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  1. Article: Definition of Polypharmacy in Heart Failure: A Scoping Review of the Literature.

    Patel, Keshav / Irizarry-Caro, Jorge A / Khan, Adil / Holder, Travis / Salako, Darrell / Goyal, Parag / Kwak, Min Ji

    Cardiology research

    2024  Volume 15, Issue 2, Page(s) 75–85

    Abstract: Patients with heart failure (HF) have a high prevalence of polypharmacy, which can lead to drug interactions, cognitive impairment, and medication non-compliance. However, the definition of polypharmacy in these patients is still inconsistent. The aim of ...

    Abstract Patients with heart failure (HF) have a high prevalence of polypharmacy, which can lead to drug interactions, cognitive impairment, and medication non-compliance. However, the definition of polypharmacy in these patients is still inconsistent. The aim of this scoping review was to find the most common definition of polypharmacy in HF patients. We conducted a scoping review searching Medline, Embase, CINAHL, and Cochrane using terms including polypharmacy, HF and deprescribing, which resulted in 7,949 articles. Articles without a definition of polypharmacy in HF patients and articles which included patients < 18 years of age were excluded; only 59 articles were included. Of the 59 articles, 49% (n = 29) were retrospective, 20% (n = 12) were prospective, 10% (n = 6) were cross-sectional, and 27% (n = 16) were review articles. Twenty percent (n = 12) of the articles focused on HF with reduced ejection fraction, 10% (n = 6) focused on HF with preserved ejection fraction and 69% (n = 41) articles either focused on both diagnoses or did not clarify the specific type of HF. The most common cutoff for polypharmacy in HF was five medications (59%, n = 35). There was no consensus regarding the inclusion or exclusion of over-the-counter medications, supplements, or vitamins. Some newer studies used a cutoff of 10 medications (14%, n = 8), and this may be a more practical and meaningful definition for HF patients.
    Language English
    Publishing date 2024-04-15
    Publishing country Canada
    Document type Journal Article ; Review
    ZDB-ID 2598593-0
    ISSN 1923-2837 ; 1923-2829
    ISSN (online) 1923-2837
    ISSN 1923-2829
    DOI 10.14740/cr1636
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The addition of evolocumab to maximal tolerated statin therapy improves walking performance in patients with peripheral arterial disease and intermittent claudication (Evol-PAD study).

    Clavijo, Leonardo C / Caro, Jorge / Choi, Jongkyu / Caro, Jorge A / Tun, Han / Rowe, Vincent / Kumar, S Ram / Shavelle, David M / Matthews, Ray V

    Cardiovascular revascularization medicine : including molecular interventions

    2023  Volume 55, Page(s) 1–5

    Abstract: Objective: To test the hypothesis that in patients with peripheral arterial disease (PAD) and claudication, treated with maximal tolerated statin therapy, the addition of a monthly subcutaneous injection of evolocumab for 6 months improves treadmill ... ...

