1
|
Ferreira BR, Vulink N, Mostaghimi L, Jafferany M, Balieva F, Gieler U, Poot F, Reich A, Romanov D, Szepietowski JC, Tomas-Aragones L, Campos R, Tausk F, Zipser M, Bewley A, Misery L. Classification of psychodermatological disorders: Proposal of a new international classification. J Eur Acad Dermatol Venereol 2024; 38:645-656. [PMID: 38084889 DOI: 10.1111/jdv.19731] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/17/2023] [Indexed: 03/26/2024]
Abstract
INTRODUCTION Several classifications of psychodermatology disorders have been proposed, with most of them based on two to four main disorder category groups. However, there is, to date, no classification that has resulted from a consensus established by psychodermatology experts. The DSM-5-TR (Diagnostic and statistical manual of mental disorders (5th ed.), Text Revision) and the ICD-11 (International classification of diseases (11th revision)) also do not provide a systematized approach of psychodermatology disorders. Taking into consideration that classifications are a key pillar for a comprehensive approach to the pathologies of each branch of medicine, the proposal of a classification in psychodermatology appeared as a central need for the recognition of psychodermatological disorders, in an attempt to improve their recognition and, in that sense, to find a common language for the development of this subspecialty that crosses dermatology and psychiatry. METHODS Previously published classifications in psychodermatology were critically reviewed and discussed by expert opinion from an international multidisciplinary panel of 16 experts in psychodermatology and a new classification system is proposed, considering classical concepts in general dermatology and psychopathology. RESULTS Two main categories of disorders are presented (a main group related to primary mental health disorders and another main group related to primary skin disorders), which are subsequently subdivided into subgroups considering pathophysiological and phenomenological similarities, including key aspects of dermatological examination, namely the presence of visible skin lesions (primary and secondary skin lesions) and psychopathological correlates. CONCLUSION This new classification aims to unify previous classifications, systematize the disorders that belong to psychodermatology and highlight their tenuous boundaries, to improve their management. It has been built and approved by the Psychodermatology Task Force of the European Academy of Dermatology and Venereology (EADV), the European Society for Dermatology and Psychiatry (ESDaP) and the Association for Psychoneurocutaneous Medicine of North America (APMNA).
Collapse
|
2
|
Santana B, Campos R, Amorim E, Jorge A, Silvano P, Nunes S. A survey on narrative extraction from textual data. Artif Intell Rev 2023. [DOI: 10.1007/s10462-022-10338-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
AbstractNarratives are present in many forms of human expression and can be understood as a fundamental way of communication between people. Computational understanding of the underlying story of a narrative, however, may be a rather complex task for both linguists and computational linguistics. Such task can be approached using natural language processing techniques to automatically extract narratives from texts. In this paper, we present an in depth survey of narrative extraction from text, providing a establishing a basis/framework for the study roadmap to the study of this area as a whole as a means to consolidate a view on this line of research. We aim to fulfill the current gap by identifying important research efforts at the crossroad between linguists and computer scientists. In particular, we highlight the importance and complexity of the annotation process, as a crucial step for the training stage. Next, we detail methods and approaches regarding the identification and extraction of narrative components, their linkage and understanding of likely inherent relationships, before detailing formal narrative representation structures as an intermediate step for visualization and data exploration purposes. We then move into the narrative evaluation task aspects, and conclude this survey by highlighting important open issues under the domain of narratives extraction from texts that are yet to be explored.
