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Furtado TA, Carvalho AC, Garcia DPC. Estrangulated obturatory hernia. Case report of a challenging diagnosis of obstructive syndrome. Int J Surg Case Rep 2024; 118:109643. [PMID: 38663288 PMCID: PMC11064598 DOI: 10.1016/j.ijscr.2024.109643] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Revised: 04/03/2024] [Accepted: 04/17/2024] [Indexed: 05/05/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Obturator hernia accounts for less than 1 % of all documented cases of pelvic hernias. It most commonly presents as an obstructive syndrome in elderly, multiparous, slim women, characterized by a wider pelvis that facilitates the passage of the hernia sac through the obturator foramen alongside the obturator nerve. In this case, adhering to the SCARE (Updating Consensus Surgical CAse REport) checklist criteria, we present a typical scenario involving an elderly woman who was initially misdiagnosed with a fecaloma, concealing an obturator hernia. CASE REPORT An 85-year-old patient, displaying prodromal signs of senile disease, presented for medical attention with incapacitating abdominal pain in the right iliac fossa, accompanied by nausea and vomiting. Rectal examination revealed the presence of a fecaloma, and glycerin administration was performed rectally. The patient's condition worsened with the development of mental confusion and hyperactive delirium. Abdominal Computer tomography scan (CT scan) revealed right obturator hernia with enteral segment insinuation and dilation of the proximal bowel. An infraumbilical laparotomy was performed. The herniation of an ileal segment and the right ovary through the obturator foramen was identified. The content proved irreducible to manual maneuvers, leading to obturator muscle section following the dissection of the Retzius space. The right round ligament of the uterus was sectioned, and we manage to preserve the Obturatory branch of the lumbar plexus throughout dissection. A polypropylene mesh was positioned and secured with non-absorbable sutures on the Cooper's ligament, iliac crest, and obturator muscle and segmental enterectomy with primary anastomosis using a linear stapler was performed. CLINICAL DISCUSSION This demanding case brings to the spotlight the importance of reevaluating even the usual cases. We provide our experience bringing together an unusual diagnosis after the conduction of a once diagnosed fecaloma that almost went down to a perforated acute abdomen. Hence the importance of suspect obturator hernia in unknown obstructive abdomen in elderly women. CONCLUSION With this report we aim to raise awareness of careful propaedeutic inquiry of acute abdomen. We provide our experience bringing together the diagnosis that agrees with our literature review. Elderly patients commonly challenge the clinical evaluation, especially those with signs of senile disease. Thereby, inkling hidden diagnosis in typical scenarios can improve the patient's care in emergency settings.
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Affiliation(s)
- T A Furtado
- General Surgery at Hospital Felício Rocho, Belo Horizonte, MG, Brazil
| | - A C Carvalho
- General Surgery at Hospital Felício Rocho, Belo Horizonte, MG, Brazil.
| | - D P C Garcia
- Anatomy and Surgery Department in Faculdade de Ciências Médicas de Minas Gerais, General Surgery at Hospital Felício Rocho, Belo Horizonte, MG, Brazil
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Gómez E, Montero JL, Molina E, García-Buey L, Casado M, Fuentes J, Simón MA, Díaz-González A, Jorquera F, Morillas RM, Presa J, Berenguer M, Conde MI, Olveira A, Macedo G, Garrido I, Hernández-Guerra M, Olivas I, Rodríguez-Taje S, Londoño M, Sousa JM, Ampuero J, Romero-González E, González-Padilla S, Escudero-García D, Carvalho A, Santos A, Gutiérrez ML, Pérez-Fernández E, Aburruza L, Uriz J, Gomes D, Santos L, Martínez-González J, Albillos A, Fernández-Rodríguez CM. Longitudinal outcomes of obeticholic acid therapy in ursodiol-nonresponsive primary biliary cholangitis: Stratifying the impact of add-on fibrates in real-world practice. Aliment Pharmacol Ther 2024. [PMID: 38690746 DOI: 10.1111/apt.18004] [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] [Received: 12/14/2023] [Revised: 01/06/2024] [Accepted: 04/07/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Suboptimal response to ursodeoxycholic acid occurs in 40% of primary biliary cholangitis (PBC) patients, affecting survival. Achieving a deep response (normalisation of alkaline phosphatase [ALP] and bilirubin ≤0.6 upper limit of normal) improves survival. Yet, the long-term effectiveness of second-line treatments remains uncertain. AIMS To evaluate the long-term effectiveness of obeticholic acid (OCA) ± fibrates. Focusing on biochemical response (ALP ≤1.67 times the upper limit of normal, with a decrease of at least 15% from baseline and normal bilirubin levels), normalisation of ALP, deep response and biochemical remission (deep response plus aminotransferase normalisation). METHODS We conducted a longitudinal, observational, multicentre study involving ursodeoxyccholic acid non-responsive PBC patients (Paris-II criteria) from Spain and Portugal who received OCA ± fibrates. RESULTS Of 255 patients, median follow-up was 35.1 months (IQR: 20.2-53). The biochemical response in the whole cohort was 47.2%, 61.4% and 68.6% at 12, 24 and 36 months. GLOBE-PBC and 5-year UK-PBC scores improved (p < 0.001). Triple therapy (ursodeoxycholic acid plus OCA plus fibrates) had significantly higher response rates than dual therapy (p = 0.001), including ALP normalisation, deep response and biochemical remission (p < 0.001). In multivariate analysis, triple therapy remained independently associated with biochemical response (p = 0.024), alkaline phosphatase normalisation, deep response and biochemical remission (p < 0.001). Adverse effects occurred in 41.2% of cases, leading to 18.8% discontinuing OCA. Out of 55 patients with cirrhosis, 12 developed decompensation. All with baseline portal hypertension. CONCLUSION Triple therapy was superior in achieving therapeutic goals in UDCA-nonresponsive PBC. Decompensation was linked to pre-existing portal hypertension.
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Affiliation(s)
- E Gómez
- Hospital Universitario 12 De Octubre, Madrid, Spain
| | - J L Montero
- Hospital Universitario Reina Sofia, Córdoba, Spain
| | - E Molina
- Complexo Hospitalario Universitario De Santiago, Coruña, Spain
| | - L García-Buey
- Hospital Universitario De La Princesa, Madrid, Spain
| | - M Casado
- Hospital Universitario de Torrecárdenas, Almería, Spain
| | - J Fuentes
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - M A Simón
- Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
- University of Zaragoza, Zaragoza, Spain
| | - A Díaz-González
- Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - F Jorquera
- Complejo Hospitalario de Leon, Leon, Spain
| | | | - J Presa
- Centro Hospitalar Tras-os-Montes a Alto Douro, Vila Real, Portugal
| | - M Berenguer
- Hospital Universitario La Fe, Valencia, Spain
- University of Valencia, Valencia, Spain
| | - M I Conde
- Hospital Universitario La Fe, Valencia, Spain
| | - A Olveira
- Hospital Universitario La Paz, Madrid, Spain
| | - G Macedo
- Serviço de Gastrenterologia Do Centro Hospitalar Universitário São João (CHUSJ), Porto, Portugal
| | - I Garrido
- Serviço de Gastrenterologia Do Centro Hospitalar Universitário São João (CHUSJ), Porto, Portugal
| | | | - I Olivas
- Hospital Clinic, Barcelona, Spain
| | | | | | - J M Sousa
- Hospital Universitario Virgen del Rocio, Sevilla, Spain
| | - J Ampuero
- Hospital Universitario Virgen del Rocio, Sevilla, Spain
- Instituto De Biomedicina De Sevilla (IBIS), Sevilla, Spain
| | - E Romero-González
- Hospital Clinico Universitario de Valencia, Universidad de Valencia, Valencia, Spain
| | - Sh González-Padilla
- Hospital Clinico Universitario de Valencia, Universidad de Valencia, Valencia, Spain
| | - D Escudero-García
- Hospital Clinico Universitario de Valencia, Universidad de Valencia, Valencia, Spain
| | - A Carvalho
- Centro Hospitalar e Universitário De Coimbra, Coimbra, Portugal
| | - A Santos
- Centro Hospitalar e Universitário De Coimbra, Coimbra, Portugal
| | - M L Gutiérrez
- Hospital Universitario Fundacion Alcorcon, Alcorcon Madrid, Spain
- University Rey Juan Carlos, Madrid, Spain
| | - E Pérez-Fernández
- Hospital Universitario Fundacion Alcorcon, Alcorcon Madrid, Spain
- University Rey Juan Carlos, Madrid, Spain
| | - L Aburruza
- Hospital Universitario de Donostia, Donostia-San Sebastián, Spain
| | - J Uriz
- Complejo Hospitalario de Navarra, Pamplona, Spain
| | - D Gomes
- Departamento de Gastrenterología, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - L Santos
- Departamento de Gastrenterología, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | | | - A Albillos
- Hospital Universitario Ramón y Cajal, Madrid, Spain
- Ramón y Cajal Institute of Health Research, Madrid, Spain
- University of Alcalá de Henares, Alcalá de Henares, Spain
| | - C M Fernández-Rodríguez
- Hospital Universitario Fundacion Alcorcon, Alcorcon Madrid, Spain
- University Rey Juan Carlos, Madrid, Spain
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Mota PC, Soares ML, Ferreira AC, Santos RF, Rufo JC, Vasconcelos D, Carvalho A, Guimarães S, Vasques-Nóvoa F, Cardoso C, Melo N, Alexandre AT, Coelho D, Novais-Bastos H, Morais A. Polymorphisms and haplotypes of TOLLIP and MUC5B are associated with susceptibility and survival in patients with fibrotic hypersensitivity pneumonitis. Pulmonology 2024:S2531-0437(24)00007-2. [PMID: 38309995 DOI: 10.1016/j.pulmoe.2024.01.002] [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: 11/15/2023] [Revised: 12/27/2023] [Accepted: 01/04/2024] [Indexed: 02/05/2024] Open
Abstract
INTRODUCTION AND OBJECTIVES Hypersensitivity pneumonitis (HP) is an interstitial lung disease with diverse clinical features that can present a fibrotic phenotype similar to idiopathic pulmonary fibrosis (IPF) in genetically predisposed individuals. While several single nucleotide polymorphisms (SNPs) have been associated with IPF, the genetic factors contributing to fibrotic HP (fHP) remain poorly understood. This study investigated the association of MUC5B and TOLLIP variants with susceptibility, clinical presentation and survival in Portuguese patients with fHP. MATERIAL AND METHODS A case-control study was undertaken with 97 fHP patients and 112 controls. Six SNPs residing in the MUC5B and TOLLIP genes and their haplotypes were analyzed. Associations with risk, survival, and clinical, radiographic, and pathological features of fHP were probed through comparisons among patients and controls. RESULTS MUC5B rs35705950 and three neighboring TOLLIP variants (rs3750920, rs111521887, and rs5743894) were associated with increased susceptibility to fHP. Minor allele frequencies were greater among fHP patients than in controls (40.7% vs 12.1%, P<0.0001; 52.6% vs 40.2%, P = 0.011; 22.7% vs 13.4%, P = 0.013; and 23.2% vs 12.9%, P = 0.006, respectively). Haplotypes formed by these variants were also linked to fHP susceptibility. Moreover, carriers of a specific haplotype (G-T-G-C) had a significant decrease in survival (adjusted hazard ratio 6.92, 95% CI 1.73-27.64, P = 0.006). Additional associations were found between TOLLIP rs111521887 and rs5743894 variants and decreased lung function at baseline, and the MUC5B SNP and radiographic features, further highlighting the influence of genetic factors in fHP. CONCLUSION These findings suggest that TOLLIP and MUC5B variants and haplotypes may serve as valuable tools for risk assessment and prognosis in fibrotic hypersensitivity pneumonitis, potentially contributing to its patient stratification, and offer insights into the genetic factors influencing the clinical course of the condition.
