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Botelho F, Gripp K, Yanchar N, Naus A, Poenaru D, Baird R, Reis E, Farias L, Silva AG, Viana F, Neto JAP, Silva S, Ribeiro K, Gatto L, Faleiro MD, Fernandez MG, Salgado LS, Sampaio NZ, Faleiro MD, Mendes AL, Ferreira RV, Marcião L, Canto G, Borges J, Araújo V, Andrade G, Braga J, Bentes L, Pinto L, Ndasi HT, Amlani LM, Aminake G, Penda X, Tima S, Lechtig A, Agarwal-Harding KJ, Whyte M, Fowler-Woods M, Fowler-Woods A, Shingoose G, Hatala A, Daeninck F, Vergis A, Clouston K, Hardy K, Djadje L, Djoutsop OM, Djabo AT, Kanmounye US, Youmbi VN, Kakobo P, Djoutsop OM, Djabo AT, Kanmounye US, Tafesse S, Tamene B, Chimdesa Z, Alemayehu E, Abera B, Yifru D, Belachew FK, Tirsit A, Deyassa N, Moen BE, Sundstrøm T, Lund-Johansen M, Abebe M, Khan R, Mekasha A, Soklaridis S, Haji F, Asingei J, O'Flynn EP, O'Donovan DT, Masuka SC, Mashava D, Akello FV, Ulisubisya MM, Franco H, Njai A, Simister S, Joseph M, Woolley P, James D, Evans FM, Rai E, Roy N, Bansal V, Kamble J, Aroke A, David S, Veetil D, Soni KD, Wärnberg MG, Zadey S, Vissoci JRN, Iyer H, Zadey S, Shetty R, Zadey S, Jindal A, Iyer H, Ouma G, Shah SSNH, Hinchman C, Rayel IM, Dworkin M, Agarwal-Harding KJ, Mlinde E, Amlani LM, May CJ, Banza LN, Chokotho L, Agarwal-Harding KJ, Dworkin M, Mbomuwa F, Chidothi P, Martin C, Harrison WJ, Agarwal-Harding KJ, Chokotho L, Paek S, Amlani L, Mbomuwa F, Chidothi P, Martin C, Harrison WJ, Agarwal-Harding KJ, Chokotho L, Adégné T, Abdoulmouinou P, Amadou T, Youssouf T, Madiassa K, Younoussa DM, Moussa S, Amadou B, Hawa T, Laurent A, Jesuyajolu DA, Okeke CA, Obuh O, Jesuyajolu DA, Ehizibue PE, Ikemefula NE, Ekennia-Ebeh JO, Ibraham AA, Ikegwuonu OE, Diehl TM, Bunogerane GJ, Neal D, Ndibanje AJ, Petroze RT, Ntaganda E, Milligan L, Cairncross L, Malherbe F, Roodt L, Kyengera DK, O'Hara NN, Stockton D, Bedada A, Hsiao M, Chilisa U, Yarranton B, Chinyepi N, Azzie G, Moon J, Rehany Z, Bakhshi M, Bergeron A, Boulanger N, Watt L, Wong EG, Pawlak N, Bierema C, Ameh E, Bekele A, Jimenez MF, Lakhoo K, Roy N, Sacato H, Tefera G, Ozgediz D, Jayaraman S, Peric I, Youngson G, Ameh E, Borgstein E, O'Flynn E, Simoes J, Kingsley PA, Sasson L, Dekel H, Sternfeld AR, Assa S, Sarid RS, Mnong'one NJ, Sharau GG, Mongella SM, Caryl WG, Goldman B, Bola R, Ngonzi J, Ujoh F, Kihumuro RB, Lett R, Torquato A, Tavares C, Lech G, Džunic A, Ujoh F, Gusa V, Apeaii R, Noor R, Bola R, Guyan IO, Christilaw J, Hodgins S, Lett R, Binda C, Heo K, Cheng S, Foggin H, Hu G, Lam S, Feng L, Labinaz A, Adams J, Livergant R, Williams S, Vasanthakumaran T, Lounes Y, Mata J, Hache P, Schamberg-Bahadori C, Monytuil A, Mayom E, Joharifard S, Joos É, Paterson A, Maswime S, Hardy A, Pearse RM, Biccard BM, Salehi M, Zivkovic I, Jatana S, Joharifard S, Joos É, Flores MJ, Brown KE, Roberts HJ, Donnelley CA, von Kaeppler EP, Eliezer E, Haonga B, Morshed S, Shearer DW. Decolonizing Global SurgeryOvercoming barriers to pediatric trauma education in low-and middle-income countriesTaskforce on minor dermatological surgeries: an experience in a small Brazilian cityVasospasm and delayed cerebral ischemia management after subarachnoid hemorrhage in an underdeveloped country: Hustle or nightmare?Regional disparities in access and death rate of exploratory laparotomy in BrazilThe access of the riverside population in the Amazon region to emergency health care: a narrative reviewPeas: from Mendel’s table to the surgical fieldThe utility of low-cost negative pressure wound therapy in CameroonSacred sharing circles: urban Indigenous Manitobans’ experiences with bariatric surgeryUrological complications following gynecological procedures in Cameroon: a cross-sectional studyAccess to routine otolaryngology–head and neck surgery care in the Democratic Republic of Congo: a cross-sectional studyReducing surgical site infection among mothers who underwent cesarean section at Zewditu Memorial HospitalAddressing priorities for surgical research in Africa: implementation of a multicentre cloud-based perioperative registry in EthiopiaProspective study of surgery for traumatic brain injury in Addis Ababa, Ethiopia: surgical procedures, complications and postoperative outcomesNeurosurgery training in a low-income country: an evaluation of neurosurgical residents’ and graduates’ perspectives following completion of an international partnershipThe specialist anesthesiology workforce in East, Central and Southern Africa: a cross sectional studyScaling surgical resources: a preliminary analysis of orthopedic surgical care and C-arm baseline capacity analysis following the 2021 Haitian earthquakeDelivering essential surgical care for lower-limb musculoskeletal disorders in