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Magliocca S, Dolenz F, Silva A, Madeddu F, Calati R. Italian validation of the interpersonal needs questionnaire (INQ-15-I) in a sample of university students. Eur Psychiatry 2021. [PMCID: PMC9479980 DOI: 10.1192/j.eurpsy.2021.1559] [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 The Interpersonal Theory of Suicide posits that thwarted belongingness (TB) and perceived burdensomeness (PB) are proximal causes of current suicidal desire, while the acquired capability predicts suicide attempts (Joiner, 2005). Objectives This study examined the psychometric properties of the Interpersonal Needs Questionnaire (INQ-15-I), as a measure of the two constructs, on a sample of 458 Italian university students. Methods After examining the socio-demographic, clinical and psychosocial characteristics of the sample, we tested the differences in current suicidal ideation and lifetime suicide risk among students. We conducted a confirmatory factor analyses to identify the latent structure of the INQ-15-I and we tested the reliability, criterion concurrent validity and convergent/discriminant validity. Results The socio-demographic, clinical and psychosocial features of the sample are in line with the literature on the topic. A two-factor related model with 15 item, showed a good fit to the data and subscales showed excellent internal consistencies (α ≥ 0.84). TB, but mostly PB, were mainly correlated with concurrent suicidal ideation and less with suicidal risk. Divergent validity has emerged with the constructs of the acquired capability. Convergent validity is supported for similar constructs such as depression, low reasons for living, anxiety, interoceptive awareness, psychological pain, loneliness, absence of social support and low self-esteem. Conclusions INQ-15-I provides a valid measure of the interpersonal needs among Italian university students by indirectly investigating suicidal risk factors. It also suggest specific clinical intervention areas in suicide prevention. Thus it may be included in suicide risk assessment protocols in Italy.
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Silva A, Politi P, Brondino N, Olivola M. Efficacy of IV immunoglobulins on depressive symptoms and self-injury: A case report. Eur Psychiatry 2021. [PMCID: PMC9480233 DOI: 10.1192/j.eurpsy.2021.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Introduction Some studies in literature highlight the correlation between immune-mediated inflammatory processes and psychiatric pathologies. However, there are few studies about the efficacy of IV immunoglobulins in psychiatric features (1). (1) ZUNSZAIN, Patricia A.; HEPGUL, Nilay; PARIANTE, Carmine M. Inflammation and depression. In: Behavioral neurobiology of depression and its treatment. Springer, Berlin, Heidelberg, 2012. p. 135-151. Objectives Case report: a 39 year patient diagnosed with borderline personality disorder and myasthenia was hospitalized for self-injury ideation, acting out and depressive episode treated with acid valproic, aripiprazole, gabapentin; flare-up of myasthenia that needed treatment. Methods Clinical and test evaluation was performed in three stages: before (t0), immediately after (t1) and 3 weeks after (t2) the administration of the IgEV without other treatment modifications. We have used: - Inventory of Statements About Self-Injury (ISAS) - Barrat Impulsiveness Scale, Version 11 (BIS-11) - Hamilton Anxiety Rating Scale (HAM-A) - Montgomery-Asberg Depression Rating Scale (MADRS) - Alexian Brothers Urge to Selfe-Injure Scale (ABUSI) Results The patient has a score of 79 at BIS-11. She used to have a huge number of acting aout as we see on ISAS (Fig.1).![]() ![]() Conclusions We observed a reduction in non-suicidal self-injurious ideation, the suspension of acting-out, a complete remission of depressive symptoms with mild persistence of anxious symptoms immediately after the administration of immunoglobulins, and the remission continue until one month after the administration (Fig.2). Disclosure No significant relationships.