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Affiliation(s)
- P C Mota
- Departamento de Pneumologia, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - M L Soares
- Laboratório de Apoio à Investigação em Medicina Molecular (LAIMM), Departamento de Biomedicina, Faculdade de Medicina da Universidade do Porto, Portugal; LAIMM, Núcleo de Recursos Laboratoriais, Unidade de Gestão de Conhecimento, Departamento de Recursos Comuns, Faculdade de Medicina da Universidade do Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.
| | - A C Ferreira
- Laboratório de Apoio à Investigação em Medicina Molecular (LAIMM), Departamento de Biomedicina, Faculdade de Medicina da Universidade do Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - R F Santos
- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; Escola Superior de Saúde - Instituto Politécnico do Porto, Portugal
| | - J C Rufo
- Indoor Air Quality and Respiratory Health Lab, Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Center for Translational Health and Medical Biotechnology Research (T.Bio), Escola Superior de Saúde, Instituto Politécnico do Porto, Porto, Portugal
| | - D Vasconcelos
- Laboratório de Apoio à Investigação em Medicina Molecular (LAIMM), Departamento de Biomedicina, Faculdade de Medicina da Universidade do Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - A Carvalho
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Departamento de Radiologia, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
| | - S Guimarães
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Departamento de Anatomia Patológica, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
| | - F Vasques-Nóvoa
- Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Departamento de Medicina Interna, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal; UnIC@RISE, Department of Surgery and Physiology, Portugal
| | - C Cardoso
- Departamento de Pneumologia, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - N Melo
- Departamento de Pneumologia, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
| | - A T Alexandre
- Departamento de Pneumologia, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal
| | - D Coelho
- Departamento de Pneumologia, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - H Novais-Bastos
- Departamento de Pneumologia, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - A Morais
- Departamento de Pneumologia, Centro Hospitalar Universitário de São João, EPE, Porto, Portugal; Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
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Garcia DPC, Carvalho AC, Gulati S, Ballecer C, Neto CS. Bone anchor as fixation method for abdominal wall reconstruction. A case report about a ten times recurred inguinal hernia. Int J Surg Case Rep 2023; 111:108730. [PMID: 37699285 PMCID: PMC10498188 DOI: 10.1016/j.ijscr.2023.108730] [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: 08/01/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/14/2023] Open
Abstract
INTRODUCTION While the use of bone anchor fixation for abdominal wall reconstruction for supra-pubic incisional hernia is well described (Yee et al., 2008 [1]), we show in this case report, written in line with the SCARE criteria (Agha et al., 2020 [2]), a novel use of this tool as an adjunct in the repair of a ten time recurrent inguinal hernia. CASE REPORT A 65 years old multiparous, diabetic non-obese female, with previous abdominoplasty was submitted for left inguinal hernia for ten times, between multiples complications between infection, more than one mesh excision by anterior approach and laparoscopic approach. The wide range of procedures culminated in a destruction of the abdominal wall, making it impossible for a usual fixation of mesh in the region. Therefore, a multidisciplinary approach was planned for the patient with a bone anchor as a mesh fixation method. With a year follow up we did not observe a local hernia recurrence. CLINICAL DISCUSSION Hernia itself is a multifactorial disease. As a anatomical defect, surgery is the only effective treatment. Our report brings a novel approach to a challenging case with many previous unsuccessful applications of conventional surgeries. Hence, we stimulate the multidisciplinary discussion for enhancing post operatory outcomes and a better point of care for the patient.
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Affiliation(s)
- D P C Garcia
- Anatomy and Surgery Department in Faculdade de Ciências Médicas de Minas Gerais, General Surgery at Hospital Felício Rocho, Belo Horizonte, MG, Brazil
| | - A C Carvalho
- General Surgery at Hospital Felício Rocho, Belo Horizonte, MG, Brazil.
| | - S Gulati
- Creighton University School of Medicine, Phoenix, United States of America
| | - C Ballecer
- Surgery at Creighton University School of Medicine, Phoenix, United States of America
| | - C S Neto
- General Surgery and Trauma Surgery at Hospital Joao XXIII, Belo Horizonte, MG, Brazil
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Monteiro SS, Santos TS, Pereira CA, Duarte DB, Neto H, Gomes A, Loureiro L, Martins J, Silva F, Martins LS, Ferreira L, Amaral C, Freitas C, Carvalho AC, Carvalho R, Dores J. The influence of simultaneous pancreas-kidney transplantation on the evolution of diabetic foot lesions and peripheral arterial disease. J Endocrinol Invest 2023:10.1007/s40618-023-02009-3. [PMID: 36645638 DOI: 10.1007/s40618-023-02009-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 01/05/2023] [Indexed: 01/17/2023]
Abstract
PURPOSE Simultaneous pancreas-kidney transplantation (SPKT) remains the best treatment option in patients with type 1 diabetes and chronic kidney failure. There are only a few studies addressing the potential ischemic deterioration of peripheral arterial disease (PAD) due to blood diverting from the iliac artery to the kidney graft. We aimed to evaluate diabetic foot lesions and PAD evolution in SPKT recipients and investigate if they are more frequent in ipsilateral lower limb of kidney graft. METHODS We developed a retrospective cohort, including patients submitted to SPKT in our tertiary center, between 2000 and 2017. Diabetic foot lesions and PAD frequencies were compared in the period before and after transplantation. RESULTS Two hundred and eleven patients were included, 50.2% (n = 106) female, with a median age at transplantation of 35 years (IQR 9). After a median follow-up period of 10 years (IQR 7), patient, kidney, and pancreatic graft survival were 90.5% (n = 191), 83.4% (n = 176), and 74.9% (n = 158), respectively. Before transplant, 2.8% (n = 6) had PAD and 5.3% (n = 11) had history of foot lesions. In post-transplant period, 17.1% (n = 36) patients presented PAD and 25.6% (n = 54) developed diabetic foot ulcers, 47.6% (n = 35) of which in the ipsilateral and 53.3% (n = 40) in the contralateral lower limb of the kidney graft (p = 0.48). Nine patients (4.3%) underwent major lower limb amputation, 3 (30%) ipsilateral and 7 (70%) contralateral to the kidney graft (p = 0.29). CONCLUSIONS Diabetic foot lesions were not more frequent in the ipsilateral lower limb of the kidney graft, therefore downgrading the 'steal syndrome' role in these patients.
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Affiliation(s)
- S S Monteiro
- Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário Do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal.
| | - T S Santos
- Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário Do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal
| | - C A Pereira
- Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário Do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal
| | - D B Duarte
- Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário Do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal
| | - H Neto
- Diabetic Foot Unit, Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário Do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal
| | - A Gomes
- Diabetic Foot Unit, Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário Do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal
| | - L Loureiro
- Diabetic Foot Unit, Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário Do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal
| | - J Martins
- Diabetic Foot Unit, Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário Do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal
| | - F Silva
- Division of Nephrology and Transplant, Centro Hospitalar Universitário Do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal
| | - L S Martins
- Division of Nephrology and Transplant, Centro Hospitalar Universitário Do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal
| | - L Ferreira
- Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário Do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal
- Diabetic Foot Unit, Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário Do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal
| | - C Amaral
- Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário Do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal
- Diabetic Foot Unit, Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário Do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal
| | - C Freitas
- Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário Do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal
- Diabetic Foot Unit, Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário Do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal
| | - A C Carvalho
- Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário Do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal
- Diabetic Foot Unit, Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário Do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal
| | - R Carvalho
- Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário Do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal
- Diabetic Foot Unit, Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário Do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal
| | - J Dores
- Division of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário Do Porto, Largo Professor Abel Salazar, 4099-001, Porto, Portugal
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Rodrigues Sousa S, Tenda A, Farinha I, Carvalho A, Chaves Loureiro C. Home administration of biological treatment in severe asthma in real-life experience: impact on asthma control and quality of life. Eur Ann Allergy Clin Immunol 2023; 55:35-40. [PMID: 35261225 DOI: 10.23822/eurannaci.1764-1489.248] [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] [Indexed: 01/14/2023]
Abstract
Summary Introduction. Several biological agents for the treatment of severe asthma have been approved for self-administration on an outpatient basis in the last years. However, data on the impact of home administration in outcomes such as asthma control and quality of life in real-life settings are sparse. Being this knowledge crucial for clinical practice, this study aimed to assess asthma control and quality of life in patients who transitioned from day hospital administration of biological therapy to home administration. Methods. A single-center prospective analysis of 33 patients treated with biologics for severe asthma, who switched from hospital to home treatment was performed. Asthma Control Test (ACT), Control of Allergic Rhinitis and Asthma Test (CARAT), Asthma Life Quality (ALQ) and the number of exacerbations were assessed 3 months before and 3 and 6 months after of home-use. Results. ACT and CARAT did not show statistical differences comparing to the baseline values (21.8 ± 2.7 and 23.8 ± 5.5) within 3 months (22.1 ± 2.4, p = 0.609; 23.2 ± 5.3, p = 0.572) or 6 months (23.4 ± 0.9, p = 0.553; 23.7 ± 6.2, p = 0.149) of home administration. Also, ALQ score did not show meaningful variations between baseline (9.5 ± 3.2) and after 3 months (11.2 ± 4.4, p = 0.275) and 6 months (10.3 ± 3.8, p = 0.209) of home-use. Regarding asthma exacerbations, we did not record a significant difference comparing to the baseline values of 3 months/patient exacerbations (0.2 ± 0.4) and after 3 months (0.2 ± 0.5, p = 0.786) or 6 months (0.2 ± 0.4, p = 1.000) of change in modality treatment. There was no cases of anaphylaxis or other serious adverse effects in those patients treated at home. Conclusions. Transition of day hospital administration of biologic treatment for severe asthma to home administration did not lead to any deterioration of asthma control or quality of life. Our results emphasized the efficacy and safety of home administration of biologic treatment and provide support on changing the paradigm of the administration of biological treatment in severe asthma.
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Affiliation(s)
- S Rodrigues Sousa
- Department of Pulmonology, Coimbra University Hospital, Coimbra, Portugal
| | - A Tenda
- Department of Pulmonology, Coimbra University Hospital, Coimbra, Portugal
| | - I Farinha
- Department of Pulmonology, Coimbra University Hospital, Coimbra, Portugal
| | - A Carvalho
- Department of Pulmonology, Coimbra University Hospital, Coimbra, Portugal
| | - C Chaves Loureiro
- Department of Pulmonology, Coimbra University Hospital, Coimbra, Portugal
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Amaral A, Carvalho A, Lima J. Consumption of legumes in children from 3 to 6 years – evaluation of an intervention program. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.514] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Eating habits are a key aspect of a healthy lifestyle. This study focuses on the importance of consuming legumes - rich and accessible source of protein, and a healthy and sustainable option, in environmental terms - contributing to increment health literacy levels at the population level.
Objectives
To design, implement and evaluate a program to promote the consumption of legumes - Beans4Life. Specifically, to assess its impact on the knowledge and frequency of consumption of the eight legumes (beans, grain, peas, beans, beans, lentils, chickpeas and lupins).
Methods
Pre-test post-test analytical study, with three evaluation moments: 1) before the intervention; 2) after the intervention with the children and 3) after the intervention with the guardians (end of the intervention). Participants: 90 children from 3 to 6 years old (54.4% male) and their guardians. Instruments: questionnaire to assess knowledge and food preferences, questionnaire on eating habits and a questionnaire to evaluate sessions. The intervention had two components, the first with the children (4 food education sessions) and the second with the families (activities that facilitate the inclusion of recipes with legumes in the family's daily life).
Results
Before the intervention, the results obtained show low levels of knowledge and frequency of consumption of legumes, influencing low health literacy. Peas and beans are the best known legumes (81.1% and 55.6%) and also preferred (77.8% and 73.3%). The results obtained in the second and third assessments show that there was a significant increase (p < 0.05) in the knowledge and frequency of consumption of most legumes.
Conclusions
The objectives initially proposed were achieved and it will be pertinent to continue the present study, with larger samples, in order to increase health literacy awareness and the consumption of this food group in childhood, and provide more robust results that help to clarify the relationships found.
