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New environmental factors related to diabetes risk in humans:Emerging bisphenols used in synthesis of plastics

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World Journal of Diabetes 2023年第8期14卷 1301-1313页

作者： Rafael Moreno-Gómez-Toledano María Delgado-Marín Alberto Cook-Calvete Claudia González-Cucharero Nunzio Alcharani Beatriz Jiménez-Guirado Ignacio Hernandez Rafael Ramirez-Carracedo Laura Tesoro Laura Botana Sandra Sánchez-Esteban javier Diez-Mata Jose Luis Zamorano Ricardo J.Bosch Carlos Zaragoza Marta Saura Universidad de Alcalá Department of Biological Systems/PhysiologyAlcaláde Henares 28871Spain Cardiology Department University Hospital Ramón y CajalMadrid 28034Spain Laboratory of Cardiovascular Pathophysiology Joint Translational Research UnitUniversity Francisco de Vitoria School of MedicineMadrid 28034Spain Instituto Ramón y Cajal de Investigación Sanitaria-IRYCIS Madrid 28034Spain

BACKGROUND Diabetes mellitus(DM)is one of the largest global health emergencies of the 21st *** recent years,its connection with environmental pollutants,such as bisphenol A(BPA),has been demonstrated;consequently,new structurally similar molecules are used to replace BPA in the plastics industry(BPS,BPF and BPAF).AIM To carry out a systematic review to allow coherent evaluation of the state of the ***,a meta-analysis was performed to unify the existing quantitative *** Firstly,a systematic review was carried out,using the terms“(bisphenol)AND(Diabetes OR Hyperglycemia)”,to maximize the number of ***,three authors analyzed the set of ***,a meta-analysis was performed for each BP,using RevMan *** addition,funnel plots were developed to study publication *** The systematic analysis of the literature revealed 13 recent articles(2017–2023)related to the study *** qualitative analysis showed interesting data linking diabetes to the three most widely used substitute BPs in the industry:BPS,BPF and ***,the meta-analysis determined a positive relationship with BPS,BPF and BPAF,which was only statistically significant with *** There is a need to apply the precautionary principle,regulating the use of new ***,replacing BPA with BPS,BPF or BPAF is unlikely to protect the population from potential health risks,such as DM.

关键词： Bisphenol S Bisphenol F Bisphenol AF Diabetes mellitus Systematic review Meta-analysis

原发性免疫缺陷病患者肿瘤发生情况:美国免疫缺陷网络注册患者肿瘤发病率分析

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中华临床免疫和变态反应杂志 2018年第2期12卷 236-246页

作者： Paul C.Mayor Kevin H.Eng Kelly L.Singel Scott I.Abrams Kunle Odunsi Kirsten B.Moysich Ramsay Fuleihan Elizabeth Garabedian Patricia Lugar Hans D.Ochs francisco A.bonilla Rebecca H.Buckley Kathleen E.Sullivan Zuhair K.Ballas Charlotte Cunningham-Rundles Brahm H.Segal 白炜曾小峰中国医学科学院北京协和医学院北京协和医院风湿免疫科

研究背景评估了在美国免疫缺陷网络(USIDNET)注册的原发性免疫缺陷病(PIDDs)患者的总体和器官特异性肿瘤发病率,并与监测、流行病学和最终结果项目(SEER)数据库中经年龄校正的人群的肿瘤发病率进行比较。目的假设PIDD患者由于免疫功能受... 详细信息

