospital Universitari de Bellvitge, Barcelona, Spain
| | | | - Imma Ocaña
- Infectious Disease Unit, HUVH, Barcelona, Spain
| | - Silvia Sauleda
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Banc de Sang i Teixits (BST), Barcelona, Spain
| | - Marta Bes
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Banc de Sang i Teixits (BST), Barcelona, Spain
| | - Judit Carbonell
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain
| | - Elena Vargas-Accarino
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain
| | - Sofía P Ruzo
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain
| | - Mercedes Guerrero-Murillo
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain
| | - Georg Von Massow
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain
| | - María Isabel Costafreda
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Banc de Sang i Teixits (BST), Barcelona, Spain
| | - Rosa Maria López
- Biochemistry and Microbiology Department, VHIR-HUVH, Barcelona, Spain
| | | | - Yolanda Real
- Liver Unit, Hospital Universitario La Princesa, Madrid, Spain
| | | | - Silvia Viroles
- Gastroenterology Department, Hospital Universitari Doctor Josep Trueta, Girona, Spain
| | - Xavier Pamplona
- Gastroenterology Department, Hospital Universitari Doctor Josep Trueta, Girona, Spain
| | - Mireia Cairó
- Gastroenterology Unit, Hospital Universitari Mútua Terrassa, Spain
| | | | | | - Angel Estébanez
- Gastroenterology and Hepatology Department, Instituto de Investigación (IDIVAL), Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Joan Carles Quer
- Gastroenterology Unit, Joan XXIII University Hospital, Tarragona, Spain
| | - Álvaro Mena-de-Cea
- Liver Unit, Complejo Hospitalario Universitario A Coruña (CHUAC), La Coruña, Spain
| | - Alejandra Otero
- Liver Unit, Complejo Hospitalario Universitario A Coruña (CHUAC), La Coruña, Spain
| | | | - Francisco Suárez
- Liver Unit, Complejo Hospitalario Universitario A Coruña (CHUAC), La Coruña, Spain
| | - Ángeles Vázquez
- Liver Unit, Complejo Hospitalario Universitario A Coruña (CHUAC), La Coruña, Spain
| | - David Vieito
- Liver Unit, Complejo Hospitalario Universitario A Coruña (CHUAC), La Coruña, Spain
| | - Soledad López-Calvo
- Liver Unit, Complejo Hospitalario Universitario A Coruña (CHUAC), La Coruña, Spain
| | | | | | - Raúl Rodríguez
- Virology and Molecular Biology Unit, Microbiology Department, Complexo Hospitalario Universitario de Ourense (CHUO), Ourense, Spain
| | - Ramiro Macenlle
- Virology and Molecular Biology Unit, Microbiology Department, Complexo Hospitalario Universitario de Ourense (CHUO), Ourense, Spain
| | - Alba Cachero
- Liver Unit, Hospital d'Igualada, Barcelona, Spain
| | | | | | - Silvia Fábregas
- Fundació Salut Empordà - Hospital de Figueres, Girona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | - Manolo Romero-Gómez
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Hospital Universitario Virgen de Valme, Seville, Spain
| | - José Antonio Del-Campo
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Liver Unit, Hospital Universitario Virgen de Valme, Seville, Spain
| | - Esteban Domingo
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain; Centro de Biología Molecular "Severo Ochoa" (CBMSO), Universidad Autónoma de Madrid, Madrid, Spain
| | - Rafael Esteban
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Ignacio Esteban
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.
| | - Josep Quer
- Liver Unit, Liver Diseases - Viral Hepatitis, Vall d'Hebron Institut of Research (VHIR), Hospital Universitari Vall d'Hebron (HUVH), Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.
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Abstract
Two particles interacting by photon exchange, form the bound states predicted by the non-relativistic Schrödinger equation with the Coulomb potential (Balmer series). More than 60 years ago, in the solutions of relativistic Bethe-Salpeter equation, in addition to the Balmer series, were found another series of energy levels. These new series, appearing when the fine structure constant α is large enough (α > π/4), are not predicted by the Schrödinger equation. However, this new (non-Balmer) states can hardly exist in nature, since in order to create a strong e.m. field with α > π/4 a point-like charge Z > 107 is needed. The nuclei having this charge, though exist starting with bohrium, are far from to be point-like.
In the present paper, we analyze the more realistic case of a strong interaction created by exchange of a massive particle. It turns out that in the framework of the Bethe-Salpeter equation this interaction still generates a series of new relativistic states, which are similar to those of the massless exchange case, and which are absent in the Schrödinger equation. The properties of these solutions are studied. Their existence in nature seems possible.
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Ferrando C, Tusman G, Suarez-Sipmann F, León I, Pozo N, Carbonell J, Puig J, Pastor E, Gracia E, Gutiérrez A, Aguilar G, Belda FJ, Soro M. Individualized lung recruitment maneuver guided by pulse-oximetry in anesthetized patients undergoing laparoscopy: a feasibility study. Acta Anaesthesiol Scand 2018; 62:608-619. [PMID: 29377061 DOI: 10.1111/aas.13082] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 12/21/2017] [Accepted: 01/02/2018] [Indexed: 01/27/2023]
Abstract
BACKGROUND We conducted this study to test whether pulse-oximetry hemoglobin saturation (SpO2 ) can personalize the implementation of an open-lung approach during laparoscopy. Thirty patients with SpO2 ≥ 97% on room-air before anesthesia were studied. After anesthesia and capnoperitoneum the FIO2 was reduced to 0.21. Those patients whose SpO2 decreased below 97% - an indication of shunt related to atelectasis - completed the following phases: (1) First recruitment maneuver (RM), until reaching lung's opening pressure, defined as the inspiratory pressure level yielding a SpO2 ≥ 97%; (2) decremental positive end-expiratory (PEEP) titration trial until reaching lung's closing pressure defined as the PEEP level yielding a SpO2 < 97%; (3) second RM and, (4) ongoing ventilation with PEEP adjusted above the detected closing pressure. RESULTS When breathing air, in 24 of 30 patients SpO2 was < 97%, PaO2 /FIO2 ˂ 53.3 kPa and negative end-expiratory transpulmonary pressure (PTP-EE ). The mean (SD) opening pressures were found at 40 (5) and 33 (4) cmH2 O during the first and second RM, respectively (P < 0.001; 95% CI: 3.2-7.7). The closing pressure was found at 11 (5) cmH2 O. This SpO2 -guided approach increased PTP-EE (from -6.4 to 1.2 cmH2 O, P < 0.001) and PaO2 /FIO2 (from 30.3 to 58.1 kPa, P < 0.001) while decreased driving pressure (from 18 to 10 cmH2 O, P < 0.001). SpO2 discriminated the lung's opening and closing pressures with accuracy taking the reference parameter PTP-EE (area under the receiver-operating-curve of 0.89, 95% CI: 0.80-0.99). CONCLUSION The non-invasive SpO2 monitoring can help to individualize an open-lung approach, including all involved steps, from the identification of those patients who can benefit from recruitment, the identification of opening and closing pressures to the subsequent monitoring of an open-lung condition.
