21 research outputs found
New insights into the genetic etiology of Alzheimer's disease and related dementias
- Author
- Aaltonen L.
- Aaltonen V.
- Aarsland Dag
- Aavikko M.
- Abalos M.S.
- Abdelnour Carla
- Abner E.
- Abraham R.
- Adams H.
- Adams P.M.
- Adarmes-Gómez A.
- Adarmes-Gómez A.D.
- Aguilera N.
- Aguilera N.
- Aguirre A.
- Ahmad S.
- Akinyemi R.O.
- Al-Chalabi A.
- Alarcón-Martín Emilio
- Albert M.S.
- Albin R.L.
- Alcolea Daniel
- Alegret Montserrat
- Ali M.
- Allen M.
- Allende I.R.
- Alonso M.D.
- Alonso M.D.
- Alvarez I.
- Alvarez L.
- Amer-Ferrer G.
- Amin N.
- Amouyel Philippe
- Anastasiou A.
- Anastasiou C.
- Andrade V.
- Andreassen Ole A.
- Andreoni S.
- Antequera M.
- Antikainen R.
- Antonell A.
- Anttonen V.
- Antúnez C.
- Aparicio H.J.
- Apostolova L.G.
- Appollonio I.
- Arcaro M.
- Archetti S.
- Armstrong N.J.
- Arnold S.E.
- Arosio B.
- Arvas M.
- Assogna F.
- Asthana S.
- Athanasiu L.
- Atwood C.S.
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- Ayres G.
- Bacha J.I.
- Bahadori M.
- Bahrami S.
- Bailly H.
- Baldwin C.T.
- Banaj N.
- Baquero M.
- Barber R.C.
- Barnes L.L.
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- Barral S.
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- Bass N.J.
- Bastiani P.
- Bayer A.
- Beach T.G.
- Becker J.T.
- Becker J.T.
- Becker T.
- Beecham G.W.
- Beekly D.
- Behrens T.
- Beiser A.
- Belezhanska D.
- Bellenguez Céline
- Below J.E.
- Below J.E.
- Ben-Shlomo Y.
- Benchek P.
- Benchek P.
- Benitez B.A.
- Bennett D.
- Benussi A.
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- Bergh S.
- Bernardo-Harrington M.
- Berr Claudine
- Bertelson J.
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- Bessi V.
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- Biessels G.J.
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- Giegling I.
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- Publication venue
- Publication date
- 01/01/2022
- Field of study
Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele
Canagliflozin and renal outcomes in type 2 diabetes and nephropathy
- Author
- A Kaldun Nossuli
- Aamir Jamal
- Adalbert Schiller
- Adam Cheifetz
- Adarsh Daswani
- Adeera Levin
- Adline Ghazi
- Adrian Guinsburg
- Adriana Cif
- Adriana Gabriela Onaca
- Adriana Ilavska
- Adriana Villarino
- Agarwal R.
- Agnieszka Starzec
- Ahmed Arif
- Ahmed Awad
- Aiping Yin
- Akimichi Asano
- Alan Jackson
- Alan McMahon
- Alan Perlman
- Alberto Di Carlo
- Alberto Esquenazi
- Alejandra Oviedo
- Alejandro Valdes Depeda
- Aleksandra Kendereski
- Alex Valenzuela
- Alexander Dreval
- Alexander Gonzalez
- Alexander Shinkov
- Alexander Turchin
- Alexandre Klein
- Alfonso Soto Gonzalez
- Alfred Penfornis
- Alfredo Chew Wong
- Alfredo Wassermann
- Ali Torshizi
- Alicia Chilito
- Alina Agafyina
- Alison Dawson
- Alva Hansraj
- Amer Al-Karadsheh
- Amorin Remus Popa
- Amrendra Kumar
- Amy Sprague
- Ana Limos
- Ana Maria Cusumano
- Ana Maria Elosegui
- Anabella Amigo
- Anatoliy Kazmirchuk
- Andrea Phillips
- Andrea Stella
- Andreas Maddux
- Andrej Dzupina
- Andres Alvarisqueta
- Andrew Johnson
- Andrew O'Shaughnessy
- Andrew Steele
- Andrian Yakov
- Andrzej Januszewicz
- Andrzej Madej
- Angelina Angelova
- Anibal Gastaldi
- Anil Gupta
- Anita Bhajan Manocha
- Anjanette Tan
- Anna Kaminska
- Anna Maria Veronelli
- Anna Strzelecka
- Anna Zateyshchikova
- Anselmo Bordonava
- Antanas Navickas
- Anthony Gunstone
- Anthony Roberts
- Antonio Ceriello
- Antonio Galan Serrano
- Antonio Scafuto Scotton
- Antonio Terrelonge
- Antônio Roberto Chacra
- Anupama Gowda
- Arjun D Sinha
- Armando Perez
- Ashot Mkrtumyan
- Atanas Koundurdjiev
- Augusto Vallejos
- Aurelian-Emil Ranetti
- Ayim Akyea-Djamson
- Aysha Badat
- Bakris G.
- Baldev Singh
- Barbara Greco
- Barbara Kaczmarek
- Barbara Rewerska
- Barry M Brenner
- Belia Martin Del Camp Blanco
- Bernard Zinman
- Bertrand Cariou
- Bertrand Dussol
- Bhasker Mehta
- Bhimavarapu Sudhakar
- Björn Paschen
- Bompoint S.
- Borys Mankovskyy
- Botond Csiky
- Boyan Nonchev
- Brenner B. M.
- Brett Kissela
- Brian Nichol
- Bruce Neal
- Bruce Trippe
- Bruno Geloneze Neto
- Bull S.
- Byung-Wan Lee
- C B Keshavamurthy
- Cannon C. P.
- Capuano G.
- Carlo Giorda
- Carlos Alberto Cuneo
- Carlos Arauz-Pacheco
- Carlos Barrera
- Carlos Perez
- Carmel Hawley
- Carmen Crisan
- Carol Pollock
- Carolyn Droste
- Caroucel Chuateco
- Caryl David
- Cecilia Garcia Ballesteros
- Cecilia Jimeno
- Celso Amodeo
- Cesar Javier Zaidman
- Cesar Yoiti Hayashida
- Chamberlain Obialo
- Chang-Hsun Hsieh
- Charles Cook
- Charles Kaupke
- Charytan D. M.
- Chek Loong Loh
- Chen Leia
- Cheol-Young Park
- Chih-Ching Lin
- Christopher P Cannon
- Christy Yao
- Chu P. -L.
- Chwen-Tzuei Chang
- Chye Lee Gan
- Clara Barrios
- Claude Galphin
- Claudia Goycoa
- Claudia Moreira de Brito
- Clodoaido Caringal
- Cristian Serafinceanu
- Cristina Toarba
- Cristobal Morales Portillo
- Csaba Kovesdy
- Cynthia Bowman-Stroud
- Cynthia Christiano
- Cynthia Mustieles Rocha
- Cyrus Desouza
- Cássio Slompo Ramos
- Dagmar Bartaskova
- Dale Crawford Allison
- Dalia Kozloviene
- Dan Scharfstein
- Dana Cosma
- Daniel Coyne
- Daniel Hiser
- Daniel Kolansky
- Daniel Panarotto
- Daniel Pella
- Daniel Weiner
- Daniil Chizhov
- Dariusz Sowinski
- Darren K McGuire
- Davesh Sennik
- David C Wheeler
- David Cherney 3rd
- David Gorson
- David Johnson
- David M Charytan
- David Packham
- David Scott
- David Wheeler
- De Zeeuw D.
