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Philippi H, Sommerfeld V, Monteiro A, Rodehutscord M, Olukosi OA. Bone characteristics, pre-caecal phytate degradation, mineral digestibility and tissue expression were marginally affected by zinc level and source in phytase-supplemented diets in 21-day-old broiler chickens. Br Poult Sci 2024:1-11. [PMID: 38393942 DOI: 10.1080/00071668.2024.2311290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 12/29/2023] [Indexed: 02/25/2024]
Abstract
1. This study determined the effect of dietary Zn concentration and source in phytase-supplemented diets on bone mineralisation, gastrointestinal phytate breakdown, mRNA-level gene expression (in jejunum, liver and Pectoralis major muscle) and growth performance in broiler chickens.2. Male Cobb 500 broilers were housed in floor pens (d 0-d 21) to test seven treatments with six replicate pens (12 birds per pen). Diets were arranged in a 2 × 3 + 1-factorial arrangement. The experimental factors were Zn source (Zn-oxide (ZnO) or Zn-glycinate (ZnGly) and Zn supplementation level (10, 30 or 50 mg/kg of diet). A maize-soybean meal-based diet without supplementation and formulated to contain 28 mg Zn/kg (analysed to be 35 mg Zn/kg), served as a control.3. Zinc source and level did not influence (p > 0.05) bone ash concentration and quantity or mineral concentrations in bone ash. Tibia thickness was greater in the treatment ZnO10 than in the treatments ZnO30 and ZnGly50 (Zn level × Zn source: p = 0.036), but width and breaking strength were not affected.4. Pre-caecal P digestibility and concentrations of phytate breakdown products in the ileum, except for InsP5, were not affected by Zn source or level. Only the expression of EIF4EBP1 (eukaryotic translation initiation factor 4E-binding protein 1) and FBXO32 (F-box only protein 32) in Pectoralis major muscle was affected by source, where expression was increased in ZnO compared to ZnGly diets (p < 0.05).5. In conclusion, Zn level and source did not affect gastrointestinal phytate degradation and bone mineralisation in phytase-supplemented diets. The intrinsic Zn concentration appeared to be sufficient for maximum bone Zn deposition under the conditions of the present study but requires validation in longer-term trials.
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Affiliation(s)
- H Philippi
- Institute of Animal Science, University of Hohenheim, Stuttgart, Germany
| | - V Sommerfeld
- Institute of Animal Science, University of Hohenheim, Stuttgart, Germany
| | | | - M Rodehutscord
- Institute of Animal Science, University of Hohenheim, Stuttgart, Germany
| | - O A Olukosi
- Department of Poultry Science, University of Georgia, Athens, GA, USA
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2
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Lobo RR, Almeida E, Monteiro A, Silva SS, Salas-Solis G, Coronella CJ, Hiibel SR, Faciola AP. Replacing soybean meal with microalgae biomass in diets with contrasting carbohydrate profile can reduce in vitro methane production and improve short-chain fatty acids production. J Dairy Sci 2024:S0022-0302(24)00495-8. [PMID: 38395394 DOI: 10.3168/jds.2023-24025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 01/20/2024] [Indexed: 02/25/2024]
Abstract
The objective of this study was to evaluate the interaction of dietary carbohydrate profile and soybean meal (SBM) replacement with either Chlorella pyrenoidosa (CHL) or Spirulina platensis (SPI) on in vitro fermentation. This experiment was conducted as a randomized complete block design, with fermentation run (3 runs) considered as blocks. The treatments were arranged in a 2 × 5 factorial design, where the first factor was the carbohydrate profile, which was composed of diets containing 42.5% NDF and 26.8% starch (HF-LS) or 26.8% NDF and 40.6% starch (LF-HS) and the second factor was the protein source, in which a control diet (100% SBM), partial replacement of SBM with CHL (1/2 CHL) or SPI (1/2 SPI), or total replacement of SBM with CHL or SPI were used. All experimental diets were formulated to have 17% crude protein. The ruminal fluid was collected from 2 lactating Holstein cows, buffered with Van Soest medium at a ratio of 1:2 and added to serum bottles containing 0.50 g of the experimental diets. Bottles were incubated at 39°C for 24 and 48 h in triplicate; headspace pressure was measured, along with gas collection for methane (CH4) quantification at 0, 2, 4, 8, 16, 24, 36, and 48 h after incubation. The final medium was used to measure pH, ammonia, and volatile-fatty acid (VFA). After incubation, feed bags were recovered and used for estimation of degradability of DMD, NDF, and OMD. Statistical analysis was carried out using the MIXED procedure of SAS, with carbohydrate profile, protein source, assay, and its interactions as fixed effects, with run and bottle as random effects. Orthogonal contrasts were used to compare carbohydrate profile, algae species, carbohydrate profile × algae interaction, and linear and quadratic effects of SBM replacement with CHL or SPI. There was no interaction effect between carbohydrate profile and algae source. LF-HS improved gas production, degradability of nutrients, and VFA, mainly increasing the production of butyrate and propionate. When compared with CHL, SPI had a greater degradability of nutrients and branched VFA, along with reduction in total gas production and tended to reduce total CH4 yield. The replacement of SBM with algae linearly reduced the degradability of nutrients, along with a linear reduction in gas production. When replacement of SBM with only SPI was evaluated, SPI slightly reduced the degradability of nutrients; however, it promoted a linear reduction in CH4 yield, as well as reduction in CH4 yield by unit of degraded DM, NDF, and OM. In summary, there was no interaction of carbohydrate profile and protein source, which means that SBM replacement had a similar effect, regardless of dietary carbohydrate profile. Spirulina may be a more suitable algae source when compared with Chlorella due to the potential to reduce CH4.
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Affiliation(s)
- R R Lobo
- Department of Animal Sciences, University of Florida, Gainesville, FL 32608, United States
| | - E Almeida
- Department of Animal Sciences, University of Florida, Gainesville, FL 32608, United States; Department of Animal Science, Federal University of Viçosa, Viçosa, MG, Brazil
| | - A Monteiro
- Department of Animal Sciences, University of Florida, Gainesville, FL 32608, United States; Animal Nutrition Laboratory, Center for Nuclear Energy in Agriculture, University of São Paulo, Piracicaba, SP, Brazil
| | - S S Silva
- Department of Animal Sciences, University of Florida, Gainesville, FL 32608, United States
| | - G Salas-Solis
- Department of Animal Sciences, University of Florida, Gainesville, FL 32608, United States
| | - C J Coronella
- Department of Chemical and Materials Engineering, University of Nevada, Reno, NV 89557
| | - S R Hiibel
- Department of Chemical and Materials Engineering, University of Nevada, Reno, NV 89557
| | - A P Faciola
- Department of Animal Sciences, University of Florida, Gainesville, FL 32608, United States.
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Russo MA, Rafael S, Lopes D, Quinteiro P, Monteiro A. An integrated analysis of COVID-19 impacts on energy and environment: Lessons learnt. Atmos Pollut Res 2023; 14:101637. [PMID: 36540303 PMCID: PMC9754326 DOI: 10.1016/j.apr.2022.101637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
Carbon neutrality, sustainable development and reducing our impact on the environment is the top priority in future measures. The COVID-19 pandemic brought challenges to every sector at a global scale but can provide valuable insight to reach these goals. The main objective of this work is to provide an integrated analysis of the impact of the COVID-19 pandemic, focused on energy and its related aspects, i.e., environment and costs. Mainland Portugal was used as a case study and two years were analysed, one pre pandemic (2019) and another post pandemic (2020). In 2020, the majority of sectors - Transport, Services, Industry and Agriculture & Fisheries - show a reduction of energy consumption, atmospheric emissions, carbon footprint and related monetary and social costs. In contrast, the Domestic sector presents an overall increase, with maximums of 25.4% in electricity consumption (during Spring), 0.72% in the PM10 (particulate matter) and NOx (nitrogen dioxides) emissions (in Summer), and 2.9% in carbon footprint (in Spring). The integrated analysis proposed in this work was crucial to identify the paths to a post pandemic world focused on the different aspects of sustainability - new concepts of mobility and workplace, as well as increased investment in energy performance and renewable energy sources. This study showed that changing our energy consumption patterns could significantly affect future greenhouse gas emissions, and contribute to the sustainable growth of the economy, while maintaining good progress towards climate-neutral goals.
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Affiliation(s)
- M A Russo
- CESAM, Department of Environment and Planning, University of Aveiro, 3810-193, Aveiro, Portugal
| | - S Rafael
- CESAM, Department of Environment and Planning, University of Aveiro, 3810-193, Aveiro, Portugal
| | - D Lopes
- CESAM, Department of Environment and Planning, University of Aveiro, 3810-193, Aveiro, Portugal
| | - P Quinteiro
- CESAM, Department of Environment and Planning, University of Aveiro, 3810-193, Aveiro, Portugal
| | - A Monteiro
- CESAM, Department of Environment and Planning, University of Aveiro, 3810-193, Aveiro, Portugal
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4
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Luo L, Srivastava A, Freisenhausen J, Saha P, Khera N, Prieux R, Monteiro A, Pivarcsi A, Sonkoly E. 346 MiR-149: a microRNA regulating keratinocyte immune responses in psoriasis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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5
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Carvalho D, Rafael S, Monteiro A, Rodrigues V, Lopes M, Rocha A. How well have CMIP3, CMIP5 and CMIP6 future climate projections portrayed the recently observed warming. Sci Rep 2022; 12:11983. [PMID: 35835803 PMCID: PMC9283450 DOI: 10.1038/s41598-022-16264-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 02/25/2022] [Accepted: 07/07/2022] [Indexed: 11/16/2022] Open
Abstract
Despite the dire conclusions of the Intergovernmental Panel on Climate Change (IPCC) Assessment Reports in terms of global warming and its impacts on Earth’s climate, ecosystems and human society, a skepticism claiming that the projected global warming is alarmist or, at least, overestimated, still persists. Given the years passed since the future climate projections that served as basis for the IPCC 4th, 5th and 6th Assessment Reports were released, it is now possible to answer this fundamental question if the projected global warming has been over or underestimated. This study presents a comparison between CMIP3, CMIP5 and CMIP6 future temperature projections and observations. The results show that the global warming projected by all CMIPs and future climate scenarios here analyzed project a global warming slightly lower than the observed one. The observed warming is closer to the upper level of the projected ones, revealing that CMIPs future climate scenarios with higher GHG emissions appear to be the most realistic ones. These results show that CMIPs future warming projections have been slightly conservative up to 2020, which could suggest a similar cold bias in their warming projections up to the end of the current century. However, given the short future periods here analyzed, inferences about warming at longer timescales cannot be done with confidence, since the models internal variability can play a relevant role on timescales of 20 years and less.