研究背景评估了在美国免疫缺陷网络(USIDNET)注册的原发性免疫缺陷病(PIDDs)患者的总体和器官特异性肿瘤发病率,并与监测、流行病学和最终结果项目(SEER)数据库中经年龄校正的人群的肿瘤发病率进行比较。目的假设PIDD患者由于免疫功能受损,肿瘤发病率会增加。方法将2003年至2015年在USIDNET注册中心注册的PIDD (n=3658)患者的总体和器官特异性肿瘤发病率进行评估,并与SEER数据库中经年龄校正的人群发病率进行比较。结果与年龄相匹配的SEER人群相比,观察到PIDD患者罹患肿瘤的相对危险率为1. 42倍(P<0. 001)。PIDD的男性患癌症的风险是年龄校正的男性人群的1. 91倍(P<0. 001),而PIDD女性患者的总体肿瘤发病率与经年龄校正的女性人群相比并无差异。对SEER数据库中最常见的4个恶性肿瘤——肺癌、结肠癌、乳腺癌和前列腺癌的发病率进行分析,PIDD患者中这些肿瘤的发病没有显著增加。男性和女性PIDD患者的淋巴瘤发病率均显著增加(男性10倍,P<0. 001;女性8. 34倍,P<0. 001)。结论 PIDD患者的肿瘤发病率较高。在特定的PIDD人群中淋巴瘤发病率的增高是导致总体肿瘤发病率提高的主要原因,而常见的实体肿瘤的风险没有增加。这些数据表明免疫系统在预防特定肿瘤方面有一定的作用。

关键词：原发性免疫缺陷病普通变异性免疫缺陷病肿瘤白血病淋巴瘤美国免疫缺陷网络

IPNA临床实践建议:儿童激素敏感型肾病综合征的诊断和治疗

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中国合理用药探索 2023年第2期20卷 1-35页

作者： Agnes Trautmann Olivia Boyer Elisabeth Hodson Arvind Bagga Debbie S.Gipson Susan Samuel Jack Wetzels Khalid Alhas an Sushmita Banerjee Rajendra Bhimma Melvin bonilla-Felix francisco Cano Martin Christian Deirdre Hahn Hee Gyung Kang Koichi Nakanishi Hesham Safouh Howard Trachtman Hong Xu Wendy Cook Marina Vivarelli Dieter Hafner on behalf of the International Pediatric Nephrology Association 韩思雨(翻译) 季丽娜(翻译) 不详清华大学附属北京清华长庚医院儿科北京102218

特发性肾病综合征是最常见的儿童肾小球疾病,其特征是大量蛋白尿、低蛋白血症和(或)伴有水肿,全球每年儿童患病率为(1.15~16.90)每10万例。约有85%~90%的患者在接受糖皮质激素治疗的4~6周内可达到蛋白尿完全缓解,表现为激素敏感型肾病... 详细信息

特发性肾病综合征是最常见的儿童肾小球疾病,其特征是大量蛋白尿、低蛋白血症和(或)伴有水肿,全球每年儿童患病率为(1.15~16.90)每10万例。约有85%~90%的患者在接受糖皮质激素治疗的4~6周内可达到蛋白尿完全缓解,表现为激素敏感型肾病综合征(SSNS)。约70%~80%的SSNS患者在随访期间至少复发1次,其中多达50%的患者出现频繁复发或依赖糖皮质激素以维持蛋白尿缓解。为延长复发间隔时间,激素治疗的用药剂量和用药时长始终是热点问题之一,且患者出现激素相关并发症的概率较高。临床已应用多种激素助减药物(免疫抑制药物),但在疾病治疗过程中这些药物的选择和用药时机存在明显差异。因此,需要国际循证临床实践建议(CPRs)来指导临床实践、减少实践差异。国际儿科肾脏病学会(IPNA)召集专家小组通过对12个临床相关PICO(研究对象、干预措施、对照、结果/结局)问题进行系统的文献回顾,制定了关于儿童SSNS诊断和治疗的建议和分级。对治疗转归提出了新的定义,有助于指导治疗改变,并为重要的研究问题提供了参考。

关键词：激素敏感型肾病综合征儿童频复发型肾病综合征激素依赖型肾病综合征激素毒性儿科免疫抑制治疗

Improving Compost Process Efficiency by Leachates Inoculation and Shredding of the Organic Fraction of Municipal Solid Waste at Bordo Poniente Composting Plant,Mexico City

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Journal of Environmental Science and Engineering(A) 2021年第5期10卷 177-183页