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Dolenz F, Magliocca S, Silva A, Madeddu F, Calati R. Italian validation of the ACSS-FAD in a sample of university students. Eur Psychiatry 2021. [PMCID: PMC9480321 DOI: 10.1192/j.eurpsy.2021.1579] [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 Suicide is one of the most relevant cause of death especially in young populations. The Interpersonal Theory of Suicide (Joiner, 2005) is an important contribution tends to explain variability in suicidal behavior, particularly the difference between suicidal ideation and suicide attempt. Objectives This study aimed at the Italian validation of the Acquired Capability for Suicide Scale – Fearlessness About Death (ACSS-FAD), assessing fearlessness about death, one of the facets of the acquired capability (AC) to commit suicide as postulated by the Interpersonal Theory of Suicide by Thomas Joiner. Methods This cross-sectional research was conducted on a sample of university students (n = 458) assessed with a battery including ACSS-FAD. The sample was evaluated for the presence of suicidal ideation and suicide risk. Factor structure, internal consistency and convergent/divergent validity of the scale were assessed. Results One-factor structure with good internal consistency (Cronbach’s α: 0.84) was derived. ACSS-FAD correlated with suicidal ideation and suicidal risk, and there was a tendency towards significance considering its capacity to discriminate between those who had a history of suicide attempts and those who did not. 4.1% of the sample attempted suicide at least one time. The tool showed good convergent/discriminant validity results, but the relationship between ACSS-FAD and pain needs further investigations. Conclusions ACSS-FAD seems to be a useful and valid measure of fearlessness about death especially in young adults, which could be really important to enhance suicide risk assessment. Conflict of interest No significant relationships.
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Vieira A, Andrade F, Machado A, Barbosa D, Sousa A, Da Costa IS, Silva A. Inpatient psychiatry care during coronavirus 2019 pandemic lockdown: Results from a department of psychiatry in northern Portugal. Eur Psychiatry 2021. [PMCID: PMC9471828 DOI: 10.1192/j.eurpsy.2021.828] [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: 12/03/2022] Open
Abstract
Introduction COVID-19 pandemic and the consequent containment measures have a negative impact on mental health. Simultaneously, the fear of infection can discourage patients from seeking necessary care. Objectives We aim to compare sociodemographic and clinical characteristics of inpatients admitted during the COVID-19 confinement period in Portugal vs. inpatients admitted in the same period the previous year. Methods Retrospective observational study of inpatients admitted between March 19th 2020 and May 1st 2020 and the analog period of 2019 in a psychiatry inpatient unit of a tertiary hospital. Descriptive analysis of the results was performed using the SPSS software, version 26.0. Results During the lockdown period, there were 30 admissions to the psychiatry inpatient unit, 55.2% less than the same period last year (n=67). The proportion of compulsory admissions and the average length of stay did not differ between the two periods. Regarding sociodemographic characteristics, in the confinement period inpatients were similar to the ones in the same period of 2019. In both periods, the majority of patients had previous psychiatric history (lockdown vs. same period last year: 95.5% and 90.0%) and a similar proportion of readmissions rate (previous year) was similar in the two groups (49.9% vs 47.6%). At discharge, the most frequent diagnostic groups were mood disorders (33.3% (n=10) and 34.3% (n=23)) and schizophrenia, schizotypal and delusional disorders (26,7% (n=8) and 31.3% (n=21)). Conclusions Although there was an expressive reduction of admissions to the psychiatry inpatient unit during lockdown, the clinical characteristics of these patients were analogous to the same period in the previous year.
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Silva A, Sachdev B, Kostusiak M, Yousif M, Flint G, Dhir J, Furtado N, Laing R. Out of hours magnetic resonance imaging for suspected cauda equina syndrome: lessons from a comparative study across two centres. Ann R Coll Surg Engl 2021; 103:218-222. [PMID: 33645281 DOI: 10.1308/rcsann.2020.7086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Cauda equina syndrome, a rare but disabling spinal surgical emergency, requires prompt investigation, ideally using magnetic resonance imaging as patients may require decompressive surgery. Out of hours access to magnetic resonance imaging is only routinely available in major trauma centres and neurosurgical units. Patients in regional hospitals with suspected cauda equina syndrome may require transfer for diagnostic imaging. We retrospectively studied the proportion of patients referred with suspected cauda equina syndrome who required out of hours transfer for magnetic resonance imaging and decompressive surgery. MATERIALS ANDS METHODS Retrospective cohort study of patients referred using online referral platforms with suspected acute cauda equina syndrome and transferred out of hours between 6pm to 8am on weekdays and all day on weekends to two of the largest neurosurgical units in the UK in Birmingham and Cambridge. RESULTS A total of 441 patients were referred across both sites with a suspicion of acute cauda equina syndrome; 339 patients were transferred for diagnostic scans and only 16 of them (4.7%) were positive for cauda equina compression, necessitating prompt decompressive surgery. Of the patients with negative magnetic resonance scans, 50% had their discharge or transfer back to referring hospitals delayed by more than 24 hours. CONCLUSIONS Over 95% of patients who were transferred for imaging did not undergo emergency decompression. The authors propose a greater role for the provision of out of hours magnetic resonance imaging in all hospitals admitting emergency patients to streamline management.