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Affiliation(s)
- C. Ferrando
- Department of Anaesthesiology and Critical Care; Hospital Clínico Universitario; Valencia Spain
- CIBER de Enfermedades Respiratorias; Instituto de Salud Carlos III; Madrid Spain
| | - G. Tusman
- Department of Anesthesiology; Hospital Privado de Comunidad Mar de Plata; Mar de Plata Argentina
| | - F. Suarez-Sipmann
- Department of Anaesthesiology and Critical Care; Hospital Clínico Universitario; Valencia Spain
- Deparment of Intensive Care; Hospital Universitario La Princesa; Madrid Spain
| | - I. León
- Department of Anaesthesiology and Critical Care; Hospital Clínico Universitario; Valencia Spain
| | - N. Pozo
- Department of Anaesthesiology and Critical Care; Hospital Clínico Universitario; Valencia Spain
| | - J. Carbonell
- Department of Anaesthesiology and Critical Care; Hospital Clínico Universitario; Valencia Spain
| | - J. Puig
- Department of Anaesthesiology and Critical Care; Hospital Clínico Universitario; Valencia Spain
| | - E. Pastor
- Department of Anaesthesiology and Critical Care; Hospital Clínico Universitario; Valencia Spain
| | - E. Gracia
- Department of Anaesthesiology and Critical Care; Hospital Clínico Universitario; Valencia Spain
| | - A. Gutiérrez
- Department of Anaesthesiology and Critical Care; Hospital Clínico Universitario; Valencia Spain
| | - G. Aguilar
- Department of Anaesthesiology and Critical Care; Hospital Clínico Universitario; Valencia Spain
| | - F. J. Belda
- Department of Anaesthesiology and Critical Care; Hospital Clínico Universitario; Valencia Spain
| | - M. Soro
- Department of Anaesthesiology and Critical Care; Hospital Clínico Universitario; Valencia Spain
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Díaz F, León C, García-García F, Chacón-Solano E, Larcher F, Carbonell J, Puig J, Puig S, Dopazo J, del Río M. 601 Common mechanisms and signaling pathways in fibroblasts of cancer-prone genodermatoses. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.798] [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: 10/18/2022]
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Carbonell J, Karmanov V. Direct Bethe-Salpeter solutions in Minkowski space. EPJ Web of Conferences 2016. [DOI: 10.1051/epjconf/201611303012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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6
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Sarbu MI, Salman-Monte TC, Rubio Muñoz P, Lisbona MP, Bernabé MA, Carbonell J. Differences between clinical and laboratory findings in patients with recent diagnosis of SLE according to the positivity of anti-dsDNA by the Crithidia luciliae method. Lupus 2015; 24:1198-203. [DOI: 10.1177/0961203315573852] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 01/27/2015] [Indexed: 11/17/2022]
Abstract
Background Of all anti-dsDNA antibody detection methods, the Crithidia luciliae immunofluorescence test (CLIF) is considered to have the highest specificity for systemic lupus erythematosus (SLE). Objective The objective of this report is to evaluate whether the presence of anti-dsDNA antibodies detected by the CLIF method is associated with a specific clinical phenotype in recently diagnosed SLE. Methods This retrospective cross-sectional study included all patients with newly diagnosed SLE between 1990 and 2011 and followed up in our institution. Demographic, clinical and laboratory findings were assessed. Correlations between positivity of anti-dsDNA by the CLIF method, clinical and laboratory data were analyzed. Results A total of 104 patients were included in the analysis. Patients who were positive for anti-dsDNA by the CLIF method at the time of diagnosis had (statistically) significantly higher titers of anti-dsDNA by the ELISA method, antinuclear (ANA) and anticardiolipin antibodies, lymphopenia and complement consumption compared with the other two groups. Also they presented significantly more musculoskeletal symptoms at baseline. Conclusion The presence of anti-dsDNA by the CLIF method in newly diagnosed SLE was associated with certain markers of increased disease activity. Its use could be a useful biomarker for a specific clinical phenotype suggestive of a more severe involvement at the time of the diagnosis.
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Affiliation(s)
- M I Sarbu
- Rheumatology Department Hospital del Mar/Parc de Salut Mar-IMIM, Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, (Spain)
| | - T C Salman-Monte
- Rheumatology Department Hospital del Mar/Parc de Salut Mar-IMIM, Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, (Spain)
| | - P Rubio Muñoz
- Rheumatology Department Hospital del Mar/Parc de Salut Mar-IMIM, Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, (Spain)
| | - M P Lisbona
- Rheumatology Department Hospital del Mar/Parc de Salut Mar-IMIM, Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, (Spain)
| | - M Almirall Bernabé
- Rheumatology Department Hospital del Mar/Parc de Salut Mar-IMIM, Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, (Spain)
| | - J Carbonell
- Rheumatology Department Hospital del Mar/Parc de Salut Mar-IMIM, Department of Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, (Spain)
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Fernández-Marín AA, Méndez-Bermúdez JA, Carbonell J, Cervera F, Sánchez-Dehesa J, Gopar VA. Beyond Anderson localization in 1D: anomalous localization of microwaves in random waveguides. Phys Rev Lett 2014; 113:233901. [PMID: 25526129 DOI: 10.1103/physrevlett.113.233901] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Indexed: 06/04/2023]
Abstract
Experimental evidence demonstrating that anomalous localization of waves can be induced in a controllable manner is reported. A microwave waveguide with dielectric slabs randomly placed is used to confirm the presence of anomalous localization. If the random spacing between slabs follows a distribution with a power-law tail (Lévy-type distribution), unconventional properties in the microwave-transmission fluctuations take place revealing the presence of anomalous localization. We study both theoretically and experimentally the complete distribution of the transmission through random waveguides characterized by α=1/2 ("Lévy waveguides") and α=3/4, α being the exponent of the power-law tail of the Lévy-type distribution. As we show, the transmission distributions are determined by only two parameters, both of them experimentally accessible. Effects of anomalous localization on the transmission are compared with those from the standard Anderson localization.
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Affiliation(s)
- A A Fernández-Marín
- Instituto de Física, Benemérita Universidad Autónoma de Puebla, Apartado Postal J-48, Puebla 72570, Mexico
| | - J A Méndez-Bermúdez
- Instituto de Física, Benemérita Universidad Autónoma de Puebla, Apartado Postal J-48, Puebla 72570, Mexico
| | - J Carbonell
- Wave Phenomena Group, Universitat Politècnica de València, Camino de vera s.n. (Edificio 7F), ES-46022 Valencia, Spain
| | - F Cervera
- Wave Phenomena Group, Universitat Politècnica de València, Camino de vera s.n. (Edificio 7F), ES-46022 Valencia, Spain
| | - J Sánchez-Dehesa
- Wave Phenomena Group, Universitat Politècnica de València, Camino de vera s.n. (Edificio 7F), ES-46022 Valencia, Spain
| | - V A Gopar
- Departamento de Física Teórica, Facultad de Ciencias, and Instituto de Biocomputación y Física de Sistemas Complejos, Universidad de Zaragoza, Pedro Cerbuna 12, E-50009 Zaragoza, Spain
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Martí-Herrero J, Alvarez R, Rojas MR, Aliaga L, Céspedes R, Carbonell J. Improvement through low cost biofilm carrier in anaerobic tubular digestion in cold climate regions. Bioresour Technol 2014; 167:87-93. [PMID: 24971949 DOI: 10.1016/j.biortech.2014.05.115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 05/29/2014] [Accepted: 05/31/2014] [Indexed: 06/03/2023]
Abstract
The aim of this research is to evaluate the increase of biogas production with low cost tubular digesters in cold climates using PET rings inside the reactor. Two similar digesters have been operated and monitored in cold weather conditions and have been fed with cow manure. Digester 1 was filled with PET - rings as a biofilm carrier, Digester 2 was kept as a reference. Through the PET - rings the functional surface could be increased by a factor 4.2. The results show that 44% more biogas per Kg SV has been produced with the biofilm carrier in use (0.33 m(3)/kg SV) (reference digester -0.23 m(3)/kg SV), at an organic load rate of 0.26 kg SV/m(3)/d. The thermal performance shows that with an adaptation of the low cost tubular digester the slurry temperature can be raised up to 16.6°C (average) by surrounding temperature of 6.1°C (average) without using any active heating system.