    Abstract Objective: To test the hypothesis that in patients with peripheral arterial disease (PAD) and claudication, treated with maximal tolerated statin therapy, the addition of a monthly subcutaneous injection of evolocumab for 6 months improves treadmill walking performance.
    Background: Lipid lowering therapy improves walking parameters in patients with PAD and claudication. Evolocumab decreases cardiac and limb adverse events in patients with PAD; however, the effect of evolocumab on walking performance is not known.
    Methods: We performed a double-blind, randomized, placebo-controlled study to compare maximal walking time (MWT) and pain free walking time (PFWT) in patients with PAD and claudication treated with monthly subcutaneous injections of evolocumab 420 mg (n = 35) or placebo (n = 35). We also performed measurements of lower limb perfusion, brachial flow mediated dilatation (FMD), carotid intima media thickness (IMT), and serum biomarkers of PAD disease severity.
    Results: After six-months of treatment with evolocumab MWT increased by 37.7 % (87.5 ± 24 s) compared to 1.4 % (-21.7 ± 22.9 s) in the placebo group, p = 0.01. PFWT increased by 55.3 % (67.3 ± 21.2 s) in the evolocumab group compared to 20.3 % (8.5 ± 20.3 s) in the placebo group, p = 0.051. There was no difference in lower extremity arterial perfusion measurements. FMD increased by 42.0 ± 73.9 % (1.01 ± 0.7 %) in the evolocumab group and decreased by 16.29 ± 20.06 % (0.99 ± 0.68 %) in the placebo group (p < 0.001). IMT decreased by 7.16 ± 4.6 % (0.06 ± 0.04 mm) in the evolocumab group and increased by 6.68 ± 4.9 % (0.05 ± 0.03 mm) in the placebo group, (p < 0.001).
    Conclusions: The addition of evolocumab to maximal tolerated statin therapy improves maximal walking time in patients with PAD and claudication, increases FMD, and decreases IMT.
    Condensed abstract: Peripheral arterial disease (PAD) impairs quality of life by causing lower extremity intermittent claudication, rest pain, or amputation. Evolocumab is a monthly injectable monoclonal antibody medication that reduces cholesterol. In this study, we randomly treated patients with PAD and claudication, and on background statin therapy, with evolocumab or placebo, and found that evolocumab improves walking performance on a treadmill test by increasing maximal walking time. We also found that evolocumab decreases plasma MRP-14 levels, a marker of PAD severity.
    MeSH term(s) Humans ; Carotid Intima-Media Thickness ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects ; Intermittent Claudication/diagnosis ; Intermittent Claudication/drug therapy ; Peripheral Arterial Disease/diagnosis ; Peripheral Arterial Disease/drug therapy ; Quality of Life ; Walking ; Double-Blind Method
    Chemical Substances evolocumab (LKC0U3A8NJ) ; Hydroxymethylglutaryl-CoA Reductase Inhibitors
    Language English
    Publishing date 2023-04-29
    Publishing country United States
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 2212113-4
    ISSN 1878-0938 ; 1553-8389
    ISSN (online) 1878-0938
    ISSN 1553-8389
    DOI 10.1016/j.carrev.2023.04.020
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    Zs.A 5562: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Let's go fishing: A quantitative analysis of subsistence choices with a special focus on mixed economies among small-scale societies.

    Ahedo, Virginia / Zurro, Débora / Caro, Jorge / Galán, José Manuel

    PloS one

    2021  Volume 16, Issue 8, Page(s) e0254539

    Abstract: The transition to agriculture is regarded as a major turning point in human history. In the present contribution we propose to look at it through the lens of ethnographic data by means of a machine learning approach. More specifically, we analyse both ... ...

    Abstract The transition to agriculture is regarded as a major turning point in human history. In the present contribution we propose to look at it through the lens of ethnographic data by means of a machine learning approach. More specifically, we analyse both the subsistence economies and the socioecological context of 1290 societies documented in the Ethnographic Atlas with a threefold purpose: (i) to better understand the variability and success of human economic choices; (ii) to assess the role of environmental settings in the configuration of the different subsistence economies; and (iii) to examine the relevance of fishing in the development of viable alternatives to cultivation. All data were extracted from the publicly available cross-cultural database D-PLACE. Our results suggest that not all subsistence combinations are viable, existing just a subset of successful economic choices that appear recurrently in specific ecological systems. The subsistence economies identified are classified as either primary or mixed economies in accordance with an information-entropy-based quantitative criterion that determines their degree of diversification. Remarkably, according to our results, mixed economies are not a marginal choice, as they constitute 25% of the cases in our data sample. In addition, fishing seems to be a key element in the configuration of mixed economies, as it is present across all of them.
    MeSH term(s) Agriculture/economics ; Animal Husbandry ; Animals ; Animals, Domestic ; Economics/trends ; Ecosystem ; Entropy ; Food/economics ; Humans ; Machine Learning ; Societies/economics
    Language English
    Publishing date 2021-08-04
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0254539
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  4. Article ; Online: Evaluation of Midodrine Utilization in Patients with Cancer and Heart Failure.

    Irizarry-Caro, Jorge A / Song, Juhee / Miller, Chase / Desai, Shyam / Going, James / Fossas-Espinosa, Jose / Fatakdawala, Mariya M / Ali, Abdelrahman / Iliescu, Cezar / Palaskas, Nicolas / Deswal, Anita / Koutroumpakis, Efstratios

    Cardiovascular drugs and therapy

    2024  

    Abstract: Purpose: The purpose of this study was to evaluate safety and cardiovascular outcomes as well as overall survival of cancer patients with concomitant heart failure (HF) treated with midodrine for hypotension.: Methods: Adult patients diagnosed with ... ...

