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Raya JG, Duarte A, Wang N, Mazzoli V, Jaramillo D, Blamire AM, Dietrich O. Applications of Diffusion-Weighted MRI to the Musculoskeletal System. J Magn Reson Imaging 2024; 59:376-396. [PMID: 37477576 DOI: 10.1002/jmri.28870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 06/05/2023] [Accepted: 06/05/2023] [Indexed: 07/22/2023] Open
Abstract
Diffusion-weighted imaging (DWI) is an established MRI technique that can investigate tissue microstructure at the scale of a few micrometers. Musculoskeletal tissues typically have a highly ordered structure to fulfill their functions and therefore represent an optimal application of DWI. Even more since disruption of tissue organization affects its biomechanical properties and may indicate irreversible damage. The application of DWI to the musculoskeletal system faces application-specific challenges on data acquisition including susceptibility effects, the low T2 relaxation time of most musculoskeletal tissues (2-70 msec) and the need for sub-millimetric resolution. Thus, musculoskeletal applications have been an area of development of new DWI methods. In this review, we provide an overview of the technical aspects of DWI acquisition including diffusion-weighting, MRI pulse sequences and different diffusion regimes to study tissue microstructure. For each tissue type (growth plate, articular cartilage, muscle, bone marrow, intervertebral discs, ligaments, tendons, menisci, and synovium), the rationale for the use of DWI and clinical studies in support of its use as a biomarker are presented. The review describes studies showing that DTI of the growth plate has predictive value for child growth and that DTI of articular cartilage has potential to predict the radiographic progression of joint damage in early stages of osteoarthritis. DTI has been used extensively in skeletal muscle where it has shown potential to detect microstructural and functional changes in a wide range of muscle pathologies. DWI of bone marrow showed to be a valuable tool for the diagnosis of benign and malignant acute vertebral fractures and bone metastases. DTI and diffusion kurtosis have been investigated as markers of early intervertebral disc degeneration and lower back pain. Finally, promising new applications of DTI to anterior cruciate ligament grafts and synovium are presented. The review ends with an overview of the use of DWI in clinical routine. EVIDENCE LEVEL: 5 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- José G Raya
- Department of Radiology, NYU Langone Health, New York, New York, USA
| | - Alejandra Duarte
- Division of Musculoskeletal Radiology, Department of Radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Nian Wang
- Department of Radiology and Imaging Sciences, Indiana University, Indianapolis, Indiana, USA
- Stark Neurosciences Research Institute, Indiana University, Indianapolis, Indiana, USA
| | - Valentina Mazzoli
- Department of Radiology, Stanford University, Stanford, California, USA
| | - Diego Jaramillo
- Department of Radiology, Columbia University Medical Center, New York, New York, USA
| | - Andrew M Blamire
- Magnetic Resonance Centre, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Olaf Dietrich
- Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany
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Ponirakis G, Odriozola A, Ortega L, Martinez L, Odriozola S, Torrens A, Coroleu D, Martínez S, Sanz X, Ponce M, Meije Y, Clemente M, Duarte A, Odriozola MB, Malik RA. Quantitative sensory testing defines the trajectory of sensory neuropathy after severe COVID-19. Diabetes Res Clin Pract 2024; 207:111029. [PMID: 38007044 DOI: 10.1016/j.diabres.2023.111029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/01/2023] [Accepted: 11/22/2023] [Indexed: 11/27/2023]
Abstract
AIMS To assess sensory neuropathy development after severe COVID-19. METHODS Patients with severe COVID-19 underwent assessment of neuropathic symptoms, tendon reflexes, and quantitative sensory testing to evaluate vibration (VPT), cold (CPT), warm (WPT) and heat perception thresholds (HPT) within 1-3 weeks of admission and after 1-year. RESULTS 32 participants with severe COVID-19 aged 68.6 ± 12.4 (18.8 % diabetes) were assessed. At baseline, numbness and neuropathic pain were present in 56.3 % and 43.8 % of participants, respectively. On the feet, VPT, WPT, and HPT were abnormal in 81.3 %, CPT was abnormal in 50.0 % and HPT on the face was abnormal in 12.5 % of patients. At 1-year follow-up, the prevalence of abnormal VPT (81.3 % vs 50.0 %, P < 0.01), WPT (81.3 % vs 43.8 %, P < 0.01), and HPT (81.3 % vs 50.0 %, P < 0.01) decreased, with no change in CPT (P = 0.21) on the feet or HPT on the face (P = 1.0). Only participants without diabetes recovered from an abnormal VPT, CPT, and WPT. Patients with long-COVID (37.5 %) had comparable baseline VPT, WPT and CPT with those without long-COVID (P = 0.07-0.69). CONCLUSIONS Severe COVID-19 is associated with abnormal vibration and thermal thresholds which are sustained for up to 1 year in patients with diabetes. Abnormal sensory thresholds have no association with long-COVID development.
