Author: "Santiago J" / Topic: medicine.medical_specialty - Searchworks@Jio Institute Digital Library Search Results

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1. 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

2. 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

3. 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

4. Potential impacts of a novel integrated extracorporeal-CPR workflow using an interventional radiology and immediate whole-body computed tomography system in the emergency department

Author: Kazuma Yamakawa, Takahiro Kinoshita, Lance B Becker, Kei Hayashida, Satoshi Fujimi, and Santiago J. Miyara
Subjects: medicine.medical_specialty, Extracorporeal Circulation, lcsh:Diseases of the circulatory (Cardiovascular) system, Time Factors, Computed tomography, 030204 cardiovascular system & hematology, Radiography, Interventional, Extracorporeal, Time-to-Treatment, Workflow, 03 medical and health sciences, 0302 clinical medicine, Concurrent treatment, Correspondence, medicine, Humans, Extracorporeal cardiopulmonary resuscitation, Whole Body Imaging, Program Development, Patient Care Team, Out-of-hospital cardiac arrest, medicine.diagnostic_test, business.industry, Delivery of Health Care, Integrated, Emergency department, 030208 emergency & critical care medicine, Interventional radiology, medicine.disease, Cardiopulmonary Resuscitation, Cardiac surgery, HERS, lcsh:RC666-701, Life support, Models, Organizational, Critical Pathways, Medical emergency, Cardiology and Cardiovascular Medicine, business, Emergency Service, Hospital, Tomography, X-Ray Computed
Abstract: Extracorporeal cardiopulmonary resuscitation (ECPR) can be associated with increased survival and neurologic benefits in selected patients with out-of-hospital cardiac arrest (OHCA). However, there remains insufficient evidence to recommend the routine use of ECPR for patients with OHCA. A novel integrated trauma workflow concept that utilizes a sliding computed tomography (CT) scanner and interventional radiology (IR) system, named a hybrid emergency room system (HERS), allowing emergency therapeutic interventions and CT examination without relocating trauma patients, has recently evolved in Japan. HERS can drastically shorten the ECPR implementation time and more quickly facilitate definitive interventions than the conventional advanced cardiovascular life support workflow. Herein, we discuss our novel workflow concept using HERS on ECPR for patients with OHCA.
Published: 2020

5. Guidelines, recommendations and consensus on obstructive sleep apnea

Author: Santiago J. Carrizo and Jose M. Marin
Subjects: Obstructive sleep apnea, medicine.medical_specialty, Guidelines recommendations, business.industry, Medicine, General Medicine, business, medicine.disease, Intensive care medicine
Published: 2021

6. Sequential Use of Romiplostim after Eltrombopag for Refractory Thrombocytopenia in Hydrocarbon-Induced Myelodysplasia

Author: Rishabh C. Choudhary, Gabriel I. Aranalde, Muhammad Shoaib, Elena C. Brindley, Elvio Mazzotta, Sara Guevara, Alexia McCann-Molmenti, Young Min Cho, Stefanos Zafeiropoulos, Stacey Watt, Yaser M. Alsalmay, Kei Hayashida, Lance B Becker, Koichiro Shinozaki, Luis F. Morales, Stavros Zanos, Christine N. Metz, Ernesto P. Molmenti, Ryosuke Takegawa, Daniel A. Grande, Santiago J. Miyara, Mitsuaki Nishikimi, and Adam M. Kressel
Subjects: Thrombopoietin receptor, Pediatrics, medicine.medical_specialty, Romiplostim, business.industry, Myelodysplastic syndromes, Eltrombopag, medicine.disease, Thrombocytopenic purpura, law.invention, chemistry.chemical_compound, Randomized controlled trial, Refractory, chemistry, law, hemic and lymphatic diseases, Medicine, Refractory Thrombocytopenia, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract: We describe the clinical course of a 65-year-old male patient who suffered from hydrocarbon-induced myelodysplasia and was successfully treated with the thrombopoietin receptor agonist (TPO-RA), romiplostim. Myelodysplastic syndromes (MDS) are characterized by ineffective hematopoiesis, cytopenias, and increased risk of leukemic transformation. Here, we present a clinical vignette of MDS-associated thrombocytopenia refractory to first-line drugs as well as the TPO-RA, eltrombopag. To date, romiplostim is an U.S. Food and Drug Administration (FDA)-approved drug for idiopathic thrombocytopenic purpura and thrombocytopenia secondary to liver disease. Of note, currently the FDA advises against its use in MDS based on previous long-term safety concerns. Since the therapeutic options for thrombocytopenia in MDS patients are sparse, repurposing and reassessing romiplostim in this setting have been the focus of recent studies. At the time of writing, no published double-blind randomized clinical trials have conducted a head-to-head comparison between romiplostim and eltrombopag in thrombocytopenic MDS patients. To the best of our knowledge, for a thrombocytopenic patient in the setting of MDS, this is the first documented report of refractory clinical response after a 2-year use of eltrombopag in which replacement of treatment with romiplostim resulted in sustained physiological counts of thrombocytes within four weeks.
Published: 2021