    Abstract Purpose: The purpose of this study was to evaluate safety and cardiovascular outcomes as well as overall survival of cancer patients with concomitant heart failure (HF) treated with midodrine for hypotension.
    Methods: Adult patients diagnosed with cancer and HF who were treated with midodrine at a tertiary cancer center from 03/2013 to 08/2021 were identified. Demographic and clinical parameters were collected retrospectively.
    Results: A total of 85 patients were included with a median age of 68 years (IQR: 60, 74; 33% female and 85% White). Of those, 31% had HFpEF (EF ≥ 50%), 42% HF with mildly reduced EF (HFmrEF; EF 41-49%), and 27% HFrEF (EF ≤ 40%). The most common indication for midodrine use was orthostatic hypotension (49%). Midodrine was continued for at least one month in 57% of the patients. Supine hypertension was the only side effect reported in 6% of patients. No statistically significant changes in NYHA class, guideline-directed medical therapy, cardiac biomarkers (NT-proBNP or troponin T), echocardiographic findings or cardiovascular hospitalizations were observed between patients who continued treatment with midodrine compared to those who stopped using midodrine over a median follow-up of 38 months. In the multivariable cox regression analysis, continuation of midodrine, compared to discontinuation, and use of midodrine for orthostatic hypotension, as opposed to other causes of hypotension, were not associated with an increased risk of mortality (HR 0.41, 95% CI 0.24-0.69, p < .0001; HR 0.34, 95% CI 0.18-0.64, p < .001, respectively). In contrast, elevated creatinine (> 1.3 for males and > 1.1 for females) was associated with an increased risk of mortality (HR 1.83, 95% CI 1.07-3.14). LVEF was not significantly associated with lower or higher risk of mortality.
    Conclusions: In our study, midodrine use in patients with cancer and HF was not associated with significant adverse effects, worse cardiovascular outcomes, or increased risk of mortality. Larger, prospective studies are needed to confirm these findings.
    Language English
    Publishing date 2024-01-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639068-7
    ISSN 1573-7241 ; 0920-3206
    ISSN (online) 1573-7241
    ISSN 0920-3206
    DOI 10.1007/s10557-024-07546-4
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    Zs.B 3057: Show issues Location:
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  5. Article ; Online: How to Diagnose and Manage QT Prolongation in Cancer Patients.

    Kim, Peter Y / Irizarry-Caro, Jorge A / Ramesh, Tushar / Iliescu, Cezar / Lopez-Mattei, Juan C

    JACC. CardioOncology

    2021  Volume 3, Issue 1, Page(s) 145–149

    Language English
    Publishing date 2021-03-16
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2666-0873
    ISSN (online) 2666-0873
    DOI 10.1016/j.jaccao.2021.01.002
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  6. Article ; Online: Quantifying the relationship between food sharing practices and socio-ecological variables in small-scale societies: A cross-cultural multi-methodological approach.

    Ahedo, Virginia / Caro, Jorge / Bortolini, Eugenio / Zurro, Débora / Madella, Marco / Galán, José Manuel

    PloS one

    2019  Volume 14, Issue 5, Page(s) e0216302

    Abstract: This article presents a cross-cultural study of the relationship among the subsistence strategies, the environmental setting and the food sharing practices of 22 modern small-scale societies located in America (n = 18) and Siberia (n = 4). Ecological, ... ...

    Abstract This article presents a cross-cultural study of the relationship among the subsistence strategies, the environmental setting and the food sharing practices of 22 modern small-scale societies located in America (n = 18) and Siberia (n = 4). Ecological, geographical and economic variables of these societies were extracted from specialized literature and the publicly available D-PLACE database. The approach proposed comprises a variety of quantitative methods, ranging from exploratory techniques aimed at capturing relationships of any type between variables, to network theory and supervised-learning predictive modelling. Results provided by all techniques consistently show that the differences observed in food sharing practices across the sampled populations cannot be explained just by the differential distribution of ecological, geographical and economic variables. Food sharing has to be interpreted as a more complex cultural phenomenon, whose variation over time and space cannot be ascribed only to local adaptation.
    MeSH term(s) Americas ; Behavior ; Biobehavioral Sciences/methods ; Cross-Cultural Comparison ; Culture ; Food ; Humans ; Siberia ; Societies ; Socioeconomic Factors
    Language English
    Publishing date 2019-05-29
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0216302
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  7. Article ; Online: Determinants of change in code status among patients with cardiopulmonary arrest admitted to the intensive care unit.

