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Miranda J, Caires A, Botelho C, Rodrigues Cernadas J. Anaphylaxis in a Central University Hospital: A 2-Decade Comparison Study. J Investig Allergol Clin Immunol 2023; 33:417-418. [PMID: 36789838 DOI: 10.18176/jiaci.0889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Affiliation(s)
- J Miranda
- Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João EPE, Porto, Portugal
| | - A Caires
- Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João EPE, Porto, Portugal
| | - C Botelho
- Consulta de Imunoalergología, Hospital de Braga EPE, Braga, Portugal
| | - J Rodrigues Cernadas
- Serviço de Imunoalergologia, Centro Hospitalar Universitário de São João EPE, Porto, Portugal
- Unidade de Imunoalergología, Hospital Lusíadas, Porto, Portugal
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Dias de Castro E, Barbosa J, Mesquita AM, Caires A, Ribeiro L, R Cernadas J, Baiardini I. Drug Hypersensitivity Quality of Life Questionnaire: validation procedures and first results of the Portuguese version. Health Qual Life Outcomes 2021; 19:143. [PMID: 33971887 PMCID: PMC8108344 DOI: 10.1186/s12955-021-01749-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hypersensitivity reactions to drugs are unpredictable and can be very complex and severe, even life threatening. Assess its impact on patient's health related quality of life (HRQoL) is crucial. The Drug Hypersensitivity Quality of Life Questionnaire (DrHy-Q) is the only validated disease-specific HRQoL questionnaire. We aimed to translate and cross-cultural validate the DrHy-Q to the Portuguese population. It was also our purpose to determine the impact of drug hypersensitivity on patients' HRQoL. METHODS The translation and cross-cultural adaptation of the DrHy-Q to Portuguese was performed according to standards. Reliability of the DrHy-Q Portuguese version was assessed in terms of internal consistency and test-retest reliability. Structural validity, divergent validity (with a generic health related QoLQ-PGWBI) and discriminant validity were also evaluated. Forty patients accepted to participate in the validation phase. The Portuguese version of the DrHy-Q was applied to 260 consecutively adult patients, studied in our Department for suspected drug hypersensitivity. RESULTS The Portuguese DrHy-Q showed adequate internal consistency (Cronbach's ɑ = 0.938), good test-retest reliability [ICC = 0.713 (95% CI 0.488-0.850] and one-dimensional structure. No significant correlation was found between the DrHy-Q and the PGWBI total scores (r = - 0.010, p = 0.957). Two hundred of patients completed the study: 78.5% female; mean age = 44 ± 15 years. Mean DrHy-Q score was 36.8 ± 12.6. Two clinical factors significantly predict DrHy-Q total score: clinical manifestations and number of suspected drugs. Patients with anaphylaxis (β = 11.005; 95% CI 5.523; 16.487), urticaria/angioedema (β = 7.770; 95% CI 2.600; 12.940) and other manifestations (β = 7.948; 95% CI 1.933; 13.962) are more likely to have higher DrHy-Q total score than patients with maculopapular exanthema. Patients with ≥ 2 suspected drugs are also more likely to have worse QoL (β = 7.927; 95% CI 3.687; 12.166). CONCLUSION The Portuguese version of DrHy-Q revealed adequate validity and reliability, indicating that it is appropriate to assess the impact of drug hypersensitivity on patients' HRQoL, providing data for a better comprehension and management of our patients. Moreover, our results highlight that the severity of the drug hypersensitivity reaction and the number of suspected drugs have impact on patient's DrHy-QoL.
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Affiliation(s)
- E Dias de Castro
- Allergy and Clinical Immunology Department, Centro Hospitalar Universitário de S. João EPE, Porto, Portugal. .,MedInUP- Center for Drug Discover and Innovative Medicines, Faculty of Medicine, University of Porto, Porto, Portugal.