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Affiliation(s)
- Georgios Ponirakis
- Department of Medicine, Weill Cornell Medicine-Qatar, Qatar Foundation, Doha, Qatar
| | | | | | | | | | | | | | | | - Xavier Sanz
- Hospital of Barcelona SCIAS, Barcelona, Spain
| | | | | | | | | | | | - Rayaz A Malik
- Department of Medicine, Weill Cornell Medicine-Qatar, Qatar Foundation, Doha, Qatar
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Duarte A, González-Gómez S, Rueda M, Cardona Ortegón JD. Comment on: "Return to Sports: A Risky Business? A Systematic Review with Meta-analysis of Risk Factors for Graft Rupture Following ACL Reconstruction". Sports Med 2023:10.1007/s40279-023-01964-4. [PMID: 37999880 DOI: 10.1007/s40279-023-01964-4] [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] [Accepted: 10/30/2023] [Indexed: 11/25/2023]
Affiliation(s)
- Alejandra Duarte
- Hospital Universitario de la Fundación Santa Fe de Bogotá, 116 street # 9-02, 110111, Bogotá, Colombia
| | - Silvia González-Gómez
- Hospital Universitario de la Fundación Santa Fe de Bogotá, 116 street # 9-02, 110111, Bogotá, Colombia
| | - Maria Rueda
- Hospital Universitario de la Fundación Santa Fe de Bogotá, 116 street # 9-02, 110111, Bogotá, Colombia
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Duarte A, Montagna DR, Pastorini M, Alemán M. Apoptosis-mediated inhibition of human T-cell acute lymphoblastic leukemia upon treatment with Staphylococus Aureus enterotoxin-superantigen. Front Immunol 2023; 14:1176432. [PMID: 37377961 PMCID: PMC10291079 DOI: 10.3389/fimmu.2023.1176432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
Patients with relapsed T cell acute lymphoblastic leukemia (T-ALL) have limited therapeutic options and poor prognosis. The finding of efficient strategies against this refractory neoplasm is a medical priority. Superantigens (SAgs) are viral and bacterial proteins that bind to major histocompatibility complex class II molecules as unprocessed proteins and subsequently interact with a high number of T cells expressing particular T cell receptor Vβ chains. Although on mature T cells, SAgs usually trigger massive cell proliferation producing deleterious effects on the organism, in contrast, on immature T cells, they may trigger their death by apoptosis. On this basis, it was hypothesized that SAgs could also induce apoptosis in neoplastic T cells that are usually immature cells that probably conserve their particular Vβ chains. In this work, we investigated the effect of the SAg Staphylococcus aureus enterotoxin E (SEE) (that specifically interacts with cells that express Vβ8 chain), on human Jurkat T- leukemia line, that expresses Vβ8 in its T receptor and it is a model of the highly aggressive recurrent T-ALL. Our results demonstrated that SEE could induce apoptosis in Jurkat cells in vitro. The induction of apoptosis was specific, correlated to the down regulation of surface Vβ8 TCR expression and was triggered, at least in part, through the Fas/FasL extrinsic pathway. The apoptotic effect induced by SEE on Jurkat cells was therapeutically relevant. In effect, upon transplantation of Jurkat cells in the highly immunodeficient NSG mice, SEE treatment reduced dramatically tumor growth, decreased the infiltration of neoplastic cells in the bloodstream, spleen and lymph nodes and, most importantly, increased significantly the survival of mice. Taken together, these results raise the possibility that this strategy can be, in the future, a useful option for the treatment of recurrent T-ALL.
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Affiliation(s)
- Alejandra Duarte
- Institute of Experimental Medicine, National Council of Scientific and Technical Research, National Medicine Academy (IMEX-CONICET-ANM), Buenos Aires, Argentina
- Fundación Héctor Alejandro (H.A.) Barceló, Instituto Universitario de Ciencias de la Salud, Buenos Aires, Argentina
| | - Daniela R. Montagna
- Institute of Experimental Medicine, National Council of Scientific and Technical Research, National Medicine Academy (IMEX-CONICET-ANM), Buenos Aires, Argentina
| | - Mercedes Pastorini
- Institute of Experimental Medicine, National Council of Scientific and Technical Research, National Medicine Academy (IMEX-CONICET-ANM), Buenos Aires, Argentina
| | - Mercedes Alemán
- Institute of Experimental Medicine, National Council of Scientific and Technical Research, National Medicine Academy (IMEX-CONICET-ANM), Buenos Aires, Argentina
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Badano MN, Duarte A, Salamone G, Sabbione F, Pereson M, Chuit R, Baré P. Prevalence of salivary anti-SARS-CoV-2 IgG antibodies in vaccinated children. Immunology 2023. [PMID: 37188378 DOI: 10.1111/imm.13656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 04/25/2023] [Indexed: 05/17/2023] Open
Affiliation(s)
- María Noel Badano
- Instituto de Medicina Experimental (IMEX)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Academia Nacional de Medicina, Buenos Aires, Argentina
- Instituto de Investigaciones Hematológicas (IIHEMA), Academia Nacional de Medicina, Buenos Aires, Argentina
| | - Alejandra Duarte
- Instituto de Medicina Experimental (IMEX)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Academia Nacional de Medicina, Buenos Aires, Argentina
| | - Gabriela Salamone
- Instituto de Medicina Experimental (IMEX)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Academia Nacional de Medicina, Buenos Aires, Argentina
| | - Florencia Sabbione
- Instituto de Medicina Experimental (IMEX)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Academia Nacional de Medicina, Buenos Aires, Argentina
| | - Matias Pereson
- Instituto de Investigaciones en Bacteriología y Virología Molecular (IBaViM), Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Roberto Chuit
- Instituto de Investigaciones Epidemiológicas (IIE), Academia Nacional de Medicina, Buenos Aires, Argentina
| | - Patricia Baré
- Instituto de Medicina Experimental (IMEX)-Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Academia Nacional de Medicina, Buenos Aires, Argentina
- Instituto de Investigaciones Hematológicas (IIHEMA), Academia Nacional de Medicina, Buenos Aires, Argentina
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Ladino Archila F, Cardeñosa D, Bessudo S, Cuellar A, Muriel F, Carvajal J, Amariles D, Duarte A. Monitoreo de fauna pelágica de los Montes submarinos del Pacífico colombiano usando BRUVS. Biota 2022. [DOI: 10.21068/2539200x.1103] [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: 12/24/2022] Open
Abstract
En diciembre de 2021 se desarrolló la primera expedición a los montes submarinos de las dorsales de Malpelo y de Yuruparí. En total se exploraron ocho montes submarinos por medio de BRUVS (Baited Remote Underwater Video Systems). Se desplegaron 48 BRUVS, registrando cinco especies pelágicas (Sphyrna lewini, Mobula birostris, Pteroplatytrygon violácea, Kajikia audax y Istiophorus platypterus), donde Pteroplatytrygon violácea constituyó un nuevo registro para la región. En todas las zonas se registraron especies pelágicas, aunque los tiburones se asociaron exclusivamente a los montes al oeste de las dorsales, en especial al monte conocido como Bajo Navegador, el más somero de la región. Este trabajo es un primer paso para orientar las siguientes exploraciones de estos ecosistemas.
