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4. A comparison of proximity and land use regression traffic exposure models and wheezing in infants

Author

Ryan, Patrick H., LeMasters, Grace K., Biswas, Pratim, Levin, Linda, Hu, Shaohua, Lindsey, Mark, Bernstein, David I., Lockey, James, Villareal, Manuel, Hershey, Gurjit K. Khurana, and Grinshpun, Sergey A.

Subjects
Asthma, Land use
Abstract

BACKGROUND: We previously reported an association between infant wheezing and residence < 100 m from stop-and-go bus and truck traffic. The use of a proximity model, however, may lead to [...]

Published
2007

6. Report AtlantOS fitness for offshore aquaculture siting

Author

Dale, Trine, Cusack, Caroline, Villareal, Manuel Ruiz, Dabrowski, Tomasz, Lyons, Kieran, and Carr, Ramona

Abstract

European policy intends to expand the space available to aquaculture by cultivating sites that are offshore. This presents challenges in terms of building structures, e.g., fish cages that withstand the effects of offshore weather conditions along the Atlantic coast. In order to establish possible future sites for offshore aquaculture production AtlantOS T8.5 gathered relevant wave, current velocity and water column structure measurements from the coasts of Ireland, Norway and Spain and used these data to validate site assessment models of the potential new offshore aquaculture sites. This deliverable report assesses the fitness for purpose of the generic aquaculture decision support tool developed.

Published
2019

8. Traffic-related air pollution exposure in the first year of life and behavioral scores at 7 years of age

Author

Newman, Nicholas C., Ryan, Patrick, LeMasters, Grace, Levin, Linda, Bernstein, David, Hershey, Gurjit K. Khurana, Lockey, James E., Villareal, Manuel, Reponen, Tiina, Grinshpun, Sergey, Sucharew, Heidi, and Dietrich, Kim N.

Subjects
Research, Health aspects, Environmental aspects, Air pollution research, Air pollution -- Health aspects, Child health -- Research, Automobiles -- Health aspects -- Environmental aspects, Children -- Health aspects
Abstract

Ultrafine particles (UFP; < 100 nm in diameter) are implicated in the pathophysiology of air pollution-related disease (Zanobetti and Schwartz 2009). Research in animals and humans demonstrates that the brain [...], BACKGROUND: There is increasing concern about the potential effects of traffic-related air pollution (TRAP) on the developing brain. The impact of TRAP exposure on childhood behavior is not fully understood because of limited epidemiologic studies. OBJECTIVE: We explored the association between early-life exposure to TRAP using a surrogate, elemental carbon attributed to traffic (ECAT), and attention deficit/hyperactivity disorder (ADHD) symptoms at 7 years of age. METHODS: From the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS) birth cohort we collected data on exposure to ECAT during infancy and behavioral scores at 7 years of age. Children enrolled in CCAAPS had at least one atopic parent and a birth residence either < 400 m or > 1,500 m from a major highway. Children were followed from infancy through 7 years of age. ECAT exposure during the first year of life was estimated based on measurements from 27 air sampling sites and land use regression modeling. Parents completed the Behavioral Assessment System for Children, 2nd Edition, when the child was 7 years of age. ADHD-related symptoms were assessed using the Hyperactivity, Attention Problems, Aggression, Conduct Problems, and Atypicality subscales. RESULTS: Exposure to the highest tertile of ECAT during the child&apos;s first year of life was significantly associated with Hyperactivity T-scores in the "at risk" range at 7 years of age, after adjustment [adjusted odds ratio (aOR) = 1.7; 95% CI: 1.0, 2.7]. Stratification by maternal education revealed a stronger association in children whose mothers had higher education (aOR = 2.3; 95% CI: 1.3, 4.1). CONCLUSIONS: ECAT exposure during infancy was associated with higher Hyperactivity scores in children; this association was limited to children whose mothers had more than a high school education. KEY WORDS: attention deficit/hyperactivity disorder, child behavior, epidemiology, land use regression, traffic-related air pollution. Environ Health Perspect 121:731-736 (2013). http://dx.doi.org/10.1289/ehp.1205555 [Online 21 May 2013]

Published
2013
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11. Early-life mold and tree sensitivity is associated with allergic eosinophilic rhinitis at age four

Author

Codispoti, Christopher D., Bernstein, David I., Levin, Linda, Reponen, Tiina, Ryan, Patrick H., Biagini Myers, Jocelyn M, Villareal, Manuel, Burkle, Jeff, Lummus, Zana, Lockey, James E., Khurana Hershey, Gurjit K., and LeMasters, Grace K.