the low-resource settingRisk factors associated with mortality following geriatric trauma in urban India: a multicentre cohort studyMulti-methods modelling and construction of a novel access to surgical care index for rural IndiaUnderstanding equity in surgical care uptake and provision in underprivileged communities in India under Pradhan Mantri Jan Arogya Yojana (PMJAY)Prioritization of surgical care in national policies of India: a quantitative document analysisThe provision of labour pain management and its related barriers among maternal health care providers in a tertiary hospital in KenyaSafety, cost and regulation of re-used orthopedic devicesOutcomes of nonoperatively treated pediatric supracondylar humeral fractures at the Nkhotakota District Hospital, MalawiPredicting hospital of presentation for fracture management in MalawiFactors associated with surgical treatment of hip fractures in Malawian central hospitalsAnal disorders in pregnant and postpartum women: epidemiological, diagnostic and therapeutic aspects in 10 maternity hospitals in Bamako, MaliThe challenges faced by female surgeons in Africa: a narrative review of the existing literatureFactors affecting the utilization of antenatal services among women of reproductive age in a rural area in West AfricaImpact of intravenous access on sepsis and death among surgical neonates in Kigali, RwandaBreast cancer surgical services in South AfricaUnreamed intramedullary nailing versus external fixation for the treatment of open tibial shaft fractures in Uganda: a randomized clinical trialSurgical simulation training for medical students: strategies and implications in BotswanaDisparities in trauma outcomes for Indigenous Peoples in Canada: a systematic review and meta-analysisDevelopment of universal academic competencies for the global surgeon: a modified Delphi consensus studyPAPSEP — Pan-African Paediatric Surgery E-Learning ProgrammeCatastrophic expenditure and treatment attrition in patients seeking colorectal cancer treatment in India: a prospective multicentre studyAccess to pediatric cardiac care in TanzaniaAn evaluation of obstetrical data collection at health institutions in Mbarara region, Uganda, and Benue State, NigeriaAssociation of socioeconomic vulnerability among pregnant women with death rate by postpartum hemorrhage in Minas Gerais, BrazilThe efficiency of digital midwifery training: a randomized controlled trial in Benue State, NigeriaCreating concise reference videos for a low-resource Essential Surgical Skills Training Program: a MSF-UBC Global Surgery Laboratory CollaborationSurgical outcomes for women in Africa: an international risk-adjusted analysis of prospective observational cohortsUpdate on the evaluation of a surgical task-sharing program in South SudanEstimating the indirect economic impact of fracture-related infection and/or nonunion: a secondary analysis of the Pilot Local Gentamicin for Open Tibial Fractures in Tanzania (pGO-Tibia). Can J Surg 2022; 65:S1-S18. [PMID: 35961679 PMCID: PMC9388215 DOI: 10.1503/cjs.007622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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Borges J, Sautier C, Krebs-Drouot L, Henry P, Paysant F, Scolan V. Death and non-lethal weapons: A case of homicide by penetrating injury without projectile. Forensic Sci Int 2022; 337:111374. [PMID: 35839685 DOI: 10.1016/j.forsciint.2022.111374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 05/09/2022] [Accepted: 06/26/2022] [Indexed: 11/27/2022]
Abstract
Herein, we report the death of a man, approximately thirty years old, victim of a short-range shot to the thorax from a PIEXON JPX4, a hand weapon classed category D in France, said to be non-lethal. External examination of the lesion revealed characteristics similar to those of ballistic injuries. The autopsy found an intercostal wound that reached the pulmonary parenchyma and the pulmonary artery, with severe hemothorax. By the end of the autopsy, no projectile had been found in the body, nor any exit orifice. Death was caused by the effects of hemorrhagic shock. The PIEXON JPX4 has four cartridges, projecting a capsaicin gel that is designed to irritate the ENT area (ear nose throat) to incapacitate an assailant. The manufacturer recommends not to use it at distances of less than 1.5 m. Experimental shots were performed on gelatine blocks at point-blank range and at distances of 5, 10, 20, 30, 50, 100 and 150 cm to evaluate the distance necessary for the jet of gel to have a penetrating effect. Shots at 5-30 cm penetrated the structure. None of the other shots were penetrating. The autopsy and experiment data therefore show the penetrating potential of the jet of gel. Herein, we report the first death due to use of the PIEXON JPX4. From a forensic investigation viewpoint, we add a new exception to the "bullet rule". (The odd and even bullet rule states that if the number of gunshot wounds of entrance and exit found in the body is even, the presumption is that no bullet is lodged in the body. If the number of gunshot wounds of entrance and exit is odd, the presumption is that one or more bullets have been lodged in the body.).