    Ploch, Michelle / Ahmed, Talha / Reyes, Stephan / Irizarry-Caro, Jorge A / Fossas-Espinosa, Jose E / Shoar, Saeed / Amatullah, Atia / Jogimahanti, Arjun / Antonioli, Matthew / Iliescu, Cesar A / Balan, Prakash / Naeini, Payam Safavi / Madjid, Mohammad

    Resuscitation

    2022  Volume 181, Page(s) 190–196

    Abstract: Background: Patients with cardiopulmonary arrest often have a poor prognosis, prompting discussion with families about code status. The impact of socioeconomic factors, demographics, medical comorbidities and medical interventions on code status changes ...

    Abstract Background: Patients with cardiopulmonary arrest often have a poor prognosis, prompting discussion with families about code status. The impact of socioeconomic factors, demographics, medical comorbidities and medical interventions on code status changes is not well understood.
    Methods: This retrospective study included adult patients presenting with cardiac arrest to the intensive care unit of a hospital group between 5/1/2010-5/1/2020. We extracted chart data on socioeconomic factors, demographics, and medical comorbidities.
    Results: We identified 1,254 patients, of which 57.5% were males. Age was different across the groups with (61.2 ± 15.5 years) and without (61.2 ± 15.5 years) code status change (p= <0.0001). Code status was changed in 583 patients (46.5%). Among patients with code status change, the highest prevalence was White patients (34.8%), followed by African Americans (30.9%), and Hispanics (25.4%). Compared to patients who did not have a code status change, those with a change in code status were older (66.7 ± 14.8 years vs 61.2 ± 15.5 years). They were also more likely to receive vasopressor/inotropic support (74.6% vs 58.5%), and broad-spectrum antibiotics (70.3% vs 57.7%). Insurance status, ethnicity, religion, education, and salary did not lead to statistically significant changes in code status.
    Conclusions: In patients with cardiopulmonary arrest, code status change was more likely to be influenced by the presence of medical comorbidities and medical interventions during hospitalization rather than by socioeconomic factors.
    MeSH term(s) Adult ; Male ; Humans ; Middle Aged ; Aged ; Female ; Retrospective Studies ; Heart Arrest/epidemiology ; Heart Arrest/therapy ; Intensive Care Units ; Ethnicity ; Hospitalization ; Cardiopulmonary Resuscitation
    Language English
    Publishing date 2022-09-26
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 189901-6
    ISSN 1873-1570 ; 0300-9572
    ISSN (online) 1873-1570
    ISSN 0300-9572
    DOI 10.1016/j.resuscitation.2022.08.022
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1048: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  8. Article ; Online: Tympanoplasty: factors associated with anatomical and audiometric results.

    Lagos, Antonia / Villarroel, Pablo / García-Huidobro, Francisco / Delgado, Valentina / Huidobro, Bárbara / Caro, Jorge / San Martín, José

    Acta otorrinolaringologica espanola

    2020  Volume 71, Issue 4, Page(s) 219–224

    Abstract: Introduction: Tympanoplasty is a frequent surgery in otolaryngology. Its main indication is tympanic perforation, followed by adhesive otopathy. Its main and (or) anatomic objective is to restore the tympanic membrane's integrity, preventing infections, ...

