Publications by authors named "Michelle Castillo"

Background: Cardiac allograft vasculopathy (CAV) results in impaired blood flow in both epicardial vessels and the microvasculature and is a leading cause of poor outcomes in heart transplant (HT) recipients. Most patients have mild (ISHLT CAV 1) disease. This study examined outcomes amongst those with ISHLT CAV 1 and investigated the value of physiologic assessment via cardiac positron emission tomography/computed tomography (PET/CT) for added risk stratification.

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  • - Transthyretin cardiac amyloidosis (ATTR-CA) is more commonly diagnosed in older men, but research indicates that women may be underrepresented in previous statistics regarding its prevalence.
  • - The SCAN-MP study used nuclear imaging to assess ATTR-CA in older Black and Caribbean Hispanic individuals, revealing that this cohort had a higher percentage of women (31.3%) compared to a referral center (13.3%).
  • - Women in the SCAN-MP cohort displayed a less severe form of the disease, indicated by higher heart function and lower heart mass, suggesting that targeted identification in women is essential to address existing sex disparities in ATTR-CA diagnoses.
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  • Cardiac hybrid PET/CT is used to assess cardiac allograft vasculopathy (CAV) in heart transplant patients and visually estimated coronary artery calcium (VECAC) from CT scans can help predict cardiovascular outcomes.
  • A study of 430 heart transplant patients found that higher VECAC scores (specifically 10-99 and 100+) were linked to a significantly greater risk of death or retransplantation during a median follow-up of 4.2 years.
  • The findings suggest that VECAC can be a valuable independent marker for predicting adverse outcomes post-heart transplant and should be considered in patient evaluations.
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  • Many COVID-19 survivors from the early pandemic showed signs of cardiac injury, prompting investigations into long-term heart effects using cardiac imaging techniques like CMR and TTE.
  • A study involving 40 COVID-19 survivors and 12 matched controls conducted TTE and CMR at an average of 308 days post-infection, revealing no significant differences in heart structure, function, or tissue abnormalities between the groups.
  • The findings suggest that there is no lasting damage or inflammation to the heart in these survivors, despite previous reports of cardiac issues during acute COVID-19.
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  • This study focused on how Body Mass Index (BMI) influences radiation exposure in patients with chest pain undergoing different imaging techniques, highlighting the importance of optimizing doses for patient safety.
  • A total of 9,046 patients were analyzed, and results showed PET/CT had the lowest radiation exposure, particularly for patients with higher BMI, while CCTA had significantly higher doses in heavier patients.
  • The findings emphasize that while radiation doses for these imaging methods are generally modest, understanding BMI's impact is crucial for improving imaging practices and reducing unnecessary radiation exposure.
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  • The study investigates how the size of the heart affects the accuracy of SPECT myocardial perfusion imaging (MPI) in identifying obstructive coronary artery disease (CAD).
  • Among 2066 patients, it was found that those with a low left ventricular volume had lower diagnostic performance compared to those with larger volumes, particularly affecting older and male patients.
  • The results indicate that smaller heart sizes lead to a significant decrease in the effectiveness of SPECT MPI, highlighting the need for tailored diagnostic approaches based on cardiac size, age, and sex.
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Aims: Gestational diabetes (GDM) is associated with the development of postpartum (PP) glucose intolerance. Plasma glycated CD59 (pGCD59) is an emerging biomarker for the detection of hyperglycaemia. The aim of this study was to assess the ability of PP pGCD59 to predict the development of PP GI as defined by the 2 h 75 g OGTT using the ADA criteria, in a cohort of women diagnosed with prior GDM in the index pregnancy using the 2 h 75 g OGTT at 24-28 weeks of gestation according to the World Health Organization (WHO) 2013 criteria.

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  • The study investigates the best heart-to-contralateral chest (H/CL) ratio threshold for diagnosing transthyretin cardiac amyloidosis (ATTR-CA) using Tc pyrophosphate (PYP) imaging in older adults with heart failure.
  • Among 229 patients, only 14 confirmed cases of ATTR-CA were identified, and most scans showed no PYP uptake, highlighting the challenge of accurate diagnosis.
  • An H/CL threshold of ≥ 1.4 provided high specificity and positive predictive value, but a lower threshold of ≥ 1.3 had higher sensitivity, indicating that using these thresholds in low pretest probability populations could lead to misclassifications.
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Pain is prevalent among patients with cancer who are being treated with radiotherapy. However, the prevalence of pain varies across regions, and pain management is affected by several factors. This cross-sectional study aims to determine the prevalence of pain, assess the adequacy of pain management and identify factors affecting pain in patients undergoing radiotherapy.

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Background: There is a growing interest in the use of hypofractionation in the setting of post-mastectomy radiation therapy (PMRT). Here, we present an interim report on the acute toxicities and the dosimetry of a 15-day hypofractionated regimen.

Materials And Methods: Patients aged 18-75 years who underwent mastectomy and had pathological stage IIB-IIIC or any clinical stage who had received neoadjuvant chemotherapy were treated with PMRT at a dose of 43.

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Aim: Even though most pregnancies are uneventful, occasionally complications do occur. Gestational diabetes is linked to an increased risk of adverse pregnancy outcomes. Early identification of women at risk of experiencing adverse outcomes, ideally through a single blood test, would facilitate early intervention.

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  • Cardiac allograft vasculopathy (CAV) is a serious complication that affects nearly 50% of heart transplant patients within a decade, leading to reduced blood flow in the heart.
  • An analysis of 181 heart transplant recipients revealed that those with a reduced myocardial blood flow reserve (MBFR ≤2.0) faced significantly higher risks of death, retransplantation, and cardiovascular issues compared to those with normal MBFR (>2.0).
  • The findings suggest that monitoring myocardial blood flow can provide crucial prognostic insights for heart transplant patients, even when there are no visible signs of epicardial CAV.
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Background: The coronavirus disease 2019 (COVID-19) pandemic has negatively affected the outcomes of surgical neuro-oncology patients worldwide. We aimed to review the practice patterns in surgical neuro-oncology in low- and middle-income countries (LMICs). We also present a situational report from our own country.

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Placenta-mediated pregnancy complications are a major challenge in the management of maternal-fetal health. Maternal thrombophilia is a suspected risk factor, but the role of thrombotic processes in these complications has remained unclear. Endothelial protein C receptor (EPCR) is an anticoagulant protein highly expressed in the placenta.

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Tissue factor pathway inhibitor (TFPI) is a serine protease with multiple anticoagulant activities. The Kunitz1 (K1) domain of TFPI binds the active site of factor VIIa and is required for inhibition of tissue factor (TF)/factor VIIa catalytic activity. Mice lacking TFPI K1 domain die in utero.

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