Publications by authors named "L Beltran"

231 Publications

Evaluation of a patient specific, targeted-intensity pharmacologic thromboprophylaxis protocol in hospitalized patients with COVID-19.

J Thromb Thrombolysis 2021 Aug 19. Epub 2021 Aug 19.

Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Pharmacy & Pharmaceutical Sciences, 12850 E. Montview Blvd., Aurora, CO, 80045, USA.

Patients with COVID-19 are at higher risk of thrombosis due to the inflammatory nature of their disease. A higher-intensity approach to pharmacologic thromboprophylaxis may be warranted. The objective of this retrospective cohort study was to determine if a patient specific, targeted-intensity pharmacologic thromboprophylaxis protocol incorporating severity of illness, weight, and biomarkers decreased incidence of thrombosis in hospitalized patients with COVID-19. Included patients were hospitalized with COVID-19 and received thromboprophylaxis within 48 h of admission. Exclusion criteria included receipt of therapeutic anticoagulation prior to or within 24 h of admission, history of heparin-induced thrombocytopenia, extracorporeal membrane oxygenation, pregnancy, or incarceration. Per-protocol patients received thromboprophylaxis according to institutional protocol involving escalated doses of anticoagulants based upon severity of illness, total body weight, and biomarker thresholds. The primary outcome was thrombosis. Secondary outcomes included major bleeding, mortality, and identification of risk factors for thrombosis. Of 1189 patients screened, 803 were included in the final analysis. The median age was 54 (42-65) and 446 (55.5%) were male. Patients in the per-protocol group experienced significantly fewer thrombotic events (4.4% vs. 10.7%, p = 0.002), less major bleeding (3.1% vs. 9.6%, p < 0.001), and lower mortality (6.3% vs. 11.8%, p = 0.02) when compared to patients treated off-protocol. Significant predictors of thrombosis included mechanical ventilation and male sex. Post-hoc regression analysis identified mechanical ventilation, major bleeding, and D-dimer ≥ 1500 ng/mL FEU as significant predictors of mortality. A targeted pharmacologic thromboprophylaxis protocol incorporating severity of illness, body weight, and biomarkers appears effective and safe for preventing thrombosis in patients with COVID-19.
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http://dx.doi.org/10.1007/s11239-021-02552-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8375286PMC
August 2021

'I did not get this disease on the street; it was brought home as a gift': Gender, violence and HIV vulnerability among Cuban women.

Cult Health Sex 2021 Jul 13:1-15. Epub 2021 Jul 13.

Department of Epidemiology, Centre of Research, Diagnosis and Reference, Pedro Kourí Tropical Medicine Institute, Havana, Cuba.

While gay, bisexual and other men who have sex with men are most affected by HIV in Cuba, infections among women have increased over time, but there has been little research to contextualise their vulnerability to HIV. The purpose of this study was to explore the role of gender and violence in shaping vulnerability to HIV among Cuban women. Qualitative in-depth interviews were conducted with women living with HIV at an outpatient HIV clinic in Havana. Narrative and thematic technique were used to systematically analyse the data. Participants described negotiating sexual relationships in a context where traditional gender norms merge with the paradox of increasing professional opportunities for women alongside growing economic precarity. Interconnected economic and emotional dependence along with violence influenced the acceptance of certain behaviours that heightened vulnerability to HIV, including inconsistent condom use and infidelity. Gender transformative approaches that recognise the complex interplay between gender norms, economic precarity and violence are needed to address women's vulnerability to HIV in the Cuban context. Such efforts can reinforce existing strategies to promote behaviourally focused prevention while creating an enabling environment for the integration and expansion of biomedical innovation in HIV prevention.
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http://dx.doi.org/10.1080/13691058.2021.1925744DOI Listing
July 2021

A suite of rare microbes interacts with a dominant, heritable, fungal endophyte to influence plant trait expression.

ISME J 2021 09 31;15(9):2763-2778. Epub 2021 Mar 31.

Ecology, Evolution, and Conservation Biology Program, Biology Department, University of Nevada, Reno, NV, USA.