7. Nosocomial Covid-19 Infection in Women Undergoing Elective Cesarean Sections: A prospective cohort study

Author: Ernesto P. Molmenti, Michael L. Nimaroff, Andrew W. Menzin, Santiago J. Miyara, Aaron Nizam, and Gary L. Goldberg
Subjects: medicine.medical_specialty, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Cohort Studies, Pregnancy, Elective Cesarean Delivery, Medicine, Humans, Prospective Studies, Prospective cohort study, Pandemics, Original Research, Cross Infection, business.industry, Obstetrics, Cesarean Section, SARS-CoV-2, COVID-19, General Medicine, Perioperative, After discharge, Infection rate, Female, business, Nosocomial Infection
Abstract: BACKGROUND The COVID-19 pandemic placed obstetricians in a difficult position of continuing to perform elective cesarean delivery without the knowledge of the risk of the spread of nosocomial infection of the COVID-19 virus. OBJECTIVE This study aimed to determine the nosocomial infection rate in women undergoing elective cesarean delivery at 2 academic institutions. STUDY DESIGN This nonrandomized prospective cohort trial evaluated patients undergoing elective cesarean delivery during the reopening phase of the COVID-19 pandemic in the state of New York at 2 large volume labor and delivery units. Eligible patients with a negative preoperative reverse transcriptase-polymerase chain reaction test and immunoglobulin G antibody test for COVID-19 were retested 6 to 9 days after discharge. The primary objective was the COVID-19 test conversion rate defined as a positive polymerase chain reaction test for SARS-CoV-2 after discharge with a negative preoperative test. This was used as a proxy for the nosocomial infection rate. RESULTS A total of 136 patients were screened for participation. Of these patients, 2 tested positive for COVID-19 on preoperative testing, and 25 declined to participate. Overall, 111 patients consented to participate, and 96 patients underwent both preoperative and postoperative testing. No patient with a negative polymerase chain reaction test preoperatively, had a positive polymerase chain reaction test for the COVID-19 virus postoperatively. CONCLUSION With strict and methodical perioperative and postpartum protocols, we can limit nosocomial COVID-19 infection in women undergoing elective cesarean delivery.
Published: 2021

8. 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

9. Right Ventricle Embolization of IVC Filter Fragments: An Incidental Finding

Author: Young Min Cho, Ryosuke Takegawa, Stefanos Zafeiropoulos, Christine N. Metz, Ernesto P. Molmenti, Lawrence Lau, Muhammad Shoaib, Rishabh C. Choudhary, Alexia McCann-Molmenti, Cristian D. Bartoc, Anthony M. Baez, Kei Hayashida, Koichiro Shinozaki, Mitsuaki Nishikimi, Tomoaki Aoki, Judith Aronsohn, Santiago J. Miyara, Lisandro Montorfano, Claudia Kirsch, Linda Shore-Lesserson, Stavros Zanos, Lance B Becker, Alexis Morell, Stacey Watt, Sara Guevara, Vinay Nair, and Claudio M. Lumermann
Subjects: medicine.medical_specialty, business.industry, medicine.medical_treatment, Perforation (oil well), Inferior vena cava filter, medicine.disease, Asymptomatic, Intracardiac injection, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Ventricle, Cardiac tamponade, medicine, 030212 general & internal medicine, Embolization, Radiology, Gonadal vein, medicine.symptom, Cardiology and Cardiovascular Medicine, business
Abstract: This case report describes a 52-year-old male patient, with the incidental finding of inferior vena cava filter (IVCF) fragments impacted into the right ventricle, secondary to IVCF fragmentation and subsequent embolization. While IVCFs are prescribed to prevent pulmonary embolizations when anticoagulation is either contraindicated, or has failed, IVCF embolizations to the heart represent an extremely rare, but potentially life-threatening complication. Of note, at the time of writing, the utility and effectiveness of IVCF are not fully established. Intracardiac embolizations of IVCF typically present with complications such as hypotension, cardiac tamponade, arrhythmias, ventricle perforation, bleeding, cardiac arrest, and death. To our knowledge, this is the first case report of an asymptomatic kidney transplant recipient found to have right ventricle embolizations of IVCF fragments through routine assessment. Additionally, this is also the first report of an asymptomatic patient who presented IVCF fragments embolized to the right ventricle and left gonadal vein in the same clinical setting.
Published: 2021

10. 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

11. External Stenting (Exostenting) to Correct Vascular Torsion and Angulation

Author: Stacey Watt, Stefanos Zafeiropoulos, Lance B Becker, Yaser M. Alsalmay, Muhammad Shoaib, Kei Hayashida, Grace Covelli, Sara Guevara, Michael B. Silva, Alexia McCann-Molmenti, Ernesto P. Molmenti, H. Colleen Silva, Gabriel I. Aranalde, Luca Cicalese, Daniel A. Grande, Young Min Cho, Santiago J. Miyara, Linda Shore-Lesserson, Ryosuke Takegawa, Adam M. Kressel, Rishabh C. Choudhary, and Koichiro Shinozaki
Subjects: medicine.medical_specialty, business.industry, medicine.medical_treatment, Torsion (gastropod), External iliac artery, Stent, Synthetic graft, 030204 cardiovascular system & hematology, medicine.disease, Organ transplantation, Surgery, Kidney transplant recipient, 03 medical and health sciences, surgical procedures, operative, 0302 clinical medicine, 030228 respiratory system, medicine.artery, Medicine, Cardiology and Cardiovascular Medicine, business, Kidney transplantation, Polytetrafluoroethylene graft
Abstract: Organ transplantation can be associated with vascular torsions and angulations of both recipient and donor vessels. Such kinks and/or torsions of vessels can compromise the vascular integrity, obstruct inflow and/or outflow, and result in loss of the organ and/or body parts. On many occasions, mild angulations and torsions can be successfully addressed by repositioning the organ. In cases where the abnormal findings persist, maneuvers such as placing a fat pad to create a smoother curve, or even opening the peritoneum (in the case of kidney transplants) to allow for a better positioning of the organ, are associated with successful outcomes. When such torsions/angulations persist despite these approaches, further innovative tactics are required. In the current report, we propose a technique that involves longitudinally opening of a synthetic graft that is rigid enough to maintain its shape, such as a ringed polytetrafluoroethylene graft, and placing it as an external stent around the angulated/torsioned vessel. This maneuver will correct the underlying vascular compromise without having to perform any further invasive interventions, such as reimplanting the organ or resecting part of the involved vessel. Although primarily illustrated for application by describing an instance in which exostenting was applied during kidney transplantation, our approach could be applied to any vessel under many circumstances where angulations/twists are encountered. In this report, we describe the use of an external stent, also called exostenting, to correct a severe torsion/angulation of the external iliac artery in a kidney transplant recipient where all other measures were unsuccessful.
Published: 2021