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Leite RA, Costa A, Borges J, Alcafache J, Mesquita A. Electroconvulsive therapy as life-saving in an acute catatonic syndrome associated with bipolar disorder: A case report. Eur Psychiatry 2021. [PMCID: PMC9480219 DOI: 10.1192/j.eurpsy.2021.2072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Catatonia is a neuropsychiatric syndrome characterized by an onset of a dysfunction in psychomotor activity and/or muscle tone, which may be associated with changes in consciousness, affect, and thinking. It is characterized by negativism, wax flexibility, catalepsy, mutism echolalia, ecopraxia, or stupor. It was first described in 1874 by Kahlbaum, who characterized it as specific motor disorder associated with different psychiatric disorders. Kraepelin and Bleuler restricted catatonia to a specific subtype of schizophrenia. However, the association between catatonia and other disorders, notably mood disorders, has been reinstated, including Bipolar Disorder. Its etiology is multiple and there are two severe forms: Neuroleptic Malignant Syndrome (NMS) and Malignant Catatonia (MC). These are syndromes that present high mortality, and the health professional should be aware of its etiology, signs, symptoms, evaluation and treatment. Objectives The aim of this work is to present a clinical case of MC, who was sustained by literature included on scientific platforms. Methods Case report Results
It is essential to recognize the different clinical presentations of catatonia, taking into account that these are psychiatric alterations in which urgent intervention is justified. In the presented case, the use of antipsychotic medication has worsened the motor function and its suspension, associated with the introduction of lorazepam, resulted in a slight improvement. The electroconvulsive therapy was the last resort, fully succeeded. Conclusions The relationship between SMN and Catatonia/MC remains nuclear from a psychopathological and pathophysiological point of view. Nevertheless, there is general agreement that catatonia represents a very significant risk factor for NMS. Disclosure No significant relationships.
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Borges J, Leite RA, Almeida M, Morais S, Madeira N. Attention deficit hyperactivity disorder in adulthood and the heritability of this condition. Eur Psychiatry 2021. [PMCID: PMC9479830 DOI: 10.1192/j.eurpsy.2021.1638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Attention Deficit Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder characterized by inattention and/or hyperactivity-impulsivity resulting from the interaction of genetic and environmental risk factors. Family studies shows that persistent ADHD is very familial. Objectives We aim to review the literature on this condition and its heritability and describe the implications that a possible misdiagnosis can have during life. Methods Bibliography review was performed using the databases PubMed and Cochrane, using the following keywords: “ADHD”; “Adults”; “Heretability”; “Family” and “Rater effect”. Results
Childhood ADHD persists into adolescence and adulthood substantially, identified in some studies, as going up to 78%. The prevalence of ADHD in children and adults is between 2.5% and 5% worldwide. Family studies have shown that children of adults with ADHD are at higher risk of having ADHD. Some large-scale twin studies of adult ADHD, used self-report assessments of ADHD symptoms and estimated the heritability of this condition to be between 30 to 40%, which differs from other studies that analyse parents and teachers responses and estimates heritability to be between 60 and 90%. Conclusions Since there is a direct influence of the evaluators in estimating the extent of ADHD heritability, future studies need to clarify and describe in detail all the related characteristics of the raters. Although ADHD is widely studied, there is still a lot to learn about its etiology. The diagnosis of ADHD is clinical and complex and must be considered both in childhood and adolescence and in adulthood, with special emphasis on the family antecedents. Disclosure No significant relationships.
