138 results on '"Santiago J"'
Search Results
2. [Spanish clinical research in heart failure and its contribution to the European congress of internal medicine (1997-2009)].
- Author
-
Montes-Santiago J and Formiga F
- Subjects
- Europe, Humans, Spain, Biomedical Research statistics & numerical data, Congresses as Topic, Heart Failure, Internal Medicine
- Published
- 2010
- Full Text
- View/download PDF
3. [European impact of Spanish Internal Medicine].
- Author
-
Montes-Santiago J, Alvarez Muñiz ML, Martínez López M, and Baz Lomba A
- Subjects
- Europe, Spain, Congresses as Topic statistics & numerical data, Internal Medicine statistics & numerical data
- Abstract
Objectives: To evaluate the scientific contributions of spanish specialists in Internal Medicine in the Congresses of the European Federation of Internal Medicine (EFIM) during the period from 1997 to 2003., Material and Methods: Communications and posters from the books of abstracts of the last four EFIM meetings held in Maastricht (1997), Florence (1999), Edinburgh (2001) and Berlin (2003) were studied. The field of research was recorded and case reports were excluded., Results: 1,616 scientific communications were taken in account. Two percent (31) were from countries outside Europe. Spain ranked first with 487 communications (30.1%), followed by Italy (11.9%), France (10.5%) and Portugal (10.2%). In Spain, Madrid, Galicia, Andalusia and Valencia were the regional communities with the most contributions. The main fields of research were cardiovascular diseases and infectious diseases-AIDS infections., Conclusions: The speciality of Internal Medicine in Spain is very active in terms of scientific contributions as judged by the number of communications to the european congresses.
- Published
- 2006
- Full Text
- View/download PDF
4. [What is the opinion of Spanish internists on osteoporosis?].
- Author
-
Sosa Henríquez M, Filgueira Rubio J, López-Harce Cid JA, Díaz Curiel M, Lozano Tonkin C, del Castillo Rueda A, Sánchez Molini P, Montes Santiago J, Serrano Fernández C, Díaz López B, Pérez Cano R, Blázquez JA, Ortego Centeno N, Tirado Miranda R, Sánchez Linares JR, Nogués Solán X, Farrerons Minguela J, Escobar Jiménez F, del Pino del Montes J, González-Macías J, and Gómez Alonso C
- Subjects
- Aged, Densitometry, Diphosphonates therapeutic use, Humans, Middle Aged, Osteoporosis diagnosis, Osteoporosis drug therapy, Spain, Surveys and Questionnaires, Attitude of Health Personnel, Internal Medicine, Osteoporosis physiopathology
- Abstract
Objective: To conduct an opinion survey on osteoporosis in Spanish internists., Method: Survey sent by mail and by personal visit to members of the Spanish Internists Society. Collection of data on opinion on the disease, diagnostic and therapeutic attitude and means available (general laboratory analyses, conventional radiology, biochemical markers of bone remodeling, densitometry and ultrasounds) and preference when choosing a certain treatment., Results: A total of 538 internists answered. More than 90% of those surveyed consider that osteoporosis is a disease that should be treated by internists. A total of 93% consider that osteoporosis is a prevalent disease. More than 80% have access to densitometry., Conclusions: The majority of Spanish internists consider that osteoporosis is a disease that should be treated by internists and that it is a disease that enters into their action scope. In general, they have the means necessary for its study and treatment. Bisphosphonates constitute the drug of choice and calcium and vitamin D supplements are indicated in almost all the cases.
- Published
- 2005
- Full Text
- View/download PDF
5. [Contribution of Galician hospitals to national and international Internal Medicine scientific meetings].
- Author
-
Montes Santiago J and Pérez Alvarez R
- Subjects
- Humans, Periodicals as Topic, Spain, Bibliometrics, Congresses as Topic statistics & numerical data, Databases, Bibliographic statistics & numerical data, Hospitals statistics & numerical data, Internal Medicine, Research statistics & numerical data
- Abstract
Objectives: To evaluate the scientific contributions of internal medicine services from Galicia to nationals and internationals specialty meetings and to describe theirs preferences in clinical research., Material and Method: We analysed the communications from the Abstracts books of the last four Spanish Internal Medicine National Congress (1994-2000 period) in comparison with that of 1984, the last two European Congress (1999 and 2001) and the last World Congress (2000). Case reports were excluded., Results: An increasing number of communicating hospitals and a sustained number of reports was observed with a minimum of 2 hospitals (1984) to a maximum of 12 (1996) with 5-6 hospitals on average. Number of communications became stable and reached 5% of the whole spanish reports. Cardiovascular and AIDS-Infectious diseases were the preferred research fields., Conclusions: An increment of scientific communications from a growing number of galician hospitals was observed. This scientific production became continuous and stabilized notoriously on cardiovascular and AIDS-infectious disease fields.
- Published
- 2002
6. Prescripciones potencialmente inapropiadas en pacientes geriátricos hospitalizados en el servicio de medicina interna en un hospital de referencia en México
- Author
-
María G. Martínez-Ruiz, Felisardo Corona-Ruiz, Adriana P. Solís-Rivera, Sonia Sifuentes-Franco, Virginia A. Sánchez-López, Santiago J. Guevara-Martínez, and Selene G. Huerta-Olvera
- Subjects
Errores de medicación. Farmacovigilancia. Pacientes geriátricos. Prescripciones inapropiadas. Riesgo en la medicación. ,Public aspects of medicine ,RA1-1270 ,Internal medicine ,RC31-1245 - Abstract
Antecedentes: Una prescripción potencialmente inapropiada (PPI) constituye un riesgo de presentar efectos adversos por un fármaco que superan los beneficios de este, pudiendo considerarse como uso inadecuado de medicamentos. Objetivo: Describir la prevalencia de prescripciones potencialmente inapropiadas en pacientes geriátricos hospitalizados en el servicio de medicina interna de un hospital de referencia en México. Material y métodos: Diseño descriptivo transversal, con asignación simple de expedientes clínicos de pacientes hospitalizados mayores de 65 años, entre enero de 2016 y agosto de 2017. Se aplicaron los criterios STOPP y START para identificar el número de PPI, cantidad de medicamentos prescritos, presencia, cantidad y tipo de comorbilidades, así como días de estancia hospitalaria. Resultados: Se encontró una prevalencia de 73.3 % de PPI y las principales comorbilidades fueron hipertensión arterial y diabetes mellitus tipo 2. Se cuantificaron 1885 medicamentos prescritos; la estancia hospitalaria media fue de 6.3 días. Conclusiones: Se identificó alta prevalencia de PPI en los pacientes geriátricos hospitalizados, de ahí la importancia de aplicar los criterios STOPP y START y del papel del farmacéutico en la validación de la prescripción antes de la administración de medicamentos.
- Published
- 2023
- Full Text
- View/download PDF
7. Stents recubiertos o farmacoactivos en aneurismas, resultados del Registro Internacional de Aneurismas Coronarios (CAAR)
- Author
-
Iván J. Núñez-Gil, Enrico Cerrato, Mario Bollati, Luis Nombela-Franco, Belén Terol, Emilio Alfonso-Rodríguez, Santiago J. Camacho-Freire, Pedro A. Villablanca, Ignacio J. Amat Santos, José M. de la Torre-Hernández, Isaac Pascual, Christoph Liebetrau, Benjamín Camacho, Marco Pavani, Roberto Adriano Latini, Ferdinando Varbella, Víctor Alfonso Jiménez Díaz, Davide Piraino, Massimo Mancone, Fernando Alfonso, José Antonio Linares, Jesús M. Jiménez-Mazuecos, Jorge Palazuelos-Molinero, Íñigo Lozano, and Antonio Fernández-Ortiz
- Subjects
Aneurismas coronarios ,Registro ,Resultados ,Stent ,Stent-graft ,Angioplastia ,Internal medicine ,RC31-1245 - Abstract
RESUMEN Introducción y objetivos: Los aneurismas coronarios son una situación compleja. Planteamos como objetivo principal describir la frecuencia de utilización de stents recubiertos (grafts) para su tratamiento y caracterizar sus resultados a largo plazo en comparación con stents farmacoactivos. Métodos: Estudio observacional ambispectivo, con información procedente del Registro Internacional de Aneurismas Coronarios (CAAR) (NCT-02563626). Se seleccionaron los pacientes que recibieron un stent-graft o un stent farmacoactivo en la zona del aneurisma. Resultados: Un total de 17 pacientes recibieron al menos un stent-graft y 196 un stent farmacoactivo en la zona aneurismática. Se observa un predominio del sexo masculino y una mayor frecuencia de dislipemia, antecedentes de coronariopatía, enfermedad coronaria revascularizada previamente y aneurismas gigantes en la cohorte de stent-graft. Como variables independientes predictoras del desarrollo del evento combinado (muerte por cualquier causa, insuficiencia cardiaca, angina inestable, reinfarto, ictus, embolia sistémica, sangrado o cualquier complicación en el aneurisma), tras una mediana de seguimiento de 38 meses, destacaron la existencia de conectivopatías (hazard ratio [HR] = 5,94; intervalo de confianza del 95% [IC95%], 1,82-19,37), la disfunción del ventrículo izquierdo ≤ 55% (HR = 1,84; IC95%, 1,09-3,1) y la indicación aguda del cateterismo índice (HR = 2,98; IC95%, 1,39-6,3). El uso de stent-grafts comparado con el de stents farmacoactivos no se asoció al desarrollo de más eventos combinados (23,5 frente a 29,6%; p = 0,598). Conclusiones: El uso de stents recubiertos en aneurismas coronarios es factible y seguro a largo plazo. Se necesitan estudios clínicos aleatorizados para decidir el mejor tratamiento de este tipo de lesiones complejas.
- Published
- 2022
- Full Text
- View/download PDF
8. Stent-grafts versus drug-eluting stents in arterial aneurysms, insights from the International Coronary Artery Aneurysm Registry (CAAR)
- Author
-
Iván J. Núñez-Gil, Enrico Cerrato, Mario Bollati, Luis Nombela-Franco, Belén Terol, Emilio Alfonso-Rodríguez, Santiago J. Camacho-Freire, Pedro A. Villablanca, Ignacio J. Amat Santos, José M. de la Torre-Hernández, Isaac Pascual, Christoph Liebetrau, Benjamín Camacho, Marco Pavani, Roberto Adriano Latini, Ferdinando Varbella, Víctor Alfonso Jiménez Díaz, Davide Piraino, Massimo Mancone, Fernando Alfonso, José Antonio Linares, Jesús M. Jiménez-Mazuecos, Jorge Palazuelos-Molinero, Íñigo Lozano, and, Antonio Fernández-Ortiz, and on behalf of the CAAR registry investigators
- Subjects
Coronary artery aneurysm ,Drug ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,media_common.quotation_subject ,Stent ,medicine.disease ,Arterial aneurysms ,Internal medicine ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,media_common - Published
- 2022
9. Implante valvular pulmonar percutáneo en tracto de salida nativo: ¿ha llegado el momento?
- Author
-
Pablo Merás Colunga and Santiago Jiménez Valero
- Subjects
Internal medicine ,RC31-1245 - Abstract
INTRODUCCIÓN La patología del tracto de salida del ventrículo derecho (TSVD) es frecuente en niños y adultos con cardiopatías congénitas, a menudo como secuela tras una cirugía previa. En las últimas dos décadas, el implante percutáneo de prótesis pulmonares ha ido aumentando progresivamente, hasta el punto de que las guías actuales1 lo recomiendan como vía de elección en pacientes con conductos o bioprótesis previas. No obstante, muchos pacientes presentan tractos de salida nativos o reparados con parche (en adelante englobados como TSVD nativos), cuya lesión predominante es la insuficiencia pulmonar, en los que la valvulación percutánea es más compleja debido a la propia anatomía del TSVD, su comportamiento dinámico, las mayores dimensiones del anillo pulmonar y la inexistencia de una zona de anclaje adecuada para la válvula. Las diferencias en la cardiopatía de base, en la reparación quirúrgica previa y en la configuración de las arterias pulmonares hacen que el TSVD tenga una morfología muy variable, pudiéndose agrupar en 5 subtipos2 (figura 1). Figura 1. Cinco tipos de anatomía del TSVD nativo. I: piramidal; II: cilíndrico o tubular; III: piramidal inverso; IV: ensanchamiento central; V: estrechamiento central. (Reproducido de Schievano et al.2 con permiso de la autora). La tetralogía de Fallot reparada es...
- Published
- 2024
- Full Text
- View/download PDF
10. Long-term Noninvasive Ventilation in Obesity Hypoventilation Syndrome Without Severe OSA
- Author
-
Eusebi Chiner, Nieves B. Navarro-Soriano, Maria A. Martinez-Martinez, Santiago J. Carrizo, Trinidad Díaz-Cambriles, Begoña Gallego, Teresa Gomez-Garcia, Auxiliadora Romero, Francisco J. Vázquez-Polo, Babak Mokhlesi, Maria F. Troncoso, Javier Barca, Cristina Senent, María Luz Alonso-Álvarez, Jesús Sanchez-Gómez, Mónica González, Nicolás González-Mangado, Juan F. Masa, Sergi Marti, Maria Antonia Ramon, M.A. Gómez-Mendieta, Odile Romero, Maria A. Sanchez-Quiroga, Rafael Golpe, Silvia Gómez, Daniel López-Padilla, Miguel Ángel Negrín, Soledad López-Martín, Mercedes Pallero, Jose M. Marin, Estrella Ordax-Carbajo, Carlos Egea, Iván Benítez, Francisco Javier Gómez De Terreros, Jesús Muñoz-Méndez, José N. Sancho-Chust, José M. Benítez, Candela Caballero-Eraso, Jaime Corral, Mónica Bengoa, Elena Ojeda-Castillejo, Emilia Barrot, Ferran Barbé, Eva Arias, Juan Antonio Riesco, and María Martel-Escobar
- Subjects
Pulmonary and Respiratory Medicine ,Obesity hypoventilation syndrome ,medicine.medical_specialty ,SF-36 ,business.industry ,Epworth Sleepiness Scale ,Critical Care and Intensive Care Medicine ,Rate ratio ,medicine.disease ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,030228 respiratory system ,Randomized controlled trial ,Interquartile range ,law ,Internal medicine ,Positive airway pressure ,Ambulatory ,medicine ,030212 general & internal medicine ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Noninvasive ventilation (NIV) is an effective form of treatment in obesity hypoventilation syndrome (OHS) with severe OSA. However, there is paucity of evidence in patients with OHS without severe OSA phenotype. Research Question Is NIV effective in OHS without severe OSA phenotype? Study Design and Methods In this multicenter, open-label parallel group clinical trial performed at 16 sites in Spain, we randomly assigned 98 stable ambulatory patients with untreated OHS and apnea-hypopnea index Results Forty-nine patients in the NIV group and 49 in the control group were randomized, and 48 patients in each group were analyzed. During a median follow-up of 4.98 years (interquartile range, 2.98-6.62), the mean hospitalization days per year ± SD was 2.60 ± 5.31 in the control group and 2.71 ± 4.52 in the NIV group (adjusted rate ratio, 1.07; 95% CI, 0.44-2.59; P = .882). NIV therapy, in contrast with the control group, produced significant longitudinal improvement in Paco2, pH, bicarbonate, quality of life (Medical Outcome Survey Short Form 36 physical component), and daytime sleepiness. Moreover, per-protocol analysis showed a statistically significant difference for the time until the first ED visit favoring NIV. In the subgroup with high NIV adherence, the time until the first event of hospital admission, ED visit, and mortality was longer than in the low adherence subgroup. Adverse events were similar between arms. Interpretation In stable ambulatory patients with OHS without severe OSA, NIV and lifestyle modification had similar long-term hospitalization days per year. A more intensive program aimed at improving NIV adherence may lead to better outcomes. Larger studies are necessary to better determine the long-term benefit of NIV in this subgroup of OHS. Trial Registry ClinicalTrials.gov; No.: NCT01405976; URL: www.clinicaltrials.gov
- Published
- 2020
11. Echocardiographic Changes with Positive Airway Pressure Therapy in Obesity Hypoventilation Syndrome. Long-Term Pickwick Randomized Controlled Clinical Trial
- Author
-
Juan F. Masa, Babak Mokhlesi, Iván Benítez, Maria Victoria Mogollon, Francisco Javier Gomez de Terreros, Maria Ángeles Sánchez-Quiroga, Auxiliadora Romero, Candela Caballero-Eraso, Maria Luz Alonso-Álvarez, Estrella Ordax-Carbajo, Teresa Gomez-Garcia, Mónica González, Soledad López-Martín, José M. Marin, Sergi Martí, Trinidad Díaz-Cambriles, Eusebi Chiner, Carlos Egea, Javier Barca, Francisco-José Vázquez-Polo, Miguel A. Negrín, María Martel-Escobar, Ferran Barbe, Jaime Corral, Agustin Sojo, Nicolás González-Mangado, Maria F. Troncoso, Maria-Ángeles Martinez-Martinez, Elena Ojeda-Castillejo, Daniel López Padilla, Santiago J. Carrizo, Begoña Gallego, Mercedes Pallero, Odile Romero, Maria Antonia Ramón, Eva Arias, Jesús Muñoz-Méndez, Cristina Senent, Jose N. Sancho-Chust, Nieves Belén Navarro Soriano, Emilia Barrot, José M. Benítez, Jesús Sanchez-Gómez, Rafael Golpe, María Antonia Gómez Mendieta, Silvia Gomez, and Mónica Bengoa
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.medical_treatment ,Continuous positive airway pressure ,Critical Care and Intensive Care Medicine ,Pulmonary hypertension ,law.invention ,Hypercapnia ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,Positive airway pressure ,medicine ,030212 general & internal medicine ,Obesity hypoventilation syndrome ,business.industry ,Sleep apnea ,medicine.disease ,respiratory tract diseases ,Clinical trial ,030228 respiratory system ,Cardiology ,Diastolic dysfunction ,medicine.symptom ,business ,Noninvasive ventilation - Abstract
Spanish Sleep Network., [Rationale] Obesity hypoventilation syndrome (OHS) has been associated with cardiac dysfunction. However, randomized trials assessing the impact of long-term noninvasive ventilation (NIV) or continuous positive airway pressure (CPAP) on cardiac structure and function assessed by echocardiography are lacking. Rationale: Obesity hypoventilation syndrome (OHS) has been associated with cardiac dysfunction. However, randomized trials assessing the impact of long-term noninvasive ventilation (NIV) or continuous positive airway pressure (CPAP) on cardiac structure and function assessed by echocardiography are lacking., [Objectives] In a prespecified secondary analysis of the largest multicenter randomized controlled trial of OHS (Pickwick Project; N = 221 patients with OHS and coexistent severe obstructive sleep apnea), we compared the effectiveness of three years of NIV and CPAP on structural and functional echocardiographic changes., [Methods] At baseline and annually during three sequential years, patients underwent transthoracic two-dimensional and Doppler echocardiography. Echocardiographers at each site were blinded to the treatment allocation. Statistical analysis was performed using a linear mixed-effects model with a treatment group and repeated measures interaction to determine the differential effect between CPAP and NIV. Measurements and Main Results: A total of 196 patients were analyzed: 102 were treated with CPAP and 94 were treated with NIV. Systolic pulmonary artery pressure decreased from 40.5 ± 1.47 mm Hg at baseline to 35.3 ± 1.33 mm Hg at three years with CPAP, and from 41.5 ± 1.56 mm Hg to 35.5 ± 1.42 with NIV (P, [Conclusions] In patients with OHS who have concomitant severe obstructive sleep apnea, long-term treatment with NIV and CPAP led to similar degrees of improvement in pulmonary hypertension and left ventricular diastolic dysfunction.
- Published
- 2020
12. Fenoldopam Increases Urine Output in Oliguric Critically Ill Surgical Patients
- Author
-
Joaquin A Cagliani, Laura Marinelli, Youngmin Cho, Santiago J Miyara, Andres Ruhemann, Andre Loyola, Ernesto Molmenti, Candace Smith, Gene Coppa, and Rafael Barrera
- Subjects
acute kidney injury ,Anesthesiology ,urine output ,sicu ,General Engineering ,Endocrinology/Diabetes/Metabolism ,Internal Medicine ,perioperative management ,fenoldopam ,oliguria ,diuretics - Abstract
Background Fenoldopam is a short-acting dopamine A1 receptor agonist which mediates vasodilation of the renal arteries, thereby increasing urine output. The objective of this study was to compare the effects of fenoldopam and its synergistic effect on furosemide for improving the urine output in postoperative critically ill patients with acute kidney injury (AKI). Methods This is a retrospective study of postoperative critically ill patients with AKI. Patients who received furosemide (control group) were compared with those who received furosemide plus fenoldopam (treatment group) and evaluated at 12 and 24 hours post-treatment. Patients with oliguria and AKI were included in the study, while patients with chronic kidney disease (CKD) were excluded. Glomerular filtration rate, serum creatinine, blood pressure, calculated fluid accumulation, fluid intake, urine output, and total fluid output were used as variables to assess the medication effect. Results Of the 126 patients who met the inclusion and exclusion criteria, 87 patients received furosemide alone, and 39 patients received furosemide plus fenoldopam during their first 24 hours of admission to the surgical intensive care unit (SICU). Although not statistically significant, the addition of fenoldopam demonstrated an increase in mean urine output of 1525ml (IQR; 1530-2095) in the first 24 hours (P=0.06). There was also noted an increase in the urine output (p= 0.07) and a decrease in the total fluid accumulation when fenoldopam was co-administered with furosemide when compared to the patients who were only treated with furosemide (p=0.06). There was no significant change in creatinine clearance from baseline in either group. Conclusion Fenoldopam may increase urine output in postoperative critically ill patients with acute kidney injury when administered within the first 24 hours of presentation. Based on our results, fenoldopam appears to have a synergistic effect with furosemide in our study population.
- Published
- 2021
13. Láser Excimer en lesiones coronarias gravemente calcificadas: tiempo de romper el mito
- Author
-
Lucía Cobarro, Alfonso Jurado-Román, Daniel Tébar-Márquez, Silvio Vera-Vera, Artemio García-Escobar, Clara Ugueto, Cristina Contreras, Borja Rivero, Santiago Jiménez-Valero, Guillermo Galeote, and Raúl Moreno
- Subjects
ICP compleja ,Láser coronario ,Lesiones coronarias calcificadas ,Internal medicine ,RC31-1245 - Abstract
RESUMEN Introducción y objetivos: El uso contemporáneo y los resultados de la aterectomía coronaria con láser Excímer (ELCA) en el intervencionismo coronario percutáneo (ICP) de lesiones coronarias gravemente calcificadas no están establecidos. El objetivo de este estudio fue evaluar la eficacia, seguridad y resultados a 1 año de ELCA en este escenario. Métodos: Se revisaron de forma retrospectiva las características clínicas y angiográficas, y los resultados de los procedimientos de revascularización de lesiones gravemente calcificadas tratadas con ICP asistido por ELCA en nuestro centro entre 2016 y 2022. Resultados: Se incluyeron 78 pacientes consecutivos (80 procedimientos) (edad media 71,2 ± 8,6 años, 80,5% varones). La presentación clínica fue enfermedad arterial coronaria estable en 45 (56,2%) pacientes y síndromes coronarios agudos en 33 (43,8%). Todas las lesiones presentaban calcificación grave. Además, el 40% eran lesiones incruzables, el 28,75% lesiones indilatables, el 2,5% reestenosis intrastent, el 6,25% infraexpansión del stent y el 7,5% oclusiones crónicas. La combinación de ≥ 2 de los escenarios anatómicos anteriores existió en el 12,5% de los procedimientos. La fluencia máxima fue de 73 ± 9,6 mJ/mm2 y la frecuencia máxima de 72,7 ± 10,4 Hz. ELCA con lavado con solución salina se utilizó inicialmente en todos los procedimientos y se utilizó contraste en 2 procedimientos. La tasa de éxito de ELCA y de éxito técnico fueron del 91,25 %. Fueron necesarias terapias adyuvantes de modificación de placa en 4 casos. La tasa de éxito clínico fue del 87,5%. Ocurrieron complicaciones relacionadas con ELCA en 2 (2,5%) procedimientos. Tras una mediana de seguimiento de 15,5 meses (IQR, 5,0-29,3), se produjeron eventos cardiovasculares adversos mayores (MACE) (nueva revascularización de la lesión diana, infarto de miocardio o muerte cardiaca) en 9 pacientes (11,25%). Conclusiones: A pesar de la complejidad de la ICP en lesiones gravemente calcificadas, ELCA demostró ser efectivo con una incidencia relativamente baja de complicaciones relacionadas con ELCA y MACE en el seguimiento.
- Published
- 2024
- Full Text
- View/download PDF
14. Room for Improvement in the Treatment of Helicobacter pylori Infection: Lessons from the European Registry on H. pylori Management (Hp-EuReg)
- Author
-
Nyssen O. P., Vaira D., Tepes B., Kupcinskas L., Bordin D., Perez-Aisa A., Gasbarrini A., Castro-Fernandez M., Bujanda L., Garre A., Lucendo A. J., Vologzhanina L., Jurecic N. B., Rodrigo-Saez L., Huguet J. M., Voynovan I., Perez-Lasala J., Romero P. M., Vujasinovic M., Abdulkhakov R., Barrio J., Fernandez-Salazar L., Megraud F., O'Morain C., Gisbert J. P., Ilchishina T., Arino I., Zaytsev O., Perona M., Sarsenbaeva A. S., Ortuno J., Alekseenko S., Dominguez-Cajal M., Rodriguez B. J. G., Notari P. A., Pellicano R., Consorci I. M., Nardone G., Bote J. M. B. -A., Nunez O., Gomez-Camarero J., Guadix J. H., Fiorini G., Jonaitis L., Galan H. A., Ferrer L., Molina-Infante J., Kikec Z., Alcaide N., Lanas A., Sant'Orsola V. C., Medina-Chulia E., Canelles P., Santos-Fernandez J., Velayos B., Di Maira T., Lafuente M. R., Moreno M. J., Dekhnich N. N., Varela P., de la Coba C., Osipenko M. F., Lopez R. R. -Z., Huerta-Madrigal A., Livzan M. A., Pozzati L. S., Iyo E., Amelchugova O. S., Vasyutin A. V., Tsukanov V. V., Barenys M., Burkov S. G., Gravina A. G., Romano M., Bakulina N. V., Fernandez-Bermejo M., Alcedo J., Franceschi F., Campillo A., Seruga M., Villarroya R. P., Mego M., Dore M. P., Tito L., Gmez B., Jimenez J. L. D., Bermejo F., Algaba A., Belousova L. N., Plotnikova E. Y., Calvet X., Figuerola A., Tarasova L., Grigorieva L., Amorena E., Estremera F., Sanchez-Pobre P., Millastre J., Tomas A., Baryshnikova N., Kucheryavyy Y. A., Kononova A., Bakulin I., Cerezo F. J. M., Venciene R., Zhestkova T. V., Rocco A., Gonzalez Santiago J. M., Nyssen, O. P., Vaira, D., Tepes, B., Kupcinskas, L., Bordin, D., Perez-Aisa, A., Gasbarrini, A., Castro-Fernandez, M., Bujanda, L., Garre, A., Lucendo, A. J., Vologzhanina, L., Jurecic, N. B., Rodrigo-Saez, L., Huguet, J. M., Voynovan, I., Perez-Lasala, J., Romero, P. M., Vujasinovic, M., Abdulkhakov, R., Barrio, J., Fernandez-Salazar, L., Megraud, F., O'Morain, C., Gisbert, J. P., Ilchishina, T., Arino, I., Zaytsev, O., Perona, M., Sarsenbaeva, A. S., Ortuno, J., Alekseenko, S., Dominguez-Cajal, M., Rodriguez, B. J. G., Notari, P. A., Pellicano, R., Consorci, I. M., Nardone, G., Bote, J. M. B. -A., Nunez, O., Gomez-Camarero, J., Guadix, J. H., Fiorini, G., Jonaitis, L., Galan, H. A., Ferrer, L., Molina-Infante, J., Kikec, Z., Alcaide, N., Lanas, A., Sant'Orsola, V. C., Medina-Chulia, E., Canelles, P., Santos-Fernandez, J., Velayos, B., Di Maira, T., Lafuente, M. R., Moreno, M. J., Dekhnich, N. N., Varela, P., de la Coba, C., Osipenko, M. F., Lopez, R. R. -Z., Huerta-Madrigal, A., Livzan, M. A., Pozzati, L. S., Iyo, E., Amelchugova, O. S., Vasyutin, A. V., Tsukanov, V. V., Barenys, M., Burkov, S. G., Gravina, A. G., Romano, M., Bakulina, N. V., Fernandez-Bermejo, M., Alcedo, J., Franceschi, F., Campillo, A., Seruga, M., Villarroya, R. P., Mego, M., Dore, M. P., Tito, L., Gmez, B., Jimenez, J. L. D., Bermejo, F., Algaba, A., Belousova, L. N., Plotnikova, E. Y., Calvet, X., Figuerola, A., Tarasova, L., Grigorieva, L., Amorena, E., Estremera, F., Sanchez-Pobre, P., Millastre, J., Tomas, A., Baryshnikova, N., Kucheryavyy, Y. A., Kononova, A., Bakulin, I., Cerezo, F. J. M., Venciene, R., Zhestkova, T. V., Rocco, A., Gonzalez Santiago, J. M., Lucendo, A., and the Hp-EuReg, Investigator
- Subjects
Registrie ,medicine.medical_specialty ,Proton Pump Inhibitor ,medicine.drug_class ,Settore MED/12 - GASTROENTEROLOGIA ,Antibiotics ,MEDLINE ,Helicobacter Infections ,03 medical and health sciences ,0302 clinical medicine ,Pharmacotherapy ,Drug Therapy ,Clarithromycin ,Internal medicine ,Metronidazole ,Anti-Bacterial Agent ,bismuth ,medicine ,non-bismuth ,Humans ,Prospective Studies ,Registries ,Disease management (health) ,levofloxacin ,biology ,Helicobacter pylori ,business.industry ,mistake ,Gastroenterology ,Amoxicillin ,Proton Pump Inhibitors ,biology.organism_classification ,error ,Anti-Bacterial Agents ,Penicillin ,Prospective Studie ,030220 oncology & carcinogenesis ,Combination ,030211 gastroenterology & hepatology ,Drug Therapy, Combination ,business ,Helicobacter Infection ,H. pylori ,medicine.drug ,Human - Abstract
BACKGROUND: Managing Helicobacter pylori infection requires constant decision making, and each decision is open to possible errors. AIM: The aim was to evaluate common mistakes in the eradication of H. pylori, based on the "European Registry on Helicobacter pylori management". METHODS: European Registry on Helicobacter pylori management is an international multicentre prospective noninterventional registry evaluating the decisions and outcomes of H. pylori management by European gastroenterologists in routine clinical practice. RESULTS: Countries recruiting more than 1000 patients were included (26,340 patients). The most common mistakes (percentages) were: (1) To use the standard triple therapy where it is ineffective (46%). (2) To prescribe eradication therapy for only 7 to 10 days (69%). (3) To use a low dose of proton pump inhibitors (48%). (4) In patients allergic to penicillin, to prescribe always a triple therapy with clarithromycin and metronidazole (38%). (5) To repeat certain antibiotics after eradication failure (>15%). (6) Failing to consider the importance of compliance with treatment (2%). (7) Not to check the eradication success (6%). Time-trend analyses showed progressive greater compliance with current clinical guidelines. CONCLUSION: The management of H. pylori infection by some European gastroenterologists is heterogeneous, frequently suboptimal and discrepant with current recommendations. Clinical practice is constantly adapting to updated recommendations, although this shift is delayed and slow.