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Montagna DR, Duarte A, Chiarella P, Rearte B, Bustuoabad OD, Vermeulen M, Ruggiero RA. Inhibition of hyperprogressive cancer disease induced by immune-checkpoint blockade upon co-treatment with meta-tyrosine and p38 pathway inhibitor. BMC Cancer 2022; 22:845. [PMID: 35922755 PMCID: PMC9347122 DOI: 10.1186/s12885-022-09941-2] [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: 10/14/2021] [Accepted: 07/26/2022] [Indexed: 11/21/2022] Open
Abstract
Background Although immune-checkpoint inhibitors (ICI) are overall promissory for cancer treatment, they entail, in some cases, an undesired side-effect called hyperprogressive-cancer disease (HPD) associated with acceleration of tumor growth and shortened survival. Methods To understand the mechanisms of HPD we assayed the ICI therapy on two murine tumors widely different regarding immunogenicity and, subsequently, on models of local recurrences and metastases of these tumors. To potentiate the immune response (IR), we combined ICI with meta-tyrosine—that counteracts immune-suppressive signals—and a selective inhibitor of p38 pathway that proved to counteract the phenomenon of tumor-immunostimulation. Results ICI were therapeutically effective against both tumor models (proportionally to their immunogenicity) but only when they faced incipient tumors. In contrast, ICI produced acceleration of large and residual tumors. The combined treatment strongly inhibited the growth of large tumors and it managed to cure 80% of mice with local recurrences and 60% of mice bearing residual metastases. Conclusions Tumor enhancement was paradoxically correlated to a weak increase of the antitumor IR suggesting that a weak IR – different from a strong tumor-inhibitory one—may produce stimulation of tumor growth, mimicking the HPD observed in some clinical settings. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09941-2.
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Affiliation(s)
- Daniela R Montagna
- Laboratory of Experimental Oncology, Instituto de Medicina Experimental (IMEX-CONICET), Academia Nacional de Medicina de Buenos Aires, Buenos Aires, Argentina.
| | - Alejandra Duarte
- Laboratory of Experimental Immunology, IMEX-CONICET, Academia Nacional de Medicina de Buenos Aires, Buenos Aires, Argentina
| | - Paula Chiarella
- Laboratory of Experimental Oncology, Instituto de Medicina Experimental (IMEX-CONICET), Academia Nacional de Medicina de Buenos Aires, Buenos Aires, Argentina
| | - Bárbara Rearte
- Laboratory of Physiology of Inflammatory Processes, IMEX-CONICET, Academia Nacional de Medicina de Buenos Aires, Buenos Aires, Argentina
| | - Oscar D Bustuoabad
- Laboratory of Experimental Oncology, Instituto de Medicina Experimental (IMEX-CONICET), Academia Nacional de Medicina de Buenos Aires, Buenos Aires, Argentina
| | - Mónica Vermeulen
- Laboratory of Antigen Presenting Cells and Inflammatory Response, IMEX-CONICET, Academia Nacional de Medicina de Buenos Aires, Buenos Aires, Argentina
| | - Raúl A Ruggiero
- Laboratory of Experimental Oncology, Instituto de Medicina Experimental (IMEX-CONICET), Academia Nacional de Medicina de Buenos Aires, Buenos Aires, Argentina
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M M de Souza S, Medeiros-Ribeiro AC, Bredemeier M, Duarte A, Pinheiro M, Stadler B, Macieira JC, Ranza R, Miranda J, Valim V, Castro G, Bertolo M, Sauma MDF, Fernandes V, Botelho R, Brenol C, Da Silveira DE Carvalho HM, Studart S, Da Rocha Castelar Pinheiro G, Rocha L, De Leon de Lima H, Pereira I, Ohira Gazzeta M, Kakehasi A, Louzada P, Hayata ALS, Pina F, Alves Ferreira M, Balarini L, Silveira IG, Kowalski S, Titton D, Mendonça Da Silva Chakr R, Ranzolin A, Laurindo I, Xavier R. AB1173 INCIDENT CASES OF COVID-19 AND VACCINATION ADHERENCE IN A MULTICENTRIC COHORT OF INFLAMMATORY ARTHRITIS IN BRAZIL. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4722] [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: 11/04/2022]
Abstract
BackgroundThe SARS-CoV-2 virus has caused a worldwide health crisis. Patients with inflammatory arthritis are at higher risk of hospitalization and death by COVID-19 due to comorbidities or immunosuppressive treatments. Vaccination is one the most important strategies to control the pandemic.ObjectivesTo evaluate the incident cases of SARS-CoV-2 infection in a multicentric cohort of inflammatory arthritis in Brazil.MethodsBiobadaBrasil is a multicentric registry-based cohort study of Brazilian patients with rheumatic diseases starting their first bDMARD or tsDMARD (1). The present analysis is a retrospective evaluation of adult patients with inflammatory arthritis (rheumatoid arthritis – RA, spondylarthritis -SpA and psoriatic arthritis-PsA) that were alive since the beginning of the COVID-19 pandemics in Brazil in February 2020. We evaluated the incidence and severity of COVID-19 infection and the adherence to anti- SARS-CoV-2 vaccines schedules, up to January 2022.ResultsA total of 300 patients were interviewed and 69 (23.0%) reported confirmed anti-SARS-CoV infection and 5 (1.7%) had a second infection. Among known infected patients, 18.8% need hospitalization and oxygen support, 7.2% were admitted at ICU, and 5.8% died. After COVID-19 infection, 31.8% reported worsening of disease activity but only 6.1% had modification in medication due to disease activity. Distribution of cases followed the pattern of waves observed in Brazil (Figure 1). Regarding vaccination, 285 (95%) reported to have received at least one dose of any anti-SARS-CoV-2 vaccine: 43% received the first with the adenovirus ChAdOx1 nCoV-19 (AstraZeneca) adenovirus vaccine, 32% received the Sinovac-CoronaVac inactivated vaccine, 22% received the BNT162b2 (Pfizer-BioNtech) mRNA vaccine and 3% received the BNT162b2 (Pfizer-BioNtech) adenovirus vaccine. Almost all (98.1%) of these patients had already received the second dose of vaccine and after the first and second vaccine doses, 6% and 4% of patients, respectively, reported worsening of articular disease activity, while, after the third dose, no patient reported disease activity worsening.Figure 1.ConclusionDuring the pandemics, patients with inflammatory arthritis had a pattern of distribution of cases very similar to general population. Adherence to vaccination is high and well tolerated.References[1]Bredemeier et al. J Rheumatol 2021;48:1519-27Disclosure of InterestsNone declared
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Abstract
Introduction The recent literature indicates that the gut microbiota may affect brain functions through endocrine and metabolic pathways, antibody production and the enteric network while supporting its possible role in the onset and maintenance of several neuropsychiatric disorders, neurodevelopment and neurodegenerative disorders. Objectives The aim of this work is to discuss the role of probiotics, prebiotics, or synbiotics as a potential treatment for symptoms of depression, anxiety, and stress. Methods Pub Med database was searched using following key words: “probiotics”, “prebiotics”, “mental disorders”, “psychological disorders”. Results Although the exact mechanism is unknown, there is a link between the gut and mood disorders. Psychosocial factors, such as quality of life or well-being, are greatly influenced by gut function and there is a strong correlation between psychosocial features and gastrointestinal disorders. Elevated stress, anxiety, and depression are linked to intestinal dysbiosis and mood disorders are disproportionately high in patients with functional gut disorders. So, psychobiotics may provide benefit when used in conjunction with current antidepressant medications. Probiotics may exert their therapeutic benefits by restoring microbial balance in the gut, and also by minimizing gastrointestinal complaints, allowing for the effects of antidepressant medication to not be reduced. Stress and immune responses were improved following psychobiotic intervention in stressed adults. Psychobiotics offer potential alternative treatment options in mood disorders and their accompanying symptoms. Conclusions Pro and prebiotics can improve mental health and psychological function and can be offered as new medicines for common mental disorders. However, more clinical studies are required to support the clinical use of probiotics. Disclosure No significant relationships.
