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  • 1
    Online Resource
    Online Resource
    Transformed Alpha-Fetoprotein (t-AFP) Levels in Women with Threatened Preterm Labor
    S. Karger AG ; 2009
    In:  Gynecologic and Obstetric Investigation Vol. 68, No. 3 ( 2009), p. 199-204
    Details
    In: Gynecologic and Obstetric Investigation, S. Karger AG, Vol. 68, No. 3 ( 2009), p. 199-204
    Abstract: 〈 i 〉 Background/Aims: 〈 /i 〉 To evaluate maternal serum transformed α-fetoprotein (MSt-AFP) levels, a new molecular conformation of AFP was used in cases of threatened preterm labor (TPL). 〈 i 〉 Methods: 〈 /i 〉 Prospective case-control study. Maternal serum levels of classical AFP and transformed AFP (t-AFP) were compared between 2 groups matched by gestational age: 25 women with TPL and 25 healthy pregnant women as controls. 〈 i 〉 Results: 〈 /i 〉 There was no significant difference in classical maternal serum AFP (MSAFP) levels between the 2 groups. In contrast, MSt-AFP levels were significantly lower in cases of TPL than in the control group [7.64 (1.78–29.06) vs. 33.38 (13.80–190.50) ng/ml; p = 0.006]. Similarly, the t-AFP:AFP ratio was also decreased in the TPL group [0.04 (0.004–0.12) vs. 0.16 (0.05–0.80); p = 0.008] . There was no significant correlation between MSAFP and MSt-AFP levels. 〈 i 〉 Conclusions: 〈 /i 〉 MSt-AFP levels are decreased in women with TPL.
    Type of Medium: Online Resource
    ISSN: 0378-7346 , 1423-002X
    URL: Article
    DOI: 10.1159/000233239
    RVK:
    XA 45603
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2009
    detail.hit.zdb_id: 1482695-1
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  • 2
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    Online Resource
    Long-Term Omalizumab in Elderly Patients with Chronic Urticaria: Is It a Safe Therapy?
    S. Karger AG ; 2023
    In:  International Archives of Allergy and Immunology Vol. 184, No. 10 ( 2023), p. 1003-1009
    Details
    In: International Archives of Allergy and Immunology, S. Karger AG, Vol. 184, No. 10 ( 2023), p. 1003-1009
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Biologics have revolutionized the treatment of many diseases. In this regard, omalizumab (OMA), an anti-IgE monoclonal antibody, is the recommended therapeutic option for patients with chronic spontaneous urticaria (CSU) refractory to second-generation H1-antihistamines. Several studies confirm the efficacy and safety of the drug. However, the literature focusing on the elderly population is scarce, as this age group is often excluded from clinical trials. Therefore, the pharmacological treatment of CSU in elderly patients is a challenge that is increased by their comorbidities and consequent polypharmacy. 〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 We describe the real-life safety profile of OMA in elderly patients (≥70 years) with CSU and chronic inducible urticaria (CIndU). We aimed to provide data for daily clinical practice in this vulnerable patient group. 〈 b 〉 〈 i 〉 Method: 〈 /i 〉 〈 /b 〉 A retrospective review was performed of the records of patients with CSU/CIndU from May 2003 to December 2019 in the Hospital Universitario La Paz. We describe qualitative and quantitative data according to measures of central tendency. Comparisons between qualitative and quantitative data were performed with the Mann-Whitney U test and the Fisher’s test for qualitative variables. A 〈 i 〉 p 〈 /i 〉 value & lt;0.05 was considered statistically significant. 〈 b 〉 〈 i 〉 Results and Conclusions: 〈 /i 〉 〈 /b 〉 Eighty-nine patients were included, divided into two groups ( & lt;70 vs. ≥70 years). The overall rate of adverse events (AEs) was 48%, mainly mild. No association between age and AE was found ( 〈 i 〉 p 〈 /i 〉 = 0.789). No serious AE such as anaphylaxis was detected. CSU predominated in both groups. CIndU was less prevalent in the elderly ( 〈 i 〉 p 〈 /i 〉 = 0.017). There was no association between age and the other variables. Although the frequency of neoplasms was slightly higher in the elderly with OMA, we found no difference compared to the incidence of neoplasms in the general population. Therefore, our data suggest that OMA may be a safe treatment in elderly people with CSU/CIndU for prolonged periods of treatment, although further studies with larger samples are needed to corroborate our observations.