Subjects
Male, Rhinitis, Allergic, Perennial, Penicillium, Acer, Allergens, Article, Eosinophils, Nasal Mucosa, Child, Preschool, Eosinophilia, Humans, Female, Prospective Studies, Biomarkers, Skin Tests
Abstract

Nasal eosinophils are a biomarker for allergic rhinitis (AR) and are associated with increased symptom severity.To identify predictors of allergic eosinophilic rhinitis (AER) in early childhood in children at higher risk for chronic allergic respiratory disorders.In the Cincinnati Childhood Allergy and Air Pollution Study, infants born to aeroallergen-sensitized and symptomatic parents were examined and underwent skin prick testing (SPT) annually to 15 aeroallergens from 1 to 4 years of age. Wheal circumferences were traced and scanned and areas were determined by computer planimetry. At 4 years, AER was defined as (1) at least 1 positive aeroallergen SPT result, (2) presence of sneezing and runny nose without a cold or influenza, and (3) nasal eosinophilia of at least 5%. Wheal areas at 1 to 3 years were analyzed for an association with AER compared with children without AR.At 4 years, 487 children completed rhinitis health histories, SPT, and nasal sampling. Ninety-nine children (22.8%) had AR. Thirty-eight children had AER (8.8% of total sample and 38.4% of AR sample, respectively). At 3 years, for every 1-mm(2) increase in Penicillium species (adjusted odds ratio 1.18, 95% confidence interval 1.06-1.32, P = .002) and maple (adjusted odds ratio 1.07, 95% confidence interval 1.01-1.13, P = .02), wheal area significantly increased the risk of AER at 4 years of age.Allergic eosinophilic rhinitis was identified in 8.8% of children at 4 years of age. Age 3 years was the earliest that aeroallergen SPT wheal areas were predictive of AER. Skin testing at 3 years identifies children at risk for an AR phenotype with nasal eosinophilia.

Published
2015

12. Early transformation of the Mediterranean Outflow Water (MOW) in the Gulf Of Cádiz, SW Iberian Peninsula: pathways, mixing and temporal variability

Author

Sánchez Leal, Ricardo, Sanchez-Garrido, Jose Carlos, Bellanco Esteban, María Jesús, Ruiz Villareal, Manuel, and González-Pola Muñiz, César

Subjects
Oceanografia física
Abstract

The inverse estuarine circulation through the strait of Gibraltar is responsible for the overflow of dense, saline MOW towards the Atlantic basin. Initially as a gravity undercurrent, the MOW entrains large amounts of the overlying Eastern North Atlantic CentralWater to become a multi-layered, buoyant plume at depths of 800-1300 m past Cape St. Vincent. Much of the entrainment occurs within 100 km of the Strait over a highly abrupt topography. In this work we analyze a repeated series of high-resolution CTD-LADCP observations along a number of standard sections crossing the early MOW. These data show that from the Strait of Gibraltar, the bottom-trapped flow bifurcates in the vicinity of the topographic features, diverting or rejoining the main MOWpath as a function of the orientation of channels and valleys. As it turns anticyclonically, the undercurrent exhibits a cross-axis geostrophic gradient, with the margin closer to the slope being in near-geostrophic balance whereas the distal band is largely ageostrophic due to the flow curvature. Mixing is steered by the interplay of tidal stirring, bottom roughness, shear instability and double diffusion along the MOWpath. Data also shows that seasonal variability is mostly related to the fluctuations in the overlying layer rather than to MOW dynamics. This is a contribution to INGRES3 project (Mediterranean outflow at Gibraltar, its influence on deep Mediterranean water ventilation and first transformation and coupling with North-Atlantic central waters in the Gulf of Cádiz, CTM2010_21229) Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Published
2014

13. Influencia del peso corporal a las 22 semanas de edad en pollas leghorn sobre la producción y peso del huevo

Author

Edmundo Enrique Rojas R., Ernesto Avila G., and Villareal Manuel

Subjects
Pollas leghorn, Animal culture, SF1-1100, Veterinary medicine, SF600-1100
Abstract

Se realizó un experimento de 46 semanas de duración para observar el efecto del peso corporal en aves de 22 semanas de edad sobre el % de postura, consumo de alimento, peso promedio del huevo y la conversión alimenticia. Se utilizaron 180 pollas Leghom blancas seleccionadas a las 20 semanas de edad y puestas en jaulas individuales para aves en postura de acuerdo en el peso en: pesadas, ligeras y medianas. Las gallinas a las 22 semanas de edad pesaron en promedio: 1.267 kg las aves ligeras, 1.470 kg las medianas y 1.579 kg las pesadas. Los datos de este estudio indicaron diferencias significativas entre tratamientos resultando las gallinas pesadas las mejores en producción de huevo, peso del mismo y conversión alimenticia. El peso corporal a las 22 semanas de edad estuvo altamente correlacionado (P