作者： francisco javier Barrón-Santos Ma.Eugenia Gutiérrez-Castillo Luis Raúl Tovar-Gálvez Ma.Teresa Núñez-Cardona Ricardo Estrada-Núñez Claudia Rodríguez Tapia Alfonso Espitia-Cabrera Departamento de Posgrado Salud OcupacionalSeguridad e HigieneEscuela Nacional de Medicina y HomeopatíaInstituto Politécnico NacionalCiudad de México 07320México Departamento de Biociencias e Ingeniería Centro Interdisciplinario de Investigaciones y Estudios sobre Medio Ambiente y DesarrolloInstituto Politécnico NacionalCiudad de México 07340México Departamento El Hombre y su Ambiente Universidad Autónoma Metropolitana XochimilcoCiudad de México 04960México Secretaría de Obras y Servicios Gobierno de la Ciudad de MéxicoCiudad de México 06000México Unidad Profesional Interdisciplinaria de Biotecnología Instituto Politécnico NacionalCiudad de México 07340México Departamento de Energía Universidad Autónoma Metropolitana AzcapotzalcoCiudad de México 02200México

Management of MSW(Municipal Solid Waste)is a major downside in most of the biggest *** composting of the organic fraction of MSW is one of the oldest and simplest ways of organic waste *** is a self-heating biological conversion that generates appropriate finished merchandise such as soil conditioner or *** City generates about 12,500 ton/day of MSW,44%of it is food scraps and yard trimmings which are the OFMSW(Organic Fraction of Municipal Solid Waste),2,500 ton/day of it is composted at the BPCP(Bordo Poniente Composting Plant)yielding 500 ton/day of *** purpose of this study was to evaluate three treatments to accelerate the composting process,so eventually the city could increase the amount of the OFMSW at *** compared three different treatments;one of them showed a significant reduction in time of the composting process(p≤0.05)i.e.,it took less time to reach the thermophilic stage,maturity and stabilization *** was achieved at 35 days and 60 days to *** conclude that shredding the feedstock plus leachate inoculum addition at the beginning of the process,reduces the composting time in about 61%with respect to the time it takes at the BPCP,where lasted 90 days.

关键词： Composting organic fraction municipal solid waste inoculum leachates size particle

Renal function assessment in atrial fibrillation:Usefulness of chronic kidney disease epidemiology collaboration vs reexpressed 4 variable modification of diet in renal disease

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World Journal of Cardiology 2015年第10期7卷 685-694页

作者： Rami Riziq-Yousef Abumuaileq Emad Abu-Assi Andrea López-López Sergio Raposeiras-Roubin Moisés Rodríguez-Manero Luis Martínez-Sande francisco javier García-Seara Xesus Alberte Fernandez-López Jose Ramón González-Juanatey Cardiology Department University Clinical Hospital of Santiago de Compostela

AIM: To compare the performance of the re-expressed Modification of Diet in Renal Disease equation vs the new Chronic Kidney Disease Epidemiology Collaboration equation in patients with non-valvular atrial ***: We studied 911 consecutive patients with non-valvular atrial fibrillation on vitamin-K antagonist. The performance of the re-expressed Modification of Diet in Renal Disease equation vs the new Chronic Kidney Disease Epidemiology Collaboration equation in patients with non-valvular atrial fibrillation with respect to either a composite endpoint of major bleeding, thromboembolic events and all-cause mortality or each individual component of the composite endpoint was assessed using continuous and categorical ≥ 60, 59-30, and < 30 m L/min per 1.73 m2 estimated glomerular filtration ***: During 10 ± 3 mo, the composite endpoint occurred in 98(10.8%) patients: 30 patients developed major bleeding, 18 had thromboembolic events, and 60 died. The new equation provided lower prevalence of renal dysfunction < 60 m L/min per 1.73 m2(32.9%),compared with the re-expressed equation(34.1%). Estimated glomerular filtration rate from both equations was independent predictor of composite endpoint(HR = 0.98 and 0.97 for the re-expressed and the new equation, respectively; P < 0.0001) and all-cause mortality(HR = 0.98 for both equations, P < 0.01). Strong association with thromboembolic events was observed only when estimated glomerular filtration rate was < 30 m L/min per 1.73 m2: HR is 5.1 for the re-expressed equation, and HR = 5.0 for the new equation. No significant association with major bleeding was observed for both ***: The new equation reduced the prevalence of renal dysfunction. Both equations performed similarly in predicting major adverse outcomes.