Collapse
|
3
|
Britto-Júnior J, Lima AT, Santos-Xavier JS, Gonzalez P, Mónica FZ, Campos R, Souza VBD, Schenka AA, Antunes E, Nucci GD. Relaxation of thoracic aorta and pulmonary artery rings of marmosets (Callithrix spp.) by endothelium-derived 6-nitrodopamine. Braz J Med Biol Res 2023; 56:e12622. [PMID: 37042871 PMCID: PMC10085761 DOI: 10.1590/1414-431x2023e12622] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/21/2023] [Indexed: 04/13/2023] Open
Abstract
6-Nitrodopamine is a novel catecholamine released by vascular tissues, heart, and vas deferens. The aim of this study was to investigate whether 6-nitrodopamine is released from the thoracic aorta and pulmonary artery rings of marmosets (Callithrix spp.) and to evaluate the relaxing and anti-contractile actions of this catecholamine. Release of 6-nitrodopamine, dopamine, noradrenaline, and adrenaline was assessed by liquid chromatography with tandem mass spectrometry (LC-MS/MS). The relaxations induced by 6-nitrodopamine and by the selective dopamine D2 receptor antagonist L-741,626 were evaluated on U-46619 (3 nM)-pre-contracted vessels. The effects of 6-nitrodopamine and L-741,626 on the contractions induced by electric-field stimulation (EFS), dopamine, noradrenaline, and adrenaline were also investigated. Both aorta and pulmonary artery rings exhibited endothelium-dependent release of 6-nitrodopamine, which was significantly reduced by the NO synthesis inhibitor L-NAME. Addition of 6-nitrodopamine or L-741,626 caused concentration-dependent relaxations of both vascular tissues, which were almost abolished by endothelium removal, whereas L-NAME and the soluble guanylate cyclase inhibitor ODQ had no effect on 6-nitrodopamine-induced relaxations. Additionally, pre-incubation with 6-nitrodopamine antagonized the dopamine-induced contractions, without affecting the noradrenaline- and adrenaline-induced contractions. Pre-incubation with L-741,626 antagonized the contractions induced by all catecholamines. The EFS-induced contractions were significantly increased by L-NAME, but unaffected by ODQ. Immunohistochemical assays showed no immunostaining of the neural tissue markers S-100 and calretinin in either vascular tissue. The results indicated that 6-nitrodopamine is the major catecholamine released by marmoset vascular tissues, and it acts as a potent and selective antagonist of dopamine D2-like receptors. 6-nitrodopamine release may be the major mechanism by which NO causes vasodilatation.
Collapse
|
4
|
Costa JC, Campos R, Castro Â, Farinha A, Oliveira GNDP, Araujo JP, Santos LB. The Effect of Ionic Liquids on the Nucleation and Growth of Perylene Films Obtained by Vapor Deposition. CrystEngComm 2023. [DOI: 10.1039/d2ce01495e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Microdroplets and thin films of imidazolium-based ionic liquids (ILs) of different sizes and shapes were used as confining agents for the formation of high-quality perylene crystals by vapor deposition. The...
Collapse
|
5
|
Escobar JC, Maturana D, Campos R, Urrego R, Torres V. 43 Resveratrol during the warming process improves the quality of. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
|
6
|
Amaya LM, Campos R, Urrego R, Velez M, Torres V. 209 Supplementation of the. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
|
7
|
Monteiro MR, Nunes NCC, Crespo J, Abrahão ABK, Buscacio G, Lerner LCC, Sermoud L, Arakelian R, Piotto G, Lemos C, Campos R, Victorino D, Andrade PM, Ferreira TAV, Pecoraro JP, Meton F, Gaui MF, Araujo LH. Patient-centered Outcomes in Breast Cancer: Description of EQ-5D-5L and EORTC-QLQ-BR23 Measurements in Real-world Data and Their Association With Survival. Clin Oncol (R Coll Radiol) 2022; 34:608-616. [PMID: 35667940 DOI: 10.1016/j.clon.2022.05.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/25/2022] [Accepted: 05/18/2022] [Indexed: 11/27/2022]