12. 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

13. The interplay between bystander cardiopulmonary resuscitation and ambient temperature on neurological outcome after cardiac arrest: A nationwide observational cohort study

Author: Koichiro Shinozaki, Ernesto P. Molmenti, Masaru Suzuki, Kei Hayashida, Timmy Li, Tatsuma Fukuda, Mitsuaki Nishikimi, Daniel M Rolston, Muhammad Shoaib, Tomoaki Aoki, Santiago J. Miyara, Lance B Becker, Ryo Emoto, Ryosuke Takegawa, Junichi Sasaki, and Shigeyuki Matsui
Subjects: Adult, medicine.medical_specialty, Emergency Medical Services, education, 030204 cardiovascular system & hematology, Emergency Nursing, Return of spontaneous circulation, Logistic regression, Odds, 03 medical and health sciences, 0302 clinical medicine, Japan, medicine, Bystander cardiopulmonary resuscitation, Humans, Favorable outcome, Prospective Studies, Registries, business.industry, Temperature, 030208 emergency & critical care medicine, Odds ratio, Hypothermia, Cardiopulmonary Resuscitation, Emergency medicine, Emergency Medicine, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Out-of-Hospital Cardiac Arrest, Cohort study
Abstract: Background At lower ambient temperature, patients with out-of-hospital cardiac arrest (OHCA) easily experience hypothermia. Hypothermia has shown to improve the rate of successful return of spontaneous circulation (ROSC) in animal models. We hypothesized that lower temperature affects the impact of bystander cardiopulmonary resuscitation (CPR) on the increased odds of a favorable neurological outcome post-OHCA. Methods This study used information collected by the prospective, nationwide, Utstein registry to examine data from 352,689 adult patients who experienced OHCA from 2012 to 2016 in Japan. The primary outcome was a 1-month favorable neurological outcomes. Multivariable logistic regression analyses were conducted to test the impact of bystander CPR according to the temperature on the favorable outcome. Results A total of 201,111 patients with OHCA were included in the complete case analysis. The lower temperature group had lower proportions of receiving bystander CPR (46.5 vs. 47.9%) and having favorable outcome (2.1 vs 2.8%) than those in the higher group. Multivariable analysis revealed that bystander CPR at lower temperatures was significantly associated with favorable outcomes (adjusted odds ratio, 1.22; 95% CI, 1.09–1.37), whereas bystander CPR at higher temperatures was not associated with favorable outcomes (1.02; 0.92–1.13). The nonlinear relationship using a spline curve in the multivariable model revealed that odds ratio of favorable neurological outcomes associated with bystander CPR increased as the temperature decreased. Conclusion Bystander CPR was associated with favorable neurological outcomes at lower temperatures. The odds of a favorable outcome associated with bystander CPR increased as the temperature decreased.
Published: 2021

14. 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
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15. 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

16. Predicting critical illness on initial diagnosis of COVID-19 based on easily obtained clinical variables: development and validation of the PRIORITY model

Author: Martínez Lacalzada, Miguel, Viteri Noël, Adrián, Manzano Espinosa, Luis, Fabregate, Martin, Rubio Rivas, Manuel, Luis García, Sara, Arnalich Fernández, Francisco, Beato Pérez, José Luis, Vargas Núñez, Juan Antonio, Calvo Manuel, Elpidio, Espiño Álvarez, Alexia Constanza, Freire Castro, Santiago J., Loureiro Amigo, Jose, Pesqueira Fontan, Paula Maria, Pina, Adela, Álvarez Suárez, Ana María, Silva Asiain, Andrea, García López, Beatriz, Luque del Pino, Jairo, Sanz Cánovas, Jaime, Chazarra Pérez, Paloma, García García, Gema María, Núñez Cortés, Jesús Millán, Casas Rojo, José Manuel, Gómez Huelgas, Ricardo, Abrego Vaca, Luis F., Andreu Arnanz, Ana, Arce García, Octavio A., Bajo González, Marta, Borque Sanz, Pablo, Cózar Llistó, Alberto, Hoyo Cuenda, Beatriz del, Gamboa Osorio, Alejandra, García Sánchez, Isabel, López Cisneros, Óscar A., Merino Ortiz, Borja, Riera González, Elisa, Rey García, Jimena, Sánchez Díaz, Cristina, Starita Fajardo, Grisell, Suárez Carantoña, Cecilia, Zhilina Zhilina, Svetlana, SEMI-COVID-19 Network, and UAM. Departamento de Medicina
Subjects: Microbiology (medical), medicine.medical_specialty, Evidence-based medicine, Prognostic models, Referral, Medicina, Critical Illness, Logistic regression, Initial assessment, Risk Assessment, law.invention, law, medicine, Humans, Medical history, Generalizability theory, Hospital Mortality, Retrospective Studies, business.industry, Medicina basada en l'evidència, COVID-19, Easily obtained clinical variables, General Medicine, Models, Theoretical, medicine.disease, Intensive care unit, Confidence interval, Hospitalization, Infectious Diseases, Spain, Emergency medicine, Cohort, Critical illness, business, Kidney disease
Abstract: Objectives: We aimed to develop and validate a prediction model, based on clinical history and examination findings on initial diagnosis of coronavirus disease 2019 (COVID-19), to identify patients at risk of critical outcomes. Methods: We used data from the SEMI-COVID-19 Registry, a cohort of consecutive patients hospitalized for COVID-19 from 132 centres in Spain (23rd March to 21st May 2020). For the development cohort, tertiary referral hospitals were selected, while the validation cohort included smaller hospitals. The primary outcome was a composite of in-hospital death, mechanical ventilation, or admission to intensive care unit. Clinical signs and symptoms, demographics, and medical history ascertained at presentation were screened using least absolute shrinkage and selection operator, and logistic regression was used to construct the predictive model. Results: There were 10 433 patients, 7850 in the development cohort (primary outcome 25.1%, 1967/7850) and 2583 in the validation cohort (outcome 27.0%, 698/2583). The PRIORITY model included: age, dependency, cardiovascular disease, chronic kidney disease, dyspnoea, tachypnoea, confusion, systolic blood pressure, and SpO2 ≤93% or oxygen requirement. The model showed high discrimination for critical illness in both the development (C-statistic 0.823; 95% confidence interval (CI) 0.813, 0.834) and validation (C-statistic 0.794; 95%CI 0.775, 0.813) cohorts. A freely available web-based calculator was developed based on this model (https://www.evidencio.com/models/show/2344). Conclusions: The PRIORITY model, based on easily obtained clinical information, had good discrimination and generalizability for identifying COVID-19 patients at risk of critical outcomes., No funding was received for this work.
Published: 2021

