Author: "Bruix" / Topic: humans - Searchworks@Jio Institute Digital Library Search Results

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1. BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update

Author: Reig, Maria, Forner, Alejandro, Rimola, Jordi, Ferrer-Fàbrega, Joana, Burrel, Marta, Garcia-Criado, Ángeles, Kelley, Robin K, Galle, Peter R, Mazzaferro, Vincenzo, Salem, Riad, Sangro, Bruno, Singal, Amit G, Vogel, Arndt, Fuster, Josep, Ayuso, Carmen, and Bruix, Jordi
Subjects: Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Clinical Research, Cancer, Rare Diseases, Liver Disease, Liver Cancer, Digestive Diseases, Clinical Trials and Supportive Activities, Good Health and Well Being, Carcinoma, Hepatocellular, Female, Humans, Liver Neoplasms, Male, Middle Aged, Neoplasm Staging, Prognosis, Severity of Illness Index, HCC, survival, BCLC, ablation, surgery, liver transplantation TACE, TARE, systemic treatment, ALBI score, AFP, Clinical Sciences, Public Health and Health Services, Gastroenterology & Hepatology, Clinical sciences
Abstract: There have been major advances in the armamentarium for hepatocellular carcinoma (HCC) since the last official update of the Barcelona Clinic Liver Cancer prognosis and treatment strategy published in 2018. Whilst there have been advances in all areas, we will focus on those that have led to a change in strategy and we will discuss why, despite being encouraging, data for select interventions are still too immature for them to be incorporated into an evidence-based model for clinicians and researchers. Finally, we describe the critical insight and expert knowledge that are required to make clinical decisions for individual patients, considering all of the parameters that must be considered to deliver personalised clinical management.
Published: 2022

2. Safety, Efficacy, and Pharmacodynamics of Tremelimumab Plus Durvalumab for Patients With Unresectable Hepatocellular Carcinoma: Randomized Expansion of a Phase I/II Study

Author: Kelley, Robin Kate, Sangro, Bruno, Harris, William, Ikeda, Masafumi, Okusaka, Takuji, Kang, Yoon-Koo, Qin, Shukui, Tai, David W-M, Lim, Ho Yeong, Yau, Thomas, Yong, Wei-Peng, Cheng, Ann-Lii, Gasbarrini, Antonio, Damian, Silvia, Bruix, Jordi, Borad, Mitesh, Bendell, Johanna, Kim, Tae-You, Standifer, Nathan, He, Philip, Makowsky, Mallory, Negro, Alejandra, Kudo, Masatoshi, and Abou-Alfa, Ghassan K
Subjects: Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, HIV/AIDS, Orphan Drug, Rare Diseases, Cancer, Biotechnology, Clinical Research, Digestive Diseases, Clinical Trials and Supportive Activities, Liver Cancer, Patient Safety, Liver Disease, Evaluation of treatments and therapeutic interventions, 6.1 Pharmaceuticals, 6.2 Cellular and gene therapies, Adult, Aged, Aged, 80 and over, Antibodies, Monoclonal, Humanized, Carcinoma, Hepatocellular, Female, Humans, Liver Neoplasms, Male, Middle Aged, Oncology & Carcinogenesis, Oncology and carcinogenesis
Abstract: PurposeThis phase I/II study evaluated tremelimumab (anticytotoxic T-lymphocyte-associated antigen-4 monoclonal antibody) and durvalumab (antiprogrammed death ligand-1 monoclonal antibody) as monotherapies and in combination for patients with unresectable hepatocellular carcinoma (HCC), including a novel regimen featuring a single, priming dose of tremelimumab (ClinicalTrials.gov identifier: NCT02519348).Patients and methodsPatients with HCC who had progressed on, were intolerant to, or refused sorafenib were randomly assigned to receive T300 + D (tremelimumab 300 mg plus durvalumab 1,500 mg [one dose each during the first cycle] followed by durvalumab 1,500 mg once every 4 weeks), durvalumab monotherapy (1,500 mg once every 4 weeks), tremelimumab monotherapy (750 mg once every 4 weeks [seven doses] and then once every 12 weeks), or T75 + D (tremelimumab 75 mg once every 4 weeks plus durvalumab 1,500 mg once every 4 weeks [four doses] followed by durvalumab 1,500 mg once every 4 weeks). Safety was the primary end point. Secondary end points included objective response rate (ORR) by Response Evaluation Criteria in Solid Tumors v1.1 and overall survival; exploratory end points included circulating lymphocyte profiles.ResultsA total of 332 patients were enrolled (T300 + D, n = 75; durvalumab, n = 104; tremelimumab, n = 69; and T75 + D, n = 84). Tolerability was acceptable across arms, with grade ≥ 3 treatment-related adverse events occurring in 37.8%, 20.8%, 43.5%, and 24.4%, respectively. Confirmed ORRs (95% CI) were 24.0% (14.9 to 35.3), 10.6% (5.4 to 18.1), 7.2% (2.4 to 16.1), and 9.5% (4.2 to 17.9), respectively. An early expansion of CD8+ lymphocytes was associated with response across arms, with highest proliferating CD8+ lymphocyte levels occurring in the T300 + D arm. The median (95% CI) overall survival was 18.7 (10.8 to 27.3), 13.6 (8.7 to 17.6), 15.1 (11.3 to 20.5), and 11.3 (8.4 to 15.0) months in the T300 + D, durvalumab, tremelimumab, and T75 + D arms, respectively.ConclusionAll regimens were found to be tolerable and clinically active; however, the T300 + D regimen demonstrated the most encouraging benefit-risk profile. The unique pharmacodynamic activity and association with ORR of the T300 + D regimen further support its continued evaluation in HCC.
Published: 2021

3. Anti-miR-518d-5p overcomes liver tumor cell death resistance through mitochondrial activity

Author: Fernández-Tussy, Pablo, Rodríguez-Agudo, Rubén, Fernández-Ramos, David, Barbier-Torres, Lucía, Zubiete-Franco, Imanol, Davalillo, Sergio López de, Herraez, Elisa, Goikoetxea-Usandizaga, Naroa, Lachiondo-Ortega, Sofia, Simón, Jorge, Lopitz-Otsoa, Fernando, Juan, Virginia Gutiérrez-de, McCain, Misti V, Perugorria, Maria J, Mabe, Jon, Navasa, Nicolás, Rodrigues, Cecilia MP, Fabregat, Isabel, Boix, Loreto, Sapena, Victor, Anguita, Juan, Lu, Shelly C, Mato, José M, Banales, Jesus M, Villa, Erica, Reeves, Helen L, Bruix, Jordi, Reig, Maria, Marin, Jose JG, Delgado, Teresa C, and Martínez-Chantar, María L
Subjects: Biomedical and Clinical Sciences, Oncology and Carcinogenesis, Cancer, Orphan Drug, Liver Disease, Digestive Diseases, Liver Cancer, Rare Diseases, Clinical Research, 2.1 Biological and endogenous factors, Aetiology, Animals, Apoptosis, Cell Death, Female, Humans, Liver Neoplasms, Mice, Mice, Nude, MicroRNAs, Mitochondria, Biochemistry and Cell Biology, Biochemistry and cell biology, Oncology and carcinogenesis
Abstract: Dysregulation of miRNAs is a hallmark of cancer, modulating oncogenes, tumor suppressors, and drug responsiveness. The multi-kinase inhibitor sorafenib is one of the first-line drugs for advanced hepatocellular carcinoma (HCC), although the outcome for treated patients is heterogeneous. The identification of predictive biomarkers and targets of sorafenib efficacy are sorely needed. Thus, selected top upregulated miRNAs from the C19MC cluster were analyzed in different hepatoma cell lines compared to immortalized liver human cells, THLE-2 as control. MiR-518d-5p showed the most consistent upregulation among them. Thus, miR-518d-5p was measured in liver tumor/non-tumor samples of two distinct cohorts of HCC patients (n = 16 and n = 20, respectively). Circulating miR-518d-5p was measured in an independent cohort of HCC patients receiving sorafenib treatment (n = 100), where miR-518d-5p was analyzed in relation to treatment duration and patient's overall survival. In vitro and in vivo studies were performed in human hepatoma BCLC3 and Huh7 cells to analyze the effect of miR-518d-5p inhibition/overexpression during the response to sorafenib. Compared with healthy individuals, miR-518d-5p levels were higher in hepatic and serum samples from HCC patients (n = 16) and in an additional cohort of tumor/non-tumor paired samples (n = 20). MiR-518d-5p, through the inhibition of c-Jun and its mitochondrial target PUMA, desensitized human hepatoma cells and mouse xenograft to sorafenib-induced apoptosis. Finally, serum miR-518d-5p was assessed in 100 patients with HCC of different etiologies and BCLC-stage treated with sorafenib. In BCLC-C patients, higher serum miR-518d-5p at diagnosis was associated with shorter sorafenib treatment duration and survival. Hence, hepatic miR-518d-5p modulates sorafenib resistance in HCC through inhibition of c-Jun/PUMA-induced apoptosis. Circulating miR-518d-5p emerges as a potential lack of response biomarker to sorafenib in BCLC-C HCC patients.
Published: 2021

4. LI‐RADS (Liver Imaging Reporting and Data System): Summary, discussion, and consensus of the LI‐RADS Management Working Group and future directions

Author: Mitchell, Donald G, Bruix, Jordi, Sherman, Morris, and Sirlin, Claude B
Subjects: Biomedical and Clinical Sciences, Clinical Sciences, Rare Diseases, Cancer, Prevention, Biomedical Imaging, Digestive Diseases, Liver Cancer, Liver Disease, Carcinoma, Hepatocellular, Consensus, Humans, Liver Neoplasms, Magnetic Resonance Imaging, Practice Guidelines as Topic, Tomography, X-Ray Computed, Medical Biochemistry and Metabolomics, Immunology, Gastroenterology & Hepatology, Clinical sciences
Abstract: To improve standardization and consensus regarding performance, interpreting, and reporting computed tomography (CT) and magnetic resonance imaging (MRI) examinations of the liver in patients at risk for hepatocellular carcinoma (HCC), LI-RADS (Liver Imaging Reporting and Data System) was launched in March 2011 and adopted by many clinical practices throughout the world. LI-RADS categorizes nodules recognized at CT or MRI, in patients at high risk of HCC, as definitively benign, probably benign, intermediate probability of being HCC, probably HCC, and definitively HCC (corresponding to LI-RADS categories 1-5). The LI-RADS Management Working Group, consisting of internationally recognized medical and surgical experts on HCC management, as well as radiologists involved in the development of LI-RADS, was convened to evaluate management implications related to radiological categorization of the estimated probability that a lesion will be ultimately diagnosed as HCC. In this commentary, we briefly review LI-RADS and the initial consensus of the LI-RADS Management Working Group reached during its deliberations in 2013. We then focus on initial discordance of LI-RADS with American Association for the Study of Liver Diseases and Organ Procurement Transplant Network guidelines, the basis for these differences, and how they are being addressed going forward to optimize reporting of CT and MRI findings in patients at risk for HCC and to increase consensus throughout the international community of physicians involved in the diagnosis and treatment of HCC.
Published: 2015

5. Stabilization of LKB1 and Akt by neddylation regulates energy metabolism in liver cancer

Author: Barbier-Torres, Lucía, Delgado, Teresa C, García-Rodríguez, Juan L, Zubiete-Franco, Imanol, Fernández-Ramos, David, Buqué, Xabier, Cano, Ainara, Juan, Virginia Gutiérrez-de, Fernández-Domínguez, Itziar, Lopitz-Otsoa, Fernando, Fernández-Tussy, Pablo, Boix, Loreto, Bruix, Jordi, Villa, Erica, Castro, Azucena, Lu, Shelly C, Aspichueta, Patricia, Xirodimas, Dimitris, Varela-Rey, Marta, Mato, José M, Beraza, Naiara, and Martínez-Chantar, María L
Subjects: Cancer, Liver Disease, Liver Cancer, Digestive Diseases, Rare Diseases, Aetiology, 2.1 Biological and endogenous factors, AMP-Activated Protein Kinase Kinases, Animals, Blotting, Western, Carcinoma, Hepatocellular, Cyclopentanes, Energy Metabolism, Hep G2 Cells, Hepatocytes, Humans, Liver Neoplasms, Male, Mice, Inbred C57BL, Mice, Knockout, Mice, Nude, NEDD8 Protein, Prohibitins, Protein Processing, Post-Translational, Protein Serine-Threonine Kinases, Proto-Oncogene Proteins c-akt, Pyrimidines, RNA Interference, Repressor Proteins, Reverse Transcriptase Polymerase Chain Reaction, Signal Transduction, Transplantation, Heterologous, Ubiquitins, Neddylation, Cancer metabolism, Hepatocellular Carcinoma, LKB1, Akt, Oncology and Carcinogenesis
Abstract: The current view of cancer progression highlights that cancer cells must undergo through a post-translational regulation and metabolic reprogramming to progress in an unfriendly environment. In here, the importance of neddylation modification in liver cancer was investigated. We found that hepatic neddylation was specifically enriched in liver cancer patients with bad prognosis. In addition, the treatment with the neddylation inhibitor MLN4924 in Phb1-KO mice, an animal model of hepatocellular carcinoma showing elevated neddylation, reverted the malignant phenotype. Tumor cell death in vivo translating into liver tumor regression was associated with augmented phosphatidylcholine synthesis by the PEMT pathway, known as a liver-specific tumor suppressor, and restored mitochondrial function and TCA cycle flux. Otherwise, in protumoral hepatocytes, neddylation inhibition resulted in metabolic reprogramming rendering a decrease in oxidative phosphorylation and concomitant tumor cell apoptosis. Moreover, Akt and LKB1, hallmarks of proliferative metabolism, were altered in liver cancer being new targets of neddylation. Importantly, we show that neddylation-induced metabolic reprogramming and apoptosis were dependent on LKB1 and Akt stabilization. Overall, our results implicate neddylation/signaling/metabolism, partly mediated by LKB1 and Akt, in the development of liver cancer, paving the way for novel therapeutic approaches targeting neddylation in hepatocellular carcinoma.
Published: 2015

6. Portal hypertension may influence the registration of hypointensity of small hepatocellular carcinoma in the hepatobiliary phase in gadoxetic acid MR

Author: Carla Caparroz, Alejandro Forner, Jordi Rimola, Anna Darnell, Ángeles García-Criado, Juan Ramón Ayuso, María Reig, Jordi Bruix, and Carmen Ayuso
Subjects: Gadolinium DTPA, Liver Cirrhosis, Carcinoma, Hepatocellular, Oncology, Hypertension, Portal, Liver Neoplasms, Contrast Media, Humans, Radiology, Nuclear Medicine and imaging, Prospective Studies, Magnetic Resonance Imaging
Abstract: Background The aim of the study was to analyze the association between the liver uptake of Gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid (Gd-EOB-DTPA) in the hepatobiliary phase (HBP) in cirrhotic patients and the presence of clinically significant portal hypertension (CSPH), and how these features impact on hepatocellular carcinoma (HCC) detection in the HBP. Patients and methods Post-hoc analysis of a prospective cohort of 62 cirrhotic patients with newly US-detected nodule between 1–2 cm (study group). Twenty healthy subjects were used as control group. Qualitative and quantitative analysis of the liver contrast uptake in the HBP assessed by Relative Liver-Enhancement (RLE), Liver-Spleen (LSCR), Liver-Muscle (LMCR), and Liver-Kidney Contrast-Ratio (LKCR), Contrast Enhancement Index (CEI), and Hepatic Uptake (HUI), and biliary excretion, were registered. CSPH was confirmed invasively (HVPG > 10 mmHg) or by indirect parameters. The appearance of HCC at the HBP was analyzed. Results Nineteen patients (30.6%) did not have CSPH. In 41 patients (66.1%) the final diagnosis was HCC. All indices were significantly higher in the control group, indicating a more intense HBP liver signal intensity compared to patients with cirrhosis, even if the comparison was restricted to patients with no CSPH. CSPH was associated to a lower rate of HCC hypointensity in the HBP (51.9% vs. 85.7% without CSPH, p = 0.004). Conclusions Liver uptake of Gd-EOB-DTPA at the HBP is decreased in cirrhosis even if the liver function is minimally impaired and it falls down significantly in patients with CSPH compromising the recognition of hypointense lesions. This fact may represent a limitation for the detection of small HCC in patients with cirrhosis and CSPH.
Published: 2022

7. Polyethylene Glycol Drug-Eluting Embolic Microspheres Loaded with Doxorubicin for the Treatment of Hepatocellular Carcinoma: Feasibility, Safety, and Pharmacokinetic Study

Author: Katerina Malagari, Alban Denys, Marta Burrel, Maria Reig, Mercé Brunet, Rafael Duran, Theodoros Kiakidis, Hippokratis Moschouris, Marco Sanduzzi-Zamparelli, and Jordi Bruix
Subjects: Male, Antibiotics, Antineoplastic, Carcinoma, Hepatocellular, Liver Neoplasms, Microspheres, Polyethylene Glycols, Treatment Outcome, Doxorubicin, Feasibility Studies, Humans, Female, Radiology, Nuclear Medicine and imaging, Chemoembolization, Therapeutic, Cardiology and Cardiovascular Medicine
Abstract: Polyethylene glycol drug-eluting microspheres (PEG-DEMs) can be loaded to elute doxorubicin. The current study evaluated the pharmacokinetic profile and safety of PEG-DEMs in the treatment of patients with hepatocellular carcinoma (HCC).The current prospective, multicenter, dose-escalation study enrolled 25 patients (68% men) with early or intermediate stage HCC and a performance status of 0. Patients in Cohort I were assigned to receive target doxorubicin doses of 75, 100, or 150 mg. Analyses were performed on the basis of the specific dose of doxorubicin that the patients received because some patients received less than the assigned dose. Patients in Cohort II received the maximum safe tested dose. Adverse events were classified according to the Common Terminology Criteria for Adverse Events version 4.03. The tumor response was evaluated every 3 months according to the European Association for the Study of the Liver criteria and modified Response Evaluation Criteria in Solid Tumors.The maximum tested safe dose of doxorubicin was 150 mg. For the groups that received ≤75, 75-100, and 101-150 mg of doxorubicin, the peak plasma concentrations were 286.7 ng/mL ± 220.1, 157.1 ng/mL ± 94.6, and 245.4 ng/mL ± 142.8, respectively; the areas under the curves calculated from 0 to 24 h were 421.7 (ng × h)/mL ± 221.2, 288.1 (ng × h)/mL ± 100.9, and 608.3 (ng × h)/mL ± 319.3, respectively, with almost complete clearance at 24 h. There was no death within 30 d. The best objective response rate was 81%, and the disease control rate was 91%. The median overall survival was 27.2 months (95% confidence interval [CI], 17.5 months to not evaluated [n.e.]); the median progression-free survival was 9.8 months (95% CI, 5.5 months to n.e.).PEG-DEMs demonstrated a favorable safety profile with low systemic concentration of doxorubicin, and promising efficacy.
Published: 2022

8. Outcome of liver cancer patients with SARS‐CoV‐2 infection: an international, multicentre, cohort study

Author: Muñoz- Martínez, Sergio, Sapena, Victor, Forner, Alejandro, Bruix, Jordi, Sanduzzi-Zamparelli, Marco, Ríos, José, Bouattour, Mohamed, El Kassas, Mohamed, Guedes Leal, Cassia Regina, Mocan, Tudor, Nault, Jean-Charles, Camargo Pinheiro Alves, Rogerio, Reeves, Helen L., da Fonseca, Leonardo, García-Juárez, Ignacio, Pinato, David J., Varela, María, Alqahtani, Saleh A., Alvares-da-Silva, Mario Reis, Bandi, Juan C., Rimassa, Lorenza, Lozano, Mar, González Santiago, Jesús M., Tacke, Frank, Sala, Margarita, Anders, Maria Margarita, Lachenmayer, Anja, Piñero, Federico, França, Alex, Guarino, María, Elvevi, Alessandra, Cabibbo, Giuseppe, Peck-Radosavljevic, Markus, Rojas, Ángela, Vergara, Mercedes, Braconi, Chiara, Pascual, Sonia, Perelló, Christie, Mello, Vivianne, Rodríguez-Lope, Carlos, Acevedo, Juan, Villani, Rosanna, Hollande, Clemence, Vilgrain, Valérie, Tawheed, Ahmed, Ferguson Theodoro, Carmem, Sparchez, Zeno, Blaise, Lorraine, Viera-Alves, Daniele E., Watson, Robyn, Carrilho, Flair J., Moctezuma-Velázquez, Carlos, D'Alessio, Antonio, Iavarone, Massimo, Reig, María, Ministerio de Sanidad (España), European Association for the Study of the Liver, Cancer Treatment and Research Trust, Wellcome Trust, Cancer Research UK, Instituto de Salud Carlos III, Bristol Myers Squibb Foundation, Muñoz- Martínez, Sergio [0000-0003-0663-0575], Sapena, Victor [0000-0003-4379-6486], Forner, Alejandro [0000-0002-9014-4950], Ríos, José [0000-0002-0716-8784], González Santiago, Jesús M. [0000-0003-4667-4492], Rojas, Ángela [0000-0003-0853-4800], Hollande, Clemence [0000-0002-2287-0635], Muñoz- Martínez, Sergio, Sapena, Victor, Forner, Alejandro, Ríos, José, González Santiago, Jesús M., Rojas, Ángela, Hollande, Clemence, and Sergio Muñoz-Martínez, Victor Sapena, Alejandro Forner, Jordi Bruix, Marco Sanduzzi-Zamparelli, José Ríos, Mohamed Bouattour, Mohamed El-Kassas, Cassia R. G. Leal, Tudor Mocan, Jean-Charles Nault, Rogerio C. P. Alves, Helen L. Reeves, Leonardo da Fonseca, Ignacio García-Juárez, David J. Pinato, María Varela, Saleh A. Alqahtani, Mario R. Alvares-da-Silva, Juan C. Bandi, Lorenza Rimassa, Mar Lozano, Jesús M. González Santiago, Frank Tacke, Margarita Sala, María Anders, Anja Lachenmayer, Federico Piñero, Alex França, Maria Guarino, Alessandra Elvevi, Giuseppe Cabibbo, Markus Peck-Radosavljevic, Ángela Rojas, Mercedes Vergara, Chiara Braconi, Sonia Pascual, Christie Perelló, Vivianne Mello, Carlos Rodríguez-Lope, Juan Acevedo, Rosanna Villani, Clemence Hollande, Valérie Vilgrain, Ahmed Tawheed, Carmem Ferguson Theodoro, Zeno Sparchez, Lorraine Blaise, Daniele E. Viera-Alves, Robyn Watson, Flair J. Carrilho, Carlos Moctezuma-Velázquez, Antonio D'Alessio, Massimo Iavarone, Maria Reig
Subjects: Settore MED/12 - Gastroenterologia, Carcinoma, Hepatocellular, Hepatology, Hepatocellular carcinoma, SARS-CoV-2, Liver Neoplasms, COVID-19, hepatocellular carcinoma, mortality, Cohort Studies, liver cancer, COVID-19 Testing, Cross-Sectional Studies, Humans, Mortality, Liver cancer, Retrospective Studies
Abstract: Background & Aims Information about the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patients with liver cancer is lacking. This study characterizes the outcomes and mortality risk in this population. Methods Multicentre retrospective, cross-sectional, international study of liver cancer patients with SARS-CoV-2 infection registered between February and December 2020. Clinical data at SARS-CoV-2 diagnosis and outcomes were registered. Results Two hundred fifty patients from 38 centres were included, 218 with hepatocellular carcinoma (HCC) and 32 with intrahepatic cholangiocarcinoma (iCCA). The median age was 66.5 and 64.5 years, and 84.9% and 21.9% had cirrhosis in the HCC and iCCA cohorts respectively. Patients had advanced cancer stage at SARS-CoV-2 diagnosis in 39.0% of the HCC and 71.9% of the iCCA patients. After a median follow-up of 7.20 (IQR: 1.84–11.24) months, 100 (40%) patients have died, 48% of the deaths were SARS-CoV-2-related. Forty (18.4%) HCC patients died within 30-days. The death rate increase was significantly different according to the BCLC stage (6.10% [95% CI 2.24–12.74], 11.76% [95% CI 4.73–22.30], 20.69% [95% CI 11.35–31.96] and 34.52% [95% CI 17.03–52.78] for BCLC 0/A, B, C and D, respectively; p = .0017). The hazard ratio was 1.45 (95% CI 0.49–4.31; p = .5032) in BCLC-B versus 0/A, and 3.13 (95% CI 1.29–7.62; p = .0118) in BCLC-C versus 0/A in the competing risk Cox regression model. Nineteen out of 32 iCCA (59.4%) died, and 12 deaths were related to SARS-CoV-2 infection. Conclusions This is the largest cohort of liver cancer patients infected with SARS-CoV-2. It characterizes the 30-day mortality risk of SARS-CoV-2 infected patients with HCC during this period., Spanish Health Ministry; Ricerca Corrente, Grant/Award Number: RC2019/105-01, RC2018/105-01 and RC2017/105-01; European Association for the Study of the Liver (Andrew Burroughs Fellowship); Cancer Treatment and Research Trust (CTRT); Wellcome Trust Strategic Fund, Grant/Award Number: PS3416; Cancer Research UK (CR UK) centre, Grant/Award Number: C9380/A26813, C18342/A23390 and C9380/A18084; Instituto de Salud Carlos III, Grant/Award Number: PI18/0358, PI15/00145, CD18/00126, PI19/00819, FI19/00222, 16-0026, PI044031, PI18/00768, PI18/00542 and PI13/01229; Bristol Myers Squibb and Celgene; Cancer Research UK, Grant/Award Number: RCCPDB-Nov21/100008
Published: 2022

9. The pituitary tumour‐transforming gene 1/delta‐like homologue 1 pathway plays a key role in liver fibrogenesis

Author: Meritxell Perramón, Silvia Carvajal, Vedrana Reichenbach, Guillermo Fernández‐Varo, Loreto Boix, Laura Macias‐Muñoz, Pedro Melgar‐Lesmes, Jordi Bruix, Shlomo Melmed, Santiago Lamas, and Wladimiro Jiménez
Subjects: Liver Cirrhosis, Hepatology, Calcium-Binding Proteins, Membrane Proteins, Oncogenes, Fibrosis, Rats, Securin, Mice, Liver, Animals, Humans, Intercellular Signaling Peptides and Proteins, Pituitary Neoplasms
Abstract: PTTG1 is almost undetectable in adult livers but is highly expressed in hepatocarcinoma. While little is known about its involvement in liver fibrosis, PTTG1 expression is associated with DLK1. We assessed the role of the PTTG1/DLK1 pathway in fibrosis progression and the potential therapeutic effect of PTTG1 silencing in fibrosis.Pttg1 and Dlk1 were studied in liver and isolated cell populations of control and fibrotic rats and in human liver biopsies. The fibrotic molecular signature was analysed in Pttg1Pttg1 and Dlk1 mRNA selectively increased in fibrotic rats paralleling fibrosis progression. Serum DLK1 concentrations correlated with hepatic collagen content and systemic and portal haemodynamics. Human cirrhotic livers showed greater PTTG1 and DLK1 transcript abundance than non-cirrhotic, and reduced collagen was observed in Pttg1 Pttg1Pttg1/Dlk1 are selectively overexpressed in the cirrhotic liver and participate in ECM turnover regulation. Pttg1 disruption decreases Dlk1 transcription and attenuates collagen deposition. PTTG1/DLK1 signalling is a novel pathway for targeting the progression of liver fibrosis.
Published: 2022

10. HCC-neuroendocrine transition: Tumor plasticity under immunotherapy

Author: Marco Sanduzzi-Zamparelli, Carla Fuster-Anglada, Jordi Bruix, Maria Reig, and Alba Díaz
Subjects: Carcinoma, Hepatocellular, Hepatology, Liver Neoplasms, Gastroenterology, Humans, Immunologic Factors, Immunotherapy, General Medicine
Published: 2022

11. Safety, Efficacy, and Pharmacodynamics of Tremelimumab Plus Durvalumab for Patients With Unresectable Hepatocellular Carcinoma: Randomized Expansion of a Phase I/II Study

Author: Philip He, Robin Kate Kelley, Ho Yeong Lim, Takuji Okusaka, Thomas Yau, David Wai-Meng Tai, Ghassan K. Abou-Alfa, Masafumi Ikeda, Bruno Sangro, Yoon-Koo Kang, Silvia Damian, Johanna C. Bendell, Mitesh J. Borad, William P. Harris, Tae-You Kim, Shukui Qin, Alejandra Negro, Mallory Makowsky, Nathan Standifer, Masatoshi Kudo, Ann-Lii Cheng, Jordi Bruix, Antonio Gasbarrini, and Wei Peng Yong
Subjects: Male, 0301 basic medicine, Oncology, Cancer Research, Durvalumab, 0302 clinical medicine, Monoclonal, 80 and over, Humanized, 6.2 Cellular and gene therapies, Cancer, Aged, 80 and over, Liver Disease, Liver Neoplasms, Middle Aged, 6.1 Pharmaceuticals, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, HIV/AIDS, Female, Patient Safety, Biotechnology, medicine.drug, Liver Cancer, Adult, medicine.medical_specialty, Carcinoma, Hepatocellular, medicine.drug_class, Clinical Trials and Supportive Activities, Clinical Sciences, Oncology and Carcinogenesis, Antibodies, Monoclonal, Humanized, Monoclonal antibody, Antibodies, 03 medical and health sciences, Rare Diseases, Clinical Research, Internal medicine, medicine, Humans, Oncology & Carcinogenesis, Aged, business.industry, Carcinoma, Evaluation of treatments and therapeutic interventions, Hepatocellular, medicine.disease, Orphan Drug, 030104 developmental biology, Phase i ii, Pharmacodynamics, Digestive Diseases, business, Tremelimumab
Abstract: PURPOSE This phase I/II study evaluated tremelimumab (anticytotoxic T-lymphocyte–associated antigen-4 monoclonal antibody) and durvalumab (antiprogrammed death ligand-1 monoclonal antibody) as monotherapies and in combination for patients with unresectable hepatocellular carcinoma (HCC), including a novel regimen featuring a single, priming dose of tremelimumab (ClinicalTrials.gov identifier: NCT02519348 ). PATIENTS AND METHODS Patients with HCC who had progressed on, were intolerant to, or refused sorafenib were randomly assigned to receive T300 + D (tremelimumab 300 mg plus durvalumab 1,500 mg [one dose each during the first cycle] followed by durvalumab 1,500 mg once every 4 weeks), durvalumab monotherapy (1,500 mg once every 4 weeks), tremelimumab monotherapy (750 mg once every 4 weeks [seven doses] and then once every 12 weeks), or T75 + D (tremelimumab 75 mg once every 4 weeks plus durvalumab 1,500 mg once every 4 weeks [four doses] followed by durvalumab 1,500 mg once every 4 weeks). Safety was the primary end point. Secondary end points included objective response rate (ORR) by Response Evaluation Criteria in Solid Tumors v1.1 and overall survival; exploratory end points included circulating lymphocyte profiles. RESULTS A total of 332 patients were enrolled (T300 + D, n = 75; durvalumab, n = 104; tremelimumab, n = 69; and T75 + D, n = 84). Tolerability was acceptable across arms, with grade ≥ 3 treatment-related adverse events occurring in 37.8%, 20.8%, 43.5%, and 24.4%, respectively. Confirmed ORRs (95% CI) were 24.0% (14.9 to 35.3), 10.6% (5.4 to 18.1), 7.2% (2.4 to 16.1), and 9.5% (4.2 to 17.9), respectively. An early expansion of CD8+ lymphocytes was associated with response across arms, with highest proliferating CD8+ lymphocyte levels occurring in the T300 + D arm. The median (95% CI) overall survival was 18.7 (10.8 to 27.3), 13.6 (8.7 to 17.6), 15.1 (11.3 to 20.5), and 11.3 (8.4 to 15.0) months in the T300 + D, durvalumab, tremelimumab, and T75 + D arms, respectively. CONCLUSION All regimens were found to be tolerable and clinically active; however, the T300 + D regimen demonstrated the most encouraging benefit-risk profile. The unique pharmacodynamic activity and association with ORR of the T300 + D regimen further support its continued evaluation in HCC.
Published: 2021

12. Radiological endpoints as surrogates for survival benefit in hepatocellular carcinoma trials: All that glitters is not gold

Author: Giuseppe Cabibbo and Jordi Bruix
Subjects: Carcinoma, Hepatocellular, Hepatology, Liver Neoplasms, Humans, Immunotherapy, Disease-Free Survival
Published: 2022

13. International and multicenter real‐world study of sorafenib‐treated patients with hepatocellular carcinoma under dialysis

Author: Aline Lopes Chagas, Gabriel Aballay Soteras, Margarita Sala, Adolfo Gallego, Yolanda Sánchez-Torrijos, Marcus-Alexander Wörns, Carlos Huertas, Leonardo Gomes da Fonseca, Carlos Rodríguez de Lope, Margarita Anders, M. Varela, Manuel Hernández-Guerra, Rogerio Alves, Maria Reig, Sonia Pascual, Marco Sanduzzi-Zamparelli, Tania Hernáez, Lorenza Rimassa, Mário Reis Álvares-da-Silva, Alessandro Granito, Juan Arenas, Beatriz Minguez, Cassia Leal, Ana Matilla, Jordi Bruix, Morten Ladekarl, Alberto Lué, Alex Vianey Callado França, Christie Perelló, Rodolfo Sacco, José Luis Lledó, Álvaro Díaz-González, Matthias Pinter, Juan Ignacio Marín, Gustavo Pereira, Susanna Coll, Giovan Giuseppe Di Costanzo, Massimo Iavarone, Ángela Rojas, Federico Piñero, Mercedes Vergara, Edoardo G. Giannini, Jean-Charles Nault, Mar Lozano, Bruno Sangro, Ignacio Garcia Juarez, Vivianne Mello, Josemaría Menéndez, Manuel Delgado, Diaz-Gonzalez A., Sanduzzi-Zamparelli M., da Fonseca L.G., Di Costanzo G.G., Alves R., Iavarone M., Leal C., Sacco R., Matilla A.M., Hernandez-Guerra M., Aballay Soteras G., Worns M.-A., Pinter M., Varela M., Ladekarl M., Chagas A.L., Minguez B., Arenas J.I., Granito A., Sanchez-Torrijos Y., Rojas A., Rodriguez de Lope C., Alvares-da-Silva M.R., Pascual S., Rimassa L., Lledo J.L., Huertas C., Sangro B., Giannini E.G., Delgado M., Vergara M., Perello C., Lue A., Sala M., Gallego A., Coll S., Hernaez T., Pinero F., Pereira G., Franca A., Marin J., Anders M., Mello V., Lozano M., Nault J.C., Menendez J., Garcia Juarez I., Bruix J., and Reig M.
Subjects: Niacinamide, safety, Sorafenib, dialysi, medicine.medical_specialty, Carcinoma, Hepatocellular, Hepatocellular carcinoma, medicine.medical_treatment, Population, adverse event, Antineoplastic Agents, survival, 03 medical and health sciences, 0302 clinical medicine, Renal Dialysis, Interquartile range, Internal medicine, adverse events, dialysis, sorafenib, medicine, Humans, education, Dialysis, Aged, education.field_of_study, Hepatology, business.industry, Phenylurea Compounds, Liver Neoplasms, Retrospective cohort study, Hepatitis C, medicine.disease, Europe, Treatment Outcome, Tolerability, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, business, medicine.drug
Abstract: Background & Aims: Information on safety and efficacy of systemic treatment in patients with hepatocellular carcinoma (HCC) under dialysis are limited due to patient exclusion from clinical trials. Thus, we aimed to evaluate the rate, prevalence, tolerability, and outcome of sorafenib in this population. Methods: We report a multicenter study comprising patients from Latin America and Europe. Patients treated with sorafenib were enrolled; demographics, dose modifications, adverse events (AEs), treatment duration, and outcome of patients undergoing dialysis were recorded. Results: As of March 2018, 6156 HCC patients were treated in 44 centres and 22 patients were concomitantly under dialysis (0.36%). The median age was 65.5years, 40.9% had hepatitis C, 75% had Child-Pugh A, and 85% were Barcelona Clinic Liver Cancer-C. The median time to first dose modification, treatment duration and overall survival rate were 2.4months (interquartile ranges [IQR], 0.8-3.8), 10.8months (IQR, 4.5-16.9), and 17.5months (95% CI, 7.2-24.5), respectively. Seventeen patients required at least 1 dose modification. The main causes of first dose modification were asthenia/worsening of Eastern Cooperative Oncology Group-Performance Status and diarrhoea. At the time of death or last follow-up, four patients were still on treatment and 18 had discontinued sorafenib: 14 were due to tumour progression, 2 were sorafenib-related, and 2 were non-sorafenib-related AE. Conclusions: The outcomes observed in this cohort seem comparable to those in the non-dialysis population. Thus, to the best of our knowledge, this is the largest and most informative dataset regarding systemic treatment outcomes in HCC patients undergoing dialysis.
Published: 2020

14. Liver Imaging Reporting and Data System: Review of Pros and Cons

Author: Eleonora Terzi, Carmen Ayuso, Fabio Piscaglia, and Jordi Bruix
Subjects: medicine.medical_specialty, Carcinoma, Hepatocellular, Contrast Media, Malignancy, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, In patient, Retrospective Studies, Liver imaging, Hepatology, medicine.diagnostic_test, business.industry, Liver Neoplasms, cons, Magnetic resonance imaging, medicine.disease, Magnetic Resonance Imaging, digestive system diseases, Review article, Hepatocellular carcinoma, 030211 gastroenterology & hepatology, Radiology, business, Contrast-enhanced ultrasound
Abstract: The American College of Radiology has released the Liver Imaging Reporting and Data System (LI-RADS) scheme which categorizes focal liver lesions (FLLs) in patients at risk for hepatocellular carcinoma (HCC) according to the degree of risk of nodules to be HCC. It subgroups FLL in LR-1 (definitely benign), LR-2 (probably benign), LR-3 (intermediate probability of malignancy), LR-4 (probably HCC), LR-5 (definitely HCC), and LR-M (probable malignancy not specific for HCC). Computed tomography/magnetic resonance imaging (CT/MRI) and contrast enhanced ultrasound (CEUS) LI-RADS diagnostic algorithm have the goal to standardize the acquisition, interpretation, reporting, and data collection for imaging examinations in patients at risk for HCC. Nevertheless, there remain controversial issues that should be dealt with. The aim of this review is to discuss the pros and cons of the interpretation and reporting part of CT/MRI and CEUS LI-RADS diagnostic algorithm to permit future refinements of the scheme and optimize patient and nodule management.
Published: 2021