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Leite RA, Costa A, Borges J, Mesquita A. Clozapine in severe psychotic disorders: Balancing safety with efficacy. Eur Psychiatry 2021. [PMCID: PMC9479940 DOI: 10.1192/j.eurpsy.2021.2053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Clozapine is a member of the dibenazepine class of antipsychotic drugs and has been designated an atypical antipsychotic drug. Clinical studies have shown that clozapine is effective in ameliorating the core symptoms, as well as the negative symptoms, in severe psychotic disorders and is therapeutically effective in treating about 30% of schizophrenic patients who are resistant to standard antipsychotic drugs. Objectives The goal is to review pharmacology, efficacy, and clinical use of clozapine, such as its side effects, and the benefit-to-risk ratio of this antipsychotic drug. Methods Non-systematic literature review based on scientific databases such as PubMed, using key words such as “clozapine”, “efficacy”, “side effects” and “resistant schizophrenia”. Results Clozapine was developed as the first atypical antipsychotic with activity for both the negative and positive symptoms of schizophrenia. The primary indications for clozapine are treatment-resistant psychotic disorder, defined as persistent moderate to severe delusions or hallucinations despite two or more clinical trials with other antipsychotic drugs, and patients who are at high risk for suicide. Concerns over a number of safety considerations are responsible for much of the underutilization of clozapine, such as agranulocytosis, metabolic side effects and myocarditis. These side effects can be detected, prevented, minimized and treated, but there will be a very small number of fatalities. Conclusions Awareness of the benefits and risks of clozapine is essential for increasing the use of this lifesaving agent. Disclosure No significant relationships.
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Leite RA, Almeida M, Borges J, Costa A. Lithium in severe affective disorders: Balancing safety with efficacy. Eur Psychiatry 2021. [PMCID: PMC9480386 DOI: 10.1192/j.eurpsy.2021.2060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionLithium has been one of the oldest substances used in psychiatric treatments and remains the first-line treatment for prevention of manic and depressive episodes of bipolar disorder (BD), but it has also a wide spectrum of side-effects.ObjectivesThe goal is to review efficacy, and clinical use of lithium, such as its side effects, and its benefit-to-risk ratio.MethodsNon-systematic literature review based on scientific databases such as PubMed.ResultsThe first modern use of lithium was for the treatment of mania. Lithium has also proven useful in major depression, particularly for augmentation of antidepressants, for aggressive behavior and it has a specific antisuicide effect. Lithium’s prophylactic and antisuicidal effects are most unique. However, the use of lithium became problematic due to the serious toxicity since lithium also a narrow therapeutic index, with therapeutic levels between 0.6 and 1.5 mEq/L.ConclusionsAwareness of the benefits and risks of lithium is essential for the use of this lifesaving agent. Lithium levels must be carefully monitored and lithium dosage adjusted as necessary.DisclosureNo significant relationships.
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Silva E, Borges J, Moreira T, Rodrigues M, Souza A. Prevalência e fatores de risco associados ao acidente vascular cerebral em pessoas com hipertensão arterial: uma análise hierarquizada. REVISTA DE ENFERMAGEM REFERÊNCIA 2020. [DOI: 10.12707/rv20014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Sobral T, Galvão T, Borges J. Visualization of Urban Mobility Data from Intelligent Transportation Systems. SENSORS 2019; 19:s19020332. [PMID: 30650641 PMCID: PMC6359619 DOI: 10.3390/s19020332] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/02/2019] [Accepted: 01/10/2019] [Indexed: 11/16/2022]
Abstract
Intelligent Transportation Systems are an important enabler for the smart cities paradigm. Currently, such systems generate massive amounts of granular data that can be analyzed to better understand people’s dynamics. To address the multivariate nature of spatiotemporal urban mobility data, researchers and practitioners have developed an extensive body of research and interactive visualization tools. Data visualization provides multiple perspectives on data and supports the analytical tasks of domain experts. This article surveys related studies to analyze which topics of urban mobility were addressed and their related phenomena, and to identify the adopted visualization techniques and sensors data types. We highlight research opportunities based on our findings.