Published
1977

14. Hydrography of the Pontevedra Ria: Intra-annual spatial and temporal variability in a Galician coastal system (NW Spain)

Author

Prego, Ricardo, Dale, Andrew W., deCastro, Maite, Gómez-Gesteira, Moncho, Taboada, Juan J., Montero, Pedro, Villareal, Manuel R., Pérez-Villar, Vicente, Prego, Ricardo, Dale, Andrew W., deCastro, Maite, Gómez-Gesteira, Moncho, Taboada, Juan J., Montero, Pedro, Villareal, Manuel R., and Pérez-Villar, Vicente

Abstract

In order to ameliorate the dearth of existing scientific knowledge concerning the hydrography of the Pontevedra Ria, a systematic investigation was carried out between October 1997-98. Salinity variations were closely related to river discharge whereas bottom waters presented oceanic characteristics over the whole year. Current was controlled by tide, river discharge, and wind in the internal ria where the highest velocities were directed along the ria channel with a low transverse component. Favorable atmospheric conditions in spring induced coastal upwelling up the continental shelf. In May the upwelling was sufficiently strong to be detected in the inner ria and intensified in July and August, cooling the ria water to 12 degrees -14 degreesC. Upwelling ceased in September, and from November to March seawater transported by the poleward current (35.9; 15 degreesC) was detected on the shelf. From January until March, unanticipated favorable upwelling conditions provoked an influx of poleward inside the ria. Ria intrusion of poleward water and association with occasional winter upwelling conditions has not been observed previously. Isopycnic three-dimensional (3-D) surface and 2-D isopycnal maps show that with high river runoff or intense upwelling, lower-salinity water leaves the ria near the northern margin in the surface layer. Under negative upwelling conditions, the water is partially dammed inside the ria and exits the ria when the wind speed falls. During upwelling events, ENACW penetrated the ria, especially near the southern shore. Arrival of ENACW at the northern entrance impedes the outward water flow through this mouth.

Published
2001
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15. Hydrography of the Pontevedra Ria: Intra-annual spatial and temporal variability in a Galician coastal system (NW Spain)

Author

Prego, R., Dale, Andrew W., Castro, Maite de, Gómez-Gesteira, Moncho, Taboada, Juan José, Montero, Pedro, Villareal, Manuel R., Pérez-Villar, Vicente, Prego, R., Dale, Andrew W., Castro, Maite de, Gómez-Gesteira, Moncho, Taboada, Juan José, Montero, Pedro, Villareal, Manuel R., and Pérez-Villar, Vicente

Abstract

In order to ameliorate the dearth of existing scientific knowledge concerning the hydrography of the Pontevedra Ria, a systematic investigation was carried out between October 1997–98. Salinity variations were closely related to river discharge whereas bottom waters presented oceanic characteristics over the whole year. Current was controlled by tide, river discharge, and wind in the internal ria where the highest velocities were directed along the ria channel with a low transverse component. Favorable atmospheric conditions in spring induced coastal upwelling up the continental shelf. In May the upwelling was sufficiently strong to be detected in the inner ria and intensified in July and August, cooling the ria water to 12°–14°C. Upwelling ceased in September, and from November to March seawater transported by the poleward current (35.9; 15°C) was detected on the shelf. From January until March, unanticipated favorable upwelling conditions provoked an influx of poleward inside the ria. Ria intrusion of poleward water and association with occasional winter upwelling conditions has not been observed previously. Isopycnic three-dimensional (3-D) surface and 2-D isopycnal maps show that with high river runoff or intense upwelling, lower-salinity water leaves the ria near the northern margin in the surface layer. Under negative upwelling conditions, the water is partially dammed inside the ria and exits the ria when the wind speed falls. During upwelling events, ENACW penetrated the ria, especially near the southern shore. Arrival of ENACW at the northern entrance impedes the outward water flow through this mouth.

Published
2001

16. Relative moldiness index as predictor of childhood respiratory illness

Author

Vesper, Stephen J, primary, Mckinstry, Craig, additional, Haugland, Richard A, additional, Iossifova, Yulia, additional, Lemasters, Grace, additional, Levin, Linda, additional, Khurana Hershey, Gurjit K, additional, Villareal, Manuel, additional, Bernstein, David I, additional, Lockey, James, additional, and Reponen, Tiina, additional

Published
2006
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18. Integración de los modelos curriculares que estandarizan la formación en cardiología a nivel mundial y su aplicación a nivel nacional

Author

Argüelles Argüello, Ana Beatriz, Brenes Solano, Daniel Eduardo, Bolaños Gómez, Carlos Eduardo, and Vindas Villareal, Manuel Antonio