Abstract
AIMS In recent years, major improvements in breast cancer treatments have led to a significant increase in survival. Despite that, this population's quality of life (QoL) information is lacking, especially real-world data. MATERIALS AND METHODS This was a prospective, multicentre, observational study of female breast cancer patients, without prior systemic treatment, treated between 2012 and 2019 in private health care in Brazil. QoL was assessed by two questionnaires, the EQ-5D-5L and the EORTC-QLQ-BR23. Additional data were retrospectively collected. RESULTS The study comprised 1372 patients, most with early-stage disease (80.2% stages 0-II). At a median follow-up of 25.6 months, the estimated 3-year overall survival was 93.6%. Patients with locally advanced and metastatic breast cancer had the lowest visual analogue scale scores and the highest symptom burden in all dimensions of EQ-5D-5L, but with the most significant improvement after treatment. With the EORTC-QLQ-BR23 questionnaire, patients undergoing lumpectomy had a better perception of body image. Axillary dissection led to greater arm symptoms after 12 months, radiotherapy enhanced breast symptoms and patients treated with chemotherapy had significant worsening in the effects of systemic therapy compared with endocrine or HER2 therapy. Staging and immunohistochemical subtype correlated with survival and with several QoL parameters, but overall survival was not independently affected by patient-reported outcomes in this cohort. CONCLUSION Our results show that early diagnosis and access to treatments with fewer side-effects, such as endocrine or targeted therapy, and less aggressive surgeries are the best strategies to achieve a better QoL for breast cancer patients.
Collapse
|
8
|
Facio FN, Warick Facio MF, Nagle Spessoto AC, Godoy M, Tessaro H, Campos R, Zanatto D, Calmon M, Rahal P, Fava Spessoto LC. Clinical and Molecular Profile of Patients With Condyloma Acuminatum Treated in the Brazilian Public Healthcare System. Cureus 2022; 14:e21961. [PMID: 35282509 PMCID: PMC8904063 DOI: 10.7759/cureus.21961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2022] [Indexed: 11/05/2022] Open
Abstract
Condyloma acuminatum is a common clinical outcome of human papillomavirus (HPV) in men. A prospective investigation was performed of the clinical and molecular profile of 122 patients with condyloma acuminatum treated by the Brazilian public healthcare system. The patients were evaluated clinically. The fragments were submitted to molecular analysis for the identification of HPV genotypes. A total of 104 (85.2%) patients presented multiple warts and 18 (14.8%) presented a single wart. The predominant location was the body of the penis (48.4% of cases of multiple warts and 7.4% of cases of single warts), and 49 (40.2%) cases were recurrences and 73 (59.8%) were initial occurrences. Regarding sexual activity, 56 patients (45.9%) had multiple partners and 65 (53.3%) had a single partner. The most frequent genotype was HPV6 (70%). In conclusion, the most frequent anatomic location of condyloma acuminatum was the body of the penis in the present sample. The present findings suggest that the natural history of infection by HPV is not yet completely known and that greater care is needed to ensure clinical safety in the follow-up of these patients due to the oncogenic potential.
