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2. Magnetic Nanoparticles for Power Absorption: optimizing size, shape and magnetic properties

Author

Gonzalez-Fernandez, M. A., Torres, T., Andres-Verges, M., Costo, R., de la Presa, P., Serna, C. J., Morales, M. P., Marquina, C., Ibarra, M. R., and Goya, G. F.

Subjects
Condensed Matter - Materials Science
Abstract

We present a study on the magnetic properties of naked and silica-coated Fe3O4 nanoparticles with sizes between 5 and 110 nm. Their efficiency as heating agents was assessed through specific power absorption (SPA) measurements as a function of particle size and shape. The results show a strong dependence of the SPA with the particle size, with a maximum around 30 nm, as expected for a Neel relaxation mechanism in single-domain particles. The SiO2 shell thickness was found to play an important role in the SPA mechanism by hindering the heat outflow, thus decreasing the heating efficiency. It is concluded that a compromise between good heating efficiency and surface functionality for biomedical purposes can be attained by making the SiO2 functional coating as thin as possible., Comment: 15 pages, 7 figures, 2 tables

Published
2009
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3. Mitochondrial heteroplasmy as a marker for premature coronary artery disease: analysis of the poly-C tract of the control region sequence

Author

Gonzalez Urbistondo, F, primary, Aparicio-Gavilanes, A, additional, Gomez, J, additional, Alvarez-Velasco, R, additional, Pascual, I, additional, Avanzas, P, additional, Alen, A, additional, Vazquez-Coto, M, additional, Gonzalez-Fernandez, M, additional, Garcia-Largo, C, additional, Cuesta-Llavona, E, additional, Moris De La Tassa, C, additional, Eliecer, C, additional, and Lorca, R, additional

Published
2023
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5. OMERACT agreement and reliability study of ultrasonographic elementary lesions in osteoarthritis of the foot

Author

Zabotti, A, Filippou, G, Canzoni, M, Adinolfi, A, Picerno, V, Carrara, G, Balint, P, Bruyn, G, D'Agostino, M, Damjanov, N, Delle Sedie, A, Filippucci, E, Gonzalez Fernandez, M, Hammer, H, Karim, Z, Mandl, P, Moller, I, Morales Lozano, M, Naredo, E, Porta, F, Sakellariou, G, Terslev, L, Scire, C, Iagnocco, A, Zabotti A., Filippou G., Canzoni M., Adinolfi A., Picerno V., Carrara G., Balint P., Bruyn G., D'Agostino M. A., Damjanov N., Delle Sedie A., Filippucci E., Gonzalez Fernandez M. L., Hammer H. B., Karim Z., Mandl P., Moller I., Morales Lozano M. R., Naredo E., Porta F., Sakellariou G., Terslev L., Scire C. A., Iagnocco A., Zabotti, A, Filippou, G, Canzoni, M, Adinolfi, A, Picerno, V, Carrara, G, Balint, P, Bruyn, G, D'Agostino, M, Damjanov, N, Delle Sedie, A, Filippucci, E, Gonzalez Fernandez, M, Hammer, H, Karim, Z, Mandl, P, Moller, I, Morales Lozano, M, Naredo, E, Porta, F, Sakellariou, G, Terslev, L, Scire, C, Iagnocco, A, Zabotti A., Filippou G., Canzoni M., Adinolfi A., Picerno V., Carrara G., Balint P., Bruyn G., D'Agostino M. A., Damjanov N., Delle Sedie A., Filippucci E., Gonzalez Fernandez M. L., Hammer H. B., Karim Z., Mandl P., Moller I., Morales Lozano M. R., Naredo E., Porta F., Sakellariou G., Terslev L., Scire C. A., and Iagnocco A.

Abstract

Objective To evaluate the level of agreement on ultrasonographic (US) lesions among highly experienced sonographers as well as the intraobserver and interobserver reliability of inflammatory and structural US lesions in patients with osteoarthritis (OA) of the foot. Methods After a systematic literature review, a Delphi survey was performed to test definitions of US lesions in OA of the foot, including inflammatory lesions (ie, synovial hypertrophy [SH], joint effusion [JE], power Doppler signal [PD]), and structural abnormalities (ie, cartilage damage [CD] and osteophytes). Subsequently, the reliability of US in assessing the aforementioned lesions was tested on static images as well as during a live exercise. Reliability was assessed by kappa analyses and prevalence-adjusted bias-adjusted kappa (PABAK) on a dichotomous and an ordinal scale. Results Intraobserver and interobserver reliability for SH and JE evaluated by binary scoring was good for both components, while the intraobserver reliability for semiquantitative scoring of SH ranged from moderate in the web-based exercise (PABAK 0.49) to good (PABAK 0.8) in the live exercise. Reliability for CD and PD assessments were respectively good and excellent in all exercises (ranged from PABAK 0.61 to 0.79 for CD and 0.88 to 0.95 for PD). The interobserver reliability for the semiquantitative scoring of osteophytes was fair in the live exercise (PABAK 0.36) and moderate in the static exercise (PABAK 0.60). Conclusions Consensual US definitions were found to be reliable for assessing inflammatory lesions in OA of the foot, while the use of US to assess structural damage requires further studies.

Published
2019

6. 1516P Health-related quality of life (hrqol) analysis from KEYNOTE-859: First-line (1L) pembrolizumab (pembro) + chemotherapy (chemo) for advanced HER2-negative gastric or gastroesophageal junction (G/GEJ) adenocarcinoma

Author

Lowery, M., Wyrwicz, L., Oh, D-Y., Shiu, K-K., Yanez Weber, P., Bai, Y., Lee, J., Rivera, F., Alves, G., Garrido, M., González Fernández, M., Li, J., Cil, T., Cruz, F., Qin, S., Yin, L., Valderrama, A., Bordia, S., and Rha, S.Y.