- Debbie Cohen-Stein
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- Doru Negru
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- Edoardo Mannucci
- Eduardo Farias
- Edward Watson
- Edwards R.
- Egle Gaupsiene
- Egle Urbanaviciene
- Ekaterina Velichkova
- Elena Christofides
- Elena Grineva
- Elena Kolmakova
- Elena Shutemova
- Eleonora Harcsa
- Elizabeth Barranco
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- Elizabeth Kern
- Elizete Keitel
- Eloisa Tellez Chavez
- Emanuela Orsi
- Emil Martinka
- Emyr Davies
- Enrique Gonzalez
- Eric Alamartine
- Eric Hernandez Triana
- Eric Thervet
- Erick Turcios Juarez
- Esteban Cercos
- Eugenia Galindo-Ramos
- Eva Peterfai
- Evaly Chen
- Evandro de Souza Portes
- Evgueniy Vazelov
- Fabian Otreras
- Fabiana Loss de Carvalho Contieri
- Fabio Malberti
- Fadi Saba
- Fadlo Fraige Filho
- Favio Edmundo Enriquez Sosa
- Fayzal Ahmed
- Ferdinando Carlo Sasso
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- François Dubé
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- Freemu Varghese
- Gabriela Cecilia Coloma
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- Gabriele von Ingersleben
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- Gopal Krishna
- Grace Aquitania
- Grace Lin
- Graham Hillis
- Graziano Di Cianni
- Grazyna Orlowska-Kowalik
- Grazyna Popenda
- Greene T.
- Greg Fulcher
- Gregorio Obrador
- Gregorio Obrador Vera
- Grit Faulmann
- Guadalupe Morales Franco
- Guillermo Fragale
- Guixia Wang
- Gulam Latiff
- Gustavo Cristian Greloni
- Guy Chouinard
- Gyongyi Csecsei
- Gyorgy Paragh
- Halyna Tomashkevych
- Hans Prozesky
- Harpreet Bajaj
- Hasnain Khandwala
- Hector Rodriguez
- Heerspink H. J. L.
- Helena Oosthuizen
- Hendrik Nortje
- Henry Watson
- Hermann Haller
- Hernan Finkelstein
- Hernan Yupanqui
- Hiddo J L Heerspink
- Hiralal Maheshwari
- Hiroko Oishi
- Hiromi Aoki
- Hiromi Rodriguez Pattzi
- Hiroshi Kono
- Hitoshi Akiyama
- Holly Wang
- Hong Mao
- Hong Zhang
- Hongguang Zheng
- Hongli Lin
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- Hugo Roberto Kurtz Lisboa
- Humberto Pavon
- Hyuk-Sang Kwon
- Iain MacDougall
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- Idalia Acosta
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- Ines Bartolacci
- Ingrid Abrahamsen
- Ingrid Buganova
- Inna Kolesnyk
- Ioana Emilia Ferariu
- Irene Noronha
- Irina Glinkina
- Irina Osipova
- Iryna Dudar
- Isabel Erika Rucker Joerg
- Isabel Garcia
- Isam Marar
- Israel Hartman
- Iuliia Komisarenko
- Ivan Fushtey
- Ivan Ory
- Ivan Rychlik
- Ivan Rychlík
- Ivan Smirnov
- Ivan Topchii
- Ivan Villegas
- Iveta Smatanova
- Jaco Jurgens
- Jakkidi Reddy
- Jamal Hammoud
- James Conway
- James Januzzi
- James Welker
- Jan Culak
- Jana Babikova
- Jana Belobradkova
- Jana Dzuponova
- Janos Mucsi
- Jardine M. J.
- Jason Gaglia
- Javier Narvarte
- Javier Nieto Iglesias
- Jayameena Peringat
- Jayant Kumar
- Jean Carlo Tibes Hachmann
- Jean Welsh
- Jean-Pierre Fauvel
- Jeevren Reddy
- Jeffrey Kropp
- Jeffrey Stephens
- Jeimeen Agra
- Jelena Ignjatovic
- Jesus Cuadrado
- Jesus Egido de Los Rios
- Jian Liu
- Jiao Sun
- Jinkui Yang
- Jiri Lastuvka
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- Jorgelina Sala
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- Jose Hector Sanchez Mijangos
- Jose L Górriz
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- Jose Osvaldo Fretes
- Jose Ricardo Correa Rotter
- Joseph Abdallah
- Joseph Aiello
- Joseph Feuerstein
- Joseph O'Hare
- Joseph Proietto
- Josier Nisnisan
- José Vicente Sanchez Polo
- João Lindolfo Cunha Borges
- João Soares Felício
- Juan Alfredo Tamayo Y Orozco
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- Juan Carlos Santos
- Juan Diego Higuera
- Juan Frias
- Juan Gonzalo Godoy Jorquera
- Juan Pablo Albisu
- Juan Pablo Moreira Diaz
- Juan Peralta Calcaneo
- Juan Rosas Guzman
- Juan Villagordoa Mesa
- JungEun Lee
- Kamal Abouglila
- Karel Peterka
- Karina Hufert
- Karlton Pettis
- Katalin Keltai
- Katalin Revesz
- Katarina Halciakova
- Katarina Lalic
- Kathy Nicholls
- Kati De Brouwer
- Kazuhiro Yanagida
- Kazunori Koyama
- Kazuyuki Mizuyama
- Kee Sing Ng
- Kenneth Cohen
- Kenneth Deck
- Kenneth Hershon
- Kenneth Liss
- Kenneth W Mahaffey
- Khalid Abdul Kadir
- Khurram Wadud
- Kim Travis
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- Li Yuan Lee
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- Rajiv Agarwal
- Rajiv Ranjan
- Raju Sree Bhushan
- Rakesh Gulati
- Rakhi Khanna
- Rallabhandi Sankaram
- Raman Purighalla
- Ramesh Chandra Vyasam
- Ramesh Thimmaiah
- Ramon Berenguer
- Ramon Moreda
- Rangel Rangelov
- Rao K Satyanarayana
- Ravendran Govender
- Ravi Sarin
- Reddy Sreedhar
- Reginald Parker
- Rehan Symonds
- Reinhold Jerwan-Keim
- Remi Rabasa-Lhoret
- Renan Montenegro Junior
- Renata Bijata-Bronisz
- Rhea Severina Comia
- Rhonda Bentley-Lewis
- Riad Darwish
- Ricardo Alfonso Leon de la Fuente
- Ricardo Dario Dran
- Ricardo Rosero
- Riccardo Bonadonna
- Richard Ferkl
- Richard Kovar
- Richard Lindley
- Richard Orozco Castellanos