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Affiliation(s)
- D Carvalho
- CESAM-Department of Physics, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal.
| | - S Rafael
- CESAM-Department of Environment and Planning, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
| | - A Monteiro
- CESAM-Department of Environment and Planning, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
| | - V Rodrigues
- CESAM-Department of Environment and Planning, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
| | - M Lopes
- CESAM-Department of Environment and Planning, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
| | - A Rocha
- CESAM-Department of Physics, University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
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Duarte F, Coutinho I, Barradas MI, Oliveira L, Serena C, Fontes A, Monteiro A, Machado C, Santos E, Pelicano N, Pacheco M, Tavares A, Martins D. Acute ST-elevation myocardial infarction: are men and women particular cases of STEMI ? Eur J Cardiovasc Nurs 2022. [DOI: 10.1093/eurjcn/zvac060.021] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
ST-segment elevation myocardial infarction (STEMI) has high levels of morbidity and mortality. Multiple risk factors may contribute to clinical outcomes and some studies demonstrate gender-related differences in baseline characteristics and in-hospital management.
Purpose
To access the difference in clinical characteristics and prognostic outcomes between men and women who were admitted in our Cardiac Intensive Care Unit with STEMI diagnosis.
Methods
We retrospectively analyzed 121 non-consecutive patients with STEMI during a mean follow-up period 135 ± 31 weeks.
We accessed baseline characteristics and time course of events (symptom onset-to-door admission; time to first EKG; time to fibrinolytic therapy; door-to-cath lab time and time from fibrinolytic therapy to PCI (for patients transferred from another centers).
Primary endpoint (PE) was a composite of in-hospital cardiovascular death, arrhythmic events or STEMI evolution in Killip-Kimbal III or IV.
Secondary endpoint (SE) was in-hospital major bleeding events, considered intracerebral hemorrhage, cases of hemodynamic compromise or requiring a blood transfusion.
Tertiary endpoint (TE) included admissions to the emergency department or hospitalization by heart failure decompensation, acute or chronic coronary syndromes and all-cause mortality.
Results
Of the 121 patients, 102 were male (84.3%) and 19 (15.7%) female. The mean age was 58.3 ± 12.7 years and women had a superior mean age (69.8 ± 12.2 years) vs. Men mean age 56 ± 11.6 years.
Hypertension was more prevalent in women (84.2% vs. 47.1%, respectively; p 0.003) and also diabetes – 36.8% of women had type 2 diabetes (vs 10.8% of men) and 5.3% of these female patients requires insulin therapy (vs 2% of men; p 0.021).
According to Charlson Comorbidity Index (CCI), women had a higher disease burden with 73.7% of them included into the moderate or severe group of mortality risk, compared to 42.2% of men (p 0.014).
Conversely, less women smoke (31.6% vs. 82.2%; p <0.001) and less frequently chest pain was the onset symptom (78.9% vs. 95.1%; p 0.04).
Time since symptom onset to door admission was estimated on 510 ± 1149 minutes and the mean women delay was superior (557 ± 858 minutes).
Regarding to in-hospital hemorrhagic events (secondary endpoint), female patients had a statistically significant higher risk (22.2% vs. 7.1%, p 0.045), independently of hypertension, diabetes or anticoagulant therapy (r=0.249; ANOVA p-value < 0.005), but it was associated with higher CCI (p 0.033). No other gender differences in outcomes or survival function were observed.
Conclusion
Our study demonstrates gender-related differences among patients with STEMI. Indeed, women were older, had more clinical cardiovascular risk factors and tend to delay hospital admission after symptoms onset. Secondary endpoint was statistically more frequent in women, but no other differences in outcomes were observed.
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Affiliation(s)
- F Duarte
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - I Coutinho
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - M I Barradas
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - L Oliveira
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - C Serena
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - A Fontes
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - A Monteiro
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - C Machado
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - E Santos
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - N Pelicano
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - M Pacheco
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - A Tavares
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
| | - D Martins
- Hospital Divino Espirito Santo , Ponta Delgada , Portugal
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7
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Duarte F, Barradas MI, Barradas MI, Oliveira L, Oliveira L, Serena C, Serena C, Fontes A, Fontes A, Monteiro A, Monteiro A, Machado C, Machado C, Dourado R, Dourado R, Santos E, Santos E, Pelicano N, Pelicano N, Pacheco M, Pacheco M, Tavares A, Tavares A, Martins D, Martins D. Risk scores in predicting adverse events after an acute coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehab849.081] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
ST-segment elevation myocardial infarction (STEMI) is a serious event that usually occur in patients with cardiovascular risk factors and is associated with great morbidity and mortality.
PARIS ischemic risk score and TIMI score were validated to evaluate ischemic risk in STEMI patients who underwent percutaneous coronary intervention (PCI) and to estimate mortality, respectively.
Despite these specific purposes, the usefulness of these scores in predicting adverse cardiovascular events (ACE) is unknown.
Objectives
To assess the prognostic value of PARIS and TIMI scores for cardiovascular events, coronary ischemic events and mortality in patients after STEMI.
Methods
Retrospective single center cohort study enrolled 103 patients with STEMI diagnosis between 2018 and 2019, during a mean follow-up period 30.30 ± 6.46 months and patients were included regardless of the reperfusion strategy.
Primary endpoint (PE) was a composite of acute coronary events (ACE), admissions to the emergency department by heart failure (HF) decompensation or chronic coronary syndrome and HF hospitalization. Secondary endpoint (SE) was ACE. Cardiovascular and non-cardiovascular death was determined.
PARIS ischemic risk score was calculated and patients were stratified into low (0-2), intermediate (3-4) or high (≥ 5) ischemic risk categories. TIMI score was also assessed.
Results
Out of 103 patients with STEMI diagnosis, the median age was 58.15 ± 12.6 years and 85,4% were male. Fifty-seven patients (55.3%) had hypertension, 45 (43.7%) dyslipidemia, 18 (17.5%) diabetes, 17 (15.5%) were obese and seventy-eight patients (75.7%) had history of smoking. Twenty (19.4%) patients had a previous acute coronary syndrome and 15 underwent PCI.
Twenty-five (24.3%) patients were included in low PARIS ischemic risk category, 53 (51.5%) in intermediate risk and 20 (19.4%) in high risk category.
PE occurred in 16 patient (15.5%) and SE in 7 patients (6.8%).
Eight patients died during the follow-up period (7.8%), 4 of cardiovascular causes (50%), 3 of non-cardiovascular causes (37.5%) and 1 of unknown cause.
PARIS ischemic risk score showed prognostic value for PE, with an area under the curve (AUC) of 0.65, 95% confidence interval (CI) 0.506-0.806 and p-value 0.039.
PARIS score also had predictive value for SE (AUC 0.816, 95% CI 0.604-1.000; p 0.004) as well as TIMI score (AUC 0.738, 95% CI 0.560 – 0.917; p 0.032).
Both scores showed a good prognostic value in evaluating all-cause mortality, with a slightly better predictive value for TIMI score (AUC 0.91, 95% CI 0.802 – 1.00) when compared to PARIS score (AUC 0.84, 95% CI 0.685 – 0.987).
Conclusion
This study revealed that PARIS and TIMI scores have a good discriminatory power to predict prognosis in STEMI patients. According to our study results, these scores could be an interesting tool to determine the likelihood of fatal and non-fatal outcomes, including ACS.
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Affiliation(s)
- F Duarte
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - M I Barradas
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - M I Barradas
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - L Oliveira
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - L Oliveira
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Serena
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Serena
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Fontes
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Fontes
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Monteiro
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Monteiro
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Machado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Machado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - R Dourado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - R Dourado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - E Santos
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - E Santos
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - N Pelicano
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - N Pelicano
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - M Pacheco
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - M Pacheco
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Tavares
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Tavares
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - D Martins
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - D Martins
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
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Duarte F, Barradas MI, Oliveira L, Serena C, Fontes A, Monteiro A, Machado C, Dourado R, Santos E, Pelicano N, Pacheco M, Tavares A, Martins D. Hemorrhagic risk scores in hospitalized patients with acute coronary syndrome: can they (only) predict bleeding events? Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehab849.082] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Acute coronary syndrome (ACS) is a life-threatening condition and its therapeutic approach increases the risk of important bleeding events which are associated with a worse prognosis. Along with hemorrhagic events, a drop on hemoglobin level not related to bleeding or the development of anemia could have a negative impact on prognosis.
Both CRUSADE and PARIS bleeding risk scores are used to evaluate and to stratify the risk of major bleeding in ACS. However their actual predictive value has been questioned and validity of these scores in predicting in-hospital mortality (IHM) is not established.
Objectives
To evaluate the actual prognostic value of CRUSADE and PARIS bleeding scores in ACS patients during their hospitalization stay.
Methods
Retrospective single center cohort study including 103 hospitalized patients after an acute ST-segment elevation myocardial infarction (STEMI) regardless of its reperfusion strategy.
In-hospital major hemorrhagic events (IHMHE), considered intracerebral hemorrhage, those resulting in hemodynamic compromise or requiring a blood transfusion, were assessed. Data on hemoglobin levels (HL) at hospital admission and at the time of hospital discharge were also collected and a composite endpoint (CE) of IHMHE and a drop in HL ≥ 3g/dL were elaborated.
Both scores were calculated for each patient, its predictive value and their impact on IHM were determined.
Results
Out of 103 patients enrolled, the median age was 58.15 ± 12.6 years and 85.4% were male.
Two IHMHE occurred, twenty patients (19.4%) had anemia at the time of hospital discharge and 16 of these patients (15.5%) were not anemic at the time of hospital admission. Nine (8.7%) patients had a drop in their HL of at least 3g/dL.
The five bleeding risk categories defined by CRUSADE investigators were used, with 48 (46.6%) patients in the very low risk category, 9 (8.7%) and 6 (5.8%) in the high and very high risk category, respectively.
Hospitalization length stay was 5.6 ± 4.1 days with an overall in-hospital mortality (IHM) of 5.8%.
Receiver operating characteristic curve (ROC) analysis showed that CRUSADE score had an excellent discriminatory power for the CE (AUC 0.927, 95% CI 0.854-1.000) and the PARIS score had an acceptable discriminatory value (AUC 0.775, 95% CI 0.616-0.935).
Both CRUSADE and PARIS bleeding scores also had prognostic value in evaluating IHM (AUC 0.929, 95% CI 0.856-1.000 and AUC 0.788, 95% CI 0.634-0.942, respectively).
No specific and independent predictors of IHMHE were found, neither related to individual characteristics nor to therapeutic approach.
Conclusion
The presenting study showed that CRUSADE and PARIS scores still have discriminatory power to assess CE and to assess IHM in ACS patients. Their addition to stratification tools could be of interest.