Published
2023
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7. Hyperlipoproteinaemia(a) in patients with spondyloarthritis: results of the Cardiovascular in Rheumatology (CARMA) project

Author

Garcia-Gomez, C, Martin-Martinez, M, Fernandez C, Castaneda, S, Gonzalez-Juanatey, C, Sanchez-Alonso, F, Gonzalez-Fernandez, M, Sanmarti, R, Garcia-Vadillo, J, Fernandez-Gutierrez, B, Garcia-Arias, M, Manero, F, Senabre, J, Rueda-Cid, A, Ros-Exposito, S, Pina-Salvador, J, Erra-Duran, A, Moller-Parera, I, Llorca, J, Gonzalez-Gay, M, Gonzalez de Rabago, E, Blanco Morales, E, Fernandez Lopez, J, Oreiro Villar, N, Atanes Sandoval, A, Blanco Garcia, F, Alegre De Miquel, C, Gonzalez Fernandez, M, Huguet Codina, R, Yoldi, B, Ramentol, M, Avila, G, Marsal Barril, S, Steiner, M, Munoz, S, Gamero, F, Garcia Toron, J, Moreno Gil, M, Mas, A, Espino, P, Ros, I, Ibanez, M, Murillo, C, Piqueras, J, Berman, H, Cabrera, S, Ruiz, V, Fontsere Paton, O, Fernandez Gutierrez, B, Abasolo, L, Fabregas, M, Romera Baures, M, Nolla, J, Gonzalez-Alvaro, I, Tomero Muriel, E, Garcia de Vicuna, R, Fernandez Nebro, A, Belmonte Lopez, M, Urena, I, Irigoyen, M, Coret Cagigal, V, Lopez Gonzalez, R, Pielfort Garrido, D, Sampedro Alvarez, J, Garcia Aparicio, A, Belmonte Gomez, R, Granados Bautista, P, Hernandez Sanz, A, Sanchez Gonzalez, C, Bachiller, J, Zea, A, Jimenez Zorzo, F, Gimenez Ubeda, E, Marzo Gracia, J, Beltran Audera, C, Medrano, M, Pecondon, A, Erausquin, C, Ojeda, S, Carlos Quevedo, J, Francisco, F, Rodriguez Lozano, C, Babio Herraez, J, Lopez Longo, F, Gerona, D, Gonzalez Fernandez, C, Carreno, L, Monteagudo, I, del Pino, J, Sanchez Gonzalez, M, Corrales, A, Enriqueta Peiro, M, Rosas, J, Rotes, I, Moreno, E, Erra, A, Grado, D, Calvo, J, Rueda, A, Moller, I, Rodriguez, I, Barbadillo, C, Raya, E, Morales, P, Nieto, A, Jimenez, I, Magro, C, Ruibal Escribano, A, Ros Exposito, S, Sanchez Nievas, G, Judez Navarro, E, Sianes Fernandez, M, Garcia Morales, M, Labiano Bastero, I, Consuegra, G, Palmou, N, Martinez Pardo, S, Pujol, M, Riera Alonso, E, Salvador, G, Gonzalez Alvarez, B, Cantabrana, A, Bustabad, S, Delgado, E, Munoz, A, Rodriguez Montero, S, Maria Jimenez, L, Rivera Redondo, J, Gonzalez Hernandez, T, Gonzalez Polo, F, Menor Almagro, R, Moreno, J, Giner Serret, E, Lannuzzelli Barroso, C, Cebrian Mendez, L, Teresa Navio, M, Fernandez Carballido, C, Pagan, E, Mesa del Castillo, P, Naredo, E, Cruz, A, Turrion, A, Mateo, I, Sanchez, J, Galindo, M, Garcia Gonzalez, J, Collantes, E, Ruiz, D, Font, P, Bonilla, G, Lopez Meseguer, A, Moreno, M, Moreno Martinez, M, Beteta Fernandez, M, Linares, L, Morcillo, M, Gonzalez Gomez, M, Aramburu, J, Rivera, N, Fernandez Berrizbeitia, O, Garcia Vivar, M, Riera, M, Maria Leon, Y, Maymo, J, Amirall, M, Iniesta Escolano, S, Sanchez Serrano, S, Lis Bona, M, Fiter, J, Fernandez Melon, J, Espadaler, L, Maiz, O, Belzunegui, J, Banegil, I, Diaz, C, Valls, R, Castellvi, I, Bonet, M, Moreno Ruzafa, E, Calvo Alen, J, Perez Sandoval, T, Revuelta Evrard, E, Godo, J, Fernandez Espartero, C, Navarro Blasco, F, Antonio Gonzalez, J, Miranda-Filloy, J, and CARMA Project Collaborative Grp

Subjects
musculoskeletal diseases, psoriatic arthritis, lipids, stomatognathic diseases, cardiovascular disease, lipoprotein(a), ankylosing spondylitis, spondyloarthritis
Abstract

Objective Cardiovascular (CV) disease is one of the main causes of morbi-mortality in spondyloarthritis (SpA), partially explained by traditional CV risk factors. Information on lipoprotein(a) [Lp(a)], a non-conventional risk factor, in SpA is scarce. In this study we assessed the prevalence of hyperlipoproteinaemia(a) in SpA patients and analysed the possible related factors. Methods A baseline analysis was made of ankylosing spondylitis (AS) and psoriatic arthritis (PsA) patients and controls included in the CARMA project (CARdiovascular in RheuMAtology), a 10-year prospective study evaluating the risk of CV events in chronic inflammatory rheumatic diseases. A multivariate logistic regression model was performed using hyperlipoproteinaemia( a) (Lp(a) >50 mg/dl) as a dependent variable and adjusting for confounding factors. Results 19.2% (95% CI: 16.80-22.05) of the SpA patients [20.7% (95% CI: 16.91-24.82) of those with AS and 17.7% (95% CI: 14.15-21.75) of those with PsA] and 16.7% (95% CI: 13.23-20.86) of the controls had hyperlipoproteinaemia(a) (p=0.326). Adjusting for age and sex, SpA patients were more likely to have hyperlipoproteinaemia(a) than controls (OR: 1.43, 95% CI: 1.00-2.04; p=0.05), especially those with AS (OR: 1.81, 95% CI: 1.18-2.77; p=0.007). In the adjusted model, apolipoprotein B in all patients, non-steroidal anti-inflammatory drugs in AS, and female sex in PsA, were associated with hyperlipoproteinaemia(a). No disease-specific factors associated with hyperlipoproteinaemia(a) were identified. Conclusion SpA patients show a moderately increased risk of hyperlipoproteinaemia(a) compared to controls, especially those with AS. Lp(a) determination may be of interest to improve the CV risk assessment in SpA patients.