- Published
- 2020
15. Pneumatosis Intestinalis in the Setting of COVID-19: A Single Center Case Series From New York
- Author
-
Santiago J. Miyara, Lance B. Becker, Sara Guevara, Claudia Kirsch, Christine N. Metz, Muhammad Shoaib, Elliot Grodstein, Vinay V. Nair, Nicholas Jandovitz, Alexia McCann-Molmenti, Kei Hayashida, Ryosuke Takegawa, Koichiro Shinozaki, Tsukasa Yagi, Tomoaki Aoki, Mitsuaki Nishikimi, Rishabh C. Choudhary, Young Min Cho, Stavros Zanos, Stefanos Zafeiropoulos, Hannah B. Hoffman, Stacey Watt, Claudio M. Lumermann, Judith Aronsohn, Linda Shore-Lesserson, and Ernesto P. Molmenti
- Subjects
medicine.medical_specialty ,Medicine (General) ,Coronavirus disease 2019 (COVID-19) ,molecular targeted therapy ,IL-6 inhibitor ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,ischemia-reperfusion injury ,Case Report ,Single Center ,Gastroenterology ,Pathogenesis ,tocilizumab ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Tocilizumab ,R5-920 ,Internal medicine ,Medicine ,Pneumatosis intestinalis ,pneumatosis intestinalis ,mesenteric ischemia ,business.industry ,SARS-CoV-2 ,Interleukin ,COVID-19 ,General Medicine ,medicine.disease ,chemistry ,Mesenteric ischemia ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,medicine.symptom ,business - Abstract
This case series reviews four critically ill patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [coronavirus disease 2019 (COVID-19)] suffering from pneumatosis intestinalis (PI) during their hospital admission. All patients received the biological agent tocilizumab (TCZ), an interleukin (IL)-6 antagonist, as an experimental treatment for COVID-19 before developing PI. COVID-19 and TCZ have been independently linked to PI risk, yet the cause of this relationship is unknown and under speculation. PI is a rare condition, defined as the presence of gas in the intestinal wall, and although its pathogenesis is poorly understood, intestinal ischemia is one of its causative agents. Based on COVID-19's association with vasculopathic and ischemic insults, and IL-6's protective role in intestinal epithelial ischemia–reperfusion injury, an adverse synergistic association of COVID-19 and TCZ can be proposed in the setting of PI. To our knowledge, this is the first published, single center, case series of pneumatosis intestinalis in COVID-19 patients who received tocilizumab therapy.
- Published
- 2021
16. Predictors of all-cause mortality within and beyond 1 year after an acute coronary syndrome
- Author
-
A Baroutidou, O Konstantas, Haralampos Karvounis, C Tsolakidis, S Graidis, Stefanos Zafeiropoulos, Georgios Giannakoulas, Santiago J. Miyara, G Psarakis, A Touriki, T Psathas, Ioannis Farmakis, E Vrana, O Kourti, and Anastasios Kartas
- Subjects
Acute coronary syndrome ,medicine.medical_specialty ,Epidemiology ,business.industry ,Internal medicine ,medicine ,Cardiology ,Cardiology and Cardiovascular Medicine ,medicine.disease ,business ,All cause mortality - Abstract
Funding Acknowledgements Type of funding sources: None. Background Patients discharged after an acute coronary syndrome (ACS) have substantial mortality risk, especially during the first year. Purpose To determine differences between first year and long-term all-cause mortality of patients after an ACS and identify its risk predictors. Methods This is a post-hoc analysis of the baseline data from 360 patients after ACS with a median follow up 3.2 years (IQR: 2.5-3.8) that enrolled in a prospective randomized controlled trial. Mortality rates with 95% confidence intervals (CIs) were estimated by Kaplan–Meier method. Multivariate Cox proportional hazards regression analyses of clinical parameters and cardiac biomarkers were performed to identify predictors for all-cause mortality within first year and thereafter. Results In our cohort, all-cause mortality incidence per 100 person-years at risk within and after first year was 4.9 and 2.1, respectively (RR = 2.3, p Conclusion We observed higher all-cause mortality rate during the first year, mainly driven by cardiovascular death. History of myocardial infarction and baseline NT-proBNP levels outperformed any other clinical variable or biomarker for long-term all-cause mortality in post-ACS patients. Predictors of long-term all-cause death Variables Univariate analysis Multivariate analysis HR (95% CI) P-value HR (95% CI) P-value Age per 1-year increase 1.06 (1.03 - 1.10) Abstract Figure. Kaplan-Meier for all-cause mortality
- Published
- 2021
17. An early experience on the effect of solid organ transplant status on hospitalized COVID‐19 patients
- Author
-
Nair, Vinay, Jandovitz, Nicholas, Hirsch, Jamie S., Abate, Mersema, Satapathy, Sanjaya K., Roth, Nitzan, Miyara, Santiago J., Guevara, Sara, Kressel, Adam M., Xiang, Alec, Wu, Grace, Butensky, Samuel D., Lin, David, Williams, Stephanie, Bhaskaran, Madhu C., Majure, David T., Grodstein, Elliot, Lau, Lawrence, Nair, Gayatri, Fahmy, Ahmed E., Winnick, Aaron, Breslin, Nadine, Berlinrut, Ilan, Molmenti, Christine, Becker, Lance B., Malhotra, Prashant, Gautam‐Goyal, Pranisha, Lima, Brian, Maybaum, Simon, Shah, Samit K., Takegawa, Ryosuke, Hayashida, Kei, Shinozaki, Koichiro, Teperman, Lewis W., Molmenti, Ernesto P., Birabaharan, Morgan, Bodenheimer, Henry C., Bolourani, Siavash, Caruso, Vincenza A., Cohen, Stuart L., Dominello, Andrew J., Falzon, Louise, Cookingham, Jennifer, Johnson, Jennifer C., Minaya, Josue, Keel, Trey, Khatri, Akshay, Koshy, Robin V., Kozel, Zachary M., Kvasnovsky, Charlotte, Lesser, Martin, Maria, Naomi I., Mogavero, Jazmin N., Monane, Rachel, Najjar, Salem, Ng, Jia, Saif, M. Wasif, Sheppard, Acacia, Sison, Cristina, Stevens, Gerin R., Tan, Dylan, and Vullaganti, Sirish
- Subjects
Adult ,medicine.medical_specialty ,Prognostic variable ,medicine.medical_treatment ,Population ,030230 surgery ,Logistic regression ,Article ,Organ transplantation ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Clinical endpoint ,Humans ,Immunology and Allergy ,Pharmacology (medical) ,education ,Immunosuppression Therapy ,Mechanical ventilation ,education.field_of_study ,Transplantation ,SARS-CoV-2 ,business.industry ,COVID-19 ,Organ Transplantation ,Odds ratio ,Transplant Recipients ,business ,Body mass index - Abstract
We compared the outcome of COVID-19 in immunosuppressed solid organ transplant (SOT) patients to a transplant naïve population. In total, 10 356 adult hospital admissions for COVID-19 from March 1, 2020 to April 27, 2020 were analyzed. Data were collected on demographics, baseline clinical conditions, medications, immunosuppression, and COVID-19 course. Primary outcome was combined death or mechanical ventilation. We assessed the association between primary outcome and prognostic variables using bivariate and multivariate regression models. We also compared the primary endpoint in SOT patients to an age, gender, and comorbidity-matched control group. Bivariate analysis found transplant status, age, gender, race/ethnicity, body mass index, diabetes, hypertension, cardiovascular disease, COPD, and GFR
- Published
- 2021
- Full Text
- View/download PDF
18. Reinforcing adherence to lipid-lowering therapy after an acute coronary syndrome: A pragmatic randomized controlled trial
- Author
-
Stefanos Zafeiropoulos, Anastasios Kartas, Areti Pagiantza, Haralambos Karvounis, Aristi Boulmpou, Stavros Zanos, Konstantinos Arvanitakis, Santiago J. Miyara, Eleftherios Markidis, Alexandra Arvanitaki, Diamantis Kosmidis, Vassileios Nevras, Ioannis Papadimitriou, Athina Tampaki, Anastasia Vlachou, Ernesto P. Molmenti, George Giannakoulas, Ioannis Farmakis, George Kassimis, and Antonios Ziakas
- Subjects
0301 basic medicine ,Male ,medicine.medical_specialty ,Acute coronary syndrome ,Motivational interviewing ,030204 cardiovascular system & hematology ,law.invention ,Odds ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Intervention (counseling) ,Internal medicine ,medicine ,Secondary Prevention ,Humans ,Acute Coronary Syndrome ,Dyslipidemias ,business.industry ,Odds ratio ,Cholesterol, LDL ,Middle Aged ,medicine.disease ,Confidence interval ,030104 developmental biology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Dyslipidemia - Abstract
Background and aims Achieving the low-density lipoprotein cholesterol (LDL-C) goal following an acute coronary syndrome (ACS) is a milestone often missed due to suboptimal adherence to secondary prevention treatments. Whether improved adherence could result in reduced LDL-C levels is unclear. We aimed to evaluate whether an educational-motivational intervention increases long-term lipid-lowering therapy (LLT) adherence and LDL-C goal attainment rate among post-ACS patients. Methods IDEAL-LDL was a parallel, two-arm, single-center, pragmatic, investigator-initiated randomized controlled trial. Hospitalized patients for ACS were randomized to a physician-led integrated intervention consisting of an educational session at baseline, followed by regular motivational interviewing phone sessions or usual care. Co-primary outcomes were the LLT adherence (measured by Proportion of Days Covered (PDC); good adherence defined as PDC>80%), and LDL-C goal ( Results In total, 360 patients (mean age 62 years, 81% male) were randomized. Overall, good adherence was positively associated with LDL-C goal achievement rate at one year. Median PDC was higher in the intervention group than the control group [0.92 (IQR, 0.82–1.00) vs. 0.86 (0.62–0.98); p = 0.03] while the intervention group had increased odds of good adherence (odds ratio: 1.76 (95% confidence interval 1.02 to 2.62; p = 0.04). However, neither the LDL-C goal achievement rate (49.6% in the intervention vs. 44.9% in the control group; p = 0.49) nor clinical outcomes differed significantly between the two groups. Conclusions Α multifaceted intervention improved LLT adherence in post-ACS patients without a significant difference in LDL-C goal attainment.
- Published
- 2021
19. Low-blood lymphocyte number and lymphocyte decline as key factors in COPD outcomes: a longitudinal cohort study
- Author
-
Barbara Buldini, Jose M. Marin, Umberto Semenzato, Erica Bazzan, Davide Biondini, Graziella Turato, Manuel G. Cosio, Dario Gregori, Marina Saetta, Elisabetta Balestro, Marta Marin-Oto, Santiago J Carizzo, Alvise Casara, Simonetta Baraldo, Mariaenrica Tinè, and Pablo Cubero
- Subjects
Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Lymphocyte ,Pathogenesis ,Pulmonary Disease, Chronic Obstructive ,Risk Factors ,Forced Expiratory Volume ,Neoplasms ,Internal medicine ,medicine ,Humans ,Longitudinal Studies ,Lymphocyte Count ,COPD ,Lymphocyte decline ,Proportional hazards model ,business.industry ,Incidence (epidemiology) ,Smoking ,Cancer ,COPD survival ,Middle Aged ,Prognosis ,medicine.disease ,COPD outcomes ,respiratory tract diseases ,medicine.anatomical_structure ,Respiratory failure ,Cohort ,Female ,business - Abstract
Background: Smokers with and without chronic obstructive pulmonary disease (COPD) are at risk of severe outcomes like exacerbations, cancer, respiratory failure, and decreased survival. The mechanisms for these outcomes are unclear; however, there is evidence that blood lymphocytes (BL) number might play a role. Objective: The objective of this study is to investigate the relationship between BL and their possible decline over time with long-term outcomes in smokers with and without COPD. Methods: In 511 smokers, 302 with COPD (COPD) and 209 without COPD (noCOPD), followed long term, we investigated whether BL number and BL decline over time might be associated with long-term outcomes. Smokers were divided according to BL number in high-BL (≥1,800 cells/µL) and low-BL (Results: BL count was lower in COPD (1,880 cells/µL) than noCOPD (2,300 cells/µL; p < 0.001). 43% of COPD and 23% of noCOPD had low-BL count (p < 0.001). BL decline over time was higher in COPD than noCOPD (p = 0.040). 22.5% of the whole cohort developed cancer which incidence was higher in low-BL subjects and in BL decliners than high-BL (31 vs. 18%; p = 0.001) and no decliners (32 vs. 19%; p = 0.002). 26% in the cohort died during follow-up. Furthermore, low-BL count, BL decline, and age were independent risk factors for mortality by Cox regression analysis. Conclusion: BL count and BL decline are related to worse outcomes in smokers with and without COPD, which suggests that BL count and decline might play a mechanistic role in outcomes deterioration. Insights into mechanisms inducing the fall in BL count could improve the understanding of COPD pathogenesis and point toward new therapeutic measures.
- Published
- 2021
20. Intravenous immunoglobulin treatment for mild Guillain-Barré syndrome. An international observational study
- Author
-
Verboon, C., Harbo, T., Cornblath, D. R., Hughes, R. A. C., Van Doorn, P. A., Lunn, M. P., Gorson, K. C., Barroso, F., Kuwabara, S., Galassi, G., Lehmann, H. C., Kusunoki, S., Reisin, R. C., Binda, D., Cavaletti, G., Andersen, Jacobs B. C. H., PhD (Aarhus University Hospital, Aarhus, Denmark), Attarian, S., PhD (CHU Timone, Marseille, France), Badrising, U. A., PhD (Leiden University Medical Centre, Leiden, The, Netherlands), Bateman, K., PhD (Groote Schuur Hospital, Cape, Town, South-Africa), Benedetti, L., PhD (Ospedale Sant’ Andrea La Spezia, Spezia, La, Italy), van den Berg, B., MD (Franciscus Gasthuis, Rotterdam, Van den Bergh, P., Luc, PhD (University Clinic St., Leuven, Belgium), Bertorini, T. E., MD (The University of Tennessee Health Science Center (UTHSC), Memphis, USA), Bhavaraju-Sanka, R., MD (University Hospital/ University of Texas Health Science Center, San Antonio Texas, USA), Bianco (Milan University, M., Humanitas Clinicala and Research Institute Milan, Briani, C., MD (University of Padova, Padova, Italy), Bürmann, J., MD (Universitätsklinikum des Saarlandes, Homburg, Germany), Casasnovas, C., Ciberer, PhD (Bellvitge University Hospital - IDIBELL Neurometabolic Diseases Group., Barcelona, Spain), Chao, C. C., PhD (National Taiwan University Hospital, Taipei, Taiwan), Chavada, G., PhD (Glasgow University, Glasgow, UK), Claeys, K. G., University Hospitals Leuven, PhD (1., Leuven, Belgium, KU Leuven, 2., Cosgrove, J. S., MD (Leeds General Infirmary, Leeds, UK), Dalakas, M. C., Thomas Jefferson University, MD (1., Philadelphia, Usa, National and Kapodistrian University of Athens, 2., Athens, Greece), Davidson, A., MD (University of Glasgow, van Dijk, G. W., MD (Canisius Wilhelmina Hospital, Nijmegen, Dardiotis, E., MD (University of Thessaly, Hospital of Larissa, Larissa, Greece), Derejko, M., MD (Odense University Hospital, Odense, Denmark), Dimachkie, M. M., MD (University of Kansas Medical Center, Kansas, City, Dornonville de la Cour, C., MD (National Hospital Copenhagen, Copenhagen, Denmark), Echaniz-Laguna, A., MD (Bicêtre University Hospital, Paris, France), Eftimov, F., PhD (Amsterdam University Medical Centre, Amsterdam, Faber, C. G., PhD (Maastricht University Medical Centre, Maastricht, Fazio, R., MD (Scientific Institute San Raffaele, Milan, Italy), Fulgenzi, J. Fehmi (University of Oxford E. A., MD (Hospital Cesar Milstein Buenos Aires, Buenos, Aires, Argentina), García-Sobrino, T., MD (Hospital Clínico de Santiago, Santiago de Compostela (A Coruña), Spain), Gijsbers, C. J., MD (Vlietland Hospital, Schiedam, Granit, V., MD (Montefiore Medical, Center, New, York, Grisanti, S., MD (Ospedale Sant’ Andrea La Spezia, Gutiérrez-Gutiérrez, G., MD (Hospital Universitario Infanta Sofia, San, Sebastian, Holbech, J. V., PhD (Odense University Hospital, Holt, J. K. L., Phd, FRCP (The Walton Centre, Liverpool, UK), Homedes, C., Ciberer, MD (Bellvitge University Hospital - IDIBELL Neurometabolic Diseases Group., Islam, B., PhD (International Centre for Diarrhoeal Disease Research, Bangladesh, (icddr, Dhaka, b), Bangladesh), Islam, Z., Jahan, I., PhD candidate (International Centre for Diarrhoeal Disease Research, Jericó Pascual, I., PhD (Complejo Hospitalario de Navarra, Pamplona, Spain), Karafiath, S., MD (University of Utah School of Medicine, Salt Lake City, Kerkhoff, H., PhD (Albert Schweitzer Hospital, Dordrecht, Kimpinski, K., MD (University Hospital, Lhsc, London-Ontario, Canada), Kohler, A., MD (Instituto de Investigaciones Neurológicas Raúl Carrea, Fleni, Kolb, N., MD (University of Vermont, Burlington, Vt, Kuitwaard, K., Albert Schweitzer Hospital, PhD (1., Erasmus MC, 2., Kuwahara, M., PhD (Kindai University, Osaka, Japan), Ladha, S. S., MD (Barrow Neurology Clinics, Phoenix, Arizona, Lee Pan, E., MBChB (Groote Schuur Hospital, Marfia, G. A., MD (Neurological Clinic, Policlinico Tor Vergata, Rome, Italy), Magot, A., MD (Reference Centre for NMD, Nantes University Hospital, France), Márquez Infante, C., MD (Hospital Universitario Virgen del Rocio, Seville, Spain), Martín-Aguilar, L., MD (Hospital de la Santa Creu, i Sant Pau, Universitat Autònoma de Barcelona, Martinez Hernandez, E., MD (Institut d’Investigacions Biomèdiques August Pi, i Sunyer (IDIBAPS), Hospital, Clinic, Mataluni, G., PhD (Neurological Clinic, Meekins, G., MD (University of Minnesota, Miller, J. A. L., PhD (Royal Victoria Infirmary, Newcastle, UK), Monges, M. S., Garrahan, MD (Hospital de Pediatría J. P., Nobile Orazio, E., PhD (Milan University, Pardal, A., MD (Hospital Britanico, Pardo Fernandez (Hospital Clínico de Santiago, J., Péréon, Y., PhD (Reference Centre for NMD, Pulley, M., MD (University of Florida, Jacksonville, USA), Querol Gutierrez, L., PhD (Hospital de la Santa Creu, i Sant Pau, Reddel, S. W., PhD (Concord Repatriation General Hospital, Sydney, Australia), van der Ree, T., (Westfriesgasthuis, Md, Hoorn, Rinaldi, S., Mbchb, Samijn, PhD (University of Oxford J. P. A., MD (Maasstad Hospital, Samukawa, M., Santoro, L., PhD (University Federico II, Napels, Italy), Savransky, A., Garrahan, PhD (Hospital de Pediatría J. P., Schwindling, L., Sedano Tous, M. J., MD (Hospital Universitario Marques de Valdecilla, Santander, Cantabria, Sekiguchi, Y., PhD (Chiba University, Chiba, Japan), Shahrizaila, N., MD (Neurology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Malaya), Silvestri, N. J., Sindrup, MD (Buffalo Jacobs School of Medicine S., Sommer, C. L., MD (Universitätsklinikum Würzburg, Würzburg, Germany), Spyropoulos (Royal Victoria Infirmary, A., Stein, B., Joseph’s Regional Medical Center, MD (St., Paterson, USA), Tan, C. Y., MRCP (Neurology Unit, Tankisi, H., Vermeij, F., Vytopil, M. V., Wirtz, PhD (Tufts University School of Medicine Lahey Hospital P. W., Phd, (HagaZiekenhuis, The, Hague, Waheed, W., MD (University of Vermont Medical Center, Burlington, Addington, USA). Other collaborators were:J. M., MD (University of Virginia, Charlottesville, USA), Ajroud-Driss, S., MD (Northwestern University Feinberg, Chicago, USA), Antonini, G., MD (Mental Health and Sensory Organs (NESMOS), Sapienza, University, Sant’Andrea, Hospital, Bella, I. R., MD (University of Mass Medical School, Worcester, USA), Brannagan, T. H., MD (Columbia University, New York City, Bunschoten, C., PhD candidate (Erasmus University Medical Centre, Busby, M., Bradford, UK), Butterworth, S., MD (Pinderfields Hospital, Wakefield, UK), Conti, M. E., MD (University Hospital Clinicas, Chen, S., Phd, (Rutgers, Robert Wood Johnson University Hospital, New, Brunswick, Doets, A., Feasby, T. E., MD (University of Calgary, Calgary, Canada), Fokke, C., MD (Gelre Hospital, Zutphen and Apeldoorn, Fujioka, T., MD (Toho University Medical Center, Tokyo, Japan), Garssen, M. P. J., PhD (Jeroen Bosch Hospital, Hertogenbosch, ’S, Gilchrist, J. M., MD (Soulthern Illinois University School of Medicine, Springfield, USA), Gilhuis, J., PhD (Reinier de Graaf Gasthuis, Delft, Goldstein, J. M., MD (Yale University School of Medicine, New, Haven, Goyal, N. A., MD (University of California, Irvine, USA), Hadden, R. D. M., PhD (King’s College Hospital, London, UK), Hsieh, S. T., Htut, M., George’s Hospital, MD (St., Illa, I., Jellema, K., PhD (Haaglanden Medisch Centrum, Kaida, K., PhD (National Defense Medical College, Saitama, Japan), Katzberg, H. D., MD (University of Toronto, Toronto, Canada), Kiers, L., MD (University of Melbourne, Royal Melbourne Hospital, Parkville, Australia), Kokubun, N., MD (Dokkyo Medical University, Tochigi, Japan), van Koningsveld, R., PhD (Elkerliek Hospital, Helmond and Deurne, van der Kooi, A. J., Kwan, J. Y., MD (University of Maryland School of Medicine, Baltimore, USA), Landschoff Lassen, L., MD (Glostrup Hospital, Glostrup, Denmark), Lawson, V., MD (Wexner Medical Center at The Ohio State University, Columbus, USA), Leonhard, S. E., Mandarakas, M., PhD (Erasmus University Medical Centre, Manji, H., FRCP (Ipswich Hospital, Ipswich, UK), Mattiazzi, M. G., MD (Hospital Militar Central, Mcdermott, C. J., MD (Royal Hallamshire Hospital, Nihr, Clinical, Sheffield, UK), Mohammad, Q. D., PhD (National Institute of Neurosciences and Hospital, Dhaka, Bangladesh), Morís de la Tassa, G., MD (Hospital UniversitarioCentral de Asturias, Asturias, Spain), Nascimbene, C., PhD (Luigi Sacco Hospital, Niks, E. H., Nowak, R. J., Osei-Bonsu, M., PhD (James Cook University Hospital, Middlesbrough, UK), Pascuzzi, R. M., MD (University of Indiana School of Medicine, Indianapolis, USA), Roberts, R. C., MD (Addenbrooke’s Hospital Cambridge, Cambridge, UK), Rojas-Marcos, I., MD (Hospital Univesitario Reina Sofia, Cordoba, Spain), Roodbol, J., Rudnicki, S. A., MD (University of Arkansas, Fayetteville, USA), Sachs, G. M., MD (University of Rhode Island, Providence, USA), Schenone, A., Department of Neurosciences, PhD (1., Rehabilitation, Ophthalmology, Genetics and Maternal and Infantile Sciences (DINOGMI), University of Genova, Genova, IRCCS Policlinico San Martino, Italy 2., Genova, Italy), Sheikh, K., PhD (The University of Texas Health Science Center at Houston, Houston, USA), Twydell, P., DO (Spectrum Health System, Grand, Rapids, Van Damme, P., PhD (University Hospital Leuven, Varrato, J. D., DO (Lehigh Valley Health Network, Allentown, USA), Visser, L. H., PhD (Elisabeth-TweeSteden Hospital, Tilburg and Waalwijk, Willison, H. J., PhD (University of Glasgow, van Woerkom (Erasmus MC, M., Zhou, L., PhD (Icahn School, Verboon, C, Harbo, T, Cornblath, D, Hughes, R, Van Doorn, P, Lunn, M, Gorson, K, Barroso, F, Kuwabara, S, Galassi, G, Lehmann, H, Kusunoki, S, Reisin, R, Binda, D, Cavaletti, G, Jacobs, B, consortium, IGOS, consortium, GOS, Neurosurgery, Neurology, and Immunology
- Subjects
Adult ,Male ,medicine.medical_specialty ,intravenous immunoglobulins ,DIAGNOSIS ,Guillain-Barre Syndrome ,Settore MED/26 ,DISEASE ,Disease course ,Disability Evaluation ,03 medical and health sciences ,0302 clinical medicine ,SDG 3 - Good Health and Well-being ,hemic and lymphatic diseases ,Internal medicine ,Clinical endpoint ,medicine ,Humans ,In patient ,guillain-barré syndrome ,030212 general & internal medicine ,NEUROPATHIES ,biology ,Guillain-Barre syndrome ,business.industry ,Guillain-Barré syndrome (GBS), treatment, course ,Confounding ,Immunoglobulins, Intravenous ,Middle Aged ,medicine.disease ,Confidence interval ,Psychiatry and Mental health ,Treatment Outcome ,biology.protein ,Female ,Surgery ,Observational study ,Neurology (clinical) ,Antibody ,business ,030217 neurology & neurosurgery - Abstract
ObjectiveTo compare the disease course in patients with mild Guillain-Barré syndrome (GBS) who were treated with intravenous immunoglobulin (IVIg) or supportive care only.MethodsWe selected patients from the prospective observational International GBS Outcome Study (IGOS) who were able to walk independently at study entry (mild GBS), treated with one IVIg course or supportive care. The primary endpoint was the GBS disability score four weeks after study entry, assessed by multivariable ordinal regression analysis.ResultsOf 188 eligible patients, 148 (79%) were treated with IVIg and 40 (21%) with supportive care. The IVIg group was more disabled at baseline. IVIg treatment was not associated with lower GBS disability scores at 4 weeks (adjusted OR (aOR) 1.62, 95% CI 0.63 to 4.13). Nearly all secondary endpoints showed no benefit from IVIg, although the time to regain full muscle strength was shorter (28 vs 56 days, p=0.03) and reported pain at 26 weeks was lower (n=26/121, 22% vs n=12/30, 40%, p=0.04) in the IVIg treated patients. In the subanalysis with persistent mild GBS in the first 2 weeks, the aOR for a lower GBS disability score at 4 weeks was 2.32 (95% CI 0.76 to 7.13). At 1 year, 40% of all patients had residual symptoms.ConclusionIn patients with mild GBS, one course of IVIg did not improve the overall disease course. The certainty of this conclusion is limited by confounding factors, selection bias and wide confidence limits. Residual symptoms were often present after one year, indicating the need for better treatments in mild GBS.