Subjects
CIENCIAS DE LA EDUCACIÓN, ENSEÑANZA SUPERIOR, CURSO POSTUNIVERSITARIO, PLAN DE ESTUDIOS
Abstract

El presente trabajo de graduación se realizó con el fin de contribuir a la formación médica nacional. Se realizó una investigación para justificar la importancia de contar con la posibilidad de especializarse en cardiología en el país. Se enfatiza el déficit numérico de esta especialidad para poder brindar servicio adecuado a la población costarricense actual. Buscando preservar la excelencia académica que ha caracterizado al Posgrado de Cardiología de la Universidad de Costa Rica, se actualizó el contenido de los temas a abordar durante la residencia. Si bien no se ha dejado de lado el perfil clásico del cardiólogo experto en semiología y electrocardiografía, en la actualidad, las nuevas tecnologías diagnósticas y terapéuticas cardiovasculares han expandido sustancialmente el conocimiento que el cardiólogo tiene que adquirir durante su residencia para brindar una atención de calidad a todos los pacientes. Con esto en mente, se analizaron las más prominentes mallas curriculares a nivel mundial, modelos europeo y norteamericano, para tratar de incluirlos en la realidad de nuestro posgrado mediante un planteamiento exhaustivo y detallado, pero a la vez preciso, de cada uno de los conocimientos y destrezas clínicas que el estudiante debe adquirir durante los cinco años que cursa el programa. UCR::Vicerrectoría de Investigación::Sistema de Estudios de Posgrado::Salud::Especialidad en Cardiología

Published
2022

19. Onset of effect and impact on health-related quality of life, exacerbation rate, lung function, and nasal polyposis symptoms for patients with severe eosinophilic asthma treated with benralizumab (ANDHI): a randomised, controlled, phase 3b trial