17. 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

18. 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

19. 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, 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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

20. Near-Infrared Spectroscopy Assessments of Regional Cerebral Oxygen Saturation for the Prediction of Clinical Outcomes in Patients With Cardiac Arrest: A Review of Clinical Impact, Evolution, and Future Directions

Author: Ryosuke Takegawa, Kei Hayashida, Daniel M. Rolston, Timmy Li, Santiago J. Miyara, Mitsuo Ohnishi, Tadahiko Shiozaki, and Lance B. Becker
Subjects: brain oximetry, medicine.medical_specialty, Resuscitation, near-infrared spectroscopy, medicine.medical_treatment, Review, Cerebral oxygen saturation, cardiac arrest, 030204 cardiovascular system & hematology, Return of spontaneous circulation, cardiopulmonary resuscitation, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Considered futile, Medicine, Clinical significance, In patient, Cardiopulmonary resuscitation, Intensive care medicine, neurological outcome, lcsh:R5-920, business.industry, 030208 emergency & critical care medicine, General Medicine, ROSC, prognostication, business, lcsh:Medicine (General), cerebral oxygen saturation
Abstract: Despite three decades of advancements in cardiopulmonary resuscitation (CPR) methods and post-resuscitation care, neurological prognosis remains poor among survivors of out-of-hospital cardiac arrest, and there are no reliable methods for predicting neurological outcomes in patients with cardiac arrest (CA). Adopting more effective methods of neurological monitoring may aid in improving neurological outcomes and optimizing therapeutic interventions for each patient. In the present review, we summarize the development, evolution, and potential application of near-infrared spectroscopy (NIRS) in adults with CA, highlighting the clinical relevance of NIRS brain monitoring as a predictive tool in both pre-hospital and in-hospital settings. Several clinical studies have reported an association between various NIRS oximetry measurements and CA outcomes, suggesting that NIRS monitoring can be integrated into standardized CPR protocols, which may improve outcomes among patients with CA. However, no studies have established acceptable regional cerebral oxygen saturation cut-off values for differentiating patient groups based on return of spontaneous circulation status and neurological outcomes. Furthermore, the point at which resuscitation efforts can be considered futile remains to be determined. Further large-scale randomized controlled trials are required to evaluate the impact of NIRS monitoring on survival and neurological recovery following CA.
Published: 2020

21. Transplant Renal Artery Stenosis Revascularization: Common Distal External Iliac Bypass

Author: Christopher Chiodo Ortiz, Santiago J. Miyara, Kambhampaty Krishnasastry, Kei Hayashida, Jorge Molinas, Koichiro Shinozaki, Young Min Cho, Alexia Molmenti, Joaquin Cagliani, Lance B Becker, Ryosuke Takegawa, Ernesto P. Molmenti, Sara Guevara, and Gerardo Tamayo-Enriquez
Subjects: medicine.medical_specialty, Kidney, business.industry, medicine.medical_treatment, External iliac artery, 030230 surgery, Anastomosis, Renal hilum, Revascularization, medicine.disease, Common iliac artery, Surgery, 03 medical and health sciences, Stenosis, 0302 clinical medicine, medicine.anatomical_structure, medicine.artery, Medicine, 030211 gastroenterology & hepatology, Renal artery, Cardiology and Cardiovascular Medicine, business
Abstract: Stenosis proximal to transplant renal artery anastomoses are complications leading to allograft dysfunction. This study was aimed to evaluate a novel surgical approach to renal allograft revascularization, taking into consideration the length of time elapsed since transplantation. We describe an arterial bypass using a polytetrafluoroethylene (PTFE) graft from the common iliac artery (proximal to the renal artery implantation) to the external iliac artery (distal to the renal artery implantation) that allows the adequate revascularization of both the transplant kidney, as well as the lower extremity. This technique provides several advantages when compared with previously described procedures to revascularize a transplanted kidney with an iliac artery stenosis proximal to the allograft implantation site. Benefits of this technique include (1) no need to repair the stenosis, (2) no need to take down and redo the arterial anastomosis, (3) no need to perform a dissection around the renal hilum of the transplanted kidney, (4) no requirement to address the anastomosis transfer, and (5) no need to perfuse the kidney with preservation fluid at the time of repair and/or (6) avoidance of potential injury to the renal parenchyma and/or hilum during dissections. Adequate perfusion of the organ, as well as of the lower extremity was verified by serial Doppler duplex ultrasound evaluations. Hence, we describe a novel revascularization technique in instances of kidney transplant and lower extremity ischemia.
Published: 2020