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Lourenço A, Ribeiro M, Lemos M, Duarte A, Neves A. Global world, global hospitals. Ethnic differences and psychotic symptoms presentation – a review. Eur Psychiatry 2022. [PMCID: PMC9568105 DOI: 10.1192/j.eurpsy.2022.1622] [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 We live in a global world, where immigration is no longer just an escape, but also a demand and a desire. Globalization imposes the challenge of recognizing psychiatric illness in the most diverse of patients. Objectives To review the literature about the documentation of ethnic differences and the psychotic symptoms presentation. Methods We performed a MEDLINE search using the key words: ethnic differences and psychotic symptoms. We only included studies with full text published in English. Results
Since the 1970s, some studies have shown that there are differences in the manifestation of psychiatric illness in ethnic minorities. Most recent studies confirm this statement, mainly with an increase in immigration in the 20th century, with the receiving countries having an increase in the number of cases of psychosis (affective and non-affective). Belonging to an ethnic minority increases the risk of psychotic symptoms and experiences, witch is related to the patients perception of discrimination, social differences, family separation and the stress associated with immigration. On the other hand, these groups also have less access to health care. Conclusions Currently, professionals are more aware of the global world and what this implies in the manifestations of psychiatric illnesses. However, more studies will be needed to identify these natural differences. In this way, we will be able to help our patients anywhere and support their families. Disclosure No significant relationships.
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Duarte A, Laginhas C, Lourenço A, Simões I, Martins P. Is Praecox Feeling at risk of extinction? Eur Psychiatry 2022. [PMCID: PMC9567006 DOI: 10.1192/j.eurpsy.2022.569] [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 Praecox feeling (PF) is a characteristic feeling of bizarreness or unease that a psychiatrist experiences when facing a patient with schizophrenia. This term, proposed by Rumke in 1941, was considered an important feature of a schizophrenia diagnosis. However, since the movement toward operational diagnostic methods in the late 1970s, it has fallen out of use. Objectives This work aims to discuss the role of Praecox Feeling in the clinical approach to schizophrenia diagnosis. Methods PubMed database was searched using combinations of the terms “praecox”, combined with “feeling” and “schizophrenia”. Results PF is sometimes experienced silently before the patient participates verbally. An experienced and attentive clinician can intuitively feels changes in the body posture, facial expression, the tone of the voice, motor behavior, and attitude that could look insignificant, but as a whole they present the patient as “definitely un-understandable.” Although there is lacking evidence to sustain the rehabilitation of the PF as a reliable and valid clinical criterion consistent with the operational approach, a broader scientific approach is called for. PF should not be trivialized, as is sometimes the case, into a quick diagnosis but could be a real determinant of medical decision. Conclusions Even though there may not be sufficient evidence to consider it valid clinical diagnostic criteria, it still appears to play an important role in the clinical decision-making process and should not be underestimated or stigmatized. This concept is not completely subjective and does rely on objective information, such as the patient’s behaviour and body language. Disclosure No significant relationships.
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Ribeiro M, Lourenço A, Lemos M, Duarte A. Levothyroxine supplementation among individuals with Subclinical Hypothyroidism and Depression | a review. Eur Psychiatry 2022. [PMCID: PMC9568179 DOI: 10.1192/j.eurpsy.2022.1437] [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 Depression is known to be associated with changes in the hypothalamic-pituitary-thyroid axis and the brain is a major target organ for thyroid hormone. Overt hypothyroidism can cause symptoms compatible with depression. However, its relationship with subclinical hypothyroidism (SCH) is not well established. Objectives To review the literature regarding the effect of levothyroxine therapy among patients with SCH and coexistent depression. Methods We conducted a MEDLINE search using depression, subclinical hypothyroidism and levothyroxine as keywords, selecting studies written in English. Results SCH is defined as an elevated thyroid stimulating hormone with normal peripheric hormone levels. The association between SCH and depression is controversial. Some studies indicate that SCH had the same propensity with overt hypothyroidism, while others report that major affective symptoms are not associated with SCH, but are likely due to independent psychiatric diagnoses, which are common in the general population and occur with similar frequency in patients with SCH. Individuals with SCH are recommended to initiate levothyroxine replacement therapy only when their TSH level is above 10 mIU/L or if symptoms are present. There is a lack of evidence supporting the use of levothyroxine therapy to improve mental health outcomes and the majority of meta-analysis do not show relief of affective symptoms after levothyroxine therapy, among individuals with SCH. Conclusions Routine screening for depressive symptoms among individuals with SCH is important to prevent morbidity. Nevertheless, there is no evidence enduring levothyroxine supplementation in these cases. Further studies, with larger sample sizes and longer follow-up periods are needed to enlighten the potential benefit of this therapy. Disclosure No significant relationships.