- Published
- 2021
21. Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease
- Author
-
Ridker PM, Everett BM, Thuren T, MacFadyen JG, Chang WH, Ballantyne C, Fonseca F, Nicolau J, Koenig W, Anker SD, Kastelein JJP, Cornel JH, Pais P, Pella D, Genest J, Cifkova R, Lorenzatti A, Forster T, Kobalava Z, Vida-Simiti L, Flather M, Shimokawa H, Ogawa H, Dellborg M, Rossi PRF, Troquay RPT, Libby P, Glynn RJ, Novo S, Krum H, Varigos J, Siostrzonek P, Sinnaeve P, Gotcheva N, Yong H, Urina-Triana M, Milicic D, Vettus R, Manolis AJ, Wyss F, Sigurdsson A, Fucili A, Veze I, Petrauskiene B, Salvador L, Klemsdal TO, Medina F, Budaj A, Otasevic P, Lainscak M, Seung KB, Commerford P, Donath M, Hwang JJ, Kultursay H, Bilazarian S, East C, Forgosh L, Harris B, Ligueros M, Bohula E, Charmarthi B, Cheng S, Chou S, Danik J, McMahon G, Maron B, Ning M, Olenchock B, Pande R, Perlstein T, Pradhan A, Rost N, Singhal A, Taqueti V, Wei N, Burris H, Cioffi A, Dalseg AM, Ghosh N, Gralow J, Mayer T, Rugo H, Fowler V, Limaye AP, Cosgrove S, Levine D, Lopes R, Scott J, Hilkert R, Tamesby G, Mickel C, Manning B, Woelcke J, Tan M, Manfreda S, Ponce T, Kam J, Saini R, Banker K, Salko T, Nandy P, Tawfik R, O’Neil G, Manne S, Jirvankar P, Lal S, Nema D, Jose J, Collins R, Bailey K, Blumenthal R, Colhoun H, Gersh B, Abreu M, Actis MV, Aiub J, Aiub F, Albisu J, Alvarisqueta A, Avalos V, Barreto M, Berli MA, Blumberg C, Bocanera M, Botta C, Bowen L, Budassi N, Buhlman S, Westberg JC, Carabajal T, Caruso G, Casala J, Cendali G, Coloma G, Berra FC, Cuneo C, Degennaro N, Dellasa M, Diaz M, Dos Santos P, Espinosa V, Facello A, Facello M, Farias E, Fernandez AA, Ferrari V, Pacora FF, Flores GS, Franco M, Gabito A, Viola HG, Garcia F, Garcia Duran R, Garcia Pinna J, Glenny J, Godoy Sanchez M, Grosse A, Guzman P, Hasbani E, Hominal M, Ibañez J, Jure H, Jure D, Vico ML, Liniado G, Luciardi H, Luquez H, Maehara G, Maffei L, Majul C, Mallagray M, Marinaro S, Martinez J, Massaccesi R, De Los Milagros Had M, Azize GM, Montana O, Montenegro E, Morell Y, Muntaner J, Navarrete S, Olmedo M, Paganini M, Paz S, Perez Manghi F, Piskorz D, Polato C, Recoaro R, Romano A, Salinger M, Sanchez A, Saravia MA, Sarjanovich R, Scaro G, Schiavi LB, Soler J, Tinnirello V, Tomassi A, Valle M, Vallejo MA, Venturini C, Marcela Wenetz LM, Yossen M, Zaidman C, Zalazar L, Zangroniz P, Amerena J, Brady L, Colquhoun D, Eccleston D, Ferreira-Jardim A, French J, Jayasinghe R, Mcintosh C, Ord M, Plotz M, Purnell P, Roberts-Thomson P, Schultz C, Shanahan T, Tan R, Taverner P, Turner F, Vibert J, Vorster M, William M, Youssef G, Bergler-Klein J, Brath H, Brodmann M, Fliesser-Goerzer E, Haider K, Heeren G, Hiden C, Mandic L, Paulweber B, Ploechl A, Prenner A, Steringer-Mascherbauer R, Strohner-Kaestenbauer H, Barbato E, Bouvy C, Briké C, Charlier F, Cools F, De Knijf K, De Wolf L, Delforge M, Deweerdt N, Gits F, Goffinet C, Hermans K, Hollanders G, Mestdagh I, Pirenne B, Servaes V, Simons N, Tahon S, Theunissen E, Van Genechten G, Vervoort G, Vissers C, Vranckx P, Vrolix M, Abib E Jr, Abrantes J, Araujo Fonseca M, Barbosa E, Barroso W, Barroso A, Bodanese L, Botelho R, Costa Amorim R, Da Costa F, Da Silva A, Da Silva O Jr, Da Silva D Jr, Ferreira Dos Santos T, Dos Santos F, Dos Santos A, Duda N, Feitosa G, Felario Junior GA, Ferraz R, Filho P, Fonseca A, Wanderley FF, Freitas E, Fucci F, Marengo Garcia De Carvalho L, Hernandez M, Hettwer Magedanz E, Julião K, Kormann A, Lameira A, Lima F, Lino E, Maia L, Manenti E, Marchi AL, Fischer SM, Michalaros Y, Moraes J Jr, Moreira L, Pagnan M, Pesce F, Pinheiro L, Rassi S, Reis G, Reis H, Resende I, Roel A, Ruschel K, Saporito W, Saraiva JF, Seroqui M, Silva R, Unterkircher B, Vicente C, Vieira N, Xavier JP, Zucchetti C, Angelova I, Dimitrov G, Genova D, Gospodinov K, Goudev A, Grigorova V, Hristova K, Makedonska JJ, Katova T, Kostov K, Lazov P, Manov E, Manukov I, Manukov D, Milanova M, Kabakchieva VM, Petrov D, Petrusheva T, Pramatarova I, Raev D, Runev N, Sirakova-Taseva A, Tisheva-Gospodinova S, Todorova A, Tzekova M, Yakovova S, Yanev T, Abulencia K, Arora S, Baker A, Bata IR, Beaudry M, Belle Isle J, Bilodeau N, Boivin MC, Bolduc H, Bourgeois S, Brons S, Cantor W, Chaussé I, Chhabra A, Chouinard G, Cleveland T, Dattani D, Deslongchamps F, Diodati J, Drouin K, Duchesne L, Fontaine S, d'Amours DG, Gervais B, Gosselin G, Graham J, Grover A, Gupta A, Haldane H, Hartleib M, Hickey L, Huynh T, Johnston J, Julien VE, Lachance P, Lake J, Lamontagne C, Lauzon C, Lepage S, Maheux K, Manyari D, Martin E, McPherson C, Mehta S, Michaud N, Kouz SM, Murphy G, OKeefe D, Otis R, Ouimet F, Pandey S, Peck C, Perkins L, Richert L, Robbins K, Robinson S, Cabau JR, Ross B, Roy C, Roy M, Roy A, Rupka D, Affaki GS, Saunders K, Savard D, Soucy D, St Amour E, Thiessen S, Vertes G, Vezina M, Vincelli G, Weisnagel SJ, Zadra R, Chen J, Chen Y, Dong X, Feng Y, Feng Z, Fu G, Han B, Hao Y, He Y, He Z, Hong T, Jia Z, Jiang T, Jiang J, Jiang X, Ke Y, Li Y, Li Z, Li W, Li X, Liu P, Liu Y, Liu B, Liu S, Liu L, Lu Z, Lv Y, Ma C, Ma G, Peng L, Qing L, Ren L, Sang X, Song M, Sun Z, Wang J, Wang Y, Wei J, Wu W, Wu J, Xu H, Yan J, Yang P, Yang K, Yao Z, Yaoqing H, Yuan Z, Zhai Z, Zhang J, Zhang Y, Zhao R, Zhou H, Accini Mendoza JL, Aparicio CV, Castillo T, Chaverra I, Conrado Y, Coronel J, Cotes C, Cuentas I, Cuervo A, Dussan MA, Echeverria L, Hernandez E, Ibarra J, Isaza D, Jimenez D, Lopez P, Manzur F, Mejia I, Mendoza Y, Molina DI, Patino JM, Rodriguez D, Rodriguez LM, Rodriguez SM, Sanchez Vallejo G, Luz Serrano H, Sotomayor A, Urina M, Vesga B, Yupanqui H, Akrap B, Busic N, Ciglenecki N, Cmrecnjak J, Fucak E, Gabor M, Jeric M, Jutrisa N, Kordic K, Planinc I, Popovic Z, Radeljic V, Sesto I, Sutalo K, Tusek S, Belohlavek J, Budkova J, Busak L, Capova L, Cech V, Cermak O, Coufalova Z, Cyprian R, Dedek V, Dedkova S, Ferkl R, Hanak P, Hanustiakova A, Homza M, Horackova K, Houra M, Iveta H, Kaiserova L, Kala P, Karel I, Kellnerova I, Koleckar P, Kreckova M, Krupicka J, Lorenc Z, Machova V, Malik J, Masarikova L, Matyasek I, Mikus M, Mikusova T, Ondrasik J, Otava M, Palubova L, Pavlickova L, Peterka M, Petrova I, Pokorna B, Povolny P, Radvan M, Reznakova S, Rickova Z, Roszkowska P, Rotreklova M, Samkova D, Skalicka H, Slechticka A, Sternthal P, Telekes P, Tesak M, Vesely P, Vesely J, Vins P, Vitovec M, Vodnansky P, Zidova M, Keba E, Laane E, Pool T, Randvee L, Ratnik E, Reimand M, Reinmets S, Rivis L, Siemann M, Stern M, Toom M, Vahula V, Apel T, Axthelm C, Ayasse D, Ayasse M, Baar M, Baeumer A, Bagi ES, Becker B, Binder A, Blankenberg S, Braun P, Johansen BB, Contzen C, Delfonso F, Denecke C, Dengler T, Donaubauer T, Eichinger G, Englmann E, Erhard M, Faghih M, Foerster A, Frankenstein L, Fuchs R, Furch G, Gaeb-Strasas B, Germann H, Giese C, Goette A, Gravenhorst-Muenter U, Haege R, Haenel T, Hagemann D, Hagenow A, Hanefeld M, Heider J, Heisters J, Hennig D, Hielscher S, Himpel-Boenninghoff A, Holscher A, Hornig M, Jeserich M, Kaczmarek N, Kanitz S, Kara YD, Khariouzov A, Kiefer R, Kiroglu K, Klamm M, Klein C, Korth-Wiemann B, Krapivsky A, Kuenzler J, Kuntzsch A, Landers B, Lappo M, Laube S, Leggewie S, Lehmann D, Lepp H, Lierse T, Lindner C, Luecke-Uzar M, Luedemann J, Marschke T, Maruzzo S, Mauersberger K, Maus O, Meinrich M, Meissner A, Moehring B, Muehlhaus J, Mueller S, Muenter KC, Muenzel T, Naumann R, Nebel J, Neumann J, Nuding S, Overhoff U, Papke B, Pencz I, Peter Y, Peukert AM, Radde I, Rau T, Regner S, Reichenbach D, Reimer D, Rinke A, Roettges R, Romanski A, Rummel R, Samer H, Sanuri M, Sarnighausen HE, Schäfer B, Scheibner T, Schermaul KH, Schindler A, Schlundt C, Schmidt E, Schmidt K, Schnabel A, Schoen N, Schorn K, Schroeder T, Schulenburg D, Schulz M, Schulze U, Schulze J, Schumacher M, Schwerin G, Schwerin M, Stadelmeier S, Stahl HD, Stahl A, Stockhausen J, Stockhausen G, Stoessel J, Stolze K, Stratmann M, Szymanowski N, Teschner AB, Teske A, Uecker C, Veit S, Voeller H, Walter I, Walter J, Walther I, Weber HG, Weimer J, Wichterich K, Wiebusch A, Willmerdinger M, Willner C, Winkelmann B, Winkler J, Wistuba T, Woehrle J, Wohnlich T, Wolf S, Woyczak D, Wrage P, Zirlik A, Anadiotis A, Chachalis G, Dermitzakis A, Kafarakis P, Kaldara E, Kolokathis F, Kostakou P, Lekakis J, Manolis A, Mantas I, Megalou A, Milkas A, Nanas J, Olympios CD, Patsilinakos S, Perperis A, Poulimenos L, Saloustros I, Tsioufis K, Tsorbatzoglou K, Vardas P, Zarifis I, Aguilar M, Arango JL, Borrayo NA, Corona V, Guerrero A, Guzman I, Haase F, De Krumbach L, Montenegro P, Munoz R, Munoz N, Paniagua A, Solares A, Vogel M, Anita S, Blazsek Z, Decsi K, Fulop T, Hangyal T, Hegedus V, Kalina A, Karakai H, Katona A, Kiss RG, Kovacs A, Laszlo Z, Lupkovics G, Medvegy M, Merkely B, Mihaly N, Nagy AC, Dékány JN, Nikoletta P, Noori E, Penzes J, Poor F, Sarszegi Z, Simay A, Simon J, Szakal I, Szatmarine V, Szocs A, Zilahi Z, Karsai XZ, Andersen K, Sigurdadottir E, Skuladottir F, Abdullakutty J, Abhaichand R, Abhyankar A, Agarwal DK, Aggarwal RK, Ahire N, Awasthi AK, Babu R, Bai A, Bali HK, Banker D, Bhadade S, Bisne V, Bohra P, Raghu C, Chauhan D, Chauhan H, Chavada J, Chaware G, Chella S, Chintala P, Dash D, Desai D, Devasia T, Dhanak R, Dobariya H, Dudhatra N, Duhan S, Fulwani M, Ghondale N, Ghosh S, Gohel P, Govindaraj D, Goyal B, Goyal S, Gundala AK, Gupta M, Hardas S, Iby M, Jagtap P, Jain A, Joshi U, Karpuram M, Kaur H, Khan A, Khan R, Kodem DR, Koeitti P, Kulkarni L, Kullal P, Kumar KS, Kumbla M, Latheef K, Lohkare M, Santosh MJ, Makhe B, Mandati M, Mehta A, Minocha G, Mittal A, Modi R, Mohan K, Oomman A, Pai R, Pai V, Palaniswami N, Pansheriya A, Parekh N, Patel J, Patel R, Patole T, Praveen M, Radhakrishnan V, Rajan B A, Rajasekhar D, Rao M, Rao MB, Rao NM, Rathnavel S, Rathore A, Rathore SRS, Rawat S, Reddy NC, Sarma R, Sathe S, Shah J, Shaikh P, Sharma K, Sharma S, Sharma T, Shetty P, Sidhu G, Singh V, Sohi GS, Srinath VS, Raju SS, Taran A, Thakkar B, Velusamy K, Vijan V, Vora V, Vuriya AK, Agosta GF, Antonicelli R, Ardissino D, Argiolas G, Baldin MG, Benedetti G, Berti S, Bevilacqua MT, Bolognesi MG, Dessalvi CC, Calabrese A, Campanale EG, Candusso R, Caso P, Cosmi F, Crea F, Crocamo A, De Caterina R, De Rosa S, Destro M, Di Biase M, Dognini GP, Eleuteri E, Fedele F, Ferrario M, Gabrielli D, Gamba C, Ganau A, Gravellone M, Iannopollo G, Indolfi C, Infusino F, Invitti C, Landolfi A, Lembo G, Liberato NL, Mannucci E, Marino P, Mariottoni B, Marziali A, Mercuro G, Monti L, Mos L, Mureddu V, Musumeci MB, Panzarino C, Parente A, Perotti M, Filardi PP, Petrillo C, Piatti P, Priori S, Racca V, Ragghianti B, Renda G, Righini V, Sarcone M, Senni M, Soro E, Tamburrini P, Vallone L, Villani GQ, Volpe M, Ajioka M, Akai Y, Ashino K, Baden M, Doi M, Eki Y, Endo T, Fukuike C, Hagiwara Y, Hasegawa K, Higuchi Y, Higuchi T, Hioki M, Hirayama A, Hiroma J, Hosokawa S, Ichisawa M, Iijima T, Inada T, Inagaki M, Ito K, Kaigawa K, Kajihara S, Kamiya H, Kamiya J, Kaneno Y, Katahira K, Kataoka M, Kawai M, Kawasaki T, Kojima E, Komura Y, Kuramochi T, Kuruma T, Kyo E, Mani H, Miyamoto T, Morii I, Morinaga Y, Morisawa T, Nagai Y, Naka T, Nakamura Y, Nakamura S, Nakayoshi K, Nishibe A, Ogawa M, Okada Y, Okawa M, Sakamoto Y, Sakurada M, Sasaki S, Seki S, Shimomura H, Shinozaki T, Sugimoto N, Suzuki A, Taguchi S, Takahashi J, Takase S, Tanabe K, Tanaka A, Tani S, Tomioka J, Tsuboi H, Tsuji M, Tsujita K, Tsujiyama S, Umesu A, Yamada T, Yamaguchi E, Yamamoto H, Yamamoto T, Yamane M, Yanase T, Yasuoka S, Yasutake M, Yokoyama M, Yoshida M, Yoshimoto E, Yunoki C, Balode A, Dormidontova G, Flaksa I, Nagele-Luse I, Rancane G, Sime I, Bartuseviciene S, Cepinskiene L, Dobilas V, Grigaraviciene I, Marcinkeviciene J, Mazutavicius R, Miliuniene R, Motiejuniene R, Norkiene S, Norkute-Macijauske U, Rudys A, Slapikas R, Stonkute K, Strazdiene D, Tijuneliene E, Urbonas G, Vanagiene S, Viezelis M, Arenas Leon JL, Bayram E, Carrillo J, Davalos C, De Los Rios M, Delgadillo T, Hernández N, Leon S, Mendoza N, Muñoz W, Ramos G, Anneveldt A, Bakker H, Brouwer M, Bunschoten P, De Boer P, De Jong C, De Vos A, Den Hartog F, Doesborg L, Dommerholt R, Drost I, Ellenbroek D, Engelen W, Folkeringa RJ, Hamer BJB, Herrman JP, Hoogslag PAM, Jansen M, Jerzewski A, Joosten C, Kalkman C, Kietselaer B, Kok M, Kooiman E, Kose V, Lardinois R, Lenderink T, Lok DJA, Lousberg A, Meijlis P, Mulder R, Singerling M, Smeele F, Stroes E, Swart HP, Ten Holt W, Van Der Wal M, Van Der Zwaan C, Van Kempen WW, Van Maarseveen M, Van Stein I, Viergever EP, Visseren FLJ, Voors C, Nugteren SKZ, Ata B, Berulfsen A, Rønnevik TD, Dickstein K, Furuseth B, Grundtvig M, Hansen H, Hofsoey K, Høivik HO, Bøen RH, Hurtig U, Pettersen KI, Johansen E, Kleve R, Kolleroy C, Moen S, Nilsen V, Norin V, Otterstad JE, Risberg K, Rønnevik P, Sirnes PA, Skjelvan G, Strand S, Szacinski G, Vegsundvåg J, Alcalde JM, Gomez Sanchez J, Rodriguez J, Rodriguez A, Zena N, Baszak J, Cymerman K, Czerski T, Fratczak M, Jaguszewska G, Kawka-Urbanek T, Koba M, Kopaczewski J, Kopczyńska M, Laniec M, Lysek R, Sciborski R, Szpajer M, Torun A, Wujkowski M, Zielinski M, Ahn Y, Baek C, Bang SA, Chang K, Choi AJ, Han S, Hyun K, Kim M, Kim KS, Kim B, Lee SH, Lee J, Lee HN, Lee JH, Lee KR, Moon K, Park B, Park C, Tahk S, Yim KH, Yim S, Tase T, Andor M, Aron G, Badea C, Casoinic F, Clocotan M, Coman S, Emil B, Imre BS, Istratoaie O, Liviu C, Maximov D, Militaru C, Minescu B, Istvan KP, Parepa I, Petrescu L, Podoleanu C, Pop CF, Popa V, Popescu E, Radoi M, Sarbu I, Socoteanu E, Socoteanu G, Sorodoc L, Spiridon M, Stanciulescu G, Stefanescu M, Tanaseanu C, Tudoran M, Zdrenghea D, Agafina A, Akatova E, Avdonina N, Balukova E, Barbarash OL, Bartosh L, Boyarkin M, Bulashova O, Burova N, Churina S, Demidova M, Dorogova I, Dovgalevskiy Y, Dovgolis S, Dudarev M, Fitilev S, Gapon L, Gazizianova V, Gordeev I, Ivanov I, Izmozherova N, Kazanskay E, Khirmanov V, Khromtsova O, Konradi A, Kosmacheva E, Kozlova S, Kulibaba E, Kuzin A, Libov I, Lipchenko A, Lozhkina N, Malchikova S, Morozov E, Myslyaeva L, Onuchina E, Palatkina T, Panov A, Parmon E, Petelina T, Repin A, Reznik I, Sazonova E, Sergienko T, Shaposhnik I, Shapovalova Y, Shustov S, Shvarts Y, Skopets I, Skuratova M, Smolenskaya O, Solovev O, Trofimov V, Vasiliev M, Vezikova N, Vozzhaev A, Yakushin S, Zadionchenko V, Apostolovic S, Adjic NC, Ilic I, Ilic S, Nikolic L, Pupic L, Stokuca-Korac N, Antalik L, Bugan V, Csala L, Dokupilova A, Dzupina A, Forgon T, Fulop P, Gonsorcik J, Gyorgyova E, Holoubek D, Horvat P, Kamensky G, Kolikova V, Krupciakova B, Lenner E, Lennerova J, Lukac J, Majercak I, Mancikova I, Micko K, Nociar J, Pales J, Palka J Jr, Poliacik P, Ruffini L, Sabo L, Skubova K, Slanina M, Smik R, Srdos V, Stitova M, Stofkova D, Strbova J, Such S, Toth P, Urgeova L, Vinanska D, Zareczky P, Flezar M, Kovacic D, Marcun R, Zagozen P, Bolsmann C, Conradie C, Dawood SY, Decsi KL, Ebrahim I, Henley L, Horak A, Kapp I, Komati S, Lock E, Maboyi S, Makotoko E, Manga P, Page A, Ramdas S, Ranjith N, Roos J, Talliard C, Ajax K, Al-Khalili F, Assarsson E, Bergholtz T, Blom KB, Boman K, Boström PÅ, Curiac D, Jensen ED, Dahlen G, Davidsson K, Duckert A, Hansson A, Härstedt N, Henriksson A, Olsson GH, Johansson K, Jonsson JE, Knutsson A, Lindholm CJ, Lönnberg I, Lundqvist M, Mellberg L, Moodh J, Mooe T, Olofsson M, Risenfors M, Rönndahl M, Sundelin R, Suorra I, Torgersruud M, Torstensson I, Chang KC, Chen CP, Chen ZC, Chen MH, Cheng SM, Cheng JJ, Fang CY, Ho CJ, Hsieh IC, Huang PH, Huang A, Kuo JY, Lai WT, Lee SC, Li YH, Lin T, Liu HM, Tsai MC, Tsao HM, Tzong L, Ueng KC, Wang YL, Wang HC, Wang CP, Yang CC, Abaci F, Birdane A, Yilmaz MB, Asim Oktay AO, Kan G, Koldas N, Ozcan IT, Sahin M, Sahin T, Saka B, Tekten T, Ucar N, Uresin S, Yigit Z, Arif I, Bakhai A, Baksi A, Blagdon M, Brickman T, Brown N, Burton M, Burton J, Chaggar S, Chung A, Collier D, Covell W, Crawford G, Davies N, Davies M, Dayer M, Doughty A, Duff J, Dwenger E, Fisher J, Fitzpatrick L, Garner K, Glover J, Haughton G, Ilsley M, Ivan P, Voyzey EJ, Keenan S, Kelt T, Knight J, Kondagunta V, Lang C, Lee K, Lim L, Macdonald J, Mathew A, Mckenzie A, Mckibbin A, Michalska A, Pagett K, Pogson A, Price R, Price D, Procter K, Pye M, Redfearn H, Rewbury J, Ryding A, Sattar N, Sharp A, Shaw P, Simpson H, Smith W, Squire I, Storey R, Teenan M, Thomas H, Townend J, Trevelyan J, Wakeling J, Walukiewicz P, Wilkinson S, Zaman A, Acevedo L, Benton J, Abbate A, Aboufakher R, Acampora M, Acampora D, Aceto L, Acevedo B, Acheatel R, Adams M, Adams A, Ahmad I, Ahmed SH, Aish B, Akyea-Djamson A, Al Joundi T, Alcide P, Alfieri A, Alfonso T, Alfrey A, Allen J, Alllison DC, Almaliky T, Amos A, Angiolillo D, Antolick A, Ara M, Aragorn L, Arevalo S, Armas E, Arthur A, Asafu-Adjaye N, Ashcom T, Ashford M, Aslam A, Ather N, Atieh M, Aull L, Ayala M, Azizad M, Backer T, Baehl S, Bailey S, Bair S, Baker C, Ballmajo M, Pieretti HB, Baquero A, Barnett S, Baron S, Bartkowiak A, Bashir K, Beall K, Beauregard LA, Sarah S, Beckett L, Belejchak P, Bendelow T, Bender D, Benjamin S, Berdoff R, Berger V, Bergeron P, Berk M, Bernstein M, Binns Y, Bitzer V, Blahey M, Bloch S, Bluemel J, Boffetti P, Boley K, Bonner J, Boudreaux R, Boulanger K, Bradley A, Bramlet D, Bredlau C, Briggs S, Brousalis L, Brown S, Brown C, Buchannan C, Burke W, Burley T, Burton C, Burtt D, Byars W, Caballero-Valiente B, Carr K, Halliwell TC, Castillo J, Cei L, Cerda L, Chambers J, Chamblee T, Chattin W, Chee L, Chen YC, Cherlin R, Cheung D, Chiodi L, Christensen L, Christenson S, Cislowski D, Clavier-Firmin C, Colfer H, Colvin T, Cosgrove N, Covert C, Cox B, Cox R, Craig W, Crandall L, Crepps K, Cromer M, Cruz H, Cruz M, Cucher F, Damron M, Dave K, Dave B, Davis M, Davis B, Dawkins-Hughes S, Dean J, Debnam S, Defosse C, Dehning M, Dela Llana A, Dellorso M, Denham D, Desalle D, Dettmer M, Dhawan M, Diago M, Dicken T, Diederich C, Diederich M, Diehl R, Digangi D, Diller P, Dimattia M, Dodds G, Doggett J, Donahue K, Doughty L, Dragutksy B, Dreese M, Dunhurst F, Dunn D, Dutka C, Earl J, Eaton C, Eaves W, Ebeling K, Eder F, Edgerton L, Edillo C, Edwards J, Edwards T, Einhorn D, El Hafi S, Ellis M, Erickson B, Ervin W, Eskridge L, Fail P, Falcon D, Fang C, Fattal P, Fawson A, Felix L, Ferdinand K, Fien E, Fintel D, Firek C, Fitz-Patrick D, Flores E, Flores H, Floro T, Forker A, Foster M, Foucauld J, Lehman KF, Fox B, Francoeur L, Frandsen B, Frivold G, Fruchter G, Fullerton D, Gabriel J, Gacioch G, Garas S, Garcia N, Garcia Rinaldi R, Garcia-Fragoso V, Garcia-Portela M, Gelb R, George F, Ghali J, Gilbert J, Gilley J, Glancy R, Goff R, Goldberg N, Gonzales D, Gonzales V, Gonzalez E, Gorges R, Gould R, Grabeau R, Grable M, Graham JA, Graif J, Green E, Greener R, Greenway F, Grieshaber V, Griffin S, Gros C, Gudipati RVC, Guillinta P, Gupta V, Gutmann J, Gwyn M, El Hachem M, Hage F, Hageman T, Haidar A, Hakas J, Haldis T, Hall L, Hall C, Hall S, Halpern S, Hamud-Socoro A, Hardee L, Harrell W, Harrington A, Hartwell J, Hasan F, Hattler B, Haught H, Haynes E, Haywood A, Heaney L, Hecht J, Hernandez I, Herzog W, Hess E, Hill H, Hilton T, Hinderaker P, Hodnett P, Hoffman M, Hogan C, Holmes Z, Rees DH, Hotchkiss D, Huang P, Humbert J, Hutchens E, Iachini K, Ibarra M, Igbokidi O, Ilahi T, Imbrognio M, Ipp E, Iteld B, Jacques G, Jafri A, Jafry B, Jardula M, Jefferson D, Jenkins R, Johnson E, Johnson J, Jones S, Kawahara M, Kelehan S, Kelly R, Kendall T, Kereiakes D, Khan M, Khan S, Kick J, Kimmel M, King T, King A, Kirkland S, Kissel S, Kitchens D, Klein P, Klugherz B, Korban E, Koren M, Korte M, Kostis J, Kotek L, Kozak M, Kreutter F, Kusnick B, Labovitz R, Lail J, Lamance J, Lamas G, Lambert J, Lambert C, Landzberg J, Langdon J, Lavoie W, Ledger G, Lee T, Lehman R, Leimbach W, Lennard M, Lepor N, Lester F, Levin P, Levinson L, Lewis D, Lillo J, Link L, Long C, Longaker R, Lorch G, Lucksinger G, Lynd S, Rhudy JM, Madder R, Magness K, Maheshwari A, Alan A, Malek M, Maletz L, Malhotra V, Malhotra S, Mandviwala M, Mani CK, Manuel J, Marchelletta N, Marshall L, Marsters M, Martin L, Martinez E, Mavromatis K, Maynard R, Mays M, Mays B, Mbulaiteye A, Mcalister R, Mccoy C, Mccrary D Jr, Mccullough-O'Brien H, Mcdonald M, Mcgill J, Mcgrew F, Mckenzie C, Mclaurin B, Mclellan BA, Mcneil D, Mcneill R, Mehrle A, Melbie K, Melliza T, Messina T, Meyer R, Michel K, Mikdadi G, Miller C, Miller R, Miller A, Miller G, Miller W, Mitchell J, Moats DJR, Mody F, Moffat J, Molk B, Molter D, Monroe T, Montero H, Montgomery R, Mookherjee D, Moran J, Moriarty P, Morrison J, Morton D, Moshayedi P, Mosley J, Moustafa M, Munshi K, Murray A, Mustafa J, Nadar V, Naidu R, Nalley J, Navy S, Neil L, Neutel JM, Niblack P, Nicely V, Nicolai M, Nijmeh G, Nikas A, Nikyar A, Nixon S, Norman L, Noto G, Nour K, Nugent A, Ocman B, Odegard A, Olsen S, Ortiz-Carrasquillo R, Ossino N, Paez H, Palchick B, Paliwal Y, Pannell R, Parfait V, Partridge J, Patel B, Patel M, Patel S, Paysor C, Pena A, Pereira S, Perez M, Perez A, Perkins H, Perry B, Peters P, Phillippi C, Phillips A, Piacente R, Pintado M, Pish R, Pitt W, Poling T, Pomposini D, Poock J, Potts J, Poudrier R, Prior J, Pritchard C, Purighalla R, Quddusi K, Quinones J, Quinton D, Radin M, Radojcsics B, Rajput B, Rama B, Ramos M, Rauch R, Raynes K, Reber AM, Reddy J, Reeves M, Reilly K, Renaud K, Resnick H, Reyes R, Richardson M, Riethof M, Riser J, Rodero M, Rodriguez Araya E, Roper L, Rozeman P, Ruder D, Runquist L, Sack G, Saint-Jacques H, Salfity M, Sall N, Sam K, Samal A, Sanchez D, Santiago J Jr, Savignano C, Saylor R, Scheffel M, Schifferdecker B, Schindler E, Schneider P, Schneider R, Schnitzler R, Schrager B, Schwartz A, Scott R, Seals A, Shah AV, Shah A, Shatsky K, Shayani S, Shealy N, Sheets L, Shelley J, Shepard P, Shetty S, Silver K, Simon M, Singh K, Singh N, Sizemore BC, Skatrud L, Slayton C, Slimak V, Sloane G, Smallwood B, Smith P, Smith M, Smith T, Smith G, Smith B, Smith J, Soca Y, Sofley C, Sopko K, Sosa-Padilla M, Sotolongo R, Sprinkle B, Srivastava S, Starzec M, Steinhoff J, Stelly L, Stinson J, Stoddard M, Stoltz S, Stone B, Stover T, Strain J, Strugatsky S, Stys T, Suleman A, Sullivan P, Tamez W, Tandon N, Teltser M, Terry PS, Terry K, Tessmar C, Thekkoott D, Thomas D, Thomas DM, Thompson E, Thompson J, Thornton A, Tjaden T, Tobias C, Topper J, Tran A, Treasure C, Trenkamp P, Trevino M, Tsou L, Tuholske C, Uy W, Vahtel M, Vaid B, Valenzuela M, Vance A, Vandam J, Vanhecke T, Vanness WC III, Vargas R, Vaz S, Vazquez Tanus J, Veerina K, Vega J, Vento A, Vijay N, Voelker F, Vogt E, Vold D, Vora K, Wade RD, Wadell C, Waksman R, Walker K, Wallace K, Warren M, Washam M, Watson B, Webel R, Wells T, West M, Whitaker J, White J, White C, White A, Wilhoit G, Wilkins M, Willingham K, Wilson S, Wilson V, Wise J, Woodall S, Woods A, Wright J, Xu ZJ, Yarows S, Young A, Younis L, Zarate J, Zebrack J, Zhang W, Zieve F, Zineldine A, Ridker PM, Everett BM, Thuren T, MacFadyen JG, Chang WH, Ballantyne C, Fonseca F, Nicolau J, Koenig W, Anker SD, Kastelein JJP, Cornel JH, Pais P, Pella D, Genest J, Cifkova R, Lorenzatti A, Forster T, Kobalava Z, Vida-Simiti L, Flather M, Shimokawa H, Ogawa H, Dellborg M, Rossi PRF, Troquay RPT, Libby P, Glynn RJ, Novo S, Krum H, Varigos J, Siostrzonek P, Sinnaeve P, Gotcheva N, Yong H, Urina-Triana M, Milicic D, Vettus R, Manolis AJ, Wyss F, Sigurdsson A, Fucili A, Veze I, Petrauskiene B, Salvador L, Klemsdal TO, Medina F, Budaj A, Otasevic P, Lainscak M, Seung KB, Commerford P, Donath M, Hwang JJ, Kultursay H, Bilazarian S, East C, Forgosh L, Harris B, Ligueros M, Bohula E, Charmarthi B, Cheng S, Chou S, Danik J, McMahon G, Maron B, Ning M, Olenchock B, Pande R, Perlstein T, Pradhan A, Rost N, Singhal A, Taqueti V, Wei N, Burris H, Cioffi A, Dalseg AM, Ghosh N, Gralow J, Mayer T, Rugo H, Fowler V, Limaye AP, Cosgrove S, Levine D, Lopes R, Scott J, Hilkert