Published
2019

8. Incidence of First Cardiovascular Event in Spanish Patients with Chronic Inflammatory Rheumatic Diseases. Prospective Data After Five Years of Follow Up

Author

Martin-Martinez M, Castaneda S, Sanchez-Alonso F, Garcia-Gomez C, Juanatey C, Belmonte-Lopez M, Tornero-Molina J, Santos-Rey J, Sanchez-Gonzalez C, Moreno E, Moreno-Gil M, Cobo-Ibanez T, Pinto-Tasende J, Babio-Herraez J, Bonilla G, Juan-Mas A, Manero-Ruiz F, Romera-Baures M, Bachiller-Corral J, Chamizo-Carmona E, Calvo-Catalan J, Sanmarti R, Erausquin-Arruabarrena C, Garcia-Vicuna R, Barbadillo C, Ros-Exposito S, Turrion A, Gonzalez-Fernandez M, Senabre J, Martinez-Pardo S, Ruibal-Escribano A, Giner-Serret E, Berzosa-Sola E, Martinez-Barrio J, Pagan E, Enriqueta-Peiro M, Bustabad-Reyes S, Erra-Duran A, Alvarez B, Valenciano A, Rivera-Redondo J, Ramos M, Montero S, Morcillo-Valle M, Navio M, Galindo-Izquierdo M, Riera-Soler M, Fiter J, Llorca J, and Gonzalez-Gay M

Published
2020

9. The comparative responsiveness of Hospital Universitario Princesa Index and other composite indices for assessing rheumatoid arthritis activity

Author

Gonzalez-Alvaro, Isidoro, Castrejon, Isabel, Carmona, Loreto, Dougados, M., Huizinga, T., Abu Shakra, M., Alberts, A., Alperi Lopez, M., Amital, H., Aringer, M., Aslanidis, S., Berenbaum, F., Bijlsma, H., Blanco Garcia, F. J., Bliddal, H., Borofsky, M., Brocq, O., Buldakov, S., Cantini, F., Carreno Perez, L., Chahade, W., Ciconelli, R., Codreanu, C., Dahlqvist, S. R., Damjanov, N., Diamantopoulos, A., Dimdina, L., Dimic, A., Dorokhov, A., Dubikov, A., Fadienko, G., Fano, N., Ferreira, G., Gabrielli, A., Gaffney, K., Gaudin, P., Gerlag, D. M., Gerli, R., Goncalves, C. R., Hansen, M. S., Hanvivadhanakul, P., Hoili, C., Hou, A., Hunter, J., Ilic, T., Ionescu, R., Kaine, J., Kakurina, N., Kamalova, R., Kelly, T., Knyazeva, L., Krumina, L., Kurthen, R., Lagrone, R. P., Lapadula, G., Lavrentjevs, V, Lawson, J. G., Lazic, Z., Lejnieks, A., Levy, Y., Lexberg, A., Mader, R., Mariette, X., Markovits, D., Mola, Martin E., Maugars, Y., Guarch, Maymo J., Mazurov, V., I, Mikkelsen, K., Vergles, Morovic J., Nabizadeh, S., Nanagara, R., Nasonov, E. L., Sarabia, Navarro F., Neumann, T., Novak, S., Olech, E., Oza, M., Paran, D., Parsik, E., Pegram, S., Suarez, Pombo M., Popova, T., Puechal, X., Raja, N., Ridley, D., Rosner, I, Rubbert-Roth, A., Rudin, A., Saraux, A., Saulite-Kandevica, D., Settas, L., Sfikakis, P., Sheeran, T., Sizikov, A., Stamenkovic, D., Stefanovic, D., Stolow, J. B., Tan, A. L., Tebib, J., Tishler, M., Tony, H. P., Troum, O. M., Uaratanawong, S., Ucar Angulo, E., Valenzuela, G., van der Laken, K., Van Laar, J., van Riel, P. L. C. M., Vasilopoulos, D., Veldi, T., Vinogradova, I, Vosse, D., Wassenberg, S., Weidmann, C., Weitz, M., Wollenhaupt, J., Xavier, R., Yakupova, S., Zagar, I, Zavgorodnaja, T., Zemerova, E., Zisman, D., Zonova, E., Camona, Loreto, Abasolo Alcazar, L., Alegre de Miguel, C., Andreu Sanchez, J. L., Aragon Diez, A., Balsa Criado, A., Batlle Gualda, E., Belmonte Serrano, M. A., Beltran Audera, J., Beltran Fabregat, J., Bonilla Hernan, G., Caro Fernandez, N., Casado, E., Cebrian Mendez, L., Corteguera Coro, M., Cuadra Diaz, J. L., Cuesta, E., Fiter Areste, J., Freire Gonzalez, M., Galindo Izquierdo, M., Garcia Meijide, J. A., Garcia Gomez, M. C., Gimenez Ubeda, E., Gomez Centeno, E., Gomez Vaquero, C., Gonzalez Fernandez, M. J., Gonzalez Gomez, M. L., Gonzalez Hernandez, T., Gonzalez-Alvaro, I, Gonzalez-Montagut Gomez, C., Grandal Delgado, Y., Gratacos Masmitja, J., Hernandez del Rio, A., Instxaurbe, A. R., Irigoyen Oyarzabal, M., V, Jimenez Palop, M., Juan Mas, A., Judez Navarro, E., Larrosa Padro, M., Lopez Longo, F. J., Loza Santamaria, E., Maese Manzano, J., Manero Ruiz, F. J., Mateo Bernardo, I, Mayordomo Gonzalez, L., Mazzucheli, R., Medrano San Idelfonso, M., Naranjo Hernandez, A., Pecondon Espanol, A., Peiro Callizo, E., Quiros Donate, J., Ramos Lopez, P., Rivera Redondo, J., Rodriguez Gomez, M., Rodriguez Lopez, M., Rosello Pardo, R., Sampedro Alvarez, J., Sanmarti Sala, R., Rey Rey, Santos J., Tena Marsa, X., Tenorio Martin, M., Torres Martin, M. C., Urena Garnica, I, Valdazo de Diego, J. P., Valls, M., Villaverde Garcia, V., Zarco Montejo, P., Zubieta Tabernero, J., Balsa, Alejandro, Sanmarti, Raimon, Cabezas, J. A., Cantalejo, M., Chamizo, E., Ciruelo, E., Corrales, A., Cruz, A., Diaz, C., Fiter, J., Freire, M. M., Galindo, M., Garcia de Vicuna, M. R., Gelman, S. M., Gonzalez Crespo, R., Gonzalez Fernandez, C., Gracia, A., Granados, J., Guzman, M. A., Irigoyen, M., V, Juan, A., Juanola, X., Laiz, A., Manero, F. J., Martinez, A., Martinez, F., Mata, C., Maymo, J., Navarro, F. J., Peiro, E., Perez, F., Perez, G., Perez, M., Pujol, M., Quiros, J., Ribas, B., Riera, M., Rivera, J., Rodriguez, J. M., Rosello, R., Tenorio, M., Toyos, F. J., ACT-RAY Study Grp, PROAR Study Grp, EMECAR Study Grp, Interne Geneeskunde, MUMC+: MA Reumatologie (9), and RS: CAPHRI - R3 - Functioning, Participating and Rehabilitation