关键词： Atrial fibrillation Anticoagulants Follow-up studies Kidney Prognosis

Turbo-taxonomy to assemble a megadiverse lichen genus:seventy new species of Cora(Basidiomycota:Agaricales:Hygrophoraceae),honouring David Leslie Hawksworth’s seventieth birthday

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Fungal Diversity 2017年第3期84卷 139-207页

作者： Robert Lücking Manuela Dal Forno Bibiana Moncada Luis Fernando Coca Leidy Yasmín Vargas-Mendoza André Aptroot Laura Juliana Arias Betty Besal Frank Bungartz Diego Mauricio Cabrera-Amaya Marcela E.S.Cáceres José Luis Chaves Sionara Eliasaro Martha Cecilia Gutiérrez Jesús E.Hernández Marin María de los Ángeles Herrera-Campos María E.Holgado-Rojas Harald Jonitz Martin Kukwa Fabiane Lucheta Santiago Madriñán Marcelo Pinto Marcelli Suzana Maria de Azevedo Martins Joel A.Mercado-Díaz Jorge Alberto Molina Eduardo A.Morales Peter R.Nelson Freddy Nugra francisco Ortega Telma Paredes Ayda Lucía Patiño Rouchi Nadine Peláez-Pulido Rosa Emilia Pérez Pérez Gary B.Perlmutter Eimy Rivas-Plata javier Robayo Camilo Rodríguez Diego Fernando Simijaca Edier Soto-Medina Adriano Afonso Spielmann Alejandra Suárez-Corredor Jean-Marc Torres Carlos Alberto Vargas Alba Yánez-Ayabaca Gothamie Weerakoon Karina Wilk Marcela Celis Pacheco Mauricio Diazgranados Grischa Brokamp Thomas Borsch Patrick M.Gillevet Masoumeh Sikaroodi James D.Lawrey Botanical Garden and Botanical Museum Berlin KöniginLuise-Straße 6-814195 BerlinGermany Science Education The Field Museum1400 South Lake ShoreChicagoIL 60605USA Department of Botany Smithsonian InstitutionNational Museum of Natural History10th St Constitution Ave NWWashingtonDC 20560USA Department of Environmental Science and Policy George Mason UniversityFairfaxVA 22030-4444USA Licenciatura en Biologı´a Universidad Distrital Francisco Jose´de CaldasCra.4 No.26D-54Torre de LaboratoriosHerbarioBogota´D.C.Colombia Herbario Universidad de Caldas(FAUC) Edificio BicentenarioCalle 65No.26-10ManizalesA.A.275CaldasColombia ABL Herbarium G.v.d.Veenstraat 1073762 XK SoestThe Netherlands Biologı´a Universidad del Quindı´oCarrera 15 Calle 12 NorteArmeniaQuindı´oColombia 120 Chavis Avenue LexingtonVA 24450USA Charles Darwin Foundation Puerto AyoraSanta Cruz IslandGala´pagosEcuador Schedestraße 8 53113 BonnGermany Jardı´n Bota´nico de Bogota´Jose´Celestino Mutis Avenida Calle 63 No.68-95Bogota´D.C.Colombia Departamento de Biocieˆncias Universidade Federal de SergipeAvenida Vereador Olı´mpio Grandes/n.ItabaianaCEP:49.500-000 SergipeBrazil Laboratorio de Hongos Instituto Nacional de Biodiversidad(INBio)Apdo.22-3100Santo Domingo de HerediaCosta Rica Departamento de Botaˆnica Universidade Federal do Parana´Campus Polite´cnicoSetor de Cieˆncias Biolo´gicasAv.Cel.Francisco H.dos Santoss/nJardim das Ame´ricas81531-980 CuritibaPRBrazil Ingenierı´a Ambiental Universidad Distrital Francisco Jose´de CaldasCarrera 5 Este No.15-82Av.CircumvalarBogota´D.C.Colombia Instituto Experimental Jardı´n Bota´nico Dr.Tobı´as Lasser Centro de Investigacio´n y DesarrolloUniversidad Central de VenezuelaAve.Salvador AllendeJardı´n Bota´nico de CaracasApartado#2156Caracas 1010-AVenezuela Departamento de Bota´nica Instituto de Biologı´aUniversidad Nacional Auto´noma de Me´xicoApartado Postal 70-36704510 Ciudad De Me´xicoMexico Facultad de Ciencias Escuela Profesional de Biologı´aUniv