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Martins T, Montenegro L, Silva A, Reis H, Pereira E, Lucas P. Spinal subarachnoid haematoma after neuraxial anaesthesia in a patient with polycythaemia vera. Anaesth Rep 2021; 9:8-11. [PMID: 33479701 DOI: 10.1002/anr3.12093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2020] [Indexed: 11/08/2022] Open
Abstract
Polycythaemia vera is a common haematological proliferative disorder. It is characterised by uncontrolled red cell production with ensuing peri-operative vaso-occlusive and haemorrhagic complications. Spinal haematoma after neuraxial anaesthesia is rare; most cases are associated with technical difficulties or bleeding disorders. Current consensus opinion suggests that neuraxial anaesthesia in patients with polycythaemia vera is safe due to a lower risk of thrombotic events and hypoxaemia compared with general anaesthesia. We report a case of a spinal subarachnoid haematoma after uneventful neuraxial anaesthesia in a patient with optimised polycythaemia vera. Despite an emergent laminectomy, the patient developed permanent motor deficits. This report highlights that although neuraxial anaesthesia is recommended by many authors, patients with polycythaemia vera can paradoxically have an increased haemorrhagic risk from platelet dysfunction and acquired von Willebrand disease. Clinicians proceeding with surgery under neuraxial anaesthesia should appreciate these risks even in patients with normal or apparently elevated thrombotic states. This case also demonstrates that traditional coagulation tests may need to be complemented by pre-operative platelet function tests and screening for von Willebrand disease. Finally, the importance of the patient participation in the choice of the anaesthesia technique cannot be understated, with specific attention paid to this frequently unrecognised risk.
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Silva A, Oliveira AS, Vaz CV, Correia S, Ferreira R, Breitenfeld L, Martinez-de-Oliveira J, Palmeira-de-Oliveira R, Pereira CMF, Palmeira-de-Oliveira A, Cruz MT. Anti-inflammatory potential of Portuguese thermal waters. Sci Rep 2020; 10:22313. [PMID: 33339881 PMCID: PMC7749128 DOI: 10.1038/s41598-020-79394-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 12/08/2020] [Indexed: 11/09/2022] Open
Abstract
In light of Medical Hydrology, thermal waters (TW) are all-natural mineral waters that emerge inside a thermal resort and have therapeutic applications. Their beneficial effect has been empirically recognized for centuries, being indicated for symptom alleviation and/or treatment of several diseases, almost all associated with inflammation. Indeed, an anti-inflammatory effect has been attributed to many different Portuguese TW but there is no scientific validation supporting this empiric knowledge. In the present study, we aimed to investigate the anti-inflammatory properties of 14 TW pertaining to thermal centers located in the Central Region of Portugal, and grouped according to their ionic profile. Mouse macrophage cells stimulated with lipopolysaccharide (LPS), a Toll-like receptor 4 agonist, were exposed to culture medium prepared in TW. Metabolism, nitric oxide (NO) production, inducible nitric oxide synthase (iNOS) expression levels and the scavenging capacity of TW, were investigated in vitro. 11 out of 14 TW reduced NO production and/or iNOS expression, and/or scavenging activity, in macrophages exposed to LPS. The sulphated/calcic TW did not show any effect on at least one of the inflammatory parameters evaluated. Two sulphurous/bicarbonate/sodic TW and the sulphurous/chlorinated/sodic TW promoted an increase in NO production and/or iNOS expression. Our results validate, for the first time, the anti-inflammatory properties of Portuguese TW, supporting their therapeutic use in the treatment of inflammation-related diseases and promoting their putative application in cosmetic products and medical devices.
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Castelo A, Laranjo S, Lousinha A, Cunha P, Brandao C, Alves S, Silva A, Ferreira V, Bras P, Mano T, Oliveira M, Ferreira R. Role of tilt-table testing in syncope diagnosis and management: analysis of patients referred to a syncope unit. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0710] [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
Introduction
Head-up tilt-testing (HUT) enables the reproduction of reflex syncope in a laboratory setting. Despite being used to confirm the diagnosis of this syncope, there is some concerns regarding the best protocol to use and recent studies with implantable loop recorders have called the value of HUT into question.
Aim
To characterize the population undergoing HUT according to the modified Italian protocol, type of response to HUT and subsequent management at our center in the last 4 years.