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Affiliation(s)
- A Amaral
- Polytechnic Institute of Coimbra, ESTeSC - Coimbra Health School , Coimbra, Portugal
- Polytechnic Institute of Coimbra , Labinsaúde, Coimbra, Portugal
| | - A Carvalho
- Polytechnic Institute of Coimbra, ESTeSC - Coimbra Health School , Coimbra, Portugal
- GreenUPorto, Sustainable Agrifood Production , Porto, Portugal
- HL, Leiria Hospital Center , Leiria, Portugal
| | - J Lima
- Polytechnic Institute of Coimbra, ESTeSC - Coimbra Health School , Coimbra, Portugal
- GreenUPorto, Sustainable Agrifood Production , Porto, Portugal
- ciTechCare, Center for Innovative Care and Health Technology , Porto, Portugal
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Rinaldi AR, Gonçalves LJB, Oliveira PAF, Junior NM, Carvalho AC, Santos MBD, Gouvea CP. PERFIL HEMATOLÓGICO EM UM GRUPO DE PACIENTES COM INFECÇÃO PELO NOVO CORONAVÍRUS: UM ESTUDO DESCRITIVO. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.1127] [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: 11/06/2022] Open
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Santos MBD, Gonçalves LJB, Oliveira PAF, Rinaldi AR, Lima FM, Carvalho AC, Júnior NM. A IMPORTÂNCIA DOS AVANÇOS TECNOLÓGICOS NAS DOENÇAS ONCO-HEMATOLÓGICAS RARAS. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.309] [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: 11/06/2022] Open
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10
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Olival A, Vieira SF, Gonçalves VMF, Cunha C, Tiritan ME, Carvalho A, Reis RL, Ferreira H, Neves NM. Erythrocyte-derived liposomes for the treatment of inflammatory diseases. J Drug Target 2022; 30:873-883. [PMID: 35414285 DOI: 10.1080/1061186x.2022.2066107] [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] [Indexed: 10/18/2022]
Abstract
Effective and safe therapies to counteract persistent inflammation are necessary. We developed erythrocyte-derived liposomes (EDLs) with intrinsic anti-inflammatory activity. The EDLs were prepared using lipids extracted from erythrocyte membranes, which are rich in omega-3 fatty acids with several health benefits. Diclofenac, a widely used anti-inflammatory drug, was incorporated into EDLs in relevant therapeutic concentrations. The EDLs were also functionalized with folic acid to allow their active targeting of M1 macrophages, which are key players in inflammatory processes. In the presence of lipopolysaccharide (LPS)-stimulated macrophages, empty EDLs and EDLs incorporating diclofenac were able to reduce the levels of important pro-inflammatory cytokines, namely interleukin-6 (IL-6; ≈85% and 77%, respectively) and tumor necrosis factor-alpha (TNF-α; ≈64% and 72%, respectively). Strikingly, cytocompatible concentrations of EDLs presented similar effects to dexamethasone, a potent anti-inflammatory drug, in reducing IL-6 and TNF-α concentrations, demonstrating the EDLs potential to be used as bioactive carriers in the treatment of inflammatory diseases.
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Affiliation(s)
- A Olival
- 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco, Guimarães, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - S F Vieira
- 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco, Guimarães, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - V M F Gonçalves
- CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde, Rua Central de Gandra, 1317, 4585-116 Gandra PRD, Paredes, Portugal
| | - C Cunha
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Life and Health Sciences Research Institute, School of Health Sciences, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - M E Tiritan
- CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde, Rua Central de Gandra, 1317, 4585-116 Gandra PRD, Paredes, Portugal.,Laboratório de Química Orgânica e Farmacêutica, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal.,Centro Interdisciplinar de Investigação Marinha e Ambiental (CIIMAR/CIMAR), Universidade do Porto, Rua dos Bragas 289, 4050-123 Porto, Portugal
| | - A Carvalho
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Life and Health Sciences Research Institute, School of Health Sciences, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Rui L Reis
- 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco, Guimarães, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - H Ferreira
- 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco, Guimarães, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - N M Neves
- 3B's Research Group, I3Bs - Research Institute on Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, 4805-017 Barco, Guimarães, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
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11
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Veiga N, Carvalho A, Correia P, Couto P, Correia MJ. Self-perception of childrenś oral health by their parents. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.379] [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] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Neglecting oral hygiene can lead to early tooth loss, pain, discomfort and, consequently, a great monetary investment to repair the damage caused in the stomatognathic system, whether of masticatory, phonetic or aesthetic origin. The aim of the present study consists in the characterization of oral health perception and oral hygiene habits of the children by their own parents and the creation of a scale to classify children's oral health perception by their parents.
Methods
A cross-sectional observational epidemiological study was performed. The population of this study was made up of 422 parents whose children are between five and eleven years of age and who attend schools in the districts of Viseu and Lisbon. The data collection was achieved through the application of a self-administered questionnaire in order to characterize the parentś perception of the oral health of their own children.
Results
Through the analysis of the questionnaires, 54.8% of the sample considered that their own children present inadequate oral health behaviors; 40.3% sufficient and only 4.8% consider that their children have good and adequate oral health behaviors. Regarding oral hygiene, most of the children did it one to five times a day, 44.7% took ‘2 minutes' to perform this activity, 70.3% did not use dental floss, 77.9% do not brush their teeth after lunch, 49.3% only use toothbrush for oral hygiene, 13.6% never went to the dentist, 26.9% are afraid, 38.1% have already suffered from toothache, 28.8% had gingival hemorrhage and 12.6% had gingival inflammation.
Conclusions
Oral health is a determining factor for a good quality of life. To this end, it is essential to implement oral health education and promotion strategies with all members of the household, in order to guarantee better oral health indexes in the community.
Key messages
Oral health literacy and knowledge is essential in order to improve oral health indexes in the community. The characterization of the oral health of children and adolescents is crucial to improve oral health behaviors and establish the correct oral health promotion programs.
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Affiliation(s)
- N Veiga
- Faculty of Dental Medicine, Universidade Católica Portuguesa, Viseu, Portugal
- Centre for Interdisciplinary Research in Health, Universidade Católica Portuguesa, Viseu, Portugal
| | - A Carvalho
- Faculty of Dental Medicine, Universidade Católica Portuguesa, Viseu, Portugal
| | - P Correia
- Faculty of Dental Medicine, Universidade Católica Portuguesa, Viseu, Portugal
- Centre for Interdisciplinary Research in Health, Universidade Católica Portuguesa, Viseu, Portugal
| | - P Couto
- Faculty of Dental Medicine, Universidade Católica Portuguesa, Viseu, Portugal
- Centre for Interdisciplinary Research in Health, Universidade Católica Portuguesa, Viseu, Portugal
| | - MJ Correia
- Faculty of Dental Medicine, Universidade Católica Portuguesa, Viseu, Portugal
- Centre for Interdisciplinary Research in Health, Universidade Católica Portuguesa, Viseu, Portugal
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12
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Carvalho A, Trevisanutto PE, Taioli S, Castro Neto AH. Computational methods for 2D materials modelling. Rep Prog Phys 2021; 84:106501. [PMID: 34474406 DOI: 10.1088/1361-6633/ac2356] [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] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 09/02/2021] [Indexed: 06/13/2023]
Abstract
Materials with thickness ranging from a few nanometers to a single atomic layer present unprecedented opportunities to investigate new phases of matter constrained to the two-dimensional plane. Particle-particle Coulomb interaction is dramatically affected and shaped by the dimensionality reduction, driving well-established solid state theoretical approaches to their limit of applicability. Methodological developments in theoretical modelling and computational algorithms, in close interaction with experiments, led to the discovery of the extraordinary properties of two-dimensional materials, such as high carrier mobility, Dirac cone dispersion and bright exciton luminescence, and inspired new device design paradigms. This review aims to describe the computational techniques used to simulate and predict the optical, electronic and mechanical properties of two-dimensional materials, and to interpret experimental observations. In particular, we discuss in detail the particular challenges arising in the simulation of two-dimensional constrained fermions and quasiparticles, and we offer our perspective on the future directions in this field.
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Affiliation(s)
- A Carvalho
- Centre for Advanced 2D Materials, National University of Singapore, 6 Science Drive 2, 117546, Singapore
| | - P E Trevisanutto
- European Centre for Theoretical Studies in Nuclear Physics and Related Areas (ECT*-FBK) and Trento Institute for Fundamental Physics and Applications (TIFPA-INFN), Via Sommarive, 14, 38123 Povo TN, Trento, Italy
| | - S Taioli
- European Centre for Theoretical Studies in Nuclear Physics and Related Areas (ECT*-FBK) and Trento Institute for Fundamental Physics and Applications (TIFPA-INFN), Via Sommarive, 14, 38123 Povo TN, Trento, Italy
- Peter the Great St. Petersburg Polytechnic University, Polytechnicheskaya 29, St. Petersburg 195251, Russia
| | - A H Castro Neto
- Centre for Advanced 2D Materials, National University of Singapore, 6 Science Drive 2, 117546, Singapore
- Materials Science and Engineering, National University of Singapore, 9 Engineering Drive 1, 117575, Singapore
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13
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Arastehfar A, Carvalho A, Houbraken J, Lombardi L, Garcia-Rubio R, Jenks J, Rivero-Menendez O, Aljohani R, Jacobsen I, Berman J, Osherov N, Hedayati M, Ilkit M, Armstrong-James D, Gabaldón T, Meletiadis J, Kostrzewa M, Pan W, Lass-Flörl C, Perlin D, Hoenigl M. Aspergillus fumigatus and aspergillosis: From basics to clinics. Stud Mycol 2021; 100:100115. [PMID: 34035866 PMCID: PMC8131930 DOI: 10.1016/j.simyco.2021.100115] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The airborne fungus Aspergillus fumigatus poses a serious health threat to humans by causing numerous invasive infections and a notable mortality in humans, especially in immunocompromised patients. Mould-active azoles are the frontline therapeutics employed to treat aspergillosis. The global emergence of azole-resistant A. fumigatus isolates in clinic and environment, however, notoriously limits the therapeutic options of mould-active antifungals and potentially can be attributed to a mortality rate reaching up to 100 %. Although specific mutations in CYP 51A are the main cause of azole resistance, there is a new wave of azole-resistant isolates with wild-type CYP 51A genotype challenging the efficacy of the current diagnostic tools. Therefore, applications of whole-genome sequencing are increasingly gaining popularity to overcome such challenges. Prominent echinocandin tolerance, as well as liver and kidney toxicity posed by amphotericin B, necessitate a continuous quest for novel antifungal drugs to combat emerging azole-resistant A. fumigatus isolates. Animal models and the tools used for genetic engineering require further refinement to facilitate a better understanding about the resistance mechanisms, virulence, and immune reactions orchestrated against A. fumigatus. This review paper comprehensively discusses the current clinical challenges caused by A. fumigatus and provides insights on how to address them.