Collapse
|
9
|
Campos R, Teles P. Monte Carlo: a particle transport simulation code in Python. Phys Med 2021. [DOI: 10.1016/s1120-1797(22)00562-2] [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: 10/19/2022] Open
|
10
|
Campos R, Júnior JLA, Raposo O. Arte urbana, poderes públicos e desenvolvimento territorial: uma reflexão a partir de três estudos de caso. ETNOGRAFICA 2021. [DOI: 10.4000/etnografica.10747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
11
|
Campos R, Abalos Júnior JL, Meirinho D. Olhares cruzados sobre arte, imagem e resistências urbanas. ILUMINURAS 2021. [DOI: 10.22456/1984-1191.115991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
O artigo situa a cidade como território de produção e disseminação de práticas artísticas organizada pelas múltiplas e plurais formas de resistência, ativismo e contestação utilizadas nas lutas culturais, sociais, políticas e identitárias. Destacamos, como característica da arte ativista contemporânea, as narrativas e estratégias tem estetizado os pólos de conflito e presenças a partir das dimensões macro e micropolíticas de territórios e corpos-políticos de enunciação. Entre essas performances visuais chamamos atenção para as estratégias de visibilidade e exposição a partir de práticas artísticas e poéticas contra-coloniais. Por fim, relatamos um percurso de organização de olhares cruzados sobre arte, imagem e resistências urbanas tema da edição número 56 da Revista Iluminuras (PPGAS/UFRGS).Palavras-chave: Arte. Cidades. Resistências. Subjetividades. Imagem. CROSSED LOOKS ABOUT ART, IMAGES AND URBAN RESISTANCES Abstract: The article locates the city as a territory for the production and dissemination of artistic practices organized by the multiple and plural forms of resistance, activism and contestation used in cultural, social, political and identity struggles. We highlight narratives and strategies as a characteristic of contemporary art activist have aestheticized the poles of conflict and presence from the macro and micro-political dimensions of territories and political-bodies of enunciation. Among these visual performances, we call attention to the strategies of visibility and exposure based on counter-colonial artistic and poetic practices. Finally, we report a path of organization of crossed views on art, image and urban resistance, theme of issue number 56 of Revista Iluminuras (PPGAS/UFRGS).Keywords: Art. Cities. Resistance. Subjectivities. Image.
Collapse
|
12
|
Campos R, Abalos Júnior JL, Meirinho D. Organização. ILUMINURAS 2021. [DOI: 10.22456/1984-1191.116025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
13
|
Campos R, Abalos Júnior JL, Meirinho D. Apresentação. ILUMINURAS 2021. [DOI: 10.22456/1984-1191.116024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
14
|
Barbosa-Silva M, Lima M, Amorim É, Silva A, Freitas R, Passos B, Oliveira H, Campos R, Moraes C, Granja M, Estato V, Rocco P, Faria-Neto H, Maron-Gutierrez T. Mesenchymal stromal cells protect the blood-brain barrier and prevent cognitive and behavioral impairments in infectious disease-associated encephalopathies. Cytotherapy 2021. [DOI: 10.1016/s1465324921003054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
15
|
Martin-Lopez M, Rosell-Valle C, Arribas-Arribas B, Campos R, Piudo I, Ranchal I, Fernandez B, Alaminos M, Carmona G, Gonzalez M. Evaluation of cryopreservation solutions based on human platelet lysate for bioengineered tissues aimed for advanced therapy treatments. Cytotherapy 2021. [DOI: 10.1016/s1465324921005065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
16
|
Rodriguez-Jimenez R, Corripio I, Campos R, Páramo M, Franco-Martin M, Segura E, González S, Martínez-Raga J. Structure and Functioning of Acute Inpatient Psychiatric Units in Spain: Qualitative Study. JMIR Res Protoc 2021; 10:e26214. [PMID: 33729167 PMCID: PMC8060864 DOI: 10.2196/26214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 03/11/2021] [Accepted: 03/17/2021] [Indexed: 12/03/2022] Open
Abstract