Methods
Retrospective analysis of consecutive P who underwent HUT between 2015 and 2018. Descriptive analysis of patients (P) demographics and medical history, indication for HUT, type of response to HUT and management.
Results
A total of 419P (55.1% female) were included with a mean age of 62 years. The majority (n=302, 72.1%) had comorbidities (structural heart disease – 55%, cardiac dysrhythmias – 57.6%, hypertension – 48.3%, diabetes – 15.6%, depression – 15.9%, cerebrovascular disease –10.6%) or was under medication (n=220, 52.5%) with a potential hypotensive or bradycardic effect (44.1% ACEI/ARA, 29.1% beta-blocker, 27.7% diuretic, 23.6% antidepressant, 22.7% calcium channel blocker, 19.1% benzodiazepines). Syncope/presyncope episodes accounted for 56.1% of the HUT, with falls and disequilibrium accounting for 52%. In 21 cases (5%) suspected dysautonomia or other non-specified reasons were the indication for HUT. HUT were ordered according to the guidelines in 136P (84.6% – indication level I, 3.6% – level IIa, 11.8% – level IIb). HUT was positive in 292P (69.7%) – 77.1% after nitroglycerin administration (vasodepressor – 170P, cardioinhibitory – 53P, mixed – 62P and dysautonomic – 7P). Cardioinhibitory (CI) response predominated in the younger, and vasodepressor in the older P. Of the P with CI response, 41.5% had asystole (median of 41.4s, minimum 7.5s, maximum 115s). All P were instructed in the need to avoid triggering factors and perform counterpressure maneuvers. A pacemaker was implanted in 24P (5.7% of all population, due to long sinus pauses and asystole). Twenty-four P (5.7%) completed a tilt training program.
Conclusion
Most of the HUT were requested for syncope/presyncope, frequently according to the guidelines. There was a high rate of positive tests, with a predominance of vasodepressive response, particularly in the elderly.
Funding Acknowledgement
Type of funding source: None
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Lourenço P, Santos J, Havránek A, Bogar O, Havlíček J, Zajac J, Silva A, Batista A, Hron M, Pánek R, Fernandes H. Real-time plasma position reflectometry system development and integration on COMPASS tokamak. FUSION ENGINEERING AND DESIGN 2020. [DOI: 10.1016/j.fusengdes.2020.112017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Marta G, Miranda F, Silva A, Hanna S, Neves Jr W, De Arruda F, Mancini A, Gadia R, Moraes F. PO-1253: Stereotactic Ablative Radiotherapy for spinal metastases: Experience at a Brazilian Institution. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01271-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Paixão M, Carmona A, Capelão H, Calé E, Silva A. Ending female genital mutilation – a city’s coordinated effort. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Female genital mutilation (FGM) has short and long-term impacts on the health of girls/women. In Portugal, an estimated 5246 women were subjected to it, with 568 of them residing in the city of Amadora, in the metropolitan area of the capital Lisbon. As such, Amadora was considered a priority area for developing strategies to prevent female genital mutilation, under the coordination of the local public health unit.
Our aim was to capacitate professionals to recognise and act on risk/danger and on minimising potential health impacts of FGM on the local institutions these girls/women might come into contact with.
We created a task force that held meetings with different local actors: hospital, teams at the primary healthcare facility, city hall of Amadora, child protection services, a school, social inclusion projects, representatives of the justice system and a non-governmental organisation. We designed different scenarios for the different needs and entry points of these girls/women in the system and created appropriate procedures for all these actors. Within the primary healthcare facility, we created guidelines specifying criteria for referral to other specialties. This led to the development of a county protocol targeting FGM during the summer of 2019.
We trained 160 healthcare professionals. In addition, we created a booklet for schools and held sessions in school groups targeting teachers, psychologists and operational assistants with a focus on risk and danger indicators and on how to proceed. Overall, 360 school professionals received training. During these sessions, we also presented resources on how to integrate FGM in discussions with students regarding gender violence and human rights.
This intervention will be evaluated after one year (summer of 2020) through mixed-methods to understand the impact on the practice of the professionals in Amadora. We will conduct interviews and apply questionnaires to capture the implementation of this city-wide protocol.
Key messages
Given the complexity of FGM a wide societal and multidisciplinary approach should be used with a public health team coordinating the intervention. In Portugal there is a need for an organised and systematic response by professionals regarding FGM; our county-specific protocol aimed to create that response.