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Affiliation(s)
- A. Arastehfar
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, 07110, USA
| | - A. Carvalho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Guimarães/Braga, Portugal
| | - J. Houbraken
- Westerdijk Fungal Biodiversity Institute, Utrecht, the Netherlands
| | - L. Lombardi
- UCD Conway Institute and School of Medicine, University College Dublin, Dublin 4, Ireland
| | - R. Garcia-Rubio
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, 07110, USA
| | - J.D. Jenks
- Department of Medicine, University of California San Diego, San Diego, CA, 92103, USA
- Clinical and Translational Fungal-Working Group, University of California San Diego, La Jolla, CA, 92093, USA
| | - O. Rivero-Menendez
- Medical Mycology Reference Laboratory, National Center for Microbiology, Instituto de Salud Carlos III, Madrid, 28222, Spain
| | - R. Aljohani
- Department of Infectious Diseases, Imperial College London, London, UK
| | - I.D. Jacobsen
- Department of Microbial Pathogenicity Mechanisms, Leibniz Institute for Natural Product Research and Infection Biology—Hans Knöll Institute, Jena, Germany
- Institute for Microbiology, Friedrich Schiller University, Jena, Germany
| | - J. Berman
- Research Group Microbial Immunology, Leibniz Institute for Natural Product Research and Infection Biology—Hans Knöll Institute, Jena, Germany
| | - N. Osherov
- Department of Clinical Microbiology and Immunology, Sackler School of Medicine Ramat-Aviv, Tel-Aviv, 69978, Israel
| | - M.T. Hedayati
- Invasive Fungi Research Center/Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - M. Ilkit
- Division of Mycology, Department of Microbiology, Faculty of Medicine, Çukurova University, 01330, Adana, Turkey
| | | | - T. Gabaldón
- Life Sciences Programme, Supercomputing Center (BSC-CNS), Jordi Girona, Barcelona, 08034, Spain
- Mechanisms of Disease Programme, Institute for Research in Biomedicine (IRB), Barcelona, Spain
- ICREA, Pg. Lluís Companys 23, Barcelona, Spain
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Pg. Lluís Companys 23, 08010, Barcelona, Spain
| | - J. Meletiadis
- Clinical Microbiology Laboratory, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - W. Pan
- Medical Mycology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai, 200003, China
| | - C. Lass-Flörl
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - D.S. Perlin
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ, 07110, USA
| | - M. Hoenigl
- Department of Medicine, University of California San Diego, San Diego, CA, 92103, USA
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, 8036, Graz, Austria
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, San Diego, CA 92093, USA
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Prata T, Calcides D, Vasconcelhos E, Carvalho A, De Melo E, Costa E. Prevalence of suicidal ideation among medical students at a university in Brazil. Eur Psychiatry 2021. [PMCID: PMC9480040 DOI: 10.1192/j.eurpsy.2021.1565] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Personal and environmental factors may contribute to psychological distress in medical students. As a result, they are more susceptible to suicidal ideation, a serious public health problem. Objectives Estimate the prevalence and recognize associated factors of Suicide Ideation and Suicide Attempt among medical students at the Federal University of Sergipe, Brazil. Methods A cross-sectional study was performed with randomly selected students between April and June 2019. A structured online questionnaire about sociodemographic characteristics, educational process, and the current psych emotional experiences, besides Beck Scale for Suicide Ideation (BSI), which detects the presence of suicidal ideation, were applied. Statistical evaluation was performed with descriptive analysis and logistic regression for the evaluation of multiple variables. Results The study included 133 students, with an average age of 22.9±3.5 and 51,9% were male. Among this sample, 27,1% had suicidal ideation. The frequency is higher in those students who family income <10 minimum wages (OR=3.47) and who were not satisfied with the course (OR=3.52). Furthermore, the frequency of suicide attempt was 15.8%. It was higher among those who claimed to use a doctor-prescribed psychopharmaceutical (OR=10.46) and who lost some discipline in the course (OR=8.17). Ideation and attempt were significantly associated (p<0.001). Conclusions Frequency of suicidal ideation was high, associated with dissatisfaction related to the educational process, as well as lower family income. History of attempted suicide was also frequent and associated with ideation. Intervention and prevention measures are required.
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Prata T, Vasconcelhos E, Calcides D, Carvalho A, De Melo E, Costa E. Prevalence and associated factors of common mental disorders among medical students at a university in Brazil. Eur Psychiatry 2021. [PMCID: PMC9475676 DOI: 10.1192/j.eurpsy.2021.988] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionCommon Mental Disorders (CMD) are minor manifestations of depressive, anxious or somatoform symptoms, which do not fit the diagnostic criteria of the International Code of Diseases (ICD). In medical students, this panorama can generate even more repercussions given the complexity of the medical education process.ObjectivesEstimate the prevalence and recognize associated factors of CMD among medical at the Federal University of Sergipe, Brazil.MethodsA cross-sectional study was performed with randomly selected students between April and June 2019. The Self Report Questionnaire (SRQ-20) were used, along with a questionnaire about socioeconomic and demographic characteristics, personal aspects and educational process, prepared by the authors and previously tested in a pilot study. Statistical evaluation of multiple variables was performed through backward stepwise logistic regression analysis.ResultsThe study included 80 students, equivalent to 22.59% of the total population of the studied Campus. There was an age average of 23.2 years (± 4.12), mostly female (52.5%) and single individuals (35%). The prevalence of CMD was 50% and an association was observed with the following factors: feeling of dissatisfaction with the course (p = 0.034); consider their own academic performance poor or regular (p = 0.12); lack of physical activity (p = 0.043); being anxious when not using a cell phone (p = 0.007); and the retraction pattern in the face of conflict situations in their interpersonal relationships (p = 0.025).ConclusionsResults suggest a high prevalence of CDM, associated mainly with the personal perspective about the educational process and personal habits.
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Prata T, Calcides D, Vasconcelhos E, Carvalho A, De Melo E, Costa E. Burnout syndrome among brazilian medical students under different educational models. Eur Psychiatry 2021. [PMCID: PMC9476097 DOI: 10.1192/j.eurpsy.2021.987] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Medical students are exposed to many stressors which may contribute to the onset of Burnout Syndrome (BS). It consists of a triad of emotional exhaustion, cynicism and low professional efficacy. As a result, BS may reduce academic performance, quality of life and damage future professional life. Objectives Estimate the prevalence and recognize associated factors of BS among medical students from two different medical schools form the same Brazilian Public University with different teaching models: School 1, with a traditional model, and School 2, with Problem-Based Learning model. Methods A cross-sectional study was performed with randomly selected students between April and June 2019. A structured questionnaire on socio-demographic characteristics and the educational process in addition to The Maslach Burnout Inventory/Student Survey (MBI-SS) were used. Statistical evaluation of multiple variables was performed through backward stepwise logistic regression analysis. Results Study included 213 students, with an average age of 23±3.77, 50,2% were male and 62,5% belong to School 1. Among this sample, 21,6% of the students fit tridimensional criteria for BS. Burnout levels were higher in those people who rarely get emotional support they need in the course (OR=3,98, CI 95%, 1,75-9,06), who considered abandoning the course (OR= 2,88, CI 95% 1,29-6,43) and who consider their academic performance regular or weak (OR= 12,1, CI 95%, 4-36,5). Conclusions Results suggest a high prevalence of BS with factors associated with the psychosocial and educational sphere of medical students. In our research, the teaching model was not a factor associated with BS.
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Serre-Miranda C, Nobrega C, Roque S, Canto-Gomes J, Silva CS, Vieira N, Barreira-Silva P, Alves-Peixoto P, Cotter J, Reis A, Formigo M, Sarmento H, Pires O, Carvalho A, Petrovykh DY, Diéguez L, Sousa JC, Sousa N, Capela C, Palha JA, Cunha PG, Correia-Neves M. Performance assessment of 11 commercial serological tests for SARS-CoV-2 on hospitalised COVID-19 patients. Int J Infect Dis 2021; 104:661-669. [PMID: 33484862 PMCID: PMC7817432 DOI: 10.1016/j.ijid.2021.01.038] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/14/2021] [Accepted: 01/15/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Commercial availability of serological tests to evaluate immunoglobulins (Ig) targeting severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has grown exponentially since the start of the coronavirus disease 2019 (COVID-19) outbreak. Thorough validation of these tests is important before use as epidemiological tools to infer seroprevalence in specific populations and as diagnostic tools to complement molecular approaches (e.g., quantitative reverse transcription-polymerase chain reaction). METHODS Commercial serological tests from 11 suppliers were assayed side-by-side using 126 samples from SARS-CoV-2-infected inpatients and 36 from healthy and HIV-infected individuals. RESULTS The majority of the tests assayed have >95% specificity. For the sensitivity calculation, samples were stratified by days since symptoms onset; sensitivity peaks at 16-21 days for IgM and IgA (maximum 91.2%, Euroimmun) and, dependant on the test, at 16-21 or >21 days for IgG (maximum 94.1%, Snibe). Data from semiquantitative tests show that patients with a severe clinical presentation have lower levels of Ig targeting SARS-CoV-2 at <10 days since symptoms onset and higher levels at >21 days, compared to patients with a non-severe presentation. CONCLUSIONS This study highlights the heterogeneity of sensitivity and generally high specificity of the serological tests and establishes a basis for their usefulness to complement diagnostic techniques and population seroprevalence studies.
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Affiliation(s)
- C Serre-Miranda
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - C Nobrega
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - S Roque
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - J Canto-Gomes
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - C S Silva
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - N Vieira
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - P Barreira-Silva
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - P Alves-Peixoto
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - J Cotter
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Internal Medicine Department, Senhora da Oliveira Hospital, Guimarães, Portugal
| | - A Reis
- Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Internal Medicine Department, Senhora da Oliveira Hospital, Guimarães, Portugal
| | - M Formigo
- Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Internal Medicine Department, Senhora da Oliveira Hospital, Guimarães, Portugal
| | - H Sarmento
- Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Internal Medicine Department, Senhora da Oliveira Hospital, Guimarães, Portugal
| | - O Pires
- Hospital of Braga, Braga, Portugal
| | - A Carvalho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; Hospital of Braga, Braga, Portugal
| | - D Y Petrovykh
- International Iberian Nanotechnology Laboratory (INL), Braga, Portugal
| | - L Diéguez
- International Iberian Nanotechnology Laboratory (INL), Braga, Portugal
| | - J C Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - N Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; Clinical Academic Center, Braga, Portugal
| | - C Capela
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; Hospital of Braga, Braga, Portugal
| | - J A Palha
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; Clinical Academic Center, Braga, Portugal
| | - P G Cunha
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Internal Medicine Department, Senhora da Oliveira Hospital, Guimarães, Portugal
| | - M Correia-Neves
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; Clinical Academic Center, Braga, Portugal.
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Bernal-Martínez L, Gonçalves SM, de Andres B, Cunha C, Gonzalez Jimenez I, Lagrou K, Mellado E, Gaspar ML, Maertens JA, Carvalho A, Alcazar-Fuoli L. TREM1 regulates antifungal immune responses in invasive pulmonary aspergillosis. Virulence 2021; 12:570-583. [PMID: 33525982 PMCID: PMC7872058 DOI: 10.1080/21505594.2021.1879471] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Pattern recognition receptors (PRRs) are responsible for Aspergillus fumigatus recognition by innate immunity and its subsequent immune signaling. The triggering receptor expressed on myeloid cells 1 (TREM1) is a recently characterized pro-inflammatory receptor constitutively expressed on the surface of neutrophils and macrophages. A soluble form (sTREM1) of this protein that can be detected in human body fluids has been identified. Here we investigated the role of TREM1 during invasive pulmonary aspergillosis (IPA). IPA patients displayed significantly higher levels of sTREM1 in bronchoalveolar lavages when compared to control patients. Functional analysis in TREM1 showed that the levels of sTREM1 and TREM1 pathway-related cytokines were influenced by single nucleotide polymorphisms in TREM1. In addition, we confirmed a role of TREM1 on antifungal host defense against A. fumigatus in a murine model of IPA. TREM1 deficiency increased susceptibility to infection in the immunosuppressed murine host. Deletion of TREM1 showed delayed innate and adaptive immune responses and impaired pro-inflammatory cytokine responses. The absence of TREM1 in primary macrophages attenuated the TLR signaling by altering the expression of both receptor and effector proteins that are critical to the response against A. fumigatus. In this study, and for the first time, we demonstrate the key role for the TREM1 receptor pathway during IPA.