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Affiliation(s)
- F Duarte
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - M I Barradas
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - L Oliveira
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Serena
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Fontes
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Monteiro
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Machado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - R Dourado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - E Santos
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - N Pelicano
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - M Pacheco
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Tavares
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - D Martins
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
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Oliveira K, Rodrigues V, Slingerland S, Vanherle K, Soares J, Rafael S, Trozzi C, Bouman EA, Ferreira J, Kewo A, Nielsen PS, Diafas I, Monteiro A, Miranda AI, Lopes M, Hayes E. Assessing the impacts of citizen-led policies on emissions, air quality and health. J Environ Manage 2022; 302:114047. [PMID: 34741943 DOI: 10.1016/j.jenvman.2021.114047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 10/08/2021] [Accepted: 10/30/2021] [Indexed: 06/13/2023]
Abstract
Air pollution is a global challenge, and especially urban areas are particularly affected by acute episodes. Traditional approaches used to mitigate air pollution primarily consider the technical aspects of the problem but not the role of citizen behaviour and day-to-day practices. ClairCity, a Horizon 2020 funded project, created an impact assessment framework considering the role of citizen behaviour to create future scenarios, aiming to improve urban environments and the wellbeing and health of its inhabitants. This framework was applied to six pilot cases: Bristol, Amsterdam, Ljubljana, Sosnowiec, Aveiro Region and Liguria Region, considering three-time horizons: 2025, 2035 and 2050. The scenarios approach includes the Business As Usual (BAU) scenario and a Final Unified Policy Scenarios (FUPS) established by citizens, decision-makers, local planners and stakeholders based on data collected through a citizen and stakeholder co-creation process. Therefore, this paper aims to present the ClairCity outcomes, analysing the quantified impacts of selected measures in terms of emissions, air quality, population exposure, and health. Each case study has established a particular set of measures with different levels of ambition, therefore different levels of success were achieved towards the control and mitigation of their specific air pollution problems. The transport sector was the most addressed by the measures showing substantial improvements for NO2, already with the BAU scenarios, and overall, even better results when applying the citizen-led FUPS scenarios. In some cases, due to a lack of ambition for the residential and commercial sector, the results were not sufficient to fulfil the WHO guidelines. Overall, it was found in all cities that the co-created scenarios would lead to environmental improvements in terms of air quality and citizens' health compared to the baseline year of 2015. However, in some cases, the health impacts were lower than air quality due to the implementation of the measures not affecting the most densely populated areas. Benefits from the FUPS comparing to the BAU scenario were found to be highest in Amsterdam and Bristol, with further NO2 and PM10 emission reductions around 10%-16% by 2025 and 19%-28% by 2050, compared to BAU.
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Affiliation(s)
- K Oliveira
- CESAM & Department of Environment and Planning, University of Aveiro, Aveiro, Portugal.
| | - V Rodrigues
- CESAM & Department of Environment and Planning, University of Aveiro, Aveiro, Portugal
| | - S Slingerland
- Institute for Environmental Studies, Vrije Universiteit Amsterdam, Amsterdam, Netherlands and Trinomics B.V., Rotterdam, Netherlands
| | - K Vanherle
- Transport & Mobility Leuven, Diestsesteenweg 57, 3000, Leuven, Belgium
| | - J Soares
- Environmental Impacts and Sustainability, Norwegian Institute for Air Research, Kjeller, Norway
| | - S Rafael
- CESAM & Department of Environment and Planning, University of Aveiro, Aveiro, Portugal
| | | | - E A Bouman
- Environmental Impacts and Sustainability, Norwegian Institute for Air Research, Kjeller, Norway
| | - J Ferreira
- CESAM & Department of Environment and Planning, University of Aveiro, Aveiro, Portugal
| | - A Kewo
- DTU Management, Technical University of Denmark, 2800, Kongens Lyngby, Denmark
| | - P S Nielsen
- DTU Management, Technical University of Denmark, 2800, Kongens Lyngby, Denmark
| | - I Diafas
- PBL Netherlands Environmental Assessment Agency, the Netherlands
| | - A Monteiro
- CESAM & Department of Environment and Planning, University of Aveiro, Aveiro, Portugal
| | - A I Miranda
- CESAM & Department of Environment and Planning, University of Aveiro, Aveiro, Portugal
| | - M Lopes
- CESAM & Department of Environment and Planning, University of Aveiro, Aveiro, Portugal
| | - E Hayes
- University of the West of England, Bristol, United Kingdom
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10
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Rodrigues V, Gama C, Ascenso A, Oliveira K, Coelho S, Monteiro A, Hayes E, Lopes M. Assessing air pollution in European cities to support a citizen centered approach to air quality management. Sci Total Environ 2021; 799:149311. [PMID: 34364279 DOI: 10.1016/j.scitotenv.2021.149311] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 07/07/2021] [Accepted: 07/23/2021] [Indexed: 06/13/2023]
Abstract
European cities have made significant progress over the last decades towards clean air. Despite this progress, several cities are still facing acute air pollution episodes, with various urban areas frequently exceeding air quality levels allowed by the European legal standards and WHO guidelines. In this paper, six European cities/ regions (Bristol, UK; Amsterdam, NL; Sosnowiec, PL; Ljubljana, SI; Aveiro, PT; Liguria, IT) are studied in terms of air quality, namely particulate matter, nitrogen dioxide and ozone. The concentrations trends from 2008 to 2017 in the different typology of monitoring stations are addressed, together with the knowledge of daily, weekly and seasonal pollution patterns to better understand the city specific profiles and to characterize pollutant dynamics and variations in multiple locations. Additionally, an analysis of the duration and severity of air pollution episodes is also discussed, followed by an analysis of the fulfillment of the legislated limit values. Each of our 6 case study locations face different air pollution problems, but all these case studies have made some progress in reducing ambient concentrations. In Bristol, there have been strong downward trends in many air pollutants, but the levels of NO2 remain persistently high and of concern. In recent years, decreasing concentration levels point to some success of Amsterdam air quality policies. PM10 exceedances are a seasonal pollution problem in Ljubljana, Sosnowiec and Aveiro region (even if with different levels of severity). While, exceedances of NO2 and O3 concentrations are still problematic in Liguria region. The main findings of this paper are particular relevant to define and compare future citizen-led strategies and policy initiatives that may be implemented to improve and fulfill the EU legislation and the WHO guidelines.
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Affiliation(s)
- V Rodrigues
- CESAM & Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal.
| | - C Gama
- CESAM & Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal
| | - A Ascenso
- CESAM & Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal
| | - K Oliveira
- CESAM & Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal
| | - S Coelho
- CESAM & Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal
| | - A Monteiro
- CESAM & Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal
| | - E Hayes
- University of the West of England, Bristol, United Kingdom
| | - M Lopes
- CESAM & Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal
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11
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Russo MA, Ruivo L, Carvalho D, Martins N, Monteiro A. Decarbonizing the energy supply one pandemic at a time. Energy Policy 2021; 159:112644. [PMID: 36246728 PMCID: PMC9554235 DOI: 10.1016/j.enpol.2021.112644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/17/2021] [Accepted: 09/30/2021] [Indexed: 06/16/2023]
Abstract
This study explores different energy consumption vectors during the first year of the COVID-19 pandemic in Portugal. Most of the workforce started working from home and resource consumption significantly shifted towards the domestic sector. The ensuing confinement protocols caused a shift in everyday life, which in turn significantly altered the energy supply and demand landscape. This event, although catastrophic in terms of loss of human life and economic development, can provide us with valuable data to study the potential of new strategies to achieve EU 2050 Energy goals. It was investigated whether the pandemic has opened a path and provided us with a partial answer to decarbonization in the form of home office practices as a possible energy efficiency measure. The present study shows that, in Portugal, there was a 15.7% reduction of primary energy consumption (accounting for electricity, natural gas and transport fuels) compared to 2019. The data suggest that actions targeting reduced mobility, such as home office practices and the decentralization of the workforce, could be a relevant energy efficiency measure.
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Affiliation(s)
- M A Russo
- CESAM and Department of Environment and Planning, University of Aveiro, Portugal
| | - L Ruivo
- CICECO and Department of Materials and Ceramic Engineering, University of Aveiro, Portugal
| | - D Carvalho
- CESAM and Department of Physics, University of Aveiro, Portugal
| | - N Martins
- TEMA and Department of Mechanical Engineering, University of Aveiro, Portugal
| | - A Monteiro
- CESAM and Department of Environment and Planning, University of Aveiro, Portugal
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12
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Barradas Da Silva M, Duarte F, Oliveira L, Serena C, Fontes A, Monteiro A, Machado C, Dourado R, Santos E, Pelicano N, Pacheco M, Tavares A, Martins D. STEMI treatment in remote areas – challenges of the only interventional angioplasty center located in an archipelago. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1443] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In remote islands lack of specialized medical facilities, long distance transfer and emergency medical system organization remains a challenge and fibrinolysis is necessary to achieve revascularization in optimal timing in ST-elevation myocardial infarction (STEMI) patients. Our angioplasty center is the only one located in an archipelago composed of nine islands, six of which do not have hospital facilities and only have small family health care units.
Purpose
To evaluate the reality and outcomes of our interventional angioplasty center and compare cardiovascular outcomes between STEMI patients from the main island and remote islands.
Methods
We retrospectively evaluated 103 patients with STEMI admitted to our center between 2018 and 2019. Patients from the main island where the center is located underwent primary percutaneous coronary intervention (PCI) (group 1, n=55) and patients from remote islands underwent fibrinolytic therapy followed by transference to our center with facilitated or rescue PCI (group 2, n=48). A subanalysis of the far remote islands without hospital facilities was also performed. Primary outcome was defined as cardiovascular death or re-infarction at two years and secondary outcome as intrahospital haemorrhagic complications.
Results
Mean age was 58,15±12,6 years, 85,4% were males and follow up period was 30,30±6,46 months. Seventy-eight patients (75,7%) had history of smoking, 45 (43,7%) dyslipidemia, 20 (19,4%) previous acute coronary syndrome, 18 (17,5%) diabetes and 17 (15,5%) were obese. Troponin I peak was 117,42±129,06 ug/L and 14 (13,6%) were in Killip Class III/IV. Infarct-related artery was the left anterior descending artery in 45 (45,5%) and multivessel disease was present in 38 (38,0%). In group 1 reperfusion after PCI was obtained in 91,5%. In group 2, 73,5% met criteria for reperfusion after fibrinolysis and 23,6% after rescue PCI. Mean time from fibrinolysis to PCI was 558±349 minutes. Rates of successful revascularization did not differ between groups, as well as complete patency of the culprit-vessel defined as thrombolysis in myocardial infarction (TIMI) flow 3 (91,5% vs. 97,2% and 90,0% vs. 93,0% respectively for group 1 and 2). Cardiovascular death at two years occurred in 4 (3,9%) patients and re-infarction in 11 (10,7%) and were similar between groups (3 (5,5%) vs. 1 (2,1%) and 8 (14,5%) vs. 3 (6,3%) respectively) as well as haemorrhagic complications (1 (1,8%) vs. 5 (10,4%) respectively). Nineteen (18,4%) patients were from far remote islands without hospital facilities and when comparing these patients with the others there was also no difference in primary outcome.