R, Tamesby G, Mickel C, Manning B, Woelcke J, Tan M, Manfreda S, Ponce T, Kam J, Saini R, Banker K, Salko T, Nandy P, Tawfik R, O’Neil G, Manne S, Jirvankar P, Lal S, Nema D, Jose J, Collins R, Bailey K, Blumenthal R, Colhoun H, Gersh B, Abreu M, Actis MV, Aiub J, Aiub F, Albisu J, Alvarisqueta A, Avalos V, Barreto M, Berli MA, Blumberg C, Bocanera M, Botta C, Bowen L, Budassi N, Buhlman S, Westberg JC, Carabajal T, Caruso G, Casala J, Cendali G, Coloma G, Berra FC, Cuneo C, Degennaro N, Dellasa M, Diaz M, Dos Santos P, Espinosa V, Facello A, Facello M, Farias E, Fernandez AA, Ferrari V, Pacora FF, Flores GS, Franco M, Gabito A, Viola HG, Garcia F, Garcia Duran R, Garcia Pinna J, Glenny J, Godoy Sanchez M, Grosse A, Guzman P, Hasbani E, Hominal M, Ibañez J, Jure H, Jure D, Vico ML, Liniado G, Luciardi H, Luquez H, Maehara G, Maffei L, Majul C, Mallagray M, Marinaro S, Martinez J, Massaccesi R, De Los Milagros Had M, Azize GM, Montana O, Montenegro E, Morell Y, Muntaner J, Navarrete S, Olmedo M, Paganini M, Paz S, Perez Manghi F, Piskorz D, Polato C, Recoaro R, Romano A, Salinger M, Sanchez A, Saravia MA, Sarjanovich R, Scaro G, Schiavi LB, Soler J, Tinnirello V, Tomassi A, Valle M, Vallejo MA, Venturini C, Marcela Wenetz LM, Yossen M, Zaidman C, Zalazar L, Zangroniz P, Amerena J, Brady L, Colquhoun D, Eccleston D, Ferreira-Jardim A, French J, Jayasinghe R, Mcintosh C, Ord M, Plotz M, Purnell P, Roberts-Thomson P, Schultz C, Shanahan T, Tan R, Taverner P, Turner F, Vibert J, Vorster M, William M, Youssef G, Bergler-Klein J, Brath H, Brodmann M, Fliesser-Goerzer E, Haider K, Heeren G, Hiden C, Mandic L, Paulweber B, Ploechl A, Prenner A, Steringer-Mascherbauer R, Strohner-Kaestenbauer H, Barbato E, Bouvy C, Briké C, Charlier F, Cools F, De Knijf K, De Wolf L, Delforge M, Deweerdt N, Gits F, Goffinet C, Hermans K, Hollanders G, Mestdagh I, Pirenne B, Servaes V, Simons N, Tahon S, Theunissen E, Van Genechten G, Vervoort G, Vissers C, Vranckx P, Vrolix M, Abib E Jr, Abrantes J, Araujo Fonseca M, Barbosa E, Barroso W, Barroso A, Bodanese L, Botelho R, Costa Amorim R, Da Costa F, Da Silva A, Da Silva O Jr, Da Silva D Jr, Ferreira Dos Santos T, Dos Santos F, Dos Santos A, Duda N, Feitosa G, Felario Junior GA, Ferraz R, Filho P, Fonseca A, Wanderley FF, Freitas E, Fucci F, Marengo Garcia De Carvalho L, Hernandez M, Hettwer Magedanz E, Julião K, Kormann A, Lameira A, Lima F, Lino E, Maia L, Manenti E, Marchi AL, Fischer SM, Michalaros Y, Moraes J Jr, Moreira L, Pagnan M, Pesce F, Pinheiro L, Rassi S, Reis G, Reis H, Resende I, Roel A, Ruschel K, Saporito W, Saraiva JF, Seroqui M, Silva R, Unterkircher B, Vicente C, Vieira N, Xavier JP, Zucchetti C, Angelova I, Dimitrov G, Genova D, Gospodinov K, Goudev A, Grigorova V, Hristova K, Makedonska JJ, Katova T, Kostov K, Lazov P, Manov E, Manukov I, Manukov D, Milanova M, Kabakchieva VM, Petrov D, Petrusheva T, Pramatarova I, Raev D, Runev N, Sirakova-Taseva A, Tisheva-Gospodinova S, Todorova A, Tzekova M, Yakovova S, Yanev T, Abulencia K, Arora S, Baker A, Bata IR, Beaudry M, Belle Isle J, Bilodeau N, Boivin MC, Bolduc H, Bourgeois S, Brons S, Cantor W, Chaussé I, Chhabra A, Chouinard G, Cleveland T, Dattani D, Deslongchamps F, Diodati J, Drouin K, Duchesne L, Fontaine S, d'Amours DG, Gervais B, Gosselin G, Graham J, Grover A, Gupta A, Haldane H, Hartleib M, Hickey L, Huynh T, Johnston J, Julien VE, Lachance P, Lake J, Lamontagne C, Lauzon C, Lepage S, Maheux K, Manyari D, Martin E, McPherson C, Mehta S, Michaud N, Kouz SM, Murphy G, OKeefe D, Otis R, Ouimet F, Pandey S, Peck C, Perkins L, Richert L, Robbins K, Robinson S, Cabau JR, Ross B, Roy C, Roy M, Roy A, Rupka D, Affaki GS, Saunders K, Savard D, Soucy D, St Amour E, Thiessen S, Vertes G, Vezina M, Vincelli G, Weisnagel SJ, Zadra R, Chen J, Chen Y, Dong X, Feng Y, Feng Z, Fu G, Han B, Hao Y, He Y, He Z, Hong T, Jia Z, Jiang T, Jiang J, Jiang X, Ke Y, Li Y, Li Y, Li Z, Li W, Li X, Li Y, Liu P, Liu Y, Liu B, Liu S, Liu L, Lu Z, Lv Y, Ma C, Ma G, Peng L, Qing L, Ren L, Sang X, Song M, Sun Z, Wang J, Wang Y, Wei J, Wu W, Wu J, Xu H, Yan J, Yang P, Yang K, Yao Z, Yaoqing H, Yuan Z, Zhai Z, Zhang J, Zhang Y, Zhao R, Zhou H, Accini Mendoza JL, Aparicio CV, Castillo T, Chaverra I, Conrado Y, Coronel J, Cotes C, Cuentas I, Cuervo A, Dussan MA, Echeverria L, Hernandez E, Ibarra J, Isaza D, Jimenez D, Lopez P, Manzur F, Mejia I, Mendoza Y, Molina DI, Patino JM, Rodriguez D, Rodriguez LM, Rodriguez SM, Sanchez Vallejo G, Luz Serrano H, Sotomayor A, Urina M, Vesga B, Yupanqui H, Akrap B, Busic N, Ciglenecki N, Cmrecnjak J, Fucak E, Gabor M, Jeric M, Jutrisa N, Kordic K, Planinc I, Popovic Z, Radeljic V, Sesto I, Sutalo K, Tusek S, Belohlavek J, Budkova J, Busak L, Capova L, Cech V, Cermak O, Coufalova Z, Cyprian R, Dedek V, Dedkova S, Ferkl R, Hanak P, Hanustiakova A, Homza M, Horackova K, Houra M, Iveta H, Kaiserova L, Kala P, Karel I, Kellnerova I, Koleckar P, Kreckova M, Krupicka J, Lorenc Z, Machova V, Malik J, Masarikova L, Matyasek I, Mikus M, Mikusova T, Ondrasik J, Otava M, Palubova L, Pavlickova L, Peterka M, Petrova I, Pokorna B, Povolny P, Radvan M, Reznakova S, Rickova Z, Roszkowska P, Rotreklova M, Samkova D, Skalicka H, Slechticka A, Sternthal P, Telekes P, Tesak M, Vesely P, Vesely J, Vins P, Vitovec M, Vodnansky P, Zidova M, Keba E, Laane E, Pool T, Randvee L, Ratnik E, Reimand M, Reinmets S, Rivis L, Siemann M, Stern M, Toom M, Vahula V, Apel T, Axthelm C, Ayasse D, Ayasse M, Baar M, Baeumer A, Bagi ES, Becker B, Binder A, Blankenberg S, Braun P, Johansen BB, Contzen C, Delfonso F, Denecke C, Dengler T, Donaubauer T, Eichinger G, Englmann E, Erhard M, Faghih M, Foerster A, Frankenstein L, Fuchs R, Furch G, Gaeb-Strasas B, Germann H, Giese C, Goette A, Gravenhorst-Muenter U, Haege R, Haenel T, Hagemann D, Hagenow A, Hanefeld M, Heider J, Heisters J, Hennig D, Hielscher S, Himpel-Boenninghoff A, Holscher A, Hornig M, Jeserich M, Kaczmarek N, Kanitz S, Kara YD, Khariouzov A, Kiefer R, Kiroglu K, Klamm M, Klein C, Korth-Wiemann B, Krapivsky A, Kuenzler J, Kuntzsch A, Landers B, Lappo M, Laube S, Leggewie S, Lehmann D, Lepp H, Lierse T, Lindner C, Luecke-Uzar M, Luedemann J, Marschke T, Maruzzo S, Mauersberger K, Maus O, Meinrich M, Meissner A, Moehring B, Muehlhaus J, Mueller S, Muenter KC, Muenzel T, Naumann R, Nebel J, Neumann J, Nuding S, Overhoff U, Papke B, Pencz I, Peter Y, Peukert AM, Radde I, Rau T, Regner S, Reichenbach D, Reimer D, Rinke A, Roettges R, Romanski A, Rummel R, Samer H, Sanuri M, Sarnighausen HE, Schäfer B, Scheibner T, Schermaul KH, Schindler A, Schindler A, Schlundt C, Schmidt E, Schmidt K, Schnabel A, Schoen N, Schorn K, Schroeder T, Schulenburg D, Schulz M, Schulze U, Schulze J, Schumacher M, Schwerin G, Schwerin M, Stadelmeier S, Stahl HD, Stahl A, Stockhausen J, Stockhausen G, Stoessel J, Stolze K, Stratmann M, Szymanowski N, Teschner AB, Teske A, Uecker C, Veit S, Voeller H, Walter I, Walter J, Walther I, Weber HG, Weimer J, Wichterich K, Wiebusch A, Willmerdinger M, Willner C, Winkelmann B, Winkler J, Wistuba T, Woehrle J, Wohnlich T, Wolf S, Woyczak D, Wrage P, Zirlik A, Anadiotis A, Chachalis G, Dermitzakis A, Kafarakis P, Kaldara E, Kolokathis F, Kostakou P, Lekakis J, Manolis A, Mantas I, Megalou A, Milkas A, Nanas J, Olympios CD, Patsilinakos S, Perperis A, Poulimenos L, Saloustros I, Tsioufis K, Tsorbatzoglou K, Vardas P, Zarifis I, Aguilar M, Arango JL, Borrayo NA, Corona V, Guerrero A, Guzman I, Haase F, De Krumbach L, Montenegro P, Munoz R, Munoz N, Paniagua A, Solares A, Vogel M, Anita S, Blazsek Z, Decsi K, Fulop T, Hangyal T, Hegedus V, Kalina A, Karakai H, Katona A, Kiss RG, Kovacs A, Laszlo Z, Lupkovics G, Medvegy M, Merkely B, Mihaly N, Nagy AC, Dékány JN, Nikoletta P, Noori E, Penzes J, Poor F, Sarszegi Z, Simay A, Simon J, Szakal I, Szatmarine V, Szocs A, Zilahi Z, Karsai XZ, Andersen K, Sigurdadottir E, Skuladottir F, Abdullakutty J, Abhaichand R, Abhyankar A, Agarwal DK, Aggarwal RK, Ahire N, Awasthi AK, Babu R, Bai A, Bali HK, Banker D, Bhadade S, Bisne V, Bohra P, Raghu C, Chauhan D, Chauhan H, Chavada J, Chaware G, Chella S, Chintala P, Dash D, Desai D, Devasia T, Dhanak R, Dobariya H, Dudhatra N, Duhan S, Fulwani M, Ghondale N, Ghosh S, Gohel P, Govindaraj D, Goyal B, Goyal S, Gundala AK, Gupta A, Gupta M, Hardas S, Iby M, Jagtap P, Jain A, Joshi U, Karpuram M, Kaur H, Khan A, Khan R, Kodem DR, Koeitti P, Kulkarni L, Kullal P, Kumar KS, Kumbla M, Latheef K, Lohkare M, Santosh MJ, Makhe B, Mandati M, Mehta A, Minocha G, Mittal A, Modi R, Mohan K, Oomman A, Pai R, Pai V, Palaniswami N, Pansheriya A, Parekh N, Patel J, Patel R, Patole T, Praveen M, Radhakrishnan V, Rajan B A, Rajasekhar D, Rao M, Rao MB, Rao NM, Rathnavel S, Rathore A, Rathore SRS, Rawat S, Reddy NC, Sarma R, Sathe S, Shah J, Shaikh P, Sharma K, Sharma S, Sharma T, Shetty P, Sidhu G, Singh V, Sohi GS, Srinath VS, Raju SS, Taran A, Thakkar B, Velusamy K, Vijan V, Vora V, Vuriya AK, Agosta GF, Antonicelli R, Ardissino D, Argiolas G, Baldin MG, Benedetti G, Berti S, Bevilacqua MT, Bolognesi MG, Dessalvi CC, Calabrese A, Campanale EG, Candusso R, Caso P, Cosmi F, Crea F, Crocamo A, De Caterina R, De Rosa S, Destro M, Di Biase M, Dognini GP, Eleuteri E, Fedele F, Ferrario M, Gabrielli D, Gamba C, Ganau A, Gravellone M, Iannopollo G, Indolfi C, Infusino F, Invitti C, Landolfi A, Lembo G, Liberato NL, Mannucci E, Marino P, Mariottoni B, Marziali A, Mercuro G, Monti L, Mos L, Mureddu V, Musumeci MB, Novo S, Panzarino C, Parente A, Perotti M, Filardi PP, Petrillo C, Piatti P, Priori S, Racca V, Ragghianti B, Renda G, Righini V, Sarcone M, Senni M, Soro E, Tamburrini P, Vallone L, Villani GQ, Volpe M, Ajioka M, Akai Y, Ashino K, Baden M, Doi M, Eki Y, Endo T, Fukuike C, Hagiwara Y, Hasegawa K, Higuchi Y, Higuchi T, Hioki M, Hirayama A, Hiroma J, Hosokawa S, Ichisawa M, Iijima T, Inada T, Inagaki M, Ito K, Kaigawa K, Kajihara S, Kamiya H, Kamiya J, Kaneno Y, Katahira K, Kataoka M, Kawai M, Kawasaki T, Kojima E, Komura Y, Kuramochi T, Kuruma T, Kyo E, Mani H, Miyamoto T, Morii I, Morinaga Y, Morisawa T, Nagai Y, Naka T, Nakamura Y, Nakamura S, Nakayoshi K, Nishibe A, Ogawa M, Okada Y, Okawa M, Sakamoto Y, Sakurada M, Sasaki S, Seki S, Shimomura H, Shinozaki T, Sugimoto N, Suzuki A, Taguchi S, Takahashi J, Takase S, Tanabe K, Tanaka A, Tani S, Tomioka J, Tsuboi H, Tsuji M, Tsujita K, Tsujiyama S, Umesu A, Yamada T, Yamaguchi E, Yamamoto H, Yamamoto T, Yamane M, Yanase T, Yasuoka S, Yasutake M, Yokoyama M, Yoshida M, Yoshimoto E, Yunoki C, Balode A, Dormidontova G, Flaksa I, Nagele-Luse I, Rancane G, Sime I, Bartuseviciene S, Cepinskiene L, Dobilas V, Grigaraviciene I, Marcinkeviciene J, Mazutavicius R, Miliuniene R, Motiejuniene R, Norkiene S, Norkute-Macijauske U, Rudys A, Slapikas R, Stonkute K, Strazdiene D, Tijuneliene E, Urbonas G, Vanagiene S, Viezelis M, Aguilar M, Arenas Leon JL, Bayram E, Carrillo J, Davalos C, De Los Rios M, Delgadillo T, Hernández N, Leon S, Mendoza N, Muñoz W, Ramos G, Anneveldt A, Bakker H, Brouwer M, Bunschoten P, De Boer P, De Jong C, De Vos A, Den Hartog F, Doesborg L, Dommerholt R, Drost I, Ellenbroek D, Engelen W, Folkeringa RJ, Hamer BJB, Herrman JP, Hoogslag PAM, Jansen M, Jerzewski A, Joosten C, Kalkman C, Kietselaer B, Kok M, Kooiman E, Kose V, Lardinois R, Lenderink T, Lok DJA, Lousberg A, Meijlis P, Mulder R, Singerling M, Smeele F, Stroes E, Swart HP, Ten Holt W, Van Der Wal M, Van Der Zwaan C, Van Kempen WW, Van Maarseveen M, Van Stein I, Viergever EP, Visseren FLJ, Voors C, Nugteren SKZ, Ata B, Berulfsen A, Rønnevik TD, Dickstein K, Furuseth B, Grundtvig M, Hansen H, Hofsoey K, Høivik HO, Bøen RH, Hurtig U, Pettersen KI, Johansen E, Kleve R, Kolleroy C, Moen S, Nilsen V, Norin V, Otterstad JE, Risberg K, Rønnevik P, Sirnes PA, Skjelvan G, Strand S, Szacinski G, Vegsundvåg J, Alcalde JM, Gomez Sanchez J, Rodriguez J, Rodriguez A, Zena N, Baszak J, Cymerman K, Czerski T, Fratczak M, Jaguszewska G, Kawka-Urbanek T, Koba M, Kopaczewski J, Kopczyńska M, Laniec M, Lysek R, Sciborski R, Szpajer M, Torun A, Wujkowski M, Zielinski M, Ahn Y, Baek C, Bang SA, Chang K, Choi AJ, Han S, Hong T, Hyun K, Kim M, Kim KS, Kim B, Lee SH, Lee J, Lee HN, Lee JH, Lee KR, Moon K, Park B, Park C, Tahk S, Yim KH, Yim S, Tase T, Andor M, Aron G, Badea C, Casoinic F, Clocotan M, Coman S, Emil B, Imre BS, Istratoaie O, Liviu C, Maximov D, Militaru C, Minescu B, Istvan KP, Parepa I, Petrescu L, Podoleanu C, Pop CF, Popa V, Popescu E, Radoi M, Sarbu I, Socoteanu E, Socoteanu G, Sorodoc L, Spiridon M, Stanciulescu G, Stefanescu M, Tanaseanu C, Tudoran M, Zdrenghea D, Agafina A, Akatova E, Avdonina N, Balukova E, Barbarash OL, Bartosh L, Boyarkin M, Bulashova O, Burova N, Churina S, Demidova M, Dorogova I, Dovgalevskiy Y, Dovgolis S, Dudarev M, Fitilev S, Gapon L, Gazizianova V, Gordeev I, Ivanov I, Izmozherova N, Kazanskay E, Khirmanov V, Khromtsova O, Konradi A, Kosmacheva E, Kozlova S, Kulibaba E, Kuzin A, Libov I, Lipchenko A, Lozhkina N, Malchikova S, Morozov E, Myslyaeva L, Onuchina E, Palatkina T, Panov A, Parmon E, Petelina T, Repin A, Reznik I, Sazonova E, Sergienko T, Shaposhnik I, Shapovalova Y, Shustov S, Shvarts Y, Skopets I, Skuratova M, Smolenskaya O, Solovev O, Trofimov V, Vasiliev M, Vezikova N, Vozzhaev A, Yakushin S, Zadionchenko V, Apostolovic S, Adjic NC, Ilic I, Ilic S, Nikolic L, Pupic L, Stokuca-Korac N, Antalik L, Bugan V, Csala L, Dokupilova A, Dzupina A, Forgon T, Fulop P, Gonsorcik J, Gyorgyova E, Holoubek D, Horvat P, Kamensky G, Kolikova V, Krupciakova B, Lenner E, Lennerova J, Lukac J, Majercak I, Mancikova I, Micko K, Nociar J, Pales J, Palka J Jr, Poliacik P, Ruffini L, Sabo L, Skubova K, Slanina M, Smik R, Srdos V, Stitova M, Stofkova D, Strbova J, Such S, Toth P, Urgeova L, Vinanska D, Zareczky P, Flezar M, Kovacic D, Marcun R, Zagozen P, Bolsmann C, Commerford P, Conradie C, Dawood SY, Decsi KL, Ebrahim I, Henley L, Horak A, Kapp I, Komati S, Lock E, Maboyi S, Makotoko E, Manga P, Page A, Ramdas S, Ranjith N, Roos J, Talliard C, Ajax K, Al-Khalili F, Assarsson E, Bergholtz T, Blom KB, Boman K, Boström PÅ, Curiac D, Jensen ED, Dahlen G, Davidsson K, Duckert A, Hansson A, Härstedt N, Henriksson A, Olsson GH, Johansson K, Jonsson JE, Knutsson A, Lindholm CJ, Liu B, Lönnberg I, Lundqvist M, Mellberg L, Moodh J, Mooe T, Olofsson M, Risenfors M, Rönndahl M, Sundelin R, Suorra I, Torgersruud M, Torstensson I, Chang KC, Chen CP, Chen ZC, Chen MH, Cheng SM, Cheng JJ, Fang CY, Ho CJ, Hsieh IC, Huang PH, Huang A, Hwang JJ, Kuo JY, Lai WT, Lee SC, Li YH, Lin T, Liu HM, Tsai MC, Tsao HM, Tzong L, Ueng KC, Wang YL, Wang HC, Wang CP, Yang CC, Abaci F, Birdane A, Yilmaz MB, Asim Oktay AO, Kan G, Koldas N, Ozcan IT, Sahin M, Sahin T, Saka B, Tekten T, Ucar N, Uresin S, Yigit Z, Arif I, Bakhai A, Baksi A, Blagdon M, Brickman T, Brown N, Burton M, Burton J, Chaggar S, Chung A, Collier D, Covell W, Crawford G, Davies N, Davies M, Dayer M, Doughty A, Duff J, Dwenger E, Fisher J, Fitzpatrick L, Garner K, Glover J, Haughton G, Ilsley M, Ivan P, Voyzey EJ, Keenan S, Kelt T, Knight J, Kondagunta V, Lang C, Lee K, Lim L, Macdonald J, Mathew A, Mckenzie A, Mckibbin A, Michalska A, Pagett K, Pogson A, Price R, Price D, Procter K, Pye M, Redfearn H, Rewbury J, Ryding A, Sattar N, Sharp A, Shaw P, Simpson H, Smith W, Squire I, Storey R, Teenan M, Thomas H, Townend J, Trevelyan J, Wakeling J, Walukiewicz P, Wilkinson S, Zaman A, Acevedo L, Benton J, Abbate A, Aboufakher R, Acampora M, Acampora D, Aceto L, Acevedo B, Acheatel R, Adams M, Adams A, Ahmad I, Ahmed SH, Aish B, Akyea-Djamson A, Al Joundi T, Alcide P, Alfieri A, Alfonso T, Alfrey A, Allen J, Alllison DC, Almaliky T, Amos A, Angiolillo D, Antolick A, Ara M, Aragorn L, Arevalo S, Armas E, Arthur A, Asafu-Adjaye N, Ashcom T, Ashford M, Aslam A, Ather N, Atieh M, Aull L, Ayala M, Azizad M, Backer T, Baehl S, Bailey S, Bair S, Baker C, Ballmajo M, Pieretti HB, Baquero A, Barnett S, Baron S, Bartkowiak A, Bashir K, Beall K, Beauregard LA, Sarah S, Beckett L, Belejchak P, Bendelow T, Bender D, Benjamin S, Berdoff R, Berger V, Bergeron P, Berk M, Bernstein M, Binns Y, Bitzer V, Blahey M, Bloch S, Bluemel J, Boffetti P, Boley K, Bonner J, Boudreaux R, Boulanger K, Bradley A, Bramlet D, Bredlau C, Briggs S, Brousalis L, Brown S, Brown C, Buchannan C, Burke W, Burley T, Burton C, Burtt D, Byars W, Caballero-Valiente B, Carr K, Halliwell TC, Castillo J, Cei L, Cerda L, Chambers J, Chamblee T, Chattin W, Chee L, Chen YC, Cherlin R, Cheung D, Chiodi L, Christensen L, Christenson S, Cislowski D, Clavier-Firmin C, Colfer H, Colvin T, Cosgrove N, Covert C, Cox B, Cox R, Craig W, Crandall L, Crepps K, Cromer M, Cruz H, Cruz H, Cruz M, Cucher F, Damron M, Dave K, Dave B, Davis M, Davis B, Dawkins-Hughes S, Dean J, Debnam S, Defosse C, Dehning M, Dela Llana A, Dellorso M, Denham D, Desalle D, Dettmer M, Dhawan M, Diago M, Dicken T, Diederich C, Diederich M, Diehl R, Digangi D, Diller P, Dimattia M, Dodds G, Doggett J, Donahue K, Doughty L, Dragutksy B, Dreese M, Dunhurst F, Dunn D, Dutka C, Earl J, Eaton C, Eaves W, Ebeling K, Eder F, Edgerton L, Edillo C, Edwards J, Edwards T, Einhorn D, El Hafi S, Ellis M, Erickson B, Ervin W, Eskridge L, Fail P, Falcon D, Fang C, Fattal P, Fawson A, Felix L, Ferdinand K, Fien E, Fintel D, Firek C, Fitz-Patrick D, Flores E, Flores E, Flores H, Floro T, Forker A, Foster M, Foucauld J, Lehman KF, Fox B, Francoeur L, Frandsen B, Frandsen B, Frivold G, Fruchter G, Fullerton D, Gabriel J, Gacioch G, Garas S, Garcia N, Garcia Rinaldi R, Garcia-Fragoso V, Garcia-Portela M, Gelb R, George F, Ghali J, Gilbert J, Gilley J, Glancy R, Goff R, Goldberg N, Gonzales D, Gonzales V, Gonzalez E, Gorges R, Gould R, Grabeau R, Grable M, Graham JA, Graif J, Green E, Greener R, Greenway F, Grieshaber V, Griffin S, Gros C, Gudipati RVC, Guillinta P, Gupta V, Gutmann J, Gwyn M, El Hachem M, Hage F, Hageman T, Haidar A, Hakas J, Haldis T, Hall L, Hall C, Hall S, Halpern S, Hamud-Socoro A, Hardee L, Harrell W, Harrington A, Hartwell J, Hasan F, Hattler B, Haught H, Haynes E, Haywood A, Heaney L, Hecht J, Hernandez I, Herzog W, Hess E, Hill H, Hilton T, Hinderaker P, Hodnett P, Hoffman M, Hogan C, Holmes Z, Rees DH, Hotchkiss D, Huang P, Humbert J, Hutchens E, Iachini K, Ibarra M, Igbokidi O, Ilahi T, Imbrognio M, Ipp E, Iteld B, Jacques G, Jafri A, Jafry B, Jardula M, Jefferson D, Jenkins R, Johnson E, Johnson J, Jones S, Kawahara M, Kelehan S, Kelly R, Kendall T, Kereiakes D, Khan M, Khan S, Kick J, Kimmel M, King T, King A, Kirkland S, Kissel S, Kitchens D, Klein P, Klugherz B, Korban E, Koren M, Korte M, Kostis J, Kotek L, Kozak M, Kreutter F, Kusnick B, Labovitz R, Lail J, Lamance J, Lamas G, Lambert J, Lambert C, Landzberg J, Langdon J, Lavoie W, Ledger G, Lee T, Lee K, Lehman R, Leimbach W, Lennard M, Lepor N, Lester F, Levin P, Levinson L, Lewis D, Lillo J, Link L, Long C, Longaker R, Lorch G, Lucksinger G, Lynd S, Rhudy JM, Madder R, Magness K, Maheshwari A, Alan A, Malek M, Maletz L, Malhotra V, Malhotra S, Mandviwala M, Mani CK, Manuel J, Marchelletta N, Marshall L, Marsters M, Martin L, Martinez E, Mavromatis K, Maynard R, Mays M, Mays B, Mbulaiteye A, Mcalister R, Mccoy C, Mccrary D Jr, Mccullough-O'Brien H, Mcdonald M, Mcgill J, Mcgrew F, Mckenzie C, Mclaurin B, Mclellan BA, Mcneil D, Mcneill R, Mehrle A, Melbie K, Melliza T, Messina T, Meyer R, Michel K, Mikdadi G, Miller C, Miller R, Miller A, Miller G, Miller W, Mitchell J, Moats DJR, Mody F, Moffat J, Molk B, Molter D, Monroe T, Montero H, Montgomery R, Mookherjee D, Moran J, Moriarty P, Morrison J, Morton D, Moshayedi P, Mosley J, Moustafa M, Munshi K, Murray A, Mustafa J, Nadar V, Naidu R, Nalley J, Navy S, Neil L, Neutel JM, Niblack P, Nicely V, Nicolai M, Nijmeh G, Nikas A, Nikyar A, Nixon S, Norman L, Noto G, Nour K, Nugent A, Ocman B, Odegard A, Olsen S, Ortiz-Carrasquillo R, Ossino N, Paez H, Palchick B, Paliwal Y, Pannell R, Parfait V, Partridge J, Patel B, Patel R, Patel M, Patel S, Paysor C, Pena A, Pereira S, Perez M, Perez A, Perkins H, Perry B, Peters P, Phillippi C, Phillips A, Phillips A, Piacente R, Pintado M, Pish R, Pitt W, Poling T, Pomposini D, Poock J, Potts J, Poudrier R, Prior J, Pritchard C, Purighalla R, Quddusi K, Quinones J, Quinton D, Radin M, Radojcsics B, Rajput B, Rama B, Ramos M, Rauch R, Raynes K, Reber AM, Reddy J, Reeves M, Reilly K, Renaud K, Resnick H, Reyes R, Richardson M, Riethof M, Riser J, Rodero M, Rodriguez Araya E, Roper L, Rozeman P, Ruder D, Runquist L, Sack G, Saint-Jacques H, Salfity M, Sall N, Sam K, Samal A, Sanchez D, Santiago J Jr, Savignano C, Saylor R, Scheffel M, Schifferdecker B, Schindler E, Schneider P, Schneider R, Schnitzler R, Schrager B, Schwartz A, Scott R, Seals A, Shah AV, Shah A, Shatsky K, Shayani S, Shealy N, Sheets L, Shelley J, Shepard P, Shetty S, Silver K, Simon M, Singh K, Singh N, Sizemore BC, Skatrud L, Slayton C, Slimak V, Sloane G, Smallwood B, Smith P, Smith M, Smith T, Smith G, Smith B, Smith W, Smith M, Smith J, Smith J, Soca Y, Sofley C, Sopko K, Sosa-Padilla M, Sotolongo R, Sprinkle B, Srivastava S, Starzec M, Steinhoff J, Stelly L, Stinson J, Stoddard M, Stoltz S, Stone B, Stover T, Strain J, Strugatsky S, Stys T, Suleman A, Sullivan P, Tamez W, Tandon N, Teltser M, Terry PS, Terry K, Tessmar C, Thekkoott D, Thomas D, Thomas DM, Thompson E, Thompson J, Thornton A, Tjaden T, Tobias C, Topper J, Tran A, Treasure C, Trenkamp P, Trevino M, Tsou L, Tuholske C, Uy W, Vahtel M, Vaid B, Valenzuela M, Vance A, Vandam J, Vanhecke T, Vanness WC III, Vargas R, Vaz S, Vazquez Tanus J, Veerina K, Vega J, Vento A, Vijay N, Voelker F, Vogt E, Vold D, Vora K, Wade RD, Wadell C, Waksman R, Walker K, Walker K, Wallace K, Warren M, Washam M, Watson B, Webel R, Wells T, West M, Whitaker J, White J, White C, White A, White A, Wilhoit G, Wilkins M, Willingham K, Wilson S, Wilson V, Wise J, Woodall S, Woods A, Wright J, Wu J, Xu ZJ, Yarows S, Young A, Younis L, Zarate J, Zebrack J, Zhang W, Zieve F, Zineldine A, Ridker, P. M., Everett, B. M., Thuren, T., Macfadyen, J. G., Chang, W. H., Ballantyne, C., FONSECA E PIRES, CARLOS EDUARDO, Nicolau, J., Koenig, W., Anker, S. D., Kastelein, J. J. P., Cornel, J. H., Pais, P., Pella, D., Genest, J., Cifkova, R., Lorenzatti, A., Forster, T., Kobalava, Z., Vida-Simiti, L., Flather, M., Shimokawa, H., Ogawa, H., Dellborg, M., Rossi, P. R. F., Troquay, R. P. T., Libby, P., Glynn R., J, CANTOS Trial, Group, Perrone, Filardi, P, ACS - Amsterdam Cardiovascular Sciences, Vascular Medicine, ACS - Pulmonary hypertension & thrombosis, and ACS - Atherosclerosis & ischemic syndromes
- Subjects
0301 basic medicine ,030204 cardiovascular system & hematology ,law.invention ,0302 clinical medicine ,c-reactive protein ,Randomized controlled trial ,law ,Cardiovascular Disease ,middle aged ,double-blind method ,antibodies ,Myocardial infarction ,humans ,Stroke ,interleukin-1beta ,biology ,Antibodies, Monoclonal ,drug ,General Medicine ,Lipid ,Aged ,anti-inflammatory agents ,monoclonal ,humanized ,atherosclerosis ,cardiovascular diseases ,dose-response relationship ,female ,incidence ,infections ,lipids ,male ,myocardial infarction ,neutropenia ,secondary prevention ,stroke ,Anti-Inflammatory Agent ,aged ,Editorial ,Atherosclerosi ,Monoclonal ,Human ,medicine.drug ,medicine.medical_specialty ,Neutropenia ,Antibodies, Monoclonal, Humanized ,Infections ,Placebo ,antibodies, monoclonal ,dose-response relationship, drug ,infection ,medicine (all) ,03 medical and health sciences ,Internal medicine ,medicine ,Dose-Response Relationship, Drug ,business.industry ,Antiinflammatory Therapy, Canakinumab, for Atherosclerotic Disease ,C-reactive protein ,medicine.disease ,Surgery ,Canakinumab ,030104 developmental biology ,biology.protein ,business - Abstract
Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.)