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Chakr R, Bredemeier M, Duarte A, Pinheiro M, Stadler B, Macieira JC, Ranza R, Miranda J, Valim V, Castro G, Bertolo M, Sauma MDF, Fernandes V, Medeiros-Ribeiro AC, Botelho R, Brenol C, Da Silveira De Carvalho HM, Studart S, Da Rocha Castelar Pinheiro G, Rocha L, Pereira I, De Leon de Lima H, Ohira Gazzeta M, Kakehasi A, Louzada P, Hayata ALS, Pina F, Lupo C, Balarini L, Silveira I, Schowalski S, Titton D, Ranzolin A, Laurindo I, Xavier R. POS0650 THE IMPACT OF OLD AGE ON THE PERSISTENCE AND SAFETY OF TREATMENT WITH BIOLOGIC AGENTS OR JAK INHIBITORS IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2706] [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: 11/04/2022]
Abstract
BackgroundThe effect of age on persistence and safety of treatment with biologic disease modifying anti-rheumatic drugs (bDMARDs) in rheumatoid arthritis has been a subject to research interest. Two recently published studies did not observe significantly different survival of treatment with bDMARDs among older age (≥ 65 years) individuals (1,2); incidence of serious adverse events was higher in these patients (2).Objectivesto evaluate association of the age with treatment survival and overall safety among patients receiving one or multiple courses of bDMARDs or targeted synthetic (ts-) DMARDs.MethodsBiobadaBrasil is a multicentric registry-based cohort study of Brazilian patients with rheumatic diseases starting their first bDMARD or tsDMARD (3). The present analysis includes RA patients recruited from Jan 2009 to Oct 2019, followed-up over one or multiple (up to six) courses of treatment necessarily involving a bDMARD or tsDMARD (latest date, Nov 19, 2019). Treatment course is defined as a period during which the medication scheme does not change, except for dose adjustments. Primary outcome was the incidence treatment interruption for any reason (except for pregnancy or disease remission), while interruption due to adverse events (AEs; including death) and due to inefficacy served as secondary outcomes. Incidence of serious adverse events (SAEs) also served as a secondary outcome. Extended (frailty) multivariate Cox proportional hazards models and negative binomial regression with generalized estimating equations (to calculate incidence rate ratios [IRRs]) were used for statistical analyses (both types of analyses including time-varying covariates over multiple courses of treatment).ResultsIn total, 1316 patients (2335 treatment courses, 6508 patient-years [PY]) were enrolled. Of these, 160 patients (643 PY; 237 treatment courses) were ≥ 65 years old, mean age at starting treatment = 71 ± 5 yrs (84% female). Old age was not significantly associated with treatment interruption for any reason, but presented higher risk of interruption due to adverse events (after multivariate adjustment) and lower risk of stopping because of inefficacy (see Table 1). Older patients presented higher incidence of SAEs than younger ones (16.0 vs 8.4/100 PY, respectively; multivariate IRR: 2.06, 95% CI: 1.51 to 2.80, P<0.001). Among old patients, tocilizumab (HR: 2.73, 95% CI: 1.13 to 6.64, P=0.026), etanercept (2.13, 1.12 to 4.07, P=0.022), and infliximab (2.39, 1.19 to 4.79, P=0.014) presented higher risk of treatment termination as compared with adalimumab. In this subgroup (age ≥65 yrs), there was no significant difference in the risk of SAEs between different bDMARDs/tsDMARDs.Table 1.Univariate and multivariate hazard ratios (HRs) of interruption of treatment course comparing older (≥65 years) versus younger patients (reference category). Results are HRs, 95% CIs, and P values.Cause of interruption (n of events)Crude analysisAdjusted covariates*Interruption - any reason (1321)0.96 (0.75 to 1.23), P=0.7601.09 (0.82 to 1.43), P=0.550Interruption - adverse events (368)1.33 (0.75 to 0.89), P=0.1601.59 (1.07 to 2.35), P=0.020Interruption - inefficacy (680)0.56 (0.39 to 0.80), P=0.0020.57 (0.38 to 0.87), P=0.009* Age, baseline DAS28, disease duration, gender, smoking, RF or anti-CCP, previous malignancy, interstitial lung disease, diabetes, hypertension, hypercholesterolemia, renal failure, ischemic cardiomyopathy, COPD, heart failure, concomitant use of each cs-, b-, and tsDMARDs, corticosteroids, starting year, osteoporosis, hepatitis B,C, treatment sequence.ConclusionThe overall risk of treatment interruption with biologic or targeted synthetic DMARDs is not higher in older patients. Higher risk of interruption due to AE was balanced by a lower risk of stopping treatment due to inefficacy. Older patients had a higher incidence of SAEs.References[1]Mathieu et al. Rheumatol Int 2021;41:879-85.[2]Freitas et al. Drugs Aging 2020;37:899-907.[3]Bredemeier et al. J Rheumatol 2021;48:1519-27.Disclosure of InterestsNone declared
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Duarte A, Ribeiro M, Lopes J, Oliveira S, Martins P. Risk of suicide during pregnacy and postpartum period. Eur Psychiatry 2022. [PMCID: PMC9568081 DOI: 10.1192/j.eurpsy.2022.2214] [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 Pregnancy and the postpartum are generally characterized by positive feelings and expectations but they may also disguise maternal stress and difficulties. These are typical periods for the onset or relapse of psychiatric symptoms and disorders. Even though suicide during pregnancy and postpartum is rare, it is among the leading causes of maternal perinatal mortality. Objectives To provide an overview on the risk of suicide during pregnancy and postpartum. Methods PubMed database was searched using combinations of the terms “suicide”, combined with “pregnancy” and “depression”. Results The major risk factors for suicidal ideation are previous suicide attempts, self-harm, current or past history of psychiatric disorder, young maternal age, being unmarried, an unplanned pregnancy, substance use disorders, lack effective psychosocial support and discontinuation of psychotropic drugs. Pregnant women with suicidality behavior have also an increased risk for various adverse obstetric outcomes, including miscarriage, preterm delivery, maternal hemorrhage, and stillbirth. Furthermore, the postpartum period is often associated with the onset of mood and psychotic disorders with an increased risk of both suicide and infanticide. Women who have suffered from serious psychiatric conditions either after childbirth or in other phases of life should be informed about the possibility of relapse after subsequent pregnancies, thus presenting a higher risk of suicide. Conclusions During pregnancy and postpartum, it is fundamental to investigate suicide risk, including suicidal ideation, thoughts, and intent, especially (but not only) in women affected by mental pathology. Moreover, maternal suicide behaviour affects the child’s neuropsychological development and can also increase the infant´s suicide risk. Disclosure No significant relationships.