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Affiliation(s)
- J Martí-Herrero
- Centre Internacional de Mètodes Numèrics en Enginyeria (CIMNE), Building Energy and Environment Group, Edifici GAIA (TR14), C/Rambla Sant Nebridi 22, 08222 Terrassa, Barcelona, Spain(1).
| | - R Alvarez
- IIDEPROQ, UMSA, Plaza del Obelisco 1175, La Paz, Bolivia
| | - M R Rojas
- IIDEPROQ, UMSA, Plaza del Obelisco 1175, La Paz, Bolivia
| | - L Aliaga
- Energising Development Bolivia (EnDev-Bolivia/GIZ), Calle 12 de Calacoto, 7978, La Paz, Bolivia
| | - R Céspedes
- Estación Experimental de Choquenaira, UMSA, Viacha, Bolivia
| | - J Carbonell
- Centre Internacional de Mètodes Numèrics en Enginyeria (CIMNE), Building Energy and Environment Group, Edifici GAIA (TR14), C/Rambla Sant Nebridi 22, 08222 Terrassa, Barcelona, Spain(1)
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Giraldo P, Carbonell J, Pujolar N, Burón A, Castells X. [Experience in the development of a code of best practices in healthcare]. Rev Calid Asist 2014; 29:250-251. [PMID: 24985243 DOI: 10.1016/j.cali.2014.05.005] [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] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 05/16/2014] [Accepted: 05/19/2014] [Indexed: 06/03/2023]
Affiliation(s)
- P Giraldo
- Programa de Calidad, Servicio de Epidemiología y Evaluación, Hospital del Mar-Parc de Salut Mar, Barcelona, España; Escola Superior d'Infermeria del Mar, Centre adscrit a la Universitat Pompeu Fabra (UPF), Barcelona, España.
| | - J Carbonell
- Servicio de Reumatología, Hospital del Mar-Parc de Salut Mar, Barcelona, España
| | - N Pujolar
- Área de Enfermería, Unidad de Cardiología y Nefrología, Hospital del Mar-Parc de Salut Mar, Barcelona, España
| | - A Burón
- Programa de Calidad, Servicio de Epidemiología y Evaluación, Hospital del Mar-Parc de Salut Mar, Barcelona, España; Red de Investigación en Servicios de Salud en Enfermedades (REDISSEC), España
| | - X Castells
- Programa de Calidad, Servicio de Epidemiología y Evaluación, Hospital del Mar-Parc de Salut Mar, Barcelona, España; Red de Investigación en Servicios de Salud en Enfermedades (REDISSEC), España; Universitat Autónoma de Barcelona (UAB), Barcelona, España
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Méndez-Rosado LA, Hechavarría-Estenoz D, de la Torre ME, Pimentel-Benitez H, Hernández-Gil J, Perez B, Barrios-Martínez A, Morales-Rodriguez E, Soriano-Torres M, Garcia M, Suarez-Mayedo U, Cedeño-Aparicio N, Blanco I, Díaz-Véliz P, Vidal-Hernández B, Mitjans-Torres M, Miñoso S, Alvarez-Espinosa D, Reyes-Hernández E, Angulo-Cebada E, Torres-Palacios M, Lozano-Lezcano L, Lima-Rodriguez U, Mayeta M, Noblet M, Benítez Y, Lardoeyt-Ferrer R, Yosela-Martin S, Carbonell P, Pérez-Ramos M, de León N, Perez M, Carbonell J. Current status of prenatal diagnosis in Cuba: causes of low prevalence of Down syndrome. Prenat Diagn 2014; 34:1049-54. [PMID: 24861354 DOI: 10.1002/pd.4421] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 05/13/2014] [Accepted: 05/19/2014] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To analyze trends in cytogenetic prenatal diagnosis in Cuba and to analyze possible causes leading to a low Down syndrome prevalence in a country where the triple test is not available. METHODS An analysis of the Cuban program in prenatal cytogenetic diagnosis from 1984 to 2012 was conducted. Results are described, with particular emphasis on indications, abnormal results, types of invasive procedures, and terminations of pregnancy. RESULTS Cytogenetic prenatal diagnostic analyses (n = 75,095) were conducted; maternal age was the indication for 77.9% of the amniocenteses and chorionic villus samplings. The detection rate of chromosomally abnormal pregnancies was 2.3% for maternal age and increased to 8-9% for other indications. When a chromosomal abnormality was identified, 88.5% terminated the pregnancy. In 2002, the live birth prevalence of Down syndrome was 8.4 per 10,000 live births, and in 2012, 7 per 10,000. CONCLUSION Prenatal diagnosis in Cuba has contributed to a significant reduction in chromosomal aberrations. The impact increased because of the demographic trends of the population, the high index of terminations of pregnancy, and the establishment of a network of cytogenetic laboratories throughout Cuba.
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Torrente-Segarra V, Iglesias E, Gonzalez MI, Sanchez J, Ricart S, Bou R, Salman-Monte T, Carbonell J, Antón-López J. PReS-FINAL-2309: Juvenile systemic lupus erythematosus: a case series depiction in an urban community and a comparison to an adult case series. Pediatr Rheumatol Online J 2013. [PMCID: PMC4043330 DOI: 10.1186/1546-0096-11-s2-p299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Sanchez S, Iniesta S, Lisbona M, Pàmies A, Almirall M, Maymo J, Carbonell J. THU0461-HPR Global assessment of disease by the patient in the new ACR/EULAR remission criteria: Why do not fulfil the remission?:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Lisbona M, Maymό J, Solano A, Almirall M, Sanchez S, Pamies A, Navallas M, Carbonell J. SAT0388 Comparative assessment of methotrexate and leflunomide by magnetic resonance imaging in patients with early rheumatoid arthritis:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.3334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Salman Monte TC, López-Velandia J, Sarbú M, Rubio P, Padró I, Carbonell J. AB0381 Safety and efficacy of rituximab in systemic lupus erythematosus. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2703] [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: 11/04/2022]
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Lisbona M, Maymo J, Pàmies A, Ares J, Solano A, Almirall M, Sanchez S, Carbonell J. AB0542 Early reduction in synovitis and bone EDEMA evaluated by MRI in tocilizumab-treated RA patients with inadequate response to anti-TNF:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.542] [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: 11/04/2022]
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Lopez Velandia J, Almirall M, Perez Ruiz J, Maymό Guarch J, Lisbona M, Pàmies A, Silvia I, Carbonell J. THU0277 Absence of radiographic progression at two years in a cohort of patients with non- radiographic axial spondyloarthritis treated with TNFA blockers. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2242] [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: 11/04/2022]
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Salman Monte TC, Pérez Ruiz J, Torrente-Segarra V, Mojal S, Padró I, Carbonell J. AB0433 Prevalence of osteopenia and osteoporosis in women with systemic lupus erythematosus. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Pàmies A, Lisbona M, Maymό J, Almirall M, Sanchez S, Carbonell J. AB0293 Changes in glucocorticoid treatment in the first year of biological therapy in RA patients:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Docampo E, Escaramis G, Rabionet R, Carbonell J, Rivera J, Alegre J, Vidal J, Estivill X, Collado A. OP0067 Cluster analysis of clinical data identifies fibromyalgia subgroups. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Lisbona M, Maymo J, Ares J, Almirall M, Navallas M, Solano A, Carbonell J. OP0134 Cut-Offs Values for Inflammatory H-MRI Lesions to Define Remission. Comparison Between DAS28, SDAI and New Boolean ACR/EULAR Criteria. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.339] [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: 11/04/2022]
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Lisbona M, Maymó J, Solano A, Almirall M, Navallas M, Ares J, Carbonell J. Repair of erosions in patients with rheumatoid arthritis treated with etanercept: magnetic resonance imaging findings after 1 year of follow-up. Scand J Rheumatol 2013; 42:437-44. [PMID: 23607571 DOI: 10.3109/03009742.2013.776104] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To monitor repair of bone erosions using magnetic resonance imaging (MRI) in patients with rheumatoid arthritis (RA) during etanercept combination therapy. METHOD The study population comprised 29 RA patients [biologic-naïve, 28-joint Disease Activity Score (DAS28) ≥ 3.2] starting etanercept combination therapy with disease-modifying anti-rheumatic drugs (DMARDs) and completing the 1-year study period with the same treatment. Clinical and laboratory assessments and MRI of the hand were performed at baseline and at 1 year. MRI findings were scored by two readers using the Rheumatoid Arthritis MRI Scoring System (RAMRIS). Both readers were blind to the chronological order of the MRI scans, the identity of the patients, and clinical and other imaging data. Tenosynovitis was also scored. The intra- and inter-reader intraclass correlation coefficients (ICCs) were calculated, along with the sensitivity to change with the smallest detectable difference (SDD). Repair of erosions was defined as a RAMRIS score of at least 1 point lower than baseline. RESULTS The mean RAMRIS score for erosions did not change but all other inflammatory MRI parameters decreased significantly. In 19 patients, the RAMRIS score for erosions remained unchanged after 1 year. In five patients the score decreased after 1 year, although the decrease exceeded the SDD in only one patient (3.4%). CONCLUSIONS Etanercept combined with DMARDs stopped the progression of erosions, as measured by the RAMRIS, in 82.8% of our RA patients and occasional repair of bone erosions occurred after 1 year of treatment.