- Richard Solomon
- Robert Busch
- Robert Cohen
- Robert Schreiman
- Robert Takacs
- Robert Walker
- Roberto Abrão Raduan
- Roberto Jorge da Silva Franco
- Roberto Pecoits Filho
- Roberto Pecoits-Filho
- Roberto Simões de Almeida
- Roberto Trevisan
- Rodica-Ioana Avram
- Rodolfo Andres Ahuad Guerrero
- Rohana Abdul Ghani
- Rohit Pankhaniya
- Rolando Zamarripa Escobedo
- Ronald Goldenberg
- Ronald Harris
- Ronald Watts
- Ronaldo Arturo Gonzalez Orellana
- Ronan Roussel
- Ronnie Aronson
- Rosa Isela Luna Ceballos
- Rosângela Milagres
- Ruben Dario Vargas Alonso
- Rury Holman
- Russell Scott
- Sacha De Serres
- Sahay Manisha
- Saiful Shahrizal Bin Shudim
- Sailaja Ventrapragada
- Salah Abusnana
- Salvatore De Cosmo
- Sam Henein
- Sam Philip
- Samuel Cohen
- Samuel Mujica Trenche
- Samy Hadjadj
- Sandor Keresztesi
- Sandor Vangel
- Sandra Berenice Saaveddra Sanchez
- Sanjeev Rastogi
- Sara Jaffer
- Sarah Olelewe
- Satoshi Ota
- Satu Pesickova
- Scott Kasner
- Secundino Cigarran Guldris
- Senan Sultan
- Serge Cournoyer
- Sergei Nedogoda
- Sergey Vorobyev
- Sergio Saul Irizar Santana
- Shahabul Arfeen
- Shahnaz Shahinfar
- Shang-Jyh Hwang
- Shelley Williams
- Shenaz Ramtoola
- Shenglian Gan
- Sherry Sussman
- Shizuo Kajiyama
- Shozo Miyauchi
- Silvia Ines Orio
- Silvia Nicolai
- Simon Davies
- Simon Roger
- Simon Young
- Sin Gon Kim
- Singhan Krishnan
- Sini George
- Slobodan Antic
- Sohan Dua
- Sonia Hermida
- Soo Kun Lim
- Sophie Borot
- Souhila Ounadjela
- Sreedhar Mandayam
- Srikanth Bellary
- Stanislav Zemek
- Stanislaw Mazur
- Stefan Dimitrov
- Stephan Maxeiner
- Stephen Grubb
- Stephen Smith
- Steven Fishbane
- Stuart Handelsman
- Suely Keiko Kohara
- Sun Kim
- Sun-Hee Park
- Sunil Sheth
- Susumu Kashine
- Svetlana Goykhman
- Svitlana D Bilyk
- Swee Win Lam
- Sylvia Rosas
- Sylvia Shaw
- Szilard Vasas
- Sérgio Alberto Cunha Vêncio
- Sérgio Yamada
- Tadashi Iitsuka
- Takamoto Kodera
- Takashi Wada
- Takayuki Watanabe
- Tamara Malek Marin
- Tamas Oroszlan
- Tara Chang
- Tareq Nassar
- Tarissa Beatrice Zanata Petry
- Tatiana Koroleva
- Tatiana Morugova
- Tatiana Raskina
- Tatyana Zykova
- Te-Lin Hsia
- Terue Sakakibara
- Tetiana Zlova
- Tetsuji Niiya
- Tetyana Pertseva
- Tiago Schuch
- Timothy Hall
- Tom Christensen
- Tom Greene
- Tomas Drasnar
- Tomas Smith Casabella
- Tonatiu Diaz Escalante
- Toshihiko Yanase
- Toshio Kawada
- Vadym Vizir
- Vanassa Ratnasingam
- Venessa Tsang
- Venkata Behara
- Vera Klokocnikova
- Vera Krane
- Veronica Anghel
- Veselka Genadieva
- Vesna Popovic-Radinovic
- Viacheslav Marasaev
- Victor Commendatore
- Victor Saavedra Gajardo
- Vijayaraman Arutchelvam
- Viktor Margaritov
- Viktor Zaviriukha
- Viktoria Andreeva
- Vimladhevi Govender
- Vincent Pichette
- Vincent Woo
- Vira Tseluyko
- Virginia Esther Visco
- Vivek Sood
- Vivekan Jha
- Vladimir Dobronravov
- Vladimir Khirmanov
- Vladimir Tesar
- Vlado Perkovic
- Volker Burst
- Volodymyr Botsyurko
- Walter Guillermo Douthat
- Walter Pharr
- Wasim Hanif
- Wataru Yumita
- Wayne H-H Sheu
- Wayne Turner
- Wei Yen Kong
- Weihong Song
- Weiping Lu
- Wendy Lane
- Wenge Li
- Wheeler D. C.
- Wladmir Saporito
- Xuemei Li
- Xueqing Yu
- Yamil Canaan
- Yan Ren
- Yannick Le Meur
- Yaozhong Kong
- Yasuro Kumeda
- Yasushi Wakida
- Yavin Y.
- Yeong Hoon Kim
- Yevgeniya Svyshchenko
- Young Min Cho
- Yulia Samoylova
- Yung-Chuan Lu
- Yuriy Mostovoy
- Yuriy Shwartz
- Yvette Ethel Yap
- Zaynab Abejuela
- Zdravko Kamenov
- Zeid Khitan
- Zhang H.
- Zinman B.
- Zishan Ali
- Zuzana Ochodnicka
- Ângela Regina Nazario Sabbag
- Publication venue
- 'Massachusetts Medical Society'
- Publication date
- 01/01/2019
- Field of study
BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years
Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial
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- Abreu Matheus O.
- Acerbi Paulo S. C.
- Albuquerque Regis B.
- Aldrighi Jose R.
- Alencastro Andre
- Almeida Marilia S.
- Almeida Patricia S.
- Almeida Samara D.
- Almeida Samara D.
- Alves Janine D.
- Amaral Karine A. E. H.
- Amaro Andreson F.
- Amato Marcelo B. P.
- Amato Marcelo B. P.
- Amorim Denise S.
- Amorim Fabio F.
- Andrade Ana H. V.
- Andrade Isaac G.
- Andrade Lucia C.
- Andrade Luciana A. S.
- Andrade Wandalvo
- Apoena Pablo
- Araujo Neto Jose A.
- Araujo Arthur C.
- Araujo Jose F.
- Araujo Marcelo E. U.
- Araujo Mario F. A.
- Arduini Rodrigo G.
- Assef Maria G. P. L.
- Azevedo Luciano C. P.
- Azevedo Luciano C. P.
- Backes Fabiane
- Bainy Marina P.
- Baptista Filho Mario L. A.
- Barbosa Pierry O.
- Barra Williams F.
- Barros Dalton
- Baruzzi Claudio
- Bastos Ana C. A. G.
- Bastos Rafael S.
- Batista Roseane A.
- Becker Daniel A.
- Bergo Ricardo R.
- Berto Paula
- Berwanger Otavio
- Berwanger Otavio
- Bigolin Rodrigo
- Bitencourt Wesley S.
- Bitencourt Wesley S.
- Blattner Clarissa
- Boldo Rodrigo
- Boniatti Marcio M.
- Borges Marcos C.
- Bozi Giovana G.
- Brandao Andre L. S. B.
- Brilenger Caroline O.
- Brilhante Yuzeth Nobrega
- Broilo Fabiano P.
- Burigo Ana C.
- Cacau Lucas A. P.
- Caixeta Carlos R.