15. Early diarrhoea under sorafenib as a marker to consider the early migration to second‐line drugs

Author: Marco Sanduzzi-Zamparelli, Loreto Boix, Maria Reig, Alejandro Forner, Carmen Ayuso, Gemma Iserte, Victor Sapena, Ernest Belmonte, Sergio Muñoz-Martínez, Cassia Guedes, Anna Darnell, Ferran Torres, Jordi Bruix, Leonardo G Da Fonseca, Jordi Rimola, Neus Llarch, and Álvaro Díaz-González
Subjects: Male, Cancer cells, Time Factors, Gastroenterology, Tyrosine-kinase inhibitor, Proteïna-tirosina-fosfatasa, tyrosine kinase inhibitor, Second line, Protein kinases, Survival analysis (Biometry), Protein-tyrosine phosphatase, Inhibition, Liver Neoplasms, digestive, oral, and skin physiology, Hazard ratio, hepatocellular carcinoma, Middle Aged, Sorafenib, Prognosis, Survival Rate, Treatment Outcome, Oncology, Hepatocellular carcinoma, Cèl·lules canceroses, Female, Original Article, Liver cancer, medicine.drug, Diarrhea, medicine.medical_specialty, Carcinoma, Hepatocellular, Bevacizumab, medicine.drug_class, Antineoplastic Agents, survival, Càncer de fetge, resistance, Anàlisi de supervivència (Biometria), Atezolizumab, Internal medicine, medicine, Humans, Adverse effect, Protein Kinase Inhibitors, neoplasms, Resistència als medicaments, Aged, Proportional Hazards Models, Hepatology, business.industry, medicine.disease, Hepatologia, Proteïnes quinases, diarrhoea, Inhibició, Drug Resistance, Neoplasm, Drug resistance, Hepatobiliary, Diarrea, business
Abstract: Background Despite atezolizumab and bevacizumab (A + B) is currently the first‐line treatment for hepatocellular carcinoma (HCC) patients, some patients will not be adequate for this combination. In the setting of sorafenib some adverse events have been proposed as prognostic factors. Objective To characterize the early diarrhoea development as prognostic factor in 344 HCC patients. Methods The development of early diarrhoea in sorafenib treatment defined as patients who developed diarrhoea and needed dose modification within the first 60 days of treatment (e‐diarrhoea) and 3‐grouping variables were analysed: Patients with e‐diarrhoea, patients who developed diarrhoea after the first 60 days of treatment (L‐diarrhoea) and patients that never developed diarrhoea (never diarrhoea). Results The median overall survival in sorafenib treated patients was significantly different across groups (6.8 months for e‐diarrhoea, 26.7 months for L‐diarrhoea and 13.3 months for never‐diarrhoea). The emergence of e‐diarrhoea was associated with poor outcomes (hazard ratio [HR] 1.84 [95%CI 1.15–2.95]), while there was no increased/decreased risk of dismal evolution in patients with L‐diarrhoea (HR 0.66 [95%CI 0.42–1.03]). Conclusion The emergence of e‐diarrhoea in HCC patients treated with sorafenib is an early predictor of dismal evolution under this therapy. Thus, prompt identification of these non‐responders may be useful for an early switch to second‐line therapies., Key Summary Established knowledge on this subject Diarrhoea is a frequent adverse event of sorafenib and its emergence has been associated to better outcomes. What are the significant and/or new findings of this study? Early diarrhoea (e‐diarrhoea) in hepatocellular carcinoma patients treated with sorafenib is an early predictor of dismal evolution.Diarrhoea under sorafenib should not be taken as a predictive parameter of lack of benefit.E‐diarrhoea could be used as clinical biomarker for switching to second‐line therapies.
Published: 2021

16. Endpoints in clinical trials for liver cancer and their value in evidence-based clinical decision making: An unresolved Gordian knot

Author: Jordi Bruix
Subjects: 0301 basic medicine, Value (ethics), medicine.medical_specialty, Carcinoma, Hepatocellular, Evidence-based practice, Clinical Decision-Making, Antineoplastic Agents, 03 medical and health sciences, Clinical Trials, Phase II as Topic, 0302 clinical medicine, Clinical decision making, medicine, Humans, Treatment Failure, Precision Medicine, Intensive care medicine, Hepatology, business.industry, Liver Neoplasms, Cancer, Evidence-based medicine, medicine.disease, Progression-Free Survival, Clinical trial, 030104 developmental biology, Precision oncology, Disease Progression, 030211 gastroenterology & hepatology, Immunotherapy, Liver cancer, business
Abstract: Summary The design and execution of clinical trials relies on strict definitions and criteria to avoid heterogeneous decisions by investigators at different sites. Ideally, definitions and decision making in clinical practice should mimic those implemented in trials, but this is not the case. Target populations are narrowly defined in trials, with the goal of evaluating activity and toxicity, and ultimately, demonstrating a survival benefit. In real-world practice, patients may not fit into the stringent inclusion/exclusion criteria of clinical trials. The evaluation of activity may also differ and the common policy to stop therapy upon progression may not be followed if progression is minor. Indeed, registration of progression may not reflect treatment failure or resistance. Parameters such as response according to RECIST criteria, time to progression and progression-free survival are not fully informative and cannot be assumed as a definitive surrogate for survival, which is the hardest endpoint in therapeutic cancer studies. This difference is because of the varying methods used to evaluate drug activity and tumour evolution, which ultimately dictates patient outcome. This expert opinion exposes the current discrepancies between research trials and clinical practice. Understanding the origin and limitations of such a conundrum should be the first step in refining the criteria that define drug activity, toxicity and treatment failure. Otherwise, evidence-based clinical practice and precision oncology will be an unattainable reality.
Published: 2021

17. Hepatocellular carcinoma recurrence after direct-acting antiviral therapy: An individual patient data meta-analysis

Author: Javier Crespo, Amit G. Singal, Pei-Chien Tsai, Giuseppe Cabibbo, Zoe Mariño, Alberto Zanetto, Elisabetta Degasperi, Xavier Forns, Pierre Nahon, Hiroko Nagata, Calogero Cammà, Francesco Paolo Russo, Mohamed El Kassas, Stefano Brillanti, Mina Nakagawa, Luisa Cavalletto, Tatsuya Minami, Giacomo Emanuele Maria Rizzo, Rob Bielen, Maria Reig, Liliana Chemello, Caitlin C. Murphy, Ming-Lung Yu, Mohamed Kohla, Sarah Shalaby, Gaetano Serviddio, Jose Luis Calleja, Angelo Sangiovanni, Ashraf Omar, Rosanna Villani, Franco Trevisani, Yasuhiro Asahina, Victor Sapena, Jean-François Dufour, Claudio Zavaglia, Fabio Conti, Jordi Bruix, Kévin Jean, Ciro Celsa, José Ríos, Hend Ibrahim Shousha, Nicolás Merchante, Stanislas Pol, C. Masetti, Marco Enea, Ferran Torres, Ryosuke Tateishi, Hidenori Toyoda, Universitat de Barcelona (UB), Università degli studi di Palermo - University of Palermo, Génomique Fonctionnelle des Tumeurs Solides (U1162), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), The University of Tokyo (UTokyo), Università degli Studi di Milano [Milano] (UNIMI), University of Bologna, University of Milan, National Kaohsiung University of Science and Technology [Taiwan], Laboratoire Modélisation, épidémiologie et surveillance des risques sanitaires (MESuRS), Conservatoire National des Arts et Métiers [CNAM] (CNAM), Pasteur-Cnam Risques infectieux et émergents (PACRI), Institut Pasteur [Paris]-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Helwan University [Caire], Cairo University - Faculty of Medicine, Tokyo Medical and Dental University [Japan] (TMDU), University of Texas Southwestern Medical Center, National Liver Institute [Menoufia, Egypt], Menoufia University [Egypte], PoliclinicoTor Vergata - Fondatione PTV, Bern University Hospital [Berne] (Inselspital), Universita degli Studi di Padova, ANRS France Recherche Nord & sud Sida-hiv hépatites, Universidad de Cantabria [Santander], Centro de Investigación Biomédica en Red en el Área temática de Enfermedades Hepáticas y Digestivas (CIBERehd), Liver Unit, Clínica Universitaria, CIBER-EHD, Università degli Studi di Foggia - University of Foggia, Hasselt University (UHasselt), Alma Mater Studiorum University of Bologna (UNIBO), The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors., Jean, Kevin/0000-0001-6462-7185, Tateishi, Ryosuke/0000-0003-3021-2517, Rios, Jose/0000-0002-0716-8784, Reig, Maria/0000-0002-5711-9534, Bruix, Jordi/0000-0002-9826-0753, Celsa, Ciro/0000-0002-5662-2162, Youssef, Naglaa/0000-0002-0368-1759, Torres, Ferran/0000-0002-7355-7913, Sapena, Victor/0000-0003-4379-6486, RUSSO, FRANCESCO PAOLO/0000-0003-4127-8941, Minami, Tatsuya/0000-0002-2918-892X, Rizzo, Giacomo Emanuele, Maria/0000-0001-9335-6740, Merchante, Nicolas/0000-0003-1120-8942, Crespo, Javier/0000-0001-8248-0172, SHALABY, SARAH/0000-0002-8700-6282, El Kassas, Mohamed/0000-0002-3396-6894, Sapena, Victor, Enea, Marco, Torres , Ferran, Celsa, Ciro, Rios, Jose, Rizzo, Giacomo Emanuele Maria, Nahon, Pierre, Marino, Zoe, Tateishi, Ryosuke, Minami, Tatsuya, Sangiovanni, Angelo, Forns, Xavier, Toyoda, Hidenori, Brillanti, Stefano, Conti, Fabio, Degasperi, Elisabetta, Yu, Ming-Lung, Tsai, Pei-Chien, Jean, Kevin, El Kassas, Mohamed, Shousha, Hend Ibrahim, Omar, Ashraf, Zavaglia, Claudio, Nagata, Hiroko, Nakagawa, Mina, Asahina, Yasuhiro, Singal, Amit G., Murphy, Caitlin, Kohla, Mohamed, Masetti, Chiara, Dufour, Jean-Francois, Merchante, Nicolas, Cavalletto, Luisa, Chemello, Liliana L. C., Pol, Stanislas, Crespo, Javier, Calleja, Jose Luis, Villani, Rosanna, Serviddio, Gaetano, Zanetto, Alberto, Shalaby, Sarah, Russo, Francesco Paolo, BIELEN, Rob, Trevisani, Franco, Camma, Calogero, Bruix, Jordi, Cabibbo, Giuseppe, Reig, Maria, Sapena V., Enea M., Torres F., Celsa C., Rios J., Rizzo G.E.M., Nahon P., Marino Z., Tateishi R., Minami T., Sangiovanni A., Forns X., Toyoda H., Brillanti S., Conti F., Degasperi E., Yu M.-L., Tsai P.-C., Jean K., El Kassas M., Shousha H.I., Omar A., Zavaglia C., Nagata H., Nakagawa M., Asahina Y., Singal A.G., Murphy C., Kohla M., Masetti C., Dufour J.-F., Merchante N., Cavalletto L., Chemello L.L.C., Pol S., Crespo J., Calleja J.L., Villani R., Serviddio G., Zanetto A., Shalaby S., Russo F.P., Bielen R., Trevisani F., Camma C., Bruix J., Cabibbo G., Reig M., Università degli Studi di Milano = University of Milan (UNIMI), University of Bologna/Università di Bologna, HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM), Institut Pasteur [Paris] (IP)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Università degli Studi di Padova = University of Padua (Unipd), Università degli Studi di Foggia = University of Foggia (Unifg), and Cammà Calogero
Subjects: medicine.medical_specialty, Carcinoma, Hepatocellular, Cirrhosis, Antiviral Agents, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, antiviral therapy, medicine, Humans, Propensity Score, hepatocellular carcinoma, meta-analysis, business.industry, Liver Neoplasms, Antiviral therapy, Patient data, medicine.disease, 3. Good health, 030220 oncology & carcinogenesis, Meta-analysis, Hepatocellular carcinoma, Relative risk, Cohort, 030211 gastroenterology & hepatology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neoplasm Recurrence, Local, business, Direct acting
Abstract: ObjectiveThe benefit of direct-acting antivirals (DAAs) against HCV following successful treatment of hepatocellular carcinoma (HCC) remains controversial. This meta-analysis of individual patient data assessed HCC recurrence risk following DAA administration.DesignWe pooled the data of 977 consecutive patients from 21 studies of HCV-related cirrhosis and HCC, who achieved complete radiological response after surgical/locoregional treatments and received DAAs (DAA group). Recurrence or death risk was expressed as HCC recurrence or death per 100 person-years (100PY). Propensity score-matched patients from the ITA.LI.CA. cohort (n=328) served as DAA-unexposed controls (no-DAA group). Risk factors for HCC recurrence were identified using random-effects Poisson.ResultsRecurrence rate and death risk per 100PY in DAA-treated patients were 20 (95% CI 13.9 to 29.8, I2=74.6%) and 5.7 (2.5 to 15.3, I2=54.3), respectively. Predictive factors for recurrence were alpha-fetoprotein logarithm (relative risk (RR)=1.11, 95% CI 1.03 to 1.19; p=0.01, per 1 log of ng/mL), HCC recurrence history pre-DAA initiation (RR=1.11, 95% CI 1.07 to 1.16; pConclusionEffects of DAA exposure on HCC recurrence risk remain inconclusive. Active clinical and radiological follow-up of patients with HCC after HCV eradication with DAA is justified.
Published: 2021

18. The valve uptake index: improving assessment of prosthetic valve endocarditis and updating [18F]FDG PET/CT(A) imaging criteria

Author: Albert Roque, María N Pizzi, Nuria Fernández-Hidalgo, Guillermo Romero-Farina, Gemma Burcet, José Luis Reyes-Juarez, Carina Espinet, Joan Castell-Conesa, Manuel Escobar, Ignacio Ferreira-González, Santiago Aguadé-Bruix, Hug Cuellar-Calabria, Institut Català de la Salut, [Roque A, Burcet G, Reyes-Juarez JL, Cuellar-Calabria H] Servei de Radiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. IDI (Institut de Diagnòstic per la Imatge), Barcelona, Spain. Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. [Pizzi MN] Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Servei de Cardiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Centro de Investigación Biomedica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain. [Fernández-Hidalgo N] Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Servei de Malalties Infeccioses, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Romero-Farina G] Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Servei de Cardiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Espinet C, Castell-Conesa J] IDI (Institut de Diagnòstic per la Imatge), Barcelona, Spain. Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain. Servei de Medicina Nuclear, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Escobar M] Servei de Radiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. IDI (Institut de Diagnòstic per la Imatge), Barcelona, Spain. [Ferreira-González I] Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain. Servei de Cardiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. CIBER de Epidemiologıa y Salud Pública (CIBERESP), Madrid, Spain. [Aguadé-Bruix S] Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Centro de Investigación Biomedica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain. Servei de Medicina Nuclear, Vall d’Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
Subjects: Endocarditis bacteriana - Imatgeria, Pròtesis valvulars cardíaques, Prosthesis-Related Infections, Endocarditis, infecciones bacterianas y micosis::infección::infecciones relacionadas con prótesis [ENFERMEDADES], diagnóstico::técnicas y procedimientos diagnósticos::diagnóstico por imagen::interpretación de imágenes asistida por ordenador::tomografía computarizada por rayos X::angiografía por tomografía computarizada [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Otros calificadores::Otros calificadores::/diagnóstico por imagen [Otros calificadores], General Medicine, Endocarditis, Bacterial, Fluorodeoxyglucose F18, Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Image Interpretation, Computer-Assisted::Tomography, X-Ray Computed::Computed Tomography Angiography [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Heart Valve Prosthesis, Positron Emission Tomography Computed Tomography, Cardiovascular Diseases::Heart Diseases::Endocarditis [DISEASES], Bacterial Infections and Mycoses::Infection::Prosthesis-Related Infections [DISEASES], Humans, Radiology, Nuclear Medicine and imaging, Tomografia per emissió de positrons, enfermedades cardiovasculares::enfermedades cardíacas::endocarditis [ENFERMEDADES], Radiopharmaceuticals, Cardiology and Cardiovascular Medicine, Other subheadings::Other subheadings::/diagnostic imaging [Other subheadings], Retrospective Studies
Abstract: Aims Diagnosis of prosthetic valve endocarditis (PVE) by positron emission computed tomography angiography (PET/CTA) is based on visual and quantitative morpho-metabolic features. However, the fluorodeoxyglucose (FDG) uptake pattern can be sometimes visually unclear and susceptible to subjectivity. This study aimed to validate a new parameter, the valve uptake index [VUI, maximum standardized uptake value (SUVmax)−mean standardized uptake value (SUVmean)/SUVmax], designed to provide a more objective indication of the distribution of metabolic activity. Secondly, to re-evaluate the utility of traditionally used PVE imaging criteria and determine the potential value of adding the VUI in the diagnostic algorithm of PVE. Methods and results Retrospective analysis of 122 patients (135 prosthetic valves) admitted for suspicion of endocarditis, with a conclusive diagnosis of definite (N = 57) or rejected (N = 65) PVE, and who had undergone a cardiac PET/CTA scan as part of the diagnostic evaluation. We measured the VUI and recorded the SUVmax, SUVratio, uptake pattern, and the presence of endocarditis-related anatomic lesions. The VUI, SUVmax, and SUVratio values were 0.54 ± 0.1 vs. 0.36 ± 0.08, 7.68 ± 3.07 vs. 3.72 ± 1.11, and 4.28 ± 1.93 vs. 2.16 ± 0.95 in the ‘definite’ PVE group vs. the ‘rejected’ group, respectively (mean ± SD; P < 0.001). A cut-off value of VUI > 0.45 showed a sensitivity, specificity, and diagnostic accuracy for PVE of 85%, 88%, and 86.7% and increased diagnostic ability for confirming endocarditis when combined with the standard diagnostic criteria. Conclusions The VUI demonstrated good diagnostic accuracy for PVE, even increasing the diagnostic power of the traditionally used morphometabolic parameters, which also confirmed their own diagnostic performance. More research is needed to assess whether the integration of the VUI into the PVE diagnostic algorithm may clarify doubtful cases and thus improve the diagnostic yield of PET/CTA.
Published: 2021