Background As a consequence of the decentralization of health care provision to the different Regions (called Autonomous Communities) in Spain, different health care models and resources have been developed for psychiatric patients. It would be very useful to obtain comprehensive and comparative data on health care models, resources, and activity of acute inpatient psychiatric units (AIPUs) as a key part of mental health systems. Objective The aim of this study was to determine the current state of AIPUs in Spain through a national scorecard that allows the current situation to be visualized in terms of resources, processes, and outputs. Methods A 104-item online questionnaire was sent to all the AIPUs of the different Regions in Spain. It was divided into 11 sections, including data on the resources, processes, and outputs of the AIPUs plus general data, an indicator dashboard, and good practices. Results The questionnaire was completed by 60.0% (117/195) of the AIPUs invited to participate. The information collected has allowed us to obtain a detailed snapshot of the current situation of AIPUs in Spain at the levels of infrastructure and material resources, staffing, organization and activity of the units, coordination with other units, guidelines, processes and protocols used, participation and communication with patients and their families, teaching activity, and research linked to the units. Conclusions This project aimed to help understand the general situation of AIPUs in Spain and its different Regions, contribute to enhancing the benchmarking and harmonization among Spanish Regions, and provide data for future comparisons with other countries. International Registered Report Identifier (IRRID) RR1-10.2196/26214
Collapse
|
17
|
Mendes GM, Silveira FAO, Oliveira C, Dáttilo W, Guevara R, Ruiz‐Guerra B, Boaventura MG, Sershen, Ramdhani S, Phartyal SS, Ribeiro SP, Pinto VD, Vasconcelos HL, Tito R, Pereira CC, Carvalho B, Carvalho GM, del‐Val E, Buisson E, Arruda AJ, Toth J, Roque FDO, Souza AH, Bolzan F, Neves F, Kuchenbecker J, Demetrio GR, Seixas L, Romero GQ, Omena PM, Silva JO, Paolucci L, Queiroz E, Ooi MKJ, Mills CH, Gerhold P, Merzin A, Massante JC, Aguilar R, Carbone LM, Campos R, Gomes I, Zorzal G, Solar R, Ramos L, Sobrinho T, Sanders P, Cornelissen T. How much leaf area do insects eat? A data set of insect herbivory sampled globally with a standardized protocol. Ecology 2021; 102:e03301. [DOI: 10.1002/ecy.3301] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 11/08/2022]
|
18
|
Martins MV, Formiga A, Santos C, Sousa D, Resende C, Campos R, Nogueira N, Carvalho P, Ferreira S. Adolescent internet addiction - role of parental control and adolescent behaviours. Int J Pediatr Adolesc Med 2020; 7:116-120. [PMID: 33094139 PMCID: PMC7568070 DOI: 10.1016/j.ijpam.2019.12.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 12/10/2019] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Excessive Internet use can negatively affect academic performance, family relationships and emotional development among the youth. Such issues have been identified as Internet addiction (IA). We aimed to determine the prevalence of IA among Portuguese adolescents and assess how parental control can relate to IA. METHODS An observational cross-sectional study was performed at public schools within a Portuguese region, using Young's Internet Addiction Test survey. General sociodemographic and emotional well-being data were obtained. A descriptive and bivariate analysis was done among Internet-addicted and average users, followed by a logistic regression analysis. Adjusted odds ratios (aORs) were computed with two-sided P values < .05 for statistical significance. RESULTS A total of 1916 eligible responses were obtained. Mean age was 15 ± 1.8 years, with a slight predominance of female (53.3%) participants. In our sample, 16.5% were deemed Internet addicted and less likely to have any parental control over Internet use (aOR 0.74, P <.05). Moreover, 28% of the Internet-addicted users were less likely to have control over time spent online (aOR 0.72, P < .05), and close to half were unlikely to have online content restrictions (aOR 0.56, P < .01). CONCLUSIONS Our findings reported a significant rate of Internet-addicted youth. IA was negatively related to parental control. Whenever any kind of parental control over Internet use was reported, IA was less likely to occur. Healthcare professionals should be aware of the risks of IA in adolescents to improve its prevention and intervention.