- Caldeira Milton
- Caldeira Milton
- Canavessi Hugo Schlebinger
- Canzi Regina A.
- Cappi Sylas B.
- Carbonell Roberto C. C.
- Cardoso Lucienne T. Q.
- Carmona Cesar V.
- Carneiro Mauricio
- Carneiro Saul R.
- Carvalho Alexandre G. R.
- Carvalho Carlos R. R.
- Carvalho Carlos R. R.
- Carvalho Fabricio R. T.
- Carvalho Fernanda L. G.
- Carvalho Frederico B.
- Carvalho Frederico B.
- Carvalho Ivana L. V.
- Carvalho Vitor O.
- Carvalho Waneska L. N.
- Caser Eliana
- Castanelo Carlos
- Cavalcante Eulalia
- Cavalcanti Alexandre B.
- Cavalcanti Alexandre B.
- Cavalcanti Raphael Ali
- Cerantola Rodrigo B.
- Chagas Filho Aldir
- Chamy Gauco
- Chaves Filho Francisco G.
- Chiasso Tatiana M.
- Coelho Adalberto M.
- Coelho Edward, Jr.
- Coelho Milena P. P. M.
- Conde Katia A. P.
- Cordeiro Rodrigo B.
- Correa Fabiano G.
- Correa Tiago A.
- Correa Viviane M.
- Correia Emmanuel I. S.
- Cortegiani Andrea
- Costa Andre F.
- Costa Maristela C.
- Costa Ramon T.
- Couto Wivian A. D.
- Cramer Amanda S.
- Cunha Adenard F. C.
- Dadam Michelli M.
- Damasceno Bruna
- de Oliveira Filho Wilson
- de Oliveira Filho Wilson
- Decio Janaina C.
- Demarzo Sergio E.
- Dias Alysson P.
- Dias Fernando S.
- Dias Polyana P. L. C.
- Diaz S. Edgard
- Diaz-Quijano Fredi A.
- Diaz-Quijano Fredi A.
- Domingues Sergio M., Jr.
- Dragosavak Desanka
- Duarte Juliana N.
- Duarte Pericles A. D.
- Duarte Robson
- Dutra Victor G.
- Eberhart Neto Ervin
- Falcao Antonio
- Falcao Jansen G.
- Farran Jorge
- Felizardo Livia R. S. M.
- Ferguson Niall
- Ferraz Iris L.
- Ferreira Neto Fleury
- Ferreira Ana P.
- Ferreira Cassia M.
- Ferreira Claiton S.
- Ferreira Denise M.
- Ferreira Edgard V.
- Ferreira Elaine M.
- Ferreira Firmino H., Jr.
- Ferreira Reinaldo
- Festti Josiane
- Fialkow Lea
- Figueiredo Adelaide C.
- Figueiredo Luciana C.
- Filgueira Feto Jose E.
- Flores Dimitri G.
- Flores Dimitri G.
- Foernges Rafael B.
- Franca Gustavo G. P.
- Francisco Renata S.
- Franke Cristiano
- Galassi Marcela S.
- Gallego Raquel C. N.
- Galvao Endi L.
- Garcez Melissa C. M.
- Garcia L. Sandra M. C.
- Gatti Ciro
- Geha Nadia N.
- Germano Almir
- Germiniani Bruno C.
- Giacomassi Ivens W. S.
- Giancursi Thiago S.
- Giannini Fabio
- Gil Fernando S. U.
- Gimenez Francielli M. P.
- Giuberti Adriana F. T.
- Giuberti Jonas, Jr.
- Gois Aecio
- Gomes Bruno C.
- Gomes Tania M.
- Goncalves Neto Graciliano J. L.
- Goncalves Fernanda A. F.
- Goncalves Iran, Jr.
- Gonzalez C. Octavio
- Gorski Anthony G.
- Grion Cintia M. C.
- Grion Cintia M. C.
- Guadalupe Erika G. L.
- Guerra Andre
- Guerreiro Marcio O.
- Guimaraes Daniela M. Q. S.
- Guimaraes Helio P.
- Guimaraes Helio P.
- Guimaraes Helio P.
- Gurgel Sanderland J. T.
- Guyatt Gordon
- Hajjar Ludhmila A.
- Heirel Debora C. B.
- Henriques Lilian A.
- Herek Andrea
- Hinestrosa Alfredo
- Hirota Adriana S.
- Holanda Marcelo A.
- Hopf Joao L. S.
- Horner Marina B. W.
- Inagaki Alexandre S.
- Infantini Rodrigo M.
- Isola Alexandre
- Jesus Karinne R.
- Kauss Ivanil A. M.
- Kawaguchi Ines A. L.
- Kazue Priscila
- Kleber Wladimy
- Kleber Wladmy
- Kodama Alessandra A.
- Kretzer Lara
- Kuroda Cristina M.
- Lago Roberto
- Laprovita Maria P.
- Larangeira Alexandre S.
- Laube Gilberto, Jr.
- Leao Rosangela M.
- Leite Petronio A.
- Lima Cyntia M. L. S.
- Lima Fernando B.
- Lima Maria H. B. S.
- Lima Zildamara B.
- Lira Jose A.
- Lopes Renato D.
- Lovato Wilson
- Lucena Debora N. L.
- Lunardi Maria C.
- Luzzi Sergio
- Maccari Juara G.
- Macedo Pedro L.
- Machado Fernando O.
- Machado Flavia R.
- Machado Luis A. M. W.
- Machado Nelma J. N.
- Magalhaes Nascimento Francine J.
- Maia Israel S.
- Maia Marcelo O.
- Malbouison Luiz M.
- Marcilino Antonielen
- Margalho Silviano B.
- Margarida Kathia
- Marino Nathalia F.
- Marques Leonardo S.
- Marraccini Thiago
- Martinez Amadeu
- Martins Edna T. J.
- Martins Eliauria R.
- Martins Eliauria R.
- Martins Gloria A.
- Martins Marcele F.
- Martins Marcio A.
- Martins Marcio A.
- Martins Mariana L.
- Matsubara Rosely R.
- Matsui Mirna
- Mazza Bruno F.
- Mecatti Giovana C.
- Medeiros Luciana G.
- Mendez Vanessa M. F.
- Mendonca Angela
- Menescal Brena
- Merluzzi Thalita
- Mezzaroba Ana L.
- Miranda Whiniton
- Miura Claudia
- Monteiro Livia L.
- Moraes Ana P. P.
- Moraes Rafael B.
- Morais Jussara E. P.
- Morais Mirene O.
- Morales Daniela
- Moreira Cora L. C. B.
- Moreira Fabiana B. R.
- Moreira Monique A.
- Moreno Marcelo S.
- Morong Aline S.
- Morsch Rafaela D.
- Nassar Antonio P., Jr.
- Naves Sergio A.
- Nedel Wagner
- Neto Jeronimo C. B.
- Nienstedt Esteban C.
- Nobrega Marciano S.
- Nogueira Filho Wilson
- Nogueira Eduardo E. F.
- Nomoto Silmara H.
- Nunes Andre L.
- Odir Isaura
- Oliveira Aline E.
- Oliveira Andre L. V.
- Oliveira Clezio S.
- Oliveira Glauce L.
- Oliveira Ivonaldo M.