19. Impact of COVID-19 on Cardiovascular Testing in the United States Versus the Rest of the World

Author: Hirschfeld, Cole B., Shaw, Leslee J., Williams, Michelle C., Lahey, Ryan, Villines, Todd C., Dorbala, Sharmila, Choi, Andrew D., Shah, Nishant R., Bluemke, David A., Berman, Daniel S., Blankstein, Ron, Ferencik, Maros, Narula, Jagat, Winchester, David, Malkovskiy, Eli, Goebel, Benjamin, Randazzo, Michael J., Lopez-Mattei, Juan, Parwani, Purvi, Vitola, Joao V., Cerci, Rodrigo J., Better, Nathan, Raggi, Paolo, Lu, Bin, Sergienko, Vladimir, Sinitsyn, Valentin, Kudo, Takashi, Nørgaard, Bjarne Linde, Maurovich-Horvat, Pál, Cohen, Yosef A., Pascual, Thomas N. B., Pynda, Yaroslav, Dondi, Maurizio, Paez, Diana, Einstein, Andrew J., Cerci, Rodrigo, Hinterleitner, Gerd, Lu, Yao, Morozova, Olga, Xu, Zhuoran, Cohen, Yosef, Randazzo, Michael, Choi, Andrew, Nasery, Mohammad Nawaz, Goda, Artan, Shirka, Ervina, Benlabgaa, Rabie, Bouyoucef, Salah, Medjahedi, Abdelkader, Nailli, Qais, Agolti, Mariela, Aguero, Roberto Nicolas, Alak, Maria del Carmen, Alberguina, Lucia Graciela, Arroñada, Guillermo, Astesiano, Andrea, Astesiano, Alfredo, Norton, Carolina Bas, Benteo, Pablo, Blanco, Juan, Bonelli, Juan Manuel, Bustos, Jose Javier, Cabrejas, Raul, Cachero, Jorge, Campisi, Roxana, Canderoli, Alejandro, Carames, Silvia, Carrascosa, Patrícia, Castro, Ricardo, Cendoya, Oscar, Cognigni, Luciano Martin, Collaud, Carlos, Cortes, Claudia, Courtis, Javier, Cragnolino, Daniel, Daicz, Mariana, De La Vega, Alejandro, De Maria, Silvia Teresa, Del Riego, Horacio, Dettori, Fernando, Deviggiano, Alejandro, Dragonetti, Laura, Embon, Mario, Enriquez, Ruben Emilio, Ensinas, Jorge, Faccio, Fernando, Facello, Adolfo, Garofalo, Diego, Geronazzo, Ricardo, Gonza, Natalia, Gutierrez, Lucas, Guzzo, Miguel Angel, Hasbani, Victor, Huerin, Melina, Jäger, Victor, Lewkowicz, Julio Manuel, Nieves A López De Munaín, Maria, Lotti, Jose Maria, Marquez, Alejandra, Masoli, Osvaldo, Masoli, Osvaldo Horacio, Mastrovito, Edgardo, Mayoraz, Matias, Melado, Graciela Eva, Mele, Anibal, Merani, Maria Fernanda, Meretta, Alejandro Horacio, Molteni, Susana, Montecinos, Marcos, Noguera, Eduardo, Novoa, Carlos, Sueldo, Claudio Pereyra, Ascani, Sebastian Perez, Pollono, Pablo, Pujol, Maria Paula, Radzinschi, Alejandro, Raimondi, Gustavo, Redruello, Marcela, Rodríguez, Marina, Rodríguez, Matías, Romero, Romina Lorena, Acuña, Arturo Romero, Rovaletti, Federico, San Miguel, Lucas, Solari, Lucrecia, Strada, Bruno, Traverso, Sonia, Traverzo, Sonia Simona, Espeche, Maria del Huerto Velazquez, Weihmuller, Juan Sebastian, Wolcan, Juan, Zeffiro, Susana, Sakanyan, Mari, Beuzeville, Scott, Boktor, Raef, Butler, Patrick, Calcott, Jennifer, Carr, Loretta, Chan, Virgil, Chao, Charles, Chong, Woon, Dobson, Mark, Downie, D'Arne, Dwivedi, Girish, Elison, Barry, Engela, Jean, Francis, Roslyn, Gaikwad, Anand, Basavaraj, Ashok Gangasandra, Goodwin, Bruce, Greenough, Robert, Hamilton-Craig, Christian, Hsieh, Victar, Joshi, Subodh, Lederer, Karin, Lee, Kenneth, Lee, Joseph, Magnussen, John, Mai, Nghi, Mander, Gordon, Murton, Fiona, Nandurkar, Dee, Neill, Johanne, O'Rourke, Edward, O'Sullivan, Patricia, Pandos, George, Pathmaraj, Kunthi, Pitman, Alexander, Poulter, Rohan, Premaratne, Manuja, Prior, David, Ridley, Lloyd, Rutherford, Natalie, Salehi, Hamid, Saunders, Connor, Scarlett, Luke, Seneviratne, Sujith, Shetty, Deepa, Shrestha, Ganesh, Shulman, Jonathan, Solanki, Vijay, Stanton, Tony, Stuart, Murch, Stubbs, Michael, Swainson, Ian, Taubman, Kim, Taylor, Andrew, Thomas, Paul, Unger, Steven, Upton, Anthony, Vamadevan, Shankar, Van Gaal, William, Verjans, Johan, Voutnis, Demetrius, Wayne, Victor, Wilson, Peter, Wong, David, Wong, Kirby, Younger, John, Feuchtner, Gudrun, Mirzaei, Siroos, Weiss, Konrad, Maroz-Vadalazhskaya, Natallia, Gheysens, Olivier, Homans, Filip, Moreno-Reyes, Rodrigo, Pasquet, Agnès, Roelants, Veronique, Van De Heyning, Caroline M., Ríos, Raúl Araujo, Soldat-Stankovic, Valentina, Stankovic, Sinisa, Albernaz Siqueira, Maria Helena, Almeida, Augusto, Alves Togni, Paulo Henrique, Andrade, Jose Henrique, Andrade, Luciana, Anselmi, Carlos, Araújo, Roberta, Azevedo, Guilherme, Bezerra, Sabbrina, Biancardi, Rodrigo, Grossman, Gabriel Blacher, Brandão, Simone, Pianta, Diego Bromfman, Carreira, Lara, Castro, Bruno, Chang, Tien, Cunali, Fernando, Cury, Roberto, Dantas, Roberto, de Amorim Fernandes, Fernando, De Lorenzo, Andrea, De Macedo Filho, Robson, Erthal, Fernanda, Fernandes, Fabio, Fernandes, Juliano, De Souza, Thiago Ferreira, Alves, Wilson Furlan, Ghini, Bruno, Goncalves, Luiz, Gottlieb, Ilan, Hadlich, Marcelo, Kameoka, Vinícius, Lima, Ronaldo, Lima, Adna, Lopes, Rafael Willain, Machado e Silva, Ricardo, Magalhães, Tiago, Silva, Fábio Martins, Mastrocola, Luiz Eduardo, Medeiros, Fábio, Meneghetti, José Claudio, Naue, Vania, Naves, Danilo, Nolasco, Roberto, Nomura, Cesar, Oliveira, Joao Bruno, Paixao, Eduardo, De Carvalho, Filipe Penna, Pinto, Ibraim, Possetti, Priscila, Quinta, Mayra, Nogueira Ramos, Rodrigo Rizzo, Rocha, Ricardo, Rodrigues, Alfredo, Rodrigues, Carlos, Romantini, Leila, Sanches, Adelina, Santana, Sara, Sara da Silva, Leonardo, Schvartzman, Paulo, Matushita, Cristina Sebastião, Senra, Tiago, Shiozaki, Afonso, Menezes de Siqueira, Maria Eduarda, Siqueira, Cristiano, Smanio, Paola, Soares, Carlos Eduardo, Junior, José Soares, Bittencourt, Marcio Sommer, Spiro, Bernardo, Mesquita, Cláudio Tinoco, Torreao, Jorge, Torres, Rafael, Uellendahl, Marly, Monte, Guilherme Urpia, Veríssimo, Otávia, Cabeda, Estevan Vieira, Pedras, Felipe Villela, Waltrick, Roberto, Zapparoli, Marcello, Naseer, Hamid, Garcheva-Tsacheva, Marina, Kostadinova, Irena, Theng, Youdaline, Abikhzer, Gad, Barette, Rene, Chow, Benjamin, Dabreo, Dominique, Friedrich, Matthias, Garg, Ria, Hafez, Mohammed Nassoh, Johnson, Chris, Kiess, Marla, Leipsic, Jonathon, Leung, Eugene, Miller, Robert, Oikonomou, Anastasia, Probst, Stephan, Roifman, Idan, Small, Gary, Tandon, Vikas, Trivedi, Adwait, White, James, Zukotynski, Katherine, Canessa, Jose, Muñoz, Gabriel Castro, Concha, Carmen, Hidalgo, Pablo, Lovera, Cesar, Massardo, Teresa, Vargas, Luis Salazar, Abad, Pedro, Arturo, Harold, Ayala, Sandra, Benitez, Luis, Cadena, Alberto, Caicedo, Carlos, Moncayo, Antonio Calderón, Gomez, Sharon, Gutierrez Villamil, Claudia T., Jaimes, Claudia, Londoño, Juan, Londoño Blair, Juan Luis, Pabon, Luz, Pineda, Mauricio, Rojas, Juan Carlos, Ruiz, Diego, Escobar, Manuel Valencia, Vasquez, Andres, Vergel, Damiana, Zuluaga, Alejandro, Gamboa, Isabel Berrocal, Castro, Gabriel, González, Ulises, Baric, Ana, Batinic, Tonci, Franceschi, Maja, Paar, Maja Hrabak, Jukic, Mladen, Medakovic, Petar, Persic, Viktor, Prpic, Marina, Punda, Ante, Batista, Juan Felipe, Gómez Lauchy, Juan Manuel, Gutierrez, Yamile Marcos, Menéndez, Rayner, Peix, Amalia, Rochela, Luis, Panagidis, Christoforos, Petrou, Ioannis, Engelmann, Vaclav, Kaminek, Milan, Kincl, Vladimír, Lang, Otto, Simanek, Milan, Abdulla, Jawdat, Bøttcher, Morten, Christensen, Mette, Gormsen, Lars Christian, Hasbak, Philip, Hess, Søren, Holdgaard, Paw, Johansen, Allan, Kyhl, Kasper, Norgaard, Bjarne Linde, Øvrehus, Kristian Altern, Rønnow Sand, Niels Peter, Steffensen, Rolf, Thomassen, Anders, Zerahn, Bo, Perez, Alfredo, Escorza Velez, Giovanni Alejandro, Velez, Mayra Sanchez, Abdel Aziz, Islam Shawky, Abougabal, Mahasen, Ahmed, Taghreed, Allam, Adel, Asfour, Ahmed, Hassan, Mona, Hassan, Alia, Ibrahim, Ahmed, Kaffas, Sameh, Kandeel, Ahmed, Ali, Mohamed Mandour, Mansy, Ahmad, Maurice, Hany, Nabil, Sherif, Shaaban, Mahmoud, Flores, Ana Camila, Poksi, Anne, Knuuti, Juhani, Kokkonen, Velipekka, Larikka, Martti, Uusitalo, Valtteri, Bailly, Matthieu, Burg, Samuel, Deux, Jean-François, Habouzit, Vincent, Hyafil, Fabien, Lairez, Olivier, Proffit, Franck, Regaieg, Hamza, Sarda-Mantel, Laure, Tacher, Vania, Schneider, Roman P., Ayetey, Harold, Angelidis, George, Archontaki, Aikaterini, Chatziioannou, Sofia, Datseris, Ioannis, Fragkaki, Christina, Georgoulias, Panagiotis, Koukouraki, Sophia, Koutelou, Maria, Kyrozi, Eleni, Repasos, Evangelos, Stavrou, Petros, Valsamaki, Pipitsa, Gonzalez, Carla, Gutierrez, Goleat, Maldonado, Alejandro, Buga, Klara, Garai, Ildiko, Schmidt, Erzsébet, Szilveszter, Balint, Várady, Edit, Banthia, Nilesh, Bhagat, Jinendra Kumar, Bhargava, Rishi, Bhat, Vivek, Bhatia, Mona, Choudhury, Partha, Chowdekar, Vijay Sai, Irodi, Aparna, Jain, Shashank, Joseph, Elizabeth, Kumar, Sukriti, Girijanandan Mahapatra, Prof Dr, Mitra, Deepanjan, Mittal, Bhagwant Rai, Ozair, Ahmad, Patel, Chetan, Patel, Tapan, Patel, Ravi, Patel, Shivani, Saxena, Sudhir, Sengupta, Shantanu, Singh, Santosh, Singh, Bhanupriya, Sood, Ashwani, Verma, Atul, Affandi, Erwin, Alam Edison, Padma Savenadia, Gunawan, Gani, Hapkido, Habusari, Hidayat, Basuki, Huda, Aulia, Mukti, Anggoro Praja, Prawiro, Djoko, Soeriadi, Erwin Affandi, Syawaluddin, Hilman, Albadr, Amjed, Assadi, Majid, Emami, Farshad, Houshmand, Golnaz, Maleki, Majid, Rostami, Maryam Tajik, Zakavi, Seyed Rasoul, Zaid, Eed Abu, Agranovich, Svetlana, Arnson, Yoav, Bar-Shalom, Rachel, Frenkel, Alex, Knafo, Galit, Lugassi, Rachel, Maor Moalem, Israel Shlomo, Mor, Maya, Muskal, Noam, Ranser, Sara, Shalev, Aryeh, Albano, Domenico, Alongi, Pierpaolo, Arnone, Gaspare, Bagatin, Elisa, Baldari, Sergio, Bauckneht, Matteo, Bertelli, Paolo, Bianco, Francesco, Bonfiglioli, Rachele, Boni, Roberto, Bruno, Andrea, Bruno, Isabella, Busnardo, Elena, Califaretti, Elena, Camoni, Luca, Carnevale, Aldo, Casoni, Roberta, Cavallo, Armando Ugo, Cavenaghi, Giorgio, Chierichetti, Franca, Chiocchi, Marcello, Cittanti, Corrado, Colletta, Mauro, Conti, Umberto, Cossu, Alberto, Cuocolo, Alberto, Cuzzocrea, Marco, De Rimini, Maria Luisa, De Vincentis, Giuseppe, Del Giudice, Eleonora, Del Torto, Alberico, Della Tommasina, Veronica, Durmo, Rexhep, Erba, Paola Anna, Evangelista, Laura, Faletti, Riccardo, Faragasso, Evelina, Farsad, Mohsen, Ferro, Paola, Florimonte, Luigia, Frantellizzi, Viviana, Fringuelli, Fabio Massimo, Gatti, Marco, Gaudiano, Angela, Gimelli, Alessia, Giubbini, Raffaele, Giuffrida, Francesca, Ialuna, Salvatore, Laudicella, Riccardo, Leccisotti, Lucia, Leva, Lucia, Liga, Riccardo, Liguori, Carlo, Longo, Giampiero, Maffione, Margherita, Mancini, Maria Elisabetta, Marcassa, Claudio, Milan, Elisa, Nardi, Barbara, Pacella, Sara, Pepe, Giovanna, Pontone, Gianluca, Pulizzi, Sabina, Quartuccio, Natale, Rampin, Lucia, Ricci, Fabrizio, Rossini, Pierluigi, Rubini, Giuseppe, Russo, Vincenzo, Sacchetti, Gian Mauro, Sambuceti, Gianmario, Scarano, Massimo, Sciagrà, Roberto, Sperandio, Massimiliano, Stefanelli, Antonella, Ventroni, Guido, Zoboli, Stefania, Baugh, Dainia, Chambers, Duane, Madu, Ernest, Nunura, Felix, Asano, Hiroshi, Chimura, Chimura Misato, Fujimoto, Shinichiro, Fujisue, Koichiro, Fukunaga, Tomohisa, Fukushima, Yoshimitsu, Fukuyama, Kae, Hashimoto, Jun, Ichikawa, Yasutaka, Iguchi, Nobuo, Imai, Masamichi, Inaki, Anri, Ishimura, Hayato, Isobe, Satoshi, Kadokami, Toshiaki, Kato, Takao, Kumita, Shinichiro, Maruno, Hirotaka, Mataki, Hiroyuki, Miyagawa, Masao, Morimoto, Ryota, Moroi, Masao, Nagamachi, Shigeki, Nakajima, Kenichi, Nakata, Tomoaki, Nakazato, Ryo, Nanasato, Mamoru, Naya, Masanao, Norikane, Takashi, Ohta, Yasutoshi, Okayama, Satoshi, Okizaki, Atsutaka, Otomi, Yoichi, Otsuka, Hideki, Saito, Masaki, Sakata, Sakata Yasushi, Sarai, Masayoshi, Sato, Daisuke, Shiraishi, Shinya, Suwa, Yoshinobu, Takanami, Kentaro, Takehana, Kazuya, Taki, Junichi, Tamaki, Nagara, Taniguchi, Yasuyo, Teragawa, Hiroki, Tomizawa, Nobuo, Tsujita, Kenichi, Umeji, Kyoko, Wakabayashi, Yasushi, Yamada, Shinichiro, Yamazaki, Shinya, Yoneyama, Tatsuya, Rawashdeh, Mohammad, Batyrkhanov, Daultai, Dautov, Tairkhan, Makhdomi, Khalid, Ombati, Kevin, Alkandari, Faridah, Garashi, Masoud, Coie, Tchoyoson Lim, Rajvong, Sonexay, Kalinin, Artem, Kalnina, Marika, Haidar, Mohamad, Komiagiene, Renata, Kviecinskiene, Giedre, Mataciunas, Mindaugas, Vajauskas, Donatas, Picard, Christian, Karim, Noor Khairiah A., Reichmuth, Luise, Samuel, Anthony, Allarakha, Mohammad Aaftaab, Naojee, Ambedhkar Shantaram, Alexanderson-Rosas, Erick, Barragan, Erika, González-Montecinos, Alejandro Becerril, Cabada, Manuel, Rodriguez, Daniel Calderon, Carvajal-Juarez, Isabel, Cortés, Violeta, Cortés, Filiberto, De La Peña, Erasmo, Gama-Moreno, Manlio, González, Luis, Ramírez, Nelsy Gonzalez, Jiménez-Santos, Moisés, Matos, Luis, Monroy, Edgar, Morelos, Martha, Ornelas, Mario, Ortga Ramirez, Jose Alberto, Preciado-Anaya, Andrés, Preciado-Gutiérrez, Óscar Ulises, Barragan, Adriana Puente, Rosales Uvera, Sandra Graciela, Sandoval, Sigelinda, Tomas, Miguel Santaularia, Sierra-Galan, Lilia M., Siu, Silvia, Vallejo, Enrique, Valles, Mario, Faraggi, Marc, Sereegotov, Erdenechimeg, Ilic, Srdja, Ben-Rais, Nozha, Alaoui, Nadia Ismaili, Taleb, Sara, Myo, Khin Pa, Thu, Phyo Si, Ghimire, Ram Kumar, Rajbanshi, Bijoy, Barneveld, Peter, Glaudemans, Andor, Habets, Jesse, Koopmans, Klaas Pieter, Manders, Jeroen, Pool, Stefan, Scholte, Arthur, Scholtens, Asbjørn, Slart, Riemer, Thimister, Paul, Van Asperen, Erik-Jan, Veltman, Niels, Verschure, Derk, Wagenaar, Nils, Edmond, John, Ellis, Chris, Johnson, Kerryanne, Keenan, Ross, Hua, Shaw, Occleshaw, Christopher, Sasse, Alexander, To, Andrew, Van Pelt, Niels, Young, Calum, Cuadra, Teresa, Roque Vanegas, Hector Bladimir, Soli, Idrissa Adamou, Issoufou, Djibrillou Moussa, Ayodele, Tolulope, Madu, Chibuzo, Onimode, Yetunde, Efros-Monsen, Elen, Forsdahl, Signe Helene, Hildre Dimmen, Jenni-Mari, Jørgensen, Arve, Krohn, Isabel, Løvhaugen, Pål, Bråten, Anders Tjellaug, Al Dhuhli, Humoud, Al Kindi, Faiza, Al-Bulushi, Naeema, Jawa, Zabah, Tag, Naima, Afzal, Muhammad Shehzad, Fatima, Shazia, Younis, Muhammad Numair, Riaz, Musab, Saadullah, Mohammad, Herrera, Yariela, Lenturut-Katal, Dora, Vázquez, Manuel Castillo, Ortellado, José, Akhter, Afroza, Cao, Dianbo, Cheung, Stephen, Dai, Xu, Gong, Lianggeng, Han, Dan, Hou, Yang, Li, Caiying, Li, Tao, Li, Dong, Li, Sijin, Liu, Jinkang, Liu, Hui, Ng, Ming Yen, Sun, Kai, Tang, Gongshun, Wang, Jian, Wang, Ximing, Wang, Zhao-Qian, Wang, Yining, Wang, Yifan, Wu, Jiang, Wu, Zhifang, Xia, Liming, Xiao, Jiangxi, Xu, Lei, Yang, Youyou, Yin, Wu, Yu, Jianqun, Yuan, Li, Zhang, Tong, Zhang, Longjiang, Zhang, Yong-Gao, Zhang, Xiaoli, Zhu, Li, Alfaro, Ana, Abrihan, Paz, Barroso, Asela, Cruz, Eric, Gomez, Marie Rhiamar, Magboo, Vincent Peter, Medina, John Michael, Obaldo, Jerry, Pastrana, Davidson, Pawhay, Christian Michael, Quinon, Alvin, Tang, Jeanelle Margareth, Tecson, Bettina, Uson, Kristine Joy, Uy, Mila, Kostkiewicz, Magdalena, Kunikowska, Jolanta, Bettencourt, Nuno, Cantinho, Guilhermina, Ferreira, Antonio, Syed, Ghulam, Arnous, Samer, Atyani, Said, Byrne, Angela, Gleeson, Tadhg, Kerins, David, Meehan, Conor, Murphy, David, Murphy, Mark, Murray, John, O'Brien, Julie, Bang, Ji-In, Bom, Henry, Cho, Sang-Geon, Hong, Chae Moon, Jang, Su Jin, Jeong, Yong Hyu, Kang, Won Jun, Kim, Ji-Young, Lee, Jaetae, Namgung, Chang Kyeong, So, Young, Won, Kyoung Sook, Majstorov, Venjamin, Vavlukis, Marija, Salobir, Barbara Gužic, Štalc, Monika, Benedek, Theodora, Benedek, Imre, Mititelu, Raluca, Stan, Claudiu Adrian, Ansheles, Alexey, Dariy, Olga, Drozdova, Olga, Gagarina, Nina, Gulyaev, Vsevolod Milyevich, Itskovich, Irina, Karalkin, Anatoly, Kokov, Alexander, Migunova, Ekaterina, Pospelov, Viktor, Ryzhkova, Daria, Saifullina, Guzaliya, Sazonova, Svetlana, Shurupova, Irina, Trifonova, Tatjana, Ussov, Wladimir Yurievich, Vakhromeeva, Margarita, Valiullina, Nailya, Zavadovsky, Konstantin, Zhuravlev, Kirill, Alasnag, Mirvat, Okarvi, Subhani, Saranovic, Dragana Sobic, Keng, Felix, Jason See, Jia Hao, Sekar, Ramkumar, Yew, Min Sen, Vondrak, Andrej, Bejai, Shereen, Bennie, George, Bester, Ria, Engelbrecht, Gerrit, Evbuomwan, Osayande, Gongxeka, Harlem, Vuuren, Magritha Jv, Kaplan, Mitchell, Khushica, Purbhoo, Lakhi, Hoosen, Louw, Lizette, Malan, Nico, Milos, Katarina, Modiselle, Moshe, More, Stuart, Naidoo, Mathava, Scholtz, Leonie, Vangu, Mboyo, Aguadé-Bruix, Santiago, Blanco, Isabel, Cabrera, Antonio, Camarero, Alicia, Casáns-Tormo, Irene, Cuellar-Calabria, Hug, Flotats, Albert, Fuentes Cañamero, Maria Eugenia, García, María Elia, Jimenez-Heffernan, Amelia, Leta, Rubén, Diaz, Javier Lopez, Lumbreras, Luis, Marquez-Cabeza, Juan Javier, Martin, Francisco, Martinez de Alegria, Anxo, Medina, Francisco, Canal, Maria Pedrera, Peiro, Virginia, Pubul-Nuñez, Virginia, Rayo Madrid, Juan Ignacio, Rey, Cristina Rodríguez, Perez, Ricardo Ruano, Ruiz, Joaquín, Hernández, Gertrudis Sabatel, Sevilla, Ana, Zeidán, Nahla, Nanayakkara, Damayanthi, Udugama, Chandraguptha, Simonsson, Magnus, Alkadhi, Hatem, Buechel, Ronny Ralf, Burger, Peter, Ceriani, Luca, De Boeck, Bart, Gräni, Christoph, Juillet de Saint Lager Lucas, Alix, Kamani, Christel H., Kawel-Boehm, Nadine, Manka, Robert, Prior, John O., Rominger, Axel, Vallée, Jean-Paul, Khiewvan, Benjapa, Premprabha, Teerapon, Thientunyakit, Tanyaluck, Sellem, Ali, Kir, Kemal Metin, Sayman, Haluk, Sebikali, Mugisha Julius, Muyinda, Zerida, Kmetyuk, Yaroslav, Korol, Pavlo, Mykhalchenko, Olena, Pliatsek, Volodymyr, Satyr, Maryna, Albalooshi, Batool, Ahmed Hassan, Mohamed Ismail, Anderson, Jill, Bedi, Punit, Biggans, Thomas, Bularga, Anda, Bull, Russell, Burgul, Rajesh, Carpenter, John-Paul, Coles, Duncan, Cusack, David, Deshpande, Aparna, Dougan, John, Fairbairn, Timothy, Farrugia, Alexia, Gopalan, Deepa, Gummow, Alistair, Ramkumar, Prasad Guntur, Hamilton, Mark, Harbinson, Mark, Hartley, Thomas, Hudson, Benjamin, Joshi, Nikhil, Kay, Michael, Kelion, Andrew, Khokhar, Azhar, Kitt, Jamie, Lee, Ken, Low, Chen, Mak, Sze Mun, Marousa, Ntouskou, Martin, Jon, Mcalindon, Elisa, Menezes, Leon, Morgan-Hughes, Gareth, Moss, Alastair, Murray, Anthony, Nicol, Edward, Patel, Dilip, Peebles, Charles, Pugliese, Francesca, Luis Rodrigues, Jonathan Carl, Rofe, Christopher, Sabharwal, Nikant, Schofield, Rebecca, Semple, Thomas, Sharma, Naveen, Strouhal, Peter, Subedi, Deepak, Topping, William, Tweed, Katharine, Weir-Mccall, Jonathan, Abbara, Suhny, Abbasi, Taimur, Abbott, Brian, Abohashem, Shady, Abramson, Sandra, Al-Abboud, Tarek, Al-Mallah, Mouaz, Almousalli, Omar, Ananthasubramaniam, Karthikeyan, Kumar, Mohan Ashok, Askew, Jeffrey, Attanasio, Lea, Balmer-Swain, Mallory, Bayer, Richard R., Bernheim, Adam, Bhatti, Sabha, Bieging, Erik, Bloom, Stephen, Blue, Sean, Bluemke, David, Borges, Andressa, Branch, Kelley, Bravo, Paco, Brothers, Jessica, Budoff, Matthew, Bullock-Palmer, Renée, Burandt, Angela, Burke, Floyd W., Bush, Kelvin, Candela, Candace, Capasso, Elizabeth, 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George Kinzfogl, Kircher, Jacqueline, Kirkbride, Rachael, Kontos, Michael, Kottam, Anupama, Krepp, Joseph, Layer, Jay, Lee, Steven H., Leppo, Jeffrey, Lesser, John, Leung, Steve, Lewin, Howard, Litmanovich, Diana, Liu, Yiyan, Magurany, Kathleen, Markowitz, Jeremy, Marn, Amanda, Matis, Stephen E., Mckenna, Michael, Mcrae, Tony, Mendoza, Fernando, Merhige, Michael, Min, David, Moffitt, Chanan, Moncher, Karen, Moore, Warren, Morayati, Shamil, Morris, Michael, Mossa-Basha, Mahmud, Mrsic, Zorana, Murthy, Venkatesh, Nagpal, Prashant, Napier, Kyle, Nelson, Katarina, Nijjar, Prabhjot, Osman, Medhat, Passen, Edward, Patel, Amit, Patil, Pravin, Paul, Ryan, Phillips, Lawrence, Polsani, Venkateshwar, Poludasu, Rajaram, Pomerantz, Brian, Porter, Thomas, Prentice, Ryan, Pursnani, Amit, Rabbat, Mark, Ramamurti, Suresh, Rich, Florence, Luna, Hiram Rivera, Robinson, Austin, Robles, Kim, Rodríguez, Cesar, Rorie, Mark, Rumberger, John, Russell, Raymond, Sabra, Philip, Sadler, Diego, Schemmer, Mary, Schoepf, U. Joseph, Shah, Samir, Shah, Nishant, Shanbhag, Sujata, Sharma, Gaurav, Shayani, Steven, Shirani, Jamshid, Shivaram, Pushpa, Sigman, Steven, Simon, Mitch, Slim, Ahmad, Smith, David, Smith, Alexandra, Soman, Prem, Sood, Aditya, Srichai-Parsia, Monvadi Barbara, Streeter, James, T, Albert, Tawakol, Ahmed, Thomas, Dustin, Thompson, Randall, Torbet, Tara, Trinidad, Desiree, Ullery, Shawn, Unzek, Samuel, Uretsky, Seth, Vallurupalli, Srikanth, Verma, Vikas, Waller, Alfonso, Wang, Ellen, Ward, Parker, Weissman, Gaby, Wesbey, George, White, Kelly, Wolinsky, David, Yost, Sandra, Zgaljardic, Michael, Alonso, Omar, Beretta, Mario, Ferrando, Rodolfo, Kapitan, Miguel, Mut, Fernando, Djuraev, Omoa, Rozikhodjaeva, Gulnora, Le Ngoc, Ha, Mai, Son Hong, Nguyen, Xuan Canh, Hirschfeld, Cole B., Shaw, Leslee J., Williams, Michelle C., Lahey, Ryan, Villines, Todd C., Dorbala, Sharmila, Choi, Andrew D., Shah, Nishant R., Bluemke, David A., Berman, Daniel S., Blankstein, Ron, Ferencik, Maro, Narula, Jagat, Winchester, David, Malkovskiy, Eli, Goebel, Benjamin, Randazzo, Michael J., Lopez-Mattei, Juan, Parwani, Purvi, Vitola, Joao V., Cerci, Rodrigo J., Better, Nathan, Raggi, Paolo, Lu, Bin, Sergienko, Vladimir, Sinitsyn, Valentin, Kudo, Takashi, Nørgaard, Bjarne Linde, Maurovich-Horvat, Pál, Cohen, Yosef A., Pascual, Thomas N. B., Pynda, Yaroslav, Dondi, Maurizio, Paez, Diana, Einstein, Andrew J., Cerci, Rodrigo, Hinterleitner, Gerd, Lu, Yao, Morozova, Olga, Xu, Zhuoran, Cohen, Yosef, Randazzo, Michael, Choi, Andrew, Nasery, Mohammad Nawaz, Goda, Artan, Shirka, Ervina, Benlabgaa, Rabie, Bouyoucef, Salah, Medjahedi, Abdelkader, Nailli, Qai, Agolti, Mariela, Aguero, Roberto Nicola, Alak, Maria del Carmen, Alberguina, Lucia Graciela, Arroñada, Guillermo, Astesiano, Andrea, Astesiano, Alfredo, Norton, Carolina Ba, Benteo, Pablo, Blanco, Juan, Bonelli, Juan Manuel, Bustos, Jose Javier, Cabrejas, Raul, Cachero, Jorge, Campisi, Roxana, Canderoli, Alejandro, Carames, Silvia, Carrascosa, Patrícia, Castro, Ricardo, Cendoya, Oscar, Cognigni, Luciano Martin, Collaud, Carlo, Cortes, Claudia, Courtis, Javier, Cragnolino, Daniel, Daicz, Mariana, De La Vega, Alejandro, De Maria, Silvia Teresa, Del Riego, Horacio, Dettori, Fernando, Deviggiano, Alejandro, Dragonetti, Laura, Embon, Mario, Enriquez, Ruben Emilio, Ensinas, Jorge, Faccio, Fernando, Facello, Adolfo, Garofalo, Diego, Geronazzo, Ricardo, Gonza, Natalia, Gutierrez, Luca, Guzzo, Miguel Angel, Hasbani, Victor, Huerin, Melina, Jäger, Victor, Lewkowicz, Julio Manuel, Nieves A López De Munaín, Maria, Lotti, Jose Maria, Marquez, Alejandra, Masoli, Osvaldo, Masoli, Osvaldo Horacio, Mastrovito, Edgardo, Mayoraz, Matia, Melado, Graciela Eva, Mele, Anibal, Merani, Maria Fernanda, Meretta, Alejandro Horacio, Molteni, Susana, Montecinos, Marco, Noguera, Eduardo, Novoa, Carlo, Sueldo, Claudio Pereyra, Ascani, Sebastian Perez, Pollono, Pablo, Pujol, Maria Paula, Radzinschi, Alejandro, Raimondi, Gustavo, Redruello, Marcela, Rodríguez, Marina, Rodríguez, Matía, Romero, Romina Lorena, Acuña, Arturo Romero, Rovaletti, Federico, San Miguel, Luca, Solari, Lucrecia, Strada, Bruno, Traverso, Sonia, Traverzo, Sonia Simona, Espeche, Maria del Huerto Velazquez, Weihmuller, Juan Sebastian, Wolcan, Juan, Zeffiro, Susana, Sakanyan, Mari, Beuzeville, Scott, Boktor, Raef, Butler, Patrick, Calcott, Jennifer, Carr, Loretta, Chan, Virgil, Chao, Charle, Chong, Woon, Dobson, Mark, Downie, D'Arne, Dwivedi, Girish, Elison, Barry, Engela, Jean, Francis, Roslyn, Gaikwad, Anand, Basavaraj, Ashok Gangasandra, Goodwin, Bruce, Greenough, Robert, Hamilton-Craig, Christian, Hsieh, Victar, Joshi, Subodh, Lederer, Karin, Lee, Kenneth, Lee, Joseph, Magnussen, John, Mai, Nghi, Mander, Gordon, Murton, Fiona, Nandurkar, Dee, Neill, Johanne, O'Rourke, Edward, O'Sullivan, Patricia, Pandos, George, Pathmaraj, Kunthi, Pitman, Alexander, Poulter, Rohan, Premaratne, Manuja, Prior, David, Ridley, Lloyd, Rutherford, Natalie, Salehi, Hamid, Saunders, Connor, Scarlett, Luke, Seneviratne, Sujith, Shetty, Deepa, Shrestha, Ganesh, Shulman, Jonathan, Solanki, Vijay, Stanton, Tony, Stuart, Murch, Stubbs, Michael, Swainson, Ian, Taubman, Kim, Taylor, Andrew, Thomas, Paul, Unger, Steven, Upton, Anthony, Vamadevan, Shankar, Van Gaal, William, Verjans, Johan, Voutnis, Demetriu, Wayne, Victor, Wilson, Peter, Wong, David, Wong, Kirby, Younger, John, Feuchtner, Gudrun, Mirzaei, Siroo, Weiss, Konrad, Maroz-Vadalazhskaya, Natallia, Gheysens, Olivier, Homans, Filip, Moreno-Reyes, Rodrigo, Pasquet, Agnè, Roelants, Veronique, Van De Heyning, Caroline M., Ríos, Raúl Araujo, Soldat-Stankovic, Valentina, Stankovic, Sinisa, Albernaz Siqueira, Maria Helena, Almeida, Augusto, Alves Togni, Paulo Henrique, Andrade, Jose Henrique, Andrade, Luciana, Anselmi, Carlo, Araújo, Roberta, Azevedo, Guilherme, Bezerra, Sabbrina, Biancardi, Rodrigo, Grossman, Gabriel Blacher, Brandão, Simone, Pianta, Diego Bromfman, Carreira, Lara, Castro, Bruno, Chang, Tien, Cunali, Fernando, Cury, Roberto, Dantas, Roberto, de Amorim Fernandes, Fernando, De Lorenzo, Andrea, De Macedo Filho, Robson, Erthal, Fernanda, Fernandes, Fabio, Fernandes, Juliano, De Souza, Thiago Ferreira, Alves, Wilson Furlan, Ghini, Bruno, Goncalves, Luiz, Gottlieb, Ilan, Hadlich, Marcelo, Kameoka, Viníciu, Lima, Ronaldo, Lima, Adna, Lopes, Rafael Willain, Machado e Silva, Ricardo, Magalhães, Tiago, Silva, Fábio Martin, Mastrocola, Luiz Eduardo, Medeiros, Fábio, Meneghetti, José Claudio, Naue, Vania, Naves, Danilo, Nolasco, Roberto, Nomura, Cesar, Oliveira, Joao Bruno, Paixao, Eduardo, De Carvalho, Filipe Penna, Pinto, Ibraim, Possetti, Priscila, Quinta, Mayra, Nogueira Ramos, Rodrigo Rizzo, Rocha, Ricardo, Rodrigues, Alfredo, Rodrigues, Carlo, Romantini, Leila, Sanches, Adelina, Santana, Sara, Sara da Silva, Leonardo, Schvartzman, Paulo, Matushita, Cristina Sebastião, Senra, Tiago, Shiozaki, Afonso, Menezes de Siqueira, Maria Eduarda, Siqueira, Cristiano, Smanio, Paola, Soares, Carlos Eduardo, Junior, José Soare, Bittencourt, Marcio Sommer, Spiro, Bernardo, Mesquita, Cláudio Tinoco, Torreao, Jorge, Torres, Rafael, Uellendahl, Marly, Monte, Guilherme Urpia, Veríssimo, Otávia, Cabeda, Estevan Vieira, Pedras, Felipe Villela, Waltrick, Roberto, Zapparoli, Marcello, Naseer, Hamid, Garcheva-Tsacheva, Marina, Kostadinova, Irena, Theng, Youdaline, Abikhzer, Gad, Barette, Rene, Chow, Benjamin, Dabreo, Dominique, Friedrich, Matthia, Garg, Ria, Hafez, Mohammed Nassoh, Johnson, Chri, Kiess, Marla, Leipsic, Jonathon, Leung, Eugene, Miller, Robert, Oikonomou, Anastasia, Probst, Stephan, Roifman, Idan, Small, Gary, Tandon, Vika, Trivedi, Adwait, White, Jame, Zukotynski, Katherine, Canessa, Jose, Muñoz, Gabriel Castro, Concha, Carmen, Hidalgo, Pablo, Lovera, Cesar, Massardo, Teresa, Vargas, Luis Salazar, Abad, Pedro, Arturo, Harold, Ayala, Sandra, Benitez, Lui, Cadena, Alberto, Caicedo, Carlo, Moncayo, Antonio Calderón, Gomez, Sharon, Gutierrez Villamil, Claudia T., Jaimes, Claudia, Londoño, Juan, Londoño Blair, Juan Lui, Pabon, Luz, Pineda, Mauricio, Rojas, Juan Carlo, Ruiz, Diego, Escobar, Manuel Valencia, Vasquez, Andre, Vergel, Damiana, Zuluaga, Alejandro, Gamboa, Isabel Berrocal, Castro, Gabriel, González, Ulise, Baric, Ana, Batinic, Tonci, Franceschi, Maja, Paar, Maja Hrabak, Jukic, Mladen, Medakovic, Petar, Persic, Viktor, Prpic, Marina, Punda, Ante, Batista, Juan Felipe, Gómez Lauchy, Juan Manuel, Gutierrez, Yamile Marco, Menéndez, Rayner, Peix, Amalia, Rochela, Lui, Panagidis, Christoforo, Petrou, Ioanni, Engelmann, Vaclav, Kaminek, Milan, Kincl, Vladimír, Lang, Otto, Simanek, Milan, Abdulla, Jawdat, Bøttcher, Morten, Christensen, Mette, Gormsen, Lars Christian, Hasbak, Philip, Hess, Søren, Holdgaard, Paw, Johansen, Allan, Kyhl, Kasper, Norgaard, Bjarne Linde, Øvrehus, Kristian Altern, Rønnow Sand, Niels Peter, Steffensen, Rolf, Thomassen, Ander, Zerahn, Bo, Perez, Alfredo, Escorza Velez, Giovanni Alejandro, Velez, Mayra Sanchez, Abdel Aziz, Islam Shawky, Abougabal, Mahasen, Ahmed, Taghreed, Allam, Adel, Asfour, Ahmed, Hassan, Mona, Hassan, Alia, Ibrahim, Ahmed, Kaffas, Sameh, Kandeel, Ahmed, Ali, Mohamed Mandour, Mansy, Ahmad, Maurice, Hany, Nabil, Sherif, Shaaban, Mahmoud, Flores, Ana Camila, Poksi, Anne, Knuuti, Juhani, Kokkonen, Velipekka, Larikka, Martti, Uusitalo, Valtteri, Bailly, Matthieu, Burg, Samuel, Deux, Jean-Françoi, Habouzit, Vincent, Hyafil, Fabien, Lairez, Olivier, Proffit, Franck, Regaieg, Hamza, Sarda-Mantel, Laure, Tacher, Vania, Schneider, Roman P., Ayetey, Harold, Angelidis, George, Archontaki, Aikaterini, Chatziioannou, Sofia, Datseris, Ioanni, Fragkaki, Christina, Georgoulias, Panagioti, Koukouraki, Sophia, Koutelou, Maria, Kyrozi, Eleni, Repasos, Evangelo, Stavrou, Petro, Valsamaki, Pipitsa, Gonzalez, Carla, Gutierrez, Goleat, Maldonado, Alejandro, Buga, Klara, Garai, Ildiko, Schmidt, Erzsébet, Szilveszter, Balint, Várady, Edit, Banthia, Nilesh, Bhagat, Jinendra Kumar, Bhargava, Rishi, Bhat, Vivek, Bhatia, Mona, Choudhury, Partha, Chowdekar, Vijay Sai, Irodi, Aparna, Jain, Shashank, Joseph, Elizabeth, Kumar, Sukriti, Girijanandan Mahapatra, Prof Dr, Mitra, Deepanjan, Mittal, Bhagwant Rai, Ozair, Ahmad, Patel, Chetan, Patel, Tapan, Patel, Ravi, Patel, Shivani, Saxena, Sudhir, Sengupta, Shantanu, Singh, Santosh, Singh, Bhanupriya, Sood, Ashwani, Verma, Atul, Affandi, Erwin, Alam, Edison, Padma, Savenadia, Gunawan, Gani, Hapkido, Habusari, Hidayat, Basuki, Huda, Aulia, Mukti, Anggoro Praja, Prawiro, Djoko, Soeriadi, Erwin Affandi, Syawaluddin, Hilman, Albadr, Amjed, Assadi, Majid, Emami, Farshad, Houshmand, Golnaz, Maleki, Majid, Rostami, Maryam Tajik, Zakavi, Seyed Rasoul, Zaid, Eed Abu, Agranovich, Svetlana, Arnson, Yoav, Bar-Shalom, Rachel, Frenkel, Alex, Knafo, Galit, Lugassi, Rachel, Maor Moalem, Israel Shlomo, Mor, Maya, Muskal, Noam, Ranser, Sara, Shalev, Aryeh, Albano, Domenico, Alongi, Pierpaolo, Arnone, Gaspare, Bagatin, Elisa, Baldari, Sergio, Bauckneht, Matteo, Bertelli, Paolo, Bianco, Francesco, Bonfiglioli, Rachele, Boni, Roberto, Bruno, Andrea, Bruno, Isabella, Busnardo, Elena, Califaretti, Elena, Camoni, Luca, Carnevale, Aldo, Casoni, Roberta, Cavallo, Armando Ugo, Cavenaghi, Giorgio, Chierichetti, Franca, Chiocchi, Marcello, Cittanti, Corrado, Colletta, Mauro, Conti, Umberto, Cossu, Alberto, Cuocolo, Alberto, Cuzzocrea, Marco, De Rimini, Maria Luisa, De Vincentis, Giuseppe, Del Giudice, Eleonora, Del Torto, Alberico, Della Tommasina, Veronica, Durmo, Rexhep, Erba, Paola Anna, Evangelista, Laura, Faletti, Riccardo, Faragasso, Evelina, Farsad, Mohsen, Ferro, Paola, Florimonte, Luigia, Frantellizzi, Viviana, Fringuelli, Fabio Massimo, Gatti, Marco, Gaudiano, Angela, Gimelli, Alessia, Giubbini, Raffaele, Giuffrida, Francesca, Ialuna, Salvatore, Laudicella, Riccardo, Leccisotti, Lucia, Leva, Lucia, Liga, Riccardo, Liguori, Carlo, Longo, Giampiero, Maffione, Margherita, Mancini, Maria Elisabetta, Marcassa, Claudio, Milan, Elisa, Nardi, Barbara, Pacella, Sara, Pepe, Giovanna, Pontone, Gianluca, Pulizzi, Sabina, Quartuccio, Natale, Rampin, Lucia, Ricci, Fabrizio, Rossini, Pierluigi, Rubini, Giuseppe, Russo, Vincenzo, Sacchetti, Gian Mauro, Sambuceti, Gianmario, Scarano, Massimo, Sciagrà, Roberto, Sperandio, Massimiliano, Stefanelli, Antonella, Ventroni, Guido, Zoboli, Stefania, Baugh, Dainia, Chambers, Duane, Madu, Ernest, Nunura, Felix, Asano, Hiroshi, Chimura, Chimura Misato, Fujimoto, Shinichiro, Fujisue, Koichiro, Fukunaga, Tomohisa, Fukushima, Yoshimitsu, Fukuyama, Kae, Hashimoto, Jun, Ichikawa, Yasutaka, Iguchi, Nobuo, Imai, Masamichi, Inaki, Anri, Ishimura, Hayato, Isobe, Satoshi, Kadokami, Toshiaki, Kato, Takao, Kumita, Shinichiro, Maruno, Hirotaka, Mataki, Hiroyuki, Miyagawa, Masao, Morimoto, Ryota, Moroi, Masao, Nagamachi, Shigeki, Nakajima, Kenichi, Nakata, Tomoaki, Nakazato, Ryo, Nanasato, Mamoru, Naya, Masanao, Norikane, Takashi, Ohta, Yasutoshi, Okayama, Satoshi, Okizaki, Atsutaka, Otomi, Yoichi, Otsuka, Hideki, Saito, Masaki, Sakata, Sakata Yasushi, Sarai, Masayoshi, Sato, Daisuke, Shiraishi, Shinya, Suwa, Yoshinobu, Takanami, Kentaro, Takehana, Kazuya, Taki, Junichi, Tamaki, Nagara, Taniguchi, Yasuyo, Teragawa, Hiroki, Tomizawa, Nobuo, Tsujita, Kenichi, Umeji, Kyoko, Wakabayashi, Yasushi, Yamada, Shinichiro, Yamazaki, Shinya, Yoneyama, Tatsuya, Rawashdeh, Mohammad, Batyrkhanov, Daultai, Dautov, Tairkhan, Makhdomi, Khalid, Ombati, Kevin, Alkandari, Faridah, Garashi, Masoud, Coie, Tchoyoson Lim, Rajvong, Sonexay, Kalinin, Artem, Kalnina, Marika, Haidar, Mohamad, Komiagiene, Renata, Kviecinskiene, Giedre, Mataciunas, Mindauga, Vajauskas, Donata, Picard, Christian, Karim, Noor Khairiah A., Reichmuth, Luise, Samuel, Anthony, Allarakha, Mohammad Aaftaab, Naojee, Ambedhkar Shantaram, Alexanderson-Rosas, Erick, Barragan, Erika, González-Montecinos, Alejandro Becerril, Cabada, Manuel, Rodriguez, Daniel Calderon, Carvajal-Juarez, Isabel, Cortés, Violeta, Cortés, Filiberto, De La Peña, Erasmo, Gama-Moreno, Manlio, González, Lui, Ramírez, Nelsy Gonzalez, Jiménez-Santos, Moisé, Matos, Lui, Monroy, Edgar, Morelos, Martha, Ornelas, Mario, Ortga Ramirez, Jose Alberto, Preciado-Anaya, André, Preciado-Gutiérrez, Óscar Ulise, Barragan, Adriana Puente, Rosales Uvera, Sandra Graciela, Sandoval, Sigelinda, Tomas, Miguel Santaularia, Sierra-Galan, Lilia M., Siu, Silvia, Vallejo, Enrique, Valles, Mario, Faraggi, Marc, Sereegotov, Erdenechimeg, Ilic, Srdja, Ben-Rais, Nozha, Alaoui, Nadia Ismaili, Taleb, Sara, Myo, Khin Pa, Thu, Phyo Si, Ghimire, Ram Kumar, Rajbanshi, Bijoy, Barneveld, Peter, Glaudemans, Andor, Habets, Jesse, Koopmans, Klaas Pieter, Manders, Jeroen, Pool, Stefan, Scholte, Arthur, Scholtens, Asbjørn, Slart, Riemer, Thimister, Paul, Van Asperen, Erik-Jan, Veltman, Niel, Verschure, Derk, Wagenaar, Nil, Edmond, John, Ellis, Chri, Johnson, Kerryanne, Keenan, Ro, Hua, Shaw, Occleshaw, Christopher, Sasse, Alexander, To, Andrew, Van Pelt, Niel, Young, Calum, Cuadra, Teresa, Roque Vanegas, Hector Bladimir, Soli, Idrissa Adamou, Issoufou, Djibrillou Moussa, Ayodele, Tolulope, Madu, Chibuzo, Onimode, Yetunde, Efros-Monsen, Elen, Forsdahl, Signe Helene, Hildre Dimmen, Jenni-Mari, Jørgensen, Arve, Krohn, Isabel, Løvhaugen, Pål, Bråten, Anders Tjellaug, Al Dhuhli, Humoud, Al Kindi, Faiza, Al-Bulushi, Naeema, Jawa, Zabah, Tag, Naima, Afzal, Muhammad Shehzad, Fatima, Shazia, Younis, Muhammad Numair, Riaz, Musab, Saadullah, Mohammad, Herrera, Yariela, Lenturut-Katal, Dora, Vázquez, Manuel Castillo, Ortellado, José, Akhter, Afroza, Cao, Dianbo, Cheung, Stephen, Dai, Xu, Gong, Lianggeng, Han, Dan, Hou, Yang, Li, Caiying, Li, Tao, Li, Dong, Li, Sijin, Liu, Jinkang, Liu, Hui, Ng, Ming Yen, Sun, Kai, Tang, Gongshun, Wang, Jian, Wang, Ximing, Wang, Zhao-Qian, Wang, Yining, Wang, Yifan, Wu, Jiang, Wu, Zhifang, Xia, Liming, Xiao, Jiangxi, Xu, Lei, Yang, Youyou, Yin, Wu, Yu, Jianqun, Yuan, Li, Zhang, Tong, Zhang, Longjiang, Zhang, Yong-Gao, Zhang, Xiaoli, Zhu, Li, Alfaro, Ana, Abrihan, Paz, Barroso, Asela, Cruz, Eric, Gomez, Marie Rhiamar, Magboo, Vincent Peter, Medina, John Michael, Obaldo, Jerry, Pastrana, Davidson, Pawhay, Christian Michael, Quinon, Alvin, Tang, Jeanelle Margareth, Tecson, Bettina, Uson, Kristine Joy, Uy, Mila, Kostkiewicz, Magdalena, Kunikowska, Jolanta, Bettencourt, Nuno, Cantinho, Guilhermina, Ferreira, Antonio, Syed, Ghulam, Arnous, Samer, Atyani, Said, Byrne, Angela, Gleeson, Tadhg, Kerins, David, Meehan, Conor, Murphy, David, Murphy, Mark, Murray, John, O'Brien, Julie, Bang, Ji-In, Bom, Henry, Cho, Sang-Geon, Hong, Chae Moon, Jang, Su Jin, Jeong, Yong Hyu, Kang, Won Jun, Kim, Ji-Young, Lee, Jaetae, Namgung, Chang Kyeong, So, Young, Won, Kyoung Sook, Majstorov, Venjamin, Vavlukis, Marija, Salobir, Barbara Gužic, Štalc, Monika, Benedek, Theodora, Benedek, Imre, Mititelu, Raluca, Stan, Claudiu Adrian, Ansheles, Alexey, Dariy, Olga, Drozdova, Olga, Gagarina, Nina, Gulyaev, Vsevolod Milyevich, Itskovich, Irina, Karalkin, Anatoly, Kokov, Alexander, Migunova, Ekaterina, Pospelov, Viktor, Ryzhkova, Daria, Saifullina, Guzaliya, Sazonova, Svetlana, Shurupova, Irina, Trifonova, Tatjana, Ussov, Wladimir Yurievich, Vakhromeeva, Margarita, Valiullina, Nailya, Zavadovsky, Konstantin, Zhuravlev, Kirill, Alasnag, Mirvat, Okarvi, Subhani, Saranovic, Dragana Sobic, Keng, Felix, Jason See, Jia Hao, Sekar, Ramkumar, Yew, Min Sen, Vondrak, Andrej, Bejai, Shereen, Bennie, George, Bester, Ria, Engelbrecht, Gerrit, Evbuomwan, Osayande, Gongxeka, Harlem, Vuuren, Magritha Jv, Kaplan, Mitchell, Khushica, Purbhoo, Lakhi, Hoosen, Louw, Lizette, Malan, Nico, Milos, Katarina, Modiselle, Moshe, More, Stuart, Naidoo, Mathava, Scholtz, Leonie, Vangu, Mboyo, Aguadé-Bruix, Santiago, Blanco, Isabel, Cabrera, Antonio, Camarero, Alicia, Casáns-Tormo, Irene, Cuellar-Calabria, Hug, Flotats, Albert, Fuentes Cañamero, Maria Eugenia, García, María Elia, Jimenez-Heffernan, Amelia, Leta, Rubén, Diaz, Javier Lopez, Lumbreras, Lui, Marquez-Cabeza, Juan Javier, Martin, Francisco, Martinez de Alegria, Anxo, Medina, Francisco, Canal, Maria Pedrera, Peiro, Virginia, Pubul-Nuñez, Virginia, Rayo Madrid, Juan Ignacio, Rey, Cristina Rodríguez, Perez, Ricardo Ruano, Ruiz, Joaquín, Hernández, Gertrudis Sabatel, Sevilla, Ana, Zeidán, Nahla, Nanayakkara, Damayanthi, Udugama, Chandraguptha, Simonsson, Magnu, Alkadhi, Hatem, Buechel, Ronny Ralf, Burger, Peter, Ceriani, Luca, De Boeck, Bart, Gräni, Christoph, Juillet de Saint Lager Lucas, Alix, Kamani, Christel H., Kawel-Boehm, Nadine, Manka, Robert, Prior, John O., Rominger, Axel, Vallée, Jean-Paul, Khiewvan, Benjapa, Premprabha, Teerapon, Thientunyakit, Tanyaluck, Sellem, Ali, Kir, Kemal Metin, Sayman, Haluk, Sebikali, Mugisha Juliu, Muyinda, Zerida, Kmetyuk, Yaroslav, Korol, Pavlo, Mykhalchenko, Olena, Pliatsek, Volodymyr, Satyr, Maryna, Albalooshi, Batool, Ahmed Hassan, Mohamed Ismail, Anderson, Jill, Bedi, Punit, Biggans, Thoma, Bularga, Anda, Bull, Russell, Burgul, Rajesh, Carpenter, John-Paul, Coles, Duncan, Cusack, David, Deshpande, Aparna, Dougan, John, Fairbairn, Timothy, Farrugia, Alexia, Gopalan, Deepa, Gummow, Alistair, Ramkumar, Prasad Guntur, Hamilton, Mark, Harbinson, Mark, Hartley, Thoma, Hudson, Benjamin, Joshi, Nikhil, Kay, Michael, Kelion, Andrew, Khokhar, Azhar, Kitt, Jamie, Lee, Ken, Low, Chen, Mak, Sze Mun, Marousa, Ntouskou, Martin, Jon, Mcalindon, Elisa, Menezes, Leon, Morgan-Hughes, Gareth, Moss, Alastair, Murray, Anthony, Nicol, Edward, Patel, Dilip, Peebles, Charle, Pugliese, Francesca, Luis Rodrigues, Jonathan Carl, Rofe, Christopher, Sabharwal, Nikant, Schofield, Rebecca, Semple, Thoma, Sharma, Naveen, Strouhal, Peter, Subedi, Deepak, Topping, William, Tweed, Katharine, Weir-Mccall, Jonathan, Abbara, Suhny, Abbasi, Taimur, Abbott, Brian, Abohashem, Shady, Abramson, Sandra, Al-Abboud, Tarek, Al-Mallah, Mouaz, Almousalli, Omar, Ananthasubramaniam, Karthikeyan, Kumar, Mohan Ashok, Askew, Jeffrey, Attanasio, Lea, Balmer-Swain, Mallory, Bayer, Richard R., Bernheim, Adam, Bhatti, Sabha, Bieging, Erik, Bloom, Stephen, Blue, Sean, Bluemke, David, Borges, Andressa, Branch, Kelley, Bravo, Paco, Brothers, Jessica, Budoff, Matthew, Bullock-Palmer, Renée, Burandt, Angela, Burke, Floyd W., Bush, Kelvin, Candela, Candace, Capasso, Elizabeth, Cavalcante, Joao, Chang, Donald, Chatterjee, Saurav, Chatzizisis, Yianni, Cheezum, Michael, Chen, Tiffany, Chen, Jennifer, Chen, Marcu, Clarcq, Jame, Cordero, Ayreen, Crim, Matthew, Danciu, Sorin, Decter, Bruce, Dhruva, Nimish, Doherty, Neil, Doukky, Rami, Dunbar, Anjori, Duvall, William, Edwards, Rachael, Esquitin, Kerry, Farah, Husam, Fentanes, Emilio, Fisher, Daniel, Fitzpatrick, Daniel, Foster, Cameron, Fuisz, Tony, Gannon, Michael, Gastner, Lori, Gerson, Myron, Ghoshhajra, Brian, Goldberg, Alan, Goldner, Brian, Gonzalez, Jorge, Gore, Rosco, Gracia-López, Sandra, Hage, Fadi, Haider, Agha, Haider, Sofia, Hamirani, Yasmin, Hassen, Karen, Hatfield, Mallory, Hawkins, Carolyn, Hawthorne, Katie, Heath, Nichola, Hendel, Robert, Hernandez, Phillip, Hill, Gregory, Horgan, Stephen, Huffman, Jeff, Hurwitz, Lynne, Iskandrian, Ami, Janardhanan, Rajesh, Jellis, Christine, Jerome, Scott, Kalra, Dinesh, Kaviratne, Summanther, Kay, Fernando, Kelly, Faith, Khalique, Omar, Kinkhabwala, Mona, Iii, George Kinzfogl, Kircher, Jacqueline, Kirkbride, Rachael, Kontos, Michael, Kottam, Anupama, Krepp, Joseph, Layer, Jay, Lee, Steven H., Leppo, Jeffrey, Lesser, John, Leung, Steve, Lewin, Howard, Litmanovich, Diana, Liu, Yiyan, Magurany, Kathleen, Markowitz, Jeremy, Marn, Amanda, Matis, Stephen E., Mckenna, Michael, Mcrae, Tony, Mendoza, Fernando, Merhige, Michael, Min, David, Moffitt, Chanan, Moncher, Karen, Moore, Warren, Morayati, Shamil, Morris, Michael, Mossa-Basha, Mahmud, Mrsic, Zorana, Murthy, Venkatesh, Nagpal, Prashant, Napier, Kyle, Nelson, Katarina, Nijjar, Prabhjot, Osman, Medhat, Passen, Edward, Patel, Amit, Patil, Pravin, Paul, Ryan, Phillips, Lawrence, Polsani, Venkateshwar, Poludasu, Rajaram, Pomerantz, Brian, Porter, Thoma, Prentice, Ryan, Pursnani, Amit, Rabbat, Mark, Ramamurti, Suresh, Rich, Florence, Luna, Hiram Rivera, Robinson, Austin, Robles, Kim, Rodríguez, Cesar, Rorie, Mark, Rumberger, John, Russell, Raymond, Sabra, Philip, Sadler, Diego, Schemmer, Mary, Schoepf, U. Joseph, Shah, Samir, Shah, Nishant, Shanbhag, Sujata, Sharma, Gaurav, Shayani, Steven, Shirani, Jamshid, Shivaram, Pushpa, Sigman, Steven, Simon, Mitch, Slim, Ahmad, Smith, David, Smith, Alexandra, Soman, Prem, Sood, Aditya, Srichai-Parsia, Monvadi Barbara, Streeter, Jame, T, Albert, Tawakol, Ahmed, Thomas, Dustin, Thompson, Randall, Torbet, Tara, Trinidad, Desiree, Ullery, Shawn, Unzek, Samuel, Uretsky, Seth, Vallurupalli, Srikanth, Verma, Vika, Waller, Alfonso, Wang, Ellen, Ward, Parker, Weissman, Gaby, Wesbey, George, White, Kelly, Wolinsky, David, Yost, Sandra, Zgaljardic, Michael, Alonso, Omar, Beretta, Mario, Ferrando, Rodolfo, Kapitan, Miguel, Mut, Fernando, Djuraev, Omoa, Rozikhodjaeva, Gulnora, Le Ngoc, Ha, Mai, Son Hong, Nguyen, Xuan Canh, Hirschfeld, C, Shaw, L, Williams, M, Lahey, R, Villines, T, Dorbala, S, Choi, A, Shah, N, Bluemke, D, Berman, D, Blankstein, R, Ferencik, M, Narula, J, Winchester, D, Malkovskiy, E, Goebel, B, Randazzo, M, Lopez-Mattei, J, Parwani, P, Vitola, J, Cerci, R, Better, N, Raggi, P, Lu, B, Sergienko, V, Sinitsyn, V, Kudo, T, Nørgaard, B, Maurovich-Horvat, P, Cohen, Y, Pascual, T, Pynda, Y, Dondi, M, Paez, D, Einstein, A, and Erba, P
Subjects: Aging, Coronavirus disease 2019 (COVID-19), Clinical Sciences, coronavirus, Disease, 030204 cardiovascular system & hematology, Cardiorespiratory Medicine and Haematology, Cardiovascular, 030218 nuclear medicine & medical imaging, NO, 03 medical and health sciences, 0302 clinical medicine, COVID-19 Testing, Cardiovascular procedures, Predictive Value of Tests, cardiovascular disease, Clinical Research, Environmental health, INCAPS-COVID Investigators Group, Pandemic, Volume reduction, Medicine, Humans, Radiology, Nuclear Medicine and imaging, cardiovascular imaging, diagnostic cardiovascular procedure, Pandemics, business.industry, SARS-CoV-2, Prevention, COVID-19, Health Services, United States/epidemiology, United States, Invasive coronary angiography, coronaviru, Heart Disease, Good Health and Well Being, MYOCARDIAL-INFARCTION, Cardiovascular System & Hematology, Predictive value of tests, HOSPITAL ADMISSIONS, Cardiology and Cardiovascular Medicine, Early phase, business
Abstract: Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-U.S. institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection.
Published: 2021