Following a large-scale phylogenetic study of the lichenized genus Cora(Basidiomycota:Agaricales:Hygrophoraceae),we formally describe 70 new species,honouring the seventieth birthday of David Leslie Hawksworth,one of the preeminent figures in mycology and lichenology in the past 50 *** on an updated phylogeny using the ITS fungal barcoding locus,we now recognize 189 taxa in a genus that until recently was considered to represent a single species;including this contribution,92 of these are formally recognized,including five taxa based on historical names or collections that have not been *** of Cora can be recognized by a combination of morphological(size,colour,lobe configuration,surface hairs,hymenophore size and shape),anatomical(thallus thickness,cortex structure,photobiont type,hyphal papillae),and ecogeographical features(substrate,habitat,distribution),and a keytable allowing the identification of all accepted taxa is *** new species are:Cora accipiter Moncada,Madrin˜a´n&Lücking ***.,*** Moncada,Soto-Medina&Lücking ***.,*** Moncada,Dal Forno&Lücking ***.,*** Dal Forno,Chaves&Lücking ***.,*** Moncada,***ı´guez&Lücking ***.,*** Lücking,Moncada&*** ***.,*** Moncada,Ya´nez-Ayabaca&Lücking ***.,*** Moncada,Patin˜o&Lücking ***.,*** Lücking,***&Dal Forno ***.,*** Holgado,Rivas Plata&Perlmutter ***.,*** Dal Forno,Eliasaro&Spielmann ***.,*** Nugra,Dal Forno&Lücking ***.,*** Lücking,Martins&Lucheta ***.,*** Moncada,R.-***´rez&Lücking ***.,*** Moncada,***.&Lücking ***.,*** Moncada,CabreraAmaya&Lücking ***.,*** Moncada,R.-***´rez&***.,*** Lücking,***&Dal Forno ***.,*** Moncada,***´rez-Corredor&Lücking ***.,*** Moncada,***&Lücking ***.,***

关键词： Bolivia Citizen science Chile Mexico Puerto Rico Sri Lanka

Dendritic cell deficiencies persist seven months after SARS-CoV-2 infection

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Cellular & Molecular Immunology 2021年第9期18卷 2128-2139页