- Published
- 2017
22. Diseño del estudio ROLLERCOASTR: aterectomía rotacional, litotricia o láser para el tratamiento de estenosis coronarias calcificadas
- Author
-
Alfonso Jurado-Román, Antonio Gómez-Menchero, Ignacio J. Amat-Santos, Juan Caballero-Borrego, Soledad Ojeda, Raymundo Ocaranza-Sánchez, Santiago Jiménez-Valero, Guillermo Galeote, and Raúl Moreno
- Subjects
Intervencionismo coronario percutáneo ,Placas calcificadas ,Láser ,Litotricia ,Aterectomía rotacional ,Tomografía de coherencia óptica ,Internal medicine ,RC31-1245 - Abstract
RESUMEN Introducción y objetivos: La calcificación coronaria es uno de los principales factores que inciden negativamente en la seguridad y la eficacia del intervencionismo coronario percutáneo. Existen varias técnicas de modificación del calcio, pero falta evidencia de estudios aleatorizados sobre la terapia de elección en este escenario. Métodos: El ROLLERCOASTR es un estudio prospectivo, multicéntrico y aleatorizado, diseñado para comparar la seguridad y la eficacia de 3 técnicas de modificación de la placa en el contexto de calcificación coronaria moderada o grave: aterectomía rotacional (AR), aterectomía coronaria con láser láser excimer (ACLE) y litotricia intracoronaria (LIC). El objetivo primario es la expansión del stent evaluada mediante tomografía de coherencia óptica. Su análisis se hará por intención de tratar, con un α de 0,05 entre el grupo de referencia (AR) y cada uno de los otros grupos (ACLE y LIC). Se realizará también un análisis del objetivo primario por protocolo para mantener la coherencia. Si se confirma la hipótesis de no inferioridad, se realizará un análisis bilateral de superioridad. El comité de eventos clínicos y el laboratorio central independiente no conocerán la rama de tratamiento. Asumiendo un error α de 0,05, un error β de 0,2 (80% de potencia), un margen de irrelevancia (ε) del 7% y un 10% de pérdidas por dificultad de medición o imposibilidad de completar la intervención, se estima un tamaño de muestra de 56 casos en cada grupo. Los objetivos secundarios son el éxito del dispositivo, el éxito del procedimiento, la tasa de cruce entre técnicas y la presentación de eventos cardiovasculares adversos importantes al año de seguimiento. Conclusiones: El estudio ROLLERCOASTR evaluará y comparará la seguridad y la eficacia, en pacientes con estenosis coronaria calcificada, de 3 técnicas de modificación de placa: AR, ACLE y LIC. Este ensayo se ha registrado en Clinicaltrials.gov: NCT04181268.
- Published
- 2023
- Full Text
- View/download PDF
23. The evaluation of pituitary damage associated with cardiac arrest: An experimental rodent model
- Author
-
Santiago J. Miyara, Tomoaki Aoki, Junhwan Kim, Yu Okuma, Kei Hayashida, Mitsuaki Nishikimi, Lance B Becker, Koichiro Shinozaki, Tai Yin, and Ryosuke Takegawa
- Subjects
Male ,medicine.medical_specialty ,Pituitary gland ,medicine.medical_treatment ,Science ,Pituitary Diseases ,Cell death in the nervous system ,030204 cardiovascular system & hematology ,Article ,Rats, Sprague-Dawley ,03 medical and health sciences ,0302 clinical medicine ,Sodium-Glucose Transporter 2 ,Internal medicine ,medicine ,Endocrine system ,Animals ,Cardiopulmonary resuscitation ,HMGB1 Protein ,Pathological ,Asphyxia ,Inflammation ,Multidisciplinary ,business.industry ,Translational research ,Staining ,Heart Arrest ,Rats ,Endocrinology ,medicine.anatomical_structure ,Immunohistochemistry ,Medicine ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Biomarkers ,Hormone - Abstract
The pituitary gland plays an important endocrinal role, however its damage after cardiac arrest (CA) has not been well elucidated. The aim of this study was to determine a pituitary gland damage induced by CA. Rats were subjected to 10-min asphyxia and cardiopulmonary resuscitation (CPR). Immunohistochemistry and ELISA assays were used to evaluate the pituitary damage and endocrine function. Samples were collected at pre-CA, and 30 and 120 min after cardio pulmonary resuscitation. Triphenyltetrazolium chloride (TTC) staining demonstrated the expansion of the pituitary damage over time. There was phenotypic validity between the pars distalis and nervosa. Both CT-proAVP (pars nervosa hormone) and GH/IGF-1 (pars distalis hormone) decreased over time, and a different expression pattern corresponding to the damaged areas was noted (CT-proAVP, 30.2 ± 6.2, 31.5 ± 5.9, and 16.3 ± 7.6 pg/mg protein, p p p = 0.025) and IGF-1 (r = −0.775, p = 0.024) demonstrated a strong correlation with TTC staining area. Our data suggested that CA induces pathological and functional damage to the pituitary gland.
- Published
- 2020
24. Impact of age on the selection of nuclear cardiology stress protocols: The INCAPS (IAEA nuclear cardiology protocols) study
- Author
-
Al-Mallah, Mh, Pascual, Tnb, Mercuri, M, Vitola, Jv, Karthikeyan, G, Better, N, Dondi, M, Paez, D, Eistein, Aj, Bouyoucef, Se, Allam, Ah, Vangu, M, Rehani, Mm, Kashyap, R, Lele, V, Magboo, Vpc, Mahmarian, Jj, Mut, F, Alexánderson, E, Allam, A, Bom, H, Flotats, A, Jerome, S, Kaufmann, Pa, Luxenburg, O, Mahmarian, J, Shaw, Lj, Underwood, Sr, Amouri, W, Essabbah, H, Gassama, Ss, Makhdomi, Kb, El Mustapha, Gie, El Ouchdi, N, Qaïs, N, Soni, N, Vangu, W, Abazid, Rm, Adams, B, Agarwal, V, Alfeeli, Ma, Alnafisi, N, Bernabe, L, Bural, Gg, Chaiwatanarat, T, Chandraguptha, Jm, Cheon, Gj, Cho, I, Dogan, As, Eftekhari, M, Frenkel, A, Garty, I, George, S, Geramifar, P, Golan, H, Habib, S, Hussain, R, Im, H, Jeon, H-J, Kalawat, T, Kang, Wj, Keng, F, Klaipetch, A, Kumar, Pg, Lee, J, Lee, Ww, Lim, I, Macaisa, Cmm, Malhotra, G, Mittal, Br, Mohammad, Mh, Mohan, P, Mulyanto, Id, Nariman, D, Nayak, Un, Niaz, K, Nikolov, G, Obaldo, Jm, Ozturk, E, Park, Jm, Park, S, Patel, Cd, Phuong, Hk, Quinon, Ap, Rajini, Tr, Saengsuda, Y, Santiago, J, Sayman, Hb, Shinto, As, Sivasubramaniyan, V, Son, Mh, Sudhakar, P, Syed, Gms, Tamaki, N, Thamnirat, K, Thientunyakit, T, Thongmak, S, Velasco, Dn, Verma, A, Vutrapongwatana, U, Wang, Y, Won, Ks, Yao, Z, Yingsa-Nga, T, Yudistiro, R, Yue, Kt, Zafrir, N, Adrian, Sc, Agostini, D, Aguadé, S, Armitage, G, Backlund, M, Backman, M, Baker, M, Balducci, Mt, Bavelaar, C, Berovic, M, Bertagna, F, Beuchel, R, Biggi, A, Bisi, G, Bonini, R, Bradley, A, Brudin, L, Bruno, I, Busnardo, E, Casoni, R, Choudhri, A, Cittanti, C, Clauss, R, Costa, Dc, Costa, M, Dixon, K, Dziuk, M, Egelic, N, Eriksson, I, Fagioli, G, De Faria, Db, Florimonte, L, Francini, Alberto, French, M, Gallagher, E, Garai, I, Geatti, O, Genovesi, D, Gianolli, L, Gimelli, A, Del Giudice, E, Halliwell, S, Hansson, Mj, Harrison, C, Homans, F, Horton, F, Jȩdrzejuk, D, Jogi, J, Johansen, A, Johansson, H, Kalnina, M, Kaminek, M, Kiss, A, Kobylecka, M, Kostkiewicz, M, Kropp, J, Kullenberg, R, Lahoutte, T, Lang, O, Larsson, Yh, Lázár, M, Leccisotti, L, Leners, N, Lindner, O, Lipp, Rw, Maenhout, A, Maffioli, L, Marcassa, C, Martins, B, Marzullo, P, Medolago, G, Mendiguchía, Cg, Mirzaei, S, Mori, M, Nardi, B, Nazarenko, S, Nikoletic, K, Oleksa, R, Parviainen, T, Patrina, J, Peace, R, Pirich, C, Piwowarska-Bilska, H, Popa, S, Prakash, V, Pubul, V, Puklavec, L, Rac, S, Ratniece, M, Rogan, Sa, Romeo, Annunziata, Rossi, M, Ruiz, D, Sabharwal, N, Salobir, Bg, Santos, Ai, Saranovic, S, Sarkozi, A, Schneider, Rp, Sciagra, R, Scotti, S, Servini, Z, Setti, Lr, Starck, S-A., Vajauskas, D, Veselý, J, Vieni, A, Vignati, A, Vito, I. M., Weiss, K, Wild, D, Zdraveska-Kochovska, M, Agüro, Rn, Alvarado, N, Barral, Cm, Beretta, M, Berrocal, I, Batista Cuellar, Jf, Cabral Chang, T-M, Cabrera Rodríguez, Lo, Canessa, J, Castro Mora, G, Claudia, Ac, Clavelo, Gf, Cruz, Af, Faccio, Ff, Fernández, Km, Gomez Garibo, Jr, Gonzalez, U, González, Pe, Guzzo, Ma, Jofre, J, Kapitán, M, Kempfer, G, Lopez, Jl, Massardo, Tv, Medeiros Colaco, I, Mesquita, Ct, Montecinos, M, Neubauer, S, Pabon, Lm, Puente, A, Rochela Vazquez, Lm, Serna Macias, Ja, Silva Pino, Ag, Tártari Huber, Fz, Tovar, Ap, Vargas, L, Wiefels, C, Aljizeeri, A, Alvarez, Rj, Barger, D, Beardwood, W, Behrens, J, Brann, L, Brown, D, Carr, H, Churchwell, K, Comingore, Ga, Corbett, J, Costello, M, Cruz, F, Depinet, T, Dorbala, S, Earles, M, Esteves, Fp, Etherton, E, Fanning, Rj, Fornace, J, Franks, L, Gewirtz, H, Gulanchyn, K, Hannah, C-L, Hays, J, Hendrickson, J, Hester, J, Holmes, K, Johnson, A, Jopek, C, Lewin, H, Lyons, J, Manley, C, Meden, J, Moore, S, Moore, Wh, Murthy, V, Nace, R, Neely, D, Nelson, L, Niedermaier, O, Rice, D, Rigs, R, Schiffer, K, Schockling, E, Schultz, T, Schumacker, T, Sheesley, B, Sheikh, A, Siegel, B, Slim, Am, Smith, J, Szulc, Mc, Tanskersley, N, Tilkemeier, P, Valdez, Gd, Vrooman, R, Wawrowicz, D, Winchester, De, Alcheikh, A, Allen, B, Atkins, E, Bevan, J, Bonomini, C, Christiansen, J, Clack, L, Craig, E, Dixson, H, Duncan, I, Fredericks, S, Gales, S, Hampson, R, Hanley, T, Hartcher, K, Hassall, J, Kelley, B, Kelly, S, Kidd, T, De Kort, T, Larcos, G, Macdonald, W, Mcgrath, C, Murdoch, E, O'Malley, S, O'Rourke, M, Pack, M, Pearce, R, Praehofer, R, Ramsay, S, Scarlett, L, Smidt, K, Souvannavong, F, Taubman, K, Taylor, G, Tse, K, Unger, S, and Weale, J
- Subjects
Ionizing radiation ,Male ,medicine.medical_specialty ,Cross-sectional study ,Cardiology ,Guidelines ,030204 cardiovascular system & hematology ,Radiation Dosage ,Effective dose (radiation) ,NO ,Cohort Studies ,03 medical and health sciences ,Myocardial perfusion imaging ,Age ,0302 clinical medicine ,Internal medicine ,Humans ,Medicine ,030212 general & internal medicine ,Tomography ,Age Factors ,Aged ,Cross-Sectional Studies ,Female ,Middle Aged ,Myocardial Perfusion Imaging ,Positron-Emission Tomography ,Practice Guidelines as Topic ,Radiation Exposure ,Retrospective Studies ,Tomography, Emission-Computed, Single-Photon ,Nuclear Energy ,medicine.diagnostic_test ,business.industry ,Retrospective cohort study ,Radiation exposure ,Cohort ,Emission-Computed ,Cardiology and Cardiovascular Medicine ,business ,Single-Photon ,Cohort study - Abstract
There is growing concern about radiation exposure from nuclear myocardial perfusion imaging (MPI), particularly among younger patients who are more prone to develop untoward effects of ionizing radiation, and hence US and European professional society guidelines recommend age as a consideration in weighing radiation risk from MPI. We aimed to determine how patient radiation doses from MPI vary across age groups in a large contemporary international cohort.Data were collected as part of a global cross-sectional study of centers performing MPI coordinated by the International Atomic Energy Agency (IAEA). Sites provided information on each MPI study completed during a single week in March-April 2013. We compared across age groups laboratory adherence to pre-specified radiation-related best practices, radiation effective dose (ED; a whole-body measure reflecting the amount of radiation to each organ and its relative sensitivity to radiation's deleterious effects), and the proportion of patients with ED ≤ 9 mSv, a target level specified in guidelines.Among 7911 patients undergoing MPI in 308 laboratories in 65 countries, mean ED was 10.0 ± 4.5 mSv with slightly higher exposure among younger age groups (trend p value 0.001). There was no difference in the proportion of patients with ED ≤ 9 mSv across age groups, or in adherence to best practices based on the median age of patients in a laboratory.In contemporary nuclear cardiology practice, the age of the patient appears not to impact protocol selection and radiation dose, contrary to professional society guidelines.
- Published
- 2018
25. Nuclear cardiology practices and radiation exposure in Africa: results from the IAEA Nuclear Cardiology Protocols Study (INCAPS)
- Author
-
Bouyoucef, Salah E., Mercuri, Mathew, Pascual, Thomas N. B., Allam, Adel H., Vangu, Mboyo, Vitola, João V., Better, Nathan, Karthikeyan, Ganesan, Mahmarian, John J., Rehani, Madan M., Kashyap, Ravi, Dondi, Maurizio, Paez, Diana, Einstein, Andrew J., Einstein, A. J., Pascual, T. N. B., Paez, D., Dondi, M., Better, N., Bouyoucef, S. E., Karthikeyan, G., Kashyap, R., Lele, V., Magboo, V. P. C., Mahmarian, J. J., Mercuri, M., Mut, F., Rehani, M. M., Vitola, J. V., Alexánderson, E., Allam, A., Al-Mallah, M. H., Bom, H., Flotats, A., Jerome, S., Kaufmann, P. A., Luxenburg, O., Mahmarian, J., Shaw, L. J., Underwood, S. R., Vitola, J., Amouri, W., Essabbah, H., Gassama, S. S., Makhdomi, K. B., El Mustapha, G. I. E., El Ouchdi, N., Qaïs, N., Soni, N., Vangu, W., Abazid, R. M., Adams, B., Agarwal, V., Alfeeli, M. A., Alnafisi, N., Bernabe, L., Bural, G. G., Chaiwatanarat, T., Chandraguptha, J. M., Cheon, G. J., Cho, I., Dogan, A. S., Eftekhari, M., Frenkel, A., Garty, I., George, S., Geramifar, P., Golan, H., Habib, S., Hussain, R., Im, H., Jeon, H. -J., Kalawat, T., Kang, W. J., Keng, F., Klaipetch, A., Kumar, P. G., Lee, J., Lee, W. W., Lim, I., Macaisa, C. M. M., Malhotra, G., Mittal, B. R., Mohammad, M. H., Mohan, P., Mulyanto, I. D., Nariman, D., Nayak, U. N., Niaz, K., Nikolov, G., Obaldo, J. M., Ozturk, E., Park, J. M., Park, S., Patel, C. D., Phuong, H. K., Quinon, A. P., Rajini, T. R., Saengsuda, Y., Santiago, J., Sayman, H. B., Shinto, A. S., Sivasubramaniyan, V., Son, M. H., Sudhakar, P., Syed, G. M. S., Tamaki, N., Thamnirat, K., Thientunyakit, T., Thongmak, S., Velasco, D. N., Verma, A., Vutrapongwatana, U., Wang, Y., Won, K. S., Yao, Z., Yingsa-Nga, T., Yudistiro, R., Yue, K. T., Zafrir, N., Adrian, S. C., Agostini, D., Aguadé, S., Armitage, G., Backlund, M., Backman, M., Baker, M., Balducci, M. T., Bavelaar, C., Berovic, M., Bertagna, F., Beuchel, R., Biggi, A., Bisi, G., Bonini, R., Bradley, A., Brudin, L., Bruno, I., Busnardo, E., Casoni, R., Choudhri, A., Cittanti, C., Clauss, R., Costa, D. C., Costa, M., Dixon, K., Dziuk, M., Egelic, N., Eriksson, I., Fagioli, G., De Faria, D. B., Florimonte, L., Francini, A., French, M., Gallagher, E., Garai, I., Geatti, O., Genovesi, D., Gianolli, L., Gimelli, A., Del Giudice, E., Halliwell, S., Hansson, M. J., Harrison, C., Homans, F., Horton, F., Jȩdrzejuk, D., Jogi, J., Johansen, A., Johansson, H., Kalnina, M., Kaminek, M., Kiss, A., Kobylecka, M., Kostkiewicz, M., Kropp, J., Kullenberg, R., Lahoutte, T., Lang, O., Larsson, Y. H., Lázár, M., Leccisotti, L., Leners, N., Lindner, O., Lipp, R. W., Maenhout, A., Maffioli, L., Marcassa, C., Martins, B., Marzullo, P., Medolago, G., Mendiguchía, C. G., Mirzaei, S., Mori, M., Nardi, B., Nazarenko, S., Nikoletic, K., Oleksa, R., Parviainen, T., Patrina, J., Peace, R., Pirich, C., Piwowarska-Bilska, H., Popa, S., Prakash, V., Pubul, V., Puklavec, L., Rac, S., Ratniece, M., Rogan, S. A., Romeo, A., Rossi, M., Ruiz, D., Sabharwal, N., Salobir, B. G., Santos, A. I., Saranovic, S., Sarkozi, A., Schneider, R. P., Sciagra, R., Scotti, S., Servini, Z., Setti, L. R., Starck, S-Ã…., Vajauskas, D., Veselý, J., Vieni, A., Vignati, A., Vito, I. M., Weiss, K., Wild, D., Zdraveska-Kochovska, M., Agüro, R. N., Alvarado, N., Barral, C. M., Beretta, M., Berrocal, I., Batista Cuellar, J. F., Cabral Chang, T. -M., Cabrera Rodríguez, L. O., Canessa, J., Castro Mora, G., Claudia, A. C., Clavelo, G. F., Cruz, A. F., Faccio, F. F., Fernández, K. M., Gomez Garibo, J. R., Gonzalez, U., González, P. E., Guzzo, M. A., Jofre, J., Kapitán, M., Kempfer, G., Lopez, J. L., Massardo, T. V., Medeiros Colaco, I., Mesquita, C. T., Montecinos, M., Neubauer, S., Pabon, L. M., Puente, A., Rochela Vazquez, L. M., Serna Macias, J. A., Silva Pino, A. G., Tártari Huber, F. Z., Tovar, A. P., Vargas, L., Wiefels, C., Aljizeeri, A., Alvarez, R. J., Barger, D., Beardwood, W., Behrens, J., Brann, L., Brown, D., Carr, H., Churchwell, K., Comingore, G. A., Corbett, J., Costello, M., Cruz, F., Depinet, T., Dorbala, S., Earles, M., Esteves, F. P., Etherton, E., Fanning, R. J., Fornace, J., Franks, L., Gewirtz, H., Gulanchyn, K., Hannah, C. -L., Hays, J., Hendrickson, J., Hester, J., Holmes, K., Johnson, A., Jopek, C., Lewin, H., Lyons, J., Manley, C., Meden, J., Moore, S., Moore, W. H., Murthy, V., Nace, R., Neely, D., Nelson, L., Niedermaier, O., Rice, D., Rigs, R., Schiffer, K., Schockling, E., Schultz, T., Schumacker, T., Sheesley, B., Sheikh, A., Siegel, B., Slim, A. M., Smith, J., Szulc, M. C., Tanskersley, N., Tilkemeier, P., Valdez, G. D., Vrooman, R., Wawrowicz, D., Winchester, D. E., Alcheikh, A., Allen, B., Atkins, E., Bevan, J., Bonomini, C., Christiansen, J., Clack, L., Craig, E., Dixson, H., Duncan, I., Fredericks, S., Gales, S., Hampson, R., Hanley, T., Hartcher, K., Hassall, J., Kelley, B., Kelly, S., Kidd, T., De Kort, T., Larcos, G., Macdonald, W., Mcgrath, C., Murdoch, E., O'Malley, S., O'Rourke, M., Pack, M., Pearce, R., Praehofer, R., Ramsay, S., Scarlett, L., Smidt, K., Souvannavong, F., Taubman, K., Taylor, G., Tse, K., Unger, S., and Weale, J.
- Subjects
Male ,medicine.medical_specialty ,Heart Diseases ,Cross-sectional study ,MEDLINE ,effective dose ,Cardiology ,030204 cardiovascular system & hematology ,Effective dose (radiation) ,NO ,030218 nuclear medicine & medical imaging ,CONSECUTIVE SAMPLE ,03 medical and health sciences ,Myocardial perfusion imaging ,0302 clinical medicine ,Interquartile range ,Internal medicine ,medicine ,best practices ,Humans ,Registries ,Africa ,Best practices ,Effective dose ,Radiation ,Aged ,Cross-Sectional Studies ,Female ,Incidence ,Middle Aged ,Myocardial Perfusion Imaging ,Radiation Exposure ,Radiation Injuries ,Tomography, Emission-Computed, Single-Photon ,Cardiology and Cardiovascular Medicine ,Tomography ,medicine.diagnostic_test ,business.industry ,Cardiovascular Topics ,Radiation dose ,General Medicine ,Radiation exposure ,radiation ,Emission-Computed ,business ,Single-Photon - Abstract
OBJECTIVE While nuclear myocardial perfusion imaging (MPI) offers many benefits to patients with known or suspected cardiovascular disease, concerns exist regarding radiation-associated health effects. Little is known regarding MPI practice in Africa. We sought to characterise radiation doses and the use of MPI best practices that could minimise radiation in African nuclear cardiology laboratories, and compare these to practice worldwide. METHODS Demographics and clinical characteristics were collected for a consecutive sample of 348 patients from 12 laboratories in six African countries over a one-week period from March to April 2013. Radiation effective dose (ED) was estimated for each patient. A quality index (QI) enumerating adherence to eight best practices, identified a priori by an IAEA expert panel, was calculated for each laboratory. We compared these metrics with those from 7 563 patients from 296 laboratories outside Africa. RESULTS Median (interquartile range) patient ED in Africa was similar to that of the rest of the world [9.1 (5.1-15.6) vs 10.3 mSv (6.8-12.6), p = 0.14], although a larger proportion of African patients received a low ED, ≤ 9 mSv targeted in societal recommendations (49.7 vs 38.2%, p < 0.001). Bestpractice adherence was higher among African laboratories (QI score: 6.3 ± 1.2 vs 5.4 ± 1.3, p = 0.013). However, median ED varied significantly among African laboratories (range: 2.0-16.3 mSv; p < 0.0001) and QI range was 4-8. CONCLUSION Patient radiation dose from MPI in Africa was similar to that in the rest of the world, and adherence to best practices was relatively high in African laboratories. Nevertheless there remain opportunities to further reduce radiation exposure to African patients from MPI.
- Published
- 2017
26. Diagnostic Value of Cerebrospinal Fluid Neurofilament Light Protein in Neurology: A Systematic Review and Meta-analysis
- Author
-
van Wieringen Wn, Marcel M. Verbeek, Ludwig Kappos, van Swieten Jc, Tove Christensen, Edward J. Wild, Lieke H.H. Meeter, Mattias Vågberg, Ross W. Paterson, Tobias Skillbäck, Lu Ch, Markus Axelsson, Shorena Janelidze, Ulf Andreasson, Maria Bjerke, Jonathan M. Schott, José C. Álvarez-Cermeño, Megan K. Herbert, Nadia K. Magdalinou, Michael Jonsson, Betty M. Tijms, Peter Sundström, Troiano M, Fredrik Piehl, Mohsen Khademi, Pyykkö Ot, Rosanna Tortelli, Jens Kuhle, Lena Brundin, Ales Bartos, Joel Jakobsson, Jessen-Krut J, Michael Khalil, Isabella Laura Simone, Stilund M, Julio C. Rojas, Carole Scherling, Lenka Fialová, David Bäckström, Finn Sellebjerg, Anders Wallin, Jette L. Frederiksen, Pieter Jelle Visser, Signe Modvig, Henrik Zetterberg, Mikael Landén, Mehta, Carla Tortorella, Gudmundur Johannsson, Andrea Malaspina, Giancarlo Logroscino, Pijnenburg Yal, Pérez-Santiago J, Claire Bridel, Weiss A, Romme Christensen J, Niklas Mattsson, Martin Gunnarsson, Alessandro Trentini, Sandberg L, Sara Hall, Kaj Blennow, Lars Forsgren, Ragnarsson O, Oskar Hansson, Jan Lycke, Tomas Olsson, Magnus Gisslén, Joachim Burman, Carsten Wikkelsö, Anders Svenningsson, Luisa M. Villar, Leinonen, Martin R Turner, Charlotte E. Teunissen, Elizabeth Gray, A. Boxer, Neurology, Human genetics, Laboratory Medicine, Epidemiology and Data Science, Amsterdam Neuroscience - Neuroinfection & -inflammation, CCA - Imaging and biomarkers, Clinical sciences, and Group, NFL
- Subjects
NATIONAL INSTITUTE ,medicine.medical_specialty ,Neurology ,neuroaxonal damage ,CLINICAL-DIAGNOSIS ,cerebrospinal fluid ,AMYOTROPHIC-LATERAL-SCLEROSIS ,NO ,AXONAL DAMAGE ,03 medical and health sciences ,0302 clinical medicine ,PARKINSONS-DISEASE ,Internal medicine ,medicine ,Dementia ,030212 general & internal medicine ,Amyotrophic lateral sclerosis ,FIBRILLARY ACIDIC PROTEIN ,Original Investigation ,Medicine(all) ,Neurofilament light protein ,business.industry ,Multiple sclerosis ,MULTIPLE-SCLEROSIS ,Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] ,medicine.disease ,Amyotrophic-lateral-sclerosis ,fibrillary acidic protein ,csf neurofilament ,multiple-sclerosis ,alzheimers-disease ,axonal damage ,neurodegenerative diseases ,parkinsons-disease ,clinical-diagnosis ,national institute ,3. Good health ,ALZHEIMERS-DISEASE ,CSF NEUROFILAMENT ,Meta-analysis ,Biomarker (medicine) ,healthy controls ,Neurology (clinical) ,diagnostic value ,Alzheimer's disease ,business ,NEURODEGENERATIVE DISEASES ,030217 neurology & neurosurgery ,Frontotemporal dementia - Abstract
Key PointsQuestionHow do levels of neurofilament light in cerebrospinal fluid (cNfL) compare between neurological conditions and with healthy controls? FindingsAmong 10 059 individuals in this systematic review and meta-analysis, cNfL was elevated in most neurological conditions compared with healthy controls, and the magnitude of the increase varies extensively. Although cNfL overlaps between most clinically similar conditions, its distribution did not overlap in frontotemporal dementia and other dementias or in Parkinson disease and atypical parkinsonian syndromes. MeaningThe cNfL is a marker of neuronal damage and may be useful to differentiate some clinically similar conditions, such as frontotemporal dementia from Alzheimer disease and Parkinson disease from atypical parkinsonian syndromes. This systematic review and meta-analysis assesses the associations of age, sex, and diagnosis with neurofilament light in cerebrospinal fluid and evaluates its potential in discriminating clinically similar conditions. ImportanceNeurofilament light protein (NfL) is elevated in cerebrospinal fluid (CSF) of a number of neurological conditions compared with healthy controls (HC) and is a candidate biomarker for neuroaxonal damage. The influence of age and sex is largely unknown, and levels across neurological disorders have not been compared systematically to date. ObjectivesTo assess the associations of age, sex, and diagnosis with NfL in CSF (cNfL) and to evaluate its potential in discriminating clinically similar conditions. Data SourcesPubMed was searched for studies published between January 1, 2006, and January 1, 2016, reporting cNfL levels (using the search terms neurofilament light and cerebrospinal fluid) in neurological or psychiatric conditions and/or in HC. Study SelectionStudies reporting NfL levels measured in lumbar CSF using a commercially available immunoassay, as well as age and sex. Data Extraction and SynthesisIndividual-level data were requested from study authors. Generalized linear mixed-effects models were used to estimate the fixed effects of age, sex, and diagnosis on log-transformed NfL levels, with cohort of origin modeled as a random intercept. Main Outcome and MeasureThe cNfL levels adjusted for age and sex across diagnoses. ResultsData were collected for 10059 individuals (mean [SD] age, 59.7 [18.8] years; 54.1% female). Thirty-five diagnoses were identified, including inflammatory diseases of the central nervous system (n=2795), dementias and predementia stages (n=4284), parkinsonian disorders (n=984), and HC (n=1332). The cNfL was elevated compared with HC in a majority of neurological conditions studied. Highest levels were observed in cognitively impaired HIV-positive individuals (iHIV), amyotrophic lateral sclerosis, frontotemporal dementia (FTD), and Huntington disease. In 33.3% of diagnoses, including HC, multiple sclerosis, Alzheimer disease (AD), and Parkinson disease (PD), cNfL was higher in men than women. The cNfL increased with age in HC and a majority of neurological conditions, although the association was strongest in HC. The cNfL overlapped in most clinically similar diagnoses except for FTD and iHIV, which segregated from other dementias, and PD, which segregated from atypical parkinsonian syndromes. Conclusions and RelevanceThese data support the use of cNfL as a biomarker of neuroaxonal damage and indicate that age-specific and sex-specific (and in some cases disease-specific) reference values may be needed. The cNfL has potential to assist the differentiation of FTD from AD and PD from atypical parkinsonian syndromes.