Conclusion
Even in remote islands, an organized STEMI network with attempted fibrinolytic treatment and coordinated transference of patients for facilitated or rescue PCI can provide successful revascularization with cardiovascular outcomes similar to those submitted to primary PCI.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - F Duarte
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - L Oliveira
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Serena
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Fontes
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Monteiro
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Machado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - R Dourado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - E Santos
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - N Pelicano
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - M Pacheco
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Tavares
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - D Martins
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
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13
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Oliveira L, Duarte F, Barradas MI, Serena C, Fontes A, Almeida C, Machado C, Dourado R, Monteiro A, Santos E, Pelicano N, Pacheco A, Tavares A, Martins D. Early and long term prognostic accuracy of 4 acute pulmonary embolism mortality risk scores. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1893] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Acute pulmonary embolism (PE) is a frequent condition associated with significant morbidity and mortality. Multiple scores have been developed and validated to predict 30-day mortality risk, however accurate prognostic assessment remains a challenge in clinical practice.
Purpose
To compare the performance of PESI, simplified PESI, Hestia and Bova scores in predicting in-hospital, 30-day and 1-year mortality risk for acute PE.
Methods
We retrospectively assessed consecutive patients from a single center registry who were hospitalized with acute PE between January 2017 and October 2020. Discriminative power of each score was assessed by receiver operating characteristic curve analysis. Charlson comorbidity index (CCI) was also assessed for comparison.
Results
A total of 131 patients with a mean age of 67.6±15.3 years were included with a mean follow-up of 46.3±17.7 months. Thirty-six patients (27.5%) had a recent hospitalization or major surgery and 26 (19.8%) a medical history of cancer. Besides anticoagulation, 7 patients (5.3%) underwent fibrinolysis. Overall in-hospital mortality was 8.4%, 30-day mortality 12.2% and 1-year mortality 19.8%. All acute PE scores, except Bova score, were significantly higher in those patients who died during hospitalization and on 30-day and 1-year follow-up. CCI was also higher in those patients. Discriminative power for in-hospital mortality was higher for PESI (c-statistic 0.84, 95% CI 0.74–0.93, p=0.002), followed by sPESI (c-statistic 0.77, 95% CI 0.65–0.90, p=0.010) and Hestia (c-statistic 0.77, 95% CI 0.61–0.92, p=0.011). The Bova score showed a poor discriminative power for prediction of in-hospital mortality (c-statistic 0.61, 95% CI 0.43–0.78, p=0.325). For 30-day and 1-year mortality PESI score still maintained the best performance with acceptable discriminative power (c-statistic 0.73, 95% CI 0.61–0.85, p=0.007 for 30-day mortality; c-statistic 0.80, 95% CI 0.71–0.89, p<0.0001 for 1-year mortality). However at longer follow-up CCI had a better performance to predict worse outcomes (c-statistic 0.79, 95% CI 0.65–0.92, p=0.001 for 30-day mortality; c-statistic 0.83, 95% CI 0.74–0.92, p<0.0001 for 1-year mortality).
Conclusions
All scores, except Bova score, showed overall good performance in stratifying mortality for acute PE, however PESI score performed better in this population particularly at shorter follow-up. At longer follow-up, although PESI score maintained an acceptable performance, comorbidities seem to play a bigger role. The different performance of multiple scores highlights the complexity of this condition.
Funding Acknowledgement
Type of funding sources: None. ROC curves for mortality risk scores
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Affiliation(s)
- L Oliveira
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - F Duarte
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - M I Barradas
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - C Serena
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - A Fontes
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - C Almeida
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - C Machado
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - R Dourado
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - A Monteiro
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - E Santos
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - N Pelicano
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - A Pacheco
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - A Tavares
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
| | - D Martins
- Hospital Divino Espirito Santo, Cardiology, Ponta Delgada, Portugal
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14
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Duarte F, Barradas M, Oliveira L, Serena C, Dourado R, Fontes A, Monteiro A, Machado C, Santos E, Pelicano N, Tavares A, Pacheco M, Martins D. New York Heart Association class change on heart failure patients with implantable devices: does it matters? Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0697] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Chronic heart failure (CHF) is a pathology with high prevalence and an important cause of morbidity and mortality. Benefits of implantable devices have been demonstrated in selected groups of patients with benefits on symptoms and heart failure hospitalization.
Purpose
To determine the clinical impact of New York Heart Association class change (NYHA) in patients with CHF and Cardiac Implantable Electric Devices (CIEDs).
Methods
We retrospectively enrolled 178 consecutive patients with CHF and CIEDs between November 2003 and January 2021, during a follow-up period of 51±43,9 months. Patients demographic characteristic and NYHA class change impact on occurrence of arrhythmic events, heart failure hospitalization (HFH) or long-term admission in an emergency department were assessed. Patients with NYHA class change were considered responders to therapy.
Results
Out of 178 patients enrolled in this study, sixty-seven (37,6%) had a reduction ≥1 in NYHA functional class and in this group, 61 patients (91,0%) had a cardiac resynchronization therapy (CRT) and 9% had an implantable cardioverter defibrillator. Mean age 68±11,3 years, 44 (65,7%) patients were male, 33 (49,2%) were in NYHA class II, 30 (44,8%) NYHA class III and 4 (6%) NYHA class IV. Mean QRS width 129,9±63,1 ms before CIEDs. Fifty-eight patients (86,6%) had an improvement in one NYHA functional class and 9 patients (13,4%) in two NYHA functional class.
Fourty NYHA responders patients (59,7%) had paroxistic or permanent atrial fibrillation and 31,9% had an epicardial coronary artery disease, that was a negative predictor of NYHA response (p=0,012).
A total of 35 (19,7%) enrolled patients experience non-sustained ventricular tachycardia (NSVT) and 74,3% were non-responders (p=0,019).
There was fifteen and twenty HFH at 2 and 5 years of follow-up, respectively, and we observed that an improvement in NYHA class was associated with a reduction in HFH at 2 years of follow-up (p=0,043; OR 0,029, 95% CI 0,050–1,06) and 5 years of follow-up (p 0,027, OR 0,252; 95% CI 0,069 – 0,915). Emergency department (ED) admission related to HF decompensations was significantly reduced at 2 years of follow-up (p=0,035, OR 0,22, 95% CI 0,048 – 1,0) and at 5 years of follow-up (p=0,001, OR 0,15, 95% CI 0,044 – 0,55).
There was no difference on cardiovascular or all-cause mortality.
Conclusion
CHF patients with CIEDs and improving on NYHA class have less NSVT episodes, HFH and HF decompensations with ED admission, both at 2 and 5 years of follow-up.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- F Duarte
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - M.I Barradas
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - L Oliveira
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Serena
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - R Dourado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Fontes
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Monteiro
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Machado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - E Santos
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - N Pelicano
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Tavares
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - M Pacheco
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - D Martins
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
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15
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Barradas Da Silva M, Duarte F, Oliveira L, Serena C, Fontes A, Monteiro A, Machado C, Dourado R, Santos E, Pelicano N, Pacheco M, Tavares A, Martins D. Non-sustained ventricular tachycardia on remote patient monitoring in heart failure patients. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0974] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Non-sustained ventricular tachycardia (NSVT) is commonly found in patients with structural heart disease and was historically obtained from registers of external ambulatory monitoring. The advent of remote patient monitoring (RPM) in Cardiac implantable electronic devices (CIEDs) has made it possible to detect asymptomatic NSVT in Heart Failure (HF) patients more frequently, but its impact in real world is uncertain.
Purpose
To determine the clinical impact of NSVT detection in RPM in ischemic and non-ischemic chronic heart failure patients with reduced ejection fraction (HFrEF) and CIEDs.
Methods
We retrospectively enrolled 121 consecutive patients with HFrEF, CIEDs and RPM. Patients were evaluated through routine episodic CIEDs interrogation, routine clinical evaluations and continuous monitoring data obtained from CIEDs and transmitted remotely to the care team and divided into NSVT positive (Group 1) and negative groups (Group 2). Primary endpoint was admissions to the emergency department by HF decompensation and secondary endpoint was the occurrence of arrhythmic events. A sub-analysis of non-ischemic HF was also performed.
Results
NSVT was detected in 78 (72,2%) patients. The mean number of episodes of NSVT was 611,68±3271,25 during the follow-up period or 2,445±16,688 in 24 hours. Mean age was 62,40±13,218 years, 71,9% were males and mean follow-up period was 56,30±39,37 months. Fifty-eight patients (47,9%) had transvenous implantable cardioverter defibrillator (ICD), 48 (39,7%) implantable cardiac resynchronization therapy (CRT) defibrillator (CRT-D), 14 (11,6%) subcutaneous ICD (S-ICD) and 1 (0,8%) CRT pacemaker (CRT-P). Medium left ventricular ejection fraction (LVEF) was 34,70±12,53%, 25 (23,14%) were in NYHA III-IV and 46 (39,0%) were ischemic (29 (37,7%) in Group 1 and 11 (37,9%) in Group 2). NSVT was associated with the occurrence of sustained ventricular tachycardia (VT) (1,88±0,186episodes of VT in group 1 and 0,03±0,186 in group 2, p=0,012), ventricular fibrillation (VF) (1,44±5,325 episodes of VT in group 1 and 0,03±0,186 in group 2, p=0,011) and admissions to the emergency department by HF decompensation at 5 years (r=0,310, p=0,011). A sub-analysis in non-ischemic HF patients also showed correlation between NSVT and VT (r=0,602, p<0,05) and admissions to the emergency department by HF decompensation at 5 years (r=0,382, p=0,014).
Conclusions
On remote patient monitoring with CIEDs, NSVT in HF patients was associated with arrhythmic events and may serve as a predictor for HF decompensations.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - F Duarte
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - L Oliveira
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Serena
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Fontes
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Monteiro
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Machado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - R Dourado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - E Santos
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - N Pelicano
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - M Pacheco
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Tavares
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - D Martins
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
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16
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Barradas Da Silva M, Duarte F, Oliveira L, Serena C, Fontes A, Monteiro A, Machado C, Dourado R, Santos E, Pelicano N, Pacheco M, Tavares A, Martins D. Prognostic significance of non-sustained ventricular tachycardia on stored electrograms of heart failure patients with cardiovascular implantable electronic devices. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0975] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Non-sustained ventricular tachycardia (NSVT) is commonly found in patients with structural heart disease and was historically obtained from registers of external ambulatory monitoring. The advent of Cardiac implantable electronic devices (CIEDs) has made it possible to detect asymptomatic NSVT in Heart Failure (HF) patients more frequently, but its true impact in real world is uncertain, and often does not lead to a change in clinical intervention.