- Oliveira Katia R.
- Oliveira Luiz R. C.
- Oliveira Marcelo E.
- Oliveira Roselaine P.
- Oliveira Roselaine P.
- Oliveira Roselaine P.
- Oliveira Tatiana A.
- Oliveira Vanessa M.
- Oliver Wilson R.
- Ornellas Izadora B.
- Orsatti Vinicius N.
- Park Marcelo
- Passos Denise B. V. G.
- Patrocinio Ana C. L.
- Paula Ludmila N.
- Pavia Caio L. P.
- Pedro A.
- Peixoto Daniela C.
- Peliser Priscila
- Pellegrini Jose A. S.
- Pellegrini Jose A. S.
- Pena Felipe M.
- Pereira Antonio J.
- Pereira Cesar A.
- Pereira Sheila A.
- Pincelli Mariangela
- Pinheiro Filho Gilvan R.
- Pinheiro Filho Gilvan R.
- Pinto Walkyria A. M.
- Piovesan Maysa Z. R.
- Piras Claudio
- Pizarro Camilo
- Pompilio Carlos E.
- Poquiriqui Rodolfo M. B.
- Potratz Jorge L.
- Prado Karen F.
- Prado Luiz F. A.
- Rabelo Livia A.
- Rabelo Melina V.
- Rahal Luciana
- Raineri Santi M.
- Ramos Joroastro E., Jr.
- Rangel Vivian P. L.
- Ray Alexandre
- Rech Tatiana H.
- Regenga Marisa M.
- Regenga Marisa M.
- Rego Leila R. M.
- Reis Andrezza T. J. B.
- Reis Diego L.
- Reis Diego L.
- Reis Helder
- Rezende Claudnei M.
- Rezende Ederlon
- Rezende Ederlon A. C.
- Rezende Valeria M. C.
- Ribeiro Gisele F. M.
- Ribeiro Rubens A. B.
- Ribeiro Wagner
- Rieder Marcelo M.
- Rocha Edson P.
- Rodrigues Ricardo G.
- Romano Edson
- Romano Edson
- Romano Marcelo
- Rossetti Santana Heloisa B.
- Rosso Deorgelis
- Sa Alexandre
- Sala Andrea D.
- Sales Joao A. L., Jr.
- Salgado Diamantino R.
- Salomao Maria C.
- Sandri Priscila
- Santana Hericalizandra S. R.
- Santiago Roberta R. S.
- Santos Gheisa D.
- Santos Grazielle O.
- Santos Jose R. P.
- Santos Lucio S.
- Santos Moreno C.
- Santos Patricia L.
- Santos Priscila J. C. D.
- Santos Thiago M.
- Sarat Saturnino Campo, Jr.
- Savi Augusto
- Scaglia Nris C.
- Schaich Felipe
- Schettino Guilherme P. P.
- Schiavetto Paulo M.
- Schievano Fabiana R.
- Schulz Luis F.
- Schwarz Patricia
- Schwarz Patricia
- Seeger Gabriela M.
- Segundo Valerio J.
- Severino Marta A.
- Silva Albano S.
- Silva Aline C. F.
- Silva Alline O.
- Silva Anselmo C.
- Silva Dafne C. B.
- Silva Fabiano D.
- Silva Nelson B.
- Silva Patricia N.
- Silva Rosicley S.
- Silva Rozangela R.
- Silva Sabrina F.
- Silva Sandra R. B.
- Silva Silvangela G. A.
- Smith Thiago C.
- Sousa Neto Jefferson A.
- Sousa Marcelo F.
- Souza Ana R.
- Souza Marcia L. V. D.
- Souza Marcia M. F.
- Starling Claudia M.
- Suguitani Edmundo O.
- Suzuki Vivian C.
- Suzumura Erica A.
- Suzumura Erica A.
- Tagliari Luciana
- Taino Bruno
- Taira Elisabete E.
- Takahashi Luzia
- Takahashi Luzia N.
- Takatani Rodrigo R.
- Tallo Fernando S.
- Tamazato Edys Y.
- Taniguchi Leandro
- Tarkieltaub Elcio
- Tavares Daniele
- Tavares Daniele C. C.
- Tavares Marcel V.
- Tavares Roberta C.
- Tcherniakovisk Leo
- Teixeira Cassiano
- Teixeira Cassiano
- Teixeira Cassiano
- Teixeira Cristina
- Teixeira Luciano O.
- Telles Jose M. M.
- Thompson Marlus M.
- Toledo Diogo
- Tomizuka Carlos I.
- Torres Franciele C. C.
- Toufen Carlos, Jr.
- Tozo Tatiane C.
- Trindade Renata S.
- Tucci Mauro
- Uratani Cristiana C. S.
- Vanzuita Raquel
- Vasconcelos Marcia O. M.
- Vasconcelos Paula T.
- Vassallo Paula F.
- Vendrame Leticia S.
- Verdeal Juan C.
- Vianna Arthur
- Vieira Debora F. V. B.
- Vieira Silvia R. R.
- Vieira Vitor M.
- Vieira Vitor M.
- Viera Filho Edesio
- Walter Stephen
- Wawrzeniak Iuri C.
- Werneck Vinicius
- Westphal Glauco
- Westphal Glauco
- Winveler Georgia F. P.
- Wysocki Natacha
- Xavier Patricia A.
- Yamada Sergio S.
- Zanta Camila C.
- Zoghbi Karina K.
- Publication venue
- LONDON
- Publication date
- 28/08/2012
- Field of study
Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt
Hacia un massive online open course (MOOC) para el aprendizaje de la higiene y seguridad alimentarias
- Author
- Alache Manchado Beatriz
- Beltrán Crespo Antonio
- Blanco Palmero Felipe A.
- Borrero del Pino Juan
- Cabrales Miró-Granada Ana
- Carabante Oliver Natalia
- Carmona Agraz Ana
- Carpintero Cagigas Ana
- Casarrubios Guío Pilar
- Celorrio de Ochoa David
- Chaparro Domínguez María de los Ángeles
- Cintas Izarra Luis Miguel
- Contente de Matos Diogo da Silva Serra
- Escobar Sáez Daniel
- Feito Hermida Javier
- Gómez Sala Beatriz
- Hernández Cruza Pablo Elpidio
- Marin Martínez María
- Martin de Santos María del Rosario
- Muñoz Atienza Estefanía
- Palenzuela González Cristina
- Peña Vidal Nuria
- Romero Domingo Sandra
- Álvarez López Alberto
- Ávila Alonso Óscar
- Publication venue
- Publication date
- 17/06/2021
- Field of study
Sección Dptal. de Nutrición y Ciencia de los Alimentos (Veterinaria)Fac. de VeterinariaFALSEsubmitte
Evolocumab and clinical outcomes in patients with cardiovascular disease
- Author
- Abelson M.
- Aboufakher R.
- Abrahamsen T. E.
- Accini Mendoza J. L.
- Acheatel R.
- Ackermann D.
- Adamkova V.
- Adams M.
- Adlam D.
- Aggarwal R.
- Aggarwal S.
- Ahsan A.
- Ainsworth P.
- Airody Govinda R.
- Akai A.
- Ako J.
- Al-Bahrani A.
- Al-Joundi T.
- Aldegather J.
- Aldrete Velasco J. A.