Subjects
Male, medicine.medical_specialty, Science, humanos, Severity of Illness Index, RECOMMENDATIONS, VALIDATION, VARIABLES, ensayos clínicos como asunto, Arthritis, Rheumatoid, Cohort Studies, Internal medicine, Linear regression, Severity of illness, medicine, Humans, índice de gravedad de la enfermedad, estudios de cohortes, mediana edad, Clinical Trials as Topic, DISEASE-ACTIVITY MEASURES, Multidisciplinary, SCORES, business.industry, Arthritis, resultado del tratamiento, modelos lineales, Secondary data, Gold standard (test), Middle Aged, medicine.disease, Clinical trial, Treatment Outcome, Rheumatoid arthritis, Antirheumatic Agents, Cohort, Linear Models, Medicine, Female, GENDER, business, antirreumáticos, artritis, Cohort study
Abstract

Objective To evaluate the responsiveness in terms of correlation of the Hospital Universitario La Princesa Index (HUPI) comparatively to the traditional composite indices used to assess disease activity in rheumatoid arthritis (RA), and to compare the performance of HUPI-based response criteria with that of the EULAR response criteria. Methods Secondary data analysis from the following studies: ACT-RAY (clinical trial), PROAR (early RA cohort) and EMECAR (pre-biologic era long term RA cohort). Responsiveness was evaluated by: 1) comparing change from baseline (Delta) of HUPI with Delta in other scores by calculating correlation coefficients; 2) calculating standardised effect sizes. The accuracy of response by HUPI and by EULAR criteria was analyzed using linear regressions in which the dependent variable was change in global assessment by physician (Delta GDA-Phy). Results Delta HUPI correlation with change in all other indices ranged from 0.387 to 0.791); HUPI's standardized effect size was larger than those from the other indices in each database used. In ACT-RAY, depending on visit, between 65 and 80% of patients were equally classified by HUPI and EULAR response criteria. However, HUPI criteria were slightly more stringent, with higher percentage of patients classified as non-responder, especially at early visits. HUPI response criteria showed a slightly higher accuracy than EULAR response criteria when using Delta GDA-Phy as gold standard. Conclusion HUPI shows good responsiveness in terms of correlation in each studied scenario (clinical trial, early RA cohort, and established RA cohort). Response criteria by HUPI seem more stringent than EULAR's., Our study was supported by grants RD16/0012/0011 and PI14/00442 from the Ministerio de Economia y Competitividad (Instituto de Salud Carlos III; Spain) and cofunded by the Fondo Europeo de Desarrollo Regional (FEDER). Data from ACT-RAY clinical trial were kindly provided by Hoffmann-La Roche Ltd. No financial support was received from Hoffmann-La Roche Ltd Data from EMECAR and PROAR cohorts were provided by the Spanish Society of Rheumatology. No financial support was received from the Spanish Society of Rheumatology. None of these institutions played any role in the analysis or interpretation of data, nor were they involved in the writing of the manuscript. Roche and Sociedad Espanola de Reumatologia were involved in the collection of data from ACT-RAY, and EMECAR and PROAR, respectively. However, these funders had no role in study design, analysis, decision to publish, or preparation of the manuscript.

Published
2019

10. OMERACT agreement and reliability study of ultrasonographic elementary lesions in osteoarthritis of the foot

Author

Zabotti, A., Filippou, G., Canzoni, M., Adinolfi, Annalisa, Picerno, V., Carrara, Giancarlo, Balint, P., Bruyn, G., D'Agostino, Maria Antonietta, Damjanov, N., Delle Sedie, A., Filippucci, E., Gonzalez Fernandez, M. L., Hammer, H. B., Karim, Z., Mandl, P., Moller, I., Morales Lozano, M. R., Naredo, E., Porta, F., Sakellariou, G., Terslev, L., Scire, C. A., Iagnocco, A., Adinolfi A., Carrara G., D'Agostino M. A. (ORCID:0000-0002-5347-0060), Zabotti, A., Filippou, G., Canzoni, M., Adinolfi, Annalisa, Picerno, V., Carrara, Giancarlo, Balint, P., Bruyn, G., D'Agostino, Maria Antonietta, Damjanov, N., Delle Sedie, A., Filippucci, E., Gonzalez Fernandez, M. L., Hammer, H. B., Karim, Z., Mandl, P., Moller, I., Morales Lozano, M. R., Naredo, E., Porta, F., Sakellariou, G., Terslev, L., Scire, C. A., Iagnocco, A., Adinolfi A., Carrara G., and D'Agostino M. A. (ORCID:0000-0002-5347-0060)

Abstract

Objective To evaluate the level of agreement on ultrasonographic (US) lesions among highly experienced sonographers as well as the intraobserver and interobserver reliability of inflammatory and structural US lesions in patients with osteoarthritis (OA) of the foot. Methods After a systematic literature review, a Delphi survey was performed to test definitions of US lesions in OA of the foot, including inflammatory lesions (ie, synovial hypertrophy [SH], joint effusion [JE], power Doppler signal [PD]), and structural abnormalities (ie, cartilage damage [CD] and osteophytes). Subsequently, the reliability of US in assessing the aforementioned lesions was tested on static images as well as during a live exercise. Reliability was assessed by kappa analyses and prevalence-adjusted bias-adjusted kappa (PABAK) on a dichotomous and an ordinal scale. Results Intraobserver and interobserver reliability for SH and JE evaluated by binary scoring was good for both components, while the intraobserver reliability for semiquantitative scoring of SH ranged from moderate in the web-based exercise (PABAK 0.49) to good (PABAK 0.8) in the live exercise. Reliability for CD and PD assessments were respectively good and excellent in all exercises (ranged from PABAK 0.61 to 0.79 for CD and 0.88 to 0.95 for PD). The interobserver reliability for the semiquantitative scoring of osteophytes was fair in the live exercise (PABAK 0.36) and moderate in the static exercise (PABAK 0.60). Conclusions Consensual US definitions were found to be reliable for assessing inflammatory lesions in OA of the foot, while the use of US to assess structural damage requires further studies.