Purpose
To determine the prognostic significance of NSVT detection on stored electrograms of CIEDs in HF patients with systolic left ventricle dysfunction.
Methods
We retrospectively enrolled 132 consecutive HF patients (mean age 67,5±11,1 years, males 72,0%) with systolic left ventricle dysfunction and CIEDs (biventricular pacemakers with or without cardiac defibrillators). Patients were evaluated through CIEDs interrogation and clinical evaluations and divided into NSVT positive (Group 1) and negative groups (Group 2). Mean follow-up period was 62,8±7,1 months.
Results
NSVT was detected in 51 (38,6%) patients. 70 (53,0%) had implantable cardiac resynchronization therapy (CRT) defibrillator (CRT-D), 37 (28,0%) transvenous implantable cardioverter defibrillator (ICD), 13 (9,8%) CRT pacemaker (CRT-P) and 12 (9,1%) subcutaneous ICD (S-ICD). Medium left ventricular ejection fraction (LVEF) was 31,1±7,9%, 20,6% were in NYHA III-IV and 47,0% were ischemic (49% Group 1 and 45,7% Group 2, p=0,708). Dyslipidemia was more prevalent in Group 2 (p=0,042). In total 11 (8,3%) patients died, 2 (1,5%) from sudden cardiac death and 5 (3,8%) from cardiovascular death. NSVT was associated with CIEDs treatments (hazard ratio [HR]2,52; 95% confidence interval [CI]1,2–5,1; p=0,001), ventricular fibrillation (VF) (HR: 3,71, 95% CI: 1,19–11,58; p=0,018), sustained ventricular tachycardia (VT) (HR: 9,06, 95% CI: 2,82–29,12; p<0,05) and composite outcome of VT, VF, HF re-admissions and related admissions to emergency department (ED) and death by all causes (HR: 2,52; 95% CI: 1,20–5,10; p=0,011). NSVT at 1 year was associated with HF readmissions at 1 year (p=0,004).
Conclusions
On extended monitoring possible with CIEDs, NSVT in HF patients was associated with a worse prognosis and may serve as a predictor of significant arrhythmic events, HF hospitalizations and mortality. These findings enhances the importance of remote monitoring and optimization of therapeutic modalities in these patients along with a close supervision.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - F Duarte
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - L Oliveira
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Serena
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Fontes
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Monteiro
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - C Machado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - R Dourado
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - E Santos
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - N Pelicano
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - M Pacheco
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - A Tavares
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
| | - D Martins
- Hospital Divino Espirito Santo, Ponta Delgada, Portugal
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Ahmed B, Younas U, Asar T, Monteiro A, Hayen M, Tao S, Dahl G. Maternal heat stress reduces body and organ growth in calves: Relationship to immune status. JDS Communications 2021; 2:295-299. [PMID: 36338391 PMCID: PMC9623671 DOI: 10.3168/jdsc.2021-0098] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/22/2021] [Indexed: 01/15/2023]
Abstract
In utero heat stress reduces growth relative to calves born to cooled dams. Immune organ growth is further compromised beyond whole body growth. Jejunal enterocyte apoptosis is accelerated at birth after in utero heat stress.
Late-gestation heat stress of dairy cows reduces fetal growth and influences postnatal performance and immune status of the offspring. Our first objective was to evaluate the effect of in utero heat stress on overall fetal and organ growth, particularly organs associated with immune function. The second objective was to examine the cellular mechanism of altered passive immunity in neonatal bull calves after in utero heat stress. Specifically, we examined the rate of apoptosis of intestinal cells early in life, as it is associated with gut closure. Dams were dried off approximately 45 d before expected calving and randomly assigned to 1 of 2 treatments: heat stress (HT) or cooling (CL). During the dry period all cows were housed under shade in a freestall barn, where the pen for CL cows was equipped with active cooling, including water soakers and fans, whereas the pen for HT cows had no soakers or fans. Using rectal temperature and respiration rate as indicators, heat stress was severe. Average rectal temperature in HT cows was 39.3°C compared with 39.0°C in CL cows, and HT cows had a respiration rate of 66.7 breaths/min compared with 43.2 breaths/min for CL cows. Bull calves (n = 30) were immediately separated from their dams at birth, weighed, and then killed before colostrum feeding (n = 5/treatment; d 0) or at 1 or 2 d of age following colostrum feeding (n = 5/treatment per day). After slaughter, the small intestine was removed and weighed, and samples from the jejunum were fixed for immunohistochemistry. Birth weight of bulls from HT dams was 1.1 kg lower than that of bulls from CL dams. Thymus, spleen, and heart weights of HT bulls were lower relative to those of CL bulls, whereas liver weight of HT bulls tended to be lower relative to that of CL bulls. Jejunal cell apoptosis decreased with age in both HT and CL calves after birth, mirroring gut closure. However, in utero heat stress increased the apoptotic rate in the jejunum, particularly at birth. We conclude that the chronic exposure to heat strain of HT compared with CL dams in late gestation significantly affected fetal growth and immune tissue development, which may be associated with reduced immune function in early life. Also, late-gestation heat stress increased calves' intestinal apoptosis in the first 2 d of life, which might explain the decreased IgG uptake and limited passive immune competence observed in previous studies.
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Affiliation(s)
- B.M.S. Ahmed
- Department of Animal Sciences, University of Florida, Gainesville 32608
| | - U. Younas
- Department of Animal Sciences, University of Florida, Gainesville 32608
| | - T.O. Asar
- Department of Animal Sciences, University of Florida, Gainesville 32608
| | - A.P.A. Monteiro
- Department of Animal and Dairy Science, University of Georgia, Tifton 31793
| | - M.J. Hayen
- Department of Animal Sciences, University of Florida, Gainesville 32608
| | - S. Tao
- Department of Animal and Dairy Science, University of Georgia, Tifton 31793
| | - G.E. Dahl
- Department of Animal Sciences, University of Florida, Gainesville 32608
- Corresponding author
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18
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Marques H, Ramos R, Min J, Reis J, Aguiar S, Morais L, Monteiro A, Viegas J, Cacela D, Earls J, Figueiredo L, Ferreira R. AI-enabled Comprehensive Coronary Phenotyping In Patients Being Referred For Invasive Coronary Angiography After Abnormal Stress Testing: A Randomized Controlled Trial. J Cardiovasc Comput Tomogr 2021. [DOI: 10.1016/j.jcct.2021.06.164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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19
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Garcia Bras P, Sousa L, Mano T, Monteiro A, Rito T, Ilhao Moreira R, Rio P, Silva S, Martins C, Coito S, Capile E, Agapito A, Ferreira R. Cardiopulmonary exercise testing in repaired tetralogy of Fallot: a valuable tool for pulmonary regurgitation severity assessment. Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.122] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction and purpose
The optimal timing for pulmonary valve replacement (PVR) in asymptomatic patients with repaired tetralogy of Fallot (TOF) and pulmonary regurgitation (PR) remains uncertain but is often guided by imaging characterization of the right ventricle. As cardiopulmonary exercise testing (CPET) performance is an accessible prognostic indicator, we assessed which CPET parameters best correlate with pulmonary regurgitation severity to potentially improve identification of high-risk patients.
Methods
A retrospective chart review was done from 2009 to 2018 on adult patients with repaired TOF who underwent maximal effort cardiopulmonary exercise testing with cycle ergometry and with concurrent pulmonary function testing. Demographics, standard measures of CPET interpretation, and major cardiovascular outcomes were collected.
Results
Cardiopulmonary exercise testing was performed in 54 adult repaired TOF patients (59% male), with a mean follow-up of 60 ± 33 months. The mean age was 34 ± 9 years. 30 patients (56%) had severe pulmonary regurgitation and 26 patients (48%) were submitted to PVR, with a 0% mortality rate. PVR was performed a mean 28 ± 7 years after TOF repair surgery. There was moderate to severe right ventricular dysfunction in 11 patients (20%). 12 patients (22%) had a hospitalization for heart failure. Arrhythmic events occurred in 9 patients (17%), mainly atrial fibrillation or atrial flutter (67%). 2 patients (4%) received an implantable cardioverter-defibrillator for secondary prevention of sudden cardiac death.
Peak VO2 consumption (pVO2) showed no statistically significant correlation with severity of pulmonary regurgitation (HR 0.26, 95% CI 0.879-1.036, p= 0.262) or PVR (HR 0.92, 95% CI 0.829-1.028, p = 0.914), while percent of predicted pVO2 significantly correlated with severity of pulmonary regurgitation (HR 0.95, 95% CI 0.918-0.993, p = 0.020) and PVR (HR 0.94, 95% CI 0.886-0.992, p = 0.025).
VE/VCO2 slope was not a significant predictor of severity of pulmonary regurgitation (HR 1.03, 95% CI 0.929-1.130, p = 0.622) or PVR (HR 1.04, 95% CI 0.952-1.128, p = 0.414) or) and neither cardiorespiratory optimal point (HR 0.94, 95% CI 0.786-1.120, p = 0.480) nor maximum end-tidal carbon dioxide pressure (PETCO2) (HR 0.93, 95% CI 0.846-1.037, p = 0.213) correlated with severity of pulmonary regurgitation or PVR.
Conclusion
Percent of predicted peak VO2 had the highest predictive power of all CPET parameters analysed in adult repaired TOF patients. Preoperative CPET could be an accessible way to identify high-risk patients earlier for PVR and should therefore be included in the routine assessment of these patients.