Author

Harrison, Tim W, Chanez, Pascal, Menzella, Francesco, Canonica, Giorgio Walter, Louis, Renaud, Cosio, Borja G, Lugogo, Njira L, Mohan, Arjun, Burden, Annie, McDermott, Lawrence, Garcia Gil, Esther, Zangrilli, James G, Wolfgang Pohl, Robert Voves, Maud Deschampheleire, Renaud Louis, Jean-Benoit Martinot, Rudi Peché, Kenneth Chapman, Amarjit Cheema, Delbert Dorscheid, J Mark FitzGerald, Remi Gagnon, William Patrick Killorn, Ronald Olivenstein, George Philteos, Clare Ramsey, J Douglass Rolf, Brandie Walker, Ole Hilberg, Tina Skjold, Ingrid Titlestad, Auli Hakulinen, Maritta Kilpeläinen, Michèle Ben Hayoun, Philippe Bonniaud, Arnaud Bourdin, Pascal Chanez, Frédéric De Blay, Gaëtan Deslee, Gilles Devouassoux, Alain Didier, Youcef Douadi, Stéphanie Fry, Gilles Garcia, Pierre-Olivier Girodet, Christophe Leroyer, Antoine Magnan, Guillaume Mahay, Cécilia Nocent, Christophe Pison, Pauline-Marie Roux, Camille Taillé, Juliana-Angelica Tiotiu, Ekkehard Beck, Margret Jandl, Christian Kaehler, Frank Kässner, Frank Koesters, Juliane Kronsbein, Thomas Schaum, Christian Schulz, Dirk Skowasch, Christian Taube, Tobias Welte, Andrés de Roux, Bianca Beghé, Francesco Blasi, Giorgio Walter Canonica, Giovanna Carpagnano, Cristiano Caruso, Angelo Guido Corsico, Elio Constantino, Nunzio Crimi, Piero Maestrelli, Francesco Menzella, Manlio Milanese, Alberto Papi, Girolamo Pelaia, Laura Pini, Pierachille Santus, Eleonora Savi, Nicola Scichilone, Gianenrico Senna, Giuseppe Spadaro, Adriano Vaghi, Steven Gans, Jurgen Hölters, B Langeveld, Willem Pieters, G H A Staaks, Ilonka van Veen, J W K van den Berg, Gunnar Einvik, Sverre Lehmann, Ismael Ali García, Carlos Almonacid, Irina Bobolea, Paloma Campo Mozo, Gustavo de Luiz, Christian Domingo Ribas, José María Echave-Sustaeta María-Tomé, Juan Luis García Rivero, Borja García-Cosío Piqueras, Ana Gómez-Bastero Fernández, Ruperto González Pérez, Aythamy Henríquez Santa, Carlos Martínez Rivera, Xavier Muñoz Gall, Jacinto Ramos, Jose Gregorio Soto Campos, Carmen Vidal Pan, Nikolai Stenfors, Alf Tunsäter, Ines Vinge, Rekha Chaudhuri, Timothy Harrison, Adel Mansur, Shuaib Nasser, Monica Nordstrom, Paul Pfeffer, Dinesh Saralaya, Philip Short, Arun Adlakha, Oral Alpan, Francis Averill, Anil Badhwar, Jose Bardelas, Barbara Baxter, George Bensch, William Berger, Jonathan Bernstein, Tracy Bridges, Ryan Brimeyer, William Calhoun, Edward Campbell, William Brett Cherry, Geoffrey Chupp, Lee Clore, John Cohn, Jeremy Cole, John Condemi, James Cury, Benjamin Davis, Samuel DeLeon, Luis Delacruz, Joseph Diaz, David Erb, Emeka Eziri, Faisal Fakih, Douglas Fiedler, David Fost, Stephen Fritz, Erika Gonzalez, Brad Goodman, Peter Gottlieb, Gregory Gottschlich, Richard Gower, Rizan Hajal, James Harris, Hengameh Heidarian-Raissy, Albrecht Heyder, David Hill, Fernando Holguin, Iftikhar Hussain, Jonathan Illowite, Joshua Jacobs, Mikell Jarratt, Harold Kaiser, Neil Kao, Ravindra Kashyap, David Kaufman, Edward Kent, Kenneth Kim, Ryan Klein, Monica Kraft, Ritsu Kono, Shahrukh Kureishy, Jeffrey Leflein, Mila Leong, Huamin Li, Robert Lin, Njira Lugogo, Michael Marcus, Diego Jose Maselli Caceres, Vinay Mehta, Curtis Mello, Mark Millard, Aaron Milstone, Arjun Mohan, Wendy Moore, Mark Moss, Nayla Mumneh, Thomas O'Brien, David Ostransky, Michael Palumbo, Purvi Parikh, Sudhir Parikh, Amit Patel, Guido Perez, Warren Pleskow, Bruce Prenner, Dileep Puppala, John Ramey, Joan Reibman, Ramon Reyes, Emory Robinette, Ileana Rodicio, Stephen Ryan, Sudhir Sekhsaria, Barry Sigal, Vinay Sikand, Weily Soong, Selwyn Spangenthal, Roy St John, Gary Steven, Vijay Subramaniam, Kaharu Sumino, Eric Sztejman, Ricardo A Tan, Tonny Tanus, Charles Thompson, Carl Thornblade, Manuel Villareal, Sally Wenzel, Heidi Zafra, Tomasz Ziedalski, Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Pathologies Pulmonaires et Plasticité Cellulaire - UMR-S 1250 (P3CELL), Université de Reims Champagne-Ardenne (URCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Tim W, Harrison, Pascal, Chanez, Francesco, Menzella, Giorgio Walter, Canonica, Renaud, Loui, Borja G, Cosio, Njira L, Lugogo, Arjun, Mohan, Annie, Burden, Lawrence, Mcdermott, Esther, Garcia Gil, Zangrilli, G, Jame, Pohl, Wolfgang, Voves, Robert, Deschampheleire, Maud, Louis, Renaud, Martinot, Jean-Benoit, Peché, Rudi, Chapman, Kenneth, Cheema, Amarjit, Dorscheid, Delbert, Mark FitzGerald, J, Gagnon, Remi, Patrick Killorn, William, Olivenstein, Ronald, Philteos, George, Ramsey, Clare, Douglass Rolf, J, Walker, Brandie, Hilberg, Ole, Skjold, Tina, Titlestad, Ingrid, Hakulinen, Auli, Kilpeläinen, Maritta, Ben Hayoun, Michèle, Bonniaud, Philippe, Bourdin, Arnaud, Chanez, Pascal, De Blay, Frédéric, Deslee, Gaëtan, Devouassoux, Gille, Didier, Alain, Douadi, Youcef, Fry, Stéphanie, Garcia, Gille, Girodet, Pierre-Olivier, Leroyer, Christophe, Magnan, Antoine, Mahay, Guillaume, Nocent, Cécilia, Pison, Christophe, Roux, Pauline-Marie, Taillé, Camille, Tiotiu, Juliana-Angelica, Beck, Ekkehard, Jandl, Margret, Kaehler, Christian, Kässner, Frank, Koesters, Frank, Kronsbein, Juliane, Schaum, Thoma, Schulz, Christian, Skowasch, Dirk, Taube, Christian, Welte, Tobia, de Roux, André, Beghé, Bianca, Blasi, Francesco, Walter Canonica, Giorgio, Carpagnano, Giovanna, Caruso, Cristiano, Guido Corsico, Angelo, Constantino, Elio, Crimi, Nunzio, Maestrelli, Piero, Menzella, Francesco, Milanese, Manlio, Papi, Alberto, Pelaia, Girolamo, Pini, Laura, Santus, Pierachille, Savi, Eleonora, Scichilone, Nicola, Senna, Gianenrico, Spadaro, Giuseppe, Vaghi, Adriano, Gans, Steven, Hölters, Jurgen, Langeveld, B, Pieters, Willem, A Staaks, G H, van Veen, Ilonka, K van den Berg, J W, Einvik, Gunnar, Lehmann, Sverre, Ali García, Ismael, Almonacid, Carlo, Bobolea, Irina, Campo Mozo, Paloma, de Luiz, Gustavo, Domingo