22. Life-Threatening Hematuria as Initial Presentation of a Complicated Transplant Renal Artery Pseudoaneurysm

Author: Young Min Cho, Santiago J. Miyara, Claudia Kirsch, Kambhampaty Krishnasastry, Joaquin Cagliani, Ahmed Fahmy, Kei Hayashida, Daniel M Rolston, Mustafa Al-Roubaie, Koichiro Shinozaki, Madhu Bhaskaran, Nicholas Jandovitz, Lance B Becker, Ernesto P. Molmenti, Aaron M. Winnick, Ryosuke Takegawa, Arton Isa, Sara Guevara, Lawrence Lau, Elliot Grodstein, Vinay Nair, and Lewis W. Teperman
Subjects: medicine.medical_specialty, Lower limb ischemia, business.industry, medicine.medical_treatment, 030232 urology & nephrology, Clinical course, Stent, 030230 surgery, Anastomosis, medicine.disease, Surgery, 03 medical and health sciences, Pseudoaneurysm, 0302 clinical medicine, medicine.artery, cardiovascular system, Medicine, cardiovascular diseases, Presentation (obstetrics), Renal artery, Cardiology and Cardiovascular Medicine, business, Complication
Abstract: In this case report, we describe the clinical course of a complicated transplant renal artery (TRA) pseudoaneurysm, clinically featured by gross and massive hematuria one month after a kidney transplant was performed on a 50 year-old male patient. TRA pseudoaneurysm is a rare but potentially life-threatening complication that may result in bleeding, infection, graft dysfunction/loss, lower limb ischemia/loss, hemorrhagic shock, and death. TRA pseudoaneurysm treatment remains challenging as it needs to be tailored to the patient characteristics including hemodynamic stability, graft function, anatomy, presentation, and pseudoaneurysm features. This publication discusses the clinical scenario of massive gross hematuria that derived from a retroperitoneal hematoma which originated from an actively bleeding TRA pseudoaneurysm. This case highlights the combined approach of endovascular stent placement and subsequent transplant nephrectomy as a last resort in the management of intractable bleeding from a complicated TRA pseudoaneurysm. To the best of our knowledge, this is the first published case report of an actively bleeding TRA anastomotic pseudoaneurysm that caused a massive retroperitoneal bleed that in turn evacuated via the bladder after disrupting the ureter-to-bladder anastomosis. A temporizing hemostatic arterial stent placed percutaneously allowed for a safer and controlled emergency transplant nephrectomy.
Published: 2020

23. Renal Transplant Artery Inflow Stenosis Treated with Femorofemoral Bypass

Author: Joaquin Cagliani, Ernesto P. Molmenti, Lance B Becker, Christopher Chiodo Ortiz, Koichiro Shinozaki, Sara Guevara, Santiago J. Miyara, Damian Clement, Bo Wang, Kambhampaty Krishnasastry, Kei Hayashida, Lewis W. Teperman, and Young Min Cho
Subjects: Kidney, medicine.medical_specialty, business.industry, medicine.medical_treatment, Ischemia, 030204 cardiovascular system & hematology, Anastomosis, Revascularization, medicine.disease, Surgery, 03 medical and health sciences, Stenosis, 0302 clinical medicine, medicine.anatomical_structure, surgical procedures, operative, medicine.artery, medicine, 030212 general & internal medicine, Renal artery, Cardiology and Cardiovascular Medicine, business, Vascular Stenosis, Kidney transplantation
Abstract: In this case report we describe a novel and successful revascularization approach in instances of allograft and distal limb ischemia after kidney transplantation. Stenosis proximal to transplant renal artery anastomoses is a complication leading to allograft dysfunction and/or loss. We present a femorofemoral bypass graft with ringed polytetrafluoroethylene (PTFE). In this occasion, revascularization was achieved by a backflow mechanism. The approach described achieved its goal of revascularizing the allograft as well as the distal extremity, with both short- and long-term successful outcomes. Benefits of this approach when compared with re-implantation or procedures directly involving the transplant renal artery include minimization of ischemic time, no need to repair the stenosis, anastomoses with vessels of greater diameter, no need to perfuse the kidney, no need to take down the renal artery anastomosis, no need to dissect the transplanted kidney, and no further lower extremity ischemia. This approach does not require any proximal temporary inflow occlusion (as seen with stent placement) or clamping of the arterial inflow to the kidney. This procedure was completed without having to infuse any preservation fluid into the kidney.
Published: 2020

24. 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

25. Precision Health for Chagas Disease: Integrating Parasite and Host Factors to Predict Outcome of Infection and Response to Therapy

Author: Patricia Silvia Romano, David M. Engman, and Santiago J. Martinez
Subjects: 0301 basic medicine, Microbiology (medical), Chagas disease, medicine.medical_specialty, Heart disease, Mini Review, Trypanosoma cruzi, outcome of infection, 030106 microbiology, Immunology, Argentina, lcsh:QR1-502, Microbiology, THERAPY, lcsh:Microbiology, Pathogenesis, purl.org/becyt/ford/1 [https], 03 medical and health sciences, Cellular and Infection Microbiology, parasitic diseases, Epidemiology, Animals, Humans, Medicine, Parasites, Precision Medicine, purl.org/becyt/ford/1.6 [https], chagas disease, therapy, biology, Megacolon, business.industry, CHAGAS DISEASE, Zoonosis, Megaesophagus, PRECISION HEALTH, TRYPANOSOMA CRUZI, medicine.disease, biology.organism_classification, precision health, OUTCOME OF INFECTION, 030104 developmental biology, Infectious Diseases, business
Abstract: Chagas disease, caused by the infection with the protozoan parasite Trypanosoma cruzi, is clinically manifested in approximately one-third of infected people by inflammatory heart disease (cardiomyopathy) and, to a minor degree, gastrointestinal tract disorders (megaesophagus or megacolon). Chagas disease is a zoonosis transmitted among animals and people through the contact with triatomine bugs, which are found in much of the western hemisphere, including most countries of North, Central and South America, between parallels 45° north (Minneapolis, USA) and south (Chubut Province, Argentina). Despite much research on drug discovery for T. cruzi, there remain only two related agents in widespread use. Likewise, treatment is not always indicated due to the serious side effects of these drugs. On the other hand, the epidemiology and pathogenesis of Chagas disease are both highly complex, and much is known about both. However, it is still impossible to predict what will happen in an individual person infected with T. cruzi, because of the highly variability of parasite virulence and human susceptibility to infection, with no definitive molecular predictors of outcome from either side of the host-parasite equation. In this Minireview we briefly discuss the current state of T. cruzi infection and prognosis and look forward to the day when it will be possible to employ precision health to predict disease outcome and determine whether and when treatment of infection may be necessary. Fil: Martinez, Santiago Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Histología y Embriología de Mendoza Dr. Mario H. Burgos. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Instituto de Histología y Embriología de Mendoza Dr. Mario H. Burgos; Argentina Fil: Romano, Patricia Silvia. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto de Histología y Embriología de Mendoza Dr. Mario H. Burgos. Universidad Nacional de Cuyo. Facultad de Ciencias Médicas. Instituto de Histología y Embriología de Mendoza Dr. Mario H. Burgos; Argentina Fil: Engman, David M.. Cedars Sinai Medical Center; Estados Unidos. Northwestern University; Estados Unidos. University of California at Los Angeles; Estados Unidos
Published: 2020