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Bredemeier M, Duarte A, Pinheiro M, Stadler B, Macieira JC, Ranza R, Miranda J, Valim V, Castro G, Bertolo M, Sauma MDF, Fernandes V, Medeiros-Ribeiro AC, Botelho R, Brenol C, Da Silveira DE Carvalho HM, Studart S, Da Rocha Castelar Pinheiro G, Rocha L, De Leon de Lima H, Pereira I, Ohira Gazzeta M, Kakehasi A, Louzada P, Hayata ALS, Pina F, Alves Ferreira M, Balarini L, Silveira IG, Kowalski S, Titton D, Mendonça Da Silva Chakr R, Ranzolin A, Laurindo I, Xavier R. POS0242 THE EFFECT OF ANTIMALARIALS ON THE OVERALL SAFETY AND PERSISTENCE OF TREATMENT WITH BIOLOGIC AGENTS OR JAK INHIBITORS IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4120] [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
BackgroundAntimalarials (AM) are frequently part of the initial scheme of conventional synthetic DMARDs in the treatment of rheumatoid arthritis (RA), and have been associated with lower incidence of diabetes and better lipid profile in these patients (1). However, the role of AM in schemes involving biologic (b-) or targeted synthetic (ts-) DMARDs has been much less extensively studied. In addition, a recent large scale study (2) and a consensus article (1) casted doubt on the long-term cardiovascular safety of AM.ObjectivesTo evaluate the association of concomitant use of AM with the overall safety and survival oftreatment course among patients receiving one or multiple courses of bDMARDs or tsDMARDsMethodsBiobadaBrasil is a multicentric registry-based cohort study of Brazilian patients with rheumatic diseases starting their first bDMARD or tsDMARD (3). The present analysis includes RA patients recruited from Jan 2009 to Oct 2019, followed-up over one or multiple (up to six) courses of treatment (latest date, Nov 19, 2019). A treatment course is defined as a period during which the medication scheme does not change. The primary outcome was the incidence of serious adverse events (SAEs). Total and system-specific adverse events (AEs), treatment interruption for any reason, interruption due to AEs and due to inefficacy served as secondary outcomes. Negative binomial regression with generalized estimating equations (to calculate the incidence rate ratios [ÌRRs]) and extended (frailty) Cox proportional hazards models were used for statistical analyses (both types of analyses including time-varying covariates over multiple courses of treatment).ResultsIn total, 1316 patients (2335 treatment courses, 6711 patient-years [PY]) were enrolled. The overall incidence of serious adverse events was 9.2/100 PY. AM were used over 354 courses (1254.5 PY) of therapy. The IRRs for the primary and secondary outcomes are presented in Table 1. AM were also associated with better treatment course survival (Figure 1), reducing the risk of interruption due to AEs (multivariate hazard ratio: 0.56, 95% CI: 0.39 to 0.81, P=0.002) and inefficacy (0.65, 0.48 to 0.87, P=0.003).Figure 1.Table 1.Univariate and multivariate incidence rate ratios (IRRs) of adverse events comparing use versus non-use (reference category) of antimalarials. Results are IRRs, 95% CIs, and P values.Type of adverse event (n of events)Crude analysisAdjusted covariates*Serious adverse events (617)0.60 (0.41 to 0.87), P=0.0070.51 (0.37 to 0.69), P<0.001Any adverse event (3494)0.65 (0.54 to 0.77), P<0.0010.68 (0.57 to 0.81), P<0.001Cardiovascular‡Serious (52)1.04 (0.49 to 2.20), P=0.9241.06 (0.45 to 2.50), P=0.891Total (163)0.90 (0.59 to 1.38), P=0.6420.93 (0.59 to 1.45), P=0.737InfectionsSerious (277)0.78 (0.44 to 1.39), P=0.4040.53 (0.34 to 0.83), P=0.006Total (1400)0.77 (0.61 to 0.98), P=0.0330.75 (0.60 to 0.94), P=0.014Hepatic‡Total (66)0.20 (0.07 to 0.64), P=0.0070.16 (0.04 to 0.57), P=0.005Glicemic control-relatedTotal (34)0.74 (0.29 to 1.92), P=0.5400.73 (0.26 to 2.00), P=0.535DyslipidemiaTotal (83)0.60 (0.31 to 1.13), P=0.1140.55 (0.28 to 1.06), P=0.074*Age, baseline DAS28, disease duration, gender, smoking, seropositivity (RF or anti-CCP), previous malignancy, interstitial lung disease, diabetes, hypertension, hypercholesterolemia, renal failure, ischemic cardiomyopathy, COPD, heart failure, concomitant use of each cs-, b-, and tsDMARDs, corticosteroids, starting year, osteoporosis, hepatitis B and C, and treatment sequence. ‡ Excluding infections.ConclusionAmong RA patients on treatment with bDMARDs or tsDMARDs, concomitant use of antimalarials reduced the incidence of serious and total AEs, including infections and hepatic AEs, and prolonged treatment course survival. No significant increase in the risk of cardiovascular AEs was observed.References[1]Desmarais et al. Arthritis Rheumatol 2021;73:2151-60.[2]Lane et al. Lancet Rheumatol 2020;2:e698–e711[3]Bredemeier et al. J Rheumatol 2021;48:1519-27.Disclosure of InterestsNone declared
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Lo L, Duarte A, Bencardino JT. Nerve Entrapments in the Pelvis and Hip. Semin Musculoskelet Radiol 2022; 26:153-162. [PMID: 35609576 DOI: 10.1055/s-0042-1750211] [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: 10/18/2022]
Abstract
Clinical symptoms of pelvic entrapment neuropathies are widely variable and frequently nonspecific, thus rendering it difficult to localize and diagnose. Magnetic resonance imaging (MRI), and in particular MR neurography, has become increasingly important in the work-up of entrapment neuropathies involving the pelvic and hip nerves of the lumbosacral plexus. The major sensory and motor peripheral nerves of the pelvis and hip include the sciatic nerve, superior and inferior gluteal nerves, femoral nerve, lateral femoral cutaneous nerve, obturator nerve, and pudendal nerve. Familiarity with the anatomy and imaging appearance of normal and pathologic nerves in combination with clinical presentation is crucial in the diagnosis of entrapment neuropathies.