Published
2019

11. Prevention and early diagnosis of childhood osteoporosis: are we doing the right thing?

Author

Mir-Perello, C., Galindo Zavala, R., Gonzalez Fernandez, M., I, Grana Gil, J., Sevilla Perez, Magallares Lopez, B., Bou Torrent, R., Grp Trabajo Osteoporosis Infantil, and Osteogenesis Imperfecta Sociedad E

Subjects
early diagnosis of osteoporosis, osteoporosis prevention, bone health
Abstract

Objectives: To assess prevention, early diagnosis and training received regarding osteoporosis among the pediatrics professionals in our area. Material and methods: Survey directed to physicians of pediatricians of Primary Care (PC) and Specialized Care (SC) in order to evaluate their activity in prevention, detection and training received in osteoporosis. The survey was disseminated through the relevant scientific societies. Results: 420 pediatricians participated (324 from PC and 96 from SC). 93.5% of PC pediatricians and 89.6% of SC pediatricians valued the physical activity of the patients; 85.19% and 35.4% of them, respectively, the intake of dairy products. 45.68% of PC and 70.2% of SC recommended calcium and vitamin D supplements in the case of low nutritional intake, whereas 39.2% of PC and 47.2% of SC favored follow-up. 39.6% of SC pediatricians requested bone densitometry for this disease or risk treatment, and 47.9% measured the levels of 25-OH-vitamin D. 25.93% of PC and 45.3% of SC asked about the existence of fractures, 90.4% and 96.8% requested etiopathogenic mechanism. 40% of PC and 86.2% of SC requested a bone densitometry or referred to the specialist for fractures due to low trauma energy, with specific criteria in 13.7% and 5.86%, respectively. 92% of PC and 82.3% of SC had not received recent training in childhood osteoporosis. Conclusion: Detection, derivation circuits and the training of pediatricians regarding bone health in our country can be improved. Optimizing these aspects is essential to favor the peak of bone mass in our population.

Published
2018

12. Magnetic Nanoparticles for Power Absorption: optimizing size, shape and magnetic properties.

Author

Gonzalez Fernandez, M. A., Torres, T., Andrés Vergés, M., Costo, R., Presa Muñoz del Toro, Patricia de la, Serna, C. J., Morales, M. P., Marquina, C., Ibarra, M. R., Goya, G. F., Gonzalez Fernandez, M. A., Torres, T., Andrés Vergés, M., Costo, R., Presa Muñoz del Toro, Patricia de la, Serna, C. J., Morales, M. P., Marquina, C., Ibarra, M. R., and Goya, G. F.

Abstract

©Elsevier. The authors acknowledge the financial support from Diputación General de Aragón, Comunidad de Madrid (S-0505/MAT/0194), and Ministerio de Ciencia e Innovación (MAT2005-03179 and MAT2008-01489). GFG and PP acknowledge support from the Spanish MEC through the Ramon y Cajal program., We present a Study on the magnetic properties of naked and silica-coated Fe₃O₄nanoparticles with sizes between 5 and 110 nm. Their efficiency as heating agents was assessed through specific power absorption (SPA) measurements as a function of particle size and shape. The results show a strong dependence of the SPA with the particle size, with a maximum around 30 nm, as expected for a Neel relaxation mechanism in single-domain particles. The SiO₂shell thickness was found to play an important role in the SPA mechanism by hindering the heat Outflow, thus decreasing the heating efficiency. It is concluded that a compromise between good heating efficiency and surface functionality for biomedical purposes can be attained by making the SiO₂functional coating as thin as possible., Ministerio de Ciencia e Innovación (MICINN), Comunidad de Madrid, Diputación General de Aragón, Spanish MEC through the Ramon y Cajal program, Depto. de Física de Materiales, Fac. de Ciencias Físicas, TRUE, pub

Published
2009

14. Which countries pay more or less for their long term debt? A CART approach || ¿Qué países pagan más o menos por su deuda a largo plazo? Una aproximación a través de la metodología CART

Author

González-Fernández, Marcos and González-Velasco, Carmen

Subjects
long-term yields, sovereign yields, classification trees, decision trees, tipos a largo plazo, rendimientos soberanos, árboles de clasificación, árboles de decisión, Applied mathematics. Quantitative methods, T57-57.97, Mathematics, QA1-939, Business, HF5001-6182
Abstract

The objective of this paper is to classify a group of EMU countries according to the main determinants of long-term sovereign bond yields. We apply the Classification and Regression Tree method (CART). According to the findings, countries with lower inflation, a lower debt to GDP ratio, a lower average income tax rate, higher public debt maturity and higher IPI growth are placed in classification groups that have lower bond yields. These results confirm the hypothesis that countries with better macroeconomic and fiscal indicators have lower sovereign bond yields.|| El objetivo de este artículo es clasificar un grupo de países de la UME teniendo en cuenta los principales determinantes de los tipos a largo plazo de la deuda soberana. Se aplica la metodología basada en árboles de decisión. Según los resultados, los grupos de países que tienen menor inflación, deuda pública, tipo impositivo medio y mayor vencimiento de la deuda pública y crecimiento económico pagan menos por su deuda soberana a largo plazo. Se confirma la hipótesis de que los países que tienen los mejores indicadores macroeconómicos y fiscales son los que presentan menores costes en su deuda soberana.

Published
2016

15. Hyperlipoproteinaemia(a) in patients with spondyloarthritis: results of the Cardiovascular in Rheumatology (CARMA) project