26. 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

27. Long-term follow-up of spontaneous coronary artery dissection treated with bioresorbable scaffolds

Author: Javier Escaned, José Moreu, Maria del Rosario Ortas-Nadal, Ángel Sánchez-Recalde, José F. Díaz-Fernández, Montse Massot, Santiago J Camacho-Freire, Robert Jackson, Fernando Macaya, Nieves Gonzalo, Pablo Salinas, and David Adlam
Subjects: medicine.medical_specialty, Tissue Scaffolds, business.industry, Long term follow up, medicine.medical_treatment, Treatment outcome, Follow up studies, Percutaneous coronary intervention, Coronary Artery Disease, Coronary Angiography, Absorbable Implants, Surgery, Percutaneous Coronary Intervention, Treatment Outcome, Text mining, Humans, Medicine, Vascular Diseases, Cardiology and Cardiovascular Medicine, business, Artery dissection, Bioresorbable scaffold, Follow-Up Studies
Published: 2019

28. 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

29. 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

30. Incidence of Leiomyosarcoma at Surgery for Presumed Uterine Myomas in Different Age Groups

Author: Santiago J. Gil, Patricio Rosas, Mariano Uzal, Victorio T. Viglierchio, and Guido M. Rey Valzacchi
Subjects: Leiomyosarcoma, Adult, medicine.medical_specialty, medicine.medical_treatment, Population, Morcellation, Tertiary referral hospital, Hysterectomy, 03 medical and health sciences, 0302 clinical medicine, Uterine Myomectomy, medicine, Humans, education, Laparoscopy, Retrospective Studies, education.field_of_study, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, Leiomyoma, business.industry, Incidence (epidemiology), Incidence, Obstetrics and Gynecology, Retrospective cohort study, Middle Aged, medicine.disease, Occult, Myoma, Surgery, 030220 oncology & carcinogenesis, Uterine Neoplasms, Female, business
Abstract: Study Objective To evaluate the incidence of leiomyosarcoma (LMS) at surgery for presumed uterine myomas according to different age groups. Design A retrospective cohort study. Setting A tertiary referral hospital. Patients All women undergoing surgery for presumed uterine myomas between January 1, 2006, and December 31, 2016. Interventions Laparoscopic myomectomy, laparotomic myomectomy, total hysterectomy, or hysteroscopic myomectomy. Measurements and Main Results A total of 1398 patients underwent surgery for presumed uterine myomas. The incidence of LMS was 2.15 per 1000 surgeries (n = 3, 1/466, 0.2%). In women under 40 years old, the incidence of occult LMS was 0 (0/561). In women between 40 and 49 years old, 190 myomectomies were performed (28% of the surgeries), and the rate of LMS was 1.49 per 1000 (n = 1, 1/673, 0.15%). In women over 49 years old, a total hysterectomy was performed in 82.3% of the cases, and the incidence of LMS was 12.2 per 1000 surgeries (n = 2, 1/82, 1.2%). Conclusion The incidence of occult LMS in patients under 40 years old undergoing surgery for presumed uterine myomas was 0. These findings are suggestive that the use of power morcellation in this population may be safe.
Published: 2019

31. Effect of nepafenac on the foveal profile of glaucomatous patients undergoing phacoemulsification

Author: Elena Milla, Santiago J. García Hernández, José Ríos, Susana Duch, Oana Stirbu, and Isabel Jimenez Franco
Subjects: Male, Fovea Centralis, medicine.medical_specialty, genetic structures, medicine.medical_treatment, Benzeneacetamides, Glaucoma, Pilot Projects, Nepafenac, Macular Edema, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Ophthalmology, Edema, medicine, Humans, Macular edema, Antihypertensive Agents, Aged, Phenylacetates, Retrospective Studies, Subclinical infection, Aged, 80 and over, Phacoemulsification, Dose-Response Relationship, Drug, business.industry, Anti-Inflammatory Agents, Non-Steroidal, Fovea centralis, Retrospective cohort study, Middle Aged, medicine.disease, eye diseases, medicine.anatomical_structure, 030221 ophthalmology & optometry, Female, sense organs, medicine.symptom, business, Tomography, Optical Coherence, 030217 neurology & neurosurgery, Follow-Up Studies, medicine.drug
Abstract: Retrospective, pilot study to determine whether nepafenac treatment pre- and postcataract surgery in glaucoma patients using topical hypotensive agents minimized cystoid macular edema by comparing pre- and postsurgical foveal characteristics, as in some cases these agents cannot be withdrawn and, hypothetically, their inflammatory effect on the fovea could be neutralized by the addition of nepafenac. Patients were divided into two subgroups depending on whether or not topical nepafenac was added to the surgical protocol (NEP = nepafenac group and nNEP = non nepafenac group). All had undergone phacoemulsification and data on pre- and postoperative macular status were recorded. In the nNEP group, there was a significant increase in foveal thickness (FT) in the first month postoperative visit with respect to the preoperative status (p = 0.006), and this situation did not change at the third postoperative month (p = 0.9411). In the NEP group, the increase in FT was not significant at the first month after surgery (p = 0.056) nor at the final visit (p = 0.268), in contrast to the nNEP group. This study of the possible prophylactic effect of nepafenac on postoperative macular edema supports the results of other studies that confirm subclinical edema post phacoemulsification, and found a significantly lower gradient in the increase in FT in patients treated pre- and postoperatively with nepafenac.
Published: 2016