20. International Impact of COVID-19 on the Diagnosis of Heart Disease

Author: Einstein, A. J., Shaw, L. J., Hirschfeld, C., Williams, M. C., Villines, T. C., Better, N., Vitola, J. V., Cerci, R., Dorbala, S., Raggi, P., Choi, A. D., Lu, B., Sinitsyn, V., Sergienko, V., Kudo, T., Norgaard, B. L., Maurovich-Horvat, P., Campisi, R., Milan, E., Louw, L., Allam, A. H., Bhatia, M., Malkovskiy, E., Goebel, B., Cohen, Y., Randazzo, M., Narula, J., Pascual, T. N. B., Pynda, Y., Dondi, M., Gerd Hinterleitner, Paez D., Yao, Lu, Olga, Morozova, Zhuoran, Xu, Juan, Lopez-Mattei, Purvi, Parwani, Mohammad Nawaz Nasery, Artan, Goda, Ervina, Shirka, Rabie, Benlabgaa, Salah, Bouyoucef, Abdelkader, Medjahedi, Qais, Nailli, Mariela, Agolti, Roberto Nicolas Aguero, Maria Del Carmen Alak, Lucia Graciela Alberguina, Guillermo, Arroñada, Andrea, Astesiano, Alfredo, Astesiano, Carolina Bas Norton, Pablo, Benteo, Juan, Blanco, Juan Manuel Bonelli, Jose Javier Bustos, Raul, Cabrejas, Jorge, Cachero, Alejandro, Canderoli, Silvia, Carames, Patrícia, Carrascosa, Ricardo, Castro, Oscar, Cendoya, Luciano Martin Cognigni, Carlos, Collaud, Claudia, Cortes, Javier, Courtis, Daniel, Cragnolino, Mariana, Daicz, Alejandro De La Vega, Silvia Teresa De Maria, Horacio Del Riego, Fernando, Dettori, Alejandro, Deviggiano, Laura, Dragonetti, Mario, Embon, Ruben Emilio Enriquez, Jorge, Ensinas, Fernando, Faccio, Adolfo, Facello, Diego, Garofalo, Ricardo, Geronazzo, Natalia, Gonza, Lucas, Gutierrez, Miguel Angel Guzzo, Victor, Hasbani, Melina, Huerin, Victor, Jäger, Julio Manuel Lewkowicz, Maria Nieves, A López De Munaín, Jose Maria Lotti, Alejandra, Marquez, Osvaldo, Masoli, Edgardo, Mastrovito, Matias, Mayoraz, Graciela Eva Melado, Anibal, Mele, Maria Fernanda Merani, Alejandro Horacio Meretta, Susana, Molteni, Marcos, Montecinos, Eduardo, Noguera, Carlos, Novoa, Claudio Pereyra Sueldo, Sebastian Perez Ascani, Pablo, Pollono, Maria Paula Pujol, Alejandro, Radzinschi, Gustavo, Raimondi, Marcela, Redruello, Marina, Rodríguez, Matías, Rodríguez, Romina Lorena Romero, Arturo Romero Acuña, Federico, Rovaletti, Lucas San Miguel, Lucrecia, Solari, Bruno, Strada, Sonia, Traverso, Sonia Simona Traverzo, Maria Del Huerto Velazquez Espeche, Juan Sebastian Weihmuller, Juan, Wolcan, Susana, Zeffiro, Mari, Sakanyan, Scott, Beuzeville, Raef, Boktor, Patrick, Butler, Jennifer, Calcott, Loretta, Carr, Virgil, Chan, Charles, Chao, Woon, Chong, Mark, Dobson, D'Arne, Downie, Girish, Dwivedi, Barry, Elison, Jean, Engela, Roslyn, Francis, Anand, Gaikwad, Ashok Gangasandra Basavaraj, Bruce, Goodwin, Robert, Greenough, Christian, Hamilton-Craig, Victar, Hsieh, Subodh, Joshi, Karin, Lederer, Kenneth, Lee, Joseph, Lee, John, Magnussen, Nghi, Mai, Gordon, Mander, Fiona, Murton, Dee, Nandurkar, Johanne, Neill, Edward, O'Rourke, Patricia, O'Sullivan, George, Pandos, Kunthi, Pathmaraj, Alexander, Pitman, Rohan, Poulter, Manuja, Premaratne, David, Prior, Lloyd, Ridley, Natalie, Rutherford, Hamid, Salehi, Connor, Saunders, Luke, Scarlett, Sujith, Seneviratne, Deepa, Shetty, Ganesh, Shrestha, Jonathan, Shulman, Vijay, Solanki, Tony, Stanton, Murch, Stuart, Michael, Stubbs, Ian, Swainson, Kim, Taubman, Andrew, Taylor, Paul, Thomas, Steven, Unger, Anthony, Upton, Shankar, Vamadevan, William Van Gaal, Johan, Verjans, Demetrius, Voutnis, Victor, Wayne, Peter, Wilson, David, Wong, Kirby, Wong, John, Younger, Gudrun, Feuchtner, Siroos, Mirzaei, Konrad, Weiss, Natallia, Maroz-Vadalazhskaya, Olivier, Gheysens, Filip, Homans, Rodrigo, Moreno-Reyes, Agnès, Pasquet, Veronique, Roelants, Caroline, M Van De Heyning, Raúl Araujo Ríos, Valentina, Soldat-Stankovic, Sinisa, Stankovic, Maria Helena Albernaz Siqueira, Augusto, Almeida, Paulo Henrique Alves Togni, Jose Henrique Andrade, Luciana, Andrade, Carlos, Anselmi, Roberta, Araújo, Guilherme, Azevedo, Sabbrina, Bezerra, Rodrigo, Biancardi, Gabriel Blacher Grossman, Simone, Brandão, Diego Bromfman Pianta, Lara, Carreira, Bruno, Castro, Tien, Chang, Fernando Cunali Jr, Roberto, Cury, Roberto, Dantas, Fernando de Amorim Fernandes, Andrea De Lorenzo, Robson De Macedo Filho, Fernanda, Erthal, Fabio, Fernandes, Juliano, Fernandes, Thiago Ferreira De Souza, Wilson Furlan Alves, Bruno, Ghini, Luiz, Goncalves, Ilan, Gottlieb, Marcelo, Hadlich, Vinícius, Kameoka, Ronaldo, Lima, Adna, Lima, Rafael Willain Lopes, Ricardo Machado, E Silva, Tiago, Magalhães, Fábio Martins Silva, Luiz Eduardo Mastrocola, Fábio, Medeiros, José Claudio Meneghetti, Vania, Naue, Danilo, Naves, Roberto, Nolasco, Cesar, Nomura, Joao Bruno Oliveira, Eduardo, Paixao, Filipe Penna De Carvalho, Ibraim, Pinto, Priscila, Possetti, Mayra, Quinta, Rodrigo Rizzo Nogueira Ramos, Ricardo, Rocha, Alfredo, Rodrigues, Carlos, Rodrigues, Leila, Romantini, Adelina, Sanches, Sara, Santana, Leonardo Sara da Silva, Paulo, Schvartzman, Cristina Sebastião Matushita, Tiago, Senra, Afonso, Shiozaki, Maria Eduarda Menezes de Siqueira, Cristiano, Siqueira, Paola, Smanio, Carlos Eduardo Soares, José Soares Junior, Marcio Sommer Bittencourt, Bernardo, Spiro, Cláudio Tinoco Mesquita, Jorge, Torreao, Rafael, Torres, Marly, Uellendahl, Guilherme Urpia Monte, Otávia, Veríssimo, Estevan Vieira Cabeda, Felipe Villela Pedras, Roberto, Waltrick, Marcello, Zapparoli, Hamid, Naseer, Marina, Garcheva-Tsacheva, Irena, Kostadinova, Youdaline, Theng, Gad, Abikhzer, Rene, Barette, Benjamin, Chow, Dominique, Dabreo, Matthias, Friedrich, Ria, Garg, Mohammed Nassoh Hafez, Chris, Johnson, Marla, Kiess, Jonathon, Leipsic, Eugene, Leung, Robert, Miller, Anastasia, Oikonomou, Stephan, Probst, Idan, Roifman, Gary, Small, Vikas, Tandon, Adwait, Trivedi, James, White, Katherine, Zukotynski, Jose, Canessa, Gabriel Castro Muñoz, Carmen, Concha, Pablo, Hidalgo, Cesar, Lovera, Teresa, Massardo, Luis Salazar Vargas, Pedro, Abad, Harold, Arturo, Sandra, Ayala, Luis, Benitez, Alberto, Cadena, Carlos, Caicedo, Antonio Calderón Moncayo, Sharon, Gomez, Claudia, T Gutierrez Villamil, Claudia, Jaimes, Juan Luis Londoño Blair, Luz, Pabon, Mauricio, Pineda, Juan Carlos Rojas, Diego, Ruiz, Manuel Valencia Escobar, Andres, Vasquez, Damiana, Vergel, Alejandro, Zuluaga, Isabel Berrocal Gamboa, Gabriel, Castro, Ulises, González, Ana, Baric, Tonci, Batinic, Maja, Franceschi, Maja Hrabak Paar, Mladen, Jukic, Petar, Medakovic, Viktor, Persic, Marina, Prpic, Ante, Punda, Juan Felipe Batista, Juan Manuel Gómez Lauchy, Yamile Marcos Gutierrez, Rayner, Menéndez, Amalia, Peix, Luis, Rochela, Christoforos, Panagidis, Ioannis, Petrou, Vaclav, Engelmann, Milan, Kaminek, Vladimír, Kincl, Otto, Lang, Milan, Simanek, Jawdat, Abdulla, Morten, Bøttcher, Mette, Christensen, Lars Christian Gormsen, Philip, Hasbak, Søren, Hess, Paw, Holdgaard, Allan, Johansen, Kasper, Kyhl, Kristian Altern Øvrehus, Niels Peter Rønnow Sand, Rolf, Steffensen, Anders, Thomassen, Zerahn, Bo, Alfredo, Perez, Giovanni Alejandro Escorza Velez, Mayra Sanchez Velez, Islam Shawky Abdel Aziz, Mahasen, Abougabal, Taghreed, Ahmed, Ahmed, Asfour, Mona, Hassan, Alia, Hassan, Ahmed, Ibrahim, Sameh, Kaffas, Ahmed, Kandeel, Mohamed Mandour Ali, Ahmad, Mansy, Hany, Maurice, Sherif, Nabil, Mahmoud, Shaaban, Ana Camila Flores, Anne, Poksi, Juhani, Knuuti, Velipekka, Kokkonen, Martti, Larikka, Valtteri, Uusitalo, Matthieu, Bailly, Samuel, Burg, Jean-François, Deux, Vincent, Habouzit, Fabien, Hyafil, Olivier, Lairez, Franck, Proffit, Hamza, Regaieg, Laure, Sarda-Mantel, Vania, Tacher, Roman, P Schneider, Harold, Ayetey, George, Angelidis, Aikaterini, Archontaki, Sofia, Chatziioannou, Ioannis, Datseris, Christina, Fragkaki, Panagiotis, Georgoulias, Sophia, Koukouraki, Maria, Koutelou, Eleni, Kyrozi, Evangelos, Repasos, Petros, Stavrou, Pipitsa, Valsamaki, Carla, Gonzalez, Goleat, Gutierrez, Alejandro, Maldonado, Klara, Buga, Ildiko, Garai, Erzsébet, Schmidt, Balint, Szilveszter, Edit, Várady, Nilesh, Banthia, Jinendra Kumar Bhagat, Rishi, Bhargava, Vivek, Bhat, Partha, Choudhury, Vijay Sai Chowdekar, Aparna, Irodi, Shashank, Jain, Elizabeth, Joseph, Sukriti, Kumar, Girijanandan, Mahapatra, Deepanjan, Mitra, Bhagwant Rai Mittal, Ahmad, Ozair, Chetan, Patel, Tapan, Patel, Ravi, Patel, Shivani, Patel, Sudhir, Saxena, Shantanu, Sengupta, Santosh, Singh, Bhanupriya, Singh, Ashwani, Sood, Atul, Verma, Erwin, Affandi, Padma Savenadia Alam, Edison, Edison, Gani, Gunawan, Habusari, Hapkido, Basuki, Hidayat, Aulia, Huda, Anggoro Praja Mukti, Djoko, Prawiro, Erwin Affandi Soeriadi, Hilman, Syawaluddin, Amjed, Albadr, Majid, Assadi, Farshad, Emami, Golnaz, Houshmand, Majid, Maleki, Maryam Tajik Rostami, Seyed Rasoul Zakavi, Eed Abu Zaid, Svetlana, Agranovich, Yoav, Arnson, Rachel, Bar-Shalom, Alex, Frenkel, Galit, Knafo, Rachel, Lugassi, Israel Shlomo Maor Moalem, Maya, Mor, Noam, Muskal, Sara, Ranser, Aryeh, Shalev, Domenico, Albano, Pierpaolo, Alongi, Gaspare, Arnone, Elisa, Bagatin, Sergio, Baldari, Matteo, Bauckneht, Paolo, Bertelli, Francesco, Bianco, Rachele, Bonfiglioli, Roberto, Boni, Andrea, Bruno, Isabella, Bruno, Elena, Busnardo, Elena, Califaretti, Luca, Camoni, Aldo, Carnevale, Roberta, Casoni, Armando Ugo Cavallo, Giorgio, Cavenaghi, Franca, Chierichetti, Marcello, Chiocchi, Corrado, Cittanti, Mauro, Colletta, Umberto, Conti, Alberto, Cossu, Alberto, Cuocolo, Marco, Cuzzocrea, Maria Luisa De Rimini, Giuseppe De Vincentis, Eleonora Del Giudice, Alberico Del Torto, DELLA TOMMASINA, Veronica, Rexhep, Durmo, Erba, PAOLA ANNA, Laura, Evangelista, Riccardo, Faletti, Evelina, Faragasso, Mohsen, Farsad, Paola, Ferro, Luigia, Florimonte, Viviana, Frantellizzi, Fabio Massimo Fringuelli, Marco, Gatti, Angela, Gaudiano, Alessia, Gimelli, Raffaele, Giubbini, Francesca, Giuffrida, Salvatore, Ialuna, Riccardo, Laudicella, Lucia, Leccisotti, Lucia, Leva, Liga, Riccardo, Carlo, Liguori, Giampiero, Longo, Margherita, Maffione, Maria Elisabetta Mancini, Claudio, Marcassa, Barbara, Nardi, Sara, Pacella, Giovanna, Pepe, Gianluca, Pontone, Sabina, Pulizzi, Natale, Quartuccio, Lucia, Rampin, Fabrizio, Ricci, Pierluigi, Rossini, Giuseppe, Rubini, Vincenzo, Russo, Gian Mauro Sacchetti, Gianmario, Sambuceti, Massimo, Scarano, Roberto, Sciagrà, Massimiliano, Sperandio, Antonella, Stefanelli, Guido, Ventroni, Stefania, Zoboli, Dainia, Baugh, Duane, Chambers, Ernest, Madu, Felix, Nunura, Hiroshi, Asano, Chimura Misato Chimura, Shinichiro, Fujimoto, Koichiro, Fujisue, Tomohisa, Fukunaga, Yoshimitsu, Fukushima, Kae, Fukuyama, Jun, Hashimoto, Yasutaka, Ichikawa, 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Barneveld, Andor, Glaudemans, Jesse, Habets, Klaas Pieter Koopmans, Jeroen, Manders, Stefan, Pool, Arthur, Scholte, Asbjørn, Scholtens, Riemer, Slart, Paul, Thimister, Erik-Jan Van Asperen, Niels, Veltman, Derk, Verschure, Nils, Wagenaar, John, Edmond, Chris, Ellis, Kerryanne, Johnson, Ross, Keenan, Shaw Hua Anthony Kueh, Christopher, Occleshaw, Alexander, Sasse, Andrew, To, Niels Van Pelt, Calum, Young, Teresa, Cuadra, Hector Bladimir Roque Vanegas, Idrissa Adamou Soli, Djibrillou Moussa Issoufou, Tolulope, Ayodele, Chibuzo, Madu, Yetunde, Onimode, Elen, Efros-Monsen, Signe Helene Forsdahl, Jenni-Mari Hildre Dimmen, Arve, Jørgensen, Isabel, Krohn, Pål, Løvhaugen, Anders Tjellaug Bråten, Humoud Al Dhuhli, Faiza Al Kindi, Naeema, Al-Bulushi, Zabah, Jawa, Naima, Tag, Muhammad Shehzad Afzal, Shazia, Fatima, Muhammad Numair Younis, Musab, Riaz, Mohammad, Saadullah, Yariela, Herrera, Dora, Lenturut-Katal, Manuel Castillo Vázquez, José, Ortellado, Afroza, Akhter, Dianbo, Cao, Stephen, 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Hong, Su Jin Jang, Yong Hyu Jeong, Won Jun Kang, Ji-Young, Kim, Jaetae, Lee, Chang Kyeong Namgung, Young, So, Kyoung Sook Won, Venjamin, Majstorov, Marija, Vavlukis, Barbara Gužic Salobir, Monika, Štalc, Theodora, Benedek, Imre, Benedek, Raluca, Mititelu, Claudiu Adrian Stan, Alexey, Ansheles, Olga, Dariy, Olga, Drozdova, Nina, Gagarina, Vsevolod Milyevich Gulyaev, Irina, Itskovich, Anatoly, Karalkin, Alexander, Kokov, Ekaterina, Migunova, Viktor, Pospelov, Daria, Ryzhkova, Guzaliya, Saifullina, Svetlana, Sazonova, Irina, Shurupova, Tatjana, Trifonova, Wladimir Yurievich Ussov, Margarita, Vakhromeeva, Nailya, Valiullina, Konstantin, Zavadovsky, Kirill, Zhuravlev, Mirvat, Alasnag, Subhani, Okarvi, Dragana Sobic Saranovic, Felix, Keng, Jia Hao Jason See, Ramkumar, Sekar, Min Sen Yew, Andrej, Vondrak, Shereen, Bejai, George, Bennie, Ria, Bester, Gerrit, Engelbrecht, Osayande, Evbuomwan, Harlem, Gongxeka, Magritha Jv Vuuren, Mitchell, Kaplan, Purbhoo, Khushica, Hoosen, Lakhi, Nico, Malan, Katarina, Milos, Moshe, Modiselle, Stuart, More, Mathava, Naidoo, Leonie, Scholtz, Mboyo, Vangu, Santiago, Aguadé-Bruix, Isabel, Blanco, Antonio, Cabrera, Alicia, Camarero, Irene, Casáns-Tormo, Hug, Cuellar-Calabria, Albert, Flotats, Maria Eugenia Fuentes Cañamero, María Elia García, Amelia, Jimenez-Heffernan, Rubén, Leta, Javier Lopez Diaz, Luis, Lumbreras, Juan Javier Marquez-Cabeza, Francisco, Martin, Anxo Martinez de Alegria, Francisco, Medina, Maria Pedrera Canal, Virginia, Peiro, Virginia, Pubul-Nuñez, Juan Ignacio Rayo Madrid, Cristina Rodríguez Rey, Ricardo Ruano Perez, Joaquín, Ruiz, Gertrudis Sabatel Hernández, Ana, Sevilla, Nahla, Zeidán, Damayanthi, Nanayakkara, Chandraguptha, Udugama, Magnus, Simonsson, Hatem, Alkadhi, Ronny Ralf Buechel, Peter, Burger, Luca, Ceriani, Bart De Boeck, Christoph, Gräni, Alix Juillet de Saint Lager Lucas, Christel, H Kamani, Nadine, Kawel-Boehm, Robert, Manka, John, O Prior, Axel, Rominger, Jean-Paul, Vallée, Benjapa, Khiewvan, Teerapon, Premprabha, Tanyaluck, Thientunyakit, Ali, Sellem, Kemal Metin Kir, Haluk, Sayman, Mugisha Julius Sebikali, Zerida, Muyinda, Yaroslav, Kmetyuk, Pavlo, Korol, Olena, Mykhalchenko, Volodymyr, Pliatsek, Maryna, Satyr, Batool, Albalooshi, Mohamed Ismail Ahmed Hassan, Jill, Anderson, Punit, Bedi, Thomas, Biggans, Anda, Bularga, Russell, Bull, Rajesh, Burgul, John-Paul, Carpenter, Duncan, Coles, David, Cusack, Aparna, Deshpande, John, Dougan, Timothy, Fairbairn, Alexia, Farrugia, Deepa, Gopalan, Alistair, Gummow, Prasad Guntur Ramkumar, Mark, Hamilton, Mark, Harbinson, Thomas, Hartley, Benjamin, Hudson, Nikhil, Joshi, Michael, Kay, Andrew, Kelion, Azhar, Khokhar, Jamie, Kitt, Ken, Lee, Chen, Low, Sze Mun Mak, Ntouskou, Marousa, Jon, Martin, Elisa, Mcalindon, Leon, Menezes, Gareth, Morgan-Hughes, Alastair, Moss, Anthony, Murray, Edward, Nicol, Dilip, Patel, Charles, Peebles, Francesca, Pugliese, Jonathan Carl Luis Rodrigues, Christopher, Rofe, Nikant, Sabharwal, Rebecca, Schofield, Thomas, Semple, Naveen, Sharma, Peter, Strouhal, Deepak, Subedi, William, Topping, Katharine, Tweed, Jonathan, Weir-Mccall, Suhny, Abbara, Taimur, Abbasi, Brian, Abbott, Shady, Abohashem, Sandra, Abramson, Tarek, Al-Abboud, Mouaz, Al-Mallah, Omar, Almousalli, Karthikeyan, Ananthasubramaniam, Mohan Ashok Kumar, Jeffrey, Askew, Lea, Attanasio, Mallory, Balmer-Swain, Richard, R Bayer, Adam, Bernheim, Sabha, Bhatti, Erik, Bieging, Ron, Blankstein, Stephen, Bloom, Sean, Blue, David, Bluemke, Andressa, Borges, Kelley, Branch, Paco, Bravo, Jessica, Brothers, Matthew, Budoff, Renée, Bullock-Palmer, Angela, Burandt, Floyd, W Burke, Kelvin, Bush, Candace, Candela, Elizabeth, Capasso, Joao, Cavalcante, Donald, Chang, Saurav, Chatterjee, Yiannis, Chatzizisis, Michael, Cheezum, Tiffany, Chen, Jennifer, Chen, Marcus, Chen, Andrew, Choi, James, Clarcq, Ayreen, Cordero, Matthew, Crim, Sorin, Danciu, Bruce, Decter, Nimish, Dhruva, Neil, Doherty, Rami, Doukky, Anjori, Dunbar, William, Duvall, Rachael, Edwards, Kerry, Esquitin, Husam, Farah, Emilio, Fentanes, Maros, Ferencik, Daniel, Fisher, Daniel, Fitzpatrick, Cameron, Foster, Tony, Fuisz, Michael, Gannon, Lori, Gastner, Myron, Gerson, Brian, Ghoshhajra, Alan, Goldberg, Brian, Goldner, Jorge, Gonzalez, Rosco, Gore, Sandra, Gracia-López, Fadi, Hage, Agha, Haider, Sofia, Haider, Yasmin, Hamirani, Karen, Hassen, Mallory, Hatfield, Carolyn, Hawkins, Katie, Hawthorne, Nicholas, Heath, Robert, Hendel, Phillip, Hernandez, Gregory, Hill, Stephen, Horgan, Jeff, Huffman, Lynne, Hurwitz, Ami, Iskandrian, Rajesh, Janardhanan, Christine, Jellis, Scott, Jerome, Dinesh, Kalra, Summanther, Kaviratne, Fernando, Kay, Faith, Kelly, Omar, Khalique, Mona, Kinkhabwala, George Kinzfogl Iii, Jacqueline, Kircher, Rachael, Kirkbride, Michael, Kontos, Anupama, Kottam, Joseph, Krepp, Jay, Layer, Steven, H Lee, Jeffrey, Leppo, John, Lesser, Steve, Leung, Howard, Lewin, Diana, Litmanovich, Yiyan, Liu, Kathleen, Magurany, Jeremy, Markowitz, Amanda, Marn, Stephen, E Matis, Michael, Mckenna, Tony, Mcrae, Fernando, Mendoza, Michael, Merhige, David, Min, Chanan, Moffitt, Karen, Moncher, Warren, Moore, Shamil, Morayati, Michael, Morris, Mahmud, Mossa-Basha, Zorana, Mrsic, Venkatesh, Murthy, Prashant, Nagpal, Kyle, Napier, Katarina, Nelson, Prabhjot, Nijjar, Medhat, Osman, Edward, Passen, Amit, Patel, Pravin, Patil, Ryan, Paul, Lawrence, Phillips, Venkateshwar, Polsani, Rajaram, Poludasu, Brian, Pomerantz, Thomas, Porter, Ryan, Prentice, Amit, Pursnani, Mark, Rabbat, Suresh, Ramamurti, Florence, Rich, Hiram Rivera Luna, Austin, Robinson, Kim, Robles, Cesar, Rodríguez, Mark, Rorie, John, Rumberger, Raymond, Russell, Philip, Sabra, Diego, Sadler, Mary, Schemmer, U Joseph Schoepf, Samir, Shah, Nishant, Shah, Sujata, Shanbhag, Gaurav, Sharma, Steven, Shayani, Jamshid, Shirani, Pushpa, Shivaram, Steven, Sigman, Mitch, Simon, Ahmad, Slim, David, Smith, Alexandra, Smith, Prem, Soman, Aditya, Sood, Monvadi Barbara Srichai-Parsia, James, Streeter, Albert, T Ahmed Tawakol, Dustin, Thomas, Randall, Thompson, Tara, Torbet, Desiree, Trinidad, Shawn, Ullery, Samuel, Unzek, Seth, Uretsky, Srikanth, Vallurupalli, Vikas, Verma, Alfonso, Waller, Ellen, Wang, Parker, Ward, Gaby, Weissman, George, Wesbey, Kelly, White, David, Winchester, David, Wolinsky, Sandra, Yost, Michael, Zgaljardic, Omar, Alonso, Mario, Beretta, Rodolfo, Ferrando, Miguel, Kapitan, Fernando, Mut, Omoa, Djuraev, Gulnora, Rozikhodjaeva, Ha Le Ngoc, Son Hong Mai, Xuan Canh Nguyen, Einstein, A. J., Shaw, L. J., Hirschfeld, C., Williams, M. C., Villines, T. C., Better, N., Vitola, J. V., Cerci, R., Dorbala, S., Raggi, P., Choi, A. D., Lu, B., Sinitsyn, V., Sergienko, V., Kudo, T., Norgaard, B. L., Maurovich-Horvat, P., Campisi, R., Milan, E., Louw, L., Allam, A. H., Bhatia, M., Malkovskiy, E., Goebel, B., Cohen, Y., Randazzo, M., Narula, J., Pascual, T. N. B., Pynda, Y., Dondi, M., Paez, D., Cuocolo, A., Einstein, A, Shaw, L, Hirschfeld, C, Williams, M, Villines, T, Better, N, Vitola, J, Cerci, R, Dorbala, S, Raggi, P, Choi, A, Lu, B, Sinitsyn, V, Sergienko, V, Kudo, T, Norgaard, B, Maurovich-Horvat, P, Campisi, R, Milan, E, Louw, L, Allam, A, Bhatia, M, Malkovskiy, E, Goebel, B, Cohen, Y, Randazzo, M, Narula, J, Pascual, T, Pynda, Y, Dondi, M, Paez, D, Pacella, S, and Erba, P
Subjects: INCAPS COVID Investigators Group, Heart disease, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Diagnostic Techniques, Cardiovascular, coronavirus, global health, IAEA, Disease, Telehealth, Cardiorespiratory Medicine and Haematology, 030204 cardiovascular system & hematology, Cardiovascular, 0302 clinical medicine, cardiovascular disease, cardiac testing, COVID-19, diagnostic techniques, cardiovascular, health care surveys, heart diseases, humans, international agencies, Pandemic, Global health, 030212 general & internal medicine, COVID-19 Heart Disease, Cause of death, STATEMENT, Heart Disease, International Agencie, Public Health and Health Services, Biomedical Imaging, Cardiology and Cardiovascular Medicine, Human, medicine.medical_specialty, Heart Diseases, 03 medical and health sciences, Clinical Research, medicine, Humans, Personal protective equipment, Heart Disease - Coronary Heart Disease, business.industry, International Agencies, medicine.disease, the, coronaviru, Diagnostic Techniques, Good Health and Well Being, Clinical research, Cardiovascular System & Hematology, Health Care Survey, Health Care Surveys, Emergency medicine, Global Health, business
Abstract: BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified. OBJECTIVES The study sought to assess COVID-19`s impact on global cardiovascular diagnostic procedural volumes and safety practices. METHODS The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained. RESULTS Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoradc echocardiography decreased by 59%, transesophageat echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p < 0.001 for each procedure). hi multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower-middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and teteheatth. CONCLUSIONS COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world's economically challenged. Further study of cardiovascular outcomes and COVID-19-related changes in care delivery is warranted. (C) 2021 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation.
Published: 2021

21. Hepatocellular carcinoma downstaging for liver transplantation in the era of systemic combined therapy with anti-VEGF/TKI and immunotherapy

Author: Nguyen H. Tran, Sergio Muñoz, Scott Thompson, Christopher L. Hallemeier, and Jordi Bruix
Subjects: Carcinoma, Hepatocellular, Treatment Outcome, Hepatology, Liver Neoplasms, Antibodies, Monoclonal, Humans, Angiogenesis Inhibitors, Immunotherapy, Immune Checkpoint Inhibitors, Protein Kinase Inhibitors, Liver Transplantation, Neoplasm Staging
Abstract: Hepatocellular carcinoma remains a global health challenge affecting close to 1 million cases yearly. Liver transplantation provides the best long-term outcomes for those meeting strict criteria. Efforts have been made to expand these criteria, whereas others have attempted downstaging approaches. Although locoregional approaches to downstaging are appealing and have demonstrated efficacy, limitations and challenges exists including poor imaging modality to assess response and appropriate endpoints along the process. Recent advances in systemic treatments including immune checkpoint inhibitors alone or in combination with tyrosine kinase inhibitors have prompted the discussion regarding their role for downstaging disease prior to transplantation. Here, we provide a review of prior locoregional approaches for downstaging, new systemic agents and their role for downstaging, and finally, key and critical considerations of the assessment, endpoints, and optimal designs in clinical trials to address this key question.
Published: 2022

22. BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update

Author: Jordi Rimola, Alejandro Forner, Jordi Bruix, Marta Burrel, Josep Fuster, Bruno Sangro, Robin Katie Kelley, Riad Salem, Joana Ferrer-Fàbrega, M. Reig, Arndt Vogel, Peter R. Galle, Amit G. Singal, Vincenzo Mazzaferro, Ángeles García-Criado, and C. Ayuso
Subjects: Male, Liver Cancer, Prognosis prediction, medicine.medical_specialty, Carcinoma, Hepatocellular, Tare weight, liver transplantation TACE, AFP, Clinical Trials and Supportive Activities, Clinical Sciences, Psychological intervention, Severity of Illness Index, ablation, survival, Article, TARE, surgery, Rare Diseases, Clinical Research, Medicine, Hepatectomy, Humans, HCC, Intensive care medicine, Staging system, Neoplasm Staging, Cancer, Hepatology, Gastroenterology & Hepatology, business.industry, Liver Disease, Carcinoma, Liver Neoplasms, ALBI score, Hepatocellular, systemic treatment, Middle Aged, medicine.disease, Prognosis, BCLC, Good Health and Well Being, Hepatocellular carcinoma, Public Health and Health Services, Treatment strategy, Female, business, Liver cancer, Digestive Diseases
Abstract: Treatment for hepatocellular carcinoma (HCC) has experienced major advancements since the last update of the official Barcelona Clinic Liver Cancer (BCLC) prognosis and treatment strategy published in 2018. Advancements in the field have emerged in all areas, but in this manuscript, we present those that have primed a change in the strategy and comment why some encouraging data in select interventions are still considered immature and in need of further research to gain their incorporation into an evidence-based model for clinicians and researchers. Finally, we describe the critical insight and expert knowledge that is needed to take clinical decisions in individual patients so that the recommendation takes into account all the needed parameters to allow a personalised approach.
Published: 2022