    Type of Medium: Online Resource
    ISSN: 1018-2438 , 1423-0097
    URL: Article
    DOI: 10.1159/000530494
    RVK:
    XA 49650
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2023
    detail.hit.zdb_id: 1482722-0
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  • 3
    Online Resource
    Online Resource
    Complications Associated with Mohs Micrographic Surgery: Data from the Nationwide Prospective Cohort REGESMOHS
    S. Karger AG ; 2022
    In:  Dermatology Vol. 238, No. 2 ( 2022), p. 320-328
    Details
    In: Dermatology, S. Karger AG, Vol. 238, No. 2 ( 2022), p. 320-328
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Large prospective studies on the safety of Mohs micrographic (MMS) surgery are scarce, and most focus on a single type of surgical adverse event. Mid-term scar alterations and functional loss have not been described. 〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 To describe the risk of MMS complications and the risk factors for them. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 A nationwide prospective cohort collected all adverse events on consecutive patients in 22 specialised centres. We used multilevel mixed-effects logistic regression to find out factors associated with adverse events. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 5,017 patients were included, with 14,421 patient-years of follow-up. 7.0% had some perioperative morbidity and 6.5% had mid-term and scar-related complications. The overall risk of complications was mainly associated with use of antiaggregant/anticoagulant and larger tumours, affecting deeper structures, not reaching a tumour-free border, and requiring complex repair. Age and outpatient setting were not linked to the incidence of adverse events. Risk factors for haemorrhage (0.9%) were therapy with antiaggregant/anticoagulants, tumour size, duration of surgery, and unfinished surgery. Wound necrosis (1.9%) and dehiscence (1.0%) were associated with larger defects and complex closures. Immunosuppression was only associated with an increased risk of necrosis. Surgeries reaching deeper structures, larger tumours and previous surgical treatments were associated with wound infection (0.9%). Aesthetic scar alterations (5.4%) were more common in younger patients, with larger tumours, in H-area, and in flap and complex closures. Risk factors for functional scar alterations (1.7%) were the need for general anaesthesia, larger tumours that had received previous surgery, and flaps or complex closures. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 MMS shows a low risk of complications. Most of the risk factors for complications were related to tumour size and depth, and the resulting need for complex surgery. Antiaggregant/anticoagulant intake was associated with a small increase in the risk of haemorrhage, that probably does not justify withdrawal. Age and outpatient setting were not linked to the risk of adverse events.
    Type of Medium: Online Resource
    ISSN: 1018-8665 , 1421-9832
    URL: Article
    DOI: 10.1159/000517010
    RVK:
    XA 37700
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2022
    detail.hit.zdb_id: 1482189-8
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  • 4
    Online Resource
    Online Resource
    Cleft Lip Palate in a Patient with 5q14.3 Deletion Syndrome: A Possible Unreported Feature?
    S. Karger AG ; 2021
    In:  Cytogenetic and Genome Research Vol. 161, No. 12 ( 2021), p. 556-563
    Details
    In: Cytogenetic and Genome Research, S. Karger AG, Vol. 161, No. 12 ( 2021), p. 556-563
    Abstract: 5q14.3 deletion syndrome (MIM#613443) is an uncommon but well-known syndrome characterized by intellectual disability, epilepsy, hypotonia, brain malformations, and facial dysmorphism. Most patients with this syndrome have lost one copy of the 〈 i 〉 MEF2C 〈 /i 〉 gene (MIM*600662), whose haploinsufficiency is considered to be responsible for the distinctive phenotype. To date, nearly 40 cases have been reported; the deletion size and clinical spectrum are variable, and at least 6 cases without 〈 i 〉 MEF2C 〈 /i 〉 involvement have been documented. We herein report the clinical and cytogenomic findings of an 11-year-old girl who has a 5q14.3q21.1 de novo deletion that does not involve 〈 i 〉 MEF2C 〈 /i 〉 but shares the clinical features described in other reported patients. Moreover, she additionally presents with bilateral cleft-lip palate (CLP), which has not been previously reported as a feature of the syndrome. The most frequent syndromic forms of CLP were ruled out in our patient mainly by clinical examination, and Sanger sequencing was performed to discard the presence of a 〈 i 〉 TBX22 〈 /i 〉 gene (MIM*300307) defect. Our report suggests CLP as a possible unreported feature and redefines the critical phenotypic regions of 5q14.3 deletion syndrome.