Endophytes are microbes that live, for at least a portion of their life history, within plant tissues. Endophyte assemblages are often composed of a few abundant taxa and many infrequently observed, low-biomass taxa that are, in a word, rare. The ways in which most endophytes affect host phenotype are unknown; however, certain dominant endophytes can influence plants in ecologically meaningful ways-including by affecting growth and immune system functioning. In contrast, the effects of rare endophytes on their hosts have been unexplored, including how rare endophytes might interact with abundant endophytes to shape plant phenotype. Here, we manipulate both the suite of rare foliar endophytes (including both fungi and bacteria) and Alternaria fulva-a vertically transmitted and usually abundant fungus-within the fabaceous forb Astragalus lentiginosus. We report that rare, low-biomass endophytes affected host size and foliar %N, but only when the heritable fungal endophyte (A. fulva) was not present. A. fulva also reduced plant size and %N, but these deleterious effects on the host could be offset by a negative association we observed between this heritable fungus and a foliar pathogen. These results demonstrate how interactions among endophytic taxa determine the net effects on host plants and suggest that the myriad rare endophytes within plant leaves may be more than a collection of uninfluential, commensal organisms, but instead have meaningful ecological roles.
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http://dx.doi.org/10.1038/s41396-021-00964-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8397751PMC
September 2021

Susceptibility Weighted Imaging for evaluation of musculoskeletal lesions.

Eur J Radiol 2021 May 28;138:109611. Epub 2021 Feb 28.

MRI Unit, Radiology Department, HT Medica, Carmelo Torres nº2, Jaén, 23007, Spain. Electronic address:

The presence of blood or calcium in the musculoskeletal (MSK) system may be linked to specific pathological conditions. The ability of MRI for calcium detection is usually limited compared with other techniques such as CT. In a similar manner, the accuracy of MRI for detection and evaluation of hemorrhage in soft tissues is closely linked to the degree of degradation of blood products. Blood and calcium are substances that cause local inhomogeneity of the magnetic field resulting in susceptibility artifacts. To try to evaluate these substances, specific MRI sequences which are highly sensitive to these local magnetic field inhomogeneities such as Susceptibility Weighted Imaging (SWI) have been developed and successfully applied in the Central Nervous System, but scarcely used in MSK. SWI may increase the overall sensitivity of MRI to detect blood and calcium in several clinical scenarios such as degenerative joint disease or bone and soft tissue lesion assessment and discriminate between both compounds, something which is not always possible with conventional MRI approaches. In this paper, physical basis and technical adjustment for SWI acquisition at MSK are detailed reviewing the potential application of SWI in different MSK clinical scenarios.
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http://dx.doi.org/10.1016/j.ejrad.2021.109611DOI Listing
May 2021

Proteomic comparison of adult and juvenile Santa Catalina rattlesnake (Crotalus catalinensis) venom.

Toxicon 2021 Apr 2;193:55-62. Epub 2021 Feb 2.

ISBI Biosciences S.C. Huitzilac, Morelos, CP, 62510, Mexico. Electronic address:

Rattlesnake's venom constitutes an important ecological trait that dynamically changes over time. Venoms of adult and juvenile rattleless rattlesnakes, Crotalus catalinensis, an endemic insular species from the Gulf of California, were compared by electrophoretic profile, fibrinogenolytic activity, and proteomic composition to assess ontogenetic variability. The SDS-PAGE profiles show important differences at 12, 22, and 45 kDa, which were prominent in adult samples and absent in juvenile samples, while bands around 20, 25, and 70 kDa are almost absent in adults. Both venoms hydrolyze Aa and Bb chains of fibrinogen generating different patterns of degradation products. This activity was partially inhibited by EDTA and PMSF and completely abolished only in the presence of both inhibitors. More than 260 proteins were identified and quantified in both venoms by proteomic analysis. Metalloproteinases (more than 60%), serine proteinases (14.5% in adult venom and 17.7% in juvenile venom), and C-type lectins (7.1 and 5.9%) represent the three most abundant toxin-related protein families. Bradykinin inhibitor peptides and L-amino acid oxidases were not detected in juvenile venom. A protein-specific comparison shows that adult and juvenile venom share about 30.5% of total toxin-related proteins, while 32% and 35% are exclusively present in adult and juvenile venoms, respectively. This work represents one of the first efforts to understand phenotypic diversity in the venom composition of insular rattlesnake species from Mexico.
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http://dx.doi.org/10.1016/j.toxicon.2021.01.014DOI Listing
April 2021
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