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Carmona A, Paixão M, Silva A. Planned teenage pregnancy: a sociocultural health problem that lead to a local intervention. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
According to data from the National Statistics Institute (2018), Portugal was the country with the second highest birth rate in the European Union in mothers between 15 and 19 years old. This number of births may be influenced by ethnic-cultural issues, such as acceptance and encouragement of marriage and early motherhood, especially in some African ethnic-cultural groups. Our public health unit is located in Amadora, a suburban area of the Portuguese capital with a high percentage of migrants, a high rate of teenage pregnancies and economically deprived areas.
The aim of our research was to understand beliefs and values in both native and migrant girls regarding motherhood in order to better tailor interventions aiming to prevent teenage pregnancy.
We interviewed fifteen participants, seven migrants and eight natives, who were or had been teenage mothers. The participants were selected through non-probabilistic snowball sampling. Afterwards, we performed a qualitative content analysis.
Overall, we found no difference between the 2 groups of participants with most, 12, having wished for their pregnancies. The social and religious framing of fertility as a gift was often stated. The housing context was also mentioned given several participants lived in overcrowded houses with poor conditions and believed pregnancy could have provided a way out of their living situation. Low education and poor job prospects were also mentioned as pregnancy was framed as a “life project” in the absence of a career prospect.
We found evidence of a “social and cultural pregnancy” not related to certain migrant cultures but associated with a “neighbourhood” culture associated with economic deprivation. As such, we are now implementing a pilot study within the community, by creating regular group sessions to discuss the meaning and impact of motherhood to try to capacitate girls to find a different life project other than choosing pregnancy during teenage years.
Key messages
Teenage pregnancy can be planned who use it to try to find a life project, be accepted within their community and escape their daily conditions. Public health interventions aiming to prevent teenage pregnancies should acknowledge social and cultural factors that encourage these pregnancies.
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Rocha G, de Lima FF, Machado AP, Guimarães H, Proença E, Carvalho C, Martins LG, Martins T, Freitas A, Dias CP, Silva A, Barroso A, Diogo I, Cassiano G, Ramos H, Abrantes MM, Costa P, Salazar A, Vieira F, Fontes D, Barroso R, Marques T, Santos V, Scortenschi E, Santos C, Vilela F, Quintas C. Small for gestational age very preterm infants present a higher risk of developing bronchopulmonary dysplasia. J Neonatal Perinatal Med 2020; 12:419-427. [PMID: 31256077 DOI: 10.3233/npm-180129] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Several studies assessed the influence of a low birth weight on bronchopulmonary dysplasia (BPD), but not all could find a significant association. Our aim was to assess the association between low birth weight and BPD in preterm infants, prospectively recruited at 11 level III Portuguese neonatal centers. METHODS Obstetrical and neonatal data on mothers and preterm infants with gestational ages between 24 and 30 weeks, born during 2015 and 2016 after a surveilled pregnancy, were analyzed. Neonates were considered small for gestational age (SGA) when their birthweight was below the 10th centile of Fenton's growth chats and BPD was defined as the dependency for oxygen therapy until 36 weeks of corrected age. Statistical analysis was performed using IBM SPSS® statistics 23 and a p-value <0.05 was considered statistically significant. RESULTS Out of 614, a total of 494 preterm infants delivered from 410 women were enrolled in the study; 40 (8.0%) infants with SGA criteria. SGA were more often associated with a single pregnancy, had greater use of antenatal corticosteroids, increased prevalence of gestational hypertensive disorders, C-section, rupture of membranes below 18 hours, rate of intubation in the delivery room, use of surfactant treatment, oxygen therapy, mechanical ventilation need, BPD, cystic periventricular leukomalacia, nosocomial sepsis and pneumonia; had lower prevalence of chorioamnionitis, and lower Apgar scores. The multivariate analysis by logistic regression, adjusted for BPD risk factors revealed a significant association between SGA and BPD: OR = 5.2 [CI: 1.46-18.58]; p = 0.01. CONCLUSION The results of this study increase the scientific evidence that SGA is an independent risk factor for BPD.