- Published
- 2019
27. Desaturación provocada por el ejercicio asociada a foramen, ¿infrecuente o infradiagnosticada?
- Author
-
Víctor M. Juárez Olmos, Óscar González-Fernández, Alfonso Jurado Román, Santiago Jiménez Valero, Cristina Contreras Lorenzo, and Almudena Castro Conde
- Subjects
Internal medicine ,RC31-1245 - Abstract
Sr. Editor: El foramen oval permeable (FOP) se encuentra presente en aproximadamente 1 de cada 4 personas, y para la gran mayoría de ellas no tiene consecuencias clínicas1; en otras, en cambio, puede favorecer la aparición de ictus, migrañas o síndrome de descompresión o desaturación con el ortostatismo (conocido como síndrome de platipnea-ortodesoxia)2. Una presentación todavía más infrecuente del FOP que se puede desarrollar en la edad adulta es la desaturación provocada por el ejercicio, descrita en pocas revisiones bibliográficas y con un término no totalmente acuñado3,4. Se presenta el caso de una mujer de 79 años con antecedentes de hipertensión y diabetes que es remitida a la unidad de rehabilitación cardiaca por disnea y pobre capacidad funcional. La paciente acudió con un estudio previo sin hallazgos significativos: ecocardiograma transtorácico, pruebas de función respiratoria, angiotomografía computarizada pulmonar y cateterismo coronario. En la exploración física destacaba una saturación de oxígeno del 98%. La analítica sanguínea era normal, con una fracción N-terminal del propéptido natriurético cerebral tipo B de 255 pg/ml. Cuando entró a la consulta refirió disnea de esfuerzo que apareció en el trayecto desde la sala de espera. Ante lo observado, se le colocó un pulsioxímetro y se salió a andar con ella....
- Published
- 2023
- Full Text
- View/download PDF
28. Epigenetics modifications and Subclinical Atherosclerosis in Obstructive Sleep Apnea: The EPIOSA study
- Author
-
Jose M. Marin, Rosa Bolea, José Antonio García-Erce, Teresa Martin, Marta Forner, Isabel Villar, Inmaculada Martín-Burriel, Victoria Gil, José P. Cubero, Luis Ros, A. Sanz, Jorge Artal, Marta Andrés, Luis Varona, Santiago J. Carrizo, Javier Godino, and Begoña Gallego
- Subjects
Adult ,Carotid Artery Diseases ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Pathology ,Cardiovascular Complication ,Polysomnography ,Gene Expression ,Physical examination ,Epigenesis, Genetic ,Young Adult ,Study Protocol ,Internal medicine ,Surveys and Questionnaires ,Epidemiology ,medicine ,Humans ,Longitudinal Studies ,Prospective Studies ,RNA, Messenger ,Subclinical atherosclerosis ,Prospective cohort study ,Ultrasonography ,Sleep Apnea, Obstructive ,medicine.diagnostic_test ,Systemic inflammation ,business.industry ,Sleep apnea ,DNA ,DNA Methylation ,Middle Aged ,medicine.disease ,Clinical trial ,Obstructive sleep apnea ,MicroRNAs ,Research Design ,Epigenetics ,business ,Biomarkers - Abstract
Background Obstructive sleep apnea (OSA) is associated with increased risk for cardiovascular morbidity and mortality. Epidemiological and animal models studies generate hypotheses for innovative strategies in OSA management by interferig intermediates mechanisms associated with cardiovascular complications. We have thus initiated the Epigenetics modification in Obstructive Sleep Apnea (EPIOSA) study (ClinicalTrials.gov identifier: NCT02131610). Methods/design EPIOSA is a prospective cohort study aiming to recruit 350 participants of caucasian ethnicity and free of other chronic or inflammatory diseases: 300 patients with prevalent OSA and 50 non-OSA subjects. All of them will be follow-up for at least 5 years. Recruitment and study visits are performed in single University-based sleep clinic using standard operating procedures. At baseline and at each one year follow-up examination, patients are subjected to a core phenotyping protocol. This includes a standardized questionnaire and physical examination to determine incident comorbidities and health resources utilization, with a primary focus on cardiovascular events. Confirmatory outcomes information is requested from patient records and the regional Department of Health Services. Every year, OSA status will be assessed by full sleep study and blood samples will be obtained for immediate standard biochemistry, hematology, inflammatory cytokines and cytometry analysis. For biobanking, aliquots of serum, plasma, urine, mRNA and DNA are also obtained. Bilateral carotid echography will be performed to assess subclinical atherosclerosis and atherosclerosis progression. OSA patients are treated according with national guidelines. Discussion EPIOSA will enable the prospective evaluation of inflammatory and epigenetics mechanism involved in cardiovascular complication of treated and non-treated patients with OSA compared with non OSA subjects.
- Published
- 2018
29. Liver Disease in the Elderly
- Author
-
Hanisha Manickavasagan, Teresita Gomez de Castro, and Santiago J. Munoz
- Subjects
Liver injury ,medicine.medical_specialty ,Cirrhosis ,business.industry ,General surgery ,medicine.medical_treatment ,Jaundice ,Liver transplantation ,medicine.disease ,Liver disease ,Biliary tract ,Internal medicine ,Hepatocellular carcinoma ,medicine ,medicine.symptom ,Metabolic syndrome ,business - Abstract
This chapter addresses the unique aspects of hepatic physiology and liver diseases in older adults. Aging is associated with reduced metabolic and regenerative capacity of the liver, and the clinical presentation and prognosis of many liver disorders can be different in older adults compared with younger persons. In particular, drug-induced liver injury and acute liver failure have a worse prognosis in the elderly. Older patients often have endured decades of the metabolic syndrome, and nonalcoholic steatohepatitis-related cirrhosis is increasingly observed with advancing age. Because longer duration of cirrhosis is associated with a greater risk of hepatocellular carcinoma, this tumor and other malignancies of the biliary tract are more common in elderly patients. Liver transplantation should be considered in selected older candidates guided by their physiologic status rather than by their chronologic age.
- Published
- 2018
30. Lung parenchymal development in premature infants without bronchopulmonary dysplasia
- Author
-
Christina Tiller, Shawn K. Ahlfeld, Santiago J. Assaf, Robert S. Tepper, Julie A. Mund, James E. Slaven, Jeffrey Kisling, Laura S. Haneline, Brenda B. Poindexter, Zhangsheng Yu, Jamie Case, David A. Ingram, and Daniel V. Chang
- Subjects
Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Lung ,business.industry ,medicine.medical_treatment ,Gestational age ,respiratory system ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Bronchopulmonary dysplasia ,DLCO ,Premature birth ,Internal medicine ,Pulmonary diffusion ,Pediatrics, Perinatology and Child Health ,medicine ,Cardiology ,Lung volumes ,Continuous positive airway pressure ,business - Abstract
Summary Rationale: While infants who are born extremely premature and develop bronchopulmonary dysplasia (BPD) have impaired alveolar development and decreased pulmonary diffusion (DLCO), it remains unclear whether infants born less premature and do not develop BPD, healthy premature (HP), have impaired parenchymal development. In addition, there is increasing evidence that pro-angiogenic cells are important for vascular development; however, there is little information on the relationship of pro-angiogenic cells to lung growth and development in infants. Objective and Methods Determine among healthy premature (HP) and fullterm (FT) infants, whether DLCO and alveolar volume (VA) are related to gestational age at birth (GA), respiratory support during the neonatal period (mechanical ventilation [MV], supplemental oxygen [O2], continuous positive airway pressure [CPAP]), and pro-angiogenic circulating hematopoietic stem/progenitor cells (CHSPCs). We measured DLCO, VA, and CHSPCs in infants between 3–33 months corrected-ages; HP (mean GA = 31.7 wks; N = 48,) and FT (mean GA = 39.3 wks; N = 88). Result DLCO was significantly higher in HP than FT subjects, while there was no difference in VA, after adjusting for body length, gender, and race. DLCO and VA were not associated with GA, MV and O2; however, higher values were associated with higher CHSPCs, as well as treatment with CPAP. Conclusion Our findings suggest that in the absence of extreme premature birth, as well as BPD, prematurity per se, does not impair lung parenchymal development. Pediatr Pulmonol. © 2014 Wiley Periodicals, Inc.
- Published
- 2014
31. Extracorporeal cellular therapy (ELAD) in severe alcoholic hepatitis: A multinational, prospective, controlled, randomized trial
- Author
-
Sumeet K. Asrani, Raza Malik, Andres Duarte-Rojo, Lee Landeen, Ali Al-Khafaji, Geoffrey W. McCaughan, Anupama T. Duddempudi, Nikunj Shah, Charles S. Landis, David C. Wolf, Marquis Hart, Jan Stange, Robert S. Brown, Steven D. Colquhoun, Rohit Satoskar, Lance L. Stein, Julie A. Thompson, Robert Ashley, Michael B. Millis, Talal Adhami, Rajiv Jalan, Paul J. Gaglio, Andrew Henry, Santiago J Munoz, Shahid Habib, Lewis W. Teperman, Alan Wigg, Parvez S. Mantry, Brian B. Borg, David J. Reich, Shahid M. Malik, Amay Parikh, Linda Sher, Patricia W. Bedard, Ram Subramanian, Alyssa Henry, Natasha Jones, Ahmed Elsharkawy, Tarek Hassanein, Simona Rossi, Heather Patton, Ross MacNicholas, and William Frank
- Subjects
Adult ,Hepatoblastoma ,Male ,medicine.medical_specialty ,Extracorporeal Circulation ,Time Factors ,medicine.medical_treatment ,Population ,Alcoholic hepatitis ,Kaplan-Meier Estimate ,Liver transplantation ,Gastroenterology ,Severity of Illness Index ,03 medical and health sciences ,Liver disease ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Cell Line, Tumor ,medicine ,Humans ,030212 general & internal medicine ,Prospective Studies ,education ,Survival analysis ,Transplantation ,education.field_of_study ,Intention-to-treat analysis ,Hepatology ,business.industry ,Hepatitis, Alcoholic ,Extracorporeal circulation ,Liver Neoplasms ,Australia ,Middle Aged ,medicine.disease ,United Kingdom ,United States ,Surgery ,Intention to Treat Analysis ,Treatment Outcome ,030211 gastroenterology & hepatology ,Female ,business - Abstract
Severe alcoholic hepatitis (sAH) is associated with a poor prognosis. There is no proven effective treatment for sAH, which is why early transplantation has been increasingly discussed. Hepatoblastoma-derived C3A cells express anti-inflammatory proteins and growth factors and were tested in an extracorporeal cellular therapy (ELAD) study to establish their effect on survival for subjects with sAH. Adults with sAH, bilirubin ≥8 mg/dL, Maddrey's discriminant function ≥ 32, and Model for End-Stage Liver Disease (MELD) score ≤ 35 were randomized to receive standard of care (SOC) only or 3-5 days of continuous ELAD treatment plus SOC. After a minimum follow-up of 91 days, overall survival (OS) was assessed by using a Kaplan-Meier survival analysis. A total of 203 subjects were enrolled (96 ELAD and 107 SOC) at 40 sites worldwide. Comparison of baseline characteristics showed no significant differences between groups and within subgroups. There was no significant difference in serious adverse events between the 2 groups. In an analysis of the intent-to-treat population, there was no difference in OS (51.0% versus 49.5%). The study failed its primary and secondary end point in a population with sAH and with a MELD ranging from 18 to 35 and no upper age limit. In the prespecified analysis of subjects with MELD < 28 (n = 120), ELAD was associated with a trend toward higher OS at 91 days (68.6% versus 53.6%; P = .08). Regression analysis identified high creatinine and international normalized ratio, but not bilirubin, as the MELD components predicting negative outcomes with ELAD. A new trial investigating a potential benefit of ELAD in younger subjects with sufficient renal function and less severe coagulopathy has been initiated. Liver Transplantation 24 380-393 2018 AASLD.
- Published
- 2017
32. Nuclear Cardiology Practices and Radiation Exposure in the Oceania Region: results From the IAEA Nuclear Cardiology Protocols Study (INCAPS)
- Author
-
Biswas, S, Better, N, Pascual, TNB, Mercuri, M, Vitola, JV, Karthikeyan, G, Westcott, J, Alexanderson, E, Allam, AH, Al-Mallah, MH, Bom, HHS, Bouyoucef, SE, Flotats, A, Jerome, S, Kaufman, PA, Lele, V, Luxenburg, O, Mahmarian, JJ, Shaw, LJ, Underwood, SR, Rehani, M, Kashyap, R, Dondi, M, Paez, D, Einstein, AJ, Alcheikh, A, Allen, B, Kelley, B, Bonomini, C, McGrath, C, Atkins, E, Craig, E, Murdoch, E, Souvannavong, F, Larcos, G, Taylor, G, Dixson, H, Duncan, I, Bevan, J, Christiansen, J, Hassall, J, Weale, J, Hartcher, K, Smidt, K, Taubman, K, Tse, K, Clark, L, Scarlett, L, O'Rourke, M, Pack, M, Hampson, R, Pearce, R, Praehofer, R, Fredericks, S, Gales, S, Kelly, S, O'Malley, S, Ramsay, S, Unger, S, de Kort, T, Hanley, T, Kidd, T, Macdonald, W, Magboo, VPC, Mut, F, Meeks, JB, Rehani, MM, Allam, A, Bom, H, Kaufmann, PA, Mahmarian, J, Vitola, J, Amouri, W, Essabbah, H, Gassama, SS, Makhdomi, KB, El Mustapha, GIE, El Ouchdi, N, Qais, N, Soni, N, Vangu, W, Abazid, RM, Adams, B, Agarwal, V, Alfeeli, MA, Alnafisi, N, Bernabe, L, Bural, GG, Chaiwatanarat, T, Chandraguptha, JM, Cheon, GJ, Cho, I, Dogan, AS, Eftekhari, M, Frenkel, A, Garty, I, George, S, Geramifar, P, Golan, H, Habib, S, Hussain, R, Im, H, Jeon, HJ, Kalawat, T, Kang, WJ, Keng, F, Klaipetch, A, Kumar, PG, Lee, J, Lee, WW, Lim, I, Macaisa, CMM, Malhotra, G, Mittal, BR, Mohammad, MH, Mohan, P, Mulyanto, ID, Nariman, D, Nayak, UN, Niaz, K, Nikolov, G, Obaldo, JM, Ozturk, E, Park, JM, Park, S, Patel, CD, Phuong, HK, Quinon, AP, Rajini, TR, Saengsuda, Y, Santiago, J, Sayman, HB, Shinto, AS, Sivasubramaniyan, V, Son, MH, Sudhakar, P, Syed, GMS, Tamaki, N, Thamnirat, K, Thientunyakit, T, Thongmak, S, Velasco, DN, Verma, A, Vutrapongwatana, U, Wang, Y, Won, KS, Yao, Z, Yingsa-Nga, T, Yudistiro, R, Yue, KT, Zafrir, N, Adrian, SC, Agostini, D, Aguade, S, Armitage, G, Backlund, M, Backman, M, Baker, M, Balducci, MT, Bavelaar, C, Berovic, M, Bertagna, F, Beuchel, R, Biggi, A, Bisi, G, Bonini, R, Bradley, A, Brudin, L, Bruno, I, Busnardo, E, Casoni, R, Choudhri, A, Cittanti, C, Clauss, R, Costa, DC, Costa, M, Dixon, K, Dziuk, M, Egelic, N, Eriksson, I, Fagioli, G, de Faria, DB, Florimonte, L, Francini, A, French, M, Gallagher, E, Garai, I, Geatti, O, Genovesi, D, Gianolli, L, Gimelli, A, del Giudice, E, Halliwell, S, Hansson, MJ, Harrison, C, Homans, F, Horton, F, Jedrzejuk, D, Jogi, J, Johansen, A, Johansson, H, Kalnina, M, Kaminek, M, Kiss, A, Kobylecka, M, Kostkiewicz, M, Kropp, J, Kullenberg, R, Lahoutte, T, Lang, O, Larsson, YH, Lazar, M, Leccisotti, L, Leners, N, Lindner, O, Lipp, RW, Maenhout, A, Maffioli, L, Marcassa, C, Martins, B, Marzullo, P, Medolago, G, Mendiguchia, CG, Mirzaei, S, Mori, M, Nardi, B, Nazarenko, S, Nikoletic, K, Oleksa, R, Parviainen, T, Patrina, J, Peace, R, Pirich, C, Piwowarska-Bilska, H, Popa, S, Prakash, V, Pubul, V, Puklavec, L, Rac, S, Ratniece, M, Rogan, SA, Romeo, A, Rossi, M, Ruiz, D, Sabharwal, N, Salobir, BG, Santos, AI, Saranovic, S, Sarkozi, A, Schneider, RP, Sciagra, R, Scotti, S, Servini, Z, Setti, LR, Starck, SA, Vajauskas, D, Vesely, J, Vieni, A, Vignati, A, Vito, IM, Weiss, K, Wild, D, Zdraveska-Kochovska, M, Aguro, RN, Alvarado, N, Barral, CM, Beretta, M, Berrocal, I, Cuellar, JFB, Chang, TMC, Rodriguez, LOC, Canessa, J, Mora, GC, Claudia, AC, Clavelo, GF, Cruz, AF, Faccio, FF, Fernandez, KM, Garibo, JRG, Gonzalez, U, Gonzalez, P, Guzzo, MA, Jofre, J, Kapitan, M, Kempfer, G, Lopez, JL, Massardo, TV, Colaco, IM, Mesquita, CT, Montecinos, M, Neubauer, S, Pabon, LM, Puente, A, Vazquez, LMR, Macias, JAS, Pino, AGS, Huber, FZT, Tovar, AP, Vargas, L, Wiefels, C, Aljizeeri, A, Alvarez, RJ, Barger, D, Beardwood, W, Behrens, J, Brann, L, Brown, D, Carr, H, Churchwell, K, Comingore, GA, Corbett, J, Costello, M, Cruz, F, Depinet, T, Dorbala, S, Earles, M, Esteves, FP, Etherton, E, Fanning, RJ, Fornace, J, Franks, L, Gewirtz, H, Gulanchyn, K, Hannah, CL, Hays, J, Hendrickson, J, Hester, J, Holmes, K, Johnson, A, Jopek, C, Lewin, H, Lyons, J, Manley, C, Meden, J, Moore, S, Moore, WH, Murthy, V, Nace, R, Neely, D, Nelson, L, Niedermaier, O, Rice, D, Rigs, R, Schiffer, K, Schockling, E, Schultz, T, Schumacker, T, Sheesley, B, Sheikh, A, Siegel, B, Slim, AM, Smith, J, Szulc, M, Tanskersley, N, Tilkemeier, P, Valdez, GD, Vrooman, R, Wawrowicz, D, Winchester, DE, Dixon, H, and INCAPS Investigators Grp
- Subjects
Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Oceania ,030204 cardiovascular system & hematology ,Radiation Dosage ,Effective dose (radiation) ,Sievert ,030218 nuclear medicine & medical imaging ,NO ,03 medical and health sciences ,Myocardial perfusion imaging ,Radiation exposure ,Aged ,Female ,Humans ,Middle Aged ,Myocardial Perfusion Imaging ,Radiation Exposure ,0302 clinical medicine ,Internal medicine ,medicine ,medicine.diagnostic_test ,business.industry ,Radiation dose ,Cardiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background There is concern about radiation exposure with radionuclide myocardial perfusion imaging (MPI). This sub-study of the International Atomic Energy Agency (IAEA) Nuclear Cardiology Protocols Study reports radiation doses from MPI, and use of dose-optimisation protocols in Australia and New Zealand (ANZ), and compares them with data from the rest of the world. Methods Data were collected from 7911 MPI studies performed in 308 laboratories worldwide in one week in 2013, including 439 MPI studies from 34 ANZ laboratories. For each laboratory, effective radiation dose (ED) and a quality index (QI) score (out of 8) based on pre-specified "best practices'' was determined. Results In ANZ patients, ED ranged from 0.9-17.9 milliSievert (mSv). Median ED was similar in ANZ compared with the rest of the world (10.0 (IQR: 6.5-11.7) vs. 10.0 (IQR 6.4-12.6, P=0.15), as were mean QI scores (5.5 +/- 0.7 vs. 5.4 +/- 1.3, P= 0.84). Use of stress-only imaging (17.6% vs. 31.8% of labs, P= 0.09) and weight-based dosing of technetium-99m (14.7% vs. 30.3%, P= 0.07) was lower in ANZ compared with the rest of the world but this difference was not statistically significant. Median ED was significantly lower in metropolitan versus nonmetropolitan laboratories (10.1 mSv vs. 11.6 mSv, P < 0.01), although mean QI scores were similar (5.4 +/- 0.8 vs. 5.5 +/- 0.7, P= 0.75). Conclusion Across ANZ, there is variability in ED from MPI, and use of radiation safety practices, particularly between metropolitan and non-metropolitan laboratories. Overall, ANZ laboratories have a similar median ED to laboratories in the rest of the world.
- Published
- 2017
33. The Natural History of Severe Acute Liver Injury
- Author
-
Steven-Huy B. Han, Iris Liou, Constantine J. Karvellas, K.R. Reddy, William M. Lee, Adrian Reuben, Jaime L. Speiser, Averell H. Sherker, Ram Subramanian, Timothy Davern, Anne M. Larson, Richard T. Stravitz, Natalie Murray, A. J. Hanje, Santiago J. Munoz, R.T. Chung, Lorenzo Rossaro, Raj Satyanarayana, Valerie Durkalski, R. S. Brown, Bilal Hameed, David G. Koch, Atif Zaman, Jody C. Olson, Oren K. Fix, Obaid S. Shaikh, Daniel Ganger, Michael L. Schilsky, Robert J. Fontana, Brendan M. McGuire, J. E. Hay, and Timothy M. McCashland
- Subjects
0301 basic medicine ,Adult ,Male ,medicine.medical_specialty ,Gastroenterology ,Severity of Illness Index ,Article ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Severity of illness ,medicine ,Coagulopathy ,Adverse Drug Reaction Reporting Systems ,Humans ,International Normalized Ratio ,Registries ,Hepatic encephalopathy ,Acute liver injury ,Hepatology ,biology ,business.industry ,Clinical course ,Alanine Transaminase ,Middle Aged ,medicine.disease ,Prognosis ,United States ,Natural history ,030104 developmental biology ,Alanine transaminase ,Hepatocyte necrosis ,Data Interpretation, Statistical ,Hepatic Encephalopathy ,biology.protein ,030211 gastroenterology & hepatology ,Female ,Chemical and Drug Induced Liver Injury ,business - Abstract
Acute liver failure (ALF) is classically defined by coagulopathy and hepatic encephalopathy (HE); however, acute liver injury (ALI), i.e., severe acute hepatocyte necrosis without HE, has not been carefully defined nor studied. Our aim is to describe the clinical course of specifically defined ALI, including the risk and clinical predictors of poor outcomes, namely progression to ALF, the need for liver transplantation (LT) and death.386 subjects prospectively enrolled in the Acute Liver Failure Study Group registry between 1 September 2008 through 25 October 2013, met criteria for ALI: International Normalized Ratio (INR)≥2.0 and alanine aminotransferase (ALT)≥10 × elevated (irrespective of bilirubin level) for acetaminophen (N-acetyl-p-aminophenol, APAP) ALI, or INR≥2.0, ALT≥10x elevated, and bilirubin≥3.0 mg/dl for non-APAP ALI, both groups without any discernible HE. Subjects who progressed to poor outcomes (ALF, death, LT) were compared, by univariate analysis, with those who recovered. A model to predict poor outcome was developed using the random forest (RF) procedure.Progression to a poor outcome occurred in 90/386 (23%), primarily in non-APAP (71/179, 40%) vs. only 14/194 (7.2%) in APAP patients comprising 52% of all cases (13 cases did not have an etiology assigned; 5 of whom had a poor outcome). Of 82 variables entered into the RF procedure: etiology, bilirubin, INR, APAP level and duration of jaundice were the most predictive of progression to ALF, LT, or death.A majority of ALI cases are due to APAP, 93% of whom will improve rapidly and fully recover, while non-APAP patients have a far greater risk of poor outcome and should be targeted for early referral to a liver transplant center.
- Published
- 2016
34. Sa1501 – Novel 'Enhanced Corticosteroid' Therapy for Patients with Recurrent/ Refractory Severe Acute Alcoholic Hepatitis Who Had a Prior Course of Conventional Corticosteroid Monotherapy
- Author
-
Andres Riera, Santiago J. Munoz, and Dhruvan Patel
- Subjects
medicine.medical_specialty ,Hepatology ,Corticosteroid therapy ,Refractory ,business.industry ,medicine.drug_class ,Internal medicine ,Gastroenterology ,medicine ,Corticosteroid ,business ,Acute Alcoholic Hepatitis - Published
- 2019
35. Cierre percutáneo de comunicaciones interventriculares perimembranosas por vía retrógrada. Cambio de paradigma
- Author
-
Alejandro Rasines Rodríguez, María Mercedes Aristoy Zabaleta, César Abelleira Pardeiro, Enrique José Balbacid Domingo, Santiago Jiménez Valero, and Federico Gutiérrez-Larraya Aguado
- Subjects
Internal medicine ,RC31-1245 - Abstract
Sr. Editor: El cierre percutáneo de las comunicaciones interventriculares (CIV) sigue sin estar plenamente extendido debido a sus potenciales complicaciones (bloqueo auriculoventricular, insuficiencias valvulares, hemólisis) y limitaciones técnicas, sobre todo en pacientes de bajo peso1. Los dispositivos específicamente desarrollados para el cierre de la CIV perimembranosa (CIVpm) tienen un diseño asimétrico que condiciona un implante por acceso venoso anterógrado. Por ello, el procedimiento habitual requiere realizar un circuito arteriovenoso (asa) a través del defecto para avanzar el dispositivo hasta su liberación secuencial desde la aorta o el ventrículo izquierdo. Un ejemplo es el Nit-Occlud Lê VSD-Coil (PFM Medical, Alemania), con buenos resultados en cuanto a efectividad y seguridad2. No obstante, la formación del asa puede ser causa de bloqueos transitorios e inestabilidad hemodinámica, sobre todo en pacientes de bajo peso3. Además, se ha descrito el uso de diferentes dispositivos oclusores no específicos para esta indicación con buenos resultados, sobre todo si el defecto asocia tejido aneurismático4. Algunos, por su diseño simétrico y bajo perfil, permiten su liberación desde el lado arterial (retrógrado), evitando la realización del asa. Esto simplifica la técnica, hace el procedimiento más corto y el paciente recibe menos radiación. Dicho abordaje ya se ha descrito, con buenos resultados, con un...
- Published
- 2023
- Full Text
- View/download PDF
36. Upper airway and systemic inflammation in obstructive sleep apnoea
- Author
-
Marta Forner, Paul Vicente, Eugenio Fernández Vicente, Ricardo Luengo González, Santiago J. Carrizo, Jose M. Marin, Carlos S. Osuna, Pablo Cubero, Marta Marin-Oto, Ana V. Gil, and Xavier Soler
- Subjects
Pulmonary and Respiratory Medicine ,Adult ,CD4-Positive T-Lymphocytes ,Male ,medicine.medical_specialty ,Pathology ,Adolescent ,medicine.medical_treatment ,Inflammation ,Systemic inflammation ,Gastroenterology ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Continuous positive airway pressure ,Prospective Studies ,Interleukin 6 ,Prospective cohort study ,Immunoassay ,Sleep Apnea, Obstructive ,biology ,Anthropometry ,Continuous Positive Airway Pressure ,business.industry ,Interleukin-6 ,Tumor Necrosis Factor-alpha ,Interleukin-8 ,Snoring ,Case-control study ,Interleukin ,Sleep apnea ,Middle Aged ,medicine.disease ,Flow Cytometry ,respiratory tract diseases ,Treatment Outcome ,030228 respiratory system ,Case-Control Studies ,biology.protein ,Female ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Biomarkers - Abstract
Obstructive sleep apnoea (OSA) is associated with pharyngeal inflammation, but the coexistence of systemic inflammation is controversial. This study investigated whether local and systemic inflammatory biomarkers are related in patients with OSA. An uncontrolled extension to the study assessed the response to effective treatment.We recruited 89 patients with OSA (apnoea/hypopnoea index (AHI) ≥5 events·h−1), 28 snorers and 26 healthy controls. Pharyngeal lavage (PHAL) and plasma samples were collected at baseline and after a 1-year follow-up. Inflammatory cells were evaluated by flow cytometry; interleukin (IL)-6, IL-8 and tumour necrosis factor-α were evaluated by immunoassay.In PHAL, CD4+T-cells, IL-6 and IL-8 were higher in OSA patients than in snorers or healthy controls (p+, IL-6 and IL-8 in PHAL (all p-values In patients with OSA, increased levels of inflammatory biomarkers were found in PHAL, which were reduced with effective treatment. No simultaneous increase in plasma inflammatory biomarkers was found.
