Juliana Moren | Universidad de Buenos Aires (original) (raw)

Papers by Juliana Moren

Research paper thumbnail of COVID‐19‐related medicine utilization study in pregnancy: The COVI‐PREG cohort

British Journal of Clinical Pharmacology

AIM The objective of this study was to describe the use of COVID-19-related medicines during preg... more AIM The objective of this study was to describe the use of COVID-19-related medicines during pregnancy and their evolution between the early/late periods of the pandemic. METHODS Pregnant women who tested positive for SARS-CoV-2 from March 2020 to July 2021 were included using the COVI-PREG registry. Exposure to the following COVID-19-related medicines was recorded: antibiotics, antivirals, hydroxychloroquine, corticosteroids, anti-interleukin-6 and immunoglobulins. We described the prevalence of medicines used, by trimester of pregnancy, maternal COVID-19 severity level and early/late period of the pandemic (before and after 1 July 2020). FINDINGS We included 1964 pregnant patients who tested positive for SARS-CoV-2. Overall, 10.4% (205/1964) received at least one COVID-19-related medicine including antibiotics (8.6%; 169/1694), corticosteroids (3.2%; 62/1964), antivirals (2.0%; 39/1964), hydroxychloroquine (1.4%; 27/1964) and anti-interleukin-6 (0.3%; 5/1964). The use of at least one COVID-19-related medicine was 3.1% (12/381) in asymptomatic individuals, 4.2% (52/1233) in outpatients, 19.7% (46/233) in inpatients without oxygen, 72.1% (44/61) in those requiring standard oxygen, 95.7% (22/23) in those requiring high flow oxygen, 96.2% (25/26) in patients who required intubation and 57.1% (4/7) among patients who died. The proportion who received medicines to treat COVID-19 was higher before than after July 2020 (16.7% vs. 7.7%). Antibiotics, antivirals and hydroxychloroquine had lower rates of use during the late period. CONCLUSION Medicine use in pregnancy increased with disease severity. The trend towards increased use of corticosteroids seems to be aligned with changing guidelines. Evidence is still needed regarding the effectiveness and safety of COVID-19-related medicines in pregnancy.

Research paper thumbnail of Endothelial cell-derived interleukin-6 regulates tumor growth

BMC Cancer, 2014

Background: Endothelial cells play a complex role in the pathobiology of cancer. This role is not... more Background: Endothelial cells play a complex role in the pathobiology of cancer. This role is not limited to the making of blood vessels to allow for influx of oxygen and nutrients required for the high metabolic demands of tumor cells. Indeed, it has been recently shown that tumor-associated endothelial cells secrete molecules that enhance tumor cell survival and cancer stem cell self-renewal. The hypothesis underlying this work is that specific disruption of endothelial cell-initiated signaling inhibits tumor growth. Methods: Conditioned medium from primary human dermal microvascular endothelial cells (HDMEC) stably transduced with silencing RNA for IL-6 (or controls) was used to evaluate the role of endothelial-derived IL-6 on the activation of key signaling pathways in tumor cells. In addition, these endothelial cells were co-transplanted with tumor cells into immunodefficient mice to determine the impact of endothelial cell-derived IL-6 on tumor growth and angiogenesis. Results: We observed that tumor cells adjacent to blood vessels show strong phosphorylation of STAT3, a key mediator of tumor progression. In search for a possible mechanism for the activation of the STAT3 signaling pathway, we observed that silencing interleukin (IL)-6 in tumor-associated endothelial cells inhibited STAT3 phosphorylation in tumor cells. Notably, tumors vascularized with IL-6-silenced endothelial cells showed lower intratumoral microvessel density, lower tumor cell proliferation, and slower growth than tumors vascularized with control endothelial cells. Conclusions: Collectively, these results demonstrate that IL-6 secreted by endothelial cells enhance tumor growth, and suggest that cancer patients might benefit from targeted approaches that block signaling events initiated by endothelial cells.

Research paper thumbnail of Risk factors for anxiety and depression among pregnant women during COVID ‐19 pandemic—Results of a web‐based multinational cross‐sectional study

International Journal of Gynecology & Obstetrics

Research paper thumbnail of Title: Integrating sequential screening for placental dysfunction in the first and second trimester: Results of a cohort of unselected patients. Authors

Introduction/Objective: The consequences of placental dysfunction, manifested as preeclampsia (PE... more Introduction/Objective: The consequences of placental dysfunction, manifested as preeclampsia (PE) and/or fetal grouth restriction -are major causes of maternal and fetal morbidity and mortality. In the last decades, two screening strategies have been proposed to early identify patients at high risk for these complications. In the 80s, screening with uterine artery Doppler in the second trimester (18-24 weeks, S2) was described. More recently, it has been proposed to conduct a combined screening in the first trimester (11-13 weeks, S1), using maternal characteristics, mean arterial pressure, uterine artery Doppler and PAPP-A. Several groups have published results of these two methods separately, but there are fewer reports evaluating the combined performance of sequential screening in a low risk population. Methods: S1 was performed in 952 patients between 11 and 13 weeks and were scheduled to return for S2 in second trimester. Eleven patients had a spontaneous abortion and 295 pati...