| | - J Barbosa
- Public Health and Forensic Sciences and Medical Education Department, Faculty of Medicine, University of Porto, Porto, Portugal.,UNIC- Cardiovascular Research and Development Unit, University of Porto, Porto, Portugal
| | - A M Mesquita
- Allergy and Clinical Immunology Department, Centro Hospitalar Universitário de S. João EPE, Porto, Portugal
| | - A Caires
- Allergy and Clinical Immunology Department, Centro Hospitalar Universitário de S. João EPE, Porto, Portugal
| | - L Ribeiro
- Public Health and Forensic Sciences and Medical Education Department, Faculty of Medicine, University of Porto, Porto, Portugal.,Biomedicine Department, Faculty of Medicine, University of Porto, Porto, Portugal.,I3S- Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
| | - J R Cernadas
- Allergy and Clinical Immunology Department, Centro Hospitalar Universitário de S. João EPE, Porto, Portugal
| | - I Baiardini
- Allergy and Respiratory Diseases Clinic - DIMI, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
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Caires A, Fernandes GS, Leme AM, Castino B, Pessoa EA, Fernandes SM, Fonseca CD, Vattimo MF, Schor N, Borges FT. Endothelin-1 receptor antagonists protect the kidney against the nephrotoxicity induced by cyclosporine-A in normotensive and hypertensive rats. ACTA ACUST UNITED AC 2017; 51:e6373. [PMID: 29267497 PMCID: PMC5731326 DOI: 10.1590/1414-431x20176373] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 09/12/2017] [Indexed: 01/13/2023]
Abstract
Cyclosporin-A (CsA) is an immunosuppressant associated with acute kidney injury and chronic kidney disease. Nephrotoxicity associated with CsA involves the increase in afferent and efferent arteriole resistance, decreased renal blood flow (RBF) and glomerular filtration. The aim of this study was to evaluate the effect of Endothelin-1 (ET-1) receptor blockade with bosentan (BOS) and macitentan (MAC) antagonists on altered renal function induced by CsA in normotensive and hypertensive animals. Wistar and genetically hypertensive rats (SHR) were separated into control group, CsA group that received intraperitoneal injections of CsA (40 mg/kg) for 15 days, CsA+BOS and CsA+MAC that received CsA and BOS (5 mg/kg) or MAC (25 mg/kg) by gavage for 15 days. Plasma creatinine and urea, mean arterial pressure (MAP), RBF and renal vascular resistance (RVR), and immunohistochemistry for ET-1 in the kidney cortex were measured. CsA decreased renal function, as shown by increased creatinine and urea. There was a decrease in RBF and an increase in MAP and RVR in normotensive and hypertensive animals. These effects were partially reversed by ET-1 antagonists, especially in SHR where increased ET-1 production was observed in the kidney. Most MAC effects were similar to BOS, but BOS seemed to be better at reversing cyclosporine-induced changes in renal function in hypertensive animals. The results of this work suggested the direct participation of ET-1 in renal hemodynamics changes induced by cyclosporin in normotensive and hypertensive rats. The antagonists of ET-1 MAC and BOS reversed part of these effects.
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Affiliation(s)
- A Caires
- Disciplina de Nefrologia, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - G S Fernandes
- Disciplina de Nefrologia, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - A M Leme
- Disciplina de Nefrologia, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.,Programa Interdisciplinar em Ciências da Saúde, Instituto de Ciências da Atividade Física e Esporte, Universidade Cruzeiro do Sul, São Paulo, SP, Brasil
| | - B Castino
- Programa Interdisciplinar em Ciências da Saúde, Instituto de Ciências da Atividade Física e Esporte, Universidade Cruzeiro do Sul, São Paulo, SP, Brasil
| | - E A Pessoa
- Disciplina de Nefrologia, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - S M Fernandes
- Laboratorio Experimental de Modelos Animais (LEMA), Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brasil
| | - C D Fonseca
- Laboratorio Experimental de Modelos Animais (LEMA), Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brasil.,Departamento de Enfermagem Clínica e Cirúrgica, Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - M F Vattimo
- Laboratorio Experimental de Modelos Animais (LEMA), Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brasil
| | - N Schor
- Disciplina de Nefrologia, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - F T Borges