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Affiliation(s)
| | - L Sousa
- Hospital de Santa Marta, Lisbon, Portugal
| | - T Mano
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Monteiro
- Hospital de Santa Marta, Lisbon, Portugal
| | - T Rito
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - P Rio
- Hospital de Santa Marta, Lisbon, Portugal
| | - S Silva
- Hospital de Santa Marta, Lisbon, Portugal
| | - C Martins
- Hospital de Santa Marta, Lisbon, Portugal
| | - S Coito
- Hospital de Santa Marta, Lisbon, Portugal
| | - E Capile
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Agapito
- Hospital de Santa Marta, Lisbon, Portugal
| | - R Ferreira
- Hospital de Santa Marta, Lisbon, Portugal
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Garcia S, Tavares A, Peixoto P, Costa F, Saraiva D, Varzim P, Monteiro A, Fontes M, Pinto G. PO-1073: Dosimetric Predictors of Survival in Esophageal Cancers Treated with Preoperative Chemoradiation. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01090-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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21
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Lima Aires F, Saraiva D, Costa F, Peixoto P, Monteiro A, Garcia S, Pinto M. PO-1909: Interobserver variability of CBCT for prostate radiation therapy: Fiducial Markers vs CTV/PTV. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01927-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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Dias Ferreira Reis J, Ramos R, Modas Daniel P, Aguiar Rosa S, Almeida Morais L, Cruz M, Moreira R, Mendonca T, Monteiro A, Leal C, Marques H, Figueiredo L, Cruz Ferreira R. Optimizing diagnosis of obstructive coronary artery disease by CT angiography: RCT's final results and 12-months follow-up. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1379] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Aim
In patients (pts) with suspected coronary artery disease (CAD), computed tomographic angiography (CTA) may improve pt selection for invasive coronary angiography (ICA) as alternative to functional testing. However. the role of CTA in symptomatic pts after abnormal functional test (FT) is incompletely defined.
Methods and results
This randomized clinical trial conducted in single academic tertiary center selected 218 symptomatic pts with mild to moderately abnormal FT referred to ICA to receive either the originally intended ICA (n=103) or CTA (n=115). CTA interpretation and subsequent care decisions were made by the clinical team. Pts with high risk features on FT, previous acute coronary syndrome, previously documented CAD, chronic kidney disease (GFR<60ml/min/1.73m2) or persistent atrial fibrillation were excluded. The primary endpoint was the percentage of ICA with no significant obstructive CAD (no stenosis ≥50%) in each group. Diagnostic (DY) and revascularization (RY) yields of ICA in either group were also assessed. Pts were followed up for at least 1 year for the primary safety endpoint of all cause death/ nonfatal myocardial infarction/ stroke. Unplanned revascularization
(UP) and symptomatic status (SS) were also evaluated. Pts averaged 68±9 years of age, 60% were male, 29% were diabetic. Nuclear perfusion stress test was used in 33.9% in CTA group and 31.1% in control group (p=0.655). Mean post (functional) test probability of obstructive CAD was 34%. Overall prevalence of obstructive CAD was 32.1%. In the CTA group, ICA was cancelled by referring physicians in 83 of the pts (72.2%) after receiving CTA results. For those undergoing ICA, non-obstructive
CAD was found in 5 pts (15.6%) in the CTA-guided arm and 60 (58.3%) in the usual care arm (p<0.001 Mean cumulative radiation exposure related to diagnostic work up was similar in both groups (6±14 vs 5±14mSv, p=0.152). Both DY (84.4% vs 41.7, p<0.001) and RY (71.9% vs 38.8%, p=0.001) yields were significantly higher for CTA-guided ICA as compared to standard FT-guided ICA. The rate of the primary safety endpoint was similar between both groups (1.9% vs 0%, p=0.244), as well as the rates of UP (0.9% vs 0.9%, p=1.000) and SS (persistent angina: 29.6% vs 24.8%, p=0.425).
Conclusions
In pts with suspected CAD and mild to moderately abnormal ischemia test, a diagnostic strategy including CTA as gatekeeper is safe, effective and significantly improves diagnostic and revascularization yields of ICA.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | - R Ramos
- Hospital de Santa Marta, Lisbon, Portugal
| | | | | | | | - M Cruz
- Hospital de Santa Marta, Lisbon, Portugal
| | - R Moreira
- Hospital de Santa Marta, Lisbon, Portugal
| | - T Mendonca
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Monteiro
- Hospital de Santa Marta, Lisbon, Portugal
| | - C Leal
- Hospital de Santa Marta, Radiology Department, Lisbon, Portugal
| | - H Marques
- Hospital de Santa Marta, Radiology Department, Lisbon, Portugal
| | - L Figueiredo
- Hospital de Santa Marta, Radiology Department, Lisbon, Portugal
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23
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Pereira K, Monteiro A, Neto A, Rodrigues M, Barros J, Leite R, Rothwell D, Pires B, Roda D, Gonçalves S, Alves P. Radiation proctitis in prostate cancer treated by external beam radiotherapy: A 10-year retrospective study. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)36187-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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24
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Dias Ferreira Reis J, Valente B, Ferreira V, Castelo A, Portugal G, Monteiro A, Lousinha A, Silva Cunha P, Oliveira M, Cruz Ferreira R. Performance of the padit score in patients undergoing transvenous lead extraction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0830] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The PADIT trial identified 5 independent predictors of cardiac implantable electronic device (CIED) infection (prior procedure, age, chronic kidney disease, immunosuppression and type of procedure) and developed a novel infection risk score.
Aim
To assess whether the PADIT score (PS) could predict CIED reinfection and adverse events in patients (pts) submitted to transvenous lead extraction (LE) using the Pisa Technique (PT) due to CIED infection.
Methods
We conducted a single-centre prospective study of consecutive procedures (P) of LE using the PT between February 2013 and October 2019. Demographic, clinical, microbiological, device/ procedure related variables, morbidity and mortality data were retrieved during follow-up (FUP). An univariate analysis was performed to evaluate the ability of the PS to predict CIED reinfection (Re), procedural complications (C), all-cause hospital mortality (M), all-cause mortality/ hospitalization during first year of follow-up (MH1) and cardiovascular mortality (CM).
Results
A total 171 Ps including 159 pts, of which 80.7% (130 pts)were due to CIED infection: 55.1% due to pocket site infection, 18.8% to occult bacteremia with probable CIED infection and 26.1% due to both pocket site and systemic infection, with 44% of pts presenting with valvular/ lead vegetation (mean age - 70.3Y, 77.7% male, mean LVEF of 49.6%). The Rs rate was 93.1% and the clinical success rate was 99.2%. There were no deaths related to the procedure. During a mean FUP of 33 months, 11 pts had to undergo a new P, 5 of them due to pocket reinfection. The mortality rate was 24.2% (37 pts), with 8 pts dying during hospital stay, and 19 pts during the first year post-P. The mean PS was 2.9±2.5 (min- 0, max- 10). A higher PS value was associated with Re (HR - 1,43, CI95% 1.09–1.87, p=0.011), CM (HR - 1,39, CI95% 1.06–1.85, p=0.018) and MH1 (OR - 1,19, CI95% 1.03–1.38, p=0.021). There was no association between the PS and the rate of clinical success of the procedure (2.9% vs 4.5%, p=0.395), procedural complications (2.9% vs 3.3%, p=0.656) and M (4.0% vs 2.8%, p=0.192). Interestingly, a higher PS was not associated with a higher use of an antibacterial envelope during device reimplantation (3.5% vs 2.9%, p=0.371).
Conclusion
The PADIT score revealed a high predictive power for reinfection, all-cause mortality/ hospitalization during first year of follow-up and cardiovascular mortality in pts submitted to LE using the PT for CIED infection.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | - B Valente
- Hospital de Santa Marta, Lisbon, Portugal
| | - V Ferreira
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Castelo
- Hospital de Santa Marta, Lisbon, Portugal
| | - G Portugal
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Monteiro
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Lousinha
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - M Oliveira
- Hospital de Santa Marta, Lisbon, Portugal
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25
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Soares RF, Monteiro A, Macedo F, Pereira TC, Paulo J, Marques M, Bonito N, Jacinto P, Ribeiro J, Sousa G. P-208 Is there a role for adjuvant chemotherapy in ypN0 disease rectal cancer patients? Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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26
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Monteiro A, Pereira TC, Soares RF, Macedo F, Paulo J, Marques M, Bonito N, Jacinto P, Ribeiro J, Sousa G. P-36 Prognostic value of tumor laterality and recurrence risk in patients with stage III colon cancer treated with adjuvant chemotherapy. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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27
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Pereira TC, Salgueiro F, Monteiro A, Soares RF, Macedo F, Jacinto P, Paulo J, Bonito N, Marques M, Ribeiro J, Sousa G. P-225 KRAS codon 12 and 13 mutations in metastatic colorectal cancer: Predictive marker in first-line bevacizumab-based chemotherapy. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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28
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Soares RF, Pereira TC, Monteiro A, Macedo F, Paulo J, Marques M, Bonito N, Jacinto P, Ribeiro J, Sousa G. P-203 Restaging rectal cancer after neoadjuvant chemoradiation therapy: Is magnetic resonance imaging accurate enough? Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.04.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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29
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Dias Ferreira Reis JP, Moura Branco L, Rio P, Galrinho A, Portugal G, Monteiro A, Lousinha A, Valente B, Silva Cunha P, Oliveira M, Ferreira R. P672 Predictors of ventricular arrythmias and mortality after implantation of primary prevention antitachycardia devices. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.352] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Patients (pts) with reduced left ventricular (LV) systolic function have high risk of sudden cardiac death and benefit from implantable cardioverter-defibrillators (ICDs/CRT-Ds). However, the risk for arrhythmic events and device therapies is extremely heterogeneous in this population, so more accurate tools for risk stratification are required.
Purpose
To assess predictors of mortality and arrhythmic events in pts receiving primary prevention ICDs/ CRTs.
Methods
Retrospective analysis of 150 pts submitted to primary prevention ICD/ CRT-D implantation with remote monitoring between 2014-2018. Demographic, clinical and echocardiographic data from implantation and follow-up period were retrieved. Arrhythmic events and device therapies were retrieved from remote monitoring and clinic visits. Univariate analysis was performed followed by a multivariate Cox analysis to evaluate predictors of events. p < 0.05 were considered significant.
Results
150 pts, 80.7% male, with a mean age of 64.30 ± 12.9 years (Y) and a mean follow-up (FU) time of 38 ± 15 months. 66% of pts implanted an ICD. 52.0% of pts presented with an ischemic cardiomyopathy and 41.3% had atrial fibrillation. 35.3% had chronic kidney disease (GFR < 60mL/min) and 24.0% were diabetic. Mean BNP value of 449.6 ± 631.3pg/mL and mean peak VO2 of 15.3mL/kg/min. Mean LV ejection fraction (LVEF) during FU of 35.9 ± 12.1% and a mean average global longitudinal strain (GLS) of -8.7 ± 5.5%. 63pts (42.0%) suffered a ventricular arrhythmia, mostly non-sustained ventricular tachycardia, of which 47.6% received appropriate therapies. Mortality rate of 13.3% during follow-up (20 pts). Baseline diabetes (p = 0.040) and post-procedural pulmonary artery systolic pressure (PASP) (p = 0.002) were independent predictors of overall mortality in the follow-up. Male gender (p = 0.041), baseline diabetes (p = 0.011) and atrial fibrillation (p = 0.038) were associated with ventricular events. In patients with CRT-D, a percentage of biventricular pacing superior to 95% was found to be protective against ventricular arrhythmias. Interestingly despite being associated with a higher overall mortality (p = 0.028), a reduced LVEF wasn’t related to the arrhythmic burden of our population, neither the GLS nor the LV mechanical dispersion were predictors of ventricular arrhythmias.