Ribas, Christian, María Echave-Sustaeta María-Tomé, José, Luis García Rivero, Juan, García-Cosío Piqueras, Borja, Gómez-Bastero Fernández, Ana, González Pérez, Ruperto, Henríquez Santa, Aythamy, Martínez Rivera, Carlo, Muñoz Gall, Xavier, Ramos, Jacinto, Gregorio Soto Campos, Jose, Vidal Pan, Carmen, Stenfors, Nikolai, Tunsäter, Alf, Vinge, Ine, Chaudhuri, Rekha, Harrison, Timothy, Mansur, Adel, Nasser, Shuaib, Nordstrom, Monica, Pfeffer, Paul, Saralaya, Dinesh, Short, Philip, Adlakha, Arun, Alpan, Oral, Averill, Franci, Badhwar, Anil, Bardelas, Jose, Baxter, Barbara, Bensch, George, Berger, William, Bernstein, Jonathan, Bridges, Tracy, Brimeyer, Ryan, Calhoun, William, Campbell, Edward, Brett Cherry, William, Chupp, Geoffrey, Clore, Lee, Cohn, John, Cole, Jeremy, Condemi, John, Cury, Jame, Davis, Benjamin, Deleon, Samuel, Delacruz, Lui, Diaz, Joseph, Erb, David, Eziri, Emeka, Fakih, Faisal, Fiedler, Dougla, Fost, David, Fritz, Stephen, Gonzalez, Erika, Goodman, Brad, Gottlieb, Peter, Gottschlich, Gregory, Gower, Richard, Hajal, Rizan, Harris, Jame, Heidarian-Raissy, Hengameh, Heyder, Albrecht, Hill, DAVID STANLEY, Holguin, Fernando, Hussain, Iftikhar, Illowite, Jonathan, Jacobs, Joshua, Jarratt, Mikell, Kaiser, Harold, Kao, Neil, Kashyap, Ravindra, Kaufman, David, Kent, Edward, Kim, Kenneth, Klein, Ryan, Kraft, Monica, Kono, Ritsu, Kureishy, Shahrukh, Leflein, Jeffrey, Leong, Mila, Li, Huamin, Lin, Robert, Lugogo, Njira, Marcus, Michael, Jose Maselli Caceres, Diego, Mehta, Vinay, Mello, Curti, Millard, Mark, Milstone, Aaron, Mohan, Arjun, Moore, Wendy, Moss, Mark, Mumneh, Nayla, O'Brien, Thoma, Ostransky, David, Palumbo, Michael, Parikh, Purvi, Parikh, Sudhir, Patel, Amit, Perez, Guido, Pleskow, Warren, Prenner, Bruce, Puppala, Dileep, Ramey, John, Reibman, Joan, Reyes, Ramon, Robinette, Emory, Rodicio, Ileana, Ryan, Stephen, Sekhsaria, Sudhir, Sigal, Barry, Sikand, Vinay, Soong, Weily, Spangenthal, Selwyn, St John, Roy, Gary, Steven, Subramaniam, Vijay, Sumino, Kaharu, Sztejman, Eric, A Tan, Ricardo, Tanus, Tonny, Thompson, Charle, Thornblade, Carl, Villareal, Manuel, Wenzel, Sally, Zafra, Heidi, Ziedalski, Tomasz, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Service de pneumologie, Harrison T.W., Chanez P., Menzella F., Canonica G.W., Louis R., Cosio B.G., Lugogo N.L., Mohan A., Burden A., McDermott L., Garcia Gil E., Zangrilli J.G., Pohl W., Voves R., Deschampheleire M., Martinot J.-B., Peche R., Chapman K., Cheema A., Dorscheid D., FitzGerald J.M., Gagnon R., Killorn W.P., Olivenstein R., Philteos G., Ramsey C., Rolf J.D., Walker B., Hilberg O., Skjold T., Titlestad I., Hakulinen A., Kilpelainen M., Ben Hayoun M., Bonniaud P., Bourdin A., De Blay F., Deslee G., Devouassoux G., Didier A., Douadi Y., Fry S., Garcia G., Girodet P.-O., Leroyer C., Magnan A., Mahay G., Nocent C., Pison C., Roux P.-M., Taille C., Tiotiu J.-A., Beck E., Jandl M., Kaehler C., Kassner F., Koesters F., Kronsbein J., Schaum T., Schulz C., Skowasch D., Taube C., Welte T., de Roux A., Beghe B., Blasi F., Carpagnano G., Caruso C., Corsico A.G., Constantino E., Crimi N., Maestrelli P., Milanese M., Papi A., Pelaia G., Pini L., Santus P., Savi E., Scichilone N., Senna G., Spadaro G., Vaghi A., Gans S., Holters J., Langeveld B., Pieters W., Staaks G.H.A., van Veen I., van den Berg J.W.K., Einvik G., Lehmann S., Ali Garcia I., Almonacid C., Bobolea I., Campo Mozo P., de Luiz G., Domingo Ribas C., Echave-Sustaeta Maria-Tome J.M., Garcia Rivero J.L., Garcia-Cosio Piqueras B., Gomez-Bastero Fernandez A., Gonzalez Perez R., Henriquez Santa A., Martinez Rivera C., Munoz Gall X., Ramos J., Gregorio Soto Campos J., Vidal Pan C., Stenfors N., Tunsater A., Vinge I., Chaudhuri R., Harrison T., Mansur A., Nasser S., Nordstrom M., Pfeffer P., Saralaya D., Short P., Adlakha A., Alpan O., Averill F., Badhwar A., Bardelas J., Baxter B., Bensch G., Berger W., Bernstein J., Bridges T., Brimeyer R., Calhoun W., Campbell E., Cherry W.B., Chupp G., Clore L., Cohn J., Cole J., Condemi J., Cury J., Davis B., DeLeon S., Delacruz L., Diaz J., Erb D., Eziri E., Fakih F., Fiedler D., Fost D., Fritz S., Gonzalez E., Goodman B., Gottlieb P., Gottschlich G., Gower R., Hajal R., Harris J., Heidarian-Raissy H., Heyder A., Hill D., Holguin F., Hussain I., Illowite J., Jacobs J., Jarratt M., Kaiser H., Kao N., Kashyap R., Kaufman D., Kent E., Kim K., Klein R., Kraft M., Kono R., Kureishy S., Leflein J., Leong M., Li H., Lin R., Lugogo N., Marcus M., Maselli Caceres D.J., Mehta V., Mello C., Millard M., Milstone A., Moore W., Moss M., Mumneh N., O'Brien T., Ostransky D., Palumbo M., Parikh P., Parikh S., Patel A., Perez G., Pleskow W., Prenner B., Puppala D., Ramey J., Reibman J., Reyes R., Robinette E., Rodicio I., Ryan S., Sekhsaria S., Sigal B., Sikand V., Soong W., Spangenthal S., St. John R., Steven G., Subramaniam V., Sumino K., Sztejman E., Tan R.A., Tanus T., Thompson C., Thornblade C., Villareal M., Wenzel S., Zafra H., Ziedalski T., and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Pulmonary and Respiratory Medicine, Spirometry, Adult, Male, medicine.medical_specialty, Exacerbation, [SDV]Life Sciences [q-bio], Population, Settore MED/10 - Malattie Dell'Apparato Respiratorio, Placebo, Antibodies, Monoclonal, Humanized, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Double-Blind Method, Internal medicine, medicine, Humans, 030212 general & internal medicine, Anti-Asthmatic Agents, Patient Reported Outcome Measures, education, Sinusitis, Asthma, education.field_of_study, medicine.diagnostic_test, business.industry, Middle Aged, medicine.disease, Benralizumab, 3. Good health, Eosinophils, 030228 respiratory system, chemistry, Asthma Control Questionnaire, Disease Progression, Quality of Life, Female, business
Abstract