- Disciplina de Nefrologia, Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brasil.,Programa Interdisciplinar em Ciências da Saúde, Instituto de Ciências da Atividade Física e Esporte, Universidade Cruzeiro do Sul, São Paulo, SP, Brasil
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Prima V, Gore L, Caires A, Boomer T, Yoshinari M, Imaizumi M, Varella-Garcia M, Hunger SP. Cloning and functional characterization of MEF2D/DAZAP1 and DAZAP1/MEF2D fusion proteins created by a variant t(1;19)(q23;p13.3) in acute lymphoblastic leukemia. Leukemia 2005; 19:806-13. [PMID: 15744350 DOI: 10.1038/sj.leu.2403684] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We analyzed the TS-2 acute lymphoblastic leukemia (ALL) cell line that contains a t(1;19)(q23;p13.3) but lacks E2A-PBX1 fusion typically present in leukemias with this translocation. We found that the t(1;19) in TS-2 fuses the 19p13 gene DAZAP1 (Deleted in Azoospermia-Associated Protein 1) to the 1q23 gene MEF2D (Myocyte Enhancer Factor 2D), leading to expression of reciprocal in-frame DAZAP1/MEF2D and MEF2D/DAZAP1 transcripts. MEF2D is a member of the MEF2 family of DNA binding proteins that activate transcription of genes involved in control of muscle cell differentiation, and signaling pathways that mediate response to mitogenic signals and survival of neurons and T-lymphocytes. DAZAP1 is a novel RNA binding protein expressed most abundantly in the testis. We demonstrate that MEF2D/DAZAP1 binds avidly and specifically to DNA in a manner indistinguishable from that of native MEF2D and is a substantially more potent transcriptional activator than MEF2D. We also show that DAZAP1/MEF2D is a sequence-specific RNA-binding protein. MEF2D has been identified as a candidate oncogene in murine retroviral insertional mutagenesis studies. Our data implicate MEF2D in human cancer and suggest that MEF2D/DAZAP1 and/or DAZAP1/MEF2D contribute to leukemogenesis by altering signaling pathways normally regulated by wild-type MEF2D and DAZAP1.
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Affiliation(s)
- V Prima
- Department of Pediatrics, University of Florida College of Medicine and the University of Florida Shands Cancer Center, Gainesville, FL 32610, USA
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Pereira D, de Freitas AD, Caires A, Sousa A, Freitas A, Pereira E, Silva JA, Araújo JJ, de Sousa S, Cardoso AA. [Assessment of the first myocardial infarctions with lead ECG --implications in the study of hospital mortality and its reduction using thrombolytic drugs]. Rev Port Cardiol 1991; 10:141-5. [PMID: 2059471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
STUDY OBJECTIVE Correlation between mortality reduction of first Myocardial Infarction (MI) by thrombolytic therapy and MI size evaluated with the classical Electrocardiogram (ECG). DESIGN A retrospective sequential study. SETTING Coronary Unit patients. PATIENTS Sequential sample of 132 patients with first MI obeying all the following criteria: 1) no previous MI; 2) age less than or equal to 70 years; 3) clinical evolution less than 12 hours; 4) no Left Bundle Branch Block in the CCU first ECG; 5) ischemic ST elevation in greater than or equal to 1 initial ECG leads. Patients were divided into Group A, with less than or equal to 3 initial ECG leads with ischemic ST elevation (n = 80), and Group B, with greater than or equal to 4 initial ECG leads with ischemic ST elevation (n = 52). Only 34 patients (25.7%) did thrombolytic therapy with IV Streptokinase (SK); 15 from Group A and 19 from Group B. MEASUREMENTS AND MAIN RESULTS 17 patients died in MI acute phase (12.8%); 4 in Group A (5%) and 13 in Group B (24.9%). Inhospital mortality was statistically worst in Group B than in Group A (24.9% vs 5% with p less than 0.01). Creatin kinase (CK) maximal values (A = 911.5 UI; B = 1444.6 UI with p less than 0.01) and initial Heart Rate (A = 75.7; B = 86.7 with p less than 0.001) were also statistically greatest in Group B. Inhospital mortality was smaller in patients treated with SK (8.8% vs 14.3%), as in Group B (10.5% vs. 33.3%), both without statistical significance. CONCLUSIONS Inhospital mortality and thrombolytic therapy benefit were so bigger as MI size evaluated by the number of initial ECG leads with ischemic ST elevation, by initial HR and maximal values of CK. Classical ECG can be useful by identifying patients with first MI that can more benefit with thrombolytic therapy (greater than or equal to 4 leads with ischemic ST elevation).
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Affiliation(s)
- D Pereira
- Interno do Internato Complementar de Cardiologia do CHF
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