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Affiliation(s)
- Lawrence Lo
- Department of Radiology, University of Pennsylvania, Penn Medicine at University City, Philadelphia, Pennsylvania
| | - Alejandra Duarte
- Division of Musculoskeletal Radiology, Department of Radiology, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Jenny T Bencardino
- Division of Musculoskeletal Radiology, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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Martín-Santamaría R, Sánchez-Oro J, Pérez-Peló S, Duarte A. Strategic oscillation for the balanced minimum sum-of-squares clustering problem. Inf Sci (N Y) 2022. [DOI: 10.1016/j.ins.2021.11.048] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ruiz A, Duarte A, Bravo D, Ramos E, Zhang C, Cowman MK, Kirsch T, Milne M, Luyt LG, Raya JG. In vivo multimodal imaging of hyaluronan-mediated inflammatory response in articular cartilage. Osteoarthritis Cartilage 2022; 30:329-340. [PMID: 34774790 PMCID: PMC8792232 DOI: 10.1016/j.joca.2021.11.006] [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: 02/19/2021] [Revised: 10/31/2021] [Accepted: 11/02/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE One driving factor in the progression to posttraumatic osteoarthritis (PTOA) is the perpetuation of the inflammatory response to injury into chronic inflammation. Molecular imaging offers many opportunities to complement the sensitivity of current imaging modalities with molecular specificity. The goal of this study was to develop and characterize agents to image hyaluronan (HA)-mediated inflammatory signaling. DESIGN We developed optical (Cy5.5-P15-1) and magnetic resonance contrast agents (Gd-DOTA-P15-1) based in a hyaluronan-binding peptide (P15-1) that has shown anti-inflammatory effects on human chondrocytes, and validated them in vitro and in vivo in two animal models of PTOA. RESULTS In vitro studies with a near infrared (NIR) Cy5.5-P15-1 imaging agent showed a fast and stable localization of Cy5.5-P15-1 on chondrocytes, but not in synovial cells. In vivo NIR showed significantly higher retention of imaging agent in PTOA knees between 12 and 72 h (n = 8, Cohen's d > 2 after 24 h). NIR fluorescence accumulation correlated with histologic severity in cartilage and meniscus (ρ between 0.37 and 0.57, P < 0.001). By using in vivo magnetic resonance imaging with a Gd-DOTA-P15-1 contrast agent in 12 rats, we detected a significant decrease of T1 on injured knees in all cartilage plates at 48 h (-15%, 95%-confidence interval (CI) = [-18%,-11%]) while no change was observed in the controls (-2%, 95%-CI = [-5%,+1%]). CONCLUSIONS This study provides the first in vivo evidence that hyaluronan-related inflammatory response in cartilage after injury is a common finding. Beyond P15-1, we have demonstrated that molecular imaging can provide a versatile technology to investigate and phenotype PTOA pathogenesis, as well as study therapeutic interventions.
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Affiliation(s)
- Amparo Ruiz
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA.,Tech4Health Institute, New York University Langone Health, New York, NY, USA
| | - Alejandra Duarte
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Dalibel Bravo
- Musculoskeletal Research Center, Department of Orthopaedic Surgery, New York University School of Medicine, New York, NY, USA
| | - Elisa Ramos
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Chongda Zhang
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Mary K. Cowman
- Musculoskeletal Research Center, Department of Orthopaedic Surgery, New York University School of Medicine, New York, NY, USA.,Department of Biomedical Engineering, New York University Tandon School of Engineering, New York, NY, USA
| | - Thorsten Kirsch
- Musculoskeletal Research Center, Department of Orthopaedic Surgery, New York University School of Medicine, New York, NY, USA.,Department of Biomedical Engineering, New York University Tandon School of Engineering, New York, NY, USA
| | - Mark Milne
- The University of Western Ontario, London, ON, Canada.,London Regional Cancer Program, Lawson Health Research Institute, London, ON, Canada
| | - Leonard G. Luyt
- The University of Western Ontario, London, ON, Canada.,London Regional Cancer Program, Lawson Health Research Institute, London, ON, Canada
| | - José G. Raya
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA.,Tech4Health Institute, New York University Langone Health, New York, NY, USA
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Duarte A, Borrero Leon R. Opinion on "Current status of MSK radiology training: an international survey by the European Society of Musculoskeletal Radiology (ESSR) Young Club". Insights Imaging 2022; 13:15. [PMID: 35089474 PMCID: PMC8799836 DOI: 10.1186/s13244-021-01148-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/15/2021] [Indexed: 11/10/2022] Open
Affiliation(s)
- Alejandra Duarte
- Head of Musculoskeletal Section of Radiology Department, Fundacion Santa Fe de Bogotá, Carrera 7 # 117-15, Bogota, Colombia
| | - Rodrigo Borrero Leon
- Radiology Resident, Fundación Santa Fe de Bogotá - Universidad El Bosque, Avenida Carrera 7 # 117-15, Bogotá, Colombia.