Research paper thumbnail of Screening for late placental dysfunction with uterine artery Doppler at 28-34 weeks: Results of a prospective cohort

Research paper thumbnail of Comparing new and traditional definitions of fetal growth restriction: A retrospective analysis

Research paper thumbnail of GUIDELINES Sonographic examination of the fetal central nervous system: guidelines for performing the 'basic examination' and the 'fetal neurosonogram'

Research paper thumbnail of COVID‐19‐related medicine utilization study in pregnancy: The COVI‐PREG cohort

British Journal of Clinical Pharmacology

AIM The objective of this study was to describe the use of COVID-19-related medicines during preg... more AIM The objective of this study was to describe the use of COVID-19-related medicines during pregnancy and their evolution between the early/late periods of the pandemic. METHODS Pregnant women who tested positive for SARS-CoV-2 from March 2020 to July 2021 were included using the COVI-PREG registry. Exposure to the following COVID-19-related medicines was recorded: antibiotics, antivirals, hydroxychloroquine, corticosteroids, anti-interleukin-6 and immunoglobulins. We described the prevalence of medicines used, by trimester of pregnancy, maternal COVID-19 severity level and early/late period of the pandemic (before and after 1 July 2020). FINDINGS We included 1964 pregnant patients who tested positive for SARS-CoV-2. Overall, 10.4% (205/1964) received at least one COVID-19-related medicine including antibiotics (8.6%; 169/1694), corticosteroids (3.2%; 62/1964), antivirals (2.0%; 39/1964), hydroxychloroquine (1.4%; 27/1964) and anti-interleukin-6 (0.3%; 5/1964). The use of at least one COVID-19-related medicine was 3.1% (12/381) in asymptomatic individuals, 4.2% (52/1233) in outpatients, 19.7% (46/233) in inpatients without oxygen, 72.1% (44/61) in those requiring standard oxygen, 95.7% (22/23) in those requiring high flow oxygen, 96.2% (25/26) in patients who required intubation and 57.1% (4/7) among patients who died. The proportion who received medicines to treat COVID-19 was higher before than after July 2020 (16.7% vs. 7.7%). Antibiotics, antivirals and hydroxychloroquine had lower rates of use during the late period. CONCLUSION Medicine use in pregnancy increased with disease severity. The trend towards increased use of corticosteroids seems to be aligned with changing guidelines. Evidence is still needed regarding the effectiveness and safety of COVID-19-related medicines in pregnancy.

Research paper thumbnail of Endothelial cell-derived interleukin-6 regulates tumor growth

BMC Cancer, 2014

Background: Endothelial cells play a complex role in the pathobiology of cancer. This role is not... more Background: Endothelial cells play a complex role in the pathobiology of cancer. This role is not limited to the making of blood vessels to allow for influx of oxygen and nutrients required for the high metabolic demands of tumor cells. Indeed, it has been recently shown that tumor-associated endothelial cells secrete molecules that enhance tumor cell survival and cancer stem cell self-renewal. The hypothesis underlying this work is that specific disruption of endothelial cell-initiated signaling inhibits tumor growth. Methods: Conditioned medium from primary human dermal microvascular endothelial cells (HDMEC) stably transduced with silencing RNA for IL-6 (or controls) was used to evaluate the role of endothelial-derived IL-6 on the activation of key signaling pathways in tumor cells. In addition, these endothelial cells were co-transplanted with tumor cells into immunodefficient mice to determine the impact of endothelial cell-derived IL-6 on tumor growth and angiogenesis. Results: We observed that tumor cells adjacent to blood vessels show strong phosphorylation of STAT3, a key mediator of tumor progression. In search for a possible mechanism for the activation of the STAT3 signaling pathway, we observed that silencing interleukin (IL)-6 in tumor-associated endothelial cells inhibited STAT3 phosphorylation in tumor cells. Notably, tumors vascularized with IL-6-silenced endothelial cells showed lower intratumoral microvessel density, lower tumor cell proliferation, and slower growth than tumors vascularized with control endothelial cells. Conclusions: Collectively, these results demonstrate that IL-6 secreted by endothelial cells enhance tumor growth, and suggest that cancer patients might benefit from targeted approaches that block signaling events initiated by endothelial cells.

Research paper thumbnail of Risk factors for anxiety and depression among pregnant women during COVID ‐19 pandemic—Results of a web‐based multinational cross‐sectional study

International Journal of Gynecology & Obstetrics

Research paper thumbnail of Title: Integrating sequential screening for placental dysfunction in the first and second trimester: Results of a cohort of unselected patients. Authors

Introduction/Objective: The consequences of placental dysfunction, manifested as preeclampsia (PE... more Introduction/Objective: The consequences of placental dysfunction, manifested as preeclampsia (PE) and/or fetal grouth restriction -are major causes of maternal and fetal morbidity and mortality. In the last decades, two screening strategies have been proposed to early identify patients at high risk for these complications. In the 80s, screening with uterine artery Doppler in the second trimester (18-24 weeks, S2) was described. More recently, it has been proposed to conduct a combined screening in the first trimester (11-13 weeks, S1), using maternal characteristics, mean arterial pressure, uterine artery Doppler and PAPP-A. Several groups have published results of these two methods separately, but there are fewer reports evaluating the combined performance of sequential screening in a low risk population. Methods: S1 was performed in 952 patients between 11 and 13 weeks and were scheduled to return for S2 in second trimester. Eleven patients had a spontaneous abortion and 295 pati...

Research paper thumbnail of Screening for late placental dysfunction with uterine artery Doppler at 28-34 weeks: Results of a prospective cohort

Research paper thumbnail of Comparing new and traditional definitions of fetal growth restriction: A retrospective analysis

Research paper thumbnail of GUIDELINES Sonographic examination of the fetal central nervous system: guidelines for performing the 'basic examination' and the 'fetal neurosonogram'