作者： Alberto Pérez-Gómez Joana Vitallé Carmen Gasca-Capote Alicia Gutierrez-Valencia María Trujillo-Rodriguez Ana Serna-Gallego Esperanza Muñoz-Muela María de los Reyes Jiménez-Leon Mohamed Rafii-El-Idrissi Benhnia Inmaculada Rivas-Jeremias Cesar Sotomayor Cristina Roca-Oporto Nuria Espinosa Carmen Infante-Domínguez Juan Carlos Crespo-Rivas Alberto Fernández-Villar Alexandre Pérez-González Luis Fernando López-Cortés Eva Poveda Ezequiel Ruiz-Mateos JoséMiguel Cisneros Sonsoles Salto-Alejandre Judith Berastegui-Cabrera Pedro Camacho-Martínez Carmen Infante-Domínguez Marta Carretero-Ledesma Juan Carlos Crespo-Rivas Eduardo Márquez JoséManuel Lomas Claudio Bueno Rosario Amaya JoséAntonio Lepe Jerónimo Pachón Elisa Cordero javier Sánchez-Céspedes Manuela Aguilar-Guisado Almudena Aguilera Clara Aguilera Teresa Aldabo-Pallas Verónica Alfaro-Lara Cristina Amodeo javier Ampuero María Dolores Avilés Maribel Asensio Bosco Barón-Franco Lydia Barrera-Pulido Rafael Bellido-Alba Máximo Bernabeu-Wittel Candela Caballero-Eraso Macarena Cabrera Enrique Calderón Jesús Carbajal-Guerrero Manuela Cid-Cumplido Yael Corcia-Palomo Juan Delgado Antonio Domínguez-Petit Alejandro Deniz Reginal Dusseck-Brutus Ana Escoresca-Ortega Fátima Espinosa Nuria Espinosa Michelle Espinoza Carmen Ferrándiz-Millón Marta Ferrer Teresa Ferrer Ignacio Gallego-Texeira Rosa Gámez-Mancera Emilio García Horacio García-Delgado Manuel García-Gutiérrez María Luisa Gascón-Castillo Aurora González-Estrada Demetrio González Carmen Gómez-González Rocío González-León Carmen Grande-Cabrerizo Sonia Gutiérrez Carlos Hernández-Quiles Inmaculada Concepción Herrera-Melero Marta Herrero-Romero Luis Jara Carlos Jiménez-Juan Silvia Jiménez-Jorge Mercedes Jiménez-Sánchez Julia Lanseros-Tenllado Carmina López Isabel López Álvaro López-Barrios Luis F.López-Cortés Rafael Luque-Márquez Daniel Macías-García Guillermo Martín-Gutiérrez Luis Martín-Villén JoséMolina Aurora Morillo María Dolores Navarro-Amuedo Dolores Nieto-Martín francisco Ortega María Paniagua-García Amelia Peña-Rodríguez E Clinical Unit of Infectious Diseases Microbiology and Preventive MedicineInstitute of Biomedicine of Seville(IBiS)Virgen del Rocío University HospitalCSICUniversity of SevilleSevilleSpain Department of Medical Biochemistry Molecular Biologyand ImmunologySchool of MedicineUniversity of SevilleSevilleSpain Pneumology Service Galicia Sur Health Research Instituto(IIS Galicia Sur)SERGAS-UVigoVigoSpain Infectious Diseases Unit Department of Internal MedicineComplexo HospitalarioUniversitario de VigoIIS Galicia SurSERGAS-UVigoVigoSpain Group of Virology and Pathogenesis Galicia Sur Health Research Institute(IIS Galicia Sur)-Complexo Hospitalario Universitario de VigoSERGAS-UVigoVigoSpain Unit of Infectious Diseases Microbiologyand Preventive MedicineVirgen del Rocío University HospitalSevilleSpain Institute of Biomedicine of Seville(IBiS) Virgen del Rocío University Hospital/CSIC/University of SevilleSevilleSpain Medico-Surgical Unit of Respiratory Diseases Virgen del Rocío University HospitalSevilleSpain Unit of Emergencies Virgen del Rocío University HospitalSevilleSpain Intensive Care Unit Virgen del Rocío University HospitalSevilleSpain Department of Medicine University of SevilleSevilleSpain Cardiology and Cardiovascular Surgery Unit Virgen del Rocío University HospitalSevilleSpain Rheumatology Unit Virgen del Rocío University HospitalSevilleSpain Internal Medicine Unit Virgen del Rocío University HospitalSevilleSpain Digestive and Hepatobiliary Unit Virgen del Rocío University HospitalSevilleSpain Neurology and Clinical Neurophysiology Unit Virgen del Rocío University HospitalSevilleSpain Endocrinology and Nutrition Unit Virgen del Rocío University HospitalSevilleSpain Urology and Nephrology Unit Virgen del Rocío University HospitalSevilleSpain Unit of Clinical Investigation and Clinical Trials Virgen del Rocío University HospitalSevilleSpain