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Affiliation(s)
- Mp Lisbona
- Department of Rheumatology, Parc de Salut Mar, Hospital del Mar , Barcelona , Spain
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Serra E, Spaeth M, Carbonell J, Arnould B, Benmedjahed K, Barnes N, Le Lay K, Taïeb C. Development of the Fibromyalgia Burden Assessment: measuring the multifaceted burden of fibromyalgia. Clin Exp Rheumatol 2010; 28:S87-S93. [PMID: 21176427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Accepted: 12/01/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVES To develop a questionnaire assessing the burden of fibromyalgia's impacts on patients' lives. METHODS A literature review was conducted to identify impacts of fibromyalgia and their consequences on patients' lives. Exploratory interviews were performed with 15 fibromyalgia patients in France, Germany and Spain. Using patients' wording, items were generated simultaneously in French, German, Spanish, and UK English. Relevance and comprehension of the resulting questionnaire versions were tested with 21 additional fibromyalgia patients; questionnaires were revised accordingly. RESULTS Three domains, Burden associated with the impacts of fibromyalgia, Symptoms and Influencing factors, were identified from the literature review. Following patient interviews, the burden domain was further divided based on the nature of the impact: Pain, Physical impact (including tiredness, sleep problems and other symptoms), Activities of Daily Living impact (including autonomy and coping), Social and Family Life impact, Work, Studies and Personal Finances impact, Psychological impact (including cognitive impact), and Relationship to Medicine and Disease. The resulting test versions of the questionnaire contained 79 items. Comprehension tests identified problematic items and cultural differences and suggested deletions or rewording. After revision and linguistic harmonization, the pilot version of the questionnaire contained 62 items divided into 7 sections, and was named Fibromyalgia Burden Assessment (FMBA©). CONCLUSIONS The FMBA is a self-reported questionnaire allowing the assessment and a better understanding of the impacts of fibromyalgia and the burden associated with these on patients' daily lives. It is available in UK English, French, German and Spanish. Its scoring and validation remain to be undertaken.
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Affiliation(s)
- E Serra
- Amiens University Hospital, Amiens, France
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Van den Eynde E, Crespo M, Esteban JI, Jardi R, Ribera E, Carbonell J, Rodríguez-Frias F, Falco V, Curran A, Imaz A, Villar del Saz S, Ocaña I, Esteban R, Pahissa A. Response-guided therapy for chronic hepatitis C virus infection in patients coinfected with HIV: a pilot trial. Clin Infect Dis 2009; 48:1152-9. [PMID: 19275492 DOI: 10.1086/597470] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND To study the feasibility of a response-guided therapy for chronic hepatitis C virus (HCV) infection in patients coinfected with human immunodeficiency virus (HIV) in a tertiary care hospital. METHODS Treatment duration was individualized on the basis of week 4 and week 12 virologic response. Sixty patients were enrolled and received pegylated interferon alfa-2b (1.5 microg/kg per week) plus weight-based ribavirin (800-1400 mg/day). Patients who achieved a rapid virologic response, defined as viral load <50 IU/mL at treatment week 4, completed 24 weeks of therapy. Patients who did not achieve a rapid virologic response were reassessed at treatment week 12. Patients with a complete early virologic response, defined as an HCV RNA level <600 IU/mL, were treated for 48 weeks. Patients with a partial response, defined as a decrease in the viral load > or = 2 log10 and an HCV RNA level > or = 600 IU/mL, who attained an undetectable viral load at week 24 were treated for 60 weeks. The primary efficacy end point was sustained virologic response, defined as HCV RNA <50 IU/mL, 24 weeks after the end of treatment. RESULTS Overall, 33 (55%) of 60 patients achieved a sustained virologic response: 11 (44%) of 25 patients with HCV genotype 1, 3 (27%) of 11 patients with genotype 4, and 19 (79%) of 24 patients with genotype 3. One-third of patients showed a rapid virologic response. Of patients with genotype 1, there was a rapid virologic response in 4 (16%) of 25; with genotype 4, in 1 (9%) of 11; and with genotype 3, in 14 (58%) of 24. Of the 19 patients with a rapid virologic response, 17 (89.5%) eradicated the virus after 24 weeks of therapy. The rate of sustained virologic response was significantly higher among patients with genotype 3 and low pretreatment HCV RNA levels. A high relapse rate (46%) after 48 weeks of therapy occurred among patients infected with genotypes 1 or 4 who first achieved undetectable viral load at treatment week 12. CONCLUSION A response-guide therapy is feasible and may be useful to optimize the individual outcome of HCV treatment in patients coinfected with HIV.