Conclusion
Baseline diabetes and PASP were independent predictors of mortality in our population of ICD/CRT-D pts implanted in primary prevention setting. An increased percentage of biventricular pacing was associated to improved clinical outcomes in patients receiving cardiac resynchronization therapy. Identification of predictors of events in this population can help individualize its management.
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Affiliation(s)
| | | | - P Rio
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Galrinho
- Hospital de Santa Marta, Lisbon, Portugal
| | - G Portugal
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Monteiro
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Lousinha
- Hospital de Santa Marta, Lisbon, Portugal
| | - B Valente
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - M Oliveira
- Hospital de Santa Marta, Lisbon, Portugal
| | - R Ferreira
- Hospital de Santa Marta, Lisbon, Portugal
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30
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Pupin M, Vergani G, Lima M, Silva K, Monteiro A, Ramos A, Batista R, Vicente W, Oliveira M, Fonseca J. 227 Is the antral follicle count on a random day of the oestrous cycle correlated with superovulatory responses in Santa Inês ewes? Reprod Fertil Dev 2020. [DOI: 10.1071/rdv32n2ab227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Antral follicle count (AFC) performed after an oestrus synchronization protocol has been studied as a tool to select ewes with high potential for invivo embryo production (Pinto et al. 2018 Theriogenology 113, 146-152). However, it would be interesting to know whether AFC assessed on a random day of the oestrous cycle correlates with the superovulatory response. The present study was conducted to evaluate the correlation between AFC at the beginning of progesterone (P4)-based oestrus synchronization protocol used as basis of superovulatory treatment and the number of corpora lutea (CL) 12h before recovery of embryos in Santa Inês ewes. The study was conducted during September and October in northeast Brazil (03°40′26″S and 40°14′20″W) using 8 adult Santa Inês ewes. On a random day of oestrous cycle (Day 0) all ewes received an intravaginal device (CIDR) of progesterone (0.3g, Eazi-breed, Zoetis), which remained for 9 days. On Day 7, the pFSH (133mg, Folltropin V, Vetoquinol) treatment began, with 6 decreasing doses (25, 25, 15, 15, 10, and 10%) injected IM at 12-h intervals. On Day 9, 2 equal doses of D-cloprostenol were injected at a 12-h interval (37.5µg, Prolise, Agener União). All ewes showed oestrus and were mated by fertile rams. Flunixin meglumine (24.9 mg; Banamine, MSD Animal Health) was administered IM on Days 12, 13, and 15. On Day 16, non-surgical embryo recovery (NSER) was performed after cervical dilation using D-cloprostenol and oestradiol benzoate at 16h and oxytocin 20min before. Transrectal B-mode ultrasound evaluations (Z5 Vet, Mindray), frequency 7.5MHz, were performed on Day 0 and 7 and 12h before NSER to evaluate the ovarian population present. Pearson correlation analysis (P<0.05) was performed using Bioestat 5.3 software. The number of AFC per ewe at the beginning of the protocol and on Day 7 were 9.9±2.7 and 11±3.2, respectively. The numbers of CL, recovered embryos, and viable embryos were 14.0±3.5, 8.2±10.9, and 6.0±11.0, respectively. There was no correlation of AFC on a random day of oestrous cycle with the number of AFC on Day 7 (P=0.42), number of corpora lutea (P=0.44), number of recovered embryos (P=0.18), or number of viable embryos (P=0.11) in superovulated ewes. In conclusion, we did not find significant correlations between AFC on a random day of oestrous cycle and the superovulatory/embryos response in Santa Inês ewes.
Financial support for this study was provided by Embrapa (02.13.06.026.00.02 and 02.13.06.026.00.04) and FAPEMIG (PPM 00201-17).
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Dias Ferreira Reis JP, Mano T, Valente B, Monteiro A, Silva Cunha P, Oliveira M, Pereira Da Silva T, Soares R, Rio P, Moura Branco L, Ferreira R. P175 Cardiac device infection: to extract or not to extract, that is the question. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
The incidence of infectious complications related to intracardiac devices has been increasing in recent year and is associated with a poor prognosis, which is determined not only by the infectious process but also by the severity of the underlying cardiac pathology and the spectrum of comorbidities presented. Appropriate antibiotic therapy and extraction of the devices are fundamental in the management of these patients.
Case report
We describe the case of a 66-year-old patient on a waiting list for transplantation due to non-ischemic dilated cardiomyopathy with poor left ventricular systolic function (LVEF of 10%), with severe functional mitral regurgitation and severe pulmonary hypertension, who received a CRT-D for secondary prevention (non-responder). He was admitted for decompensated heart failure (NYHA functional class IV and "dry-cold" profile) requiring inotropic support becoming dependent on dobutamine. During hospitalization, there was a progressive increase in inflammatory markers accompanied by recurrent febrile peak and inflammatory signs of the central venous catheter, with catheter-tip and serial hemocultures positive for Morganella morganii. Piperacillin / tazobactam was started. Due to the lack of response to pathogen directed antibiotic therapy, he underwent a transesophageal echocardiogram (TEE) that revealed several filiform images associated with the electrodes, with no image of valvular vegetations, which led to the association of gentamicin and device extraction (DE), according to the Pisa technique, that occurred without complications. On the 7th day after DE, there was a progressive clinical deterioration in spite of increasing doses of inotropes and vasopressors. It was considered that patient would not be candidate for cardiac transplantation or mechanical ventricular assist, and died on the 118th day of hospitalization in refractory cardiogenic shock.
Conclusion
Device endocarditis is a class I indication for intracardiac DE and TEE is fundamental in its diagnosis. Despite being a considered a non-responder to cardiac resynchronization therapy based on clinical and echocardiographic criteria, this case illustrates how the loss of cardiac resynchronization may have contributed to the patient’s hemodynamic deterioration and have played a fundamental role in the clinical outcome.
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Affiliation(s)
| | - T Mano
- Hospital de Santa Marta, Lisbon, Portugal
| | - B Valente
- Hospital de Santa Marta, Lisbon, Portugal
| | - A Monteiro
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - M Oliveira
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - R Soares
- Hospital de Santa Marta, Lisbon, Portugal
| | - P Rio
- Hospital de Santa Marta, Lisbon, Portugal
| | | | - R Ferreira
- Hospital de Santa Marta, Lisbon, Portugal
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Monteiro A, Machado P, Clara A, Opinião A, Luis A, Miguel I, Louro P, Santos S, Fragoso S, Rodrigues P, Rodrigues F, Coelho I, Parreira J, Vaz F. Non-BRCA1/2 hereditary breast and ovarian cancer: Findings from a multidisciplinary program. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz269.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Thunis P, Clappier A, Tarrason L, Cuvelier C, Monteiro A, Pisoni E, Wesseling J, Belis CA, Pirovano G, Janssen S, Guerreiro C, Peduzzi E. Source apportionment to support air quality planning: Strengths and weaknesses of existing approaches. Environ Int 2019; 130:104825. [PMID: 31226558 PMCID: PMC6686078 DOI: 10.1016/j.envint.2019.05.019] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 05/06/2019] [Accepted: 05/08/2019] [Indexed: 05/19/2023]
Abstract
Information on the origin of pollution constitutes an essential step of air quality management as it helps identifying measures to control air pollution. In this work, we review the most widely used source-apportionment methods for air quality management. Using theoretical and real-case datasets we study the differences among these methods and explain why they result in very different conclusions to support air quality planning. These differences are a consequence of the intrinsic assumptions that underpin the different methodologies and determine/limit their range of applicability. We show that ignoring their underlying assumptions is a risk for efficient/successful air quality management as these methods are sometimes used beyond their scope and range of applicability. The simplest approach based on increments (incremental approach) is often not suitable to support air quality planning. Contributions obtained through mass-transfer methods (receptor models or tagging approaches built in air quality models) are appropriate to support planning but only for specific pollutants. Impacts obtained via "brute-force" methods are the best suited but it is important to assess carefully their application range to make sure they reproduce correctly the prevailing chemical regimes.
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Affiliation(s)
- P Thunis
- European Commission, Joint Research Centre, Ispra, Italy.