- Published
- 2016
37. Estimating the Reduction in the Radiation Burden From Nuclear Cardiology Through Use of Stress-Only Imaging in the United States and Worldwide
- Author
-
Mathew, Mercuri, Pascual, Thomas N. B., Mahmarian, John J., Shaw, Leslee J., Maurizio, Dondi, Diana, Paez, Einstein, A. J., Pascual, T. N. B., Paez, D., Dondi, M., Better, N., Bouyoucef, S. E., Karthikeyan, G., Kashyap, R., Lele, V., Mut, F., Magboo, V. P. C., Mahmarian, J. J., Mercuri, M., Rehani, M. M., Vitola, J. V., Alexanderson, E., Allam, A., Al-Mallah, M. H., Bom, H., Flotats, A., Jerome, S., Kaufmann, P. A., Luxenburg, O., Mahmarian, J., Shaw, L. J., Underwood, S. R., Vitola, J., Amouri, W., Essabbah, H., Gassama, S. S., Makhdomi, K. B., El Mustapha, G. I. E., El Ouchdi, N., Qaïs, N., Soni, N., Vangu, W., Abazid, R. M., Adams, B., Agarwal, V., Alfeeli, M. A., Alnafisi, N., Bernabe, L., Bural, G. G., Chaiwatanarat, T., Chandraguptha, J. M., Cheon, G. J., Cho, I., Dogan, A. S., Eftekhari, M., Frenkel, A., Garty, I., George, S., Geramifar, P., Golan, H., Habib, S., Hussain, R., Im, H., Jeon, H-J., Kalawat, T., Kang, W. J., Keng, F., Klaipetch, A., Kumar, P. G., Lee, J., Lee, W. W., Lim, I., Macaisa, C. M. M., Malhotra, G., Mittal, B. R., Mohammad, M. H., Mohan, P., Mulyanto, I. D., Nariman, D., Nayak, U. N., Niaz, K., Nikolov, G., Obaldo, J. M., Ozturk, E., Park, J. M., Park, S., Patel, C. D., Phuong, H. K., Quinon, A. P., Rajini, T. R., Saengsuda, Y., Santiago, J., Sayman, H. B., Shinto, A. S., Sivasubramaniyan, V., Son, M. H., Sudhakar, P., Syed, G. M. S., Tamaki, N., Thamnirat, K., Thientunyakit, T., Thongmak, S., Velasco, D. N., Verma, A., Vutrapongwatana, U., Wang, Y., Won, K. S., Yao, Z., Yingsa-nga, T., Yudistiro, R., Yue, K. T., Zafrir, N., Adrian, S. C., Agostini, D., Aguadé, S., Armitage, G., Backlund, M., Backman, M., Baker, M., Balducci, M. T., Bavelaar, C., Berovic, M., Bertagna, F., Beuchel, R., Biggi, A., Bisi, G., Bonini, R., Bradley, A., Brudin, L., Bruno, Iliane Chiara, Busnardo, E., Casoni, R., Choudhri, A., Cittanti, C., Clauss, R., Costa, D. C., Costa, M., Dixon, K., Dziuk, M., Egelic, N., Eriksson, I., Fagioli, G., de Faria, D. B., Florimonte, L., Francini, A., French, M., Gallagher, E., Garai, I., Geatti, O., Genovesi, D., Gianolli, L., Gimelli, A., del Giudice, E., Halliwell, S., Hansson, M. J., Harrison, C., Homans, F., Horton, F., Jędrzejuk, D., Jogi, J., Johansen, A., Johansson, H., Kalnina, M., Kaminek, M., Kiss, A., Kobylecka, M., Kostkiewicz, M., Kropp, J., Kullenberg, R., Lahoutte, T., Lang, O., Larsson, Y. H., Lázár, M., Leccisotti, L., Leners, N., Lindner, O., Lipp, R. W., Maenhout, A., Maffioli, L., Marcassa, C., Martins, B., Marzullo, P., Medolago, G., Meeks, J. B., Mendiguchía, C. G., Mirzaei, S., Mori, M., Nardi, B., Nazarenko, S., Nikoletic, K., Oleksa, R., Parviainen, T., Patrina, J., Peace, R., Pirich, C., Piwowarska-Bilska, H., Popa, S., Prakash, V., Pubul, V., Puklavec, L., Rac, S., Ratniece, M., Rogan, S. A., Romeo, A., Rossi, M., Ruiz, D., Sabharwal, N., Salobir, B. G., Santos, A. I., Saranovic, S., Sarkozi, A., Schneider, R. P., Sciagra, R., Scotti, S., Servini, Z., Setti, L. R., Starck, S. -Å., Vajauskas, D., Veselý, J., Vieni, A., Vignati, A., Vito, I. M., Weiss, K., Wild, D., Zdraveska-Kochovska, M., Agüro, R. N., Alvarado, N., Barral, C. M., Beretta, M., Berrocal, I., Batista Cuellar, J. F., Cabral Chang, T. -M., Cabrera Rodríguez, L. O., Canessa, J., Castro Mora, G., Claudia, A. C., Clavelo, G. F., Cruz Jr, A. F., Faccio, F. F., Fernández, K. M., Gomez Garibo, J. R., Gonzalez, U., González, P., Guzzo, M. A., Jofre, J., Kapitán, M., Kempfer, G., Lopez, J. L., Massardo, T., Medeiros Colaco, I., Mesquita, C. T., Montecinos, M., Neubauer, S., Pabon, L. M., Puente, A., Rochela Vazquez, L. M., Serna Macias, J. A., Silva Pino, A. G., Tártari Huber, F. Z., Tovar, A. P., Vargas, L., Wiefels, C., Aljizeeri, A., Alvarez, R. J., Barger, D., Beardwood, W., Behrens, J., Brann, L., Brown, D., Carr, H., Churchwell, K., Comingore, G. A., Corbett, J., Costello, M., Cruz, F., Depinet, T., Dorbala, S., Earles, M., Esteves, F. P., Etherton, E., Fanning Jr, R. J., Fornace, J., Franks, L., Gewirtz, H., Gulanchyn, K., Hannah, C. -L., Hays, J., Hendrickson, J., Hester, J., Holmes, K., Johnson, A., Jopek, C., Lewin, H., Lyons, J., Manley, C., Meden, J., Moore, S., Moore, W. H., Murthy, V., Nace, R., Neely, D., Nelson, L., Niedermaier, O., Rice, D., Rigs, R., Schiffer, K., Schockling, E., Schultz, T., Schumacker, T., Sheesley, B., Sheikh, A., Siegel, B., Slim, A. M., Smith, J., Szulc, M., Tanskersley, N., Tilkemeier, P., Valdez, G. D., Vrooman, R., Wawrowicz, D., Winchester, D. E., Alcheikh, A., Allen, B., Atkins, E., Bevan, J., Bonomini, C., Christiansen, J., Clack, L., Craig, E., Dixson, H., Duncan, I., Fredericks, S., Gales, S., Hampson, R., Hanley, T., Hartcher, K., Hassall, J., Kelley, B., Kelly, S., Kidd, T., de Kort, T., Larcos, G., Macdonald, W., Mcgrath, C., Murdoch, E., O’Malley, S., O’Rourke, M., Pack, M., Pearce, R., Praehofer, R., Ramsay, S., Scarlett, L., Smidt, K., Souvannavong, F., Taubman, K., Taylor, G., Tse, K., Unger, S., and Weale, J.
- Subjects
South asia ,business.industry ,Coronary arteriosclerosis ,Myocardial Perfusion Imaging ,030204 cardiovascular system & hematology ,Radiation Dosage ,Thallium stress test ,Clinical Protocols ,Exercise Test ,Humans ,United States ,Internal Medicine ,Executive committee ,030218 nuclear medicine & medical imaging ,NO ,Radiation exposure ,03 medical and health sciences ,Kingdom ,0302 clinical medicine ,Radiology Specialty ,Medicine ,business ,Humanities - Abstract
Group Information: The INCAPS Investigators Group includes executive committee members A. J. Einstein (chair), T. N. B. Pascual (IAEA project lead), D. Paez (IAEA section head), M. Dondi (IAEA section head); N. Better, S.E. Bouyoucef, G. Karthikeyan, R. Kashyap, V. Lele, F. Mut, V. P. C. Magboo, J. J. Mahmarian, M. Mercuri, M. M. Rehani, and J. V. Vitola, and regional coordinators E. Alexanderson (Latin America), A. Allam (Africa andMiddle East), M. H. Al-Mallah (Middle East), N. Better (Oceania), S. E. Bouyoucef (Africa), H. Bom (East Asia), A. Flotats (Europe), S. Jerome (United States), P. A. Kaufmann (Europe), V. Lele (South Asia), O. Luxenburg (Israel), J. Mahmarian (North America), L. J. Shaw (North America), S. R. Underwood (United Kingdom), and J. Vitola (Latin America). Members by region include W. Amouri, H. Essabbah, S. S. Gassama, K. B. Makhdomi, G. I. E. El Mustapha, N. El Ouchdi, N. Qais, N. Soni, andW. Vangu (Africa); R. M. Abazid, B. Adams, V. Agarwal, M. A. Alfeeli, N. Alnafisi, L. Bernabe, G. G. Bural, T. Chaiwatanarat, J. M. Chandraguptha, G. J. Cheon, I. Cho, A. S. Dogan, M. Eftekhari, A. Frenkel, I. Garty, S. George, P. Geramifar, H. Golan, S. Habib, R. Hussain, H. Im, H-J. Jeon, T. Kalawat, W. J. Kang, F. Keng, A. Klaipetch, P. G. Kumar, J. Lee, W.W. Lee, I. Lim, C. M. M. Macaisa, G. Malhotra, B. R. Mittal, M. H. Mohammad, P. Mohan, I. D. Mulyanto, D. Nariman, U. N. Nayak, K. Niaz, G. Nikolov, J. M. Obaldo, E. Ozturk, J. M. Park, S. Park, C. D. Patel, H. K. Phuong, A. P. Quinon, T. R. Rajini, Y. Saengsuda, J. Santiago, H. B. Sayman, A. S. Shinto, V. Sivasubramaniyan, M. H. Son, P. Sudhakar, G. M. S. Syed, N. Tamaki, K. Thamnirat, T. Thientunyakit, S. Thongmak, D. N. Velasco, A. Verma, U. Vutrapongwatana, Y. Wang, K. S. Won, Z. Yao, T. Yingsa-nga, R. Yudistiro, K. T. Yue, and N. Zafrir (Asia); S. C. Adrian, D. Agostini, S. Aguade, G. Armitage, M. Backlund, M. Backman, M. Baker, M. T. Balducci, C. Bavelaar, M. Berovic, F. Bertagna, R. Beuchel, A. Biggi, G. Bisi, R. Bonini, A. Bradley, L. Brudin, I. Bruno, E. Busnardo, R. Casoni, A. Choudhri, C. Cittanti, R. Clauss, D. C. Costa, M. Costa, K. Dixon, M. Dziuk, N. Egelic, I. Eriksson, G. Fagioli, D. B. de Faria, L. Florimonte, A. Francini, M. French, E. Gallagher, I. Garai, O. Geatti, D. Genovesi, L. Gianolli, A. Gimelli, E. del Giudice, S. Halliwell, M. J. Hansson, C. Harrison, F. Homans, F. Horton, D. Jedrzejuk, J. Jogi, A. Johansen, H. Johansson, M. Kalnina, M. Kaminek, A. Kiss, M. Kobylecka, M. Kostkiewicz, J. Kropp, R. Kullenberg, T. Lahoutte, O. Lang, Y. H. Larsson, M. Lazar, L. Leccisotti, N. Leners, O. Lindner, R. W. Lipp, A. Maenhout, L. Maffioli, C. Marcassa, B. Martins, P. Marzullo, G. Medolago, J. B. Meeks, C. G. Mendiguchia, S. Mirzaei, M. Mori, B. Nardi, S. Nazarenko, K. Nikoletic, R. Oleksa, T. Parviainen, J. Patrina, R. Peace, C. Pirich, H. Piwowarska-Bilska, S. Popa, V. Prakash, V. Pubul, L. Puklavec, S. Rac, M. Ratniece, S. A. Rogan, A. Romeo, M. Rossi, D. Ruiz, N. Sabharwal, B. G. Salobir, A. I. Santos, S. Saranovic, A. Sarkozi, R. P. Schneider, R. Sciagra, S. Scotti, Z. Servini, L. R. Setti, S.-A. Starck, D. Vajauskas, J. Veselý, A. Vieni, A. Vignati, I. M. Vito, K. Weiss, D. Wild, andM. Zdraveska-Kochovska (Europe); R. N. Aguro, N. Alvarado, C. M. Barral, M. Beretta, I. Berrocal, J. F. Batista Cuellar, T.-M. Cabral Chang, L. O. Cabrera Rodriguez, J. Canessa, G. Castro Mora, A. C. Claudia, G. F. Clavelo, A. F. Cruz Jr, F. F. Faccio, K. M. Fernandez, J. R. Gomez Garibo, U. Gonzalez, P. Gonzalez, M. A. Guzzo, J. Jofre, M. Kapitan, G. Kempfer, J. L. Lopez, T. Massardo, I. Medeiros Colaco, C. T. Mesquita, M. Montecinos, S. Neubauer, L. M. Pabon, A. Puente, L. M. Rochela Vazquez, J. A. Serna Macias, A. G. Silva Pino, F. Z. Tartari Huber, A. P. Tovar, L. Vargas, and C. Wiefels (Latin America); A. Aljizeeri, R. J. Alvarez, D. Barger, W. Beardwood, J. Behrens, L. Brann, D. Brown, H. Carr, K. Churchwell, G. A. Comingore, J. Corbett, M. Costello, F. Cruz, T. Depinet, S. Dorbala, M. Earles, F. P. Esteves, E. Etherton, R. J. Fanning Jr, J. Fornace, L. Franks, H. Gewirtz, K. Gulanchyn, C.-L. Hannah, J. Hays, J. Hendrickson, J. Hester, K. Holmes, S. Jerome, A. Johnson, C. Jopek, H. Lewin, J. Lyons, C. Manley, J. Meden, S. Moore, W. H. Moore, V. Murthy, R. Nace, D. Neely, L. Nelson, O. Niedermaier, D. Rice, R. Rigs, K. Schiffer, E. Schockling, T. Schultz, T. Schumacker, B. Sheesley, A. Sheikh, B. Siegel, A. M. Slim, J. Smith, M. Szulc, N. Tanskersley, P. Tilkemeier, G. D. Valdez, R. Vrooman, D. Wawrowicz, and D. E. Winchester (North America); and A. Alcheikh, B. Allen, E. Atkins, J. Bevan, C. Bonomini, J. Christiansen, L. Clack, E. Craig, H. Dixson, I. Duncan, S. Fredericks, S. Gales, R. Hampson, T. Hanley, K. Hartcher, J. Hassall, B. Kelley, S. Kelly, T. Kidd, T. de Kort, G. Larcos, W. Macdonald, C. McGrath, E. Murdoch, S. O’Malley, M. O’Rourke, M. Pack, R. Pearce, R. Praehofer, S. Ramsay, L. Scarlett, K. Smidt, F. Souvannavong, K. Taubman, G. Taylor, K. Tse, S. Unger, and J. Weale (Oceania).
- Published
- 2016
38. Protective Cardiovascular Effect of Sleep Apnea Severity in Obesity Hypoventilation Syndrome
- Author
-
Candela Caballero, Eusebi Chiner, Maria F. Troncoso, Rafael Golpe, Francisco Javier Ribas-Solis, Babak Mokhlesi, Juan F. Masa, Mónica González, Cristina Senent, Pilar de Lucas, Silvia Gómez, Auxiliadora Romero, María Luz Alonso-Álvarez, José N. Sancho-Chust, M-Ángeles Sánchez-Quiroga, Jesús Sanchez-Gómez, Ana Santiago-Recuerda, Sergi Marti, José M. Benítez, Josefa Díaz-de-Atauri, Miguel Merchan, Ana Obeso, Jose M. Marin, Begoña Gallego, Joaquín Terán-Santos, Estrella Ordax, Carlos Egea, Jesús Muñoz-Méndez, Olga Cantalejo, Mónica Bengoa, Teresa Gomez-Garcia, Maria-Ángeles Martinez-Martinez, Jaime Corral, Emilia Barrot, Soledad López-Martín, Mercedes Pallero, Mª Antonia Ramón, Elena Ojeda, Trinidad Díaz-Cambriles, Santiago J. Carrizo, Garcia-Ledesma E, and Nicolás González-Mangado
- Subjects
Pulmonary and Respiratory Medicine ,Male ,cardiovascular risk ,medicine.medical_specialty ,Polysomnography ,precision medicine ,Critical Care and Intensive Care Medicine ,Logistic regression ,Severity of Illness Index ,Hypoxemia ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Obesity Hypoventilation Syndrome ,obesity hypoventilation syndrome ,Prevalence ,Humans ,Medicine ,Hypoxia ,Aged ,Obesity hypoventilation syndrome ,business.industry ,Confounding ,Sleep apnea ,Middle Aged ,Protective Factors ,medicine.disease ,sleep apnea ,respiratory tract diseases ,nervous system diseases ,Clinical trial ,Obstructive sleep apnea ,Cross-Sectional Studies ,030228 respiratory system ,Apnea–hypopnea index ,Cardiovascular Diseases ,Spain ,Concomitant ,Heart failure ,Physical therapy ,Female ,Blood Gas Analysis ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,030217 neurology & neurosurgery - Abstract
Background Obesity hypoventilation syndrome (OHS) is associated with a high burden of cardiovascular morbidity (CVM) and mortality. The majority of patients with OHS have concomitant OSA, but there is a paucity of data on the association between CVM and OSA severity in patients with OHS. The objective of our study was to assess the association between CVM and OSA severity in a large cohort of patients with OHS. Methods In a cross-sectional analysis, we examined the association between OSA severity based on tertiles of oxygen desaturation index (ODI) and CVM in 302 patients with OHS. Logistic regression models were constructed to quantify the independent association between OSA severity and prevalent CVM after adjusting for various important confounders. Results The prevalence of CVM decreased significantly with increasing severity of OSA based on ODI as a continuous variable or ODI tertiles. This inverse relationship between OSA severity and prevalence of CVM was seen in the highest ODI tertile and it persisted despite adjustment for multiple confounders. Chronic heart failure had the strongest negative association with the highest ODI tertile. No significant CVM risk change was observed between the first and second ODI tertiles. Patients in the highest ODI tertile were younger, predominantly male, more obese, more hypersomnolent, had worse nocturnal and daytime gas exchange, lower prevalence of hypertension, better exercise tolerance, and fewer days hospitalized than patients in the lowest ODI tertile. Conclusions In patients with OHS, the highest OSA severity phenotype was associated with reduced risk of CVM. This finding should guide the design of future clinical trials assessing the impact of interventions aimed at decreasing cardiovascular morbidity and mortality in patients with OHS. Trial Registry Clinicaltrial.gov; No.: NCT01405976 ; URL: www.clinicaltrials.gov
- Published
- 2016
39. Off-label use of rilpivirine in combination with emtricitabine and tenofovir in HIV-1-infected pediatric patients: A multicenter study
- Author
-
Falcon-Neyra, Lola, Palladino, Claudia, Navarro Gómez, María Luisa, Soler-Palacín, Pere, González-Tomé, María Isabel, De Ory, Santiago J, Frick, Marie Antoinette, Fortuny, Clàudia, Noguera-Julian, Antoni, Moreno, Elena Bermúdez, Santos, Juan Luis, Olbrich, Peter, López-Cortés, Luis F, Briz, Verónica, Neth, Olaf, CoRISpe working group, Red de Investigación Cooperativa en Investigación en Sida (España), Instituto de Salud Carlos III, Fundação para a Ciência e a Tecnologia (Portugal), Universitat de Barcelona, Fundação para a Ciência e Tecnologia (Portugal), CoRISpe working group, [Falcon-Neyra,L, Neth,N, Olbrich,A] Unidad de Enfermedades Infecciosas e Inmunopatologias, Hospital Infantil Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain. [Palladino,C] Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, University of Lisbon, Lisbon, Portugal. [Palladino,C, Navarro Gómez,NL] Sección de Enfermedades Infecciosas, Servicio de Pediatría, Hospital General Universitario Gregorio Marañón, Madrid. [Soler-Palacín,P, Frick,MA] Unitat de Patologia Infecciosa i Immunodeficiències de Pediatria, Hospital Universitari Vall d’Hebron, Institut de Recerca Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona. [González-Tomé,MI] Servicio de Infecciosas Pediátricas, Hospital Universitario Doce de Octubre. [De Ory,SJ] Laboratorio InmunoBiología Molecular, Hospital General Universitario Gregorio Marañón. Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Madrid. [Fortuny,C, Noguera-Julian,A] Unitat d’Infectologia, Servei de Pediatria, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain. [Bermúdez Moreno,E] Servicio de Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, Madrid. [Santos,JL] Unidad de Enfermedades Infecciosas e Inmunodeficiencias, Sección Urgencias de Pediatría, Hospital Universitario Virgen de las Nieves, Granada. [López-Cortés,LF] Enfermedades Infecciosas, Microbiología y Medicina Preventiva. Instituto de Biomedicina de Sevilla/Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville. [ Briz,V] Unit of Viral Infection and Immunity, National Center for Microbiology, Institute of Health Carlos III, Majadahonda, Madrid, Spain., Financial support was provided by the Instituto de Salud Carlos III through the Red Temática de Investigación Cooperativa en Sida (ISCIII-RETIC RD06/006, and RD12/0017/0035, and RD12/0017/0037) and FIPSE (grant number: 36-0910-10). This work has been also supported by grants from Instituto de Salud Carlos III (Ref. MPY 1039/14 to VB). CP is supported by the Portuguese Fundação para a Ciência e Tecnologia (FCT) (grant number SFRH/BPD/77448/2011, part of the EDCTP2 program supported by the European Union). VB is supported by the Miguel Servet program run by the Fondo de Investigación Sanitaria (ISCIII) (grant number CP13/00098).
- Subjects
Male ,medicine.medical_treatment ,HIV Infections ,Adolescents ,Sida en els infants ,Gastroenterology ,Pediatrics ,Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] ,chemistry.chemical_compound ,0302 clinical medicine ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Clinical Laboratory Techniques::Cytological Techniques::Cell Count::Blood Cell Count::Leukocyte Count::Lymphocyte Count::CD4 Lymphocyte Count [Medical Subject Headings] ,Emtricitabine ,030212 general & internal medicine ,Child ,Children ,Adolescente ,Chemicals and Drugs::Pharmaceutical Preparations::Dosage Forms::Tablets [Medical Subject Headings] ,Pediatria ,Antiretrovirals ,Comprimidos ,Immunosuppression ,Enzyme inhibitors ,General Medicine ,Antiretroviral therapy ,Humanos ,3. Good health ,ARN ,Combinación emtricitabina, rilpivirina y tenofovir ,Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Antiviral Agents::Anti-Retroviral Agents::Anti-HIV Agents [Medical Subject Headings] ,Treatment Outcome ,Named Groups::Persons::Age Groups::Adolescent [Medical Subject Headings] ,Rilpivirine ,Lípidos ,RNA, Viral ,Drug Therapy, Combination ,Female ,Estudios de seguimiento ,VIH-1 ,Colesterol ,Viral load ,medicine.drug ,medicine.medical_specialty ,Adolescent ,Anti-HIV Agents ,Chemicals and Drugs::Lipids [Medical Subject Headings] ,03 medical and health sciences ,Pharmacotherapy ,Chemicals and Drugs::Nucleic Acids, Nucleotides, and Nucleosides::Nucleic Acids::RNA [Medical Subject Headings] ,Internal medicine ,AIDS (Disease) in children ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Follow-Up Studies [Medical Subject Headings] ,Chemicals and Drugs::Organic Chemicals::Nitriles::Rilpivirine::Emtricitabine, Rilpivirine, Tenofovir Drug Combination [Medical Subject Headings] ,medicine ,VIH (Virus) ,Humans ,Adverse effect ,Tenofovir ,Retrospective Studies ,Organisms::Viruses::RNA Viruses::Retroviridae::Lentivirus::Lentiviruses, Primate::HIV::HIV-1 [Medical Subject Headings] ,business.industry ,HIV (Viruses) ,Recuento de linfocito CD4 ,Off-Label Use ,Antiretroviral agents ,Chemicals and Drugs::Lipids::Sterols::Cholesterol [Medical Subject Headings] ,Discontinuation ,Surgery ,Carga viral ,Regimen ,Fármacos anti-VIH ,chemistry ,Inhibidors enzimàtics ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Clinical Laboratory Techniques::Microbiological Techniques::Viral Load [Medical Subject Headings] ,HIV-1 ,business ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
To assess the safety and efficacy of rilpivirine in combination with emtricitabine and tenofovir (RPV/FTC/TDF) as a once-daily single-tablet regimen (STR) in HIV-1-infected children and adolescents we performed a multicenter case series study of HIV-1-infected patients. Inclusion criteria were initiation of therapy with RPV/FTC/TDF before the age of 18. Patients were divided into undetectable viral load (uVL) group, HIV-1 RNA
- Published
- 2016
40. Nuclear cardiology practice and associated radiation doses in Europe: results of the IAEA Nuclear Cardiology Protocols Study (INCAPS) for the 27 European countries
- Author
-
Lindner, O., Pascual, Tn, Mercuri, M, Acampa, W, Burchert, W, Flotats, A, Kaufmann, Pa, Kitsiou, A, Knuuti, J, Underwood, Sr, Vitola, Jv, Mahmarian JJ, Karthikeyan, G, Better, N, Rehani, Mm, Kashyap, R, Dondi, M, Paez, D, Einstein, Aj, INCAPS Investigators Group: Pascual TN, Bouyoucef, Se, Lele, V, Magboo, Vp, Mut, F, Mahmarian, Jj, Meeks, Jb, Alexánderson, E, Allam, A, Al-Mallah, Mh, Bom, H, Jerome, S, Luxenburg, O, Mahmarian, J, Shaw, Lj, Vitola, J, Amouri, W, Essabbah, H, Gassama, Ss, Makhdomi, Kb, El Mustapha GI, El Ouchdi, N, Qaïs, N, Soni, N, Vangu, W, Abazid, Rm, Adams, B, Agarwal, V, Alfeeli, Ma, Alnafisi, N, Bernabe, L, Bural, Gg, Chaiwatanarat, T, Chandraguptha, Jm, Cheon, Gj, Cho, I, Dogan, As, Eftekhari, M, Frenkel, A, Garty, I, George, S, Geramifar, P, Golan, H, Habib, S, Hussain, R, Im, H, Jeon, Hj, Kalawat, T, Kang, Wj, Keng, F, Klaipetch, A, Kumar, Pg, Lee, J, Lee, Ww, Lim, I, Macaisa, Cm, Malhotra, G, Mittal, Br, Mohammad, Mh, Mohan, P, Mulyanto, Id, Nariman, D, Nayak, Un, Niaz, K, Nikolov, G, Obaldo, Jm, Ozturk, E, Park, Jm, Park, S, Patel, Cd, Phuong, Hk, Quinon, Ap, Rajini, Tr, Saengsuda, Y, Santiago, J, Sayman, Hb, Shinto, As, Sivasubramaniyan, V, Son, Mh, Sudhakar, P, Syed, Gm, Tamaki, N, Thamnirat, K, Thientunyakit, T, Thongmak, S, Velasco, Dn, Verma, A, Vutrapongwatana, U, Wang, Y, Won, Ks, Yao, Z, Yingsa-nga, T, Yudistiro, R, Yue, Kt, Zafrir, N, Adrian, Sc, Agostini, D, Aguadé, S, Armitage, G, Backlund, M, Backman, M, Baker, M, Balducci, Mt, Bavelaar, C, Berovic, M, Bertagna, F, Beuchel, R, Biggi, A, Bisi, G, Bonini, R, Bradley, A, Brudin, L, Bruno, I, Busnardo, E, Casoni, R, Choudhri, A, Cittanti, C, Clauss, R, Costa, Dc, Costa, M, Dixon, K, Dziuk, M, Egelic, N, Eriksson, I, Fagioli, G, de Faria DB, Florimonte, L, Francini, A, French, M, Gallagher, E, Garai, I, Geatti, O, Genovesi, D, Gianolli, L, Gimelli, A, del Giudice, E, Halliwell, S, Hansson, Mj, Harrison, C, Homans, F, Horton, F, Jędrzejuk, D, Jogi, J, Johansen, A, Johansson, H, Kalnina, M, Kaminek, M, Kiss, A, Kobylecka, M, Kostkiewicz, M, Kropp, J, Kullenberg, R, Lahoutte, T, Lang, O, Larsson, Yh, Lázár, M, Leccisotti, L, Leners, N, Lindner, O, Lipp, Rw, Maenhout, A, Maffioli, L, Marcassa, C, Martins, B, Marzullo, P, Medolago, G, Mendiguchía, Cg, Mirzaei, S, Mori, M, Nardi, B, Nazarenko, S, Nikoletic, K, Oleksa, R, Parviainen, T, Patrina, J, Peace, R, Pirich, C, Piwowarska-Bilska, H, Popa, S, Prakash, V, Pubul, V, Puklavec, L, Rac, S, Ratniece, M, Rogan, Sa, Romeo, A, Rossi, M, Ruiz, D, Sabharwal, N, Salobir, Bg, Santos, Ai, Saranovic, S, Sarkozi, A, Schneider, Rp, Sciagra, R, Scotti, S, Servini, Z, Setti, Lr, Starck, Så, Vajauskas, D, Veselý, J, Vieni, A, Vignati, A, Vito, Im, Weiss, K, Wild, D, Zdraveska-Kochovska, M, Agüro, Rn, Alvarado, N, Barral, Cm, Beretta, M, Berrocal, I, Batista Cuellar JF, Cabral Chang TM, Cabrera Rodríguez LO, Canessa, J, Castro Mora, G, Claudia, Ac, Clavelo, Gf, Cruz Júnior AF, Faccio, Ff, Fernández, Km, Gomez Garibo JR, Gonzalez, U, E P, González, Guzzo, Ma, Jofre, J, Kapitán, M, Kempfer, G, Lopez, Jl, V T, Massardo, Medeiros Colaco, I, Mesquita, Ct, Montecinos, M, Neubauer, S, Pabon, Lm, Puente, A, Rochela Vazquez LM, Serna Macias JA, Silva Pino AG, Tártari Huber FZ, Tovar, Ap, Vargas, L, Wiefels, C, Aljizeeri, A, Alvarez, Rj, Barger, D, Beardwood, W, Behrens, J, Brann, L, Brown, D, Carr, H, Churchwell, K, Comingore, Ga, Corbett, J, Costello, M, Cruz, F, Depinet, T, Dorbala, S, Earles, M, Esteves, Fp, Etherton, E, Fanning RJ Jr, Fornace, J, Franks, L, Gewirtz, H, Gulanchyn, K, Hannah, Cl, Hays, J, Hendrickson, J, Hester, J, Holmes, K, Johnson, A, Jopek, C, Lewin, H, Lyons, J, Manley, C, Meden, J, Moore, S, Moore, Wh, Murthy, V, Nace, R, Neely, D, Nelson, L, Niedermaier, O, Rice, D, Rigs, R, Schiffer, K, Schockling, E, Schultz, T, Schumacker, T, Sheesley, B, Sheikh, A, Siegel, B, Slim, Am, Smith, J, Szulc, M, Tanskersley, N, Tilkemeier, P, Valdez, Gd, Vrooman, R, Wawrowicz, D, Winchester, De, Alcheikh, A, Allen, B, Atkins, E, Bevan, J, Bonomini, C, Christiansen, J, Clack, L, Craig, E, Dixson, H, Duncan, I, Fredericks, S, Gales, S, Hampson, R, Hanley, T, Hartcher, K, Hassall, J, Kelley, B, Kelly, S, Kidd, T, de Kort, T, Larcos, G, Macdonald, W, Mcgrath, C, Murdoch, E, O'Malley, S, O'Rourke, M, Pack, M, Pearce, R, Praehofer, R, Ramsay, S, Scarlett, L, Smidt, K, Souvannavong, F, Taubman, K, Taylor, G, Tse, K, Unger, S, Weale, J., Lindner, Oliver, Pascual, Thomas N. B, Mercuri, Mathew, Acampa, Wanda, Burchert, Wolfgang, Flotats, Albert, Kaufmann, Philipp A, Kitsiou, Anastasia, Knuuti, Juhani, Underwood, S. Richard, Vitola, João V, Mahmarian, John J, Karthikeyan, Ganesan, Better, Nathan, Rehani, Madan M, Kashyap, Ravi, Dondi, Maurizio, Paez, Diana, Einstein, Andrew J., Columbia University Medical Center (CUMC), and Columbia University [New York]
- Subjects
INCAPS Investigators Group ,[SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging ,Computed tomography ,Best practice ,030204 cardiovascular system & hematology ,Myocardial perfusion scintigraphy ,030218 nuclear medicine & medical imaging ,0302 clinical medicine ,Nuclear Medicine and Imaging ,Medicine ,media_common ,medicine.diagnostic_test ,Radiation dose ,Scientific ,General Medicine ,3. Good health ,Patient management ,Europe ,Nuclear Medicine & Medical Imaging ,Radiology Nuclear Medicine and imaging ,SPECT ,Practice Guidelines as Topic ,Cardiology ,Original Article ,Radiology ,Societies, Scientific ,medicine.medical_specialty ,Best practices ,0299 Other Physical Sciences ,[SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine ,Radiation Dosage ,NO ,03 medical and health sciences ,Internal medicine ,media_common.cataloged_instance ,Radiology, Nuclear Medicine and imaging ,Medical physics ,European Union ,Quality of care ,European union ,Cardiac Imaging Technique ,business.industry ,Nuclear cardiology ,PET ,Cardiac Imaging Techniques ,Nuclear Medicine ,Positron-Emission Tomography ,Radiology, Nuclear Medicine and Imaging ,1103 Clinical Sciences ,business ,Societies ,Medical therapy ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
Purpose Nuclear cardiology is widely used to diagnose coronary artery disease and to guide patient management, but data on current practices, radiation dose-related best practices, and radiation doses are scarce. To address these issues, the IAEA conducted a worldwide study of nuclear cardiology practice. We present the European subanalysis. Methods In March 2013, the IAEA invited laboratories across the world to document all SPECT and PET studies performed in one week. The data included age, gender, weight, radiopharmaceuticals, injected activities, camera type, positioning, hardware and software. Radiation effective dose was calculated for each patient. A quality score was defined for each laboratory as the number followed of eight predefined best practices with a bearing on radiation exposure (range of quality score 0 - 8). The participating European countries were assigned to regions (North, East, South, and West). Comparisons were performed between the four European regions and between Europe and the rest-of-the-world (RoW). Results Data on 2,381 European patients undergoing nuclear cardiology procedures in 102 laboratories in 27 countries were collected. A cardiac SPECT study was performed in 97.9 % of the patients, and a PET study in 2.1 %. The average effective dose of SPECT was 8.0 +/- 3.4 mSv (RoW 11.4 +/- 4.3 mSv; P < 0.001) and of PET was 2.6 +/- 1.5 mSv (RoW 3.8 +/- 2.5 mSv; P < 0.001). The mean effective doses of SPECT and PET differed between European regions (P < 0.001 and P = 0.002, respectively). The mean quality score was 6.2 +/- 1.2, which was higher than the RoW score (5.0 +/- 1.1; P < 0.001). Adherence to best practices did not differ significantly among the European regions (range 6 to 6.4; P = 0.73). Of the best practices, stress-only imaging and weight-adjusted dosing were the least commonly used. Conclusion In Europe, the mean effective dose from nuclear cardiology is lower and the average quality score is higher than in the RoW. There is regional variation in effective dose in relation to the best practice quality score. A possible reason for the differences between Europe and the RoW could be the safety culture fostered by actions under the Euratom directives and the implementation of diagnostic reference levels. Stress-only imaging and weight-adjusted activity might be targets for optimization of European nuclear cardiology practice.