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Affiliation(s)
- L Bernal-Martínez
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto De Salud Carlos III , Madrid, Spain.,Spanish Network for the Research in Infectious Diseases (REIPI), Instituto de Salud Carlos III , Madrid, Spain
| | - S M Gonçalves
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho , Braga, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães , Portugal
| | - B de Andres
- Department of Immunology, National Centre for Microbiology, Instituto De Salud Carlos III , Madrid, Spain
| | - C Cunha
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho , Braga, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães , Portugal
| | - I Gonzalez Jimenez
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto De Salud Carlos III , Madrid, Spain
| | - K Lagrou
- Department of Microbiology, Immunology, and Transplantation, Laboratory of Clinical Bacteriology and Mycology , KU Leuven, Leuven, Belgium.,Department of Laboratory Medicine and National Reference Center for Medical Mycology, University Hospitals Leuven , Leuven, Belgium
| | - E Mellado
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto De Salud Carlos III , Madrid, Spain.,Spanish Network for the Research in Infectious Diseases (REIPI), Instituto de Salud Carlos III , Madrid, Spain
| | - M L Gaspar
- Department of Immunology, National Centre for Microbiology, Instituto De Salud Carlos III , Madrid, Spain
| | - J A Maertens
- Department of Microbiology, Immunology, and Transplantation, Laboratory of Clinical Bacteriology and Mycology , KU Leuven, Leuven, Belgium.,Department of Haematology, University Hospitals Leuven , Leuven, Belgium
| | - A Carvalho
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho , Braga, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães , Portugal
| | - L Alcazar-Fuoli
- Mycology Reference Laboratory, National Centre for Microbiology, Instituto De Salud Carlos III , Madrid, Spain.,Spanish Network for the Research in Infectious Diseases (REIPI), Instituto de Salud Carlos III , Madrid, Spain
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19
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Carvalho A, Cunha R, Lima B, Pereira J, Madureira A. Chest CT imaging features of COVID-19 pneumonia: First radiological insights from Porto, Portugal. Eur J Radiol Open 2020; 7:100294. [PMID: 33283031 PMCID: PMC7698648 DOI: 10.1016/j.ejro.2020.100294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/13/2020] [Accepted: 11/16/2020] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION The outbreak of a highly infectious respiratory disease - COVID-19 - has spread globally and a novel type of coronavirus (SARS-CoV-2) was identified as its cause. Chest CT findings have been described as an aid for COVID-19 diagnosis and management. We aimed to describe the CT imaging characteristics in a group of COVID-19 patients while we also intended to assess if any of these radiological features were associated with short-term prognosis. MATERIALS AND METHODS CT examinations from 164 consecutive patients with at least one positive RT-PCR nucleic acid assay for SARS-CoV-2 were retrospectively analyzed. Numerous CT imaging features were recorded independently by two radiologists. Patients were grouped according to their status 14 days after the initial CT scan in either discharged/hospitalized in a non-ICU ward (favorable prognosis group) versus deceased/admitted to an intensive care unit (unfavorable prognosis group). RESULTS Ground-glass opacities (89.0 %) and consolidations (73.2 %) with multilobar involvement were the predominant imaging findings, while a nodular pattern (3.7 %) and cavitation (1.2 %) were uncommon. Mean age was higher in the mortality/ICU group. Ground-glass opacities and consolidations were dominant in both groups, but distribution pattern of abnormalities was different, being more often diffuse in the mortality/ICU group. Linear opacities and opacities that were rounded in shape were more frequently observed in the favorable prognosis group. CT severity index was significantly higher in the mortality/ICU group. For assessing unfavorable prognosis, the best cut-off for CT severity index was 24 (sensitivity 78 %; specificity 59 %). Interobserver agreement for all CT findings was excellent. CONCLUSION COVID-19 pneumonia in Porto, Portugal, manifests as multilobar ground-glass opacities and consolidations. Older age, diffuse distribution and increasing CT severity index are associated with worse short-term prognosis while linear opacities resembling organizing pneumonia and rounded opacities herald a more favorable prognosis.
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Affiliation(s)
- A. Carvalho
- Serviço de Radiologia, Centro Hospitalar Universitário de São João, EPE, Portugal
| | - R. Cunha
- Serviço de Radiologia, Centro Hospitalar Universitário de São João, EPE, Portugal
| | | | - J.M. Pereira
- Serviço de Radiologia, Centro Hospitalar Universitário de São João, EPE, Portugal
| | - A.J. Madureira
- Serviço de Radiologia, Centro Hospitalar Universitário de São João, EPE, Portugal
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20
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Barreto A, Carvalho A, Silva D, Pinto E, Almeida A, Paíga P, Correira-Sá L, Delerue-Matos C, Trindade T, Soares AMVM, Hylland K, Loureiro S, Oliveira M. Effects of single and combined exposures of gold (nano versus ionic form) and gemfibrozil in a liver organ culture of Sparus aurata. Mar Pollut Bull 2020; 160:111665. [PMID: 33181940 DOI: 10.1016/j.marpolbul.2020.111665] [Citation(s) in RCA: 3] [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: 02/25/2020] [Revised: 08/15/2020] [Accepted: 09/07/2020] [Indexed: 06/11/2023]
Abstract
In vitro methods have gained rising importance in ecotoxicology due to ethical concerns. The aim of this study was to assess the single and combined in vitro effects of gold, as nanoparticle (AuNPs) and ionic (Au+) form, and the pharmaceutical gemfibrozil (GEM). Sparus aurata liver organ culture was exposed to gold (4 to 7200 μg·L-1), GEM (1.5 to 15,000 μg·L-1) and combination 80 μg·L-1 gold +150 μg·L-1 GEM for 24 h. Endpoints related with antioxidant status, peroxidative/genetic damage were assessed. AuNPs caused more effects than Au+, increasing catalase and glutathione reductase activities and damaging DNA and cellular membranes. Effects were dependent on AuNPs size, coating and concentration. GEM damaged DNA at an environmentally relevant concentration, 1.5 μg·L-1. Overall, the effects of the combined exposures were higher than the predicted, based on single exposures. This study showed that liver culture can be a useful model to study contaminants effects.
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Affiliation(s)
- A Barreto
- Departamento de Biologia & CESAM, Universidade de Aveiro, 3810-193 Aveiro, Portugal.
| | - A Carvalho
- Departamento de Biologia & CESAM, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - D Silva
- Departamento de Biologia & CESAM, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - E Pinto
- Departamento de Saúde Ambiental, Escola Superior de Saúde, P. Porto. CISA/Centro de Investigação em saúde e Ambiente, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal; LAQV/REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
| | - A Almeida
- LAQV/REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal
| | - P Paíga
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 431, 4200-072 Porto, Portugal
| | - L Correira-Sá
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 431, 4200-072 Porto, Portugal
| | - C Delerue-Matos
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida, 431, 4200-072 Porto, Portugal
| | - T Trindade
- Departamento de Química & CICECO - Aveiro Instituto de Materiais, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - A M V M Soares
- Departamento de Biologia & CESAM, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - K Hylland
- Department of Biosciences, University of Oslo, PO Box 1066, N-0316 Oslo, Norway
| | - S Loureiro
- Departamento de Biologia & CESAM, Universidade de Aveiro, 3810-193 Aveiro, Portugal
| | - M Oliveira
- Departamento de Biologia & CESAM, Universidade de Aveiro, 3810-193 Aveiro, Portugal
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21
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Jacob L, López-Sánchez GF, Koyanagi A, Veronese N, Vioque-López J, Oh H, Shin JI, Schnitzler A, Ilie CP, Stefanescu S, Gillvray C, Machado MO, Piguet V, Carvalho A, Smith L. Chronic skin disease and levels of physical activity in 17 777 Spanish adults: a cross-sectional study. Clin Exp Dermatol 2020; 46:516-524. [PMID: 32909628 DOI: 10.1111/ced.14443] [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] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/21/2020] [Accepted: 08/31/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND To date there is limited literature on the prevalence of chronic skin conditions and its association with levels of physical activity (PA) in Spain. AIM To determine the prevalence of chronic skin disease and to compare levels of PA between people with and without chronic skin disease in a large representative sample of Spanish adults aged 15-69 years. METHODS Data from the Spanish National Health Survey 2017 were analysed. Chronic skin disease was assessed using a yes/no question. PA was measured using the short form of the International Physical Activity Questionnaire. Total PA metabolic equivalent of task min/week were calculated, and PA was included in the analyses as a continuous and a five-category variable. RESULTS This cross-sectional study included 17 777 adult participants (52.0% women; mean ± SD age 45.8 ± 14.1 years), of whom 940 (5.3%) had chronic skin disease. After adjusting for several potential confounders, there was a negative association between chronic skin disease and PA (OR = 0.87, 95% CI 0.76-1.00, P = 0.05), which was significant for men (OR = 0.76, 95% CI 0.62-0.93, P = 0.01) but not for women (OR = 0.97, 95% CI 0.81-1.16, P = 0.72). CONCLUSIONS In this large representative sample of Spanish adults, the prevalence of chronic skin disease was low. Levels of PA were lower in men with than in men without chronic skin conditions, but this association was not seen in women.
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Affiliation(s)
- L Jacob
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France.,Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain
| | | | - A Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Barcelona, Spain.,ICREA, Barcelona, Spain
| | - N Veronese
- National Research Council Neuroscience Institute Padua, Padua, Italy
| | - J Vioque-López
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain.,Nutritional Epidemiology Unit, Universidad Miguel Hernández, ISABIAL-UMH, Alicante, Spain
| | - H Oh
- University of Southern California, Suzanne Dworak Peck School of Social Work, Los Angeles, CA, USA
| | - J I Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - A Schnitzler
- Department of Physical Medicine and Rehabilitation, Raymond Poincaré Hospital, AP-HP, Garches, France.,EA4047, UFR des Sciences de la Santé Université Versailles Saint Quentin en Yvelines,, Montigny-le-Bretonneux, France
| | - C P Ilie
- Queen Elizabeth Hospital Foundation Trust, King's Lynn, UK
| | - S Stefanescu
- Queen Elizabeth Hospital Foundation Trust, King's Lynn, UK
| | - C Gillvray
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - M O Machado
- Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, ON, Canada
| | - V Piguet
- Division of Dermatology, Department of Medicine, Women's College Hospital, Toronto, ON, Canada
| | - A Carvalho
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - L Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
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22
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Marques T, Carvalho A, Miguéis A. ADHEAR in Conductive Hearing Loss: a case study. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa040.021] [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] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction Bone conduction hearing systems can be applied through non-invasive devices, using soft bands that exert pressure on the skin, or they can be surgically implanted (Bone Anchored Hearing Aid - BAHA). However, these bone conduction devices are frequently not well accepted due to the pressure on the head. Therefore, a new non-surgical hearing system was developed not to exert pressure on the skin, the ADHEAR. The bone anchorage in ADHEAR is performed through an adhesive adapter and is indicated for patients with conductive hearing loss and normal inner ear function.
Objectives Evaluate the audiological performance with the adhesive bone conduction hearing device (ADHEAR) in a patient with conductive hearing loss.
Methodology The study was designed as a prospective single-subject repeated-measure study with the subject serving as his own control. A 29 year old female patient who had a primary surgery due to middle ear cholesteatoma, was adapted with unilateral non-invasive adhesive bone conduction system for the treatment of conductive hearing loss. Air and bone conduction thresholds, word recognition scores (WRS) and speech recognition thresholds (SRT) in quiet and noise were assessed to verify the inclusion criteria of the study. Aided and unaided pure tone audiometry at 0.5, 1, 2 and 4 kHz in free field and speech audiometry in quiet and noise were performed at baseline and after 4 weeks with the ADHEAR.
Results The functional gain with the ADHEAR averaged over 0.5, 1, 2, and 4 kHz after 4 weeks of usage of the adhesive hearing system, improved from 55 dB HL to 31dB HL. Speech perception in quiet and noise improved significantly in the aided situation, with SRT in quiet improving from 60 to 35 dB HL, when compared to the unaided condition. Similar results were found in noise. The patient evaluated the ADHEAR system as being useful, and without complaints of skin pressure. There was no adverse skin reaction.
Conclusion Hearing performance was significantly better with ADHEAR under all test conditions. Therefore, this transcutaneous hearing system seems to be an excellent alternative for patients who need a hearing solution for conductive hearing loss but for clinical reasons cannot undergo surgery or conventional hearing aids. Furthermore, it preserves skin over the mastoid and reduces the risk of infection. Otherwise it has benefits verified by absence of head pressure and improvement of patient’s quality of life.