| | - A Clappier
- Université de Strasbourg, Laboratoire Image Ville Environnement, Strasbourg, France
| | - L Tarrason
- NILU - Norwegian Institute for Air Research, Kjeller, Norway
| | - C Cuvelier
- Ex European Commission, Joint Research Centre, Ispra, Italy
| | - A Monteiro
- CESAM, Department of Environment and Planning, University of Aveiro, Aveiro, Portugal
| | - E Pisoni
- European Commission, Joint Research Centre, Ispra, Italy
| | - J Wesseling
- RIVM, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - C A Belis
- European Commission, Joint Research Centre, Ispra, Italy
| | | | - S Janssen
- VITO, Boeretang 200, 2400 Mol, Belgium
| | - C Guerreiro
- NILU - Norwegian Institute for Air Research, Kjeller, Norway
| | - E Peduzzi
- European Commission, Joint Research Centre, Ispra, Italy
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34
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Miguel I, Monteiro A, Oliveira I, Marques T, Rosa I, Limbert M, Fernandez G, Barroca R, Marques I, Fonseca R, Mirones L, Ferreira T, Venâncio J, Moreira A, Freire J. Chemoradiation with capecitabine and mitomycin-C for locally advanced anal squamous cell carcinoma: experience of a single Portuguese institution. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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35
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Tomás T, Nogueira-Costa G, Eiriz I, Vitorino M, Baptista MV, Correia M, Pereira T, Oliveira A, da Costa LL, Pimenta J, Liu P, Peixoto I, Luz P, Gil L, Silva D, Caleça T, Neves M, Quintela A, Monteiro A, Atalaia G, Silva M, Fiúza T. Trifluridine/Tipiracil (TAS-102) in refractory metastatic colorectal cancer: Real-world data of 13 oncological centers in Portugal. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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36
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Bulmer L, Murray J, Burns N, Garber A, McEwan N, O'Shaughnessy P, Hemmings A, Evans N, Monteiro A, Hastie P. Development of methods to investigate the mechanisms behind increased behavioral reactivity associated with an increased-starch diet. J Equine Vet Sci 2019. [DOI: 10.1016/j.jevs.2019.03.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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37
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Monteiro A, Silva J, Sousa S, Gonçalves D, Azevedo N, Rodrigues L, Pacheco G. Height and Postural Deviations of the Spine in School-Age Children: Evaluation with Idiag® Spinal Mouse®. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz034.082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Monteiro
- CICS - Centro Interdisciplinar em Ciências da Saúde, ISAVE - Instituto Superior de Saúde
| | - J Silva
- CICS - Centro Interdisciplinar em Ciências da Saúde, ISAVE - Instituto Superior de Saúde
| | - S Sousa
- CICS - Centro Interdisciplinar em Ciências da Saúde, ISAVE - Instituto Superior de Saúde
| | - D Gonçalves
- CICS - Centro Interdisciplinar em Ciências da Saúde, ISAVE - Instituto Superior de Saúde
| | - N Azevedo
- CICS - Centro Interdisciplinar em Ciências da Saúde, ISAVE - Instituto Superior de Saúde
| | - L Rodrigues
- CICS - Centro Interdisciplinar em Ciências da Saúde, ISAVE - Instituto Superior de Saúde
| | - G Pacheco
- CICS - Centro Interdisciplinar em Ciências da Saúde, ISAVE - Instituto Superior de Saúde
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38
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Oliveira N, Samagaio A, Monteiro A. Investigating the influence of the Daylight Saving Time on the population and energy consumption. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz034.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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39
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Paratz E, Mock N, Cochrane A, Harper R, Larobina M, Wilson W, Appelbe A, Kushwaha V, Almeida IDS, Monteiro A, Bayley N. Adult and Paediatric Cardiac Intervention in Timor-Leste: Disease Burden, Demographics and Clinical Outcomes. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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40
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Paratz E, Mock N, Gutman S, Horton A, Creati L, Appelbe A, Kushwaha V, Almeida IDS, Monteiro A, Bayley N. Taking the Pulse of Timor-Leste's Cardiac Needs: a Ten-Year Descriptive Time Trend Analysis. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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41
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Fachinello M, Gasparino E, Monteiro A, Sitanaka N, Moreira C, Castilha L, Sturzenegger Partyka A, Pozza P. PSX-28 Dietary Lycopene Helps Protecting Pork Against Oxidation. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.1063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Fachinello
- Universidade Estadual de Maringá, Maringá,Brazil
| | - E Gasparino
- Universidade Estadual de Maringá, Maringá,Brazil
| | - A Monteiro
- Universidade Estadual de Maringá, Maringá, Parana,Brazil
| | - N Sitanaka
- Universidade Estadual de Maringá, Maringá, Parana,Brazil
| | - C Moreira
- Universidade Estadual de Maringá, Maringá, Parana,Brazil
| | - L Castilha
- Universidade Estadual de Maringá, Maringá,Brazil
| | | | - P Pozza
- Universidade Estadual de Maringá, Maringá,Brazil
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42
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Monteiro A, Dourmad J, Sitanaka N, Moreira C, Rossi R, Sangali C, Castilha L, Pozza P. PSVII-35 Using observed data as inputs of life cycle assessment provides a better approach to evaluate the dietary crude protein reduction for starting pigs. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Monteiro
- Universidade Estadual de Maringá, Maringá,Parana, Brazil
| | | | - N Sitanaka
- Universidade Estadual de Maringá, Maringá,Parana, Brazil
| | - C Moreira
- Universidade Estadual de Maringá, Maringá,Parana, Brazil
| | - R Rossi
- Universidade Estadual de Maringá, Maringá,Parana, Brazil
| | - C Sangali
- Centro Universitário Integrado, Campo Mourão,Parana, Brazil
| | - L Castilha
- Universidade Estadual de Maringá, Maringá, Brazil
| | - P Pozza
- Universidade Estadual de Maringá, Maringá, Brazil
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43
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Monteiro A, Peres M, Faro A, Batista R, Deiss L, Ribeiro H, Berndt A, Faisca L. PSXV-3 Sheep methane emissions in two feeding systems in summer and winter pastures in South of Brazil. J Anim Sci 2018. [DOI: 10.1093/jas/sky404.1037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- A Monteiro
- Federal University of Paraná, Brazil,Curitiba, Brazil
| | - M Peres
- Federal University of Paraná, Brazil,Curitiba, Brazil
| | - A Faro
- Instituto Federal Catarinense, Brazil,Catarinense, Brazil
| | - R Batista
- Federal University of Paraná, Brazil, Paraná,Brazil
| | - L Deiss
- UTP, Brazil,Curitiba, Brazil
| | - H Ribeiro
- Universidad Do Estado de Stanta Catarina, Lages, Brazil, Florianópolis, Brazil
| | - A Berndt
- Brazilian Agricultural Research Corporation,Brasilia, Brazil
| | - L Faisca
- Federal University of Paraná, Brazil, Paraná,Brazil
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44
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Monteiro A, Faisca L, Deiss L, Bonnet O, Peres M, Batista R, Campos K. PSXV-2 Can lambs modify their grazing behavior according to the finishing production systems? J Anim Sci 2018. [DOI: 10.1093/jas/sky404.1031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Monteiro
- Federal University of Paraná, Brazil,Curitiba, Brazil
| | - L Faisca
- Federal University of Paraná, Brazil,Curitiba, Brazil
| | - L Deiss
- UTP, Brazil,Curitiba, Brazil
| | - O Bonnet
- Federal University of Pelotas, RS, Brazil, Pelotas, Brazil
| | - M Peres
- Federal University of Paraná, Brazil, Paraná,Brazil
| | - R Batista
- Federal University of Paraná, Brazil, Paraná,Brazil
| | - K Campos
- Federal University of Paraná, Brazil, Paraná,Brazil
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45
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Affiliation(s)
- A Monteiro
- Shared Services of the Ministry of Health, Lisbon, Portugal
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46
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Monteiro A, Russo M, Gama C, Borrego C. How important are maritime emissions for the air quality: At European and national scale. Environ Pollut 2018; 242:565-575. [PMID: 30014934 DOI: 10.1016/j.envpol.2018.07.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 07/02/2018] [Accepted: 07/04/2018] [Indexed: 06/08/2023]
Abstract
Due to its dependence on fossil fuel combustion, emissions from the marine transport sector can significantly contribute to air pollution. This work aims to evaluate the impact of maritime transport emissions on air quality in Portugal using a numerical air quality modelling approach, with high-resolution emission data. Emissions from the European TNO inventory were compiled and pre-processed at hourly and high spatial (∼3 × 3 km2) resolutions. Scenarios with and without these maritime emissions were then simulated with the WRF-CHIMERE modelling system, extensively tested and validated for Portugal domain, in order to evaluate their impact on air quality. A simulation was performed for one year (2016) and the resulting differences were analysed in terms of spatial distribution, time series and deltas. The main deltas for NO2 and PM10 are located over international shipping routes and major ports, while O3 concentrations are impacted in a larger area. The modelling results also indicate that shipping emissions are responsible for deltas in the concentration of NO2 higher than 20% over specific urban areas located in the west coast of Portugal, and less than 5% for PM10. For O3 the relative contribution is low (around 2%) but this contribution is also observed at locations more than 50 km from the coast.
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Affiliation(s)
- A Monteiro
- CESAM & Department of Environment and Planning, University of Aveiro, Aveiro, Portugal.
| | - M Russo
- CESAM & Department of Environment and Planning, University of Aveiro, Aveiro, Portugal.
| | - C Gama
- CESAM & Department of Environment and Planning, University of Aveiro, Aveiro, Portugal.
| | - C Borrego
- CESAM & Department of Environment and Planning, University of Aveiro, Aveiro, Portugal.
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47
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Monteiro A, Rodrigues D, Fontes M, Varzim P, Figueira R, Lago R, Garcia S, Reis T, Carvalho A, Pinto G. EP-2382: Impact on treatment plan of daily MV EPI versus MV CBCT imaging for prostate cancer IGRT. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)32690-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Monteiro A, Cunha P, Oliveira M, Cruz M, Aguiar S, Morais L, Portugal G, Valente B, Osorio P, Lousinha A, Malveira P, Santos A, Ferreira R. P392Assessment of novel oral anticoagulant use in real-world setting: importance of a structured anticoagulation unit. Europace 2018. [DOI: 10.1093/europace/euy015.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Monteiro
- Hospital Santa Marta, Department of Cardiology, Lisbon, Portugal
| | - P Cunha
- Hospital Santa Marta, Department of Cardiology, Lisbon, Portugal
| | - M Oliveira
- Hospital Santa Marta, Department of Cardiology, Lisbon, Portugal
| | - M Cruz
- Hospital Santa Marta, Department of Cardiology, Lisbon, Portugal
| | - S Aguiar
- Hospital Santa Marta, Department of Cardiology, Lisbon, Portugal
| | - L Morais
- Hospital Santa Marta, Department of Cardiology, Lisbon, Portugal
| | - G Portugal
- Hospital Santa Marta, Department of Cardiology, Lisbon, Portugal
| | - B Valente
- Hospital Santa Marta, Department of Cardiology, Lisbon, Portugal
| | - P Osorio
- Hospital Santa Marta, Department of Cardiology, Lisbon, Portugal
| | - A Lousinha
- Hospital Santa Marta, Department of Cardiology, Lisbon, Portugal
| | - P Malveira
- Hospital Santa Marta, Department of Cardiology, Lisbon, Portugal
| | - A Santos
- Hospital Santa Marta, Department of Cardiology, Lisbon, Portugal
| | - R Ferreira
- Hospital Santa Marta, Department of Cardiology, Lisbon, Portugal
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49
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Valente B, Conceicao JM, Cunha PS, Lousinha A, Portugal G, Monteiro A, Silva MN, Osorio P, Oliveira M, Ferreira RC. P921Experience of a tertiary center in lead extraction with the “pisa technique". Europace 2018. [DOI: 10.1093/europace/euy015.522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- B Valente
- Hospital Santa Marta, CHLC, Lisbon, Portugal
| | | | - P S Cunha
- Hospital Santa Marta, CHLC, Lisbon, Portugal
| | - A Lousinha
- Hospital Santa Marta, CHLC, Lisbon, Portugal
| | - G Portugal
- Hospital Santa Marta, CHLC, Lisbon, Portugal
| | - A Monteiro
- Hospital Santa Marta, CHLC, Lisbon, Portugal
| | - M N Silva
- Hospital Santa Marta, CHLC, Lisbon, Portugal
| | - P Osorio
- Hospital Santa Marta, CHLC, Lisbon, Portugal
| | - M Oliveira
- Hospital Santa Marta, CHLC, Lisbon, Portugal
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Weng X, Monteiro A, Guo J, Ahmed B, Bernard J, Tomlinson D, DeFrain J, Dahl G, Tao S. Short communication: Repeated mammary tissue collections during lactation do not alter subsequent milk yield or composition. J Dairy Sci 2017; 100:8422-8425. [DOI: 10.3168/jds.2017-12889] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 06/06/2017] [Indexed: 11/19/2022]
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