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Dip A, Pimentel A, Rivera S, Silva A. P-22 Efficacy of sorafenib in treatment of advanced hepatocellular carcinoma in the Mexican population: Evidence from a third level hospital in Mexico. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Horta R, Tomaz D, Egipto P, Silva A. The outcome of fungal infections in a burn intensive care unit: a study of 172 patients. ANNALS OF BURNS AND FIRE DISASTERS 2020; 33:101-106. [PMID: 32913429 PMCID: PMC7452606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 03/04/2020] [Indexed: 06/11/2023]
Abstract
Burned patients are an especially fragile population in which infections are a leading cause of death and morbidity. Fungal infections have become increasingly prevalent in Intensive Care Units (ICUs) and burn ICUs. Management of fungal colonization and infection still constitutes a challenge for clinicians. The aim of this retrospective cross-sectional study was to characterize the population of burn patients with fungal infections admitted to our Burn ICU between January 2013 and December 2015. Patients were characterized according to age, gender, date of admission and exit, type of burn, type of exit, total body surface area (TBSA) and presence of inhalation injury. Positive fungal cultures, causative pathogen and site of sampling were also registered. Statistical analysis centred around the presence of fungal infection/colonization was performed using IBM SPSS Statistics. A total of 172 patients were included, 38 (22.1%) had a positive fungal culture and of these 8 (21.1%) died. Patients with fungal infection/colonization stayed more days than those without infection. However, this tendency did not reach statistical significance when patients that died in the ICU were excluded. No relationships were found when comparing positive fungal cultures with TBSA, burn aetiology, inhalation injury or mortality. Fungal infections are a major cause of morbidity and mortality despite TBSA, burn type or presence of inhalation injury. Efforts should be made to improve management of fungal infections, especially in burn patients and other critically ill groups.
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Mou J, Silva A, Figetakis K, Ho SS, Williams M, Mebust KA, Xia Y, Xie J, Wang J, Chin N, Vondran R, Vondran R. 1190 Engaging Patients And Family Members To Understand What Matters Most Living With Obstructive Sleep Apnea. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
As a common but modifiable chronic condition, obstructive sleep apnea (OSA) has been identified as the top secondary cause of many other diseases including cardiovascular diseases and type 2 diabetes. Diagnosing and managing OSA provides neurological, cardiovascular and metabolic benefits, however real-world studies indicate disconnections between evidence and outcomes. Using an engagement approach and qualitative design, this project aims to better understand care and research gaps in OSA in a community healthcare setting.
Methods: Methods
Patient and family representatives were identified and recruited through OSA support meetings hosted by MultiCare Sleep Medicine Centers, to form a board of 12, with three key patient advocates. Six meetings, each facilitated by one or two members of the board, were held to encourage focus group discussion and accommodate interactive conversations on the topic. Discussions were audio recorded and edited to exclude patients’ identifiable information, then transcribed. Manual open coding was completed by two coders for each transcription to develop a codebook, followed by auto-coding and inductive content analysis using Nvivo 11.
Results
All enrolled patients had diagnosed moderate-to-severe OSA and were prescribed with continuous positive airway pressure (CPAP) therapy. Two participants were African American and one was multiethnic. Patients’ age ranged from early 30s to 80s. Seven main themes were identified: OSA diagnostic issues; treatment experiences and options; comorbidities; patient community and support needs; long-term management challenges beyond “compliance”; knowledge of OSA, CPAP and care; and patient-driven research. The first few weeks after CPAP initiation appeared to be a critical time window that impacted patients’ adaptation and use.
Conclusion
Our study revealed barriers and facilitators in OSA diagnosis and treatment. Results showed highly prevalent chronic co-morbidities and the needs to care for patients in the comorbid scenario. It was highlighted that a paradigm of patient-centered care and research is lacking and warranted. Participants also called for better coordination between sleep medicine, primary care, other specialists, durable device suppliers and insurance. Key research efforts are expected to focus on the first 30-day post CPAP dispense to improve compliance.
Support
Patient Centered Outcomes Research Institute (PCORI) (Contract #: 7717241)
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Almeida C, Silva A, Marques S, Ribeiro M. Ocular Syphilis mimicking Acute Zonal Occult Outer Retinopathy (AZOOR). ACTA ACUST UNITED AC 2020; 95:284-288. [PMID: 32376127 DOI: 10.1016/j.oftal.2020.02.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/19/2020] [Accepted: 02/21/2020] [Indexed: 11/28/2022]
Abstract
Ocular syphilis can simulate various ophthalmic pathologies with multiple possible ophthalmic findings. Timely treatment of these patients can minimize visual damage, but its diagnosis is often a challenge for the ophthalmologist. We review a case report of a 45-year-old man with a rare and atypical clinical presentation of ocular syphilis, its clinical and imaging characteristics, its diagnosis, treatment and evolution. The patient presented with bilateral painless loss of vision, photopsia and peripheral scotomas with about 1 week evolution. There were no signs of ocular inflammation. The complementary ophthalmic study revealed an acute zonal occult outer retinopathy-like ("AZOOR-like") presentation. Ocular syphilis does not always present with ocular inflammation and its presentation as "AZOOR-like" is very rare. So, we should always maintain a high index of suspicion for this condition, as early diagnosis and treatment are essential for a better prognosis.