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Real AC, Borges J, Oliveira CB. Estimation of daily mean temperatures: an accurate method for the Douro Valley. CIÊNCIA E TÉCNICA VITIVINÍCOLA 2018. [DOI: 10.1051/ctv/20183302167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Air temperature data from many locations worldwide are only available as series of daily minima and maxima temperatures. Historically, several different approaches have been used to estimate the actual daily mean temperature, as only in the last two or three decades automatic thermometers are able to compute its actual value. The most common approach is to estimate it by averaging the daily minima and maxima. When only daily minima and maxima are available, an alternative approach, proposed by Dall’Amico and Hornsteiner in 2006, uses the two daily extremes together with next day minima temperature and a coefficient related to the local daily astronomical sunset time. Additionally, the method uses two optimizable coefficients related to the region’s temperature profile. In order to use this approach it is necessary to optimize the region’s unknown parameters. For this optimization, it is necessary a dataset containing the maxima, minima, and the actual daily mean temperatures for at least one year. In this research, for the period 2007-2014, we used three datasets of minima, maxima and actual mean temperatures obtained at three automatic meteorological stations located in the Douro Valley to optimize the two unknown parameters in the Dall’Amico and Hornsteiner approach. Moreover, we compared the actual mean daily temperatures available from the three datasets with the correspondent values estimated by using i) the usual approach of averaging the daily maxima and minima temperatures and ii) the Dall’Amico and Hornsteiner approach. Results show that the former approach overestimates, on average, the daily mean temperatures by 0.5ºC. The Dall’Amico and Hornsteiner approach showed to be a better approximation of mean temperatures for the three meteorological stations used in this research, being unbiased relative to the actual mean values of daily temperatures. In conclusion, this research confirms that the Dall’Amico and Hornsteiner is a better approach to estimate the mean daily temperatures and provides the optimized parameters for three sites located at each of the three sub-regions of the Douro Valley (Baixo Corgo, Cima Corgo and Douro Superior).
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Salgado B, Pereira R, Pereira N, Lopes A, Borges J, Filho S, Lalwani P. Seroprevalence of Hantavirus infection in residents individuals of municipalities of Amazonas state. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Frisoli A, Borges J, Martim F, Nakahara N, Soufen H, Colombo F, Carvalho ACC. P2244Normal blood pressure by ACC/AHA 2017 is associated with higher mortality in older adults with hypertension over 1 year. Results of the SARCOS study. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Rodrigues AM, Canhão H, Marques A, Ambrósio C, Borges J, Coelho P, Costa L, Fernandes S, Gonçalves I, Gonçalves M, Guerra M, Marques ML, Pimenta S, Pinto P, Sequeira G, Simões E, Teixeira L, Vaz C, Vieira-Sousa E, Vieira R, Alvarenga F, Araújo F, Barcelos A, Barcelos F, Barros R, Bernardes M, Canas da Silva J, Cordeiro A, Costa M, Cunha-Miranda L, Cruz M, Duarte AC, Duarte C, Faustino A, Figueiredo G, Fonseca JE, Furtado C, Gomes J, Lopes C, Mourão AF, Oliveira M, Pimentel-Santos FM, Ribeiro A, Sampaio da Nóvoa T, Santiago M, Silva C, Silva-Dinis A, Sousa S, Tavares-Costa J, Terroso G, Vilar A, Branco JC, Tavares V, Romeu JC, da Silva J. Portuguese recommendations for the prevention, diagnosis and management of primary osteoporosis - 2018 update. ACTA REUMATOLOGICA PORTUGUESA 2018; 43:10-31. [PMID: 29602163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Advances in osteoporosis (OP)case definition, treatment options, optimal therapy duration and pharmacoeconomic evidence in the national context motivated the Portuguese Society of Rheumatology (SPR) to update the Portuguese recommendations for the diagnosis and management of osteoporosis published in 2007. METHODS SPR bone diseases' working group organized meetings involving 55 participants (rheumatologists, rheumatology fellows and one OP specialist nurse) to debate and develop the document. First, the working group selected 11 pertinent clinical questions for the diagnosis and management of osteoporosis in standard clinical practice. Then, each question was investigated through literature review and draft recommendations were built through consensus. When insufficient evidence was available, recommendations were based on experts' opinion and on good clinical practice. At two national meetings, the recommendations were discussed and updated. A draft of the recommendations full text was submitted to critical review among the working group and suggestions were incorporated. A final version was circulated among all Portuguese rheumatologists before publication and the level of agreement was anonymously assessed using an online survey. RESULTS The 2018 SPR recommendations provide comprehensive guidance on osteoporosis prevention, diagnosis, fracture risk assessment, pharmacological treatment initiation, therapy options and duration of treatment, based on the best available evidence. They attained desirable agreement among Portuguese rheumatologists. As more evidence becomes available, periodic revisions will be performed. Target audience and patient population: The target audience for these guidelines includes all clinicians. The target patient population includes adult Portuguese people. Intended use: These recommendations provide general guidance for typical cases. They may not be appropriate in all situations - clinicians are encouraged to consider this information together with updated evidence and their best clinical judgment in individual cases.