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Affiliation(s)
- Eva Van den Eynde
- Infectious Diseases Department, Vall d'Hebron Hospital, Autonomous University of Barcelona, Spain
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Merian E, Carbonell J, Lerch U, Sanahuja V. The Saturation Values, Rates of Dyeing, Rates of Diffusion, and Migration of Disperse Dyes on Heat-set Polyester Fibres*. ACTA ACUST UNITED AC 2008. [DOI: 10.1111/j.1478-4408.1963.tb02513.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Cegarra J, Puente P, Valldeperas J, Posse R, Carbonell J. Method for the Assessment of the Dyeing Conditions of Modified Polyester with Cationic Dyes. ACTA ACUST UNITED AC 2008. [DOI: 10.1111/j.1478-4408.1982.tb03628.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- J. Cegarra
- Laboratory of Dyeing Escuela Técnica Superior de Ingenieros Industrials de Terrasa Universidad Politécnica de Barcelona Spain
| | - P. Puente
- Laboratory of Dyeing Escuela Técnica Superior de Ingenieros Industrials de Terrasa Universidad Politécnica de Barcelona Spain
| | - J. Valldeperas
- Laboratory of Dyeing Escuela Técnica Superior de Ingenieros Industrials de Terrasa Universidad Politécnica de Barcelona Spain
| | - R. Posse
- Laboratory of Dyeing Escuela Técnica Superior de Ingenieros Industrials de Terrasa Universidad Politécnica de Barcelona Spain
| | - J. Carbonell
- Laboratory of Dyeing Escuela Técnica Superior de Ingenieros Industrials de Terrasa Universidad Politécnica de Barcelona Spain
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Minguet EG, Vera-Sirera F, Marina A, Carbonell J, Blazquez MA. Evolutionary Diversification in Polyamine Biosynthesis. Mol Biol Evol 2008; 25:2119-28. [DOI: 10.1093/molbev/msn161] [Citation(s) in RCA: 125] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Carbonell J, Cobo T, Balsa A, Descalzo MA, Carmona L. The incidence of rheumatoid arthritis in Spain: results from a nationwide primary care registry. Rheumatology (Oxford) 2008; 47:1088-92. [PMID: 18511475 DOI: 10.1093/rheumatology/ken205] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J Carbonell
- Rheumatology Department, Hospital del Mar, Institut Municipal Atencio Sanitaria, Barcelona
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Mendizábal S, Zamora I, Román E, Sanahuja M, Ortega P, Gracia S, Vicente C, Sánchez R, Fons J, Hernández R, Ferrando S, Marín J, Vidal A, Tapia J, Navarro C, Badía J, Carbonell J, Ruiz J, Sánchez M, Uran M, Hervas A, Navarro I, Velasco R, Benito P, Rabasco D, Gutiérrez J, Mataix J. 22 Registro síndrome nefrótico pediátrico de la comunidad Valenciana, Murcia y Albacete. Estudio multicéntrico. An Pediatr (Barc) 2007. [DOI: 10.1016/s1695-4033(07)70740-3] [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: 11/27/2022] Open
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Hagino K, Sagawa H, Carbonell J, Schuck P. Coexistence of BCS- and BEC-like pair structures in halo nuclei. Phys Rev Lett 2007; 99:022506. [PMID: 17678220 DOI: 10.1103/physrevlett.99.022506] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2006] [Indexed: 05/16/2023]
Abstract
We investigate the spatial structure of the two-neutron wave function in the Borromean nucleus (11)Li, using a three-body model of (9)Li + n + n, which includes many-body correlations stemming from the Pauli principle. The behavior of the neutron pair at different densities is simulated by calculating the two-neutron wave function at several distances between the core nucleus (9)Li and the center of mass of the two neutrons. With this representation, a strong concentration of the neutron pair on the nuclear surface is for the first time quantitatively established for neutron-rich nuclei. That is, the neutron pair wave function in (11)Li has an oscillatory behavior at normal density, while it becomes a well-localized single peak in the dilute density region around the nuclear surface. We point out that these features qualitatively correspond to the BCS- and BEC-like structures of the pair wave function found in infinite nuclear matter.
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Affiliation(s)
- K Hagino
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
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Torrente SV, Güerri RC, Pérez-García C, Benito P, Carbonell J. Amaurosis in patients with giant cell arteritis: treatment with anti-tumour necrosis factor-?;. Intern Med J 2007; 37:280-1. [PMID: 17388875 DOI: 10.1111/j.1445-5994.2006.01299.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Beltrán E, Toll A, Pros A, Carbonell J, Pujol RM. Assessment of nailfold capillaroscopy by x 30 digital epiluminescence (dermoscopy) in patients with Raynaud phenomenon. Br J Dermatol 2007; 156:892-8. [PMID: 17388920 DOI: 10.1111/j.1365-2133.2007.07819.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Dermoscopy is a useful tool for dermatologists to study melanocytic lesions. Its possible usefulness in the assessment of capillary nailfold morphological changes (capillaroscopy) has recently been advocated. OBJECTIVES To assess the practical utility of digital epiluminescence microscopy as a capillaroscopic instrument in patients with Raynaud phenomenon (RP). To compare the sensitivity and specificity rates obtained by epiluminescence microscopy with those previously reported with conventional capillaroscopic devices. METHODS Fifty-six consecutive patients with primary RP (PRP; n = 5) or secondary RP (SRP; n = 51) (11 men and 45 women in total) were included in the study. A control group of 10 healthy subjects was also evaluated. Twenty-six patients (46%) had systemic sclerosis (SS), 12 (21%) presystemic sclerosis (pre-SS), one (2%) dermatopolymyositis-SS, one (2%) mixed connective tissue disease, two (4%) Sjögren syndrome, two (4%) an overlap syndrome, one (2%) rheumatoid arthritis and six (11%) other connective tissue diseases. Capillary nailfold changes were studied using a nonportable digital epiluminescence device (magnification x 30). Following a systematized protocol, capillary nailfold morphology, density and distribution were evaluated. Several capillaroscopic patterns were identified (normal, sclerodermic, nonspecific, nondiagnostic) as previously defined. A possible relationship between capillary nailfold changes and the intensity of RP or the presence of associated autoimmune diseases was assessed. RESULTS The sclerodermic pattern showed a sensitivity of 76.9% and a specificity of 90.9% in SS. A typical capillaroscopic SS pattern was observed in 73% of cases of limited SS and in 82% of cases of diffuse SS. Patients with Sjögren syndrome and dermatopolymyositis-SS showed a nonspecific capillaroscopic pattern. All patients with PRP presented a normal capillaroscopic pattern. A normal capillaroscopic pattern was also observed in 11 of 12 patients with pre-SS. In one of two patients presenting severe sclerodactyly and in all patients showing hand oedema (three of 56), capillaroscopic changes could not be evaluated. Avascular areas correlated significantly with severe RP (P < 0.002), bone resorption (P < 0.007) and diffuse SS (P < 0.008). CONCLUSIONS Digital epiluminescence seems to be a useful and reliable technique in the evaluation of capillary nailfold morphological changes. This technical variation allows the identification of specific capillaroscopic patterns associated with connective tissue diseases. It also permits us to differentiate PRP from SRP. The results obtained with this technique are similar to those previously reported using standard capillaroscopy devices.