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Khanabdali R, Shojaee M, Johnson J, Law S, Whitmore M, Lim M, Schoppet M, Silva A, James P, Kalionis B, Dixon I, Lichtfuss GG, Tester A. Characterization of extracellular vesicles derived from two populations of human placenta derived mesenchymal stem/stromal cells. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Grangier A, Wilhelm C, Gazeau F, Silva A. High yield and scalable EV production from suspension cells triggered by turbulence in a bioreactor. Cytotherapy 2020. [DOI: 10.1016/j.jcyt.2020.03.061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Marcelino J, Silva JP, Gameiro J, Silva A, Rego FC, Moreira F, Catry I. Extreme events are more likely to affect the breeding success of lesser kestrels than average climate change. Sci Rep 2020; 10:7207. [PMID: 32350294 PMCID: PMC7190627 DOI: 10.1038/s41598-020-64087-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 04/02/2020] [Indexed: 11/25/2022] Open
Abstract
Climate change is predicted to severely impact interactions between prey, predators and habitats. In Southern Europe, within the Mediterranean climate, herbaceous vegetation achieves its maximum growth in middle spring followed by a three-month dry summer, limiting prey availability for insectivorous birds. Lesser kestrels (Falco naumanni) breed in a time-window that matches the nestling-rearing period with the peak abundance of grasshoppers and forecasted climate change may impact reproductive success through changes in prey availability and abundance. We used Normalised Difference Vegetation Index (NDVI) as a surrogate of habitat quality and prey availability to investigate the impacts of forecasted climate change and extreme climatic events on lesser kestrel breeding performance. First, using 14 years of data from 15 colonies in Southwestern Iberia, we linked fledging success and climatic variables with NDVI, and secondly, based on these relationships and according to climatic scenarios for 2050 and 2070, forecasted NDVI and fledging success. Finally, we evaluated how fledging success was influenced by drought events since 2004. Despite predicting a decrease in vegetation greenness in lesser kestrel foraging areas during spring, we found no impacts of predicted gradual rise in temperature and decline in precipitation on their fledging success. Notwithstanding, we found a decrease of 12% in offspring survival associated with drought events, suggesting that a higher frequency of droughts might, in the future, jeopardize the recent recovery of the European population. Here, we show that extreme events, such as droughts, can have more significant impacts on species than gradual climatic changes, especially in regions like the Mediterranean Basin, a biodiversity and climate change hotspot.
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Abstract
Impulsiveness has an important role in suicide behaviour and substance abuse.In this context, it's important to assess suicide risk among drug users and to determine which factors play a protective role and which factors increase the risk.In this study the authors propose to determine the prevalence of actual or past suicidal ideation in a sample of substance users; to determine the prevalence of previous suicidal behaviours in the same sample; and to study the relation with clinical and sociodemographic variables.The sample included 119 patients with drug addiction behaviours receiving treatment in an inpatient detoxication unit (Unidade de Desabituação do Norte do IDT - Instituto da Droga e das Toxicodependências), admitted between May 2010 and July 2010.Data was obtained from the patient clinical chart, including the admission protocol form.SPSS was used for statistical analysis.The results founded were:18,5% (n = 22) had previous suicidal ideation at least once in their lifetime.2,5% (n = 3) had suicidal ideation at admission.10,9% (n = 13) had previous suicidal attempts.According to literature, in general population, lifetime prevalence of suicidal ideation is 10–18% and history of suicidal attempt is 3–5%.In the studied sample, suicidal ideation during lifetime is slightly raised (18,5%) and history of suicidal behaviours is strongly higher (10.9%).These data suggest a raised suicidal risk in drug abuse population, probably reflecting a higher impulsiveness in this population.