Background: ANDHI was done to assess the efficacy of benralizumab, including onset of effect and impact on health-related quality of life (HRQOL), exacerbation rate, lung function, and nasal polyposis symptoms. Methods: This phase 3b, randomised, double-blind, parallel-group, placebo-controlled ANDHI study was completed in adults (aged 18–75 years) with severe eosinophilic asthma with at least 2 exacerbations in the previous year, despite high-dose inhaled corticosteroid plus additional controllers, screening blood eosinophil counts of at least 150 cells per μL, and an Asthma Control Questionnaire 6 (ACQ-6) score of 1·5 or more. Patients who met eligibility criteria were randomly assigned (2:1; stratified by previous exacerbation count [two, or three or more], maintenance oral corticosteroid use, and region), using an integrated web-based response system, to receive benralizumab at 30 mg every 8 weeks (first three doses given 4 weeks apart) or matched placebo for 24 weeks. Primary efficacy measure was annualised asthma exacerbation rate, with rate ratio (RR) calculated over the approximate 24-week follow-up. Secondary efficacy measures included change from baseline to end of treatment (week 24) in St George's Respiratory Questionnaire (SGRQ) total score (key secondary endpoint), FEV1, peak expiratory flow (PEF), ACQ-6, Predominant Symptom and Impairment Assessment (PSIA), Clinician Global Impression of Change (CGI-C), Patient Global Impression of Change (PGI-C), and Sino-Nasal Outcome Test-22 (SNOT-22). All efficacy analyses, except for SNOT-22, were summarised and analysed using the full analysis set on an intention-to-treat population (all randomly assigned patients receiving investigational product, regardless of protocol adherence or continued participation in the study). SNOT-22 was summarised for the subgroup of patients with physician-diagnosed nasal polyposis with informed consent. This study is registered with ClinicalTrials.gov, NCT03170271. Findings: Between July 7, 2017, and Sept 25, 2019, 656 patients received benralizumab (n=427) or placebo (n=229). Baseline characteristics were consistent with severe eosinophilic asthma. Benralizumab significantly reduced exacerbation risk by 49% compared with placebo (RR estimate 0·51, 95% CI 0·39–0·65; p5%) were nasopharyngitis (30 [7%]), headache (37 [9%]), sinusitis (28 [7%]), bronchitis (22 [5%]), and pyrexia (26 [6%]). Fewer serious adverse events were reported for benralizumab (23 [5%]) versus placebo (25 [11%]), and the only common serious adverse event (experienced by >1% of patients) was worsening of asthma, which was reported for nine (2%) patients in the benralizumab group and nine (4%) patients in the placebo group. Interpretation: Our results extend the efficacy profile of benralizumab for patients with severe eosinophilic asthma, showing early clinical benefits in patient-reported outcomes, HRQOL, lung function, and nasal polyposis symptoms. Funding: AstraZeneca.