- Published
- 2016
41. Comparison of Radiation Doses and Best-Practice Use for Myocardial Perfusion Imaging in US and Non-US Laboratories: Findings From the IAEA (International Atomic Energy Agency) Nuclear Cardiology Protocols Study
- Author
-
Mercuri, Mathew, N B, Pascual Thomas, Mahmarian John, J, Shaw Leslee, J, Rehani Madan, M, Paez, Diana, Einstein, Andrew J, INCAPS Investigators Group: Pascual, T, Paez, D, Dondi, M, Better, N, Bouyoucef, Se, Karthikeyan, G, Kashyap, R, Lele, V, Mut, F, Magboo, V, Mahmarian, J, Mercuri, M, Rehani, M, Vitola, J, Alexanderson, E, Allam, A, Al-Mallah, M, Bouyoucef, S, Bom, H, Flotats, A, Jerome, S, Kaufmann, P, Luxenburg, O, Shaw, L, Underwood, S, Amouri, W, Essabbah, H, Gassama, S, Makhdomi, K, El Mustapha, G, El Ouchdi, N, Qaïs, N, Soni, N, Vangu, W, Abazid, R, Adams, B, Agarwal, V, Alfeeli, M, Alnafisi, N, Bernabe, L, Bural, G, Chaiwatanarat, T, Chandraguptha, J, Cheon, G, Cho, I, Dogan, A, Eftekhari, M, Frenkel, A, Garty, I, George, S, Geramifar, P, Golan, H, Habib, S, Hussain, R, Im, H, Jeon, Hj, Kalawat, T, Kang, W, Keng, F, Klaipetch, A, Kumar, P, Lee, J, Lee, W, Lim, I, Macaisa, C, Malhotra, G, Mittal, B, Mohammad, M, Mohan, P, Mulyanto, I, Nariman, D, Nayak, U, Niaz, K, Nikolov, G, Obaldo, J, Ozturk, E, Park, J, Park, S, Patel, C, Phuong, H, Quinon, A, Rajini, T, Saengsuda, Y, Santiago, J, Sayman, H, Shinto, A, Sivasubramaniyan, V, Son, M, Sudhakar, P, Syed, G, Tamaki, N, Thamnirat, K, Thientunyakit, T, Thongmak, S, Velasco, D, Verma, A, Vutrapongwatana, U, Wang, Y, Won, K, Yao, Z, Yingsa-nga, T, Yudistiro, R, Yue, K, Zafrir, N, Adrian, S, Agostini, D, Aguadé, S, Armitage, G, Backlund, M, Backman, M, Baker, M, Balducci, M, Bavelaar, C, Berovic, M, Bertagna, F, Beuchel, R, Biggi, A, Bisi, G, Bonini, R, Bradley, A, Brudin, L, Bruno, I, Busnardo, E, Casoni, R, Choudhri, A, Cittanti, C, Clauss, R, Costa, D, Costa, M, Dixon, K, Dziuk, M, Egelic, N, Eriksson, I, Fagioli, G, de Faria, D, Florimonte, L, Francini, A, French, M, Gallagher, E, Garai, I, Geatti, O, Genovesi, D, Gianolli, L, Gimelli, A, del Giudice, E, Halliwell, S, Hansson, M, Harrison, C, Homans, F, Horton, F, Jędrzejuk, D, Jogi, J, Johansen, A, Johansson, H, Kalnina, M, Kaminek, M, Kiss, A, Kobylecka, M, Kostkiewicz, M, Kropp, J, Kullenberg, R, Lahoutte, T, Lang, O, Larsson, Y, Lázár, M, Leccisotti, L, Leners, N, Lindner, O, Lipp, R, Maenhout, A, Maffioli, L, Marcassa, C, Martins, B, Marzullo, P, Medolago, G, Meeks, J, Mendiguchía, C, Mirzaei, S, Mori, M, Nardi, B, Nazarenko, S, Nikoletic, K, Oleksa, R, Parviainen, T, Patrina, J, Peace, R, Pirich, C, Piwowarska-Bilska, H, Popa, S, Prakash, V, Pubul, V, Puklavec, L, Rac, S, Ratniece, M, Rogan, S, Romeo, A, Rossi, M, Ruiz, D, Sabharwal, N, Salobir, B, Santos, A, Saranovic, S, Sarkozi, A, Schneider, R, Sciagra, R, Scotti, S, Servini, Z, Setti, L, Starck, Så, Vajauskas, D, Veselý, J, Vieni, A, Vignati, A, Vito, I, Weiss, K, Wild, D, Zdraveska-Kochovska, M, Agüro, R, Alvarado, N, Barral, C, Beretta, M, Berrocal, I, Batista Cuellar, J, Cabral Chang TM, Cabrera Rodríguez, L, Canessa, J, Castro Mora, G, Claudia, A, Clavelo, G, Cruz, A Jr, Faccio, F, Fernández, K, Gomez Garibo, J, Gonzalez, U, González, P, Guzzo, M, Jofre, J, Kapitán, M, Kempfer, G, Lopez, J, Massardo, T, Medeiros Colaco, I, Mesquita, C, Montecinos, M, Neubauer, S, Pabon, L, Puente, A, Rochela Vazquez, L, Serna Macias, J, Silva Pino, A, Tártari Huber, F, Tovar, A, Vargas, L, Wiefels, C, Aljizeeri, A, Alvarez, R, Barger, D, Beardwood, W, Behrens, J, Brann, L, Brown, D, Carr, H, Churchwell, K, Comingore, G, Corbett, J, Costello, M, Cruz, F, Depinet, T, Dorbala, S, Earles, M, Esteves, F, Etherton, E, Fanning, R Jr, Fornace, J, Franks, L, Gewirtz, H, Gulanchyn, K, Hannah, Cl, Hays, J, Hendrickson, J, Hester, J, Holmes, K, Johnson, A, Jopek, C, Lewin, H, Lyons, J, Manley, C, Meden, J, Moore, S, Moore, W, Murthy, V, Nace, R, Neely, D, Nelson, L, Niedermaier, O, Rice, D, Rigs, R, Schiffer, K, Schockling, E, Schultz, T, Schumacker, T, Sheesley, B, Sheikh, A, Siegel, B, Slim, A, Smith, J, Szulc, M, Tanskersley, N, Tilkemeier, P, Valdez, G, Vrooman, R, Wawrowicz, D, Winchester, D, Alcheikh, A, Allen, B, Atkins, E, Bevan, J, Bonomini, C, Christiansen, J, Clack, L, Craig, E, Dixson, H, Duncan, I, Fredericks, S, Gales, S, Hampson, R, Hanley, T, Hartcher, K, Hassall, J, Kelley, B, Kelly, S, Kidd, T, de Kort, T, Larcos, G, Macdonald, W, Mcgrath, C, Murdoch, E, O'Malley, S, O'Rourke, M, Pack, M, Pearce, R, Praehofer, R, Ramsay, S, Scarlett, L, Smidt, K, Souvannavong, F, Taubman, K, Taylor, G, Tse, K, Unger, S, and Weale, J.
- Subjects
Male ,medicine.medical_specialty ,Best practice ,030204 cardiovascular system & hematology ,Radiation Dosage ,Thallium stress test ,030218 nuclear medicine & medical imaging ,NO ,03 medical and health sciences ,Myocardial perfusion imaging ,0302 clinical medicine ,Clinical Protocols ,Internal Medicine ,Radiology Specialty ,Medical imaging ,medicine ,Humans ,Medical physics ,Aged ,Female ,Middle Aged ,Myocardial Perfusion Imaging ,Practice Guidelines as Topic ,United States ,medicine.diagnostic_test ,business.industry ,Atomic energy ,Coronary arteriosclerosis ,Radiation exposure ,business - Published
- 2016
42. Membrane and Capillary Components of Lung Diffusion in Infants with Bronchopulmonary Dysplasia
- Author
-
Daniel V. Chang, Robert S. Tepper, Jeffrey Kisling, Christina Tiller, and Santiago J. Assaf
- Subjects
Pulmonary and Respiratory Medicine ,Male ,medicine.medical_specialty ,Pathology ,Indiana ,Blood volume ,Critical Care and Intensive Care Medicine ,behavioral disciplines and activities ,03 medical and health sciences ,0302 clinical medicine ,DLCO ,030225 pediatrics ,Diffusing capacity ,Internal medicine ,mental disorders ,medicine ,Humans ,Full Term ,Bronchopulmonary Dysplasia ,Lung ,Blood Volume ,business.industry ,Pulmonary Gas Exchange ,Pulmonary Diffusing Capacity ,Infant, Newborn ,Infant ,respiratory system ,medicine.disease ,Pulmonary Alveoli ,medicine.anatomical_structure ,030228 respiratory system ,Bronchopulmonary dysplasia ,Case-Control Studies ,Cardiology ,Room air distribution ,Female ,business ,Infant, Premature - Abstract
Autopsied lungs of infants with bronchopulmonary dysplasia (BPD) demonstrate impaired alveolar development with larger and fewer alveoli, which is consistent with our previous physiologic findings of lower pulmonary diffusing capacity of the lung for carbon monoxide (DL(CO)) in infants and toddlers with BPD compared with healthy controls born at full term (FT). However, it is not known whether the decreased DL(CO) in infants with BPD results from a reduction in both components of DL(CO): pulmonary membrane diffusing capacity (D(M)) and Vc.We hypothesized that impairment of alveolar development in BPD results in a decrease in both D(M) and Vc components of DlCO but that the D(M)/Vc ratio would not differ between the BPD and FT groups.DL(CO) was measured under conditions of room air and high inspired oxygen (90%), which enabled D(M) and Vc to be calculated.D(M) and Vc increased with increasing body length; however, infants with BPD had significantly lower D(M) and Vc than FT subjects after adjustment for race, sex, body length, and corrected age. In contrast to D(M) and Vc, the D(M)/Vc ratio remained constant with increasing body length and did not differ for infants with BPD and FT subjects.Our findings are consistent with infants with BPD having impaired alveolar development with fewer but larger alveoli, as well as a reduced Vc.
- Published
- 2015
43. Opportunities for improvement on current nuclear cardiology practices and radiation exposure in Latin America: Findings from the 65-country IAEA Nuclear Cardiology Protocols cross-sectional Study (INCAPS)
- Author
-
Vitola, Jv, Mut, F, Alexanderson, E, Pascual, Tnb, Mercuri, M, Karthikeyan, G, Better, N, Rehani, Mm, Kashyap, R, Dondi, M, Paez, D, Einstein, Aj, Bouyoucef, Se, Allam, Ah, Vangu, M, Magboo, Vpc, Mahmarian, Jj, Allam, A, Bom, H, Flotats, A, Jerome, S, Kaufmann, Pa, Lele, V, Luxenburg, O, Mahmarian, J, Shaw, Lj, Underwood, Sr, Amouri, W, Essabbah, H, Gassama, Ss, Makhdomi, Kb, El Mustapha, Gie, El Ouchdi, N, Qaïs, N, Soni, N, Vangu, W, Abazid, Rm, Adams, B, Agarwal, V, Alfeeli, Ma, Alnafisi, N, Bernabe, L, Bural, Gg, Chaiwatanarat, T, Chandraguptha, Jm, Cheon, Gj, Cho, I, Dogan, As, Eftekhari, M, Frenkel, A, Garty, I, George, S, Geramifar, P, Golan, H, Habib, S, Hussain, R, Im, H, Jeon, H-J, Kalawat, T, Kang, Wj, Keng, F, Klaipetch, A, Kumar, Pg, Lee, J, Lee, Ww, Lim, I, Macaisa, Cmm, Malhotra, G, Mittal, Br, Mohammad, Mh, Mohan, P, Mulyanto, Id, Nariman, D, Nayak, Un, Niaz, K, Nikolov, G, Obaldo, Jm, Ozturk, E, Park, Jm, Park, S, Patel, Cd, Phuong, Hk, Quinon, Ap, Rajini, Tr, Saengsuda, Y, Santiago, J, Sayman, Hb, Shinto, As, Sivasubramaniyan, V, Son, Mh, Sudhakar, P, Syed, Gms, Tamaki, N, Thamnirat, K, Thientunyakit, T, Thongmak, S, Velasco, Dn, Verma, A, Vutrapongwatana, U, Wang, Y, Won, Ks, Yao, Z, Yingsa-Nga, T, Yudistiro, R, Yue, Kt, Zafrir, N, Adrian, Sc, Agostini, D, Aguadé, S, Armitage, G, Backlund, M, Backman, M, Baker, M, Balducci, Mt, Bavelaar, C, Berovic, M, Bertagna, F, Beuchel, R, Biggi, A, Bisi, G, Bonini, R, Bradley, A, Brudin, L, Bruno, I, Busnardo, E, Casoni, R, Choudhri, A, Cittanti, C, Clauss, R, Costa, Dc, Costa, M, Dixon, K, Dziuk, M, Egelic, N, Eriksson, I, Fagioli, G, De Faria, Db, Florimonte, L, Francini, A, French, M, Gallagher, E, Garai, I, Geatti, O, Genovesi, D, Gianolli, L, Gimelli, A, Del Giudice, E, Halliwell, S, Hansson, Mj, Harrison, C, Homans, F, Horton, F, Jȩdrzejuk, D, Jogi, J, Johansen, A, Johansson, H, Kalnina, M, Kaminek, M, Kiss, A, Kobylecka, M, Kostkiewicz, M, Kropp, J, Kullenberg, R, Lahoutte, T, Lang, O, Larsson, Yh, Lázár, M, Leccisotti, L, Leners, N, Lindner, O, Lipp, Rw, Maenhout, A, Maffioli, L, Marcassa, C, Martins, B, Marzullo, P, Medolago, G, Mendiguchía, Cg, Mirzaei, S, Mori, M, Nardi, B, Nazarenko, S, Nikoletic, K, Oleksa, R, Parviainen, T, Patrina, J, Peace, R, Pirich, C, Piwowarska-Bilska, H, Popa, S, Prakash, V, Pubul, V, Puklavec, L, Rac, S, Ratniece, M, Rogan, Sa, Romeo, A, Rossi, M, Ruiz, D, Sabharwal, N, Salobir, Bg, Santos, Ai, Saranovic, S, Sarkozi, A, Schneider, Rp, Sciagra, R, Scotti, S, Servini, Z, Setti, Lr, Starck, S-A, Vajauskas, D, Veselý, J, Vieni, A, Vignati, A, Vito, I. M., Weiss, K, Wild, D, Zdraveska-Kochovska, M, Agüro, Rn, Alvarado, N, Barral, Cm, Beretta, M, Berrocal, I, Batista Cuellar, Jf, Cabral Chang, T-M, Cabrera Rodríguez, Lo, Canessa, J, Castro Mora, G, Claudia, Ac, Clavelo, Gf, Cruz, Af, Faccio, Ff, Fernández, Km, Gomez Garibo, Jr, Gonzalez, U, González, Pe, Guzzo, Ma, Jofre, J, Kapitán, M, Kempfer, G, Lopez, Jl, Massardo, Tv, Medeiros Colaco, I, Mesquita, Ct, Montecinos, M, Neubauer, S, Pabon, Lm, Puente, A, Rochela Vazquez, Lm, Serna Macias, Ja, Silva Pino, Ag, Tártari Huber, Fz, Tovar, Ap, Vargas, L, Wiefels, C, Aljizeeri, A, Alvarez, Rj, Barger, D, Beardwood, W, Behrens, J, Brann, L, Brown, D, Carr, H, Churchwell, K, Comingore, Ga, Corbett, J, Costello, M, Cruz, F, Depinet, T, Dorbala, S, Earles, M, Esteves, Fp, Etherton, E, Fanning, Rj, Fornace, J, Franks, L, Gewirtz, H, Gulanchyn, K, Hannah, C-L, Hays, J, Hendrickson, J, Hester, J, Holmes, K, Johnson, A, Jopek, C, Lewin, H, Lyons, J, Manley, C, Meden, J, Moore, S, Moore, Wh, Murthy, V, Nace, R, Neely, D, Nelson, L, Niedermaier, O, Rice, D, Rigs, R, Schiffer, K, Schockling, E, Schultz, T, Schumacker, T, Sheesley, B, Sheikh, A, Siegel, B, Slim, Am, Smith, J, Szulc, Mc, Tanskersley, N, Tilkemeier, P, Valdez, Gd, Vrooman, R, Wawrowicz, D, Winchester, De, Alcheikh, A, Allen, B, Atkins, E, Bevan, J, Bonomini, C, Christiansen, J, Clack, L, Craig, E, Dixson, H, Duncan, I, Fredericks, S, Gales, S, Hampson, R, Hanley, T, Hartcher, K, Hassall, J, Kelley, B, Kelly, S, Kidd, T, De Kort, T, Larcos, G, Macdonald, W, Mcgrath, C, Murdoch, E, O'Malley, S, O'Rourke, M, Pack, M, Pearce, R, Praehofer, R, Ramsay, S, Scarlett, L, Smidt, K, Souvannavong, F, Taubman, K, Taylor, G, Tse, K, Unger, S, and Weale, J
- Subjects
best practices ,Latin America ,Nuclear cardiology ,PET ,radiation dose ,SPECT ,Cardiology ,Guideline Adherence ,Health Care Surveys ,Humans ,Internationality ,Middle Aged ,Myocardial Perfusion Imaging ,Practice Patterns, Physicians' ,Quality Assurance, Health Care ,Quality Improvement ,Radiation Exposure ,Radiation Protection ,Tomography, Emission-Computed ,Utilization Review ,medicine.medical_specialty ,Latin Americans ,Cross-sectional study ,Practice Patterns ,030204 cardiovascular system & hematology ,Effective dose (radiation) ,030218 nuclear medicine & medical imaging ,NO ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Radiology, Nuclear Medicine and imaging ,Medical physics ,Tomography ,Physicians' ,Guideline adherence ,business.industry ,Radiation dose ,Coronary heart disease ,Radiation exposure ,Health Care ,Emission-Computed ,Radiation protection ,Cardiology and Cardiovascular Medicine ,business ,Quality Assurance - Abstract
Comparison of Latin American (LA) nuclear cardiology (NC) practice with that in the rest of the world (RoW) will identify areas for improvement and lead to educational activities to reduce radiation exposure from NC. INCAPS collected data on all SPECT and PET procedures performed during a single week in March-April 2013 in 36 laboratories in 10 LA countries (n = 1139), and 272 laboratories in 55 countries in RoW (n = 6772). Eight “best practices” were identified a priori and a radiation-related Quality Index (QI) was devised indicating the number used. Mean radiation effective dose (ED) in LA was higher than in RoW (11.8 vs 9.1 mSv, p
- Published
- 2015
44. The Liver in Circulatory Failure
- Author
-
Kiley Kolb, Santiago J. Munoz, and Jonathan M. Fenkel
- Subjects
Hepatitis ,Liver injury ,medicine.medical_specialty ,Necrosis ,business.industry ,Ischemia ,CIRCULATORY FAILURE ,Infarction ,Hypoxia (medical) ,medicine.disease ,Internal medicine ,Shock (circulatory) ,medicine ,Cardiology ,medicine.symptom ,business - Published
- 2011
45. Dramatic Effect of Rituximab in Immunoglobulin G4-Related Primary Sclerosing Cholangitis
- Author
-
Hanisha Manickavasagan, Robert Wood, Scott Kindsfather, and Santiago J. Munoz
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Immunoglobulin g4 ,Internal medicine ,Gastroenterology ,Medicine ,Rituximab ,business ,medicine.disease ,Primary sclerosing cholangitis ,medicine.drug - Published
- 2016
46. Underutilization of SBP Prophylaxis: A Retrospective Analysis of Prophylactic Antibiotic Use for SBP Prevention in Cirrhotics
- Author
-
Andres Riera, Vishal Patel, Mitchell Kang, Anshul Dutta, Kenneth D. Rothstein, Christie Mannino, and Santiago J. Munoz
- Subjects
Prophylactic antibiotic ,medicine.medical_specialty ,Hepatology ,business.industry ,Internal medicine ,Gastroenterology ,Retrospective analysis ,Medicine ,business - Published
- 2016
47. Outcomes in Patients with Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea
- Author
-
Ana Boldova, Santiago J. Carrizo, Jose M. Marin, Joan B. Soriano, and Bartolome R. Celli
- Subjects
Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,medicine.medical_treatment ,Kaplan-Meier Estimate ,Critical Care and Intensive Care Medicine ,Severity of Illness Index ,Pulmonary Disease, Chronic Obstructive ,Intensive care ,Internal medicine ,medicine ,Humans ,Prospective Studies ,Continuous positive airway pressure ,Sleep Apnea, Obstructive ,COPD ,Continuous Positive Airway Pressure ,business.industry ,Age Factors ,Sleep apnea ,Overlap syndrome ,Middle Aged ,medicine.disease ,Pulmonary hypertension ,respiratory tract diseases ,Surgery ,Hospitalization ,Obstructive sleep apnea ,Heart failure ,Cardiology ,Female ,business ,Follow-Up Studies - Abstract
Patients with chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) (overlap syndrome) are more likely to develop pulmonary hypertension than patients with either condition alone.To assess the relation of overlap syndrome to mortality and first-time hospitalization because of COPD exacerbation and the effect of continuous positive airway pressure (CPAP) on these major outcomes.We included 228 patients with overlap syndrome treated with CPAP, 213 patients with overlap syndrome not treated with CPAP, and 210 patients with COPD without OSA. All were free of heart failure, myocardial infarction, or stroke. Median follow-up was 9.4 years (range, 3.3-12.7). End points were all-cause mortality and first-time COPD exacerbation leading to hospitalization.After adjustment for age, sex, body mass index, smoking status, alcohol consumption, comorbidities, severity of COPD, apnea-hypopnea index, and daytime sleepiness, patients with overlap syndrome not treated with CPAP had a higher mortality (relative risk, 1.79; 95% confidence interval, 1.16-2.77) and were more likely to suffer a severe COPD exacerbation leading to hospitalization (relative risk, 1.70; 95% confidence interval, 1.21-2.38) versus the COPD-only group. Patients with overlap syndrome treated with CPAP had no increased risk for either outcome compared with patients with COPD-only.The overlap syndrome is associated with an increased risk of death and hospitalization because of COPD exacerbation. CPAP treatment was associated with improved survival and decreased hospitalizations in patients with overlap syndrome.
- Published
- 2010
48. Medication Adherence and Persistence in Severe Obstructive Sleep Apnea
- Author
-
Monica Izuel, Isabel Villar, Eugenio Vicente, Santiago J. Carrizo, and Jose M. Marin
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Comorbidity ,Medication Adherence ,Cohort Studies ,Sex Factors ,Physiology (medical) ,Internal medicine ,medicine ,Humans ,Longitudinal Studies ,Prospective Studies ,Continuous positive airway pressure ,Prospective cohort study ,Antihypertensive Agents ,Aged ,Sleep Apnea, Obstructive ,Continuous Positive Airway Pressure ,business.industry ,Respiratory disease ,Middle Aged ,respiratory system ,medicine.disease ,nervous system diseases ,respiratory tract diseases ,Obstructive sleep apnea ,Cardiovascular Diseases ,Spain ,Cardiovascular agent ,Commentary ,Physical therapy ,Platelet aggregation inhibitor ,Female ,Neurology (clinical) ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,business ,Platelet Aggregation Inhibitors ,Cohort study - Abstract
The aim of this study was to compare 2 groups of patients with severe obstructive sleep apnea (OSA) who were taking medication for cardiovascular disease: those who were compliant with nasal continuous positive airway pressure (CPAP) treatment and those who refused treatment or were noncompliant with CPAP treament.In a cohort of 2158 patients with severe OSA (apnea-hypopnea index30) a 2-year prospective longitudinal assessment of adherence and persistence with 3 medication categories (antihypertensives, statins, and antiplatelets) was carried out using the administrative database of the National Health Service. Medication adherence was evaluated by calculating the medication possession ratio (%MPR = days supplylactual days to refill x 100) for each drug. Medication persistency was defined as the proportion of subjects having filled a prescription in the last 30 days of the 2-year period. CPAP use was assessed at every follow-up visit after the treatment was prescribed. Medication adherence was compared between patients who had adequate CPAP adherence (4 h/day) and those who declined CPAP therapy or had discontinued CPAP due to an average use of less than 4 hours per day.The average 2-year MPR for antihypertensives, statins, and antiplatelets was not different among patients who used CPAP (88%, 81%, 95%) or did not use CPAP (86%, 77%, 93%). Female sex and increased number of comorbidities were predictors of good medication adherence (MPR80%). The rates of persistence for the 3 studied medications after the 2-year observation period were not different between the 2 groups (patients with or without CPAP).Medication adherence and persistence during a 2-year period for 3 well-known protective cardiovascular medications were not different in patients with severe OSA, whether or not they were treated with CPAP.
- Published
- 2009
49. Management of Autoimmune and Cholestatic Liver Disorders
- Author
-
Karen L. Krok and Santiago J. Munoz
- Subjects
Cholagogues and Choleretics ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Biliary cirrhosis ,medicine.medical_treatment ,Cholangitis, Sclerosing ,Hepatobiliary Disorder ,Anti-Inflammatory Agents ,Autoimmune hepatitis ,Liver transplantation ,Gastroenterology ,Cholestasis ,Internal medicine ,Azathioprine ,medicine ,Humans ,Pharmacologic therapy ,Hepatology ,Liver Cirrhosis, Biliary ,business.industry ,Liver Neoplasms ,Ursodeoxycholic Acid ,Overlap syndrome ,medicine.disease ,Liver Transplantation ,Hepatitis, Autoimmune ,Chronic Disease ,Practice Guidelines as Topic ,Prednisone ,business ,Immunosuppressive Agents - Abstract
The management of autoimmune and cholestatic liver disorders is a challenging area of hepatology. Autoimmune and cholestatic liver diseases represent a comparatively small proportion of hepatobiliary disorders, yet their appropriate management is of critical importance for patient survival. In this article, management strategies are discussed, including the indications and expectations of pharmacologic therapy, endoscopic approaches, and the role of liver transplantation.
- Published
- 2009
50. Coagulopathy of Acute Liver Failure
- Author
-
Santiago J. Munoz, Don A. Gabriel, and R. Todd Stravitz
- Subjects
medicine.medical_specialty ,Fulminant ,medicine.medical_treatment ,Hemorrhage ,Postoperative Hemorrhage ,Liver transplantation ,Gastroenterology ,Internal medicine ,medicine ,Coagulopathy ,Humans ,International Normalized Ratio ,Intensive care medicine ,Hepatic encephalopathy ,Hepatitis ,Hepatology ,business.industry ,digestive, oral, and skin physiology ,Blood Coagulation Disorders ,Liver Failure, Acute ,medicine.disease ,Pathophysiology ,Liver Transplantation ,Hemostasis ,Disease Progression ,Liver function ,business - Abstract
Coagulopathy is an essential component of the acute liver failure (ALF) syndrome and reflects the central role of liver function in hemostasis. ALF is a syndrome characterized by the development of hepatic encephalopathy and coagulopathy within 24 weeks of the onset of acute liver disease. Coagulopathy in this setting is a useful prognostic tool in ALF and a dynamic indicator of the hepatic function. If severe, it can be associated with bleeding and is commonly a major obstacle to the performance of invasive procedures in patients with ALF. This review focuses on the epidemiology, pathophysiology, presentation, evaluation, and management of coagulopathy in ALF.
- Published
- 2009
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.