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Affiliation(s)
- E Beltrán
- Department of Rheumatology, Hospital del Mar, Passeig Maritim 25-29, Barcelona, Spain
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Rivera J, Alegre C, Ballina F, Carbonell J, Carmona L, Castel B, Collado A, Esteve J, Martínez F, Tornero J, Vallejo M, Vidal J. Documento de consenso de la Sociedad Española de Reumatología sobre la fibromialgia. ACTA ACUST UNITED AC 2006; 2 Suppl 1:S55-66. [DOI: 10.1016/s1699-258x(06)73084-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Su S, Fortes J, Kasad T, Patil M, Matsunaga A, Tsugawa M, Cavalli-Sforza V, Carbonell J, Jansen P, Ward W, Cole R, Towsley D, Chen W, Antón A, He Q, McSweeney C, de Brens L, Ventura J, Taveras P, Connolly R, Ortega C, Piñeres B, Brooks O, Murillo G, Herrera M. Transnational Information Sharing, Event Notification, Rule Enforcement and Process Coordination. International Journal of Electronic Government Research 2005. [DOI: 10.4018/jegr.2005040101] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- S. Su
- University of Florida, USA
| | | | | | | | | | | | | | | | | | | | | | | | - W. Chen
- University of Massachusetts, USA
| | | | - Q. He
- North Carolina State University, USA
| | | | - L. de Brens
- Pontifica Universidad Católica Madre y Maestra, Dominican Republic
| | - J. Ventura
- Pontifica Universidad Católica Madre y Maestra, Dominican Republic
| | - P. Taveras
- Pontifica Universidad Católica Madre y Maestra, Dominican Republic
| | | | - C. Ortega
- Organization of American States, USA
| | | | - O. Brooks
- National Drug Abuse Control Council, Belize
| | | | - M. Herrera
- National Drug Council, Dominican Republic
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Abstract
OBJECTIVE To determine the range and activity of the clinical and biological features of patients aged <40 with Paget's disease of bone. METHODS A retrospective two centre study of 314 patients with Paget's disease of bone from two university hospitals. The disease was diagnosed by radiological, serum alkaline phosphatase (AP) levels, or clinical features, and bone scintigraphy in most patients. Demographic data, reason for diagnosis, bones affected, disease extent using Coutris' index, complications during progression, and disease activity using Renier's index were assessed. Patients over and under 40 were compared. RESULTS 18/314 (5.7%) patients were diagnosed before the age of 40; median (SD) age was 35.4 (5.5) (range 18-40) and AP 555.6 (566.3) IU/l (range 70-1949). Coutris' extension index was 12.8 (10.5) and Renier's activity index 35.9 (31.9). Younger patients had more affected bones (p<0.05) than those aged >40, higher level of extension (p<0.05), higher AP value (p = 0.05), and greater incidence of thoracolumbar spine disease. Disease activity did not differ significantly between the groups. CONCLUSIONS Paget's disease diagnosed before the age of 40 is more extensive but not more active, with higher AP values than in those diagnosed after age 40.
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Affiliation(s)
- S Holgado
- Rheumatology Section, Hospital Universitari Germans Trias i Pujol, Crta. Canyet s/n, 08916 Badalona, Spain.
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Rotés-Sala D, Monfort J, Solano A, Miralles E, Vila J, Carbonell J. The clover and heart signs in vertebral scintigraphic images are highly specific of Paget's disease of bone. Bone 2004; 34:605-8. [PMID: 15050890 DOI: 10.1016/j.bone.2003.10.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/31/2003] [Indexed: 10/26/2022]
Abstract
BACKGROUND Bone scintigraphy used as a diagnostic technique frequently yields non-specific intense uptake by vertebrae. Bone biopsy may therefore be required to establish a diagnosis in cases of Paget's disease of bone. The aim of the study was to ascertain the sensitivity and specificity of two new images-heart sign and clover sign-in Paget's disease of bone. METHODS Two expert rheumatologists analyzed 294 bone scintigraphies of patients with vertebral involvement: 204 without and 90 with Paget's disease. The presence or absence of the clover or heart signs was determined in each scintigraphy. A specificity and sensitivity study was performed with the data obtained. A study of concordance was made between two radiologists blinded to the real diagnosis. Each one analyzed 120 scintigraphies for the presence and absence of the signs: 40 with Paget's disease and clover and/or heart signs (selected from the initial 90 cases), 40 with Paget's disease with neither sign and 40 selected from the pool of 4000 scintigraphies of patients with vertebral involvement, with images easily mistaken for these signs (vertebral collapse, osteoarthritis and bone metastases). Kappa statistics were calculated. FINDINGS Sensitivity of both signs for Paget's disease of bone was low: 44% (95% CI 34.0 to 55.3). However, specificity was excellent: 100% (95% CI 98.2 to 100). Inter-radiologist concordance was almost perfect: Kappa 0.86 (95% CI 0.77 to 0.95). INTERPRETATION The heart and clover signs are highly specific (probably pathognomonic) of Paget's disease of bone. In cases with doubtful radiologic images, these findings on scintigraphic vertebral images may afford a definitive diagnosis of Paget's disease of bone and thus obviate further confirmatory invasive diagnostic procedures.
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Affiliation(s)
- D Rotés-Sala
- Department of Rheumatology, Hospital del Mar i l'Esperança, Universitat Autònoma, Barcelona, Spain
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Carbonell J, Allen R, Kalsi G, McQuillin A, Livingston G, Katona C, Walker Z, Katz A, Rands G, Stevens T, Crossan I, Curtis D, Gurling H. Variation in the DCP1 gene, encoding the angiotensin converting enzyme ACE, is not associated with increased susceptibility to Alzheimer's disease. Psychiatr Genet 2003; 13:47-50. [PMID: 12605101 DOI: 10.1097/00041444-200303000-00008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To attempt to replicate previous reports that polymorphic variation in the DCP1 gene causes increased susceptibility to the development of Alzheimer's disease, either on its own or in interaction with the effects of the gene for apolipoprotein E (APOE). METHOD Subjects older than 65 years of age consisting of 81 dementia patients diagnosed as having possible or probable Alzheimer's disease and 68 controls were obtained from Camden, Islington and Harlow psychiatric services. Subjects were genotyped for APOE alleles e2, e3 and e4, and the common insertion/deletion polymorphisms for DCP1* I/D were genotyped. RESULTS There was no statistically significant difference in the frequency of the DCP1* insertion/deletion alleles between the cases and controls (X2 =0.04, 1 degree of freedom, not significant). When subjects were subdivided according to whether they possessed at least one copy of the APOE e4 allele, there were still no differences in DCP1 allele frequencies between cases and controls. CONCLUSIONS Further research is needed to elucidate any role that the DCP1 polymorphism may play in relation to Alzheimer's disease. Previous studies may be false positive, or inconsistency in replication may be due to heterogeneity.
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Affiliation(s)
- J Carbonell
- Molecular Psychiatry Laboratory, Windeyer Institute of Medical Sciences, Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, University College London, London, UK
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Engel E, Serrano S, Mariñoso ML, Lloreta J, Ulloa F, Nogués X, Diez-Pérez A, Carbonell J. Alendronate and etidronate do not regulate interleukin 6 and 11 synthesis in normal human osteoblasts in culture. Calcif Tissue Int 2003; 72:228-35. [PMID: 12522661 DOI: 10.1007/s00223-001-2136-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2001] [Accepted: 04/23/2002] [Indexed: 11/30/2022]
Abstract
Bisphosphonates exert a potent inhibitory effect on bone resorption. Several studies have been performed, with contradictory results, to ascertain whether the effect of bisphosphonates on osteoclasts could be produced, at least in part, by modulation of the synthesis of resorption-promoting factors by osteoblasts. The aim of this study was to evaluate the effect of etidronate (10-4-10-9 M) and alendronate (10-7-10-12 M) on the production of IL-6 and IL-11 using human osteoblast cultures. Cytokines were quantified by ELISA, and mRNA expression was tested. Treatment with alendronate and etidronate had no effect on the synthesis of IL-6 or IL-11, and IL-6 and IL-11 mRNA levels. These results were obtained both in nonstimulated cultures and in cultures stimulated by means of TNF-a, IL-1b, and TNF-a+IL-1b, with or without FCS. In conclusion, a possible indirect osteoclast-mediated effect of alendronate and etidronate on bone resorption would not be exerted through reduction in osteoblastic synthesis of IL-6 and IL-11.