Published
2021
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20. Caracterización epidemiológica de las personas con prueba de esfuerzo con ejercicio positiva por isquemia miocárdica realizadas en el Hospital Dr. Rafael Ángel Calderón Guardia entre el año 2018 y 2019

Author

Monge Carvajal, Carlos, Vindas Villareal, Manuel, and Vindas Villarreal, Manuel Antonio

Subjects
Prueba de Esfuerzo con ejercicio
Abstract

Introducción: La cardiopatía isquémica es la principal causa de mortalidad a nivel mundial. Para realizar una detección adecuada de esta patología existen múltiples estudios diagnósticos. Uno de ellos es la Prueba de Esfuerzo con Ejercicio, la cual es una prueba no invasiva, que a nivel mundial tiene una sensibilidad del 66% y especificidad del 57%. Con el advenimiento de nuevas técnicas de imágenes cardiacas no invasivas, es necesario evaluar la vigencia de la prueba de esfuerzo en los servicios de cardiología de los hospitales nacionales. Materiales y Métodos: Los datos fueron adquiridos de la base de datos de pruebas de esfuerzo del servicio de cardiología del Hospital Dr. Rafael Ángel Calderón Guardia. De ella se extraen los datos de 136 pacientes los cuales fueron reportados como “prueba de esfuerzo positiva por inducción de isquemia”, esto en el periodo comprendido entre el 01 de enero del 2018 y el 31 de diciembre de 2019. Se analizaron los datos a través de tablas de asociación o contingencia, así como por medio de estadística de tendencia central y asimetrías. Posteriormente se aplicaron modelos de regresión univariable y multivariable para establecer relaciones. Resultados y Conclusiones: Para el periodo de tiempo elegido, se obtuvo una sensibilidad de 68% y una especificidad del 55% para el diagnóstico de enfermedad arterial coronaria con la prueba de esfuerzo con ejercicio. Con los datos obtenidos en la base de datos, no es posible establecer un perfil de mayor certeza diagnóstica en quien la prueba sea reportada como positiva por inducción de isquemia; ya que no se observó diferencia estadísticamente significativa por sexo, edad, y la presencia de comorbilidades como hipertensión arterial, diabetes mellitus, tabaquismo o la presencia de enfermedad arterial coronaria conocida de previo. UCR::Vicerrectoría de Investigación::Sistema de Estudios de Posgrado::Salud::Especialidad en Cardiología

Published
2021

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