Collapse
|
19
|
Bermejo M, Arribas-Arribas B, Fernandez B, Campos R, Montiel M, Nogueras S, Jimenez R, Carmona G, Gonzalez M. A proprietary GMP-manufactured human platelet lysate: two-year stability study. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
20
|
Navas LL, Martin-Lopez M, Fernandez B, Campos R, Montiel M, Sanchez-Pernaute R, Carmona G, Gonzalez M. Towards a full characterization of a proprietary GMP human platelet lysate. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
21
|
Campos R, Sequeira Á. Entre VHILS e os Jerónimos: arte urbana de Lisboa enquanto objeto turístico. HORIZONTES ANTROPOLÓGICOS 2019. [DOI: 10.1590/s0104-71832019000300005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Diversas cidades têm incluído a arte urbana como parte das suas estratégias de promoção e planeamento turístico. Este facto deriva de uma gradual valorização social e legitimação institucional deste tipo de expressões estéticas presentes no espaço público. Em muitas cidades deparamo-nos, hoje, com processos de turistificação da arte urbana, uma dinâmica que está dependente de um conjunto de atores sociais. A turistificação da arte urbana tem consequências, não só ao nível da constituição da oferta turística da cidade, mas também ao nível das relações e interações que se estabelecem entre operadores e guias, turistas, artistas, instituições e comunidades locais. Com este artigo pretendemos refletir sobre a articulação entre a arte urbana e o sector turístico, partindo de um conjunto de dados preliminares de natureza qualitativa recolhidos no âmbito de um projeto em curso sobre arte urbana em Lisboa.
Collapse
|
22
|
Eckert C, Diógenes G, Dabul L, Campos R. Arte e cidade: policromia e polifonia das intervenções urbanas. HORIZONTES ANTROPOLÓGICOS 2019. [DOI: 10.1590/s0104-71832019000300001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
23
|
Twerenbold R, Costabel JP, Nestelberger T, Campos R, Arbucci R, Boeddinghaus J, Puelacher C, Du Fay De Lavallaz J, Rubini Gimenez M, Koechlin L, Lambardi F, Resi S, Alves De Lima A, Trivi M, Mueller C. 3297Real-world outcome of applying the ESC 0/1-hour algorithm in clinical routine. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0061] [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: 11/13/2022] Open
Abstract
Abstract
Background
The European Society of Cardiology (ESC) recommends the use of a 0/1h-algorithm for rapid triage of patients with suspected non-ST-elevation myocardial infarction (NSTEMI). To date, its impact on patient management and ultimately also safety when routinely applied in emergency departments (ED) is unknown. We therefore aimed to determine these important real-world outcome data.
Methods
In a prospective international multicenter study enrolling unselected patients presenting with suspected NSTEMI to the ED, we assessed the real-world feasibility, adherence, efficacy, effectiveness, and safety of the ESC 0/1h-algorithm using high-sensitivity cardiac troponin T embedded in routine clinical care. Patients with ST-segment elevation myocardial infarctions were excluded. Safety was quantified by the 30-day incidence of major adverse cardiac events (MACE, defined as the composite of cardiovascular death and myocardial infarction including the index event) in the rule-out group and in outpatients.
Results
Among 2296 patients, NSTEMI prevalence was 9.8% (224/2296). Feasibility was very high with a median time to the “1h-draw” of 65 minutes [q1 61, q3 72]. Adherence was very high with 94% (95% confidence interval [CI], 93–95) of patients managed without protocol violations. Effectiveness was very high: 98% (95% CI, 97–98) of patients triaged towards rule-out by the ESC 0/1h-algorithm did not require additional cardiac investigations including hs-cTnT measurements at later time points (e.g. 3–12h) or coronary CT-angiography in the ED. Median time to discharge from the ED was 150 [q1134, q3235] minutes in the overall population. The ESC 0/1h-algorithm triaged 62% (95% CI, 60–64) of patients towards rule-out and 13% (95% CI, 12–14) towards rule-in of NSTEMI. Overall, 71% (95% CI, 69–72) of patients underwent outpatient management (Figure 1). Safety of rule-out and outpatient management were very high with a 30-day MACE incidence of 0.2% (95% CI, 0–0.5) and 0.1% (95% CI, 0–0.2), respectively. These findings were consistent in several predefined subgroups.
Figure 1
Conclusions
These real-world data document the excellent feasibility, adherence, effectiveness, efficacy and safety of the ESC 0/1h-algorithm for the rapid management of patients presenting with suspected NSTEMI to the ED when applied in routine clinical practice.