32. 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

33. 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

34. Bone disease in cirrhosis

Author: Nishita Patel and Santiago J. Muñoz
Subjects: Pathology, medicine.medical_specialty, Cirrhosis, Hepatology, Bone disease, business.industry, medicine, medicine.disease, business
Published: 2015

35. 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

36. Multiple sclerosis: Left advantage for auditory laterality in dichotic tests of central auditory processing and relationship of psychoacoustic tests with the Multiple Sclerosis Disability Scale-EDSS

Author: Santiago J. Pérez Ruiz, Xóchitl Daisy Orozco Peña, and Yolanda Rebeca Peñaloza López
Subjects: 0301 basic medicine, Adult, Male, medicine.medical_specialty, Multiple Sclerosis, Audiology, Corpus callosum, Severity of Illness Index, Functional Laterality, Dichotic Listening Tests, Correlation, 03 medical and health sciences, Young Adult, 0302 clinical medicine, immune system diseases, medicine, Humans, Psychoacoustics, Depression (differential diagnoses), Aged, business.industry, Dichotic listening, Multiple sclerosis, General Medicine, Middle Aged, medicine.disease, Scale (music), nervous system diseases, 030104 developmental biology, Cross-Sectional Studies, Laterality, Auditory Perception, Female, business, 030217 neurology & neurosurgery
Abstract: To evaluate the central auditory processing disorders in patients with multiple sclerosis, emphasizing auditory laterality by applying psychoacoustic tests and to identify their relationship with the Multiple Sclerosis Disability Scale (EDSS) functions.Depression scales (HADS), EDSS, and 9 psychoacoustic tests to study CAPD were applied to 26 individuals with multiple sclerosis and 26 controls. Correlation tests were performed between the EDSS and psychoacoustic tests.Seven out of 9 psychoacoustic tests were significantly different (P.05); right or left (14/19 explorations) with respect to control. In dichotic digits there was a left-ear advantage compared to the usual predominance of RDD. There was significant correlation in five psychoacoustic tests and the specific functions of EDSS.The left-ear advantage detected and interpreted as an expression of deficient influences of the corpus callosum and attention in multiple sclerosis should be investigated. There was a correlation between psychoacoustic tests and specific EDSS functions.
Published: 2017

37. 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

38. Overlap Syndromes of Sleep and Breathing Disorders

Author: Santiago J. Carrizo and José Mª Marín
Subjects: 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, Physical medicine and rehabilitation, 030228 respiratory system, business.industry, Sleep and breathing, Medicine, 030212 general & internal medicine, business
Published: 2017

39. Nuclear cardiology practice in Asia: Analysis of radiation exposure and best practice for myocardial perfusion imaging ― results from the IAEA nuclear cardiology protocols cross-sectional study (INCAPS)

Author: Pascual, Tnb, Mercuri, M, El-Haj, N, Hee-Sung Bom, H, Lele, V, Al-Mallah, Mh, Luxenburg, O, Karthikeyan, G, Vitola, Jv, Mahmarian, Jj, Better, N, Shaw, Lj, Rehani, Mm, Kashyap, R, Paez, D, Dondi, M, Eistein, Aj, Bouyoucef, Salah E., Allam, Adel H., Vangu, Mboyo, Magboo, V. P. C., Mut, F., Alexánderson, E., Allam, A., Bom, H., Flotats, A., Jerome, S., Kaufmann, P. A., 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, Asia, Cross-sectional study, Best practice, Cardiology, Practice Patterns, 030204 cardiovascular system & hematology, Radiation Dosage, Effective dose (radiation), 030218 nuclear medicine & medical imaging, NO, 03 medical and health sciences, Myocardial perfusion imaging, 0302 clinical medicine, medicine, Humans, Medical physics, Dosing, Practice Patterns, Physicians', Quality of care, Thallium, Aged, Quality of Health Care, Radiation, Physicians', medicine.diagnostic_test, business.industry, Radiation dose, Technetium, Nuclear cardiology, General Medicine, Middle Aged, Radiation Exposure, Radiation exposure, Cross-Sectional Studies, Female, Nuclear Medicine, Cardiology and Cardiovascular Medicine, business, Myocardial Perfusion Imaging
Abstract: BACKGROUND This paper examines the current status of radiation exposure to patients in myocardial perfusion imaging (MPI) in Asia.Methods and Results:Laboratories voluntarily provided information on MPI performed over a 1-week period. Eight best practice criteria regarding MPI were predefined by an expert panel. Implementation of ≥6 best practices (quality index [QI] ≥6) was pre-specified as a desirable goal for keeping radiation exposure at a low level. Radiation effective dose (ED) in 1,469 patients and QI of 69 laboratories in Asia were compared against data from 239 laboratories in the rest of the world (RoW). Mean ED was significantly higher in Asia (11.4 vs. 9.6 mSv; P
Published: 2017

40. 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

41. 2295 Shunt Hunting: A Case of Long-Standing Encephalopathy Secondary to Anatomic Porto-Systemic Shunt

Author: Santiago J. Munoz, Dhruvan Patel, and Brian Lin
Subjects: medicine.medical_specialty, Hepatology, business.industry, Encephalopathy, Gastroenterology, Medicine, business, medicine.disease, Shunt (medical), Surgery
Published: 2019