- Alfieri A.
- Alt I.
- Alzohaili O.
- Amerena J.
- Amin J.
- Amoedo R.
- Amuchastegui M.
- Anderson T.
- Andreka P.
- Andreotti F.
- Angoulvant D.
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- Yamashita K.
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- Yang Y.
- Yang Z.
- Yao Zhuhua
- Yasumura Y.
- Yataco A.
- Yeh H.
- Yena L.
- Yeoman G.
- Yigit Z.
- Yilmaz M. B.
- Yokoya K.
- Yoshimichi G.
- Yotov Y.
- Youngman D.
- Younis L.
- Yuge M.
- Zabowka M.
- Zahn L.
- Zamorano Gomez J. L.
- Zarich S.
- Zateyshchikov D.
- Zdrenghea D.
- Zechowicz T.
- Zeig S.
- Zemanek J.
- Zeng X.
- Zhang L.
- Zhang X.
- Zhao S.
- Zheng Y.
- Zheng Z.
- Zhou C.
- Zhu Y.
- Zhurba S.
- Zidkova E.
- Zieba B.
- Ziegler O.
- Zilahi Z.
- Zrazhevskiy K.
- Östergren J.
- Publication venue
- 'Massachusetts Medical Society'
- Publication date
- 01/01/2017
- Field of study
peer reviewedBACKGROUND Evolocumab is a monoclonal antibody that inhibits proprotein convertase subtilisin-kexin type 9 (PCSK9) and lowers low-density lipoprotein (LDL) cholesterol levels by approximately 60%. Whether it prevents cardiovascular events is uncertain. METHODS We conducted a randomized, double-blind, placebo-controlled trial involving 27,564 patients with atherosclerotic cardiovascular disease and LDL cholesterol levels of 70 mg per deciliter (1.8 mmol per liter) or higher who were receiving statin therapy. Patients were randomly assigned to receive evolocumab (either 140 mg every 2 weeks or 420 mg monthly) or matching placebo as subcutaneous injections. The primary efficacy end point was the composite of cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization. The key secondary efficacy end point was the composite of cardiovascular death, myocardial infarction, or stroke. The median duration of follow-up was 2.2 years. RESULTS At 48 weeks, the least-squares mean percentage reduction in LDL cholesterol levels with evolocumab, as compared with placebo, was 59%, from a median baseline value of 92 mg per deciliter (2.4 mmol per liter) to 30 mg per deciliter (0.78 mmol per liter) (P<0.001). Relative to placebo, evolocumab treatment significantly reduced the risk of the primary end point (1344 patients [9.8%] vs. 1563 patients [11.3%]; hazard ratio, 0.85; 95% confidence interval [CI], 0.79 to 0.92; P<0.001) and the key secondary end point (816 [5.9%] vs. 1013 [7.4%]; hazard ratio, 0.80; 95% CI, 0.73 to 0.88; P<0.001). The results were consistent across key subgroups, including the subgroup of patients in the lowest quartile for baseline LDL cholesterol levels (median, 74 mg per deciliter [1.9 mmol per liter]). There was no significant difference between the study groups with regard to adverse events (including new-onset diabetes and neurocognitive events), with the exception of injection-site reactions, which were more common with evolocumab (2.1% vs. 1.6%). CONCLUSIONS In our trial, inhibition of PCSK9 with evolocumab on a background of statin therapy lowered LDL cholesterol levels to a median of 30 mg per deciliter (0.78 mmol per liter) and reduced the risk of cardiovascular events. These findings show that patients with atherosclerotic cardiovascular disease benefit from lowering of LDL cholesterol levels below current targets. © 2017 Massachusetts Medical Society
Effect of lung recruitment and titrated Positive End-Expiratory Pressure (PEEP) vs low PEEP on mortality in patients with acute respiratory distress syndrome - A randomized clinical trial
- Author
- Abdalla G.
- Abrahao Hajjar L.
- Abrantes Saraiva S.
- Abrunhosa A.
- Adler Maccagnan Pinheiro Besen B.
- Adrieno Westphal G.
- Afiq Syahmi Ramli M.
- Aires de Araujo Neto J.
- Akemi Higo M.
- Alberti da Silva G.
- Almeida Delfino Duarte P.
- Almeida Victorino J.
- Alves Ferreira Goncalves F.
- Amado Rabelo L.
- Amador Correia T.
- Amarante Costa A.
- Amato M. B. P.
- Andrade A. H. V.
- Andrioli de Araujo P.
- Anibal Leite Barros Agostinho T.
- Antoniazzi R.
- Aparecida Leite M.
- Aparecida Pereira J.
- Aparecida Pessoa Conde K.
- Azevedo L.
- Azzi Barbosa N.
- Baccaro Rossetti Santana H.
- Balzi A. P.
- Baptista Filho M. L. A.
- Barberena Moraes R.
- Barbosa Cerantola R.
- Barbosa Gomes Galas F. R.
- Barbosa P. G.
- Barboza Carnevalli Bueno T.
- Barros de Oliveira M. E.
- Barros Duarte I. J.
- Barroso A.
- Bassi E.
- Bastos de Moura E.
- Bastos Vieira P. C.
- Bautista-Rincon D. F.
- Belacho Azeredo Coutinho J.
- Belda F. J.
- Bermudez W. F.
- Bernadete Caser E.
- Berto P.
- Berwanger O.
- Bezerra Lima Z.
- Bin da Silva S. R.
- Blattner C.
- Bolognese D.
- Bonaccorsi Fernandino B.
- Bonin Campos L.
- Borba Pereira T.
- Botelho Foernges R.
- Braga Hagreaves Ribeiro de Freitas R.
- Breckenfeld Heirel D. C.
- Brocco Magnan G.
- Bruinje Cosentino M. F.
- Buarque Souza de Lima M. H.
- Burigo Grumann A. C.
- Buss E. K.
- Buttignol M.
- Cadavid Gutierrez C.
- Caldeira Filho M.
- Calderon L. E.
- Camargo Narciso R.
- Camassola A. P.
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- Campos Tonussi R. L.
- Carbonell J. A.
- Carolina Salomao M.
- Caser E. B.
- Castaneda J. A.
- Castro Escobar Furlan F.
- Cattelan Bonorino K.
- Cavalcante Lola Biazzoto E. P.
- Cavalcanti A. B.
- Chagas C. E. R. C.
- Charro F. A.
- Christmann Wawrzeniak I.
- Cisari G.
- Coelho M.
- Colozza Mecatti G.
- Conceicao Andrade L.
- Conti Ramos R.
- Cordeiro de Abreu Filho C. A.
- Cordioli R.
- Correia Santos Bonomo D.
- Cortegiani A.
- Costa Carvalho L. F.
- Costa G.
- Costa Lisboa T.
- Costa M.
- Cruz Carbonell R. C.
- da Cunha S.
- da Graca Pasquotto de Lima Assef M.
- da Silva Bettega F.
- da Silva Franco R. S.
- da Silva Guimaraes B. L.
- da Silva K. S.
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- da Silva Marques L.
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- da Silva P. N.
- Dadam M.
- Dal-Pizzol F.
- Damiani L. P.
- De Alencar Filho M. S.
- de Almeida M. M. M. F.
- de Andrade K. M.