23. Identification of Myocardial Insulin Resistance by Using Liver Tests: A Simple Approach for Clinical Practice

Author: José Raúl Herance, Queralt Martín-Saladich, Mayra Alejandra Velásquez, Cristina Hernandez, Carolina Aparicio, Clara Ramirez-Serra, Roser Ferrer, Marina Giralt-Arnaiz, Miguel Ángel González-Ballester, Juan M. Pericàs, Joan Castell-Conesa, Santiago Aguadé-Bruix, Rafael Simó, Institut Català de la Salut, [Herance JR] Grup de Recerca d’Imatge Mèdica Molecular, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Unitat Docent de Medicina Nuclear, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Servei de Radiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Servei de Cardiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. CIBERBBN, Instituto de Salud Carlos III, Madrid, Spain. [Martín-Saladich Q] Grup de Recerca d’Imatge Mèdica Molecular, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Unitat Docent de Medicina Nuclear, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Servei de Radiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Servei de Cardiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. BCN Medtech Group, Information and Communication Technologies Department, Pompeu Fabra University, Barcelona, Spain. [Velásquez MA] Grup de Recerca en Diabetis i Metabolisme, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Servei d’Endocrinologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Hernandez C, Simó R] Grup de Recerca en Diabetis i Metabolisme, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Servei d’Endocrinologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. CIBERDEM, Instituto de Salud Carlos III, Madrid, Spain. [Aparicio C, Castell-Conesa J, Aguadé-Bruix S] Grup de Recerca d’Imatge Mèdica Molecular, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Unitat Docent de Medicina Nuclear, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Servei de Radiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Servei de Cardiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Ramirez-Serra C, Ferrer R, Giralt-Arnaiz M] Grup de Recerca de Bioquímica Clínica, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Àrea de Core Facilities, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [González-Ballester MÁ] BCN Medtech Group, Information and Communication Technologies Department, Pompeu Fabra University, Barcelona, Spain. [Pericàs JM] Grup de Recerca de les Malalties Hepàtiques, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Unitat Hepàtica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. CIBEREHD, Instituto de Salud Carlos III, Madrid, Spain, and Vall d'Hebron Barcelona Hospital Campus
Subjects: cardiovascular risk, enfermedades nutricionales y metabólicas::enfermedades metabólicas::trastornos del metabolismo de la glucosa::diabetes mellitus::diabetes mellitus tipo II [ENFERMEDADES], Miocardi - Malalties, Diabetis no-insulinodependent, Catalysis, Inorganic Chemistry, Positron Emission Tomography Computed Tomography, Nutritional and Metabolic Diseases::Metabolic Diseases::Glucose Metabolism Disorders::Hyperinsulinism::Insulin Resistance [DISEASES], Humans, Physical and Theoretical Chemistry, Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Image Interpretation, Computer-Assisted::Tomography, Emission-Computed::Positron-Emission Tomography::Positron Emission Tomography Computed Tomography [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Molecular Biology, Transaminases, Spectroscopy, Insulinoresistència, enfermedades nutricionales y metabólicas::enfermedades metabólicas::trastornos del metabolismo de la glucosa::hiperinsulinismo::resistencia a la insulina [ENFERMEDADES], type 2 diabetes, myocardial insulin resistance, non-alcoholic fatty liver disease, Myocardium, Cardiovascular System::Heart::Myocardium [ANATOMY], Organic Chemistry, Nutritional and Metabolic Diseases::Metabolic Diseases::Glucose Metabolism Disorders::Diabetes Mellitus::Diabetes Mellitus, Type 2 [DISEASES], General Medicine, Fibrosis, Computer Science Applications, Diabetes Mellitus, Type 2, Liver, sistema cardiovascular::corazón::miocardio [ANATOMÍA], Tomografia per emissió de positrons, Insulin Resistance, diagnóstico::técnicas y procedimientos diagnósticos::diagnóstico por imagen::interpretación de imágenes asistida por ordenador::tomografía computarizada radioisotópica::tomografía por emisión de positrones::tomografía por emisión de positrones-tomografía computarizada [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS]
Abstract: Cardiovascular risk; Myocardial insulin resistance; Non-alcoholic fatty liver disease Riesgo cardiovascular; Resistencia a la insulina del miocardio; Enfermedad del higado graso no alcoholico Risc cardiovascular; Resistència a la insulina del miocardi; Malaltia del fetge gras no alcohòlic Background: We report that myocardial insulin resistance (mIR) occurs in around 60% of patients with type 2 diabetes (T2D) and was associated with higher cardiovascular risk in comparison with patients with insulin-sensitive myocardium (mIS). These two phenotypes (mIR vs. mIS) can only be assessed using time-consuming and expensive methods. The aim of the present study is to search a simple and reliable surrogate to identify both phenotypes. Methods: Forty-seven patients with T2D underwent myocardial [18F]FDG PET/CT at baseline and after a hyperinsulinemic–euglycemic clamp (HEC) to determine mIR were prospectively recruited. Biochemical assessments were performed before and after the HEC. Baseline hepatic steatosis index and index of hepatic fibrosis (FIB-4) were calculated. Furthermore, liver stiffness measurement was performed using transient elastography. Results: The best model to predict the presence of mIR was the combination of transaminases, protein levels, FIB-4 score and HOMA (AUC = 0.95; sensibility: 0.81; specificity: 0.95). We observed significantly higher levels of fibrosis in patients with mIR than in those with mIS (p = 0.034). In addition, we found that patients with mIR presented a reduced glucose uptake by the liver in comparison with patients with mIS. Conclusions: The combination of HOMA, protein, transaminases and FIB-4 is a simple and reliable tool for identifying mIR in patients with T2D. This information will be useful to improve the stratification of cardiovascular risk in T2D. This work was supported by the Carlos III Health Institute and the European Regional Development Fund (PI16/02064, PI20/01588) and the Agency for Management of University and Research Grants (AGAUR) of Catalonia (2017SGR1303).
Published: 2022

24. Pharmacokinetics and pharmacogenetics of sorafenib in patients with hepatocellular carcinoma: Implications for combination trials

Author: Mercè Brunet, Anna Darnell, Loreto Boix, Josep Corominas, Gemma Iserte, Neus Llarch, Olga Millán, Ernest Belmonte, Ferran Torres, Maria Reig, Jordi Bruix, Carmen Ayuso, Leonardo G Da Fonseca, Victor Sapena, Marco Sanduzzi-Zamparelli, Esther Samper, Álvaro Díaz-González, and Alejandro Forner
Subjects: Niacinamide, Oncology, Sorafenib, medicine.medical_specialty, Carcinoma, Hepatocellular, Antineoplastic Agents, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Pharmacokinetics, Internal medicine, medicine, Humans, SNP, Adverse effect, Hepatology, business.industry, Phenylurea Compounds, Liver Neoplasms, medicine.disease, digestive system diseases, chemistry, Pharmacogenetics, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, 030211 gastroenterology & hepatology, Lenvatinib, business, Tyrosine kinase, medicine.drug
Abstract: Background & aims Sorafenib and lenvatinib are the first-line treatments approved in hepatocellular carcinoma (HCC), but information is lacking about the relationships between their pharmacokinetics, patients pharmacogenetic profiles, adverse events (AE) and overall survival. We aimed to elucidate these relationships of tyrosine Kinase Inhibitors, such as sorafenib, in order to improve the design of trials testing it in combination with checkpoint inhibitors. Methods We assessed the pharmacokinetics of sorafenib and its N-oxide metabolite at day-0, day-7, day-30, day-60, day-90, day-120, day-150 and day-180 and nine single-nucleotide polymorphisms (SNP) in five genes related to sorafenib metabolism/transport to identify the best point for starting the combination between tyrosine kinases and checkpoint inhibitors. Results We prospectively included 49 patients (96% cirrhotic, 37% hepatitis-C, 82% Child-Pugh-A and 59% BCLC-C). Pharmacokinetic values peaked at day-7 and progressively declined until day-60. In the 16 patients without further dose modifications after day-60, pharmacokinetic values remained stable through day-180 (sorafenib P = .90; N-oxide P = .93). Pharmacokinetic values were higher in patients with early dermatological adverse events and lower in patients with early diarrhoea. Sorafenib and N-oxide pharmacokinetic values varied linearly with different alleles of MRP2*3972. Conclusions Sorafenib's pharmacokinetics is heterogeneous across HCC patients. This heterogeneity affects adverse events development and must be taken into account in setting the dose and timing of its combination with checkpoint inhibitors.
Published: 2020

25. Does transient arterial-phase respiratory-motion-related artifact impact on diagnostic performance? An intra-patient comparison of extracellular gadolinium versus gadoxetic acid

Author: Ernest Belmonte, Neus Llarch, Carmen Ayuso, Anna Darnell, Victor Sapena, Carla Caparroz, Alejandro Forner, Jordi Rimola, Jordi Bruix, and Maria Reig
Subjects: Gadolinium DTPA, Gadoxetic acid, medicine.medical_specialty, Cirrhosis, Gadolinium, Contrast Media, chemistry.chemical_element, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, medicine, Extracellular, Humans, Radiology, Nuclear Medicine and imaging, Retrospective Studies, Neuroradiology, Artifact (error), medicine.diagnostic_test, business.industry, Ultrasound, Magnetic resonance imaging, General Medicine, Image Enhancement, medicine.disease, Magnetic Resonance Imaging, Liver, chemistry, 030220 oncology & carcinogenesis, Radiology, Artifacts, business, Nuclear medicine, medicine.drug
Abstract: To compare the frequency of transient arterial-phase respiratory-motion-related artifacts in liver MRI after extracellular gadolinium and gadoxetic acid injection, and to determine the impact of these artifacts on the detection of focal areas of enhancement on arterial-phase images. Intra-patient comparison of 82 cirrhotic patients who prospectively underwent liver MR with extracellular gadolinium and with gadoxetic acid within 1 month. Two readers independently assessed the quality of dynamic T1-weighted MR images (pre-contrast, arterial, and portal-venous phases), rating respiratory-motion-related artifacts on four-point scale (0 [none]–3 [non-diagnostic]). We dichotomized these assessments, which were compared using McNemar’s test, defining transient arterial-phase respiratory-motion-related artifacts as a study with a pre-contrast score
Published: 2020

26. Impact of revascularization guided by functional testing in ischaemic cardiomyopathy

Author: Eduard Ródenas-Alesina, Guillermo Romero-Farina, Pablo Jordán, Lorena Herrador, Carina Espinet-Coll, María Nazarena Pizzi, Aida Ribera, José A Barrabés, Santiago Aguadé-Bruix, and Ignacio Ferreira-González
Subjects: Myocardial Infarction, Myocardial Ischemia, Myocardial Revascularization, Humans, Radiology, Nuclear Medicine and imaging, Stroke Volume, General Medicine, Cardiology and Cardiovascular Medicine, Cardiomyopathies, Ventricular Function, Left
Abstract: Aims The burden of ischaemia is a risk factor for adverse outcomes in ischaemic cardiomyopathy (ICM) but is not systematically tested when deciding on revascularization. Limited data exists in patients with ICM regarding the interaction between ischaemia and early coronary revascularization (ECR). This study sought to determine if the burden of ischaemia modifies the outcomes of ECR in ICM. Methods and results Consecutive patients with ICM (left ventricular ejection fraction 10% of ischaemia [hazard ratio (HR) = 0.59 (0.30–1.18)], whereas a non-significant increase of MACE was observed in those with Conclusions In a contemporary cohort of patients with ICM, the beneficial effects of ECR may be mediated by the percent of ischaemia. This study supports stress testing in ICM and an ischaemia-guided approach for ECR.
Published: 2022

27. A first-in-human phase 1/2 study of FGF401 and combination of FGF401 with spartalizumab in patients with hepatocellular carcinoma or biomarker-selected solid tumors

Author: Stephen L. Chan, Martin Schuler, Yoon-Koo Kang, Chia-Jui Yen, Julien Edeline, Su Pin Choo, Chia-Chi Lin, Takuji Okusaka, Karl-Heinz Weiss, Teresa Macarulla, Stéphane Cattan, Jean-Frederic Blanc, Kyung-Hun Lee, Michela Maur, Shubham Pant, Masatoshi Kudo, Eric Assenat, Andrew X. Zhu, Thomas Yau, Ho Yeong Lim, Jordi Bruix, Andreas Geier, Carmen Guillén-Ponce, Angelica Fasolo, Richard S. Finn, Jia Fan, Arndt Vogel, Shukui Qin, Markus Riester, Vasiliki Katsanou, Monica Chaudhari, Tomoyuki Kakizume, Yi Gu, Diana Graus Porta, Andrea Myers, and Jean-Pierre Delord
Subjects: Cancer Research, Carcinoma, Hepatocellular, Oncology, Pyridines, Liver Neoplasms, Medizin, Humans, Bayes Theorem, Antibodies, Monoclonal, Humanized, Biomarkers, Piperazines
Abstract: Background Deregulation of FGF19-FGFR4 signaling is found in several cancers, including hepatocellular carcinoma (HCC), nominating it for therapeutic targeting. FGF401 is a potent, selective FGFR4 inhibitor with antitumor activity in preclinical models. This study was designed to determine the recommended phase 2 dose (RP2D), characterize PK/PD, and evaluate the safety and efficacy of FGF401 alone and combined with the anti-PD-1 antibody, spartalizumab. Methods Patients with HCC or other FGFR4/KLB expressing tumors were enrolled. Dose-escalation was guided by a Bayesian model. Phase 2 dose-expansion enrolled patients with HCC from Asian countries (group1), non-Asian countries (group2), and patients with other solid tumors expressing FGFR4 and KLB (group3). FGF401 and spartalizumab combination was evaluated in patients with HCC. Results Seventy-four patients were treated in the phase I with single-agent FGF401 at 50 to 150 mg. FGF401 displayed favorable PK characteristics and no food effect when dosed with low-fat meals. The RP2D was established as 120 mg qd. Six of 70 patients experienced grade 3 dose-limiting toxicities: increase in transaminases (n = 4) or blood bilirubin (n = 2). In phase 2, 30 patients in group 1, 36 in group 2, and 20 in group 3 received FGF401. In total, 8 patients experienced objective responses (1 CR, 7 PR; 4 each in phase I and phase II, respectively). Frequent adverse events (AEs) were diarrhea (73.8%), increased AST (47.5%), and ALT (43.8%). Increase in levels of C4, total bile acid, and circulating FGF19, confirmed effective FGFR4 inhibition. Twelve patients received FGF401 plus spartalizumab. RP2D was established as FGF401 120 mg qd and spartalizumab 300 mg Q3W; 2 patients reported PR. Conclusions At biologically active doses, FGF401 alone or combined with spartalizumab was safe in patients with FGFR4/KLB-positive tumors including HCC. Preliminary clinical efficacy was observed. Further clinical evaluation of FGF401 using a refined biomarker strategy is warranted. Trial registration NCT02325739.
Published: 2022

28. miR-200c-3p, miR-222-5p, and miR-512-3p Constitute a Biomarker Signature of Sorafenib Effectiveness in Advanced Hepatocellular Carcinoma

Author: Patricia de la Cruz-Ojeda, Tobias Schmid, Loreto Boix, Manuela Moreno, Víctor Sapena, Juan M. Praena-Fernández, Francisco J. Castell, Juan Manuel Falcón-Pérez, María Reig, Bernhard Brüne, Miguel A. Gómez-Bravo, Álvaro Giráldez, Jordi Bruix, María T. Ferrer, Jordi Muntané, Publica, Instituto de Salud Carlos III, Junta de Andalucía, Ministerio de Educación, Cultura y Deporte (España), Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas (España), Asociación Española Contra el Cáncer, Schmid, Tobias, Boix, Loreto, Sapena, Víctor, Falcón-Pérez, Juan M., Reig, María, Brüne, Bernhard, Gómez-Bravo, Miguel A., Giráldez, Álvaro, Ferrer-Ríos, María Teresa, and Muntané, Jordi
Subjects: Carcinoma, Hepatocellular, Liquid biopsy, liquid biopsy, Hepatocellular carcinoma, extracellular vesicle, hepatocellular carcinoma, miRNA, Sorafenib, Liver Neoplasms, General Medicine, MicroRNAs, Humans, Extracellular vesicle, Biomarkers
Abstract: Background: Sorafenib constitutes a suitable treatment alternative for patients with advanced hepatocellular carcinoma (HCC) in whom atezolizumab + bevacizumab therapy is contraindicated. The aim of the study was the identification of a miRNA signature in liquid biopsy related to sorafenib response. Methods: miRNAs were profiled in hepatoblastoma HepG2 cells and tested in animal models, extracellular vesicles (EVs), and plasma from HCC patients. Results: Sorafenib altered the expression of 11 miRNAs in HepG2 cells. miR-200c-3p and miR-27a-3p exerted an anti-tumoral activity by decreasing cell migration and invasion, whereas miR-122-5p, miR-148b-3p, miR-194-5p, miR-222-5p, and miR-512-3p exerted pro-tumoral properties by increasing cell proliferation, migration, or invasion, or decreasing apoptosis. Sorafenib induced a change in EVs population with an increased number of larger EVs, and promoted an accumulation of miR-27a-3p, miR-122-5p, miR-148b-3p, miR-193b-3p, miR-194-5p, miR-200c-3p, and miR-375 into exosomes. In HCC patients, circulating miR-200c-3p baseline levels were associated with increased survival, whereas high levels of miR-222-5p and miR-512-3p after 1 month of sorafenib treatment were related to poor prognosis. The RNA sequencing revealed that miR-200c-3p was related to the regulation of cell growth and death, whereas miR-222-5p and miR-512-3p were related to metabolic control. Conclusions: The study showed that Sorafenib regulates a specific miRNA signature in which miR-200c-3p, miR-222-5p, and miR-512-3p bear prognostic value and contribute to treatment response., Instituto de Salud Carlos III, European Commission PI16/00090 PI19/01266, Consejeria de Igualdad, Salud y Politicas Sociales PI-0198-2016, Spanish Government FPU17/00026, GEIVEX Mobility Fellowships 2020, German Research Foundation (DFG), National Health and Medical Research Council (NHMRC) of Australia EST19/01091, European Commission, European Commission PI15/00145 PI18/0358 PI18/00768, AECC PI044031
Published: 2022

29. Regorafenib Efficacy After Sorafenib in Patients With Recurrent Hepatocellular Carcinoma After Liver Transplantation:A Retrospective Study

Author: Matthias Pinter, Pietro Lampertico, Ainhoa Fernandez Yunquera, Gabriel Aballay Soteras, Miguel Fraile-López, Tommy Ivanics, Maria Reig, Massimo Iavarone, Álvaro Díaz-González, Maria Varela, Lucia Cesarini, Vincenzo Mazzaferro, Gerda Elisabeth Villadsen, Federica Invernizzi, Matteo Angelo Manini, Marcus A. Wörns, Maria Jose Blanco Rodríguez, Mario Romero Cristóbal, Helene Regnault, Giovanni Giuseppe Di Costanzo, Jordi Bruix, Sherrie Bhoori, Peter Daechul Yoon, Arndt Weinmann, Marco Sanduzzi-Zamparelli, Luigia Scudeller, Maria Francesca Donato, Gonzalo Sapisochin, Giuliana Amaddeo, Stefano Mazza, Carolin Czauderna, Gonzalo Crespo, Claudio Zavaglia, Massimo De Giorgio, Margarita Anders, María Luisa González-Diéguez, Rebecca Prince, R. Tortora, and Federico Piñero
Subjects: Oncology, Sorafenib, medicine.medical_specialty, Carcinoma, Hepatocellular, Pyridines, medicine.medical_treatment, Antineoplastic Agents, Liver transplantation, chemistry.chemical_compound, Regorafenib, Internal medicine, Clinical endpoint, medicine, Humans, Retrospective Studies, Transplantation, Hepatology, business.industry, Phenylurea Compounds, Liver Neoplasms, Retrospective cohort study, medicine.disease, Recurrent Hepatocellular Carcinoma, digestive system diseases, Liver Transplantation, Discontinuation, chemistry, Hepatocellular carcinoma, Surgery, business, medicine.drug
Abstract: Background and aim Safety of regorafenib in hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) has been recently demonstrated. We aimed to assess the survival benefit of regorafenib compared to best supportive care (BSC) in LT-patients after sorafenib discontinuation. Methods This observational multicenter retrospective study included LT-patients with HCC-recurrence who discontinued first-line sorafenib. Group-1 was constituted by regorafenib-treated patients, while control group was selected among patients treated with best supportive care (BSC) due to unavailability of second-line options at the time of sorafenib discontinuation and who were sorafenib-tolerant progressors (group-2). Primary endpoint was overall survival (OS) of group-1 compared to group-2. Secondary endpoints were safety and OS of sequential treatment sorafenib+regorafenib/BSC. Results Among 132 LT-patients who discontinued sorafenib included in the study, 81 patients were sorafenib-tolerant: 36 received regorafenib (group-1) and 45 (group-2) received BSC. Overall, 24 (67%) patients died in group-1 and 40 (89%) in group-2: the median OS was significantly longer in group-1 than in group-2 (13.1 vs 5.5 months; p=0.002). Regorafenib treatment was an independent predictor of reduced mortality (HR 0.37, 95%CI 0.16-0.89, p=0.02). Median treatment duration with regorafenib was 7.0 (95%CI 5.5-8.5) months; regorafenib dose was reduced in 22 (61%) patients for adverse events and discontinued for tumor progression in 93%. The median OS calculated from sorafenib start was 28.8 months (95%CI: 17.6-40.1) in group-1 vs 15.3 months (95%CI: 8.8-21.7) in group-2 (p=0.002). Conclusions Regorafenib is an effective second-line treatment after sorafenib in patients with HCC-recurrence after LT.
Published: 2021

30. Clinical characteristics of full thickness macular holes that closed without surgery

Author: Marta S. Figueroa, Maurizio Battaglia Parodi, Wael A Alsakran, Amanda Rey, Lorenzo Lopez-Guajardo, Ismael Bakkali El Bakkali, Patricia Pera, Jay Chhablani, Abdallah A. Ellabban, Eduardo Pérez-Salvador, Vishal Govindahari, Elena Rodríguez Neila, Sofia Fernandez Larripa, Lluís Bruix, J. Fernando Arevalo, Abdulrazzak Charbaji, Suthasinee Sinawat, Frank N Hrisomalos, Sami H. Uwaydat, Lihteh Wu, Javier Mateo, Stephen G. Schwartz, Francisco Medina, Sibel Kadayifcilar, Hana A Mansour, Ignasi Jürgens, Olivia Esteban Floria, Nuria Olivier Pascual, William E Smiddy, Francisco J. Ascaso, Luiz H. Lima, Ahmad M. Mansour, Antonio Marcello Casella, Amparo Navea, Angel Salinas Alaman, A. Osman Saatci, Robert E Foster, Alexandre Assi, Komal Agarwal, Silvana Belotto, Uwaydat, S. H., Mansour, A., Ascaso, F. J., Battaglia Parodi, M., Foster, R., Smiddy, W. E., Schwartz, S. G., Charbaji, A., Belotto, S., Jurgens, I., Mateo, J., Ellabban, A. A., Wu, L., Figueroa, M., Olivier Pascual, N., Lima, L. H., Alsakran, W. A., Caliskan Kadayifcilar, S., Sinawat, S., Assi, A., Mansour, H. A., Casella, A. M., Navea, A., Neila, E. R., Saatci, A. O., Govindahari, V., Esteban Floria, O., Agarwal, K., Bakkali El Bakkali, I., Alaman, A. S., Larripa, S. F., Rey, A., Pera, P., Bruix, L., Lopez-Guajardo, L., Perez-Salvador, E., Lara Medina, F. J., Hrisomalos, F. N., Chhablani, J., and Arevalo, J. F.
Subjects: medicine.medical_specialty, Fovea Centralis, Visual acuity, genetic structures, Observation period, Visual Acuity, Ocular trauma, Wounds, Nonpenetrating, Trauma, Retina, New onset, Cellular and Molecular Neuroscience, Blunt, Vitrectomy, Full-thickness macular hole, Medicine, Humans, Retrospective Studies, business.industry, Macula, Mean age, Middle Aged, Retinal Perforations, eye diseases, Sensory Systems, Surgery, Ophthalmology, Full thickness, Treatment Medical, medicine.symptom, business, Tomography, Optical Coherence
Abstract: PurposeTo ascertain the anatomic factors that help achieve non-surgical sealing in full thickness macular hole (FTMH).MethodsRetrospective collaborative study of FTMH that closed without surgical intervention.ResultsA total of 78 patients (mean age 57.9 years) included 18 patients with blunt ocular trauma, 18 patients that received topical or intravitreal therapies and 42 patients with idiopathic FTMH. Mean±SD of the initial corrected visual acuity (VA) in logMAR improved from 0.65±0.54 to 0.34±0.45 (pConclusionOur data suggest an observation period in new onset FTMH for non-surgical closure, in the setting of trauma, treatment of CME and size
Published: 2021

31. Impact of COVID-19 on the imaging diagnosis of cardiac disease in Europe

Author: Williams M. C., Shaw L., Hirschfeld C. B., Maurovich-Horvat P., Norgaard B. L., Pontone G., Jimenez-Heffernan A., Sinitsyn V., Sergienko V., Ansheles A., Bax J. J., Buechel R., Milan E., Slart R. H. J. A., Nicol E., Bucciarelli-Ducci C., Pynda Y., Better N., Cerci R., Dorbala S., Raggi P., Villines T. C., Vitola J., Malkovskiy E., Goebel B., Cohen Y., Randazzo M., Pascual T. N. B., Dondi M., Paez D., Einstein A. J., Nasery M. N., Goda A., Shirka E., Benlabgaa R., Bouyoucef S., Medjahedi A., Nailli Q., Agolti M., Aguero R. N., Del Carmen Alak M., Alberguina L. G., Arronada G., Astesiano A., Norton C. B., Benteo P., Blanco J., Bonelli J. M., Bustos J. J., Cabrejas R., Cachero J., Campisi R., Canderoli A., Carames S., Carrascosa P., Castro R., Cendoya O., Cognigni L. M., Collaud C., Cortes C., Courtis J., Cragnolino D., Daicz M., De La Vega A., De Maria S. T., Del Riego H., Dettori F., Deviggiano A., Dragonetti L., Embon M., Enriquez R. E., Ensinas J., Faccio F., Facello A., Garofalo D., Geronazzo R., Gonza N., Gutierrez L., Guzzo M. A., Hasbani V., Huerin M., Jager V., Lewkowicz J. M., De Munain M. N. A. L., Lotti J. M., Marquez A., Masoli O., Masoli O. H., Mastrovito E., Mayoraz M., Melado G. E., Mele A., Merani M. F., Meretta A. H., Molteni S., Montecinos M., Noguera E., Novoa C., Sueldo C. P., Ascani S. P., Pollono P., Pujol M. P., Radzinschi A., Raimondi G., Redruello M., Rodriguez M., Romero R. L., Acuna A. R., Rovaletti F., Miguel L. S., Solari L., Strada B., Traverso S., Traverzo S. S., Del Huerto Velazquez Espeche M., Weihmuller J. S., Wolcan J., Zeffiro S., Sakanyan M., Beuzeville S., Boktor R., Butler P., Calcott J., Carr L., Chan V., Chao C., Chong W., Dobson M., Downie D., Dwivedi G., Elison B., Engela J., Francis R., Gaikwad A., Basavaraj A. G., Goodwin B., Greenough R., Hamilton-Craig C., Hsieh V., Joshi S., Lederer K., Lee K., Lee J., Magnussen J., Mai N., Mander G., Murton F., Nandurkar D., Neill J., O'Rourke E., O'Sullivan P., Pandos G., Pathmaraj K., Pitman A., Poulter R., Premaratne M., Prior D., Ridley L., Rutherford N., Salehi H., Saunders C., Scarlett L., Seneviratne S., Shetty D., Shrestha G., Shulman J., Solanki V., Stanton T., Stuart M., Stubbs M., Swainson I., Taubman K., Taylor A., Thomas P., Unger S., Upton A., Vamadevan S., Van Gaal W., Verjans J., Voutnis D., Wayne V., Wilson P., Wong D., Wong K., Younger J., Feuchtner G., Mirzaei S., Weiss K., Maroz-Vadalazhskaya N., Gheysens O., Homans F., Moreno-Reyes R., Pasquet A., Roelants V., Van De Heyning C. M., Rios R. A., Soldat-Stankovic V., Stankovic S., Siqueira M. H. A., Almeida A., Togni P. H. A., Andrade J. H., Andrade L., Anselmi C., Araujo R., Azevedo G., Bezerra S., Biancardi R., Grossman G. B., Brandao S., Pianta D. B., Carreira L., Castro B., Chang T., Cunali F., Cury R., Dantas R., De Amorim Fernandes F., De Lorenzo A., De MacEdo Filho R., Erthal F., Fernandes F., Fernandes J., De Souza T. F., Alves W. F., Ghini B., Goncalves L., Gottlieb I., Hadlich M., Kameoka V., Lima R., Lima A., Lopes R. W., E Silva R. M., Magalhaes T., Silva F. M., Mastrocola L. E., Medeiros F., Meneghetti J. C., Naue V., Naves D., Nolasco R., Nomura C., Oliveira J. B., Paixao E., De Carvalho F. P., Pinto I., Possetti P., Quinta M., Ramos R. R. N., Rocha R., Rodrigues A., Rodrigues C., Romantini L., Sanches A., Santana S., Da Silva L. S., Schvartzman P., Matushita C. S., Senra T., Shiozaki A., De Siqueira M. E. M., Siqueira C., Smanio P., Soares C. E., Soares J., Bittencourt M. S., Spiro B., Mesquita C. T., Torreao J., Torres R., Uellendahl M., Monte G. U., Verissimo O., Cabeda E. V., Pedras F. V., Waltrick R., Zapparoli M., Naseer H., Garcheva-Tsacheva M., Kostadinova I., Theng Y., Abikhzer G., Barette R., Chow B., Dabreo D., Friedrich M., Garg R., Hafez M. N., Johnson C., Kiess M., Leipsic J., Leung E., Miller R., Oikonomou A., Probst S., Roifman I., Small G., Tandon V., Trivedi A., White J., Zukotynski K., Canessa J., Munoz G. C., Concha C., Hidalgo P., Lovera C., Massardo T., Vargas L. S., Abad P., Arturo H., Ayala S., Benitez L., Cadena A., Caicedo C., Moncayo A. C., Gomez S., Villamil C. T. G., Jaimes C., Londono J., Blair J. L. L., Pabon L., Pineda M., Rojas J. C., Ruiz D., Escobar M. V., Vasquez A., Vergel D., Zuluaga A., Gamboa I. B., Castro G., Gonzalez U., Baric A., Batinic T., Franceschi M., Hrabak M., Jukic M., Medakovic P., Persic V., Prpic M., Punda A., Batista J. F., Lauchy J. M. G., Gutierrez Y. M., Menendez R., Peix A., Rochela L., Panagidis C., Petrou I., Engelmann V., Kaminek M., Kincl V., Lang O., Simanek M., Abdulla J., Bottcher M., Christensen M., Gormsen L. C., Hasbak P., Hess S., Holdgaard P., Johansen A., Kyhl K., Ovrehus K. A., Sand N. P. R., Steffensen R., Thomassen A., Zerahn B., Perez A., Velez G. A. E., Velez M. S., Aziz I. S. A., Abougabal M., Ahmed T., Allam A., Asfour A., Hassan M., Hassan A., Ibrahim A., Kaffas S., Kandeel A., Ali M. M., Mansy A., Maurice H., Nabil S., Shaaban M., Flores A. C., Poksi A., Knuuti J., Kokkonen V., Larikka M., Uusitalo V., Bailly M., Burg S., Deux J. -F., Habouzit V., Hyafil F., Lairez O., Proffit F., Regaieg H., Sarda-Mantel L., Tacher V., Schneider R. P., Ayetey H., Angelidis G., Archontaki A., Chatziioannou S., Datseris I., Fragkaki C., Georgoulias P., Koukouraki S., Koutelou M., Kyrozi E., Repasos E., Stavrou P., Valsamaki P., Gonzalez C., Gutierrez G., Maldonado A., Buga K., Garai I., Schmidt E., Szilveszter B., Varady E., Banthia N., Bhagat J. K., Bhargava R., Bhat V., Bhatia M., Choudhury P., Chowdekar V. S., Irodi A., Jain S., Joseph E., Kumar S., Mahapatra G., Mitra D., Mittal B. R., Ozair A., Patel C., Patel T., Patel R., Patel S., Saxena S., Sengupta S., Singh S., Singh B., Sood A., Verma A., Affandi E., Alam P. S., Edison E., Gunawan G., Hapkido H., Hidayat B., Huda A., Mukti A. P., Prawiro D., Soeriadi E. A., Syawaluddin H., Albadr A., Assadi M., Emami F., Houshmand G., Maleki M., Rostami M. T., Zakavi S. R., Zaid E. A., Agranovich S., Arnson Y., Bar-Shalom R., Frenkel A., Knafo G., Lugassi R., Moalem I. S. M., Mor M., Muskal N., Ranser S., Shalev A., Albano D., Alongi P., Arnone G., Bagatin E., Baldari S., Bauckneht M., Bertelli P., Bianco F., Bonfiglioli R., Boni R., Bruno A., Bruno I., Busnardo E., Califaretti E., Camoni L., Carnevale A., Casoni R., Cavallo A. U., Cavenaghi G., Chierichetti F., Chiocchi M., Cittanti C., Colletta M., Conti U., Cossu A., Cuocolo A., Cuzzocrea M., De Rimini M. L., De Vincentis G., Del Giudice E., Del Torto A., Della Tommasina V., Durmo R., Erba P. A., Evangelista L., Faletti R., Faragasso E., Farsad M., Ferro P., Florimonte L., Frantellizzi V., Fringuelli F. M., Gatti M., Gaudiano A., Gimelli A., Giubbini R., Giuffrida F., Ialuna S., Laudicella R., Leccisotti L., Leva L., Liga R., Liguori C., Longo G., Maffione M., Mancini M. E., Marcassa C., Nardi B., Pacella S., Pepe G., Pulizzi S., Quartuccio N., Rampin L., Ricci F., Rossini P., Rubini G., Russo V., Sacchetti G. M., Sambuceti G., Scarano M., Sciagra R., Sperandio M., Stefanelli A., Ventroni G., Zoboli S., Baugh D., Chambers D., Madu E., Nunura F., Asano H., Chimura C. M., Fujimoto S., Fujisue K., Fukunaga T., Fukushima Y., Fukuyama K., Hashimoto J., Ichikawa Y., Iguchi N., Imai M., Inaki A., Ishimura H., Isobe S., Kadokami T., Kato T., Kudo T., Kumita S., Maruno H., Mataki H., Miyagawa M., Morimoto R., Moroi M., Nagamachi S., Nakajima K., Nakata T., Nakazato R., Nanasato M., Naya M., Norikane T., Ohta Y., Okayama S., Okizaki A., Otomi Y., Otsuka H., Saito M., Sakata S. Y., Sarai M., Sato D., Shiraishi S., Suwa Y., Takanami K., Takehana K., Taki J., Tamaki N., Taniguchi Y., Teragawa H., Tomizawa N., Tsujita K., Umeji K., Wakabayashi Y., Yamada S., Yamazaki S., Yoneyama T., Rawashdeh M., Batyrkhanov D., Dautov T., Makhdomi K., Ombati K., Alkandari F., Garashi M., Coie T. L., Rajvong S., Kalinin A., Kalnina M., Haidar M., Komiagiene R., Kviecinskiene G., Mataciunas M., Vajauskas D., Picard C., Karim N. K. A., Reichmuth L., Samuel A., Allarakha M. A., Naojee A. S., Alexanderson-Rosas E., Barragan E., Becerril A., Gonzalez-Montecinos, Cabada M., Rodriguez D. C., Carvajal-Juarez I., Cortes V., Cortes F., De La Pena E., Gama-Moreno M., Gonzalez L., Ramirez N. G., Jimenez-Santos M., Matos L., Monroy E., Morelos M., Ornelas M., Ramirez J. A. O., Preciado-Anaya A., Preciado-Gutierrez O. U., Barragan A. P., Uvera S. G. R., Sandoval S., Tomas M. S., Sierra-Galan L. M., Siu S., Vallejo E., Valles M., Faraggi M., Sereegotov E., Ilic S., Ben-Rais N., Alaoui N. I., Taleb S., Myo K. P. P., Thu P. S., Ghimire R. K., Rajbanshi B., Barneveld P., Glaudemans A., Habets J., Koopmans K. P., Manders J., Pool S., Scholte A., Scholtens A., Slart R., Thimister P., Van Asperen E. -J., Veltman N., Verschure D., Wagenaar N., Edmond J., Ellis C., Johnson K., Keenan R., Kueh S. H., Occleshaw C., Sasse A., To A., Van Pelt N., Young C., Cuadra T., Vanegas H. B. R., Soli I. A., Issoufou D. M., Ayodele T., Madu C., Onimode Y., Efros-Monsen E., Forsdahl S. H., Dimmen J. -M. H., Jorgensen A., Krohn I., Lovhaugen P., Braten A. T., Al Dhuhli H., Al Kindi F., Al-Bulushi N., Jawa Z., Tag N., Afzal M. S., Fatima S., Younis M. N., Riaz M., Saadullah M., Herrera Y., Lenturut-Katal D., Vazquez M. C., Ortellado J., Akhter A., Cao D., Cheung S., Dai X., Gong L., Han D., Hou Y., Li C., Li T., Li D., Li S., Liu J., Liu H., Lu B., Ng M. Y., Sun K., Tang G., Wang J., Wang X., Wang Z. -Q., Wang Y., Wu J., Wu Z., Xia L., Xiao J., Xu L., Yang Y., Yin W., Yu J., Yuan L., Zhang T., Zhang L., Zhang Y. -G., Zhang X., Zhu L., Alfaro A., Abrihan P., Barroso A., Cruz E., Gomez M. R., Magboo V. P., Medina J. M., Obaldo J., Pastrana D., Pawhay C. M., Quinon A., Tang J. M., Tecson B., Uson K. J., Uy M., Kostkiewicz M., Kunikowska J., Bettencourt N., Cantinho G., Ferreira A., Syed G., Arnous S., Atyani S., Byrne A., Gleeson T., Kerins D., Meehan C., Murphy D., Murphy M., Murray J., O'Brien J., Bang J. -I., Bom H., Cho S. -G., Hong C. M., Jang S. J., Jeong Y. H., Kang W. J., Kim J. -Y., Namgung C. K., So Y., Won K. S., Majstorov V., Vavlukis M., Salobir B. G., Stalc M., Benedek T., Benedek I., Mititelu R., Stan C. A., Dariy O., Drozdova O., Gagarina N., Gulyaev V. M., Itskovich I., Karalkin A., Kokov A., Migunova E., Pospelov V., Ryzhkova D., Saifullina G., Sazonova S., Shurupova I., Trifonova T., Ussov W. Y., Vakhromeeva M., Valiullina N., Zavadovsky K., Zhuravlev K., Alasnag M., Okarvi S., Saranovic D. S., Keng F., See J. H. J., Sekar R., Yew M. S., Vondrak A., Bejai S., Bennie G., Bester R., Engelbrecht G., Evbuomwan O., Gongxeka H., Vuuren M. J., Kaplan M., Khushica P., Lakhi H., Louw L., Malan N., Milos K., Modiselle M., More S., Naidoo M., Scholtz L., Vangu M., Aguade-Bruix S., Blanco I., Cabrera A., Camarero A., Casans-Tormo I., Cuellar-Calabria H., Flotats A., Canamero M. E. F., Garcia M. E., Leta R., Diaz J. L., Lumbreras L., Marquez-Cabeza J. J., Martin F., De Alegria A. M., Medina F., Canal M. P., Peiro V., Pubul-Nunez V., Madrid J. I. R., Rey C. R., Perez R. R., Ruiz J., Hernandez G. S., Sevilla A., Zeidan N., Nanayakkara D., Udugama C., Simonsson M., Alkadhi H., Buechel R. R., Burger P., Ceriani L., De Boeck B., Grani C., De Saint Lager Lucas A. J., Kamani C. H., Kawel-Boehm N., Manka R., Prior J. O., Rominger A., Vallee J. -P., Khiewvan B., Premprabha T., Thientunyakit T., Sellem A., Kir K. M., Sayman H., Sebikali M. J., Muyinda Z., Kmetyuk Y., Korol P., Mykhalchenko O., Pliatsek V., Satyr M., Albalooshi B., Hassan M. I. 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A, Dougan, J, Fairbairn, T, Farrugia, A, Gopalan, D, Gummow, A, Ramkumar, P, Hamilton, M, Harbinson, M, Hartley, T, Hudson, B, Joshi, N, Kay, M, Kelion, A, Khokhar, A, Kitt, J, Low, C, Mak, S, Marousa, N, Martin, J, Mcalindon, E, Menezes, L, Morgan-Hughes, G, Moss, A, Murray, A, Patel, D, Peebles, C, Pugliese, F, Rodrigues, J, Rofe, C, Sabharwal, N, Schofield, R, Semple, T, Sharma, N, Strouhal, P, Subedi, D, Topping, W, Tweed, K, Weir-Mccall, J, Abbara, S, Abbasi, T, Abbott, B, Abohashem, S, Abramson, S, Al-Abboud, T, Al-Mallah, M, Almousalli, O, Ananthasubramaniam, K, Kumar, M, Askew, J, Attanasio, L, Balmer-Swain, M, Bayer, R, Bernheim, A, Bhatti, S, Bieging, E, Blankstein, R, Bloom, S, Blue, S, Bluemke, D, Borges, A, Branch, K, Bravo, P, Brothers, J, Budoff, M, Bullock-Palmer, R, Burandt, A, Burke, F, Bush, K, Candela, C, Capasso, E, Cavalcante, J, Chang, D, Chatterjee, S, Chatzizisis, Y, Cheezum, M, Chen, T, Chen, J, Chen, M, Choi, A, Clarcq, J, Cordero, A, Crim, M, Danciu, S, Decter, B, Dhruva, N, Doherty, N, Doukky, R, Dunbar, A, Duvall, W, Edwards, R, Esquitin, K, Farah, H, Fentanes, E, Ferencik, M, Fisher, D, Fitzpatrick, D, Foster, C, Fuisz, T, Gannon, M, Gastner, L, Gerson, M, Ghoshhajra, B, Goldberg, A, Goldner, B, Gonzalez, J, Gore, R, Gracia-Lopez, S, Hage, F, Haider, A, Haider, S, Hamirani, Y, Hassen, K, Hatfield, M, Hawkins, C, Hawthorne, K, Heath, N, Hendel, R, Hernandez, P, Hill, G, Horgan, S, Huffman, J, Hurwitz, L, Iskandrian, A, Janardhanan, R, Jellis, C, Jerome, S, Kalra, D, Kaviratne, S, Kay, F, Kelly, F, Khalique, O, Kinkhabwala, M, Iii, G, Kircher, J, Kirkbride, R, Kontos, M, Kottam, A, Krepp, J, Layer, J, Lee, S, Leppo, J, Lesser, J, Leung, S, Lewin, H, Litmanovich, D, Liu, Y, Lopez-Mattei, J, Magurany, K, Markowitz, J, Marn, A, Matis, S, Mckenna, M, Mcrae, T, Mendoza, F, Merhige, M, Min, D, Moffitt, C, Moncher, K, Moore, W, Morayati, S, Morris, M, Mossa-Basha, M, Mrsic, Z, Murthy, V, Nagpal, P, Napier, K, Narula, J, Nelson, K, Nijjar, P, Osman, M, Parwani, P, Passen, E, Patel, A, Patil, P, Paul, R, Phillips, L, Polsani, V, Poludasu, R, Pomerantz, B, Porter, T, Prentice, R, Pursnani, A, Rabbat, M, Ramamurti, S, Rich, F, Luna, H, Robinson, A, Robles, K, Rodriguez, C, Rorie, M, Rumberger, J, Russell, R, Sabra, P, Sadler, D, Schemmer, M, Schoepf, U, Shah, S, Shah, N, Shanbhag, S, Sharma, G, Shayani, S, Shirani, J, Shivaram, P, Sigman, S, Simon, M, Slim, A, Smith, D, Smith, A, Soman, P, Srichai-Parsia, M, Streeter, J, Albert, T, Tawakol, A, Thomas, D, Thompson, R, Torbet, T, Trinidad, D, Ullery, S, Unzek, S, Uretsky, S, Vallurupalli, S, Verma, V, Waller, A, Wang, E, Ward, P, Weissman, G, Wesbey, G, White, K, Winchester, D, Wolinsky, D, Yost, S, Zgaljardic, M, Alonso, O, Beretta, M, Ferrando, R, Kapitan, M, Mut, F, Djuraev, O, Rozikhodjaeva, G, Ngoc, H, Mai, S, Nguyen, X, Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Translational Immunology Groningen (TRIGR), and Cardiovascular Centre (CVC)
Subjects: INCAPS COVID Investigators Group, cardiac imaging techniques, Settore MED/11 - Malattie dell'Apparato Cardiovascolare, Practice Patterns, Disease, Cardiovascular, coronary artery disease, COVID-19, Cardiac Imaging Techniques, Cardiologists, Europe, Health Care Surveys, Healthcare Disparities, Heart Diseases, Humans, Practice Patterns, Physicians', Predictive Value of Tests, Gross domestic product, Human health, cardiovascular disease, Pandemic, Medicine, cardiovascular imaging, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Interna medicina, cardiac imaging technique, Predictive value of tests, Cardiology and Cardiovascular Medicine, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Infektologija, cardiac disease, Coronavirus disease 2019 (COVID-19), Independent predictor, cardiac imaging, NO, Imaging diagnosis, Diseases of the circulatory (Cardiovascular) system, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Internal Medicine, Physicians', business.industry, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Infectology, RC666-701, HOSPITALIZATIONS, business, Health Care Delivery, Economics and Global Health Care, Demography
Abstract: ObjectivesWe aimed to explore the impact of the COVID-19 pandemic on cardiac diagnostic testing and practice and to assess its impact in different regions in Europe.MethodsThe online survey organised by the International Atomic Energy Agency Division of Human Health collected information on changes in cardiac imaging procedural volumes between March 2019 and March/April 2020. Data were collected from 909 centres in 108 countries.ResultsCentres in Northern and Southern Europe were more likely to cancel all outpatient activities compared with Western and Eastern Europe. There was a greater reduction in total procedure volumes in Europe compared with the rest of the world in March 2020 (45% vs 41%, p=0.003), with a more marked reduction in Southern Europe (58%), but by April 2020 this was similar in Europe and the rest of the world (69% vs 63%, p=0.261). Regional variations were apparent between imaging modalities, but the largest reductions were in Southern Europe for nearly all modalities. In March 2020, location in Southern Europe was the only independent predictor of the reduction in procedure volume. However, in April 2020, lower gross domestic product and higher COVID-19 deaths were the only independent predictors.ConclusionThe first wave of the COVID-19 pandemic had a significant impact on care of patients with cardiac disease, with substantial regional variations in Europe. This has potential long-term implications for patients and plans are required to enable the diagnosis of non-COVID-19 conditions during the ongoing pandemic.
Published: 2021