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Affiliation(s)
- T Marques
- Instituto Politécnico de Coimbra, ESTeSC – Coimbra Health School, Audiologia, Portugal
- OuviSonus, Coimbra, Portugal
| | - A Carvalho
- Instituto Politécnico de Coimbra, ESTeSC – Coimbra Health School, Audiologia, Portugal
- OuviSonus, Coimbra, Portugal
| | - A Miguéis
- University Clinic of Otolaryngology, Faculty of Medicine, University of Coimbra, Portugal
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Carvalho A, Guimarães A, Sztajnbok FR, Rodrigues R, Silva B, Lopes A, Almeida I, França M. AB0561 AUTOMATIC QUANTIFICATION OF INTERSTITIAL LUNG DISEASE FROM CHEST COMPUTED TOMOGRAPHY IN SYSTEMIC SCLERODERMA. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.1641] [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: 11/03/2022]
Abstract
Background:Scleroderma-associated interstitial lung disease (SSc-ILD) is often observed in patients with systemic scleroderma (SSc) and its diagnosis contributes to early treatment decisions1,2.Objectives:The present study aims to automatically quantify SSc-ILD from high-resolution chest-computed tomography (HRCT) and to evaluate the association between interstitial lung disease (ILD) extension and lung function impairment.Methods:Ninety-four patients with SSc and 27 lung-healthy subjects matched for gender, weight, height, and age underwent HRCT, spirometry and carbon monoxide diffusion capacity (DLCO). SSc-ILD was determined as the tissue mass present between -500 and +100 Hounsfield Units normalized by the total lung tissue mass (TLM). Cut off was the highest value obtained in the control group (25% of TLM). All data are presented as mean and standard deviations (Table I). An ANOVA test followed by Bonferroni post-hoc correction was used for comparisons among groups.Results:From 94 patients with SSc, 64 were classified as having pulmonary involvement (SSc-ILD) and 30 as not having pulmonary involvement (SSc No-ILD). In SSc-ILD subjects, there was a significant reduction in forced vital capacity (FVC), carbon monoxide diffusion capacity (DLCO) and carbon monoxide diffusion capacity normalized by alveolar ventilation (DLCO/A) when compared with SSc No-ILD and control group.Conclusion:The proposed method allows the automatic quantification of SSc-ILD from HRCT and ILD extent is associated with pulmonary function impairment.References:[1]Doyle TJ, Dellaripa PF. Lung Manifestations in the Rheumatic Diseases. CHEST. 2017 Dec;152(6):1283–95.[2]Saketkoo LA, Magnus JH, Doyle MK. The primary care physician in the early diagnosis of systemic sclerosis: the cornerstone of recognition and hope. The American Journal of the Medical Sciences. 2014 Jan;347(1):54–63.Table 1.Demographic variables, pulmonary function tests and densitovolumetry considering scleroderma patients with less or greater pulmonary involvement.Control GroupN = 27SSc No-ILDN = 30SSc-ILDN = 64p-valueDemographic DataFemales16 (59.2)28 (93.3)58 (90.1)-Age (years)37.9 ± 14.851.2 ± 12.256 ± 14<0.011a,bBMI (kg/m2)26.7 ± 5.124.1 ± 5.025.9 ± 5.7-Lung Function FVC (% predicted)100.2 ± 9.299.9 ± 19.869.8 ± 16.7<0.001b,c DLco (% predicted)103 ± 13.383.8 ± 14.263.4 ± 20.3<0.002a,b,cDLco/A (% predicted)112.7 ± 17.485.7 ± 12.979.2 ± 20.6<0.001a,bDensitovolumetryTLV mL4675 ± 9864471 ± 9163492 ± 1120<0.001b,cLung Tissue Mass (g)793 ± 125756 ± 159731 ± 155- ILD Extent (% LTM)17 ± 222.9 ± 1.232.6 ± 8<0.003a,b,ca: Statistically significant difference between No-ILD SSc and control group; b and c: Statistically significant difference between SSc-ILD vs control group and SSc No-ILD, respectively.Disclosure of Interests:None declared
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Barreto A, Carvalho A, Campos A, Osório H, Pinto E, Almeida A, Trindade T, Soares AMVM, Hylland K, Loureiro S, Oliveira M. Effects of gold nanoparticles in gilthead seabream-A proteomic approach. Aquat Toxicol 2020; 221:105445. [PMID: 32078886 DOI: 10.1016/j.aquatox.2020.105445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 09/24/2019] [Revised: 01/27/2020] [Accepted: 02/10/2020] [Indexed: 06/10/2023]
Abstract
Despite the widespread use of nanoparticles (NPs), there are still major gaps of knowledge regarding the impact of nanomaterials in the environment and aquatic animals. The present work aimed to study the effects of 7 and 40 nm gold nanoparticles (AuNPs) - citrate and polyvinylpyrrolidone (PVP) coated - on the liver proteome of the estuarine/marine fish gilthead seabream (Sparus aurata). After 96 h, exposure to AuNP elicited alterations on the abundance of 26 proteins, when compared to the control group. AuNPs differentially affected several metabolic pathways in S. aurata liver cells. Among the affected proteins were those related to cytoskeleton and cell structure, gluconeogenesis, amino acids metabolism and several processes related to protein activity (protein synthesis, catabolism, folding and transport). The increased abundance of proteins associated with energy metabolism (ATP synthase subunit beta), stress response (94 kDa glucose-regulated protein) and cytoskeleton structure (actins and tubulins) may represent the first signs of cellular oxidative stress induced by AuNPs. Although higher gold accumulation was found in the liver of S. aurata exposed to 7 nm PVP-AuNPs, the 7 nm cAuNPs were more bioactive, inducing more effects in liver proteome. Gold accumulated more in the spleen than in the other assessed tissues of S. aurata exposed to AuNPs, highlighting its potential role on the elimination of these NPs.
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Affiliation(s)
- A Barreto
- Departamento de Biologia & CESAM, Universidade de Aveiro, 3810-193, Aveiro, Portugal.
| | - A Carvalho
- Departamento de Biologia & CESAM, Universidade de Aveiro, 3810-193, Aveiro, Portugal
| | - A Campos
- CIIMAR, Centro Interdisciplinar de Investigação Marinha e Ambiental, Universidade do Porto, 4450-208, Matosinhos, Portugal
| | - H Osório
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal; Instituto de Patologia e Imunologia Molecular da Universidade do Porto, IPATIMUP, Porto, Portugal; Faculdade de Medicina, Universidade do Porto, Portugal
| | - E Pinto
- LAQV-REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal; Departamento de Saúde Ambiental, Escola Superior de Saúde, P. Porto. CISA/Centro de Investigação em Saúde e Ambiente, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal
| | - A Almeida
- LAQV-REQUIMTE, Departamento de Ciências Químicas, Faculdade de Farmácia, Universidade do Porto, Rua Jorge Viterbo Ferreira, 228, 4050-313, Porto, Portugal
| | - T Trindade
- Departamento de Química & CICECO - Aveiro Instituto de Materiais, Universidade de Aveiro, 3810-193, Aveiro, Portugal
| | - A M V M Soares
- Departamento de Biologia & CESAM, Universidade de Aveiro, 3810-193, Aveiro, Portugal
| | - K Hylland
- Department of Biosciences, University of Oslo, PO Box 1066, N-0316, Oslo, Norway
| | - S Loureiro
- Departamento de Biologia & CESAM, Universidade de Aveiro, 3810-193, Aveiro, Portugal
| | - M Oliveira
- Departamento de Biologia & CESAM, Universidade de Aveiro, 3810-193, Aveiro, Portugal
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Martins J, Almeida C, Carvalho A, Capucho F, Silva S. Attitudes, knowledge, opinions, and practice of physicians and dentists toward obstructive sleep apnea syndrome and snoring. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.685] [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: 11/27/2022]
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Braun C, Soares J, Hofmanninger J, Cornet C, Ranieri A, Williamson A, Pavlisko N, Henao-Guerrero N, Giannella-Neto A, Carvalho A. Effects of two different tidal volumes on tidal recruitment and hyperaeration in dogs with acute respiratory distress syndrome ventilated mechanically with positive end expiratory pressure. Vet Anaesth Analg 2019. [DOI: 10.1016/j.vaa.2019.08.010] [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: 10/25/2022]
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Soares J, Braun C, Hofmanninger J, Cornet C, Williamson A, Ranieri A, Pavlisko N, Henao-Guerrero N, Giannella-Neto A, Carvalho A. Lung aeration distribution in anesthetized Beagles ventilated with lower or higher tidal volume in three different levels of end expiratory pressure: a computed tomography study. Vet Anaesth Analg 2019. [DOI: 10.1016/j.vaa.2019.08.042] [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: 11/15/2022]
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Cavalcanti J, Lima W, Turke K, Silva L, Carvalho A. EP.17Vaccination as possible trigger of anti-SRP mediated necrotizing myopathy - a case report. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Galhardo A, Cardoso JP, Kanhouche G, Junior VS, Lima VM, Sato DN, Oliveira RB, Reis GC, Souza CGS, Corhs FM, Junior IG, Moises VA, Carvalho AC, Moraes PIM, Alves CMR. P5522ST elevation myocardial infarction networks: relationship of hub-spoke distance with transfer time and clinical outcomes in rescue PCI. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0470] [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
Background
In the establishment of ST elevation myocardial infarction (STEMI) systems of care, transfer times between primary care units (PCU) and the cardiac catheterization lab (CCL) are pillars to therapeutic success. Objective: To analyze the relationship between PCU-CCL distance with transport time and main clinical outcomes in STEMI patients (p) treated with pharmaco-invasive therapy (PIT) and referred for rescue PCI after failed fibrinolysis.
Methods
Between January 2010 and December 2018, of the 2241 patients who received tenecteplase in PCU inserted in a large city STEMI network, 801 (35.7%) evolved without reperfusion criteria after 90 minutes (persistence of chest pain, less than 50% reduction on ST elevation or hemodynamic instability), being urgently transferred to the CCL. The PCU were divided according to the distance to the tertiary center in Group 1: between 5 and 9km (N=208p), Group 2: between 16 and 18km (N=315p) and Group 3: between 22 and 30km=266p). Considering an alpha of 0.05, sample size n=801 and an effect size of 0.11, a power of 0.80 was obtained.
Results
The groups were comparable for baseline features (Table 1). Group 2 (intermediate distances) had the highest median transport time (G1 260 interquartile 145–437 min vs G2 355 interquartile 206–573 min vs G3 241 interquartile 125–418 min; p<0.01 for G2). There were no differences between the groups regarding cardiogenic shock (G1 24.5% vs G2 23.3% vs G3 24.1%, p=0.9) or in-hospital death (G1 17.4% vs G2 12.3% vs G3 13.0%, p=0.2).
Table 1. Group's baseline features G1: Short distances G2: Intermediate distances G3: Long distances p value (5–9 km) N=208 (16–18 km) N=315 (22–30 km) N=266 Age (median) 57.5 (51–64) 57 (49–66) 59 (52–67) 0.27 Female 29.7% 28.3% 35.1% 0.19 Hypertension 67.3% 60.9% 64.4% 0.31 Diabetes 37.0% 32.1% 37.8% 0.30 Renal failure 10.3% 9.7% 6.3% 0.21 Anterior STEMI 56.1% 58.4% 62.4% 0.36 Pain-to-needle time (median min) 197.5 (137–330) 195 (120–295) 195 (125–345) 0.38
Conclusion
In STEMI patients with failed fibrinolysis treated with pharmaco-invasive therapy, the PCU-CCL distance was not related to transfer time or to outcomes of in-hospital death and cardiogenic shock. The longer transport time of hospitals located at intermediate distance can possibly reflect local logistical difficulties and are not due to hub-spoke distance. Continuous improvement in structuring and coordination of public STEMI networks is aimed.