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Sepriano A, Ramiro S, van der Heijde D, Ávila-Ribeiro P, Fonseca R, Borges J, Teixeira L, Carvalho PD, Cerqueira M, Neves J, Meirinhos T, Barcelos A, Sequeira G, Salvador MJ, Canas da Silva J, Santos H, Bernardes M, Vieira-Sousa E, Canhão H, Branco JC, Pimentel-Santos F, Landewé R. Effect of Comedication With Conventional Synthetic Disease-Modifying Antirheumatic Drugs on Retention of Tumor Necrosis Factor Inhibitors in Patients With Spondyloarthritis: A Prospective Cohort Study. Arthritis Rheumatol 2017; 68:2671-2679. [PMID: 27273894 DOI: 10.1002/art.39772] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 05/26/2016] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To evaluate whether use of comedication with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) influences the retention of tumor necrosis factor inhibitors (TNFi) in patients with spondyloarthritis (SpA). METHODS Patients with SpA from the Rheumatic Diseases Portuguese Register who started treatment with their first TNFi between 2001 and 2014 were included in this study. Cox regression analysis was used to estimate the effect of comedication with csDMARDs on TNFi retention in 2 types of models: a model in which baseline (time-fixed) variables were included, and a second model incorporating time-varying variables, including sociodemographic features, measures of disease activity, measures of physical function, and cotreatment with other drugs (nonsteroidal antiinflammatory drugs and oral steroids). To control for possible confounding by indication, the effect of csDMARD comedication on TNFi retention was also tested after adjustment for the treatment propensity score. RESULTS In total, 954 patients were included in the study, of whom 289 (30.3%) discontinued treatment with their first TNFi after a median follow-up time of 2.5 years (range 0.08-13 years). Inefficacy was the most common reason for TNFi discontinuation (55.7% of patients). In the multivariable analyses, comedication with csDMARDs had no measurable effect on TNFi retention, neither in the baseline model (hazard ratio [HR] 0.83, 95% confidence interval [95% CI] 0.59-1.16) nor during follow-up in the model adjusted for time-varying covariates (HR 1.07, 95% CI 0.68-1.68). The effect of csDMARD comedication remained nonsignificant after propensity score adjustment. CONCLUSION Comedication with csDMARDs does not prolong TNFi retention in patients with SpA in clinical practice, suggesting that there is no benefit conferred by the concomitant use of these drugs.