32. Reply to: 'An EASL position paper for systemic treatment of hepatocellular carcinoma: Go forward courageously'

Author: Jordi Bruix, Lorenza Rimassa, Bruno Sangro, Stephen L. Chan, and Peter R. Galle
Subjects: Oncology, medicine.medical_specialty, Carcinoma, Hepatocellular, Hepatology, business.industry, Liver Neoplasms, MEDLINE, medicine.disease, Text mining, Treatment Outcome, Internal medicine, Hepatocellular carcinoma, medicine, Position paper, Humans, business
Published: 2021

33. Reply to: 'Correspondence on the <BCLC strategy for prognosis prediction and treatment recommendation: The 2022 update>'

Author: Maria Reig and Jordi Bruix
Subjects: Carcinoma, Hepatocellular, Hepatology, Liver Neoplasms, Humans, Prognosis, Neoplasm Staging, Retrospective Studies
Published: 2022

34. Cholangiocarcinoma 2020: the next horizon in mechanisms and management

Author: Sergio A. Gradilone, Mario Strazzabosco, Jesper B. Andersen, Cédric Coulouarn, Gregory J. Gores, Rocio I.R. Macias, John Bridgewater, Pedro M. Rodrigues, Vincenzo Cardinale, Lewis R. Roberts, Chiara Raggi, Chiara Braconi, Anja Moncsek, Jordi Bruix, Shahid A. Khan, Juan W. Valle, Marco Marzioni, Alejandro Forner, Angela Lamarca, Domenico Alvaro, Luca Fabris, Guido Carpino, Luke Boulter, Maria J. Perugorria, Joachim C. Mertens, Julie K. Heimbach, Sumera Rizvi, Eugenio Gaudio, Jesus M. Banales, Bas Groot Koerkamp, Jose J.G. Marin, Diego F. Calvisi, Pietro Invernizzi, Laura Fouassier, European Commission, Surgery, Basque Foundation for Science (Ikerbasque), Instituto de Salud Carlos III [Madrid] (ISC), Universidad de Salamanca, University of Manchester [Manchester], Imperial College London, Mayo Clinic, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome], Università degli Studi di Roma 'Foro Italico', University of Copenhagen = Københavns Universitet (KU), University of Glasgow, Universität Regensburg (UR), Yale University [New Haven], University of Edinburgh, University of Minnesota System, Nutrition, Métabolismes et Cancer (NuMeCan), Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Università degli Studi di Firenze = University of Florence [Firenze] (UNIFI), Università degli Studi di Milano-Bicocca [Milano] (UNIMIB), Universität Zürich [Zürich] = University of Zurich (UZH), Erasmus University Medical Center [Rotterdam] (Erasmus MC), Spanish Ministry of Economy and Competitiveness [FIS PI12/00380, FIS PI15/01132, FIS PI18/01075, CON14/00129, FIS PI14/00399, FIS PI17/00022, RYC-2015-17755], 'Fondo Europeo de Desarrollo Regional' (FEDER)European Union (EU), ISCIII CIBERehd, Diputacion Foral de Gipuzkoa [DFG15/010, DFG16/004], BIOEF (Basque Foundation for Innovation and Health Research: EiTB Maratoia) [BIO15/CA/016/BD], Department of Health of the Basque CountryBasque Government [2015111100, 2017111010], 'Fundacion Cientifica de la Asociacion Espanola Contra el Cancer' (AECC Scientific Foundation), European Commission Horizon 2020 programme (ESCALON project) [825510], Danish Medical Research CouncilDanish Medical Research Council, Danish Cancer SocietyDanish Cancer Society, Novo Nordisk FoundationNovo Nordisk Foundation, A.P. MOller Foundation, Carlos III Institute of Health, SpainInstituto de Salud Carlos III [PI16/00598, PI18/00428], European Regional Development FundEuropean Union (EU), Ministry of Science and Innovation, SpainSpanish Government [SAF2016-75197-R], 'Asociacion Espanola Contra el Cancer', Spain (AECC-2017), 'Centro Internacional sobre el Envejecimiento', Spain (OLD-HEPAMARKER) [0348-CIE-6-E], Christie Charity, Universita Politecnica delle Marche, Ancona, Italy [040020_R.SCIENT.A_2018_MARZIONI_M_STRATEGICO_2017], Yale Liver Center Clinical and Translational Core and the Cellular and Molecular Core (Silvio O. Conte Digestive Diseases Research Center) [DK034989], INSERMInstitut National de la Sante et de la Recherche Medicale (Inserm), Universite de Rennes, INCaInstitut National du Cancer (INCA) France, ITMO Cancer AVIESAN dans le cadre du Plan Cancer (Non-coding RNA in Cancerology: Fundamental to Translational), Ligue Contre le CancerLigue nationale contre le cancer, Region BretagneRegion Bretagne, Instituto de Salud Carlos IIIInstituto de Salud Carlos III [PI18/00763], AECC [PI044031], WCR (AICR) [16-0026], ISCIIIInstituto de Salud Carlos III [PI13/01229, PI18/00542], Instituto de Salud Carlos IIIInstituto de Salud Carlos III, EASL Registry Award 2016 (European CCA Registry, ENS-CCA), EASL Registry Award 2019 (European CCA Registry, ENS-CCA), Ikerbasque - Basque Foundation for Science, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome] (UNIROMA), University of Copenhagen = Københavns Universitet (UCPH), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Università degli Studi di Firenze = University of Florence (UniFI), Università degli Studi di Milano-Bicocca = University of Milano-Bicocca (UNIMIB), Banales, J, Marin, J, Lamarca, A, Rodrigues, P, Khan, S, Roberts, L, Cardinale, V, Carpino, G, Andersen, J, Braconi, C, Calvisi, D, Perugorria, M, Fabris, L, Boulter, L, Macias, R, Gaudio, E, Alvaro, D, Gradilone, S, Strazzabosco, M, Marzioni, M, Coulouarn, C, Fouassier, L, Raggi, C, Invernizzi, P, Mertens, J, Moncsek, A, Rizvi, S, Heimbach, J, Koerkamp, B, Bruix, J, Forner, A, Bridgewater, J, Valle, J, Gores, G, and HAL UR1, Admin
Subjects: medicine.medical_specialty, [SDV]Life Sciences [q-bio], Diagnostic tools, Bioinformatics, bile duct neoplasms, cholangiocarcinoma, humans, Cholangiocarcinoma, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Biomarker discovery, 030304 developmental biology, Cancer, 0303 health sciences, Biliary tract cancer, Hepatology, business.industry, Extramural, Gastroenterology, Consensus Statement, Expert consensus, medicine.disease, 3. Good health, [SDV] Life Sciences [q-bio], Bile Duct Neoplasms, 030220 oncology & carcinogenesis, Hepatology, cholangiocarcinoma, therapy, business
Abstract: Cholangiocarcinoma (CCA) includes a cluster of highly heterogeneous biliary malignant tumours that can arise at any point of the biliary tree. Their incidence is increasing globally, currently accounting for ~15% of all primary liver cancers and ~3% of gastrointestinal malignancies. The silent presentation of these tumours combined with their highly aggressive nature and refractoriness to chemotherapy contribute to their alarming mortality, representing ~2% of all cancer-related deaths worldwide yearly. The current diagnosis of CCA by non-invasive approaches is not accurate enough, and histological confirmation is necessary. Furthermore, the high heterogeneity of CCAs at the genomic, epigenetic and molecular levels severely compromises the efficacy of the available therapies. In the past decade, increasing efforts have been made to understand the complexity of these tumours and to develop new diagnostic tools and therapies that might help to improve patient outcomes. In this expert Consensus Statement, which is endorsed by the European Network for the Study of Cholangiocarcinoma, we aim to summarize and critically discuss the latest advances in CCA, mostly focusing on classification, cells of origin, genetic and epigenetic abnormalities, molecular alterations, biomarker discovery and treatments. Furthermore, the horizon of CCA for the next decade from 2020 onwards is highlighted., Cholangiocarcinoma (CCA) comprises heterogeneous biliary malignant tumours, and their incidence is increasing worldwide. This expert Consensus Statement, endorsed by the ENS-CCA, summarizes the latest advances in CCA, including classification, genetics and treatment, and provides recommendations for CCA management and priorities across basic, translational and clinical research.
Published: 2020
Full Text: View/download PDF

35. Outcomes of sequential treatment with sorafenib followed by regorafenib for HCC: Additional analyses from the phase III RESORCE trial

Author: Gerold Meinhardt, Chiara Caparello, Olivier Rosmorduc, Annette Baumhauer, Weijing Sun, Charissa Chang, Osamu Yokosuka, Yi Hsiang Huang, Marc Pracht, Marie Aude Leberre, Philippe Merle, Jordi Bruix, Richard S. Finn, Alessandro Granito, György Bodoky, Roniel Cabrera, René Gerolami, CRLCC Eugène Marquis (CRLCC), UPMC - Faculté de Médecine - Département d'Enseignement et de Recherche en Médecine Générale, Université Pierre et Marie Curie - Paris 6 (UPMC), Service d'hépato-gastro-entérologie [Hôpital de la Timone -APHM], Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Icahn School of Medicine at Mount Sinai [New York] (MSSM), and Richard S. Finn, Philippe Merle, Alessandro Granito, Yi-Hsiang Huang, György Bodoky, Marc Pracht, Osamu Yokosuka, Olivier Rosmorduc, René Gerolami, Chiara Caparello, Roniel Cabrera, Charissa Chang, Weijing Sun, Marie-Aude LeBerre, Annette Baumhauer, Gerold Meinhardt, Jordi Bruix
Subjects: Male, Oncology, Pyridines, Kaplan-Meier Estimate, urologic and male genital diseases, chemistry.chemical_compound, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, heterocyclic compounds, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Liver Neoplasms, Hazard ratio, Middle Aged, Sorafenib, female genital diseases and pregnancy complications, 3. Good health, Treatment Outcome, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Disease Progression, Female, 030211 gastroenterology & hepatology, Drug Monitoring, medicine.drug, Adult, medicine.medical_specialty, Carcinoma, Hepatocellular, Antineoplastic Agents, Placebo, Drug Administration Schedule, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Internal medicine, Regorafenib, medicine, Humans, [SDV.MP.PAR]Life Sciences [q-bio]/Microbiology and Parasitology/Parasitology, Adverse effect, neoplasms, Survival analysis, Aged, Dose-Response Relationship, Drug, Hepatology, business.industry, Phenylurea Compounds, Hepatocellular carcinoma, regorafenib, sorafenib, medicine.disease, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, digestive system diseases, Confidence interval, chemistry, business
Abstract: BACKGROUND & AIMS:The RESORCE trial showed that regorafenib improves overall survival (OS) in patients with hepatocellular carcinoma progressing during sorafenib treatment (hazard ratio [HR] 0.62, 95% confidence interval [CI] 0.50-0.78; p
Published: 2018

36. Recurrent superinfection in a patient with transjugular intrahepatic portosystemic shunt (endotipsitis), findings on

Author: D, Villasboas-Rosciolesi, M, Simó-Perdigó, J, Castell-Conesa, and S, Aguadé-Bruix
Subjects: Fluorodeoxyglucose F18, Positron Emission Tomography Computed Tomography, Superinfection, Humans, Prostheses and Implants, Portasystemic Shunt, Transjugular Intrahepatic
Published: 2021

37. Reduction of cardiac imaging tests during the COVID-19 pandemic: The case of Italy. Findings from the IAEA Non-invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Author: Dondi, M., Milan, E., Pontone, G., Hirschfeld, C. B., Williams, M., Shaw, L. J., Pynda, Y., Raggi, P., Cerci, R., Vitola, J., Better, N., Villines, T. C., Dorbala, S., Pascual, T. N. B., Giubbini, R., Einstein, A. J., Paez, D., Italy: Domenico Albano, Pierpaolo, Alongi, Gaspare, Arnone, Elisa, Bagatin, Sergio, Baldari, Matteo, Bauckneht, Paolo, Bertelli, Francesco, Bianco, Rachele, Bonfiglioli, Roberto, Boni, Andrea, Bruno, Isabella, Bruno, Elena, Busnardo, Elena, Califaretti, Luca, Camoni, Aldo, Carnevale, Roberta, Casoni, Armando Ugo Cavallo, Giorgio, Cavenaghi, Franca, Chierichetti, Marcello, Chiocchi, Corrado, Cittanti, Mauro, Colletta, Umberto, Conti, Alberto, Cossu, Alberto, Cuocolo, Marco, Cuzzocrea, Maria Luisa De Rimini, Giuseppe De Vincentis, Eleonora Del Giudice, Alberico Del Torto, Veronica Della Tommasina, Rexhep, Durmo, Paola Anna Erba, Laura, Evangelista, Riccardo, Faletti, Evelina, Faragasso, Mohsen, Farsad, Paola, Ferro, Luigia, Florimonte, Viviana, Frantellizzi, Fabio Massimo Fringuelli, Marco, Gatti, Angela, Gaudiano, Alessia, Gimelli, Raffaele, Giubbini, Francesca, Giuffrida, Salvatore, Ialuna, Riccardo, Laudicella, Lucia, Leccisotti, Lucia, Leva, Liga, Riccardo, Carlo, Liguori, Giampiero, Longo, Margherita, Maffione, Maria Elisabetta Mancini, Claudio, Marcassa, Elisa, Milan, Barbara, Nardi, Sara, Pacella, Giovanna, Pepe, Gianluca, Pontone, Sabina, Pulizzi, Natale, Quartuccio, Lucia, Rampin, Fabrizio, Ricci, Pierluigi, Rossini, Giuseppe, Rubini, Vincenzo, Russo, Gian Mauro Sacchetti, Gianmario, Sambuceti, Massimo, Scarano, Roberto, Sciagrà, Massimiliano, Sperandio, Antonella, Stefanelli, Guido, Ventroni, Stefania Zoboli Members from Rest of the World (alphabetically by country and last name) Afghanistan: Mohammad Nawaz Nasery Albania: Artan Goda, Ervina Shirka Algeria: Rabie Benlabgaa, Salah, Bouyoucef, Abdelkader, Medjahedi, Qais Nailli Argentina: Mariela Agolti, Roberto Nicolas Aguero, Maria del Carmen Alak, Lucia Graciela Alberguina, Guillermo, Arroñada, Andrea, Astesiano, Alfredo, Astesiano, Carolina Bas Norton, Pablo, Benteo, Juan, Blanco, Juan Manuel Bonelli, Jose Javier Bustos, Raul, Cabrejas, Jorge, Cachero, Roxana, Campisi, Alejandro, Canderoli, Silvia, Carames, Patrícia, Carrascosa, Ricardo, Castro, Oscar, Cendoya, Luciano Martin Cognigni, Carlos, Collaud, Claudia, Cortes, Javier, Courtis, Daniel, Cragnolino, Mariana, Daicz, Alejandro De La Vega, Silvia Teresa De Maria, Horacio Del Riego, Fernando, Dettori, Alejandro, Deviggiano, Laura, Dragonetti, Mario, Embon, Ruben Emilio Enriquez, Jorge, Ensinas, Fernando, Faccio, Adolfo, Facello, Diego, Garofalo, Ricardo, Geronazzo, Natalia, Gonza, Lucas, Gutierrez, Miguel Angel Guzzo, Victor, Hasbani, Melina, Huerin, Victor, Jäger, Julio Manuel Lewkowicz, Maria Nieves, A López De Munaín, Jose Maria Lotti, Alejandra, Marquez, Osvaldo, Masoli, Osvaldo Horacio Masoli, Edgardo, Mastrovito, Matias, Mayoraz, Graciela Eva Melado, Anibal, Mele, Maria Fernanda Merani, Alejandro Horacio Meretta, Susana, Molteni, Marcos, Montecinos, Eduardo, Noguera, Carlos, Novoa, Claudio Pereyra Sueldo, Sebastian Perez Ascani, Pablo, Pollono, Maria Paula Pujol, Alejandro, Radzinschi, Gustavo, Raimondi, Marcela, Redruello, Marina, Rodríguez, Matías, Rodríguez, Romina Lorena Romero, Arturo Romero Acuña, Federico, Rovaletti, Lucas San Miguel, Lucrecia, Solari, Bruno, Strada, Sonia, Traverso, Sonia Simona Traverzo, Maria del Huerto Velazquez Espeche, Juan Sebastian Weihmuller, Juan, Wolcan, Susana Zeffiro Armenia: Mari Sakanyan Australia: Scott Beuzeville, Raef, Boktor, Patrick, Butler, Jennifer, Calcott, Loretta, Carr, Virgil, Chan, Charles, Chao, Woon, Chong, Mark, Dobson, D'Arne, Downie, Girish, Dwivedi, Barry, Elison, Jean, Engela, Roslyn, Francis, Anand, Gaikwad, Ashok Gangasandra Basavaraj, Bruce, Goodwin, Robert, Greenough, Christian, Hamilton-Craig, Victar, Hsieh, Subodh, Joshi, Karin, Lederer, Kenneth, Lee, Joseph, Lee, John, Magnussen, Nghi, Mai, Gordon, Mander, Fiona, Murton, Dee, Nandurkar, Johanne, Neill, Edward, O'Rourke, Patricia, O'Sullivan, George, Pandos, Kunthi, Pathmaraj, Alexander, Pitman, Rohan, Poulter, Manuja, Premaratne, David, Prior, Lloyd, Ridley, Natalie, Rutherford, Hamid, Salehi, Connor, Saunders, Luke, Scarlett, Sujith, Seneviratne, Deepa, Shetty, Ganesh, Shrestha, Jonathan, Shulman, Vijay, Solanki, Tony, Stanton, Murch, Stuart, Michael, Stubbs, Ian, Swainson, Kim, Taubman, Andrew, Taylor, Paul, Thomas, Steven, Unger, Anthony, Upton, Shankar, Vamadevan, William Van Gaal, Johan, Verjans, Demetrius, Voutnis, Victor, Wayne, Peter, Wilson, David, Wong, Kirby, Wong, John Younger Austria: Gudrun Feuchtner, Siroos, Mirzaei, Konrad Weiss Belarus: Natallia Maroz-Vadalazhskaya Belgium: Olivier Gheysens, Filip, Homans, Rodrigo, Moreno-Reyes, Agnès, Pasquet, Veronique, Roelants, Van De Heyning Bolivia: Raúl Araujo Ríos Bosnia - Herzegovina: Valentina Soldat-Stankovic, Caroline M., Sinisa Stankovic Brazil: Maria Helena Albernaz Siqueira, Augusto, Almeida, Paulo Henrique Alves Togni, Jose Henrique Andrade, Luciana, Andrade, Carlos, Anselmi, Roberta, Araújo, Guilherme, Azevedo, Sabbrina, Bezerra, Rodrigo, Biancardi, Gabriel Blacher Grossman, Simone, Brandão, Diego Bromfman Pianta, Lara, Carreira, Bruno, Castro, Tien, Chang, Fernando Cunali, Jr., Roberto, Cury, Roberto, Dantas, Fernando de Amorim Fernandes, Andrea De Lorenzo, Robson De Macedo Filho, Fernanda, Erthal, Fabio, Fernandes, Juliano, Fernandes, Thiago Ferreira De Souza, Wilson Furlan Alves, Bruno, Ghini, Luiz, Goncalves, Ilan, Gottlieb, Marcelo, Hadlich, Vinícius, Kameoka, Ronaldo, Lima, Adna, Lima, Rafael Willain Lopes, Ricardo Machado, e Silva, Tiago, Magalhães, Fábio Martins Silva, Luiz Eduardo Mastrocola, Fábio, Medeiros, José Claudio Meneghetti, Vania, Naue, Danilo, Naves, Roberto, Nolasco, Cesar, Nomura, Joao Bruno Oliveira, Eduardo, Paixao, Filipe Penna De Carvalho, Ibraim, Pinto, Priscila, Possetti, Mayra, Quinta, Rodrigo Rizzo Nogueira Ramos, Ricardo, Rocha, Alfredo, Rodrigues, Carlos, Rodrigues, Leila, Romantini, Adelina, Sanches, Sara, Santana, Leonardo Sara da Silva, Paulo, Schvartzman, Cristina Sebastião Matushita, Tiago, Senra, Afonso, Shiozaki, Maria Eduarda Menezes de Siqueira, Cristiano, Siqueira, Paola, Smanio, Carlos Eduardo Soares, José Soares Junior, Marcio Sommer Bittencourt, Bernardo, Spiro, Cláudio Tinoco Mesquita, Jorge, Torreao, Rafael, Torres, Marly, Uellendahl, Guilherme Urpia Monte, Otávia, Veríssimo, Estevan Vieira Cabeda, Felipe Villela Pedras, Roberto, Waltrick, Marcello Zapparoli Brunei Darussalam: Hamid Naseer Bulgaria: Marina Garcheva-Tsacheva, Irena Kostadinova Cambodia: Youdaline Theng Canada: Gad Abikhzer, Rene, Barette, Benjamin, Chow, Dominique, Dabreo, Matthias, Friedrich, Ria, Garg, Mohammed Nassoh Hafez, Chris, Johnson, Marla, Kiess, Jonathon, Leipsic, Eugene, Leung, Robert, Miller, Anastasia, Oikonomou, Stephan, Probst, Idan, Roifman, Gary, Small, Vikas, Tandon, Adwait, Trivedi, James, White, Katherine Zukotynski Chile: Jose Canessa, Gabriel Castro Muñoz, Carmen, Concha, Pablo, Hidalgo, Cesar, Lovera, Teresa, Massardo, Luis Salazar Vargas Colombia: Pedro Abad, Harold, Arturo, Sandra, Ayala, Luis, Benitez, Alberto, Cadena, Carlos, Caicedo, Antonio Calderón Moncayo, Sharon, Gomez, Gutierrez Villamil, Claudia T., Claudia, Jaimes, Juan, Londoño, Juan Luis Londoño Blair, Luz, Pabon, Mauricio, Pineda, Juan Carlos Rojas, Diego, Ruiz, Manuel Valencia Escobar, Andres, Vasquez, Damiana, Vergel, Alejandro Zuluaga Costa Rica: Isabel Berrocal Gamboa, Gabriel, Castro, Ulises, González, Croatia: Ana Baric, Tonci, Batinic, Maja, Franceschi, Maja Hrabak Paar, Mladen, Jukic, Petar, Medakovic, Viktor, Persic, Marina, Prpic, Ante Punda Cuba: Juan Felipe Batista, Juan Manuel Gómez Lauchy, Yamile Marcos Gutierrez, Rayner, Menéndez, Amalia, Peix, Luis Rochela Cyprus: Christoforos Panagidis, Ioannis Petrou Czech Republic: Vaclav Engelmann, Milan, Kaminek, Vladimír, Kincl, Otto, Lang, Milan Simanek Denmark: Jawdat Abdulla, Morten, Bøttcher, Mette, Christensen, Lars Christian Gormsen, Philip, Hasbak, Søren, Hess, Paw, Holdgaard, Allan, Johansen, Kasper, Kyhl, Bjarne Linde Norgaard, Kristian Altern Øvrehus, Niels Peter Rønnow Sand, Rolf, Steffensen, Anders, Thomassen, Bo Zerahn Dominican Republic: Alfredo Perez Ecuador: Giovanni Alejandro Escorza Velez, Mayra Sanchez Velez Egypt: Islam Shawky Abdel Aziz, Mahasen, Abougabal, Taghreed, Ahmed, Adel, Allam, Ahmed, Asfour, Mona, Hassan, Alia, Hassan, Ahmed, Ibrahim, Sameh, Kaffas, Ahmed, Kandeel, Mohamed Mandour Ali, Ahmad, Mansy, Hany, Maurice, Sherif, Nabil, Mahmoud Shaaban El Salvador: Ana Camila Flores Estonia: Anne Poksi Finland: Juhani Knuuti, Velipekka, Kokkonen, Martti, Larikka, Valtteri Uusitalo France: Matthieu Bailly, Samuel, Burg, Jean-François, Deux, Vincent, Habouzit, Fabien, Hyafil, Olivier, Lairez, Franck, Proffit, Hamza, Regaieg, Laure, Sarda-Mantel, Schneider Ghana: Harold Ayetey Greece: George Angelidis, Vania Tacher Germany: Roman P., Aikaterini, Archontaki, Sofia, Chatziioannou, Ioannis, Datseris, Christina, Fragkaki, Panagiotis, Georgoulias, Sophia, Koukouraki, Maria, Koutelou, Eleni, Kyrozi, Evangelos, Repasos, Petros, Stavrou, Pipitsa Valsamaki Guatemala: Carla Gonzalez, Goleat Gutierrez Honduras: Alejandro Maldonado Hungary: Klara Buga, Ildiko, Garai, Pál, Maurovich-Horvat, Erzsébet, Schmidt, Balint, Szilveszter, Edit Várady India: Nilesh Banthia, Jinendra Kumar Bhagat, Rishi, Bhargava, Vivek, Bhat, Mona, Bhatia, Partha, Choudhury, Vijay Sai Chowdekar, Aparna, Irodi, Shashank, Jain, Elizabeth, Joseph, Sukriti, Kumar, Prof Dr Girijanandan Mahapatra, Deepanjan, Mitra, Bhagwant Rai Mittal, Ahmad, Ozair, Chetan, Patel, Tapan, Patel, Ravi, Patel, Shivani, Patel, Sudhir, Saxena, Shantanu, Sengupta, Santosh, Singh, Bhanupriya, Singh, Ashwani, Sood, Atul Verma Indonesia: Erwin Affandi, Padma Savenadia Alam, Edison, Edison, Gani, Gunawan, Habusari, Hapkido, Basuki, Hidayat, Aulia, Huda, Anggoro Praja Mukti, Djoko, Prawiro, Erwin Affandi Soeriadi, Hilman Syawaluddin Iraq: Amjed Albadr Islamic Republic of Iran: Majid Assadi, Farshad, Emami, Golnaz, Houshmand, Majid, Maleki, Maryam Tajik Rostami, Seyed Rasoul Zakavi Israel: Eed Abu Zaid, Svetlana, Agranovich, Yoav, Arnson, Rachel, Bar-Shalom, Alex, Frenkel, Galit, Knafo, Rachel, Lugassi, Israel Shlomo Maor Moalem, Maya, Mor, Noam, Muskal, Sara, Ranser, Aryeh Shalev Jamaica: Dainia Baugh, Duane, Chambers, Ernest, Madu, Felix Nunura Japan: Hiroshi Asano, Chimura Misato Chimura, Shinichiro, Fujimoto, Koichiro, Fujisue, Tomohisa, Fukunaga, Yoshimitsu, Fukushima, Kae, Fukuyama, Jun, Hashimoto, Yasutaka, Ichikawa, Nobuo, Iguchi, Masamichi, Imai, Anri, Inaki, Hayato, Ishimura, Satoshi, Isobe, Toshiaki, Kadokami, Takao, Kato, Takashi, Kudo, Shinichiro, Kumita, Hirotaka, Maruno, Hiroyuki, Mataki, Masao, Miyagawa, Ryota, Morimoto, Masao, Moroi, Shigeki, Nagamachi, Kenichi, Nakajima, Tomoaki, Nakata, Ryo, Nakazato, Mamoru, Nanasato, Masanao, Naya, Takashi, Norikane, Yasutoshi, Ohta, Satoshi, Okayama, Atsutaka, Okizaki, Yoichi, Otomi, Hideki, Otsuka, Masaki, Saito, Sakata Yasushi Sakata, Masayoshi, Sarai, Daisuke, Sato, Shinya, Shiraishi, Yoshinobu, Suwa, Kentaro, Takanami, Kazuya, Takehana, Junichi, Taki, Nagara, Tamaki, Yasuyo, Taniguchi, Hiroki, Teragawa, Nobuo, Tomizawa, Kenichi, Tsujita, Kyoko, Umeji, Yasushi, Wakabayashi, Shinichiro, Yamada, Shinya, Yamazaki, Tatsuya Yoneyama Jordan: Mohammad Rawashdeh Kazakhstan: Daultai Batyrkhanov, Tairkhan Dautov Kenya: Khalid Makhdomi, Kevin Ombati Kuwait: Faridah Alkandari, Masoud Garashi Lao People's Democratic Republic: Tchoyoson Lim Coie, Sonexay Rajvong Latvia: Artem Kalinin, Marika Kalnina Lebanon: Mohamad Haidar Lithuania: Renata Komiagiene, Giedre, Kviecinskiene, Mindaugas, Mataciunas, Karim Malta: Luise Reichmuth, Donatas Vajauskas Luxembourg: Christian Picard Malaysia: Noor Khairiah A., Anthony Samuel Mauritius: Mohammad Aaftaab Allarakha, Ambedhkar Shantaram Naojee Mexico: Erick Alexanderson-Rosas, Erika, Barragan, Alejandro Becerril González-Montecinos, Manuel, Cabada, Daniel Calderon Rodriguez, Isabel, Carvajal-Juarez, Violeta, Cortés, Filiberto, Cortés, Erasmo De La Peña, Manlio, Gama-Moreno, Luis, González, Nelsy Gonzalez Ramírez, Moisés, Jiménez-Santos, Luis, Matos, Edgar, Monroy, Martha, Morelos, Mario, Ornelas, Jose Alberto Ortga Ramirez, Andrés, Preciado-Anaya, Óscar Ulises Preciado-Gutiérrez, Adriana Puente Barragan, Sandra Graciela Rosales Uvera, Sigelinda, Sandoval, Miguel Santaularia Tomas, Sierra-Galan, Lilia M., Silvia, Siu, Enrique, Vallejo, Mario Valles Monaco: Marc Faraggi Mongolia: Erdenechimeg Sereegotov Montenegro: Srdja Ilic Morocco: Nozha Ben-Rais, Nadia Ismaili Alaoui, Sara Taleb Myanmar: Khin Pa Pa Myo, Phyo Si Thu Nepal: Ram Kumar Ghimire, Bijoy Rajbanshi Netherlands: Peter Barneveld, Andor, Glaudemans, Jesse, Habets, Klaas Pieter Koopmans, Jeroen, Manders, Stefan, Pool, Arthur, Scholte, Asbjørn, Scholtens, Riemer, Slart, Paul, Thimister, Erik-Jan Van Asperen, Niels, Veltman, Derk, Verschure, Nils Wagenaar New Zealand: John Edmond, Chris, Ellis, Kerryanne, Johnson, Ross, Keenan, Shaw Hua (Anthony) Kueh, Christopher, Occleshaw, Alexander, Sasse, Andrew, To, Niels Van Pelt, Calum Young Nicaragua: Teresa Cuadra, Hector Bladimir Roque Vanegas Niger: Idrissa Adamou Soli, Djibrillou Moussa Issoufou Nigeria: Tolulope Ayodele, Chibuzo, Madu, Yetunde Onimode Norway: Elen Efros-Monsen, Signe Helene Forsdahl, Jenni-Mari Hildre Dimmen, Arve, Jørgensen, Isabel, Krohn, Pål, Løvhaugen, Anders Tjellaug Bråten Oman: Humoud Al Dhuhli, Faiza Al Kindi, Naeema, Al-Bulushi, Zabah, Jawa, Naima Tag Pakistan: Muhammad Shehzad Afzal, Shazia, Fatima, Muhammad Numair Younis, Musab, Riaz, Mohammad Saadullah Panama: Yariela Herrera Papua New Guinea: Dora Lenturut-Katal Paraguay: Manuel Castillo Vázquez, José Ortellado People's Republic of Bangladesh: Afroza Akhter People's Republic of China: Dianbo Cao, Stephen, Cheung, Dai, Xu, Lianggeng, Gong, Dan, Han, Yang, Hou, Caiying, Li, Tao, Li, Dong, Li, Sijin, Li, Jinkang, Liu, Hui, Liu, Bin, Lu, Ming Yen Ng, Kai, Sun, Gongshun, Tang, Jian, Wang, Ximing, Wang, Zhao-Qian, Wang, Yining, Wang, Yifan, Wang, Jiang, Wu, Zhifang, Wu, Liming, Xia, Jiangxi, Xiao, Lei, Xu, Youyou, Yang, Yin, Wu, Jianqun, Yu, Yuan, Li, Tong, Zhang, Longjiang, Zhang, Yong-Gao, Zhang, Xiaoli, Zhang, Li Zhu Peru: Ana Alfaro Philippines: Paz Abrihan, Asela, Barroso, Eric, Cruz, Marie Rhiamar Gomez, Vincent Peter Magboo, John Michael Medina, Jerry, Obaldo, Davidson, Pastrana, Christian Michael Pawhay, Alvin, Quinon, Jeanelle Margareth Tang, Bettina, Tecson, Kristine Joy Uson, Mila Uy Poland: Magdalena Kostkiewicz, Jolanta Kunikowska Portugal: Nuno Bettencourt, Guilhermina, Cantinho, Antonio Ferreira Qatar: Ghulam Syed Republic of Ireland: Samer Arnous, Said, Atyani, Angela, Byrne, Tadhg, Gleeson, David, Kerins, Conor, Meehan, David, Murphy, Mark, Murphy, John, Murray, Julie O'Brien Republic of Korea: Ji-In Bang, Henry, Bom, Sang-Geon, Cho, Chae Moon Hong, Su Jin Jang, Yong Hyu Jeong, Won Jun Kang, Ji-Young, Kim, Jaetae, Lee, Chang Kyeong Namgung, Young, So, Kyoung Sook Won Republic of North Macedonia: Venjamin Majstorov, Marija Vavlukis Republic of Slovenia: Barbara Gužic Salobir, Monika Štalc Romania: Theodora Benedek, Imre, Benedek, Raluca, Mititelu, Claudiu Adrian Stan Russian Federation: Alexey Ansheles, Olga, Dariy, Olga, Drozdova, Nina, Gagarina, Vsevolod Milyevich Gulyaev, Irina, Itskovich, Anatoly, Karalkin, Alexander, Kokov, Ekaterina, Migunova, Viktor, Pospelov, Daria, Ryzhkova, Guzaliya, Saifullina, Svetlana, Sazonova, Vladimir, Sergienko, Irina, Shurupova, Tatjana, Trifonova, Wladimir Yurievich Ussov, Margarita, Vakhromeeva, Nailya, Valiullina, Konstantin, Zavadovsky, Kirill Zhuravlev Saudi Arabia: Mirvat Alasnag, Subhani Okarvi Serbia: Dragana Sobic Saranovic Singapore: Felix Keng, Jia Hao Jason See, Ramkumar, Sekar, Min Sen Yew Slovak Republic: Andrej Vondrak South Africa: Shereen Bejai, George, Bennie, Ria, Bester, Gerrit, Engelbrecht, Osayande, Evbuomwan, Harlem, Gongxeka, Magritha Jv Vuuren, Mitchell, Kaplan, Purbhoo, Khushica, Hoosen, Lakhi, Lizette, Louw, Nico, Malan, Katarina, Milos, Moshe, Modiselle, Stuart, More, Mathava, Naidoo, Leonie, Scholtz, Mboyo Vangu Spain: Santiago Aguadé-Bruix, Isabel, Blanco, Antonio, Cabrera, Alicia, Camarero, Irene, Casáns-Tormo, Hug, Cuellar-Calabria, Albert, Flotats, Maria Eugenia Fuentes Cañamero, María Elia García, Amelia, Jimenez-Heffernan, Rubén, Leta, Javier Lopez Diaz, Luis, Lumbreras, Juan Javier Marquez-Cabeza, Francisco, Martin, Anxo Martinez de Alegria, Francisco, Medina, Maria Pedrera Canal, Virginia, Peiro, Virginia, Pubul-Nuñez, Juan Ignacio Rayo Madrid, Cristina Rodríguez Rey, Ricardo Ruano Perez, Joaquín, Ruiz, Gertrudis Sabatel Hernández, Ana, Sevilla, Nahla Zeidán Sri Lanka: Damayanthi Nanayakkara, Chandraguptha Udugama Sweden: Magnus Simonsson Switzerland: Hatem Alkadhi, Ronny Ralf Buechel, Peter, Burger, Luca, Ceriani, Bart De Boeck, Christoph, Gräni, Alix Juillet de Saint Lager Lucas, Kamani, Christel H., Nadine, Kawel-Boehm, Robert, Manka, Prior, John O., Axel, Rominger, Jean-Paul Vallée Thailand: Benjapa Khiewvan, Teerapon, Premprabha, Tanyaluck Thientunyakit Tunisia: Ali Sellem Turkey: Kemal Metin Kir, Haluk Sayman Uganda: Mugisha Julius Sebikali, Zerida Muyinda Ukraine: Yaroslav Kmetyuk, Pavlo, Korol, Olena, Mykhalchenko, Volodymyr, Pliatsek, Maryna Satyr United Arab Emirates: Batool Albalooshi, Mohamed Ismail Ahmed Hassan United Kingdom: Jill Anderson, Punit, Bedi, Thomas, Biggans, Anda, Bularga, Russell, Bull, Rajesh, Burgul, John-Paul, Carpenter, Duncan, Coles, David, Cusack, Aparna, Deshpande, John, Dougan, Timothy, Fairbairn, Alexia, Farrugia, Deepa, Gopalan, Alistair, Gummow, Prasad Guntur Ramkumar, Mark, Hamilton, Mark, Harbinson, Thomas, Hartley, Benjamin, Hudson, Nikhil, Joshi, Michael, Kay, Andrew, Kelion, Azhar, Khokhar, Jamie, Kitt, Ken, Lee, Chen, Low, Sze Mun Mak, Ntouskou, Marousa, Jon, Martin, Elisa, Mcalindon, Leon, Menezes, Gareth, Morgan-Hughes, Alastair, Moss, Anthony, Murray, Edward, Nicol, Dilip, Patel, Charles, Peebles, Francesca, Pugliese, Jonathan Carl Luis Rodrigues, Christopher, Rofe, Nikant, Sabharwal, Rebecca, Schofield, Thomas, Semple, Naveen, Sharma, Peter, Strouhal, Deepak, Subedi, William, Topping, Katharine, Tweed, Jonathan Weir-Mccall United States of America: Suhny Abbara, Taimur, Abbasi, Brian, Abbott, Shady, Abohashem, Sandra, Abramson, Tarek, Al-Abboud, Mouaz, Al-Mallah, Omar, Almousalli, Karthikeyan, Ananthasubramaniam, Mohan Ashok Kumar, Jeffrey, Askew, Lea, Attanasio, Mallory, Balmer-Swain, Bayer, Richard R., Adam, Bernheim, Sabha, Bhatti, Erik, Bieging, Ron, Blankstein, Stephen, Bloom, Sean, Blue, David, Bluemke, Andressa, Borges, Kelley, Branch, Paco, Bravo, Jessica, Brothers, Matthew, Budoff, Renée, Bullock-Palmer, Angela, Burandt, Burke, Floyd W., Kelvin, Bush, Candace, Candela, Elizabeth, Capasso, Joao, Cavalcante, Donald, Chang, Saurav, Chatterjee, Yiannis, Chatzizisis, Michael, Cheezum, Tiffany, Chen, Jennifer, Chen, Marcus, Chen, Andrew, Choi, James, Clarcq, Ayreen, Cordero, Matthew, Crim, Sorin, Danciu, Bruce, Decter, Nimish, Dhruva, Neil, Doherty, Rami, Doukky, Anjori, Dunbar, William, Duvall, Rachael, Edwards, Kerry, Esquitin, Husam, Farah, Emilio, Fentanes, Maros, Ferencik, Daniel, Fisher, Daniel, Fitzpatrick, Cameron, Foster, Tony, Fuisz, Michael, Gannon, Lori, Gastner, Myron, Gerson, Brian, Ghoshhajra, Alan, Goldberg, Brian, Goldner, Jorge, Gonzalez, Rosco, Gore, Sandra, Gracia-López, Fadi, Hage, Agha, Haider, Sofia, Haider, Yasmin, Hamirani, Karen, Hassen, Mallory, Hatfield, Carolyn, Hawkins, Katie, Hawthorne, Nicholas, Heath, Robert, Hendel, Phillip, Hernandez, Gregory, Hill, Stephen, Horgan, Jeff, Huffman, Lynne, Hurwitz, Ami, Iskandrian, Rajesh, Janardhanan, Christine, Jellis, Scott, Jerome, Dinesh, Kalra, Summanther, Kaviratne, Fernando, Kay, Faith, Kelly, Omar, Khalique, Mona, Kinkhabwala, George Kinzfogl Iii, Jacqueline, Kircher, Rachael, Kirkbride, Michael, Kontos, Anupama, Kottam, Joseph, Krepp, Jay, Layer, Steven, H Lee, Jeffrey, Leppo, John, Lesser, Steve, Leung, Howard, Lewin, Diana, Litmanovich, Yiyan, Liu, Juan, Lopez-Mattei, Kathleen, Magurany, Jeremy, Markowitz, Amanda, Marn, Stephen, E Matis, Michael, Mckenna, Tony, Mcrae, Fernando, Mendoza, Michael, Merhige, David, Min, Chanan, Moffitt, Karen, Moncher, Warren, Moore, Shamil, Morayati, Michael, Morris, Mahmud, Mossa-Basha, Zorana, Mrsic, Venkatesh, Murthy, Prashant, Nagpal, Kyle, Napier, Jagat, Narula, Katarina, Nelson, Prabhjot, Nijjar, Medhat, Osman, Purvi, Parwani, Edward, Passen, Amit, Patel, Pravin, Patil, Ryan, Paul, Lawrence, Phillips, Venkateshwar, Polsani, Rajaram, Poludasu, Brian, Pomerantz, Thomas, Porter, Ryan, Prentice, Amit, Pursnani, Mark, Rabbat, Suresh, Ramamurti, Florence, Rich, Hiram Rivera Luna, Austin, Robinson, Kim, Robles, Cesar, Rodríguez, Mark, Rorie, John, Rumberger, Raymond, Russell, Philip, Sabra, Diego, Sadler, Mary, Schemmer, Joseph Schoepf, U., Samir, Shah, Nishant, Shah, Sujata, Shanbhag, Gaurav, Sharma, Steven, Shayani, Jamshid, Shirani, Pushpa, Shivaram, Steven, Sigman, Mitch, Simon, Ahmad, Slim, David, Smith, Alexandra, Smith, Prem, Soman, Aditya, Sood, Monvadi Barbara Srichai-Parsia, James, Streeter, Albert, T, Ahmed, Tawakol, Dustin, Thomas, Randall, Thompson, Tara, Torbet, Desiree, Trinidad, Shawn, Ullery, Samuel, Unzek, Seth, Uretsky, Srikanth, Vallurupalli, Vikas, Verma, Alfonso, Waller, Ellen, Wang, Parker, Ward, Gaby, Weissman, George, Wesbey, Kelly, White, David, Winchester, David, Wolinsky, Sandra, Yost, Michael Zgaljardic Uruguay: Omar Alonso, Mario, Beretta, Rodolfo, Ferrando, Miguel, Kapitan, Fernando Mut Uzbekistan: Omoa Djuraev, Gulnora Rozikhodjaeva Vietnam: Ha Le Ngoc, Son Hong Mai, and Xuan Canh Nguyen
Subjects: medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Cardiology, Settore MED/11 - Malattie dell'Apparato Cardiovascolare, COVID-19, Cardiac imaging, Cardiovascular disease, Article, cardiac imaging, Healthcare delivery, cardiovascular disease, Intensive care, Surveys and Questionnaires, Health care, Pandemic, medicine, Humans, Pandemics, Protocol (science), business.industry, SARS-CoV-2, Non invasive, Italy, humans, pandemics, surveys and questionnaires, cardiology, Emergency medicine, Cardiology and Cardiovascular Medicine, business
Abstract: Background: In early 2020, COVID-19 massively hit Italy, earlier and harder than any other European country. This caused a series of strict containment measures, aimed at blocking the spread of the pandemic. Healthcare delivery was also affected when resources were diverted towards care of COVID-19 patients, including intensive care wards. Aim of the study: The aim is assessing the impact of COVID-19 on cardiac imaging in Italy, compare to the Rest of Europe (RoE) and the World (RoW). Methods: A global survey was conducted in May–June 2020 worldwide, through a questionnaire distributed online. The survey covered three periods: March and April 2020, and March 2019. Data from 52 Italian centres, a subset of the 909 participating centres from 108 countries, were analyzed. Results: In Italy, volumes decreased by 67% in March 2020, compared to March 2019, as opposed to a significantly lower decrease (p < 0.001) in RoE and RoW (41% and 40%, respectively). A further decrease from March 2020 to April 2020 summed up to 76% for the North, 77% for the Centre and 86% for the South. When compared to the RoE and RoW, this further decrease from March 2020 to April 2020 in Italy was significantly less (p = 0.005), most likely reflecting the earlier effects of the containment measures in Italy, taken earlier than anywhere else in the West. Conclusions: The COVID-19 pandemic massively hit Italy and caused a disruption of healthcare services, including cardiac imaging studies. This raises concern about the medium- and long-term consequences for the high number of patients who were denied timely diagnoses and the subsequent lifesaving therapies and procedures.
Published: 2021