Severe Acute Respiratory Syndrome Coronavirus(SARS-CoV)-2 infection induces an exacerbated inflammation driven by innate immunity *** cells(DCs)play a key role in the defense against viral infections,for instance plasmacytoid DCs(pDCs),have the capacity to produce vast amounts of interferon-alpha(IFN-α).In COVID-19 there is a deficit in DC numbers and IFN-αproduction,which has been associated with disease *** this work,we described that in addition to the DC deficiency,several DC activation and homing markers were altered in acute COVID-19 patients,which were associated with multiple inflammatory ***,previously hospitalized and nonhospitalized patients remained with decreased numbers of CD1c+myeloid DCs and pDCs seven months after SARS-CoV-2 ***,the expression of DC markers such as CD86 and CD4 were only restored in previously nonhospitalized patients,while no restoration of integrinβ7 and indoleamine 2,3-dyoxigenase(IDO)levels were *** findings contribute to a better understanding of the immunological sequelae of COVID-19.

关键词： SARS-CoV-2 COVID-19 Dendritic cell Long-COVID

Twelve-month efficacy and safety of the conversion to everolimus in maintenance heart transplant recipients

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World Journal of Transplantation 2015年第4期5卷 310-319页

作者： Nicolás Manito Juan F Delgado María G Crespo-Leiro José María Arizón javier Segovia francisco González-Vílchez Sònia Mirabet Ernesto Lage Domingo Pascual-Figal Beatriz Díaz Jesús Palomo Gregorio Rábago Marisa Sanz Teresa Blasco Eulàlia Roig Heart Failure and Transplant Unit Department of CardiologyHospital de Bellvitge Heart Failure and Transplant Unit Department of CardiologyHospital 12 de Octubre Department of Cardiology Complejo Hospitalario Universitario A Coru?a Department of Cardiology Hospital Universitario Reina Sofía Heart Failure Transplant and Pulmonary Hypertension UnitHospital Universitario Puerta de Hierro Department of Cardiology Hospital Universitario Marqués de Valdecilla Department of Cardiology Hospital de la Santa Creu i Sant Pau Department of Cardiology Hospital Universitario Virgen del Rocío Department of Cardiology Hospital Virgen de la Arrixaca Department of Cardiology Hospital Universitario Central de Asturias Department of Cardiology Hospital General Universitario Gregorio Mara?ón Department of Cardiovascular Surgery Clínica Universitaria de Navarra Department of Cardiology Hospital Miguel Servet Department of Cardiology Hospital Clínic i Provincial

AIM: To determine the clinical reasons for conversion to everolimus(EVL) and long-term outcomes in heart transplant(HT) ***: A retrospective 12-mo study has been carried out in 14 Spanish centres to assess the efficacy and safety of conversion to EVL in maintenance HT ***: Two hundred and twenty-two patients were included(mean age: 53 ± 10.5 years; mean time from HT: 8.1 ± 4.5 years). The most common reasons for conversion were nephrotoxicity(30%), chronic allograft vasculopathy(20%) and neoplasms(17%). The doses and mean levels of EVL at baseline(conversion to EVL) and after one year were 1.3 ± 0.3 and 1.2 ± 0.6 mg/d and 6.4 ± 3.4 and 5.6 ± 2.5 ng/mL, respectively. The percentage of patients receiving calcineurin inhibitors(CNIs) at baseline and on the final visit was 95% and 65%, respectively. The doses and mean levels of CNIs decreased between baseline and month 12 from 142.2 ± 51.6 to 98.0 ± 39.4 mg/d(P < 0.001) and from 126.1 ± 50.9 to 89.2 ± 47.7 ng/mL(P < 0.001), respectively, for cyclosporine, and from 2.9 ± 1.8 to 2.6 ± 1.9 mg/d and from 8.3 ± 4.0 to 6.5 ± 2.7 ng/mL(P = 0.011) for tacrolimus. In the subgroup of patients converted because of nephrotoxicity, creatinine clearance increased from 34.9 ± 10.1 to 40.4 ± 14.4 mL/min(P < 0.001). There were 37 episodes of acute rejection in 24 patients(11%). The most frequent adverse events were oedemas(12%), infections(9%) and gastrointestinal problems(6%). EVL was suspended in 44 patients(20%). Since the database was closed at the end of the study, no further followup data is ***: Conversion to EVL in maintenance HT recipients allowed minimisation or suspension of the CNIs, with improved kidney function in the patients with nephrotoxicity, after 12 mo.