Author

Garcia-Gomez, C., Martin-Martinez, M. A., Fernandez-Carballido, C., Castaneda, S., Gonzalez-Juanatey, C., Sanchez-Alonso, F., Gonzalez-Fernandez, M. J., Sanmarti, R., Garcia-Vadillo, J. A., Fernandez-Gutierrez, B., Garcia-Arias, M., Manero, F. J., Senabre, J. M., Rueda-Cid, A., Ros-Exposito, S., Pina-Salvador, J. M., Erra-Duran, A., Moller-Parera, I., Llorca, J., Gonzalez-Gay, M. A., Gonzalez Rabago, Eugenia, Blanco Morales, Elena Alonso, Fernandez Lopez, J. Carlos, Oreiro Villar, Natividad, Atanes Sandoval, Antonio, Blanco Garcia, Francisco J., Alegre Miquel, Cayetano, Gonzalez Fernandez, Maria J., Huguet Codina, Ramon, Yoldi, Beatriz, Ramentol, Mercedes, Avila, Gabriela, Marsal Barril, Sara, Steiner, Martina, Munoz, Santiago, Gamero, Fernando, Garcia Toron, Jose, Moreno Gil, Maria P., Mas, Antonio J., Espino, Pilar, Ros, Inmaculada, Ibanez, Monica, Murillo, Claudia, Piqueras, Jose A., Sanmarti, Raimon, Berman, Horacio, Cabrera, Sonia, Ruiz, Virginia, Fontsere Paton, Oscar, Fernandez Gutierrez, Benjamin, Abasolo, Lydia, Fabregas, Maria D., Romera Baures, Montserrat, Nolla, Joan M., Gonzalez-Alvaro, Isidoro, Tomero Muriel, Eva G., Garcia Vicuna, Rosario, Fernandez Nebro, Antonio, Belmonte Lopez, Maria Angeles, Urena, Inmaculada, Irigoyen, Maria V., Coret Cagigal, Virginia, Lopez Gonzalez, Ruth, Pielfort Garrido, Daniel, Sampedro Alvarez, Juana, Garcia Aparicio, Angel Maria, Belmonte Gomez, Rebeca, Granados Bautista, Pastora, Hernandez Sanz, Azucena, Sanchez Gonzalez, Carmen O., Bachiller, Javier, Zea, Antonio, Manero, Francisco J., Jimenez Zorzo, Fernando, Gimenez Ubeda, Eugenio, Marzo Gracia, Jesus, Beltran Audera, Chesus, Medrano, Marta, Pecondon, Angela, Erausquin, Celia, Ojeda, Soledad, Carlos Quevedo, Juan, Francisco, Felix, Rodriguez Lozano, Carlos, Babio Herraez, Jesus, Lopez Longo, Francisco J., Gerona, Delia, Gonzalez Fernandez, Carlos, Carreno, Luis, Monteagudo, Indalecio, Del Pino, Javier, Sanchez Gonzalez, Maria Dolores, Corrales, Alfonso, Enriqueta Peiro, Maria, Senabre, Jose M., Rosas, Jose C., Rotes, Isabel, Moreno, Estefania, Erra, Alba, Grado, Dolors, Calvo, Javier, Rueda, Amalia, Moller, Ingrid, Rodriguez, Isabel, Barbadillo, Carmen, Raya, Enrique, Morales, Pilar, Nieto, Ana, Jimenez, Inmaculada, Magro, Cesar, Ruibal Escribano, Ana, Ros Exposito, Sergio, Sanchez Nievas, Gines, Judez Navarro, Enrique, Sianes Fernandez, Manuela, Garcia Morales, Maria Angeles, Labiano Bastero, Isabel, Consuegra, Gloria, Palmou, Natalia, Martinez Pardo, Silvia, Pujol, Manel, Riera Alonso, Elena, Salvador, Georgina, Gonzalez Alvarez, Beatriz, Cantabrana, Alberto, Bustabad, Sagrario, Delgado, Esmeralda, Alejandro Muñoz-Jiménez, Rodriguez Montero, Sergio, Maria Jimenez, Luis, Rivera Redondo, Javier, Gonzalez Hernandez, Teresa, Gonzalez Polo, Francisco J., Menor Almagro, Raul, Moreno, Jose M., Giner Serret, Emilio, Lannuzzelli Barroso, Carla, Cebrian Mendez, Laura, Teresa Navio, Maria, Fernandez Carballido, Cristina, Pagan, Encarnacion, Mesa Del Castillo, Pablo, Naredo, Esperanza, Cruz, Ana, Turrion, Ana, Mateo, Isabel, Sanchez, Julio, Galindo, Maria, Garcia Gonzalez, Javier, Collantes, Eduardo, Ruiz, Desiree, Font, Pilar, Bonilla, Gema, Lopez Meseguer, Antonio, Moreno, Manuel J., Moreno Martinez, Ma Jose, Beteta Fernandez, Ma Dolores, Linares, Luis F., Morcillo, Mercedes, Gonzalez Gomez, Maria L., Aramburu, Jose M., Rivera, Natalia A., Fernandez Berrizbeitia, Olaia, Garcia Vivar, Maria Luz, Riera, Manel, Maria Leon, Yolanda, Maymo, Joan, Amirall, Miriam, Iniesta Escolano, Silvia, Sanchez Serrano, Silvia, Lis Bona, Maria Pilar, Fiter, Jordi, Fernandez Melon, Julia, Espadaler, Luis, Maiz, Olga, Belzunegui, Joaquin, Banegil, Inmaculada, Diaz, Cesar, Valls, Ramon, Castellvi, Ivan, Bonet, Maria, Moreno Ruzafa, Estefania, Calvo Alen, Jaime, Perez Sandoval, Trinidad, Revuelta Evrard, Eva, Godo, Javier R., Fernandez Espartero, Cruz, Navarro Blasco, Francisco J., Antonio Gonzalez, Jose, and Miranda-Filloy, Jose A.

Subjects
psoriatic arthritis, lipids, cardiovascular disease, lipoprotein(a), ankylosing spondylitis, spondyloarthritis
Abstract

Objective Cardiovascular (CV) disease is one of the main causes of morbi-mortality in spondyloarthritis (SpA), partially explained by traditional CV risk factors. Information on lipoprotein(a) [Lp(a)], a non-conventional risk factor, in SpA is scarce. In this study we assessed the prevalence of hyperlipoproteinaemia(a) in SpA patients and analysed the possible related factors. Methods A baseline analysis was made of ankylosing spondylitis (AS) and psoriatic arthritis (PsA) patients and controls included in the CARMA project (CARdiovascular in RheuMAtology), a 10-year prospective study evaluating the risk of CV events in chronic inflammatory rheumatic diseases. A multivariate logistic regression model was performed using hyperlipoproteinaemia( a) (Lp(a) >50 mg/dl) as a dependent variable and adjusting for confounding factors. Results 19.2% (95% CI: 16.80-22.05) of the SpA patients [20.7% (95% CI: 16.91-24.82) of those with AS and 17.7% (95% CI: 14.15-21.75) of those with PsA] and 16.7% (95% CI: 13.23-20.86) of the controls had hyperlipoproteinaemia(a) (p=0.326). Adjusting for age and sex, SpA patients were more likely to have hyperlipoproteinaemia(a) than controls (OR: 1.43, 95% CI: 1.00-2.04; p=0.05), especially those with AS (OR: 1.81, 95% CI: 1.18-2.77; p=0.007). In the adjusted model, apolipoprotein B in all patients, non-steroidal anti-inflammatory drugs in AS, and female sex in PsA, were associated with hyperlipoproteinaemia(a). No disease-specific factors associated with hyperlipoproteinaemia(a) were identified. Conclusion SpA patients show a moderately increased risk of hyperlipoproteinaemia(a) compared to controls, especially those with AS. Lp(a) determination may be of interest to improve the CV risk assessment in SpA patients.

16. Pericarditis caused by Corynebacterium urealyticum.

Author

Ojeda-Vargas, M., Gonzalez-Fernandez, M. A., Romero, D., Cedrés, A., and Monzón-Moreno, C.

Subjects
*PERICARDITIS, *CORYNEBACTERIUM, *DYSPNEA
Abstract

Describes the case of pericarditis caused by Corynebacterium urealyticum. History of retrosternal pain and dyspnea; Absence of pericardial effusion; Etiology of pericarditis.