38. Equilibrium radionuclide angiography: Present and future

Author: Santiago Aguadé-Bruix and Guillermo Romero-Farina
Subjects: medicine.medical_specialty, Heart Diseases, medicine.diagnostic_test, business.industry, Reproducibility of Results, Gated Blood-Pool Imaging, Stroke Volume, Coronary Angiography, Radionuclide angiography, medicine, Humans, Radiology, Nuclear Medicine and imaging, Radiology, Radionuclide Angiography, Cardiology and Cardiovascular Medicine, business
Published: 2019

39. Insights into the success and failure of systemic therapy for hepatocellular carcinoma

Author: Maria Reig, Jordi Bruix, and Leonardo G Da Fonseca
Subjects: 0301 basic medicine, Sorafenib, medicine.medical_specialty, Carcinoma, Hepatocellular, Antineoplastic Agents, Context (language use), Disease, Malignancy, Systemic therapy, 03 medical and health sciences, 0302 clinical medicine, medicine, Carcinoma, Humans, Intensive care medicine, Clinical Trials as Topic, Host Microbial Interactions, Hepatology, business.industry, Liver Neoplasms, Gastroenterology, medicine.disease, Survival Analysis, digestive system diseases, Tumor Burden, Clinical trial, 030104 developmental biology, Hepatocellular carcinoma, 030211 gastroenterology & hepatology, business, medicine.drug
Abstract: Systemic treatment for hepatocellular carcinoma (HCC) has been boosted by the incorporation of new agents after many negative phase III trials in the decade since the approval of sorafenib. Sorafenib introduced the concept that targeting specific hallmarks of hepatocarcinogenesis could modify the dismal prognosis of this disease, with the drug remaining a cornerstone in the upfront therapy for advanced HCC. The design of clinical trials in this malignancy is complicated by important obstacles related to patient selection, prognostic assessment and the need for endpoints that correlate with improvement in survival outcomes. In addition, the currently used criteria to determine treatment response or progression might prevent physicians from making appropriate clinical judgements and interpreting evidence arising from trials. In this Review, we discuss the advances in systemic therapy for HCC and critically review trial designs in HCC. Although novel therapies, such as new targeted agents and immunotherapies, are being rapidly incorporated, it is paramount to design future clinical trials based on the lessons learned from past failures and successes. The design of clinical trials for hepatocellular carcinoma is complicated by a number of obstacles. In this Review, the authors discuss the advances in systemic therapy for hepatocellular carcinoma and critically discuss trial designs in the context of past successes and failures.
Published: 2019

40. Biomarkers Associated With Response to Regorafenib in Patients With Hepatocellular Carcinoma

Author: Richard S. Finn, Henrik Seidel, Gerold Meinhardt, Josep M. Llovet, Jordi Bruix, Karl Köchert, and Michael Teufel
Subjects: Male, Vascular Endothelial Growth Factor A, 0301 basic medicine, Oncology, Pyridines, chemistry.chemical_compound, 0302 clinical medicine, beta Catenin, Chemokine CCL3, Randomized Controlled Trials as Topic, Liver Neoplasms, Biochemical markers, Hazard ratio, Gastroenterology, Middle Aged, Scavenger Receptors, Class E, Blood proteins, Progression-Free Survival, Survival Rate, Response Evaluation Criteria in Solid Tumors, Hepatocellular carcinoma, Marcadors bioquímics, Female, 030211 gastroenterology & hepatology, alpha-Fetoproteins, Liver cancer, medicine.drug, Sorafenib, medicine.medical_specialty, Carcinoma, Hepatocellular, Antineoplastic Agents, Transforming Growth Factor beta1, Càncer de fetge, 03 medical and health sciences, Internal medicine, Regorafenib, microRNA, Angiopoietin-1, Biomarkers, Tumor, medicine, Humans, Cystatin B, Aged, Retrospective Studies, Tumors, Hepatology, Proportional hazards model, business.industry, Phenylurea Compounds, Tumor Suppressor Proteins, Oncogenes, medicine.disease, MicroRNAs, 030104 developmental biology, chemistry, Mutation, Transcriptome, business
Abstract: Background & Aims In a phase 3 trial (RESORCE), regorafenib increased overall survival compared with placebo in patients with hepatocellular carcinoma (HCC) previously treated with sorafenib. In an exploratory study, we analyzed plasma and tumor samples from study participants to identify genetic, microRNA (miRNA), and protein biomarkers associated with response to regorafenib. Methods We obtained archived tumor tissues and baseline plasma samples from patients with HCC given regorafenib in the RESORCE trial. Baseline plasma samples from 499 patients were analyzed for expression of 294 proteins (DiscoveryMAP) and plasma samples from 349 patients were analyzed for levels of 750 miRNAs (miRCURY miRNA PCR). Tumor tissues from 7 responders and 10 patients who did not respond (progressors) were analyzed by next-generation sequencing (FoundationOne). Forty-six tumor tissues were analyzed for expression patterns of 770 genes involved in oncogenic and inflammatory pathways (PanCancer Immune Profiling). Associations between plasma levels of proteins and miRNAs and response to treatment (overall survival and time to progression) were evaluated using a Cox proportional hazards model. Results Decreased baseline plasma concentrations of 5 of 266 evaluable proteins (angiopoietin 1, cystatin B, the latency-associated peptide of transforming growth factor beta 1, oxidized low-density lipoprotein receptor 1, and C-C motif chemokine ligand 3; adjusted P ≤ .05) were significantly associated with increased overall survival time after regorafenib treatment. Levels of these 5 proteins, which have roles in inflammation and/or HCC pathogenesis, were not associated with survival independently of treatment. Only 20 of 499 patients had high levels and a reduced survival time. Plasma levels of α-fetoprotein and c-MET were associated with poor outcome (overall survival) independently of regorafenib treatment only. We identified 9 plasma miRNAs (MIR30A, MIR122, MIR125B, MIR200A, MIR374B, MIR15B, MIR107, MIR320, and MIR645) whose levels significantly associated with overall survival time with regorafenib (adjusted P ≤ .05). Functional analyses of these miRNAs indicated that their expression level associated with increased overall survival of patients with tumors of the Hoshida S3 subtype. Next-generation sequencing analyses of tumor tissues revealed 49 variants in 27 oncogenes or tumor suppressor genes. Mutations in CTNNB1 were detected in 3 of 10 progressors and VEGFA amplification in 1 of 7 responders. Conclusion We identified expression patterns of plasma proteins and miRNAs that associated with increased overall survival times of patients with HCC following treatment with regorafenib in the RESORCE trial. Levels of these circulating biomarkers and genetic features of tumors might be used to identify patients with HCC most likely to respond to regorafenib. ClinicalTrials.gov number NCT01774344 . NCBI GEO accession numbers: mRNA data (NanoString): GSE119220 ; miRNA data (Exiqon): GSE119221
Published: 2019

41. Liver cancer risk after HCV cure in patients with advanced liver disease without non-characterized nodules

Author: Ramón Vilana, Anna Pla, Alejandro Forner, Concepció Bartres, Sergio Muñoz-Martínez, Zoe Mariño, Anna Darnell, Maria Reig, Xavier Forns, Jordi Bruix, Luis Bianchi, Neus Llarch, Ernest Belmonte, Carmen Ayuso, Sabela Lens, Núria Granel, Ferran Torres, Victor Sapena, Carla Fuster-Anglada, Jordi Rimola, I. Núñez, Gemma Iserte, Ángeles García-Criado, Marco Sanduzzi-Zamparelli, and Alba Díaz
Subjects: Liver Cirrhosis, medicine.medical_specialty, Cirrhosis, Carcinoma, Hepatocellular, Sustained Virologic Response, Population, Gastroenterology, Antiviral Agents, Liver disease, Internal medicine, Hypertension, Portal, medicine, Humans, Prospective Studies, education, Prospective cohort study, education.field_of_study, Hepatology, business.industry, Incidence (epidemiology), Liver Neoplasms, Cancer, Hepatitis C, Chronic, medicine.disease, digestive system diseases, Hepatocellular carcinoma, Liver cancer, business
Abstract: Recognition of non-characterized liver nodules (NCLN) prior to direct-acting antivirals (DAAs) is associated with increased hepatocellular carcinoma (HCC) risk in patients with HCV. The risk of HCC has not been defined in F3/F4 patients in whom NCLN have been ruled-out before starting DAAs and at sustained virological response (SVR). This study aimed to estimate HCC incidence in this population.We performed a prospective study including HCV-infected patients with F3/F4 fibrosis, without a history of HCC, and who achieved SVR after DAAs. Patients were only included if they had undergone ultrasound imaging that excluded the presence of HCC/NCLN within 30 days after SVR. All patients were evaluated every 6 months until developing primary liver cancer, death or withdrawal of informed consent. HCC incidence was expressed per 100 patient-years (/100PY). Adherence to screening program was calculated every 6 months for the first 48 months.A total of 185 patients (63/122, F3/F4) were included. Among those with cirrhosis, 92% were Child-Pugh A and 42.7% had clinically significant portal hypertension (CSPH). Albumin-bilirubin score was 1 in 84.9% and 2 in 15.1% of patients, respectively. The median clinical and radiologic follow-up was 52.4 months and 48 months, respectively. Ten patients developed HCC: HCC incidence was 1.46/100PY (95% CI 0.79-2.71) in the whole cohort, 2.24/100PY (95% CI 1.21-4.17) in F4 only and 3.63/100PY (95% CI 1.95-6.74) in patients with CSPH. No HCC was registered in patients with F3. Median time between SVR and HCC occurrence was 28.1 months; 12 non-primary liver cancers were also identified.Patients with cirrhosis without NCLN at SVR remain at risk of HCC development. The absence of HCC in patients with F3 reinforces their marginal cancer risk, but prospective studies are needed to exclude them from screening programs.Patients with HCV-related cirrhosis, without non-characterized liver nodules at sustained virologic response, remain at risk of hepatocellular carcinoma despite viral cure. However, the cancer risk after successful direct-acting antiviral treatment is marginal in patients with F3 fibrosis without non-characterized liver nodules. If confirmed in larger prospective studies, current screening recommendations may need to be revisited in this group of patients.
Published: 2021

42. Systemic treatment of hepatocellular carcinoma: An EASL position paper

Author: Stephen L. Chan, Bruno Sangro, Jordi Bruix, Lorenza Rimassa, and Peter R. Galle
Subjects: Sorafenib, Oncology, medicine.medical_specialty, Carcinoma, Hepatocellular, Hepatology, business.industry, Liver Neoplasms, Ipilimumab, Pembrolizumab, Ramucirumab, chemistry.chemical_compound, Editorial, chemistry, Atezolizumab, Internal medicine, Regorafenib, Internal Medicine, Medicine, Humans, Liver function, Nivolumab, business, medicine.drug
Abstract: The last 5 years have witnessed relevant advances in the systemic treatment of hepatocellular carcinoma. New data have emerged since the development of the EASL Clinical Practice Guidelines on the management of hepatocellular carcinoma in 2018. Drugs licensed in some countries now include 4 oral multi-tyrosine kinase inhibitors (sorafenib, lenvatinib, regorafenib and cabozantinib), 1 anti-angiogenic antibody (ramucirumab) and 4 immune checkpoint inhibitors, alone or in combination (atezolizumab in combination with bevacizumab, ipilimumab in combination with nivolumab, nivolumab and pembrolizumab in monotherapy). Prolonged survival in excess of 2 years can be expected in most patients with sensitive tumours and well-preserved liver function that renders them fit for sequential therapies. With different choices available in any given setting, the robustness of the evidence of efficacy and a correct matching of the safety profile of a given agent with patient characteristics and preferences are key in making sound therapeutic decisions. The recommendations in this document amend the previous EASL Clinical Practice Guidelines and aim to help clinicians provide the best possible care for patients today. In view of several ongoing and promising trials, further advances in systemic therapy of hepatocellular carcinoma are foreseen in the near future and these recommendations will have to be updated regularly.
Published: 2021

43. Q waves in ischemic cardiomyopathy

Author: María Nazarena Pizzi, Carina Espinet-Coll, Guillermo Romero-Farina, Lorena Herrador, Santiago Aguadé-Bruix, Eduard Ródenas-Alesina, Pablo Jordán, and Ignacio Ferreira-González
Subjects: medicine.medical_specialty, Population, Myocardial Infarction, Ischemia, Scars, 030204 cardiovascular system & hematology, QT interval, Electrocardiography, 03 medical and health sciences, Basal (phylogenetics), 0302 clinical medicine, Predictive Value of Tests, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, 030212 general & internal medicine, education, Retrospective Studies, education.field_of_study, Ischemic cardiomyopathy, business.industry, Myocardium, medicine.disease, Apex (geometry), Cardiology, Radiopharmaceuticals, medicine.symptom, Cardiomyopathies, Cardiology and Cardiovascular Medicine, business, Perfusion
Abstract: Q waves may be observed in the absence of non-viable tissue. However, their scintigraphic translation in patients with ischemic cardiomyopathy (ICM) has not been properly assessed. This study sought to establish the determinants of Q waves in the absence of non-viable tissue and the diagnostic accuracy in this population. A retrospective study enrolling 487 consecutive patients (67.0 [57.4 – 75.4] years), with ICM, LVEF
Published: 2021