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Leite R, Macedo P, Borges J, Santos T. Depression across DSM and ICD editions: Psychiatric nosology's ‘Black Dog’. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
IntroductionThe diagnosis of depressive disorders has suffered important modifications throughout DSM and ICD editions. The history of those modifications is an important subject to fully understand the current diagnostic criteria and classification, with milestones often set not by scientific or theoretical data but rather by political decision and conflicting interests.ObjectiveThe authors propose a review of how the concept of major depression has evolved along the several DSM and ICD editions.MethodsThe results were obtained searching literature included on the platforms PubMed, Google Scholar, PsycINFO and Psychology and Behavioral Sciences Collection.ResultsThe current diagnostic entity lacks validity and utility and that is an obstacle to both scientific research and clinical practice.ConclusionThe authors also discuss alternative models which may contribute to a paradigm shift more suitable to clinical reality and to provide a useful framework for all levels of research.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Mourão A, Ribeiro C, Borges J, Gonçalves M, Bernardes M, Fernandes S, Dezerto R, Laires P, Machado P, Eusébio M, Santos M, Canhão H. AB0297 Real-Life Effectiveness of Golimumab in Biologic-Naïve Rheumatoid Arthritis Patients – Data from reuma.pt, A Portuguese Registry. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sepriano A, Ramiro S, van der Heijde D, Άvila-Ribeiro P, Fonseca R, Borges J, Teixeira L, Carvalho P, Cerqueira M, Neves J, Meirinhos T, Barcelos A, Sequeira G, Salvador M, Canas da Silva J, Santos H, Bernardes M, Vieira-Sousa E, Canhão H, Branco J, Pimentel-Santos F, Landewé R. OP0112 Effect of Comedication with Conventional Synthetic Dmards on Tnf Inhibitors-Retention in Patients with Spondyloarthritis: A Prospective Cohort. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Fernandes S, Borges J, Silva C, Simões E, Micaelo M, Barcelos F, Madeira H, Vaz Patto J, Cunha Miranda L, Sousa M, Cortes S, Faustino A. THU0536 Remission and Re-Treatment of Patients with Paget's Disease of Bone Treated with Zolendronic Acid – A Single Center 10 Year Experience. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.6083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Borges J, Pereira A, Borges D, Cabral A, Martins M, Bento E, Macedo A. Regret Anticipation Failures Scale (RAFS): Validation of the Portuguese version. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
IntroductionFailures in regret anticipation undermine regret avoidance, increasing regret frequency and ultimately the risk of regret-related problems. The Regret Anticipation Failures Scale (RAFS; Schmidt and Linden, 2011) was developed to evaluate interindividual differences in regret anticipation.ObjectiveTo investigate the psychometric properties of the RAFS Portuguese version.MethodsA community sample composed of 108 university students and 79 employees (78.1% females; mean age = 33.16 ± 13.175; range: 17–62) answered the Portuguese preliminary version of the RAFS. To study the temporal stability, 31 participants (83.9% females; mean age = 26.54 ± 18.761) answered the RAFS again after approximately 6 weeks.ResultsThe RAFS Cronbach alpha was “very good” (a = 0.81). All the items presented significant correlations with the total (excluding the item; > 0.20); only item 2 (Even when I’m stressed, I can foresee the regrets that certain behaviors could evoke in me) had the effect of lowering the internal consistency if deleted. The test-retest correlation coefficient was high, positive and significant (0.61; P < 0.001); there was not significant difference between test and re-test scores [14.26 ± 5.170 vs. 13.06 ± 4.761, t (30) = 1.532, P = 0.136]. Following Kaiser and Cattel Scree Plot criteria, only one factor was extracted, meaning that the scale is unidimensional.ConclusionsThe Portuguese version of RAFS has good reliability and construct validity. It could be very useful both in clinical and research contexts, namely in an ongoing project on the relationship between regret, personality and psychological distress.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Real AC, Borges J, Cabral JS, Jones GV. Partitioning the grapevine growing season in the Douro Valley of Portugal: accumulated heat better than calendar dates. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2015; 59:1045-1059. [PMID: 25344018 DOI: 10.1007/s00484-014-0918-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 08/12/2014] [Accepted: 10/07/2014] [Indexed: 06/04/2023]
Abstract
Temperature and water status profiles during the growing season are the most important factors influencing the ripening of wine grapes. To model weather influences on the quality and productivity of the vintages, it is necessary to partition the growing season into smaller growth intervals in which weather variables are evaluated. A significant part of past and ongoing research on the relationships between weather and wine quality uses calendar-defined intervals to partition the growing season. The phenology of grapevines is not determined by calendar dates but by several factors such as accumulated heat. To examine the accuracy of different approaches, this work analyzed the difference in average temperature and accumulated precipitation using growth intervals with boundaries defined by means of estimated historical phenological dates and intervals defined by means of accumulated heat or average calendar dates of the Douro Valley of Portugal. The results show that in situations where there is an absence of historical phenological dates and/or no available data that makes the estimation of those dates possible, it is more accurate to use grapevine heat requirements than calendar dates to define growth interval boundaries. Additionally, we analyzed the ability of the length of growth intervals with boundaries based on grapevine heat requirements to differentiate the best from the worst vintage years with the results showing that vintage quality is strongly related to the phenological events. Finally, we analyzed the variability of growth interval lengths in the Douro Valley during 1980-2009 with the results showing a tendency for earlier grapevine physiology.