    Type of Medium: Online Resource
    ISSN: 1424-8581 , 1424-859X
    URL: Article
    DOI: 10.1159/000521225
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2021
    detail.hit.zdb_id: 2061918-2
    SSG: 12
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  • 5
    Online Resource
    Online Resource
    Effect of an Intensive Weight-Loss Lifestyle Intervention on Kidney Function: A Randomized Controlled Trial
    S. Karger AG ; 2021
    In:  American Journal of Nephrology Vol. 52, No. 1 ( 2021), p. 45-58
    Details
    In: American Journal of Nephrology, S. Karger AG, Vol. 52, No. 1 ( 2021), p. 45-58
    Abstract: Introduction: Large randomized trials testing the effect of a multifactorial weight-loss lifestyle intervention including Mediterranean diet (MedDiet) on renal function are lacking. Here, we evaluated the 1-year efficacy of an intensive weight-loss intervention with an energy-reduced MedDiet (erMedDiet) plus increased physical activity (PA) on renal function. Methods: Randomized controlled “PREvención con DIeta MEDiterránea-Plus” (PREDIMED-Plus) trial is conducted in 23 Spanish centers comprising 208 primary care clinics. Overweight/obese (n = 6,719) adults aged 55–75 years with metabolic syndrome were randomly assigned (1:1) to an intensive weight-loss lifestyle intervention with an erMedDiet, PA promotion, and behavioral support (intervention) or usual-care advice to adhere to an energy-unrestricted MedDiet (control) between September 2013 and December 2016. The primary outcome was 1-year change in estimated glomerular filtration rate (eGFR). Secondary outcomes were changes in urine albumin-to-creatinine ratio (UACR), incidence of moderately/severely impaired eGFR ( 〈 60 mL/min/1.73 m2) and micro- to macroalbuminuria (UACR ≥30 mg/g), and reversion of moderately (45 to 〈 60 mL/min/1.73 m2) to mildly impaired GFR (60 to 〈 90 mL/min/1.73 m2) or micro- to macroalbuminuria. Results: After 1 year, eGFR declined by 0.66 and 1.25 mL/min/1.73 m2 in the intervention and control groups, respectively (mean difference, 0.58 mL/min/1.73 m2; 95% CI: 0.15–1.02). There were no between-group differences in mean UACR or micro- to macroalbuminuria changes. Moderately/severely impaired eGFR incidence and reversion of moderately to mildly impaired GFR were 40% lower (HR 0.60; 0.44–0.82) and 92% higher (HR 1.92; 1.35–2.73), respectively, in the intervention group. Conclusions: The PREDIMED-Plus lifestyle intervention approach may preserve renal function and delay CKD progression in overweight/obese adults.
    Type of Medium: Online Resource
    ISSN: 0250-8095 , 1421-9670
    URL: Article
    DOI: 10.1159/000513664
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2021
    detail.hit.zdb_id: 1468523-1
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  • 6
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    Online Resource
    Discordant Genotypic Sex and Phenotype Variations in Two Spanish Siblings with 17α-Hydroxylase/17,20-Lyase Deficiency Carrying the Most Prevalent Mutated〈b〉〈i〉 CYP17A1〈/i〉〈/b〉 Alleles of Brazilian Patients
    S. Karger AG ; 2017
    In:  Sexual Development Vol. 11, No. 2 ( 2017), p. 70-77
    Details
    In: Sexual Development, S. Karger AG, Vol. 11, No. 2 ( 2017), p. 70-77
    Abstract: 17α-hydroxylase/17,20-lyase deficiency is a rare form of congenital adrenal hyperplasia caused by mutations in 〈 i 〉 CYP17A1 〈 /i 〉 . Two phenotypic female sisters, aged 17 and 15 years and with 46,XY and 46,XX karyotypes, respectively, presented with primary amenorrhea and absent secondary sexual characteristics. The elder sib also presented with high blood pressure. Both patients had elevated levels of ACTH, gonadotropins, progesterone, corticosterone, and deoxycorticosterone, and reduced levels of estradiol, testosterone, androstenedione, 17-OH-P, DHEA-S, cortisol, aldosterone, and renin activity. The 〈 i 〉 CYP17A1 〈 /i 〉 gene was sequenced, and polymorphic haplotypes were further analyzed in the Spanish family and in Brazilian patients. The 2 sisters were compound heterozygous for p.Arg362Cys and p.Trp406Arg mutations, previously described as the most prevalent mutations in Brazilian families of Spanish (p.Trp406Arg) or Portuguese (p.Arg362Cys) origin. Analysis of polymorphisms in 〈 i 〉 CYP17A1 〈 /i 〉 suggested that the paternal allele with p.Arg362Cys may share a common origin with the Brazilian carriers, while the maternal allele with p.Trp406Arg did not. Hydrocortisone and sex hormone replacement therapy was initiated in both patients. In conclusion, one 〈 i 〉 CYP17A1 〈 /i 〉 mutation (p.Arg362Cys) may share a common ancestry in Brazilian and our present Spanish patients, while p.Trp406Arg may have arisen separately. The elder patient (46,XY) developed a more severe phenotype and a poorer response to estradiol replacement therapy.