44. Impact of COVID-19 on Diagnostic Cardiac Procedural Volume in Oceania: The IAEA Non-Invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Author: O'Sullivan, P., Younger, J., Van Pelt, N., O'Malley, S., Lenturut-Katal, D., Hirschfeld, C. B., Vitola, J. V., Cerci, R., Williams, M. C., Shaw, L. J., Raggi, P., Villines, T. C., Dorbala, S., Choi, A. D., Cohen, Y., Goebel, B., Malkovskiy, E., Randazzo, M., Pascual, T. N. B., Pynda, Y., Dondi, M., Paez, D., Einstein, A. J., Better, N., Afghanistan: Mohammad Nawaz Nasery Albania: Artan Goda, Ervina Shirka Algeria: Rabie Benlabgaa, Salah, Bouyoucef, Abdelkader, Medjahedi, Qais Nailli Argentina: Mariela Agolti, Roberto Nicolas Aguero, Maria del Carmen Alak, Lucia Graciela Alberguina, Guillermo, Arroñada, Andrea, Astesiano, Alfredo, Astesiano, Carolina Bas Norton, Pablo, Benteo, Juan, Blanco, Juan Manuel Bonelli, Jose Javier Bustos, Raul, Cabrejas, Jorge, Cachero, Roxana, Campisi, Alejandro, Canderoli, Silvia, Carames, Patrícia, Carrascosa, Ricardo, Castro, Oscar, Cendoya, Luciano Martin Cognigni, Carlos, Collaud, Claudia, Cortes, Javier, Courtis, Daniel, Cragnolino, Mariana, Daicz, Alejandro De La Vega, Silvia Teresa De Maria, Horacio Del Riego, Fernando, Dettori, Alejandro, Deviggiano, Laura, Dragonetti, Mario, Embon, Ruben Emilio Enriquez, Jorge, Ensinas, Fernando, Faccio, Adolfo, Facello, Diego, Garofalo, Ricardo, Geronazzo, Natalia, Gonza, Lucas, Gutierrez, Miguel Angel Guzzo, Victor, Hasbani, Melina, Huerin, Victor, Jäger, Julio Manuel Lewkowicz, Maria Nieves, A López De Munaín, Jose Maria Lotti, Alejandra, Marquez, Osvaldo, Masoli, Osvaldo Horacio Masoli, Edgardo, Mastrovito, Matias, Mayoraz, Graciela Eva Melado, Anibal, Mele, Maria Fernanda Merani, Alejandro Horacio Meretta, Susana, Molteni, Marcos, Montecinos, Eduardo, Noguera, Carlos, Novoa, Claudio Pereyra Sueldo, Sebastian Perez Ascani, Pablo, Pollono, Maria Paula Pujol, Alejandro, Radzinschi, Gustavo, Raimondi, Marcela, Redruello, Marina, Rodríguez, Matías, Rodríguez, Romina Lorena Romero, Arturo Romero Acuña, Federico, Rovaletti, Lucas San Miguel, Lucrecia, Solari, Bruno, Strada, Sonia, Traverso, Sonia Simona Traverzo, Maria del Huerto Velazquez Espeche, Juan Sebastian Weihmuller, Juan, Wolcan, Susana Zeffiro Armenia: Mari Sakanyan Australia: Scott Beuzeville, Raef, Boktor, Patrick, Butler, Jennifer, Calcott, Loretta, Carr, Virgil, Chan, Charles, Chao, Woon, Chong, Mark, Dobson, D'Arne, Downie, Girish, Dwivedi, Barry, Elison, Jean, Engela, Roslyn, Francis, Anand, Gaikwad, Ashok Gangasandra Basavaraj, Bruce, Goodwin, Robert, Greenough, Christian, Hamilton-Craig, Victar, Hsieh, Subodh, Joshi, Karin, Lederer, Kenneth, Lee, Joseph, Lee, John, Magnussen, Nghi, Mai, Gordon, Mander, Fiona, Murton, Dee, Nandurkar, Johanne, Neill, Edward, O'Rourke, Patricia, O'Sullivan, George, Pandos, Kunthi, Pathmaraj, Alexander, Pitman, Rohan, Poulter, Manuja, Premaratne, David, Prior, Lloyd, Ridley, Natalie, Rutherford, Hamid, Salehi, Connor, Saunders, Luke, Scarlett, Sujith, Seneviratne, Deepa, Shetty, Ganesh, Shrestha, Jonathan, Shulman, Vijay, Solanki, Tony, Stanton, Murch, Stuart, Michael, Stubbs, Ian, Swainson, Kim, Taubman, Andrew, Taylor, Paul, Thomas, Steven, Unger, Anthony, Upton, Shankar, Vamadevan, William Van Gaal, Johan, Verjans, Demetrius, Voutnis, Victor, Wayne, Peter, Wilson, David, Wong, Kirby, Wong, John Younger Austria: Gudrun Feuchtner, Siroos, Mirzaei, Konrad Weiss Belarus: Natallia Maroz-Vadalazhskaya Belgium: Olivier Gheysens, Filip, Homans, Rodrigo, Moreno-Reyes, Agnès, Pasquet, Veronique, Roelants, Van De Heyning Bolivia: Raúl Araujo Ríos Bosnia - Herzegovina: Valentina Soldat-Stankovic, Caroline M., Sinisa Stankovic Brazil: Maria Helena Albernaz Siqueira, Augusto, Almeida, Paulo Henrique Alves Togni, Jose Henrique Andrade, Luciana, Andrade, Carlos, Anselmi, Roberta, Araújo, Guilherme, Azevedo, Sabbrina, Bezerra, Rodrigo, Biancardi, Gabriel Blacher Grossman, Simone, Brandão, Diego Bromfman Pianta, Lara, Carreira, Bruno, Castro, Tien, Chang, Fernando Cunali, Jr., Roberto, Cury, Roberto, Dantas, Fernando de Amorim Fernandes, Andrea De Lorenzo, Robson De Macedo Filho, Fernanda, Erthal, Fabio, Fernandes, Juliano, Fernandes, Thiago Ferreira De Souza, Wilson Furlan Alves, Bruno, Ghini, Luiz, Goncalves, Ilan, Gottlieb, Marcelo, Hadlich, Vinícius, Kameoka, Ronaldo, Lima, Adna, Lima, Rafael Willain Lopes, Ricardo Machado, e Silva, Tiago, Magalhães, Fábio Martins Silva, Luiz Eduardo Mastrocola, Fábio, Medeiros, José Claudio Meneghetti, Vania, Naue, Danilo, Naves, Roberto, Nolasco, Cesar, Nomura, Joao Bruno Oliveira, Eduardo, Paixao, Filipe Penna De Carvalho, Ibraim, Pinto, Priscila, Possetti, Mayra, Quinta, Rodrigo Rizzo Nogueira Ramos, Ricardo, Rocha, Alfredo, Rodrigues, Carlos, Rodrigues, Leila, Romantini, Adelina, Sanches, Sara, Santana, Leonardo Sara da Silva, Paulo, Schvartzman, Cristina Sebastião Matushita, Tiago, Senra, Afonso, Shiozaki, Maria Eduarda Menezes de Siqueira, Cristiano, Siqueira, Paola, Smanio, Carlos Eduardo Soares, José Soares Junior, Marcio Sommer Bittencourt, Bernardo, Spiro, Cláudio Tinoco Mesquita, Jorge, Torreao, Rafael, Torres, Marly, Uellendahl, Guilherme Urpia Monte, Otávia, Veríssimo, Estevan Vieira Cabeda, Felipe Villela Pedras, Roberto, Waltrick, Marcello Zapparoli Brunei Darussalam: Hamid Naseer Bulgaria: Marina Garcheva-Tsacheva, Irena Kostadinova Cambodia: Youdaline Theng Canada: Gad Abikhzer, Rene, Barette, Benjamin, Chow, Dominique, Dabreo, Matthias, Friedrich, Ria, Garg, Mohammed Nassoh Hafez, Chris, Johnson, Marla, Kiess, Jonathon, Leipsic, Eugene, Leung, Robert, Miller, Anastasia, Oikonomou, Stephan, Probst, Idan, Roifman, Gary, Small, Vikas, Tandon, Adwait, Trivedi, James, White, Katherine Zukotynski Chile: Jose Canessa, Gabriel Castro Muñoz, Carmen, Concha, Pablo, Hidalgo, Cesar, Lovera, Teresa, Massardo, Luis Salazar Vargas Colombia: Pedro Abad, Harold, Arturo, Sandra, Ayala, Luis, Benitez, Alberto, Cadena, Carlos, Caicedo, Antonio Calderón Moncayo, Sharon, Gomez, Gutierrez Villamil, Claudia T., Claudia, Jaimes, Juan, Londoño, Juan Luis Londoño Blair, Luz, Pabon, Mauricio, Pineda, Juan Carlos Rojas, Diego, Ruiz, Manuel Valencia Escobar, Andres, Vasquez, Damiana, Vergel, Alejandro Zuluaga Costa Rica: Isabel Berrocal Gamboa, Gabriel, Castro, Ulises, González, Croatia: Ana Baric, Tonci, Batinic, Maja, Franceschi, Maja Hrabak Paar, Mladen, Jukic, Petar, Medakovic, Viktor, Persic, Marina, Prpic, Ante Punda Cuba: Juan Felipe Batista, Juan Manuel Gómez Lauchy, Yamile Marcos Gutierrez, Rayner, Menéndez, Amalia, Peix, Luis Rochela Cyprus: Christoforos Panagidis, Ioannis Petrou Czech Republic: Vaclav Engelmann, Milan, Kaminek, Vladimír, Kincl, Otto, Lang, Milan Simanek Denmark: Jawdat Abdulla, Morten, Bøttcher, Mette, Christensen, Lars Christian Gormsen, Philip, Hasbak, Søren, Hess, Paw, Holdgaard, Allan, Johansen, Kasper, Kyhl, Bjarne Linde Norgaard, Kristian Altern Øvrehus, Niels Peter Rønnow Sand, Rolf, Steffensen, Anders, Thomassen, Bo Zerahn Dominican Republic: Alfredo Perez Ecuador: Giovanni Alejandro Escorza Velez, Mayra Sanchez Velez Egypt: Islam Shawky Abdel Aziz, Mahasen, Abougabal, Taghreed, Ahmed, Adel, Allam, Ahmed, Asfour, Mona, Hassan, Alia, Hassan, Ahmed, Ibrahim, Sameh, Kaffas, Ahmed, Kandeel, Mohamed Mandour Ali, Ahmad, Mansy, Hany, Maurice, Sherif, Nabil, Mahmoud Shaaban El Salvador: Ana Camila Flores Estonia: Anne Poksi Finland: Juhani Knuuti, Velipekka, Kokkonen, Martti, Larikka, Valtteri Uusitalo France: Matthieu Bailly, Samuel, Burg, Jean-François, Deux, Vincent, Habouzit, Fabien, Hyafil, Olivier, Lairez, Franck, Proffit, Hamza, Regaieg, Laure, Sarda-Mantel, Schneider Ghana: Harold Ayetey Greece: George Angelidis, Vania Tacher Germany: Roman P., Aikaterini, Archontaki, Sofia, Chatziioannou, Ioannis, Datseris, Christina, Fragkaki, Panagiotis, Georgoulias, Sophia, Koukouraki, Maria, Koutelou, Eleni, Kyrozi, Evangelos, Repasos, Petros, Stavrou, Pipitsa Valsamaki Guatemala: Carla Gonzalez, Goleat Gutierrez Honduras: Alejandro Maldonado Hungary: Klara Buga, Ildiko, Garai, Pál, Maurovich-Horvat, Erzsébet, Schmidt, Balint, Szilveszter, Edit Várady India: Nilesh Banthia, Jinendra Kumar Bhagat, Rishi, Bhargava, Vivek, Bhat, Mona, Bhatia, Partha, Choudhury, Vijay Sai Chowdekar, Aparna, Irodi, Shashank, Jain, Elizabeth, Joseph, Sukriti, Kumar, Prof Dr Girijanandan Mahapatra, Deepanjan, Mitra, Bhagwant Rai Mittal, Ahmad, Ozair, Chetan, Patel, Tapan, Patel, Ravi, Patel, Shivani, Patel, Sudhir, Saxena, Shantanu, Sengupta, Santosh, Singh, Bhanupriya, Singh, Ashwani, Sood, Atul Verma Indonesia: Erwin Affandi, Padma Savenadia Alam, Edison, Edison, Gani, Gunawan, Habusari, Hapkido, Basuki, Hidayat, Aulia, Huda, Anggoro Praja Mukti, Djoko, Prawiro, Erwin Affandi Soeriadi, Hilman Syawaluddin Iraq: Amjed Albadr Islamic Republic of Iran: Majid Assadi, Farshad, Emami, Golnaz, Houshmand, Majid, Maleki, Maryam Tajik Rostami, Seyed Rasoul Zakavi Israel: Eed Abu Zaid, Svetlana, Agranovich, Yoav, Arnson, Rachel, Bar-Shalom, Alex, Frenkel, Galit, Knafo, Rachel, Lugassi, Israel Shlomo Maor Moalem, Maya, Mor, Noam, Muskal, Sara, Ranser, Aryeh Shalev Italy: Domenico Albano, Pierpaolo, Alongi, Gaspare, Arnone, Elisa, Bagatin, Sergio, Baldari, Matteo, Bauckneht, Paolo, Bertelli, Francesco, Bianco, Rachele, Bonfiglioli, Roberto, Boni, Andrea, Bruno, Isabella, Bruno, Elena, Busnardo, Elena, Califaretti, Luca, Camoni, Aldo, Carnevale, Roberta, Casoni, Armando Ugo Cavallo, Giorgio, Cavenaghi, Franca, Chierichetti, Marcello, Chiocchi, Corrado, Cittanti, Mauro, Colletta, Umberto, Conti, Alberto, Cossu, Alberto, Cuocolo, Marco, Cuzzocrea, Maria Luisa De Rimini, Giuseppe De Vincentis, Eleonora Del Giudice, Alberico Del Torto, Veronica Della Tommasina, Rexhep, Durmo, Erba, PAOLA ANNA, Laura, Evangelista, Riccardo, Faletti, Evelina, Faragasso, Mohsen, Farsad, Paola, Ferro, Luigia, Florimonte, Viviana, Frantellizzi, Fabio Massimo Fringuelli, Marco, Gatti, Angela, Gaudiano, Alessia, Gimelli, Raffaele, Giubbini, Francesca, Giuffrida, Salvatore, Ialuna, Riccardo, Laudicella, Lucia, Leccisotti, Lucia, Leva, Liga, Riccardo, Carlo, Liguori, Giampiero, Longo, Margherita, Maffione, Maria Elisabetta Mancini, Claudio, Marcassa, Elisa, Milan, Barbara, Nardi, Sara, Pacella, Giovanna, Pepe, Gianluca, Pontone, Sabina, Pulizzi, Natale, Quartuccio, Lucia, Rampin, Fabrizio, Ricci, Pierluigi, Rossini, Giuseppe, Rubini, Vincenzo, Russo, Gian Mauro Sacchetti, Gianmario, Sambuceti, Massimo, Scarano, Roberto, Sciagrà, Massimiliano, Sperandio, Antonella, Stefanelli, Guido, Ventroni, Stefania Zoboli Jamaica: Dainia Baugh, Duane, Chambers, Ernest, Madu, Felix Nunura Japan: Hiroshi Asano, Chimura Misato Chimura, Shinichiro, Fujimoto, Koichiro, Fujisue, Tomohisa, Fukunaga, Yoshimitsu, Fukushima, Kae, Fukuyama, Jun, Hashimoto, Yasutaka, Ichikawa, Nobuo, Iguchi, Masamichi, Imai, Anri, Inaki, Hayato, Ishimura, Satoshi, Isobe, Toshiaki, Kadokami, Takao, Kato, Takashi, Kudo, Shinichiro, Kumita, Hirotaka, Maruno, Hiroyuki, Mataki, Masao, Miyagawa, Ryota, Morimoto, Masao, Moroi, Shigeki, Nagamachi, Kenichi, Nakajima, Tomoaki, Nakata, Ryo, Nakazato, Mamoru, Nanasato, Masanao, Naya, Takashi, Norikane, Yasutoshi, Ohta, Satoshi, Okayama, Atsutaka, Okizaki, Yoichi, Otomi, Hideki, Otsuka, Masaki, Saito, Sakata Yasushi Sakata, Masayoshi, Sarai, Daisuke, Sato, Shinya, Shiraishi, Yoshinobu, Suwa, Kentaro, Takanami, Kazuya, Takehana, Junichi, Taki, Nagara, Tamaki, Yasuyo, Taniguchi, Hiroki, Teragawa, Nobuo, Tomizawa, Kenichi, Tsujita, Kyoko, Umeji, Yasushi, Wakabayashi, Shinichiro, Yamada, Shinya, Yamazaki, Tatsuya Yoneyama Jordan: Mohammad Rawashdeh Kazakhstan: Daultai Batyrkhanov, Tairkhan Dautov Kenya: Khalid Makhdomi, Kevin Ombati Kuwait: Faridah Alkandari, Masoud Garashi Lao People's Democratic Republic: Tchoyoson Lim Coie, Sonexay Rajvong Latvia: Artem Kalinin, Marika Kalnina Lebanon: Mohamad Haidar Lithuania: Renata Komiagiene, Giedre, Kviecinskiene, Mindaugas, Mataciunas, Karim Malta: Luise Reichmuth, Donatas Vajauskas Luxembourg: Christian Picard Malaysia: Noor Khairiah A., Anthony Samuel Mauritius: Mohammad Aaftaab Allarakha, Ambedhkar Shantaram Naojee Mexico: Erick Alexanderson-Rosas, Erika, Barragan, Alejandro Becerril González-Montecinos, Manuel, Cabada, Daniel Calderon Rodriguez, Isabel, Carvajal-Juarez, Violeta, Cortés, Filiberto, Cortés, Erasmo De La Peña, Manlio, Gama-Moreno, Luis, González, Nelsy Gonzalez Ramírez, Moisés, Jiménez-Santos, Luis, Matos, Edgar, Monroy, Martha, Morelos, Mario, Ornelas, Jose Alberto Ortga Ramirez, Andrés, Preciado-Anaya, Óscar Ulises Preciado-Gutiérrez, Adriana Puente Barragan, Sandra Graciela Rosales Uvera, Sigelinda, Sandoval, Miguel Santaularia Tomas, Sierra-Galan, Lilia M., Silvia, Siu, Enrique, Vallejo, Mario Valles Monaco: Marc Faraggi Mongolia: Erdenechimeg Sereegotov Montenegro: Srdja Ilic Morocco: Nozha Ben-Rais, Nadia Ismaili Alaoui, Sara Taleb Myanmar: Khin Pa Pa Myo, Phyo Si Thu Nepal: Ram Kumar Ghimire, Bijoy Rajbanshi Netherlands: Peter Barneveld, Andor, Glaudemans, Jesse, Habets, Klaas Pieter Koopmans, Jeroen, Manders, Stefan, Pool, Arthur, Scholte, Asbjørn, Scholtens, Riemer, Slart, Paul, Thimister, Erik-Jan Van Asperen, Niels, Veltman, Derk, Verschure, Nils Wagenaar New Zealand: John Edmond, Chris, Ellis, Kerryanne, Johnson, Ross, Keenan, Shaw Hua (Anthony) Kueh, Christopher, Occleshaw, Alexander, Sasse, Andrew, To, Niels Van Pelt, Calum Young Nicaragua: Teresa Cuadra, Hector Bladimir Roque Vanegas Niger: Idrissa Adamou Soli, Djibrillou Moussa Issoufou Nigeria: Tolulope Ayodele, Chibuzo, Madu, Yetunde Onimode Norway: Elen Efros-Monsen, Signe Helene Forsdahl, Jenni-Mari Hildre Dimmen, Arve, Jørgensen, Isabel, Krohn, Pål, Løvhaugen, Anders Tjellaug Bråten Oman: Humoud Al Dhuhli, Faiza Al Kindi, Naeema, Al-Bulushi, Zabah, Jawa, Naima Tag Pakistan: Muhammad Shehzad Afzal, Shazia, Fatima, Muhammad Numair Younis, Musab, Riaz, Mohammad Saadullah Panama: Yariela Herrera Papua New Guinea: Dora Lenturut-Katal Paraguay: Manuel Castillo Vázquez, José Ortellado People's Republic of Bangladesh: Afroza Akhter People's Republic of China: Dianbo Cao, Stephen, Cheung, Dai, Xu, Lianggeng, Gong, Dan, Han, Yang, Hou, Caiying, Li, Tao, Li, Dong, Li, Sijin, Li, Jinkang, Liu, Hui, Liu, Bin, Lu, Ming Yen Ng, Kai, Sun, Gongshun, Tang, Jian, Wang, Ximing, Wang, Zhao-Qian, Wang, Yining, Wang, Yifan, Wang, Jiang, Wu, Zhifang, Wu, Liming, Xia, Jiangxi, Xiao, Lei, Xu, Youyou, Yang, Yin, Wu, Jianqun, Yu, Yuan, Li, Tong, Zhang, Longjiang, Zhang, Yong-Gao, Zhang, Xiaoli, Zhang, Li Zhu Peru: Ana Alfaro Philippines: Paz Abrihan, Asela, Barroso, Eric, Cruz, Marie Rhiamar Gomez, Vincent Peter Magboo, John Michael Medina, Jerry, Obaldo, Davidson, Pastrana, Christian Michael Pawhay, Alvin, Quinon, Jeanelle Margareth Tang, Bettina, Tecson, Kristine Joy Uson, Mila Uy Poland: Magdalena Kostkiewicz, Jolanta Kunikowska Portugal: Nuno Bettencourt, Guilhermina, Cantinho, Antonio Ferreira Qatar: Ghulam Syed Republic of Ireland: Samer Arnous, Said, Atyani, Angela, Byrne, Tadhg, Gleeson, David, Kerins, Conor, Meehan, David, Murphy, Mark, Murphy, John, Murray, Julie O'Brien Republic of Korea: Ji-In Bang, Henry, Bom, Sang-Geon, Cho, Chae Moon Hong, Su Jin Jang, Yong Hyu Jeong, Won Jun Kang, Ji-Young, Kim, Jaetae, Lee, Chang Kyeong Namgung, Young, So, Kyoung Sook Won Republic of North Macedonia: Venjamin Majstorov, Marija Vavlukis Republic of Slovenia: Barbara Gužic Salobir, Monika Štalc Romania: Theodora Benedek, Imre, Benedek, Raluca, Mititelu, Claudiu Adrian Stan Russian Federation: Alexey Ansheles, Olga, Dariy, Olga, Drozdova, Nina, Gagarina, Vsevolod Milyevich Gulyaev, Irina, Itskovich, Anatoly, Karalkin, Alexander, Kokov, Ekaterina, Migunova, Viktor, Pospelov, Daria, Ryzhkova, Guzaliya, Saifullina, Svetlana, Sazonova, Vladimir, Sergienko, Irina, Shurupova, Tatjana, Trifonova, Wladimir Yurievich Ussov, Margarita, Vakhromeeva, Nailya, Valiullina, Konstantin, Zavadovsky, Kirill Zhuravlev Saudi Arabia: Mirvat Alasnag, Subhani Okarvi Serbia: Dragana Sobic Saranovic Singapore: Felix Keng, Jia Hao Jason See, Ramkumar, Sekar, Min Sen Yew Slovak Republic: Andrej Vondrak South Africa: Shereen Bejai, George, Bennie, Ria, Bester, Gerrit, Engelbrecht, Osayande, Evbuomwan, Harlem, Gongxeka, Magritha Jv Vuuren, Mitchell, Kaplan, Purbhoo, Khushica, Hoosen, Lakhi, Lizette, Louw, Nico, Malan, Katarina, Milos, Moshe, Modiselle, Stuart, More, Mathava, Naidoo, Leonie, Scholtz, Mboyo Vangu Spain: Santiago Aguadé-Bruix, Isabel, Blanco, Antonio, Cabrera, Alicia, Camarero, Irene, Casáns-Tormo, Hug, Cuellar-Calabria, Albert, Flotats, Maria Eugenia Fuentes Cañamero, María Elia García, Amelia, Jimenez-Heffernan, Rubén, Leta, Javier Lopez Diaz, Luis, Lumbreras, Juan Javier Marquez-Cabeza, Francisco, Martin, Anxo Martinez de Alegria, Francisco, Medina, Maria Pedrera Canal, Virginia, Peiro, Virginia, Pubul-Nuñez, Juan Ignacio Rayo Madrid, Cristina Rodríguez Rey, Ricardo Ruano Perez, Joaquín, Ruiz, Gertrudis Sabatel Hernández, Ana, Sevilla, Nahla Zeidán Sri Lanka: Damayanthi Nanayakkara, Chandraguptha Udugama Sweden: Magnus Simonsson Switzerland: Hatem Alkadhi, Ronny Ralf Buechel, Peter, Burger, Luca, Ceriani, Bart De Boeck, Christoph, Gräni, Alix Juillet de Saint Lager Lucas, Kamani, Christel H., Nadine, Kawel-Boehm, Robert, Manka, Prior, John O., Axel, Rominger, Jean-Paul Vallée Thailand: Benjapa Khiewvan, Teerapon, Premprabha, Tanyaluck Thientunyakit Tunisia: Ali Sellem Turkey: Kemal Metin Kir, Haluk Sayman Uganda: Mugisha Julius Sebikali, Zerida Muyinda Ukraine: Yaroslav Kmetyuk, Pavlo, Korol, Olena, Mykhalchenko, Volodymyr, Pliatsek, Maryna Satyr United Arab Emirates: Batool Albalooshi, Mohamed Ismail Ahmed Hassan United Kingdom: Jill Anderson, Punit, Bedi, Thomas, Biggans, Anda, Bularga, Russell, Bull, Rajesh, Burgul, John-Paul, Carpenter, Duncan, Coles, David, Cusack, Aparna, Deshpande, John, Dougan, Timothy, Fairbairn, Alexia, Farrugia, Deepa, Gopalan, Alistair, Gummow, Prasad Guntur Ramkumar, Mark, Hamilton, Mark, Harbinson, Thomas, Hartley, Benjamin, Hudson, Nikhil, Joshi, Michael, Kay, Andrew, Kelion, Azhar, Khokhar, Jamie, Kitt, Ken, Lee, Chen, Low, Sze Mun Mak, Ntouskou, Marousa, Jon, Martin, Elisa, Mcalindon, Leon, Menezes, Gareth, Morgan-Hughes, Alastair, Moss, Anthony, Murray, Edward, Nicol, Dilip, Patel, Charles, Peebles, Francesca, Pugliese, Jonathan Carl Luis Rodrigues, Christopher, Rofe, Nikant, Sabharwal, Rebecca, Schofield, Thomas, Semple, Naveen, Sharma, Peter, Strouhal, Deepak, Subedi, William, Topping, Katharine, Tweed, Jonathan Weir-Mccall United States of America: Suhny Abbara, Taimur, Abbasi, Brian, Abbott, Shady, Abohashem, Sandra, Abramson, Tarek, Al-Abboud, Mouaz, Al-Mallah, Omar, Almousalli, Karthikeyan, Ananthasubramaniam, Mohan Ashok Kumar, Jeffrey, Askew, Lea, Attanasio, Mallory, Balmer-Swain, Bayer, Richard R., Adam, Bernheim, Sabha, Bhatti, Erik, Bieging, Ron, Blankstein, Stephen, Bloom, Sean, Blue, David, Bluemke, Andressa, Borges, Kelley, Branch, Paco, Bravo, Jessica, Brothers, Matthew, Budoff, Renée, Bullock-Palmer, Angela, Burandt, Burke, Floyd W., Kelvin, Bush, Candace, Candela, Elizabeth, Capasso, Joao, Cavalcante, Donald, Chang, Saurav, Chatterjee, Yiannis, Chatzizisis, Michael, Cheezum, Tiffany, Chen, Jennifer, Chen, Marcus, Chen, Andrew, Choi, James, Clarcq, Ayreen, Cordero, Matthew, Crim, Sorin, Danciu, Bruce, Decter, Nimish, Dhruva, Neil, Doherty, Rami, Doukky, Anjori, Dunbar, William, Duvall, Rachael, Edwards, Kerry, Esquitin, Husam, Farah, Emilio, Fentanes, Maros, Ferencik, Daniel, Fisher, Daniel, Fitzpatrick, Cameron, Foster, Tony, Fuisz, Michael, Gannon, Lori, Gastner, Myron, Gerson, Brian, Ghoshhajra, Alan, Goldberg, Brian, Goldner, Jorge, Gonzalez, Rosco, Gore, Sandra, Gracia-López, Fadi, Hage, Agha, Haider, Sofia, Haider, Yasmin, Hamirani, Karen, Hassen, Mallory, Hatfield, Carolyn, Hawkins, Katie, Hawthorne, Nicholas, Heath, Robert, Hendel, Phillip, Hernandez, Gregory, Hill, Stephen, Horgan, Jeff, Huffman, Lynne, Hurwitz, Ami, Iskandrian, Rajesh, Janardhanan, Christine, Jellis, Scott, Jerome, Dinesh, Kalra, Summanther, Kaviratne, Fernando, Kay, Faith, Kelly, Omar, Khalique, Mona, Kinkhabwala, George Kinzfogl Iii, Jacqueline, Kircher, Rachael, Kirkbride, Michael, Kontos, Anupama, Kottam, Joseph, Krepp, Jay, Layer, Steven, H Lee, Jeffrey, Leppo, John, Lesser, Steve, Leung, Howard, Lewin, Diana, Litmanovich, Yiyan, Liu, Juan, Lopez-Mattei, Kathleen, Magurany, Jeremy, Markowitz, Amanda, Marn, Stephen, E Matis, Michael, Mckenna, Tony, Mcrae, Fernando, Mendoza, Michael, Merhige, David, Min, Chanan, Moffitt, Karen, Moncher, Warren, Moore, Shamil, Morayati, Michael, Morris, Mahmud, Mossa-Basha, Zorana, Mrsic, Venkatesh, Murthy, Prashant, Nagpal, Kyle, Napier, Jagat, Narula, Katarina, Nelson, Prabhjot, Nijjar, Medhat, Osman, Purvi, Parwani, Edward, Passen, Amit, Patel, Pravin, Patil, Ryan, Paul, Lawrence, Phillips, Venkateshwar, Polsani, Rajaram, Poludasu, Brian, Pomerantz, Thomas, Porter, Ryan, Prentice, Amit, Pursnani, Mark, Rabbat, Suresh, Ramamurti, Florence, Rich, Hiram Rivera Luna, Austin, Robinson, Kim, Robles, Cesar, Rodríguez, Mark, Rorie, John, Rumberger, Raymond, Russell, Philip, Sabra, Diego, Sadler, Mary, Schemmer, Joseph Schoepf, U., Samir, Shah, Nishant, Shah, Sujata, Shanbhag, Gaurav, Sharma, Steven, Shayani, Jamshid, Shirani, Pushpa, Shivaram, Steven, Sigman, Mitch, Simon, Ahmad, Slim, David, Smith, Alexandra, Smith, Prem, Soman, Aditya, Sood, Monvadi Barbara Srichai-Parsia, James, Streeter, Albert, T, Ahmed, Tawakol, Dustin, Thomas, Randall, Thompson, Tara, Torbet, Desiree, Trinidad, Shawn, Ullery, Samuel, Unzek, Seth, Uretsky, Srikanth, Vallurupalli, Vikas, Verma, Alfonso, Waller, Ellen, Wang, Parker, Ward, Gaby, Weissman, George, Wesbey, Kelly, White, David, Winchester, David, Wolinsky, Sandra, Yost, Michael Zgaljardic Uruguay: Omar Alonso, Mario, Beretta, Rodolfo, Ferrando, Miguel, Kapitan, Fernando Mut Uzbekistan: Omoa Djuraev, Gulnora Rozikhodjaeva Vietnam: Ha Le Ngoc, Son Hong Mai, and Xuan Canh Nguyen
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Cardiology, coronavirus, 030204 cardiovascular system & hematology, Transoesophageal echocardiography, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Health care, Stress Echocardiography, Humans, Medicine, 030212 general & internal medicine, cardiac investigations, Pandemics, Cardiac imaging, Retrospective Studies, Cardiac investigations, Coronavirus, COVID-19, medicine.diagnostic_test, SARS-CoV-2, business.industry, Non invasive, cardiac imaging, humans, pandemics, retrospective studies, tomography, x-ray computed, cardiology, Positron emission tomography, Original Article, Tomography, X-Ray Computed, Cardiology and Cardiovascular Medicine, business, Cardiac Diagnostic Procedure
Abstract: OBJECTIVES: The INCAPS COVID Oceania study aimed to assess the impact caused by the COVID-19 pandemic on cardiac procedure volume provided in the Oceania region. METHODS: A retrospective survey was performed comparing procedure volumes within March 2019 (pre-COVID-19) with April 2020 (during first wave of COVID-19 pandemic). Sixty-three (63) health care facilities within Oceania that perform cardiac diagnostic procedures were surveyed, including a mixture of metropolitan and regional, hospital and outpatient, public and private sites, and 846 facilities outside of Oceania. The percentage change in procedure volume was measured between March 2019 and April 2020, compared by test type and by facility. RESULTS: In Oceania, the total cardiac diagnostic procedure volume was reduced by 52.2% from March 2019 to April 2020, compared to a reduction of 75.9% seen in the rest of the world (p
Published: 2021

45. Limited tumour progression beyond Milan criteria while on the waiting list does not result in unacceptable impairment of survival

Author: Miquel Navasa, Juan Carlos García-Valdecasas, Maria Reig, Rosa Miquel, Alba Díaz, Alejandro Forner, Ramón Vilana, Constantino Fondevila, Josep Fuster, Carmen Ayuso, Victor Sapena, Joana Ferrer-Fàbrega, Jordi Bruix, and Jaime Sampson-Dávila
Subjects: 0301 basic medicine, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, Time Factors, Tissue and Organ Procurement, Orthotopic liver transplantation, Waiting Lists, Milan criteria, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, Survival rate, Retrospective Studies, Hepatology, business.industry, Liver Neoplasms, Cancer, Middle Aged, medicine.disease, Survival Analysis, BCLC Stage, Liver Transplantation, Transplantation, 030104 developmental biology, Waiting list, Hepatocellular carcinoma, Disease Progression, 030211 gastroenterology & hepatology, Female, business
Abstract: Background & Aims Defining optimum management of patients progressing beyond Milan criteria on the waiting list is a controversial topic. Our aim was to determine whether the policy of allowing a limited progression beyond enlistment criteria permits acceptable post-transplant outcomes in terms of survival and recurrence. Methods Patients with hepatocellular carcinoma included on the waiting list for orthotopic liver transplantation (OLT) between January 1989 and December 2016 were analysed. Tumour features were assessed at inclusion on the waiting list, before OLT and at explant pathology. Patients were retained on the waiting list despite exceeding enlistment criteria if not presenting with macrovascular invasion, extrahepatic spread or cancer-related symptoms. Results A total of 495 patients constituted the target population. Comparison between the Milan-in (n = 434) and Milan-out (n = 61) groups showed statistically significant differences in: largest tumour size; BCLC stage; patients treated before OLT; alpha-fetoprotein, and time on the waiting list. Milan-out patients showed a significantly higher number of poorly differentiated nodules, satellitosis and microscopic vascular invasion. The 1-, 3-, 5- and 10-year survival rate was 89.6%, 82.5%, 75%, and 55.5%, vs. 83.6%, 70.5%, 65.5%, and 53.9% for Milan-in/Milan-out patients, respectively. Recurrence rates at 1, 3, 5 and 10 years were 1.2%, 3.3%, 5.5%, and 10.8% vs. 7.1% 14.5%, 23%, and 23% for Milan-in and Milan-out patients, respectively (p Conclusion This study shows that although limited tumour progression without reaching major adverse predictors (vascular invasion, extrahepatic spread, cancer symptoms) has an expected impact on recurrence rate, overall survival remains above the minimum proposed benchmark of 65% at 5 years. The clinically relevant increase in tumour recurrence must be considered when analysing the benefit of this approach in the face of limited organ supply. Lay summary When considering orthotopic liver transplantation for patients with hepatocellular carcinoma, optimum results are achieved when transplanting patients within the Milan criteria. However, the most appropriate strategy for patients who progress beyond these criteria while on the waiting list is still unclear. Herein, we show that transplantation is associated with acceptable overall survival in select patients who progress beyond the Milan criteria, although recurrence rates were notably higher. Therefore, the assessment of transplantation viability in these patients must consider the availability of organs and the impact on other patient categories.
Published: 2020

46. Structural Insights into β-arrestin/CB1 Receptor Interaction: NMR and CD Studies on Model Peptides

Author: Paula Morales, M. Angeles Jiménez, Marta Bruix, Ministerio de Ciencia, Innovación y Universidades (España), and Comunidad de Madrid
Subjects: Models, Molecular, Circular dichroism, Cell signaling, Magnetic Resonance Spectroscopy, G protein, Catalysis, Protein Structure, Secondary, Article, lcsh:Chemistry, Inorganic Chemistry, GPCR, Receptor, Cannabinoid, CB1, Arrestin, Humans, β-arrestin1, Physical and Theoretical Chemistry, Receptor, lcsh:QH301-705.5, Molecular Biology, Spectroscopy, beta-Arrestins, G protein-coupled receptor, Chemistry, Organic Chemistry, General Medicine, CB1, Peptide Fragments, NMR, Computer Science Applications, Transmembrane domain, lcsh:Biology (General), lcsh:QD1-999, Biophysics, lipids (amino acids, peptides, and proteins), Signal transduction, Signal Transduction
Abstract: Activation of the cannabinoid CB1 receptor induces different cellular signaling cascades through coupling to different effector proteins (G-proteins and &beta, arrestins), triggering numerous therapeutic effects. Conformational changes and rearrangements at the intracellular domain of this GPCR receptor that accompany ligand binding dictate the signaling pathways. The GPCR-binding interface for G proteins has been extensively studied, whereas &beta, arrestin/GPCR complexes are still poorly understood. To gain knowledge in this direction, we designed peptides that mimic the motifs involved in the putative interacting region: &beta, arrestin1 finger loop and the transmembrane helix 7-helix 8 (TMH7-H8) elbow located at the intracellular side of the CB1 receptor. According to circular dichroism and NMR data, these peptides form a native-like, helical conformation and interact with each other in aqueous solution, in the presence of trifluoroethanol, and using zwitterionic detergent micelles as membrane mimics. These results increase our understanding of the binding mode of &beta, arrestin and CB1 receptor and validate minimalist approaches to structurally comprehend complex protein systems.
Published: 2020
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47. Incidence of Hepatocellular Carcinoma in Patients With Nonalcoholic Fatty Liver Disease: A Systematic Review, Meta-analysis, and Meta-regression

Author: Maria Reig, Victor Sapena, Marco Sanduzzi-Zamparelli, Lorenzo A. Orci, Berta Caballol, Nicola Colucci, Ferran Torres, Jordi Bruix, and Christian Toso
Subjects: medicine.medical_specialty, Cirrhosis, Carcinoma, Hepatocellular, Cochrane Library, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Non-alcoholic Fatty Liver Disease, Risk Factors, Internal medicine, Nonalcoholic fatty liver disease, medicine, Humans, Prospective Studies, Risk factor, Prospective cohort study, Hepatology, business.industry, Incidence (epidemiology), Incidence, Liver Neoplasms, medicine.disease, digestive system diseases, 030220 oncology & carcinogenesis, Meta-analysis, Hepatocellular carcinoma, 030211 gastroenterology & hepatology, business
Abstract: Background & Aims Nonalcoholic fatty liver disease (NAFLD) may be a risk factor for hepatocellular carcinoma (HCC), but the extent of this association still needs to be addressed. Pooled incidence rates of HCC across the disease spectrum of NAFLD have never been estimated by meta-analysis. Methods In this systematic review, we searched Web of Science, Embase, PubMed, and the Cochrane Library from January 1, 1950 through July 30, 2020. We included studies reporting on HCC incidence in patients with NAFLD. The main outcomes were pooled HCC incidences in patients with NAFLD at distinct severity stages. Summary estimates were calculated with random-effects models. Sensitivity analyses and meta-regression analyses were carried out to address heterogeneity. Results We included 18 studies involving 470,404 patients. In patients with NAFLD at a stage earlier than cirrhosis, the incidence rate of HCC was 0.03 per 100 person-years (95% confidence interval [CI], 0.01–0.07; I2 = 98%). In patients with cirrhosis, the incidence rate was 3.78 per 100 person-years (95% CI, 2.47–5.78; I2 = 93%). Patients with cirrhosis undergoing regular screening for HCC had an incidence rate of 4.62 per 100 person-years (95% CI, 2.77–7.72; I2 = 77%). Conclusions Patients with NAFLD-related cirrhosis have a risk of developing HCC similar to that reported for patients with cirrhosis from other etiologies. Evidence documenting the risk in patients with nonalcoholic steatohepatitis or simple steatosis is limited, but the incidence of HCC in these populations may lie below thresholds used to recommend a screening. Well-designed prospective studies in these subpopulations are needed. The protocol for this systematic review is registered in the Prospero database (registration number CRD42018092861).
Published: 2020

48. Tyrosine Kinase Inhibitors and Hepatocellular Carcinoma

Author: Leonardo Gomes da Fonseca, Maria Reig, and Jordi Bruix
Subjects: Sorafenib, Carcinoma, Hepatocellular, Cabozantinib, medicine.drug_class, Pyridines, Malignancy, Tyrosine-kinase inhibitor, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Regorafenib, medicine, Humans, Anilides, Molecular Targeted Therapy, Protein Kinase Inhibitors, Hepatology, business.industry, Phenylurea Compounds, Liver Neoplasms, Protein-Tyrosine Kinases, medicine.disease, digestive system diseases, chemistry, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Cancer research, Quinolines, 030211 gastroenterology & hepatology, business, Lenvatinib, Tyrosine kinase, medicine.drug
Abstract: Sorafenib was the first tyrosine kinase inhibitor (TKI) that showed success in extending survival in patients with advanced hepatocellular carcinoma (HCC). In recent years, additional TKIs have been shown to improve survival and expanded the armamentarium for treating this malignancy. The current landscape includes other classes of drugs, such as immune checkpoint inhibitors and monoclonal antibodies. The challenge is now placed on how to best select, combine, and sequence drugs with the goal of improving efficacy and minimizing toxicities to deliver better outcomes for HCC patients.
Published: 2020

49. Radiological response to nivolumab in patients with hepatocellular carcinoma: A multicenter analysis of real-life practice

Author: Laura Márquez, Christie Perelló, Carmen Ayuso, Bruno Sangro, Maria Varela, Maria Torner Simó, Jordi Bruix, Victor Sapena, Manuel de la Torre-Aláez, José Luis Lledó, Maria Reig, Leonardo G Da Fonseca, Mònica Pons, Jordi Rimola, Ana Matilla, Antonio Guerrero, Ferran Torres, Jose Luis Calleja, and Beatriz Minguez
Subjects: Oncology, medicine.medical_specialty, Carcinoma, Hepatocellular, Tomografia computada per emissió de fotó simple, Disease, 030218 nuclear medicine & medical imaging, Càncer de fetge, 03 medical and health sciences, Tumor Status, Immunitat cel·lular, Magnetic resonance imaging, 0302 clinical medicine, Imatges per ressonància magnètica, Internal medicine, Medicine, Humans, Radiology, Nuclear Medicine and imaging, Response Evaluation Criteria in Solid Tumors, Retrospective Studies, Hepatology, medicine.diagnostic_test, business.industry, Liver Neoplasms, Retrospective cohort study, General Medicine, medicine.disease, Hepatologia, Single-photon emission computed tomography, Cellular immunity, Clinical trial, Nivolumab, Treatment Outcome, 030220 oncology & carcinogenesis, Radiological weapon, Hepatocellular carcinoma, business, Liver cancer
Abstract: Background and aims Immune-checkpoint inhibitors are effective in many advanced tumors. However, there is scarce information regarding the radiological response to these agents in hepatocellular carcinoma outside clinical trials. We aimed to describe the radiological response in a retrospective cohort of hepatocellular carcinoma patients treated with nivolumab and to analyze the radiological evolution according to tumor response at first post-treatment radiological assessment. Methods We reviewed pre-treatment and post-treatment images (CT or MRI) obtained at different time-points in patients with hepatocellular carcinoma treated with nivolumab outside clinical trials at seven Spanish centers, assessing the response according to RECIST 1.1 and iRECIST and registering atypical responses. We also analyzed the imaging findings on subsequent assessments according to tumor status on the first posttreatment imaging assessment. Results From the 118 patients with hepatocellular carcinoma treated with nivolumab, we finally analyzed data from 31 patients (71 % Child-Pugh A; 74 % BCLC-C). Median follow-up was 8.39 months [IQR 5.00–10.92]; median overall survival was 12.82 months (95 %CI 10.92–34.79). According to RECIST 1.1, the objective response rate was 16 % and according to iRECIST, the objective response rate was 22.6 %. Findings at the first post-treatment assessment varied, showing stable disease in 44.8 % of patients; findings during follow-up also varied widely, including 4 hyperprogressions and 3 pseudoprogressions. Conclusion Imaging findings during nivolumab treatment are heterogeneous between and within patients. Progression of disease does not always signify treatment failure, and surrogate end-points may not reflect survival outcomes, making the management of hepatocellular carcinoma patients under immunotherapy challenging.
Published: 2020

50. Evaluation of LI-RADS 3 category by magnetic resonance in US-detected nodules ≤ 2 cm in cirrhotic patients

Author: Maria Reig, Ernest Belmonte, Jordi Bruix, Carla Caparroz, Anna Darnell, Enric Ripoll, Álvaro Díaz-González, Alejandro Forner, Ángeles García-Criado, Carmen Ayuso, Jordi Rimola, and Ramón Vilana
Subjects: Liver Cirrhosis, medicine.medical_specialty, Cirrhosis, Carcinoma, Hepatocellular, Magnetic Resonance Spectroscopy, Contrast Media, Sensitivity and Specificity, 030218 nuclear medicine & medical imaging, Metastasis, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Stage (cooking), Neuroradiology, Retrospective Studies, medicine.diagnostic_test, business.industry, Liver Neoplasms, Magnetic resonance imaging, Nodule (medicine), Interventional radiology, General Medicine, medicine.disease, Magnetic Resonance Imaging, Bile Ducts, Intrahepatic, Bile Duct Neoplasms, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Radiology, medicine.symptom, business
Abstract: Liver Imaging Reporting and Data System (LI-RADS) for hepatocellular carcinoma (HCC) diagnosis in high-risk patients is a dynamic system, which was lastly updated in 2018. We aimed to evaluate the accuracy for HCC diagnosis of LI-RADS v2018 with magnetic resonance imaging (MRI) with extracellular contrast for solitary nodules ≤ 20 mm detected during ultrasound (US) surveillance in cirrhotic patients, with particular interest in those observations categorized as LI-RADS 3. Between November 2003 and February 2017, we included 262 consecutive cirrhotic patients with a newly US-detected solitary ≤ 20-mm nodule. A LI-RADS (LR) v2018 category was retrospectively assigned. The diagnostic accuracy for each LR category was described, and the main MRI findings associated with HCC diagnosis were analyzed. Final diagnoses were as follows: 197 HCC (75.2%), 5 cholangiocarcinoma (1.9%), 2 metastasis (0.8%), and 58 benign lesions (22.1%); 0/15 (0%) LR-1, 6/26 (23.1%) LR-2, 51/74 (68.9%) LR-3, 11/12 (91.7%) LR-4, 126/127 (99.2%) LR-5, and 3/8 (37.5%) LR-M were HCC. LR-5 category displayed a sensitivity and specificity of 64% (95% CI, 56.8–70.7) and 98.5% (95% CI, 91.7–100), respectively. Considering also LR-4 as diagnostic for HCC, the sensitivity slightly increased to 69.5% (95% CI, 62.6–75.9) with minor impact on specificity (96.2%; 95% CI, 89.3–99.6). Regarding LR-3 observations, 51 out of 74 were HCC, 2 were non-HCC malignancies, and 20 out of 21 LR-3 nodules > 15 mm (95.2%) were finally categorized as HCC. The high probability of HCC in US-detected LR-3 observations (68.9%) justifies triggering an active diagnostic work-up if intended to diagnose HCC at a very early stage. • In cirrhotic patients with nodules ≤ 20 mm detected during US surveillance, 51 out of 74 (68.9%) of LR-3 nodules by MRI corresponded to an HCC. • In LR-3 nodules, HCC diagnosis was closely related to baseline tumor size. All 5 nodules smaller than 1 cm were diagnosed as benign. Oppositely, 20 out of 21 LR-3 observations > 15 mm (95.2%) were diagnosed as HCC. • The high probability of HCC in US-detected LR-3 observations justifies triggering an active diagnostic work-up if intended to diagnose HCC at a very early stage.
Published: 2020

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