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Affiliation(s)
- E Engel
- Bone and Joint Physiopathology Research Unit, Institut Municipal d'Investigació Mèdica, Universitat Pompeu Fabra, Barcelona, Spain
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Kanterewicz E, Yañez A, Del Rio L, Diez Pérez A, Carbonell J. Vertebral morphometric X-ray absorptiometry in women with Colles' fracture. J Clin Densitom 2003; 6:359-66. [PMID: 14716049 DOI: 10.1385/jcd:6:4:359] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2003] [Revised: 07/27/2003] [Accepted: 07/27/2003] [Indexed: 11/11/2022]
Abstract
Colles' fracture (CF) in younger postmenopausal women is associated with low bone mineral density (BMD) and with an increased risk of other osteoporotic fractures; however, the prevalence of vertebral deformities has been not studied in CF patients. Vertebral morphometry (MXA) using dual-energy X-ray absorptiometry (DXA) is a research tool developed to evaluate the presence of vertebral deformities, but its clinical use is still limited. The goals of this work were to know the prevalence of vertebral deformities in women with CF, to study the morphometric characteristics of height ratios, and to determine the correlation between MXA findings and BMD. MXA was evaluated within an incident case-control study in which 58 women with a recent CF and 83 population-based control women were enrolled. Anterior (Ha), middle (Hm), and posterior (Hp) heights were measured, and wedge (Ha/Hp) and mid-wedge (Hm/Hp) ratios were calculated. A vertebral deformity was defined when at least one ratio fell 3 SD below the reference mean of that ratio at any vertebral level. The mean age of cases was 65.8 yr and in controls 58.7 (p < 0.05). Morphometric vertebral deformities were found in 19% of cases against 11% of controls (nonsignificant). The cases had a lower mid-wedge ratio than controls at each vertebral level (p < 0.05), while wedge ratio results did not show significant results. When the sample was stratified by age, CF showed a trend to be associated with vertebral deformity only in the younger (<65 yr) group. A low but significant coefficient of correlation was found between mid-wedge ratio and BMD, mainly at hip level. By using MXA we found that younger Colles' fracture cases were likely to have more vertebral deformities than healthy controls of the same age range.
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Affiliation(s)
- E Kanterewicz
- Rheumatology Unit, Hospital General de Vic, Vic (Barcelona), and Universitat Autònoma de Barcelona, Barcelona, Spain.
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Abstract
BACKGROUND The goal of this study was to examine the attitudes of physicians towards the care of their health. SUBJECTS AND METHOD A structured questionnaire was addressed to a sample of 795 doctors registered in Barcelona, Spain, who were randomly selected according to sex, age and residence. RESULTS The response rate was 34%. Nearly half of doctors (49%) admitted not to have a family doctor, and in 33% of cases the family doctor was one of the Public Health. 48% of doctors were found not to have a registered medical chart. On the other hand, 52% of surveyed doctors had asked for health advice to several colleagues, yet only 48% followed their recommendations and 82% admitted to prescribe for themselves. Concerning preventive measures, 47% of doctors did not attend medical visits offered by the occupational health department of their workplaces and 19.5% of those who attended these visits did no follow the medical recommendations. CONCLUSIONS A high proportion of doctors show inadequate attitudes with regard to their health care. Therefore, a reflection should be done within the medical profession in order to change these behaviours.
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Affiliation(s)
- M Bruguera
- Collegi Oficial de Metges de Barcelona, Spain
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Gómez-Gosálvez FA, Menor F, Morant A, Clemente F, Escrivá P, Carbonell J, Mulas F. [Tectal tumours in paediatrics. A review of eight patients]. Rev Neurol 2001; 33:605-11. [PMID: 11784946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
INTRODUCTION Tumours of the tectal region form, within the group of gliomas of the brain stem, a sub group with better prognosis which require a different therapeutic strategy. OBJECTIVES A retrospective review of tectal tumours in children to find the most suitable therapeutic approach and the prognosis to be expected. PATIENTS AND METHODS We reviewed 8 paediatric patients who, during the past 11 years, had developed tectal tumours diagnosed by means of neuro imaging techniques. We evaluated their clinical features and especially their clinico radiological progress. RESULTS The average age at the time of diagnosis was 10 years. All cases presented with the clinical features of raised intracranial pressure secondary to obstruction of the aqueduct of Sylvius. MR was the key to visualization of the tectal lesion in all cases but one, which had already been shown on CT. The initial and only treatment given was a ventricular shunt. The average clinico radiological follow up in our series was 4 years, with good progress in all cases so that no other therapeutic measures were required. MR follow up showed that the tumours were stable in all cases but one, which had increased slightly in size but without parallel clinical signs. CONCLUSION In most cases tectal tumours in children follow a benign course. A ventricular shunt is usually the only treatment necessary. However, close clinical and radiological follow up should be carried out to rule out growth of the tumour which make other treatment also necessary. MR is the method of choice for initial evaluation and follow up of these tumours.
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Affiliation(s)
- F A Gómez-Gosálvez
- Servicio de Pediatría; Hospital Virgen de los Lirios, Alcoi, 03800, España.
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Gómez-Gosálvez F, Sala AG, Rubio A, Escrivá P, Clemente F, Pérez C, Carbonell J, Menor F. [Acquired oculomotor paralysis in the adolescent]. Rev Neurol 2001; 32:241-4. [PMID: 11310278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
INTRODUCTION Acquired oculomotor palsy in juvenile age are most commonly due to head trauma, tumors, migraine, vasculopathies and demyelinating diseases. CLINICAL CASES We document three cases of paroxysmal oculomotor nerve palsy in childhood, illustrating the main clinical symptoms, neurological examination, MR images, diagnosis, treatment and evolution. Final diagnosis were: multiple sclerosis, pineoblastoma, and craniopharyngioma. CONCLUSIONS Sudden oculomotor nerve palsy occurring in youth in the absence of head trauma, viral infection or migraine access, firmly suggests a serious intracranial disease, and neuroimage studies should be quickly obtained to have an early diagnosis.
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Affiliation(s)
- F Gómez-Gosálvez
- Servicio de Pediatría, Hospital Virgen de los Lirios, Alcoy, Alicante, España.
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Gómez-Gosálvez F, Sala AG, Rubio A, Escrivá P, Clemente F, Pérez C, Carbonell J, Menor F. [Brainstem pseudotumor imaging: atypical manifestation of multiple sclerosis in childhood]. Rev Neurol 2001; 32:296-7. [PMID: 11310290] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- F Gómez-Gosálvez
- Servicio de Pediatría, Hospital Virgen de los Lirios, Alcoi, Alicante, España.
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46
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Marcote MJ, Carbonell J. Transient expression of a pea MAP kinase gene induced by gibberellic acid and 6-benzyladenine in unpollinated pea ovaries. Plant Mol Biol 2000; 44:177-86. [PMID: 11117261 DOI: 10.1023/a:1006434330381] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [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
PsMAPK3, a new MAP kinase cDNA, was cloned from ovaries of Pisum sativum L. Expression of PsMAPK3 is at low basal levels in unpollinated ovaries but it is rapidly induced by gibberellic acid (peak at 30 min) and 6-benzyladenine (peak at 45 min). Both treatments promoted the development of a parthenocarpic fruit. In situ hybridization localized PsMAPK3 mRNA in ovules. The transcript was additionally detected in the mesocarp when it is expanding in response to the treatments. These observations suggest that gibberellins and cytokinins regulate PsMAPK3 mRNA levels in pea ovary shortly after fruit set is induced.