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Affiliation(s)
- A Galhardo
- Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - J P Cardoso
- Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - G Kanhouche
- Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - V S Junior
- Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - V M Lima
- Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - D N Sato
- Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - R B Oliveira
- Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - G C Reis
- Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - C G S Souza
- Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - F M Corhs
- Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - I G Junior
- Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - V A Moises
- Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - A C Carvalho
- Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - P I M Moraes
- Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - C M R Alves
- Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
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Koch M, Perrone E, Silva L, Carvalho A. EP.129A probable new pathogenic variant in RYR1 gene? - 3 case reports. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.587] [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: 11/17/2022]
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Bolonhezi B, Matsumura L, Turke K, Silva L, Langer A, Feder D, Carvalho A. EP.57Duchenne muscular dystrophy and stroke: systematic review of literature and two cases reports. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.463] [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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Soares I, Comprido V, Hsu B, Turke K, Silva L, Feder D, Carvalho A. EP.22Anti-HMGCR antibody in asymptomatic patients with high CK - Case report. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.152] [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: 10/25/2022]
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Rodrigues V, Almeida C, Castro J, Martins D, Freitas F, Carvalho A, Raimundo F, Antunes C. O27 Health of tourists who make river cruises on the Douro river. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz095.004] [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)
- V Rodrigues
- School of Health, University of Trás-os-Montes and Alto Douro, Vila Real, PORTUGAL
- Research Center in Sports Sciences, Health Sciences and Human Development, University of Trás-os-Montes and Alto Douro, Vila Real, PORTUGAL
| | - C Almeida
- School of Health, University of Trás-os-Montes and Alto Douro, Vila Real, PORTUGAL
| | - J Castro
- School of Health, University of Trás-os-Montes and Alto Douro, Vila Real, PORTUGAL
| | - D Martins
- School of Health, University of Trás-os-Montes and Alto Douro, Vila Real, PORTUGAL
| | - F Freitas
- School of Health, University of Trás-os-Montes and Alto Douro, Vila Real, PORTUGAL
| | - A Carvalho
- School of Health, University of Trás-os-Montes and Alto Douro, Vila Real, PORTUGAL
- Research Centre on Child Studies, University of Minho, Braga, PORTUGAL
| | - F Raimundo
- School of Health, University of Trás-os-Montes and Alto Douro, Vila Real, PORTUGAL
| | - C Antunes
- School of Health, University of Trás-os-Montes and Alto Douro, Vila Real, PORTUGAL
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Carvalho A. Hearing screening in primary health care: “promotion of school success in the Médio Tejo”. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz034.033] [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)
- A Carvalho
- ESTeSC - Coimbra Health School, Instituto Politécnico de Coimbra, Portugal
- OuviSonus- Centro de Audiologia, Portugal
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Ceia F, Silva-Pinto A, Carvalho AC, Piñeiro C, Soares J, Serrão R, Sarmento A. Human Immunodeficiency Virus (HIV) 2 Superinfection in a Patient Receiving Antiretroviral Therapy With Longstanding HIV-1 Viral Load Suppression. Open Forum Infect Dis 2019; 6:ofz063. [PMID: 30949532 PMCID: PMC6441564 DOI: 10.1093/ofid/ofz063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 02/09/2019] [Indexed: 11/27/2022] Open
Abstract
Dual human immunodeficiency virus (HIV) 1 and HIV-2 superinfections are rare but challenging. A HIV-1–infected patient receiving effective antiretroviral therapy was investigated for a severe CD4+ cell count decline. HIV-2 superinfection was diagnosed and genotypic test revealed mutations conferring resistance to most drug class, limiting options for treatment.
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Affiliation(s)
- F Ceia
- Infectious Diseases Department, Centro Hospitalar São João, Porto, University of Porto, Portugal.,Faculty of Medicine, University of Porto, University of Porto, Portugal
| | - A Silva-Pinto
- Infectious Diseases Department, Centro Hospitalar São João, Porto, University of Porto, Portugal.,Faculty of Medicine, University of Porto, University of Porto, Portugal
| | - A C Carvalho
- Infectious Diseases Department, Centro Hospitalar São João, Porto, University of Porto, Portugal.,Instituto de Saúde Pública da Universidade do Porto, University of Porto, Portugal
| | - C Piñeiro
- Infectious Diseases Department, Centro Hospitalar São João, Porto, University of Porto, Portugal.,Faculty of Medicine, University of Porto, University of Porto, Portugal
| | - J Soares
- Infectious Diseases Department, Centro Hospitalar São João, Porto, University of Porto, Portugal
| | - R Serrão
- Infectious Diseases Department, Centro Hospitalar São João, Porto, University of Porto, Portugal.,Faculty of Medicine, University of Porto, University of Porto, Portugal
| | - A Sarmento
- Infectious Diseases Department, Centro Hospitalar São João, Porto, University of Porto, Portugal.,Faculty of Medicine, University of Porto, University of Porto, Portugal.,Nephrology and Infectious Diseases R&D Group, Health Investigation and Innovation Institute, University of Porto, Portugal
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Nogueira BRF, Reis MP, Carvalho AC, Mendoza EAC, Oliveira BL, Silva VA, Bertechini AG. Performance, Growth Curves and Carcass Yield of Four Strains of Broiler Chicken. Braz J Poult Sci 2019. [DOI: 10.1590/1806-9061-2018-0866] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
| | - MP Reis
- São Paulo State University, Brazil
| | | | | | | | - VA Silva
- Federal University of Lavras, Brazil
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Affiliation(s)
| | - P Chaves
- Florida International University
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38
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Carvalho A. Contribuição à identificação de compostos purínicos e pirimidínicos de interesse biológico. Eclet Quim J 2018. [DOI: 10.26850/1678-4618eqj.v4.1.1979.p71-77] [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: 11/10/2022] Open
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Sant Anna V, Souza R, Barbosa A, Túlio Souza M, Sousa J, Alves C, Carvalho A, Fonseca F, Izar M, Gidlund M, Fonseca H. Modulations in humoral immune responses to autoantigens are blood-sites dependents. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.325] [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: 11/29/2022]
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Sant Anna V, Souza R, Barbosa A, Souza M, Sousa J, Alves C, Carvalho A, Fonseca F, Izar M, Gidlund M, Fonseca H. Percutaneous coronary intervention modulates inflammatory response after stent implantation in patients with stable coronary artery disease. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.326] [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: 10/28/2022]
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41
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Tavares F, Caixeta A, Alves CMR, Barbosa AHP, Souza JAM, Sousa JMA, Santos GRF, Cintra GF, Carvalho AC, Fonseca FAH. P5599Prognostic role of neutrophil to lymphocyte ratio ST-elevation acute myocardial infarction undergoing pharmacoinvasive strategy. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5599] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- F Tavares
- Federal University of Sao Paulo (UNIFESP), Department of Cardiovascular Interventions, Sao Paulo, Brazil
| | - A Caixeta
- Federal University of Sao Paulo (UNIFESP), Department of Cardiovascular Interventions, Sao Paulo, Brazil
| | - C M R Alves
- Federal University of Sao Paulo (UNIFESP), Department of Cardiovascular Interventions, Sao Paulo, Brazil
| | - A H P Barbosa
- Federal University of Sao Paulo (UNIFESP), Department of Cardiovascular Interventions, Sao Paulo, Brazil
| | - J A M Souza
- Federal University of Sao Paulo (UNIFESP), Department of Cardiovascular Interventions, Sao Paulo, Brazil
| | - J M A Sousa
- Federal University of Sao Paulo (UNIFESP), Department of Cardiovascular Interventions, Sao Paulo, Brazil
| | - G R F Santos
- Federal University of Sao Paulo (UNIFESP), Department of Cardiovascular Interventions, Sao Paulo, Brazil
| | - G F Cintra
- Federal University of Sao Paulo (UNIFESP), Department of Cardiovascular Interventions, Sao Paulo, Brazil
| | - A C Carvalho
- Federal University of Sao Paulo (UNIFESP), Department of Cardiovascular Interventions, Sao Paulo, Brazil
| | - F A H Fonseca
- Federal University of Sao Paulo (UNIFESP), Department of Cardiovascular Interventions, Sao Paulo, Brazil
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Ferreira M, Pinto M, Ferreira D, Esperto H, Verissimo M, Carvalho A. Statin therapy in very frail older adults. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.235] [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: 10/28/2022]
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Miranda RBP, Grenho L, Carvalho A, Fernandes MH, Monteiro FJ, Cesar PF. Micropatterned Silica Films with Nanohydroxyapatite for Y-TZP Implants. J Dent Res 2018; 97:1003-1009. [PMID: 29608862 DOI: 10.1177/0022034518765762] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
This investigation aimed at developing micropatterned silica thin films (MSTFs) containing nanohydroxyapatite (nano-HA) microaggregates that were not completely covered by silica so that they could directly interact with the surrounding cells. The objectives were 1) to evaluate the effect of the presence of 2 films (MSTF with or without nano-HA addition) on the characteristic strength (σ0) and Weibull modulus ( m) of a yttria-stabilized tetragonal zirconia polycrystal (Y-TZP) and 2) to evaluate the effect of these 2 films, as applied onto the Y-TZP surface, on the morphology, orientation, and proliferation of MG63 cells. Sol-gel process and soft lithography were used to apply the MSTF onto the Y-TZP specimens. Three experimental groups were produced: Y-TZP, Y-TZP + MSTF, and Y-TZP + MSTF + sprayed nano-HA. All surfaces were characterized by scanning electron microscopy and energy-dispersive X-ray spectroscopy and tested for 4-point flexural strength ( n = 30) in water at 37 °C. Weibull analysis was used to determine m and σ0 (maximum likelihood method). In vitro biological behavior was performed with human osteoblast-like cells (MG63). Y-TZP was successfully coated with MSFT and MSFT + nano-HA. Scanning electron microscopy micrographs indicated that the microaggregates of nano-HA were not entirely covered by the silica. There was no statistically significant difference among the experimental groups for σ0 and m. In the groups containing the films, the cells were elongated and aligned along the lines. The MSFT + nano-HA group showed significantly higher cell metabolic activity than that obtained for the Y-TZP group at day 7. This investigation was successful in producing an MSTF containing nano-HA microaggregates that remained exposed to the environment. The developed films did not jeopardize the structural reliability of a commercial Y-TZP, as confirmed by the Weibull statistics. The MG63 cells seeded over the films became elongated and aligned along the films' micropatterned lines. Y-TZP specimens coated with MSTF and nano-HA showed a higher cell metabolic activity and proliferation after 7 d of culture when compared with uncoated Y-TZP.