关键词： Everolimus Mammalian target of rapamycin inhibitors Heart transplantation Nephrotoxicity Renal failure

Post-Hospital Syndrome and Hyponatremia

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Health 2021年第8期13卷 846-856页

作者： José Bellod-Tonda Julio Blázquez-Encinar María Dolores Jover-Ríos Carmen Seguí-Pérez Juan Méndez-Mora francisco Caparrós-Hernández Álex Méndez-Jover Marc Seguí-Pérez David Baláž Leticia Espinosa del Barrio Jesús Corbacho-Redondo Carles García-Cervera Juan Manuel Núñez-Cruz Isidro Hernández-Isasi javier Guzmán-Martínez Angie Gómez-Uranga Pedro Esteve-Atiénzar Jorge Peris-García Veronica Martínez-Sempere Eliana Damonte-White Óscar Hernando Ruiz-Ariza Juan Carlos López-Corbalán Lourdes Lajara-Villar Andrea Riaño-Pérez Paloma Chazarra-Pérez María Escamilla-Espínola Maria Luisa Asensio-Tomás Miguel Ángel Auladell-Alemany Laura Serna-Torres Asunción Pérez-Fullana Amparo Gómez-Siurana Sergio Menargues-Irles José Miguel Seguí-Ripoll Internal Medicine Department University Hospital of San Juan Alicante Spain Internal Medicine Department Torrevieja University Hospital Alicante Spain Internal Medicine Department Hospital La Vega Baja of Orihuela Alicante Spain CEU Cardinal Herrera University Veterinary Hospital Valencia Spain Secondary School Marist Brothers High School Alicante Spain Department of Clinical Medicine Miguel Hernández University Elche Spain Primary Care Medicine Benilloba Spain Sub-Delegation of the Government Alicante Spain Chemical Engineering Department University of Alicante Alicante Spain

Introduction: Post-hospital syndrome (PHS) is defined as a period of vulnerability during the first 30 days after a patient is discharged from hospital, in which multiple factors come into play. Hyponatremia is the most frequent hydroelectrolytic disorder in hospitalized patients and may be related to the appearance of PHS. Objective: The objective is to estimate the prevalence of PHS that is assessed as the rate of readmissions in the first 30 days after discharge, in patients with hyponatremia. Material and Methods: It is a descriptive observational study of patients with hyponatremia who were discharged from 1 September 2010 to 2 February 2020 at the Internal Medicine Service of the Hospital University of San Juan (Alicante, Spain). Results: Of the 25 included patients, 5 (20%) were readmitted within a month of discharge, after a mean of 11.4 days (standard deviation [SD] 5.1). The overall mortality of the study was 20% (n = 5), with one case of death in the first 30 days post-hospitalization (4%). In 12 patients (48%) the origin of the hyponatremia was undetermined. The most frequently recorded etiology for the condition was pharmacological (n = 7, 28%), and there was pronounced variability in its clinical and laboratory study. The most widely used corrective measure was drug withdrawal, in 16 patients (64%). Water intake restriction was the most common treatment after discharge (5 patients, 20%), followed by urea (2 patients, 8%), while tolvaptan was not used. Conclusion: Hyponatremia may be the cause of PHS, which could increase the rate of early readmission. Hyponatremia is an underdiagnosed and undertreated entity, so it is necessary to apply an appropriate system to optimize its management and, in future studies, to assess its impact on PHS.

关键词： Hospitalization Hyponatremia Patient Readmission Inappropriate ADH Syndrome