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Purkayastha S, Cheng J, Chang M, Wang R, Soulen M, Stavropoulos S, Khurana S, Silva A, McGirr A, Bai H. 3:18 PM Abstract No. 266 Differentiation of low- and high-grade renal cell carcinoma using magnetic resonance–based radiomics. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Rauschert L, Purkayastha S, Zhao Y, Xi I, Wang R, Khurana S, McGirr A, Soulen M, Zhang Z, Silva A, Stavropoulos S, Ahn S, Bai H. 3:18 PM Abstract No. 292 Differentiation of malignant and benign renal tumors using magnetic resonance–based radiomics. J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Bogar O, Zajac J, Zacek F, Varavin M, Hron M, Panek R, Silva A. Microwave reflectometer for density profile and turbulence measurements on the COMPASS tokamak. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2020; 91:013515. [PMID: 32012635 DOI: 10.1063/1.5099345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 01/07/2020] [Indexed: 06/10/2023]
Abstract
The fast microwave reflectometer system on the COMPASS tokamak consists of an O-mode polarized K-band (18 GHz-26 GHz), Ka-band (26 GHz-40 GHz), and a part of U-band (40 GHz-54 GHz). The plasma density profile from the edge plasma area is measured using a fast sweeping rate up of to 6 µs of the probing wave. The processing of the reflected signal is realized by the heterodyne detection configuration based on the I/Q modulator. Two different methods of dynamic calibration of the required linear sweep frequency, together with static frequency and dispersion calibration, were used. The electron density profile was reconstructed by a spectrogram-based method with four sweeps on average. The system has the capability to measure the mid-plane low-field side electron density profile in the density range from 4 × 1018 m-3 to 3.6 × 1019 m-3. Experimental results obtained on COMPASS discharges are presented to demonstrate the performance of the diagnostics.
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Souza C, Brandão F, Santos J, Alfradique V, Brair V, Prellwitz L, Rangel PS, Silva A, Souza-Fabjan JM. 38 Ram sperm longevity after cryopreservation in extender containing L-carnitine. Reprod Fertil Dev 2020. [DOI: 10.1071/rdv32n2ab38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The cryopreservation process causes oxidative stress to the sperm cell, and the addition of antioxidants to the extender for semen freezing helps sperm protection. This study assessed the effect of L-carnitine (LC) concentrations (0, 5, or 10mM LC) on two ram semen extenders (Tris-egg yolk or the commercial optiXcell IMV medium (IMV Technologies)) for semen cryopreservation. Four Santa Inês rams were used during the breeding season. After semen collection, macroscopic and microscopic evaluations were performed, and a pool of semen was formed. The semen was diluted, and the final concentration was 100×106 per 0.25-mL straw. Cryopreservation was performed with a cooling rate of 0.25°C min−1 until 5°C, and the freezing rate used was 20°C min−1 from 5 to −120°C. After the freezing-thawing process and throughout incubation (38°C in 5% CO2) in Fert-Tyrode's albumin lactate pyruvate medium, every 1h for up to 3h, several parameters were evaluated: sperm kinetics, hypo-osmotic test, plasma membrane integrity, capacitation status, and lipid peroxidation level. We did not find any protective effect of LC on plasma membrane integrity, hypo-osmotic test, and capacitation status. The sperm kinetics values throughout incubation showed that Tris extender promoted better indices of staight-line velocity, linearity, wobble, and straightness than IMV extender along incubation, regardless of the presence of LC. There were no benefits of the LC addition throughout the incubation, and 10mM was deleterious to few parameters (amplitude of lateral head displacement, linearity, and wobble) compared with the control (0mM) in the Tris extender group. The plasma membrane integrity analysis revealed no differences (P>0.05) among the groups. The average number of intact cells (hypo-osmotic) was higher in Tris extender groups supplemented with 10mM LC at 1h and 5mM LC at 2h compared to the respective extender IMV groups. Regarding capacitation status, the Tris 5mM LC group had more acrosome-reacted cells when compared with the IMV 5mM LC group at 2h. At 3h, the percentage of acrosome-reacted cells was higher in the Tris 0-mM group when compared with the IMV 0-mM group. Regardless the presence of LC, IMV had higher (P<0.05) lipoperoxidation than the Tris treatments. In conclusion, LC supplementation in semen extender had no beneficial effect on freezing-thawing ram sperm and throughout incubation for up to 3h, with no difference in each time point evaluated. Under the conditions of this study, the use of Tris extender was superior to IMV extender for ram sperm.
Financial support for this work came from the Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (Young Scientist Program of Our State; E-26/203.168/2017).
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