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Affiliation(s)
- R B P Miranda
- 1 Departamento de Biomateriais e Biologia Oral, Faculdade de Odontologia, Universidade de São Paulo, São Paulo, Brasil.,2 i3S-Instituto de Investigação e Inovação em Saúde, U. Porto, Porto, Portugal.,3 Laboratory for Bone Metabolism and Regeneration, Faculdade de Medicina Dentária, U. Porto, Porto, Portugal
| | - L Grenho
- 3 Laboratory for Bone Metabolism and Regeneration, Faculdade de Medicina Dentária, U. Porto, Porto, Portugal.,4 LAQV/REQUIMTE, U. Porto, Portugal
| | - A Carvalho
- 2 i3S-Instituto de Investigação e Inovação em Saúde, U. Porto, Porto, Portugal.,5 Departamento de Engenharia Metalúrgica e dos Materiais, Faculdade de Engenharia, U. Porto, Porto, Portugal.,6 INEB-Instituto de Engenharia Biomédica, U. Porto, Porto, Portugal
| | - M H Fernandes
- 3 Laboratory for Bone Metabolism and Regeneration, Faculdade de Medicina Dentária, U. Porto, Porto, Portugal.,4 LAQV/REQUIMTE, U. Porto, Portugal
| | - F J Monteiro
- 2 i3S-Instituto de Investigação e Inovação em Saúde, U. Porto, Porto, Portugal.,5 Departamento de Engenharia Metalúrgica e dos Materiais, Faculdade de Engenharia, U. Porto, Porto, Portugal.,6 INEB-Instituto de Engenharia Biomédica, U. Porto, Porto, Portugal
| | - P F Cesar
- 1 Departamento de Biomateriais e Biologia Oral, Faculdade de Odontologia, Universidade de São Paulo, São Paulo, Brasil
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Oliveira MJ, Vieira M, Coutinho D, Ladeira I, Pascoal I, Ferreira J, da Silva JM, Carvalho A, Lima R. Severe asthma in obese patients: Improvement of lung function after treatment with omalizumab. Pulmonology 2018; 25:15-20. [PMID: 30827349 DOI: 10.1016/j.pulmoe.2018.01.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 01/09/2018] [Accepted: 01/27/2018] [Indexed: 12/26/2022] Open
Abstract
INTRODUCTION Asthma and obesity have a considerable impact on public health and their prevalence is increasing. Obesity is a known risk factor for asthma and can make it more difficult to control. Omalizumab is recommended in patients with severe allergic persistent asthma. The aim of this study was to assess the impact of omalizumab treatment in obese asthmatic patients with poorly controlled severe persistent asthma. METHODOLOGY A non-interventional, prospective study was conducted, in an outpatient asthma clinic. All patients with severe asthma who started treatment with omalizumab were included and followed over 12 months. The study population was divided into two groups (obese and non-obese) for statistical analysis (descriptive and comparative analysis). RESULTS Thirty-two patients (19 obese) were followed. After 12 months of omalizumab treatment, there was a statistically significant improvement in body mass index, number of exacerbations in the previous year, rescue medication, disease control and lung function, in the whole population. At the end of the study obese patients had a significantly better lung function (FEV1) than non-obese. DISCUSSION As described in the literature, there was a significant reduction in the number of exacerbations in the previous year, rescue medication and better disease control, in the whole population. In relation to lung function, about which published data are inconsistent, treatment with omalizumab significantly improved it in obese patients. CONCLUSION Our study showed that omalizumab significantly improved asthma control, reduced rescue medication and asthma exacerbations in all the population; and for the first time showed that obese patients achieved significantly improved lung function.
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Affiliation(s)
- M J Oliveira
- Department of Pulmonology, Centro Hospitalar de Vila Nova de Gaia e Espinho, EPE, Vila Nova de Gaia, Portugal.
| | - M Vieira
- Department of Immunoallergology, Centro Hospitalar de Vila Nova de Gaia e Espinho, EPE, Vila Nova de Gaia, Portugal
| | - D Coutinho
- Department of Pulmonology, Centro Hospitalar de Vila Nova de Gaia e Espinho, EPE, Vila Nova de Gaia, Portugal
| | - I Ladeira
- Department of Pulmonology, Centro Hospitalar de Vila Nova de Gaia e Espinho, EPE, Vila Nova de Gaia, Portugal
| | - I Pascoal
- Department of Pulmonology, Centro Hospitalar de Vila Nova de Gaia e Espinho, EPE, Vila Nova de Gaia, Portugal
| | - J Ferreira
- Department of Immunoallergology, Centro Hospitalar de Vila Nova de Gaia e Espinho, EPE, Vila Nova de Gaia, Portugal
| | - J M da Silva
- Department of Immunoallergology, Centro Hospitalar de Vila Nova de Gaia e Espinho, EPE, Vila Nova de Gaia, Portugal
| | - A Carvalho
- Department of Pulmonology, Centro Hospitalar de Vila Nova de Gaia e Espinho, EPE, Vila Nova de Gaia, Portugal
| | - R Lima
- Department of Pulmonology, Centro Hospitalar de Vila Nova de Gaia e Espinho, EPE, Vila Nova de Gaia, Portugal
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Carvalho AC, Vasconcelos VCA, Sasse AD. Abstract P4-12-06: Cost-effectiveness analysis of pertuzumab plus trastuzumab for advanced HER2-positive breast cancer in Brazil: A public health system perspective. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p4-12-06] [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] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Objectives:
Addition of pertuzumab to trastuzumab and docetaxel (THP) results in significant clinical benefits for women with HER2-positive metastatic breast cancer. Despite evidence of important overall survival and quality of life improvements, for the Brazilian patients depending on the public health system chemotherapy alone (CT) remains the standard treatment. Previous request for trastuzumab incorporation was denied by Brazilian Ministry of Health (MoH) due to high individual costs.
In an innovative way, the Brazilian Society of Clinical Oncology made a price negotiation directly with the pharmaceutical company, aiming to propose a formal request for the incorporation of these technologies to the National Committee for Health Technology Incorporation (CONITEC).
Our objective was to evaluate the cost-effectiveness of THP versus CT in patients with HER2-positive advanced breast cancer, under the perspective of the Brazilian public health system.
Methods:
A cost-effectiveness analysis was conducted using a Markov model over a lifetime horizon. The model considers three health states: 1st-line treatment without progression; disease progression (with chemotherapy or best supportive care) and death. Transition probabilities and mortality rates were extracted from randomized studies. Costs of standard chemotherapy, complications, and surveillance were obtained from price tables regulated by the MoH. Pertuzumab and trastuzumab prices were those negotiated with the manufacturing company. Benefits are presented in life-years (LY) and costs in USD (using exchange rate for Brazilian Real to USD = 3.50). The relation between costs and benefits were used to present the incremental cost-effectiveness ratio (ICER) per life-year saved. We have performed one-way deterministic sensitivity analyses with cost of monoclonal antibodies to define the ideal price in Brazil.
Results:
Patients with HER2-positive metastatic breast cancer treated with CT were projected to have 1.87 LY, with a total cost of $12,118. THP was projected to increase the life expectancy of these patients by 1.48 years, with an incremental cost of $63,685 per patient. Thus, the ICER was $42,893 per LY-gained.
Conclusions:
The World Health Organization recommendation of three times gross domestic product per capita have defined our cost-effectiveness threshold. Despite the discount price, at a willingness-to-pay (WTP) threshold of $25,615 per LY, THP is not a cost-effective strategy compared to CT. An additional reduction around 58.67% in the pertuzumab price would be necessary to make THP cost-effective in Brazil.
Discussion about the incorporation of trastuzumab to CT using the discount prices is in progress.
Citation Format: Carvalho AC, Vasconcelos VCA, Sasse AD. Cost-effectiveness analysis of pertuzumab plus trastuzumab for advanced HER2-positive breast cancer in Brazil: A public health system perspective [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-12-06.
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Affiliation(s)
- AC Carvalho
- Centre for Evidence in Oncology, Campinas, SP, Brazil; SONHE Group, Campinas, SP, Brazil
| | - VCA Vasconcelos
- Centre for Evidence in Oncology, Campinas, SP, Brazil; SONHE Group, Campinas, SP, Brazil
| | - AD Sasse
- Centre for Evidence in Oncology, Campinas, SP, Brazil; SONHE Group, Campinas, SP, Brazil
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Ferreira F, Carvalho A, Moura ÍJM, Coutinho J, Ribeiro RM. Adsorption of H 2, O 2, H 2O, OH and H on monolayer MoS 2. J Phys Condens Matter 2018; 30:035003. [PMID: 29256439 DOI: 10.1088/1361-648x/aaa03f] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Hydrogen and hydrogen-containing gases are commonly used as reductants in chemical vapor deposition growth of MoS2. Here, we consider the defects resulting from the presence of hydrogen during growth and the resulting electronically active defects. In particular, we find that the interstitial hydrogen defect is a negative-U center with amphoteric donor and acceptor properties. Additionally, we consider the effects of interaction with water and oxygen. The defects are analysed using density functional theory calculations.
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Affiliation(s)
- F Ferreira
- Centro de Física and Departamento de Física and QuantaLab, Universidade do Minho, Campus de Gualtar, Braga 4710-057, Portugal
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Kaczmarek B, Sionkowska A, Monteiro FJ, Carvalho A, Łukowicz K, Osyczka AM. Characterization of gelatin and chitosan scaffolds cross-linked by addition of dialdehyde starch. ACTA ACUST UNITED AC 2017; 13:015016. [PMID: 29244656 DOI: 10.1088/1748-605x/aa8910] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
In this study the influence of the addition of dialdehyde starch on the properties of scaffolds based on gelatin and chitosan obtained by the freeze-drying method was investigated. In addition, the adhesion and proliferation of human osteosarcoma SaOS-2 cells on the obtained scaffolds was examined. Chitosan and gelatin were mixed in different weight ratios (75/25, 50/50, 25/75) with 1, 2 and 5 wt% addition of dialdehyde starch. The obtained scaffolds were subjected to mechanical testing, infrared spectroscopy, swelling measurements, low-pressure porosimetry and zeta potential measurement. Internal material structures were observed by scanning electron microscopy. The results showed that the cross-linking process occurred after the addition of dialdehyde starch and resulted in increased mechanical strength, swelling properties, zeta potential and porosity of studied materials. The attachment of SaOS-2 cells to all modified materials was better compared to an unmodified control and the proliferation of these cells was markedly increased on modified scaffolds.
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Affiliation(s)
- B Kaczmarek
- Department of Chemistry of Biomaterials and Cosmetics, Faculty of Chemistry, Nicolaus Copernicus University in Toruń, Poland
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Souza RA, Alves CMR, de Oliveira CSV, Reis AF, Carvalho AC. Circulating levels of adiponectin and extent of coronary artery disease in patients undergoing elective coronary angiography. ACTA ACUST UNITED AC 2017; 51:e6738. [PMID: 29211251 PMCID: PMC5711007 DOI: 10.1590/1414-431x20176738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 05/25/2017] [Accepted: 09/19/2017] [Indexed: 11/22/2022]
Abstract
Adiponectin (APN), an adipose tissue-released adipokine with demonstrated anti-inflammatory and anti-atherogenic properties, is encoded by a gene whose polymorphisms are associated with presence of coronary artery disease (CAD). Serum APN levels are inversely related with presence and complexity of CAD. Within this context, we sought to compare levels of total APN and its high molecular weight form (HMW APN) according to clinical presentation and extent of CAD in patients undergoing elective cardiac catheterization. From March 2008 to June 2010, clinical data and blood samples for APN and HMW APN measurements were collected from 415 subjects undergoing cardiac catheterization at two tertiary centers. CAD extent was estimated by the number of coronary arteries with significant stenosis (≥70% obstruction in a major coronary artery) and by Duke Jeopardy Score (DJS). Serum APN levels were similar between groups with stable or unstable CAD (APN 9.20±5.88 vs 9.47±6.23 μg/mL, P=0.738, and HMW APN 5.31±3.72 vs 5.91±4.16 μg/mL, P=0.255), even after stratification by the number of arteries involved (single-vessel vs multivessel disease: APN 9.39±5.76 vs 9.26±6.27 μg/mL, P=0.871; HMW APN 5.29±3.79 vs 5.83±4.04 μg/mL, P=0.306) and DJS score (APN, P=0.718; HMW APN, P=0.276). We conclude that APN and HMW APN serum levels are similar across clinical presentations and different extents of CAD, despite being significantly lower in the presence of obstructive CAD.
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Affiliation(s)
- R A Souza
- Cardiologia Intervencionista, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - C M R Alves
- Cardiologia Intervencionista, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - C S V de Oliveira
- Disciplina de Endocrinologia, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - A F Reis
- Disciplina de Endocrinologia, Universidade Federal de São Paulo, São Paulo, SP, Brasil
| | - A C Carvalho
- Disciplina de Cardiologia, Universidade Federal de São Paulo, São Paulo, SP, Brasil
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Soares J, Pavlisko N, Henao-Guerrero N, Williamson A, Giannella-Neto A, Carvalho A. Cardiovascular and respiratory mechanics effects during an alveolar recruitment maneuver followed by a positive end-expiratory pressure (PEEP) titration in dogs anesthetized with isoflurane. Vet Anaesth Analg 2017. [DOI: 10.1016/j.vaa.2017.09.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Soares J, Henao-Guerrero N, Pavlisko N, Williamson A, Carvalho A, Giannella-Neto A. Agreement between static and dynamic respiratory system compliance and plateau pressure in lung-healthy dogs in volume or pressure controlled-ventilation. Vet Anaesth Analg 2017. [DOI: 10.1016/j.vaa.2017.09.029] [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: 10/18/2022]
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