Published
2000
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17. OMERACT agreement and reliability study of ultrasonographic elementary lesions in osteoarthritis of the foot

Author

Alen, Zabotti, Georgios, Filippou, Marco, Canzoni, Antonella, Adinolfi, Valentina, Picerno, Greta, Carrara, Peter, Balint, George A, Bruyn, Maria Antonietta, D'Agostino, Nemanja, Damjanov, Andrea, Delle Sedie, Emilio, Filippucci, Maria Luz, Gonzalez Fernandez, Hilde Berner, Hammer, Zunaid, Karim, Peter, Mandl, Ingrid, Moller, Maria Rosario, Morales Lozano, Esperanza, Naredo, Francesco, Porta, Garifallia, Sakellariou, Lene, Terslev, Carlo Alberto, Scirè, Annamaria, Iagnocco, Chiara, Scirocco, Zabotti, A, Filippou, G, Canzoni, M, Adinolfi, A, Picerno, V, Carrara, G, Balint, P, Bruyn, G, D'Agostino, M, Damjanov, N, Delle Sedie, A, Filippucci, E, Gonzalez Fernandez, M, Hammer, H, Karim, Z, Mandl, P, Moller, I, Morales Lozano, M, Naredo, E, Porta, F, Sakellariou, G, Terslev, L, Scire, C, and Iagnocco, A

Subjects
Settore MED/16 - REUMATOLOGIA, Immunology, Osteoarthritis, Severity of Illness Index, Imaging, NO, outcomes research, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Reliability study, Humans, Immunology and Allergy, Medicine, 030212 general & internal medicine, Cartilage damage, Reliability (statistics), Observer Variation, 030203 arthritis & rheumatology, Foot, business.industry, Intraobserver reliability, osteoarthritis, outcomes research, ultrasonography, ultrasonography, Joint effusion, medicine.disease, Exercise Therapy, osteoarthritis, Health Care Surveys, osteoarthriti, medicine.symptom, business, Nuclear medicine, Kappa, Foot (unit)
Abstract

ObjectiveTo evaluate the level of agreement on ultrasonographic (US) lesions among highly experienced sonographers as well as the intraobserver and interobserver reliability of inflammatory and structural US lesions in patients with osteoarthritis (OA) of the foot.MethodsAfter a systematic literature review, a Delphi survey was performed to test definitions of US lesions in OA of the foot, including inflammatory lesions (ie, synovial hypertrophy [SH], joint effusion [JE], power Doppler signal [PD]), and structural abnormalities (ie, cartilage damage [CD] and osteophytes). Subsequently, the reliability of US in assessing the aforementioned lesions was tested on static images as well as during a live exercise. Reliability was assessed by kappa analyses and prevalence-adjusted bias-adjusted kappa (PABAK) on a dichotomous and an ordinal scale.ResultsIntraobserver and interobserver reliability for SH and JE evaluated by binary scoring was good for both components, while the intraobserver reliability for semiquantitative scoring of SH ranged from moderate in the web-based exercise (PABAK 0.49) to good (PABAK 0.8) in the live exercise. Reliability for CD and PD assessments were respectively good and excellent in all exercises (ranged from PABAK 0.61 to 0.79 for CD and 0.88 to 0.95 for PD). The interobserver reliability for the semiquantitative scoring of osteophytes was fair in the live exercise (PABAK 0.36) and moderate in the static exercise (PABAK 0.60).ConclusionsConsensual US definitions were found to be reliable for assessing inflammatory lesions in OA of the foot, while the use of US to assess structural damage requires further studies.

Published
2019
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18. Stakeholder integration predicts better outcomes from groundwater sustainability policy.

Author

Perrone D, Rohde MM, Hammond Wagner C, Anderson R, Arthur S, Atume N, Brown M, Esaki-Kua L, Gonzalez Fernandez M, Garvey KA, Heidel K, Jones WD, Khosrowshahi Asl S, Munill C, Nelson R, Ortiz-Partida JP, and Remson EJ

Abstract

Natural resources policies that promote sustainable management are critical for protecting diverse stakeholders against depletion. Although integrating diverse stakeholders into these policies has been theorized to improve protection, empirical evidence is lacking. Here, we evaluate 108 Sustainability Plans under California's Sustainable Groundwater Management Act to quantify how well stakeholders are integrated into plans and protected from groundwater depletion. We find that the majority of Sustainability Plans do not integrate or protect the majority of their stakeholders. Nevertheless, our results show that when stakeholders are more integrated into a Sustainability Plan, they are more likely to be protected, particularly for those that lack formal access to decision-making processes. Our findings provide strong empirical evidence that integrating diverse stakeholders into sustainability planning is beneficial for stakeholders who are vulnerable to the impacts of natural resource depletion., (© 2023. The Author(s).)

Published
2023
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19. Limb loading enhances skill transfer between augmented and physical reality tasks during limb loss rehabilitation.

Author

Hunt CL, Sun Y, Wang S, Shehata AW, Hebert JS, Gonzalez-Fernandez M, Kaliki RR, and Thakor NV

Subjects
Humans, Upper Extremity, Motor Skills, Physical Examination, Amputees rehabilitation, Augmented Reality
Abstract

Background: Virtual and augmented reality (AR) have become popular modalities for training myoelectric prosthesis control with upper-limb amputees. While some systems have shown moderate success, it is unclear how well the complex motor skills learned in an AR simulation transfer to completing the same tasks in physical reality. Limb loading is a possible dimension of motor skill execution that is absent in current AR solutions that may help to increase skill transfer between the virtual and physical domains., Methods: We implemented an immersive AR environment where individuals could operate a myoelectric virtual prosthesis to accomplish a variety of object relocation manipulations. Intact limb participants were separated into three groups, the load control (CG LD ; [Formula: see text]), the AR control (CG AR ; [Formula: see text]), and the experimental group (EG; [Formula: see text]). Both the CG AR and EG completed a 5-session prosthesis training protocol in AR while the CG LD performed simple muscle training. The EG attempted manipulations in AR while undergoing limb loading. The CG AR attempted the same manipulations without loading. All participants performed the same manipulations in physical reality while operating a real prosthesis pre- and post-training. The main outcome measure was the change in the number of manipulations completed during the physical reality assessments (i.e. completion rate). Secondary outcomes included movement kinematics and visuomotor behavior., Results: The EG experienced a greater increase in completion rate post-training than both the CG AR and CG LD . This performance increase was accompanied by a shorter motor learning phase, the EG's performance saturating in less sessions of AR training than the CG AR ., Conclusion: The results demonstrated that limb loading plays an important role in transferring complex motor skills learned in virtual spaces to their physical reality analogs. While participants who did not receive limb loading were able to receive some functional benefit from AR training, participants who received the loading experienced a greater positive change in motor performance with their performance saturating in fewer training sessions., (© 2023. The Author(s).)