42. 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

43. 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

44. 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

45. 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

46. 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

47. 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

48. 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

49. Non-invasive ventilation in obesity hypoventilation syndrome without severe obstructive sleep apnoea

Author: Masa, Juan F, Corral, Jaime, Caballero, Candela, Barrot, Emilia, Terán-Santos, Joaquin, Alonso-Álvarez, Maria L, Gomez-Garcia, Teresa, González, Mónica, López-Martín, Soledad, De Lucas, Pilar, Marin, José M, Marti, Sergi, Díaz-Cambriles, Trinidad, Chiner, Eusebi, Egea, Carlos, Miranda, Erika, Mokhlesi, Babak, Spanish Sleep Network, García-Ledesma, Estefanía, Sánchez-Quiroga, M-Ángeles, Ordax, Estrella, González-Mangado, Nicolás, Troncoso, Maria F, Martinez-Martinez, Maria-Ángeles, Cantalejo, Olga, Ojeda, Elena, Carrizo, Santiago J, Gallego, Begoña, Pallero, Mercedes, Ramón, M Antonia, Díaz-de-Atauri, Josefa, Muñoz-Méndez, Jesús, Senent, Cristina, Sancho-Chust, Jose N, Ribas-Solís, Francisco J, Romero, Auxiliadora, Benítez, José M, Sanchez-Gómez, Jesús, Golpe, Rafael, Santiago-Recuerda, Ana, Gomez, Silvia, and Bengoa, Mónica
Subjects: Non-Invasive Ventilation, Pulmonary and Respiratory Medicine, Spirometry, Male, medicine.medical_specialty, Partial Pressure, Polysomnography, Vital Capacity, Blood Pressure, 03 medical and health sciences, Sleep apnoea, 0302 clinical medicine, Quality of life, Forced Expiratory Volume, Obesity Hypoventilation Syndrome, medicine, Humans, 030212 general & internal medicine, Prospective cohort study, Intensive care medicine, Life Style, Aged, Obesity hypoventilation syndrome, Aged, 80 and over, Sleep Apnea, Obstructive, Noninvasive Ventilation, medicine.diagnostic_test, business.industry, Non invasive ventilation, Carbon Dioxide, Middle Aged, medicine.disease, respiratory tract diseases, Respiratory Function Tests, Clinical trial, Blood pressure, Treatment Outcome, 030228 respiratory system, Emergency medicine, Arterial blood, Female, Respiratory Insufficiency, business
Abstract: Background Non-invasive ventilation (NIV) is an effective form of treatment in patients with obesity hypoventilation syndrome (OHS) who have concomitant severe obstructive sleep apnoea (OSA). However, there is a paucity of evidence on the efficacy of NIV in patients with OHS without severe OSA. We performed a multicentre randomised clinical trial to determine the comparative efficacy of NIV versus lifestyle modification (control group) using daytime arterial carbon dioxide tension (PaCO2) as the main outcome measure. Methods Between May 2009 and December 2014 we sequentially screened patients with OHS without severe OSA. Participants were randomised to NIV versus lifestyle modification and were followed for 2 months. Arterial blood gas parameters, clinical symptoms, health-related quality of life assessments, polysomnography, spirometry, 6-min walk distance test, blood pressure measurements and healthcare resource utilisation were evaluated. Statistical analysis was performed using intention-to-treat analysis. Results A total of 365 patients were screened of whom 58 were excluded. Severe OSA was present in 221 and the remaining 86 patients without severe OSA were randomised. NIV led to a significantly larger improvement in PaCO2 of −6 (95% CI −7.7 to −4.2) mm Hg versus −2.8 (95% CI −4.3 to −1.3) mm Hg, (p
Published: 2016

50. Consensus Document on the Overlap Phenotype COPD–Asthma in COPD

Author: Cristóbal Esteban, Juan José Soler-Cataluña, Ramón Agüero, Jose M. Marin, José Miguel Rodríguez, Eduard Monsó, Josep Morera, Francisco Ortega, Jaume Sauleda, Borja G. Cosío, José Luis Viejo, Luis Puente, Germán Peces-Barba, José Luis López-Campos, José Luis Izquierdo, Marc Miravitlles, M. Cruz González, Adolfo Baloira, Juan B. Galdiz, Joan B. Soriano, Ernest Sala, Teodoro Montemayor, and Santiago J. Carrizo
Subjects: medicine.medical_specialty, COPD, medicine.drug_class, business.industry, General Medicine, medicine.disease, Electronic mail, respiratory tract diseases, Natural history, Atopy, Bronchodilator, Physical therapy, medicine, Sputum, Eosinophilia, medicine.symptom, Intensive care medicine, business, Asthma
Abstract: Introduction Although asthma and COPD are different pathologies, many patients share characteristics from both entities. These cases can have different evolutions and responses to treatment. Nevertheless, the evidence available is limited, and it is necessary to evaluate whether they represent a differential phenotype and provide recommendations about diagnosis and treatment, in addition to identifying possible gaps in our understanding of asthma and COPD. Methods A nation-wide consensus of experts in COPD in two stages: (1) during an initial meeting, the topics to be dealt with were established and a first draft of statement was elaborated with a structured “brainstorming” method; (2) consensus was reached with two rounds of e-mails, using a Likert-type scale. Results Consensus was reached about the existence of a differential clinical phenotype known as “Overlap Phenotype COPD–Asthma”, whose diagnosis is made when 2 major criteria and 2 minor criteria are met. The major criteria include very positive bronchodilator test (increase in FEV 1 ≥15% and ≥400 ml), eosinophilia in sputum and personal history of asthma. Minor criteria include high total IgE, personal history of atopy and positive bronchodilator test (increase in FEV 1 ≥12% and ≥200 ml) on two or more occasions. The early use of individually adjusted inhaled corticosteroids is recommended, and caution must be taken with their abrupt withdrawal. Meanwhile, in severe cases the use of triple therapy should be evaluated. Finally, there is an obvious lack of specific studies about the natural history and the treatment of these patients. Conclusions It is necessary to expand our knowledge about this phenotype in order to establish adequate guidelines and recommendations for its diagnosis and treatment.
Published: 2012

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