- De Aquino Martins P.
- de Araujo Macedo Pinto W.
- de Araujo Nazare M.
- de Assuncao Melo L.
- de Azevedo Naves S.
- de Brito Cordeiro R.
- de Brito Sobrinho E.
- de Campos Balzano P.
- de Carvalho A.
- De Carvalho Borges M.
- De Carvalho C. R. R.
- de Carvalho Fonseca Assuncao N. S.
- de Carvalho M. A.
- de Carvalho-Filho M. A.
- de Faria Cordeiro H.
- De Lima Assef M. D. G. P.
- de Linhares J. M.
- de Lucca F. C.
- de Marchi Benfica A. F.
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- Gut A. L.
- Hadrich M.
- Hasan M. S.
- Helenditi Fernandes Camurca Martins R.
- Henn Moura R.
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- Hirata F.
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- Hurtado J.
- Ishiwaki S.
- Isola A.
- Iwamoto T.
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- Laranjeira L. N.
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- Lesti Esteves A. R.
- Lima de Andrade A.
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- Lobo S.
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- Longhi Simoes de Almeida S.
- Loureiro Sebold M.
- Lovato W. J.
- Luzzi S.
- Macedo Araujo L.
- Machado F. R.
- Machado J. A.
- Magalhaes Carvalho Grion C.
- Maia I. S.
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- Marcal de Vasconcelos M. O.
- Marco R.
- Marques Andrade G.
- Marques Barroso C.
- Marques Ferreira Mendez V.
- Martines Moralez G.
- Martins Arruda J.
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- Martins De Stefano L.
- Martins Dzivielevski B.
- Martins G. A.
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- Massariol T. C.
- Matheus Cadamuro F.
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- Mayumi Higa R.
- Mazza B. F.
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- Melo Silva R.
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- Menezes de Rezende C.
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- Miranda Barreto Mourao L.
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- Miura M. C.
- Morais M. O.
- Morales D.
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- Naranjo Sierra S.
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- Passos Amato M. B.
- Pastore L.
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- Penna Guimaraes H.
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- Peres I.
- Peretti Torelly A.
- Pfuetzenreiter F.
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- Pincelli M.
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- Pinto Goncalves C. H.
- Piras C.
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- Povoa P.
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- Ribeiro Salgado D.
- Riccio P.
- Rios F.
- Rios Vieira S. R.
- Ritter C.
- Rocha Rodrigues da Silva F.
- Rodrigues da Cruz M.
- Rodrigues M.
- Rodrigues Torres de Carvalho F.
- Romano E. R.
- Romano M.
- Rossi Peras Americo V.
- Rosso Verdeal J. C.
- Rubini P.
- Russotto V.
- Rutzen W.
- Ryoji Takatani R.
- Sa Malbouisson L. M.
- Saldanha Dos Santos R.
- Samartino Zavanelli G.
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- Sande L.
- Santa Maria Lucin G.
- Santa Rosa Santana H.
- Santos Pellegrini J. A.
- Santucci Cesar de Assuncao M.
- Satoshi Inagaki A.
- Scalzo A. C.
- Schmitz de Figueiredo F.
- Schwan Filho F.
- Schwarz P.
- Seczynska B.
- Sega A.
- Seiji Ueno Gil F.
- Semboloni Bitencourt W.
- Serpa Neto A.
- Shahnaz Hasan M.
- Silva Cavallaro Torres K.
- Silva de Almeida P.
- Silva de Araujo A.
- Silva de Souza A.
- Silva J. M.
- Silva M.
- Silva Maia I.
- Silva Sales B.
- Simoes da Silva F.
- Simoes Giancursi T.
- Siqueira da Silva A.
- Sisconetto L.
- Soares Nasrala M. L.
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- Souza Amorim D.
- Souza da Silva R.
- Souza Dos Santos L.
- Souza Marques A.
- Souza Ribeiro M.
- Spegiorin Moreno M.
- Sperotto G.
- Staffa Gonzaga da Silva L.
- Steponovicius Piedade Cruz F.
- Stucchi E. M.
- Suzumura E. A.
- Szczeklik W.
- Tadahiro Ikeoka D.
- Tagliari L.
- Taniguchi L. N. T.
- Tavares Gurgel S. J.
- Teixeira C.
- Teixeira de Gois A. F.
- Teixeira Pinheiro T.
- Thompson M. M.
- Tibery Queiroz Cardoso L.
- Tierno P.
- Torres D.
- Torres P.
- Toshiyuki Tanita M.
- Toufen C.
- Tozo T. C.
- Tucci M. R.
- Valente Barbas C. S.
- Valiatti J. L.
- Vantini Capasso Palamim C.
- Vargas M.
- Vasconcelos de Sousa G.
- Vasconcelos R.
- Veiga de Oliveira A. L.
- Vendrame L. S.
- Verissimo A.
- Vieda E.
- Vieira de Lacerda N. M.
- Vieira Do Nascimento Martins E.
- Vieira S. R. R.
- Vilela Costa Pinto B.
- Vilela Siqueira H.
- Villasante Troncoso E. M.
- Vinicius Pereira M.
- Vitor Fera J.
- Werneck V.
- Yen Ju C.
- Yudi Horikawa F.
- Zampieri F.
- Zandonai C. L.
- Publication venue
- 'American Medical Association (AMA)'
- Publication date
- 01/01/2017
- Field of study
IMPORTANCE: The effects of recruitment maneuvers and positive end-expiratory pressure (PEEP) titration on clinical outcomes in patients with acute respiratory distress syndrome (ARDS) remain uncertain. OBJECTIVE: To determine if lung recruitment associated with PEEP titration according to the best respiratory-system compliance decreases 28-day mortality of patients with moderate to severe ARDS compared with a conventional low-PEEP strategy. DESIGN, SETTING, AND PARTICIPANTS: Multicenter, randomized trial conducted at 120 intensive care units (ICUs) from 9 countries from November 17, 2011, through April 25, 2017, enrolling adults with moderate to severe ARDS. INTERVENTIONS: An experimental strategy with a lung recruitment maneuver and PEEP titration according to the best respiratory-system compliance (n = 501; experimental group) or a control strategy of low PEEP (n = 509). All patients received volume-assist control mode until weaning. MAIN OUTCOMES AND MEASURES: The primary outcome was all-cause mortality until 28 days. Secondary outcomes were length of ICU and hospital stay; ventilator-free days through day 28; pneumothorax requiring drainage within 7 days; barotrauma within 7 days; and ICU, in-hospital, and 6-month mortality. RESULTS: A total of 1010 patients (37.5% female; mean [SD] age, 50.9 [17.4] years) were enrolled and followed up. At 28 days, 277 of 501 patients (55.3%) in the experimental group and 251 of 509 patients (49.3%) in the control group had died (hazard ratio [HR], 1.20; 95% CI, 1.01 to 1.42; P = .041). Compared with the control group, the experimental group strategy increased 6-month mortality (65.3% vs 59.9%; HR, 1.18; 95% CI, 1.01 to 1.38; P = .04), decreased the number of mean ventilator-free days (5.3 vs 6.4; difference, −1.1; 95% CI, −2.1 to −0.1; P = .03), increased the risk of pneumothorax requiring drainage (3.2% vs 1.2%; difference, 2.0%; 95% CI, 0.0% to 4.0%; P = .03), and the risk of barotrauma (5.6% vs 1.6%; difference, 4.0%; 95% CI, 1.5% to 6.5%; P = .001). There were no significant differences in the length of ICU stay, length of hospital stay, ICU mortality, and in-hospital mortality. CONCLUSIONS AND RELEVANCE: In patients with moderate to severe ARDS, a strategy with lung recruitment and titrated PEEP compared with low PEEP increased 28-day all-cause mortality. These findings do not support the routine use of lung recruitment maneuver and PEEP titration in these patients. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01374022
Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial
- Author
- Abreu Matheus O.