    Title translation Timpanoplastias: factores asociados al resultado anatómico y auditivo.
    Abstract Introduction: Tympanoplasty is a frequent surgery in otolaryngology. Its main indication is tympanic perforation, followed by adhesive otopathy. Its main and (or) anatomic objective is to restore the tympanic membrane's integrity, preventing infections, and its secondary or audiometric objective is to preserve or improve hearing.
    Material and method: Retrospective study of all patients submitted to tympanoplasty at our hospital. Biodemographic, ear pathology and surgery characteristics were registered, and anatomic and audiometric success rates were analyzed.
    Results: A total of 182 patients were included, most female (57.1%), with average age of 36.1 years. The main surgical indication was tympanic perforation (89.0%), followed by adhesive otopathy (7.1%). Most tympanoplasties were primary surgeries (84.1%), type I (62.6%), performed by endoaural approach (83.5%) using medial or Austin technique (90.1%). Compound cartilage-perichondrium grafts were most frequently used (87.9%). The anatomic success rate was 84.6%, and the audiometric success rate was 66.8%. Patients who underwent myringoplasty (without raising of tympanomeatal flap) presented a better audiometric result (p=.003). No factors associated with better anatomical results were identified.
    Conclusions: Our anatomic and audiometric results are comparable to those previously published. Further prospective studies are required to define factors associated with improved anatomic and audiometric results.
    MeSH term(s) Adolescent ; Adult ; Aged ; Audiometry ; Child ; Child, Preschool ; Ear Diseases/surgery ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Tympanic Membrane/anatomy & histology ; Tympanic Membrane/physiology ; Tympanic Membrane/surgery ; Tympanic Membrane Perforation/surgery ; Tympanoplasty ; Young Adult
    Language Spanish
    Publishing date 2020-03-07
    Publishing country Spain
    Document type Journal Article
    ISSN 2173-5735
    ISSN (online) 2173-5735
    DOI 10.1016/j.otorri.2019.07.003
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  9. Book: Ciudades portuarias en la Gran Cuenca del Caribe

    Elías Caro, Jorge Enrique / Vidal Ortega, Antonino

    visión histórica

    2010  

    Author's details Jorge Enrique Elías Caro; Antonino Vidal Ortega (eds.)
    Keywords Cities and towns/History ; Port cities/History ; Caribbean Area
    Language Spanish
    Size VIII, 539 S., Ill., Kt.
    Publisher Ed. Uninorte
    Publishing place Barranquilla
    Document type Book
    Database Former special subject collection: coastal and deep sea fishing

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  10. Article: Pituitary Imaging Abnormalities and Related Endocrine Disorders in Erdheim-Chester Disease.

    Shekhar, Skand / Irizarry-Caro, Jorge A / Sinaii, Ninet / Gahl, William A / Estrada-Veras, Juvianee I / Dave, Rahul H / Gochuico, Bernadette R / Papadakis, Georgios Z / Patronas, Nicholas / Stratakis, Constantine A / O'Brien, Kevin / Hannah-Shmouni, Fady

    Cancers

    2021  Volume 13, Issue 16

    Abstract: Purpose: We examined abnormal pituitary imaging (API) and associated endocrine dysfunction in subjects with ECD.: Methods: A cross-sectional descriptive examination of a natural history cohort study diagnosed with ECD was conducted at a clinical ... ...

    Abstract Purpose: We examined abnormal pituitary imaging (API) and associated endocrine dysfunction in subjects with ECD.
    Methods: A cross-sectional descriptive examination of a natural history cohort study diagnosed with ECD was conducted at a clinical research center. Subjects underwent baseline endocrine tests of anterior and posterior pituitary function and dedicated pituitary gland MRI scans. We determined the frequency of various pituitary imaging abnormalities in ECD and assessed its relationships with age, sex, body mass index (BMI),
    Results: Our cohort included 61 subjects with ECD [age (SD): 54.3 (10.9) y, 46 males/15 females]. API was present in 47.5% (29/61) of ECD subjects. Loss of the posterior pituitary bright spot (36.1%) followed by thickened pituitary stalk (24.6%), abnormal enhancement (18.0%), and pituitary atrophy (14.8%) were the most common abnormalities. DI and panhypopituitarism were more frequent in subjects with API without differences in age, sex distribution, hsCRP, ESR, and
    Conclusions: We noted a high burden of API and endocrinopathies in ECD. API was highly associated with the presence of panhypopituitarism and DI. Therefore, a thorough assessment of hypothalamic-pituitary integrity should be considered in subjects with ECD.
    Language English
    Publishing date 2021-08-17
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2527080-1
    ISSN 2072-6694
    ISSN 2072-6694
    DOI 10.3390/cancers13164126
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