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MESH Headings
- Adenine/analogs & derivatives
- Adenine/pharmacology
- Amino Acid Sequence
- Benzyl Compounds
- Blotting, Northern
- DNA, Complementary/chemistry
- DNA, Complementary/genetics
- Fruit/genetics
- Fruit/growth & development
- Gene Expression Regulation, Developmental/drug effects
- Gene Expression Regulation, Enzymologic/drug effects
- Gene Expression Regulation, Plant/drug effects
- Gibberellins/pharmacology
- Kinetin
- Mitogen-Activated Protein Kinases/genetics
- Molecular Sequence Data
- Pisum sativum/enzymology
- Pisum sativum/genetics
- Pisum sativum/growth & development
- Purines
- RNA, Messenger/drug effects
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Sequence Alignment
- Sequence Analysis, DNA
- Sequence Homology, Amino Acid
- Transcription, Genetic
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Affiliation(s)
- M J Marcote
- lnstituto de Biología Molecular y Celular de Plantas, Universidad Politécnica de Valencia-CSIC, Spain
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Marcote MJ, Carbonell J. Transient expression of a pea MAP kinase gene induced by gibberellic acid and 6-benzyladenine in unpollinated pea ovaries. Plant Mol Biol 2000; 44:177-186. [PMID: 11117261 DOI: 10.1023/a:100643433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
PsMAPK3, a new MAP kinase cDNA, was cloned from ovaries of Pisum sativum L. Expression of PsMAPK3 is at low basal levels in unpollinated ovaries but it is rapidly induced by gibberellic acid (peak at 30 min) and 6-benzyladenine (peak at 45 min). Both treatments promoted the development of a parthenocarpic fruit. In situ hybridization localized PsMAPK3 mRNA in ovules. The transcript was additionally detected in the mesocarp when it is expanding in response to the treatments. These observations suggest that gibberellins and cytokinins regulate PsMAPK3 mRNA levels in pea ovary shortly after fruit set is induced.
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MESH Headings
- Adenine/analogs & derivatives
- Adenine/pharmacology
- Amino Acid Sequence
- Benzyl Compounds
- Blotting, Northern
- DNA, Complementary/chemistry
- DNA, Complementary/genetics
- Fruit/genetics
- Fruit/growth & development
- Gene Expression Regulation, Developmental/drug effects
- Gene Expression Regulation, Enzymologic/drug effects
- Gene Expression Regulation, Plant/drug effects
- Gibberellins/pharmacology
- Kinetin
- Mitogen-Activated Protein Kinases/genetics
- Molecular Sequence Data
- Peas/enzymology
- Peas/genetics
- Peas/growth & development
- Purines
- RNA, Messenger/drug effects
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Sequence Alignment
- Sequence Analysis, DNA
- Sequence Homology, Amino Acid
- Transcription, Genetic
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Affiliation(s)
- M J Marcote
- lnstituto de Biología Molecular y Celular de Plantas, Universidad Politécnica de Valencia-CSIC, Spain
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48
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Guañabens N, Farrerons J, Perez-Edo L, Monegal A, Renau A, Carbonell J, Roca M, Torra M, Pavesi M. Cyclical etidronate versus sodium fluoride in established postmenopausal osteoporosis: a randomized 3 year trial. Bone 2000; 27:123-8. [PMID: 10865219 DOI: 10.1016/s8756-3282(00)00303-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
To compare the effects of sodium fluoride and etidronate in severe postmenopausal osteoporosis, we conducted a 3 year, prospective, trial in 118 postmenopausal osteoporotic women with at least one vertebral fracture, who were randomly assigned to receive sodium fluoride (25 mg twice daily, as enteric-coated tablets) plus calcium (1000 mg/day) or intermittent etidronate (400 mg/day for 14 days) followed by calcium (1000 mg/day for 76 days). Lateral spine X-ray films and dual-energy X-ray absorptiometry (DXA) measurements of the lumbar spine and proximal femur were performed at enrollment and yearly. Nonvertebral fractures were recorded every 6 months. Thirty-one women in the fluoride group and 47 in the etidronate group completed the trial. At 36 months, the mean change from baseline of the lumbar bone density in the fluoride group was 8.5 +/- 2.04% (p = 0.001) and in the etidronate group was of 3.6 +/- 0. 84% (p < 0.001). The changes in the fluoride group were significantly higher than in the etidronate group (p = 0.01). Both groups showed nonsignificant changes in femoral neck bone density. There was no significant difference between groups in the cumulative proportion of women with new vertebral fractures, with an incidence in the fluoride group of 16% vs. 17% in the etidronate group. However, the number of new vertebral fractures was significantly lower in the fluoride group (6 fractures) than in the etidronate group (19 fractures) (p = 0.05). The number of patients with nonvertebral fractures was similar in both groups. A high incidence of side effects, mainly gastrointestinal symptoms and lower extremity pain syndrome, was observed in the fluoride group. Etidronate was well tolerated. We conclude that, in women with severe osteoporosis, although sodium fluoride is more favorable than cyclical etidronate for increasing lumbar bone mass, no differences were observed in the incidence of fractures.
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Affiliation(s)
- N Guañabens
- Metabolic Bone Diseases Unit, ICAL, Department of Medicine, IDIBAPS Hospital Clínic, University of Barcelona, Spain.
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Abstract
BACKGROUND Systematic review of the efficacy of calcium and vitamin D for the treatment of osteoporosis. MATERIAL AND METHOD Review of the database MEDLINE between 1996 and may 1998, by the key words: osteoporosis, calcium, vitamin D (and related terms) and randomized clinical trial. Review of the electronic versions of Best Evidence, The Cochrane Library, congress abstracts and references from two main textbooks. Ascending review of the literature. All the reviews were performed independently by two of the authors. Design parameters and main results of the primary publications of the identified trials were tabulated. Two independent observers carried out methodological scoring of the studies. Results were tabulated and a judgement made for the results. RESULTS Eleven studies on calcium, 8 of vitamin D and 12 about calcitriol and other hormone derivatives were included. Studies with calcium were mainly performed on non-clinical populations and in three anti-fracture efficacy was analyzed. Results were positive in population with low baseline intake and substantial supplementation. Trials on vitamin D were done in non-clinical and on institutionalized populations. Trials with calcitriol were developed mainly in osteoporotic fracture populations and reached poorer methodological validity scores. Heterogeneity of the studies precluded a meta-analysis of the different treatments. Studies on calcium showed clinical efficacy in a more consistent way. Inter-observer score was good (kappa = 0.81) and there were no significant correlations between sample size and effect in the different studies. CONCLUSIONS Calcium treatment is efficacious in populations with low intake receiving substantial supplementation. Vitamin D is efficacious associated with calcium mainly in deficient populations. Efficacy of calcitriol and other derivatives is more controversial.
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Affiliation(s)
- G Vallecillo
- Servicio de Medicina Interna y Enfermedades Infecciosas, Hospital del Mar, Barcelona
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Gómez-Gosálvez FA, Smeyers P, Menor F, Morant A, Carbonell J, Mulas F. [Disseminated acute encephalomyelitis in children. A retrospective study of seven patients]. Rev Neurol 2000; 30:304-10. [PMID: 10789136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
INTRODUCTION AND OBJECTIVE Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disease of the central nervous system. This study is based on clinical symptoms and diagnostic tests employed. PATIENTS AND METHODS We describe a seven children series indicating the initial neurologic abnormalities, diagnostic tests, treatments used and clinical-neuroradiological evolution. RESULTS The mean presentation age was 4.1 years. Initial neurologic symptoms were mainly spastic hemi/paraparesis, cerebellous and pyramidal syndrome, consciousness changes, meningeal signs, seizures and cranial nerve palsies. The cerebrospinal fluid was abnormal in four patients with positive serologic tests in two of them (Coxsackie B). Electrophysiological studies were affected in 50%. MRI findings consisted of multifocal supratentorial white matter lesions. Clinical evolution revealed a progressive improvement with resolution after two months. Follow-up was made between six months and five years. The treatment was based on aciclovir and corticosteroids. CONCLUSIONS ADEM runs a monophasic course of progressive neurologic abnormalities. Diagnosis is based on suggestive clinical and neuroimaging findings. Generally speaking, MRI showed resolution of multifocal lesions in conjunction with clinical improvement.
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