Published
2023
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20. Effects of drugs on bone metabolism in a cohort of individuals with traumatic spinal cord injury.

Author

Kokorelis C, Gonzalez-Fernandez M, Morgan M, and Sadowsky C

Subjects
Absorptiometry, Photon, Adult, Analgesics, Opioid therapeutic use, Antidepressive Agents therapeutic use, Bone Diseases, Metabolic diagnostic imaging, Bone Diseases, Metabolic epidemiology, Calcium therapeutic use, Case-Control Studies, Fractures, Spontaneous epidemiology, Humans, Male, Middle Aged, Osteoporosis diagnostic imaging, Protective Factors, Retrospective Studies, Risk Factors, Time, Vitamin D therapeutic use, Young Adult, Anticonvulsants therapeutic use, Bone Density Conservation Agents therapeutic use, Diphosphonates therapeutic use, Osteoporosis epidemiology, Spinal Cord Injuries epidemiology
Abstract

Study Design: This study is a retrospective review examining the prevalence of drugs commonly used in the management of spinal cord injury (SCI) which may influence bone health., Objective: The aim of our study was to examine the role commonly prescribed medications play in post-SCI bone health., Setting: We included all males 21 years of age and older who were evaluated over a 10-year period at an SCI-specialized center for a trauma-induced SCI., Method: We compared characteristics of individuals with normal bone mass to those with low bone mass according to their dual-energy X-ray absorptiometry (DXA) scan. Medication lists were reviewed for the presence of drugs considered to either positively or negatively affect bone metabolism., Results: Comparing individuals with normal bone mass ( n  = 68) to those with low bone mass ( n  = 211), only "Time after Injury" and "Level of Injury" were found to influence the likelihood of having low bone mass. Multivariate analysis failed to demonstrate significant associations between bone mass and the sum of drugs which either positively or negatively affect bone metabolism. When medications were reviewed individually, only bisphosphonates and anticonvulsants were found to be significantly associated with bone mass., Conclusions: Although 76% of our cohort was found to have low bone mass, the only major risk factors were "Time after Injury" and "Level of Injury". Anticonvulsant use was more common in individuals with low bone mass compared to those with normal bone mass. Given the retrospective methodology of this work, our findings underline associations that warrant further investigation., Competing Interests: Compliance with ethical standardsThe authors declare that they have no conflict of interest.

Published
2019
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21. A multi-center analysis evaluating factors associated with spinal cord stimulation outcome in chronic pain patients.

Author

Williams KA, Gonzalez-Fernandez M, Hamzehzadeh S, Wilkinson I, Erdek MA, Plunkett A, Griffith S, Crooks M, Larkin T, and Cohen SP

Subjects
Adult, Electrodes, Implanted, Female, Humans, Male, Middle Aged, Retrospective Studies, Treatment Outcome, Chronic Pain therapy, Electric Stimulation Therapy methods, Spinal Cord physiology
Abstract

Background: In addition to its conventional use as a treatment for refractory neuropathic extremity pain, spinal cord stimulation (SCS) has recently emerged as a possible treatment for visceral and arthritic pain. But concurrent with the expansion of possible conditions amenable to SCS, other studies have questioned the long-term efficacy of SCS for traditional indications. These disparate findings argue strongly for the refinement of selection criteria. The purpose of this study is to identify correlates of outcome for SCS., Methods: Data were retrospectively collected on 244 patients who underwent a SCS trial at two academic medical centers. Success was predefined as ≥50% pain relief sustained for ≥6 months. Variables analyzed for their association with outcome included demographics, location of pain, diagnosis, presence of coexisting diseases, pain descriptors, opioid and adjuvant medication use, duration and pain relief during trial, and complications., Results: The presence of allodynia and/or hyperalgesia correlated with both a positive SCS trial (P = 0.01) and long-term implantation outcome (P = 0.05). History of substance abuse was associated with a negative permanent SCS outcome (P = 0.05) but bore no relationship to trial results. The variable most strongly associated with an SCS outcome was experiencing <50% pain relief during the trial, which strongly presaged a negative result (P < 0.001)., Conclusions: Although weak associations with outcome were noted for several clinical variables, none was strongly associated with trial and permanent implantation results. The strongest predictor of a negative SCS outcome was obtaining <50% pain relief during the trial period., (Wiley Periodicals, Inc.)

Published
2011
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22. Respiration during feeding on solid food: alterations in breathing during mastication, pharyngeal bolus aggregation, and swallowing.

Author

Matsuo K, Hiiemae KM, Gonzalez-Fernandez M, and Palmer JB

Subjects
Adult, Female, Fluoroscopy, Humans, Male, Manometry, Pharynx diagnostic imaging, Plethysmography, Respiratory Aspiration physiopathology, Signal Processing, Computer-Assisted, Time Factors, Video Recording, Deglutition, Eating, Larynx physiology, Mastication, Pharynx physiology, Respiratory Aspiration prevention & control, Respiratory Mechanics
Abstract

During feeding, solid food is chewed and propelled to the oropharynx, where the bolus gradually aggregates while the larynx remains open and breathing continues. The aggregated bolus in the valleculae is exposed to respiratory airflow, yet aspiration is rare in healthy individuals. The mechanism for preventing aspiration during bolus aggregation is unclear. One possibility is that alterations in the pattern of respiration during feeding could help prevent inhalation of food from the pharynx. We hypothesized that respiration was inhibited during bolus aggregation in the valleculae. Videofluorography was performed on 10 healthy volunteers eating solid foods with barium. Respiration was monitored concurrently with plethysmography and nasal air pressure. The timing of events during mastication, food transport, pharyngeal bolus aggregation, and swallowing were measured in relation to respiration. Respiratory cycle duration decreased during chewing (P < 0.001) but increased with swallowing (P < 0.001). During 66 recordings of vallecular bolus aggregation, there was inspiration in 8%, expiration in 41%, a pause in breathing in 17%, and multiple phases (including inspiration) in 35%. Out of 98 swallows, 47% started in the expiratory phase and 50% started during a pause in breathing, irrespective of bolus aggregation in the valleculae. Plethysmography was better than nasal manometry for determining the end of active expiration during feeding and swallowing with solid food. The hypothesis is rejected in that respiration was not inhibited during bolus aggregation. These findings suggest that airflow through the pharynx does not have a role in preventing aspiration during bolus aggregation in the oropharynx.

Published
2008
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