    Type of Medium: Online Resource
    ISSN: 1661-5425 , 1661-5433
    URL: Article
    DOI: 10.1159/000468160
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2017
    detail.hit.zdb_id: 2261528-3
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  • 7
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    Fulminant Emphysematous Pyelonephritis by 〈b〉〈i〉Candida glabrata〈/i〉〈/b〉 in a Kidney Allograft
    S. Karger AG ; 2020
    In:  Nephron Vol. 144, No. 6 ( 2020), p. 304-309
    Details
    In: Nephron, S. Karger AG, Vol. 144, No. 6 ( 2020), p. 304-309
    Abstract: Emphysematous pyelonephritis (EPN) is a rare and serious necrotizing infection that is potentially life-threatening. It has been seldom reported in kidney grafts and is usually caused by Gram-negative bacteria, with some case reports caused by anaerobic bacteria, and has been closely associated with poorly controlled diabetes mellitus (DM) and urinary tract structural abnormalities. There are no reports of EPN of fungal etiology in kidney grafts. We present a case of a 53-year-old kidney transplant recipient with a history of DM, active vesicoureteral reflux, and recurrent urinary tract infections who developed EPN in the kidney allograft caused by 〈 i 〉 Candida glabrata 〈 /i 〉 , 3 weeks after starting treatment with empagliflozin, with an aggressive course that required urgent transplant nephrectomy.
    Type of Medium: Online Resource
    ISSN: 1660-8151 , 2235-3186
    URL: Article
    DOI: 10.1159/000507259
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 2810853-X
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  • 8
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    Online Resource
    Differences in Overall Mortality in the Elderly May Be Explained by Diet
    S. Karger AG ; 2008
    In:  Gerontology Vol. 54, No. 4 ( 2008), p. 232-237
    Details
    In: Gerontology, S. Karger AG, Vol. 54, No. 4 ( 2008), p. 232-237
    Abstract: 〈 i 〉 Background: 〈 /i 〉 Although a relationship between diet and mortality is well recognized, there is little information on the extent to which different food sources contribute to survival in elderly people. 〈 i 〉 Objective: 〈 /i 〉 To examine the effect of individual food groups on mortality in institutionalized elderly people from Asturias (Northern Spain) after 6 years of follow-up. 〈 i 〉 Method: 〈 /i 〉 The dietary intake of 288 elderly people aged 60–85 years was assessed using a semiquantitative food frequency questionnaire (FFQ). Age, gender, energy intake, chewing ability, hyperglycemia, hypercholesterolemia, physical activity, smoking habit, self-perceived health, education level and the institution from which participants were recruited were covariates in Cox regression models analyzing the effect of food on survival. 〈 i 〉 Results: 〈 /i 〉 Fruit intake was found to be inversely associated with overall mortality. Multivariate adjusted mortality rate ratio (95% CI) per 1 SD increase in fruit intake was 0.714 (0.519–0.981). On the contrary, each 1 SD of potato intake led to a 32% higher risk of death (RR (95% CI) = 1.319 (1.033–1.685)). 〈 i 〉 Conclusion: 〈 /i 〉 A high intake of fruit late in life was associated with a longer survival. An inverse association between potato intake and survival was also observed, but further research is necessary before any firm conclusions about the possible harmful aspects of potato consumption can be drawn.
    Type of Medium: Online Resource
    ISSN: 0304-324X , 1423-0003
    URL: Article
    DOI: 10.1159/000135069
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2008
    detail.hit.zdb_id: 1482689-6
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