- Acerbi Paulo S. C.
- Albuquerque Regis B.
- Aldrighi Jose R.
- Alencastro Andre
- Almeida Marilia S.
- Almeida Patricia S.
- Almeida Samara D.
- Almeida Samara D.
- Alves Janine D.
- Amaral Karine A. E. H.
- Amaro Andreson F.
- Amato Marcelo B. P.
- Amato Marcelo B. P.
- Amorim Denise S.
- Amorim Fabio F.
- Andrade Ana H. V.
- Andrade Isaac G.
- Andrade Lucia C.
- Andrade Luciana A. S.
- Andrade Wandalvo
- Apoena Pablo
- Araujo Neto Jose A.
- Araujo Arthur C.
- Araujo Jose F.
- Araujo Marcelo E. U.
- Araujo Mario F. A.
- Arduini Rodrigo G.
- Assef Maria G. P. L.
- Azevedo Luciano C. P.
- Azevedo Luciano C. P.
- Backes Fabiane
- Bainy Marina P.
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- Teixeira Cassiano
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- Walter Stephen
- Wawrzeniak Iuri C.
- Werneck Vinicius
- Westphal Glauco
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- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/07/2016
- Field of study
Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.13Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt
Ezetimibe added to statin therapy after acute coronary syndromes
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- Zweiker R
- Ångman K
- Édes I
- Östberg S
- Publication venue
- 'Massachusetts Medical Society'
- Publication date
- 01/01/2015
- Field of study
BACKGROUND: Statin therapy reduces low-density lipoprotein (LDL) cholesterol levels and the risk of cardiovascular events, but whether the addition of ezetimibe, a nonstatin drug that reduces intestinal cholesterol absorption, can reduce the rate of cardiovascular events further is not known. METHODS: We conducted a double-blind, randomized trial involving 18,144 patients who had been hospitalized for an acute coronary syndrome within the preceding 10 days and had LDL cholesterol levels of 50 to 100 mg per deciliter (1.3 to 2.6 mmol per liter) if they were receiving lipid-lowering therapy or 50 to 125 mg per deciliter (1.3 to 3.2 mmol per liter) if they were not receiving lipid-lowering therapy. The combination of simvastatin (40 mg) and ezetimibe (10 mg) (simvastatin-ezetimibe) was compared with simvastatin (40 mg) and placebo (simvastatin monotherapy). The primary end point was a composite of cardiovascular death, nonfatal myocardial infarction, unstable angina requiring rehospitalization, coronary revascularization ( 6530 days after randomization), or nonfatal stroke. The median follow-up was 6 years. RESULTS: The median time-weighted average LDL cholesterol level during the study was 53.7 mg per deciliter (1.4 mmol per liter) in the simvastatin-ezetimibe group, as compared with 69.5 mg per deciliter (1.8 mmol per liter) in the simvastatin-monotherapy group (P<0.001). The Kaplan-Meier event rate for the primary end point at 7 years was 32.7% in the simvastatin-ezetimibe group, as compared with 34.7% in the simvastatin-monotherapy group (absolute risk difference, 2.0 percentage points; hazard ratio, 0.936; 95% confidence interval, 0.89 to 0.99; P = 0.016). Rates of pre-specified muscle, gallbladder, and hepatic adverse effects and cancer were similar in the two groups. CONCLUSIONS: When added to statin therapy, ezetimibe resulted in incremental lowering of LDL cholesterol levels and improved cardiovascular outcomes. Moreover, lowering LDL cholesterol to levels below previous targets provided additional benefit
Evolocumab and clinical outcomes in patients with cardiovascular disease
- Author
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- Aboufakher R
- Abrahamsen Te
- Accini Mendoza Jl
- Acheatel R
- Ackermann D
- Adamkova V
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- Airody Govinda R
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- Aldegather J
- Aldrete Velasco Ja
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- Alt I
- Alzohaili O
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- Ziegler O
- Zilahi Z
- Zrazhevskiy K
- Östergren J
- Publication venue
- 'Massachusetts Medical Society'
- Publication date
- 01/01/2017
- Field of study
BACKGROUND Evolocumab is a monoclonal antibody that inhibits proprotein convertase subtilisin-kexin type 9 (PCSK9) and lowers low-density lipoprotein (LDL) cholesterol levels by approximately 60%. Whether it prevents cardiovascular events is uncertain. METHODS We conducted a randomized, double-blind, placebo-controlled trial involving 27,564 patients with atherosclerotic cardiovascular disease and LDL cholesterol levels of 70 mg per deciliter (1.8 mmol per liter) or higher who were receiving statin therapy. Patients were randomly assigned to receive evolocumab (either 140 mg every 2 weeks or 420 mg monthly) or matching placebo as subcutaneous injections. The primary efficacy end point was the composite of cardiovascular death, myocardial infarction, stroke, hospitalization for unstable angina, or coronary revascularization. The key secondary efficacy end point was the composite of cardiovascular death, myocardial infarction, or stroke. The median duration of follow-up was 2.2 years. RESULTS At 48 weeks, the least-squares mean percentage reduction in LDL cholesterol levels with evolocumab, as compared with placebo, was 59%, from a median baseline value of 92 mg per deciliter (2.4 mmol per liter) to 30 mg per deciliter (0.78 mmol per liter) (P<0.001). Relative to placebo, evolocumab treatment significantly reduced the risk of the primary end point (1344 patients [9.8%] vs. 1563 patients [11.3%]; hazard ratio, 0.85; 95% confidence interval [CI], 0.79 to 0.92; P<0.001) and the key secondary end point (816 [5.9%] vs. 1013 [7.4%]; hazard ratio, 0.80; 95% CI, 0.73 to 0.88; P<0.001). The results were consistent across key subgroups, including the subgroup of patients in the lowest quartile for baseline LDL cholesterol levels (median, 74 mg per deciliter [1.9 mmol per liter]). There was no significant difference between the study groups with regard to adverse events (including new-onset diabetes and neurocognitive events), with the exception of injection-site reactions, which were more common with evolocumab (2.1% vs. 1.6%). CONCLUSIONS In our trial, inhibition of PCSK9 with evolocumab on a background of statin therapy lowered LDL cholesterol levels to a median of 30 mg per deciliter (0.78 mmol per liter) and reduced the risk of cardiovascular events. These findings show that patients with atherosclerotic cardiovascular disease benefit from lowering of LDL cholesterol levels below current targets
New insights into the genetic etiology of Alzheimer’s disease and related dementias
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2022
- Field of study
Characterization of the genetic landscape of Alzheimer’s disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/‘proxy’ AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele. © 2022, The Author(s)