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Gonçalves MJ, Sousa S, Inês LS, Duarte C, Borges J, Silva C, Romão VC, Terroso G, Bernardes M, Cerqueira M, Raposo A, Sequeira G, Barcelos A, Macieira C, Canas da Silva J, Costa L, Pereira da Silva JA, Cunha-Miranda L, Da Silva JAP, Canhão H, Santos MJ. Characterization of damage in Portuguese lupus patients: analysis of a national lupus registry. Lupus 2014; 24:256-62. [DOI: 10.1177/0961203314555172] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background: Although the survival rate has considerably improved, many patients with systemic lupus erythematosus (SLE) develop irreversible organ damage. Objectives: The objectives of this paper are to characterize cumulative damage in SLE patients and identify variables associated with its presence and severity. Methods: A cross-sectional analysis of SLE patients from the Portuguese Lupus register Reuma.pt/SLE in whom damage assessment using the SLICC/ACR-Disability Index (SDI) was available was performed. Predictor factors for damage, defined as SDI ≥ 1, were determined by logistic regression analyses. A sub-analysis of patients with severe damage (SDI ≥ 3) was also performed. Results: In total, 976 patients were included. SDI was ≥1 in 365 patients, of whom 89 had severe damage. Musculoskeletal (24.4%), neuropsychiatric (24.1%) and ocular (17.2%) domains were the most commonly affected. Older age, longer disease duration, renal involvement, presence of antiphospholipid antibodies and current therapy with steroids were independently associated with SDI ≥ 1. The subpopulation with severe damage had, in addition, a greater interval between the first manifestation attributable to SLE and the clinical diagnosis as well as and more frequently early retirement due to SLE. Conclusions: This large lupus cohort confirmed that demographic and clinical characteristics as well as medication are independently associated with damage. Additionally, premature retirement occurs more often in patients with SDI ≥ 3. Diagnosis delay might contribute to damage accrual.
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Polzin P, Borges J, Coelho A. An Extended Kernel Density Two-Step Floating Catchment Area Method to Analyze Access to Health Care. ACTA ACUST UNITED AC 2014. [DOI: 10.1068/b120050p] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In Portugal the distribution of physicians is considered an appropriate proxy for the distribution of the actual hospital resources and additional information on hospital supply is mostly unavailable, while health care utilization data are also usually absent. A suitable method that can be used to analyze patients' access to hospital health care in countries with such characteristics is the two-step floating catchment area (2SFCA) method, since it requires only the number of physicians to represent supply and the population size to estimate demand. An improved version of the 2SFCA method is the kernel density 2SFCA (KD2SFCA) method. However, this method was not developed to analyze access to health care and it computes scores that express only the spatial access dimensions of proximity and availability. In this paper we present a new method, based on the KD2SFCA method, which improves health care access analysis and better identifies populations that are less empowered to use health care. We adapt the KD2SFCA method for the context of health care access analysis and extend it to capture additional access dimensions. We applied the extended method to the Portuguese hospital health care sector in a case study, and compared its results with those obtained with the KD2SFCA method. Our method was able to improve the identification of the less empowered populations and discovered that they represent 8.1% of the total population, instead of 4.6%, and reside in sixteen of the eighteen Portuguese districts, instead of in thirteen, as identified by the original KD2SFCA method. By improving the KD2SFCA method for the identification of the less empowered populations, our method can be a first step in an endeavor to identify opportunities to increase the health care supply or to redistribute supply resources, with the objective of increasing the access of those deprived populations.
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Cunha-Miranda L, Cardoso A, Fernandes S, Borges J, Fernandes R, Simão R, Vila I, Barcelos F, Santos H, Simões E, Vaz-Patto J. AB1072 Work Disability, Productivity, Presenteeism and Absenteeism in Rheumatic Patients. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cunha-Miranda L, Silva C, Santos H, Barcelos F, Miguel C, Borges J, Fernandes S, Trinca R, Vicente V, Aguiar P. AB1070 SF-36: is There A Difference between Paper and Touch-Screen Evaluation? Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Borges J, Fernandes S, Gonçalves I, Cardoso A, Simão R, Fernandes R, Vila I, Pires G, Barcelos F, Cunha-Miranda L, Santos H, Leitão R, Coelho P, Parente M, Simões E, Vaz Patto J. SAT0475 Serum Protein Levels, Fall Occurrence, Bone Fractures and Nutrition in Rheumatic Patients – is There Any Relationship? Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Cunha-Miranda L, Barcelos F, Miguel C, Silva C, Santos H, Fernandes S, Borges J, Trinca R, Vicente V, Aguiar P. AB1071 The Use of Visual Analogue Scale in Rheumatic Disease: Validation of an Electronic Version: Table 1. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.5384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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