Collapse
|
24
|
Lobo A, Rabanaque I, Blanch J, Campos R, Ezquiaga E, Farré JM, Gómez-Reino I, Marco C, Navío M, Ochoa E, Parramón G, Ventura T, Aguilar EJ, Artal J, Cuesta M, Devolx VM, Espárrago G, Franco MA, Hernández Fleta JL, Martínez Jambrina JJ, Ortega MÁ, Palomo J, Pérez Costillas L, Roca M. The development of psychosomatic and Liaison Psychiatry units in Spain: A national enquiry. J Psychosom Res 2019; 125:109784. [PMID: 31421327 DOI: 10.1016/j.jpsychores.2019.109784] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/03/2019] [Accepted: 07/20/2019] [Indexed: 11/30/2022]
|
25
|
Twerenbold R, Costabel JP, Campos R, Cortes M, Nestelberger T, Boeddinghaus J, Puelacher C, Du Fay De Lavallaz J, Walter J, Meier M, Hafner B, Lambardi F, Resi S, Trivi M, Mueller C. P1579Impact of Renal Dysfunction on Real-world Outcome of the ESC 0/1-hour Algorithm. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0339] [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: 11/12/2022] Open
Abstract
Abstract
Background
The ESC recommends the use of a 0/1h-algorithm for rapid triage of patients with suspected non-ST-elevation myocardial infarction (NSTEMI) using high-sensitivity cardiac troponin (hs-cTn) concentrations irrespective of renal function. Patients with renal dysfunction (RD, defined as a GFR <60ml/min) are at higher risk of NSTEMI and are presenting more often with elevated levels of hs-cTn even in absence of NSTEMI, which may contribute to an impaired efficacy and safety of the ESC 0/1h-algorithm.
Purpose
We aimed to assess and directly compare the real-world adherence, effectiveness, efficacy, and ultimately safety of the ESC 0/1h-algorithm when applied in patients with RD and normal renal function.
Methods
In a prospective international multicenter study enrolling unselected patients presenting with suspected NSTEMI to the ED, patients were assessed according to the ESC 0/1h-algorithm embedded in routine clinical care. Safety was quantified by the 30-day incidence of major adverse cardiac events (MACE, defined as the composite of cardiovascular death and myocardial infarction including the index event) in the rule-out group and in outpatients.
Results
Among 2296 enrolled patients, RD was present in 129 (6%) patients. NSTEMI prevalence was substantially higher in RD as compared with normal renal function (19% versus 9%, p<0.001). Adherence to the ESC 0/1h-algorithm protocol was excellent with no violations observed in patients with RD as compared with 132 (6%) violations in patients with normal renal function (p=0.004). Effectiveness was very high in RD and comparable to normal renal function: 94% of patients triaged towards rule-out by the ESC 0/1h-algorithm did not require additional cardiac investigations including hs-cTnT measurements at later time points (e.g. 3–12h) or coronary CT-angiography in the ED as compared with 98% in normal renal function. Median time to discharge or transfer from the ED was significantly longer in RD (285 minutes [q1174, q3392]) as compared with normal renal function (150 minutes [q1132, q3222]). Efficacy of the ESC 0/1h-algorithm was lower in RD as it triaged 13% of patients towards rule-out and 34% towards rule-in of NSTEMI as compared with 65% and 12% in normal renal function, respectively (p<0.001). Overall, 30% of patients with RD underwent outpatient management as compared with 73% in normal renal function (p<0.001). Safety of rule-out and outpatient management were excellent in RD with a 30-day MACE incidence of both 0% and comparable with 0.2% and 0.1% in normal renal function, respectively (p=0.010).
Conclusions
These real-world data document for the first time the excellent adherence, effectiveness, and safety of the ESC 0/1h-algorithm when routinely applied in patients with RD. Compared with patients with normal renal function, fewer patients with RD could be triaged towards rule-out or were treated as outpatients, most likely due to the higher prevalence of NSTEMI and comorbidities in RD.
Collapse
|