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Casagrande L, Avella M, De Deus A, Campos P, Maia A, Duarte A. Systematization of Laparoscopic Surgery for Deep Endometriosis. J Minim Invasive Gynecol 2021. [DOI: 10.1016/j.jmig.2021.09.280] [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: 10/20/2022]
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Rosário R, Augusto C, Silva MJ, Martins S, Duarte A, Ramos N, Martins MRO, Fronteira I. Digital health literacy and online information queries in Portuguese university students. Eur J Public Health 2021. [PMCID: PMC8574568 DOI: 10.1093/eurpub/ckab164.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Worldwide there is an overwhelming amount of information about COVID-19 circulating online, also named infodemic. Misinformation (the unintentional) and disinformation (the intentional) spreading of false information have proven to be very dangerous to public health. Hence, more than ever, people need skills for searching, evaluating and integrating information related to health in daily life, i.e., health literacy. Until now, little is known about the digital health literacy of university students and their information-seeking behaviour. Hence, this study aimed to analyse the associations between university students' digital health literacy and online information queries during the beginning of the COVID-19 pandemic (and infodemic) in Portugal. Methods A cross-sectional study of 3.084 Portuguese university students (75.7% females), with an average age of 24.2 (SD = 7.5), was conducted using an online survey. We used sociodemographic data (sex, age, subjective social status) and the digital health literacy questionnaire adapted to the specific COVID-19 context. Online information queries included the topics related to SARS-CoV-2 and COVID-19 searched by students. Logistic regression models were performed. Results Online information queries (e.g., individual measures to protect against infection, current spread of the virus, current situation assessments and recommendations) were associated with an increased odds of achieving sufficient digital health literacy. Conclusions Online information queries related to epidemiological and public health topics are significantly associated with digital health literacy in times of COVID-19. Further studies are needed, including programs that improve digital health literacy among university students and increase the availability of high-quality content information.
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Affiliation(s)
- R Rosário
- School of Nursing, University of Minho, Braga, Portugal
- Health Sciences Research Unit, Nursing, Nursing School of Coimbra, Coimbra, Portugal
- Research Centre in Child Studies, University of Minho, Braga, Portugal
| | - C Augusto
- School of Nursing, University of Minho, Braga, Portugal
- Health Sciences Research Unit, Nursing, Nursing School of Coimbra, Coimbra, Portugal
| | - MJ Silva
- School of Nursing, University of Minho, Braga, Portugal
- Health Sciences Research Unit, Nursing, Nursing School of Coimbra, Coimbra, Portugal
| | - S Martins
- School of Nursing, University of Minho, Braga, Portugal
- Health Sciences Research Unit, Nursing, Nursing School of Coimbra, Coimbra, Portugal
| | - A Duarte
- School of Nursing, University of Minho, Braga, Portugal
- Health Sciences Research Unit, Nursing, Nursing School of Coimbra, Coimbra, Portugal
- Research Centre in Child Studies, University of Minho, Braga, Portugal
| | - N Ramos
- Global Health and Tropical Medicine, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - MRO Martins
- Global Health and Tropical Medicine, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - I Fronteira
- Global Health and Tropical Medicine, Universidade NOVA de Lisboa, Lisbon, Portugal
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Bredemeier M, Duarte A, Pinheiro M, Stadler B, Macieira JC, Ranza R, Miranda J, Valim V, Castro G, Bertolo M, Sauma MDF, Fernandes V, Medeiros A, Botelho R, Brenol C, Negrão Gonçalo Dias D, Carvalho H, Studart S, Da Rocha Castelar Pinheiro G, Rocha L, Pereira I, Ohira Gazzeta M, Maria Kakehasi A, Louzada P, Hayata ALS, Pina F, Lupo C, Balarini L, Silveira I, Kowalski S, Titton D, Chakr R, Ranzolin A, Laurindo I, Xavier R. POS0676 SURVIVAL OF THE FIRST COURSE OF BIOLOGIC OR JAK INHIBITOR IN RHEUMATOID ARTHRITIS: ASSOCIATION WITH THE CHOICE OF AGENT AND CONCOMITANT CONVENTIONAL SYNTHETIC DMARDS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3841] [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: 11/04/2022]
Abstract
Background:After failure of conventional synthetic disease modifying anti-rheumatic drugs (csDMARDs) in the therapy of rheumatoid arthritis (RA), treatment may be escalated to biologic (bDMARDs) or JAK inhibitors (JAKi) (1). Analysis of drug survival can provide useful information on the effectiveness of these therapeutic schemes.Objectives:to evaluate the association of the choice of therapeutic agent with the survival of treatment course in RA patients receiving their first bDMARD or JAKi.Methods:BiobadaBrasil is a multicentric registry-based cohort study of Brazilian patients starting their first bDMARD/JAKi (2). This analysis includes RA patients recruited from Jan 2009 to Oct 2019, followed-up over the first course of treatment with a bDMARD/JAKi until censoring (latest date, Nov 19, 2019) or occurrence of the outcome of interest. A treatment course is defined as a period during which the medication scheme does not change, except for dose adjustments. The primary outcome was the interruption of treatment course for any reason (except for pregnancy or disease remission); interruption of treatment due to adverse events (AEs) or death and due to inefficacy served as secondary outcomes. Multivariate Cox proportional hazards models were used for analyses.Results:In total, 1177 patients (3800 patient-years [PY]) were enrolled. The overall incidence of treatment interruption was 17.5/100 PY. Adalimumab was the most frequently prescribed agent, followed by infliximab (n= 267). The hazards ratios (HR) of the primary and secondary outcomes are presented in Table 1. Figure 1 compares the survival of treatment curves of different bDMARDs/JAKi.Table 1.Hazard ratios (HR) of interruption of therapy course of each therapeutic agent (the reference category for bDMARDs/ JAKi is infliximab). Results are HR, 95% CIs, and P values*.Agent (number of patients)Interruption for any reason (665 events)Interruption due to adverse events or death (196 events)Interruption due to inefficacy (319 events)Adalimumab (354)0.83 (0.68 to 1.01), P= 0.0620.68 (0.48 to 0.96), P=0.0291.08 (0.80 to 1.44), P=0.621Etanercept (257)0.81 (0.66 to 1.01), P=0.0630.56 (0.37 to 0.83), P=0.0040.93 (0.68 to 1.29), P=0.674Certolizumab (80)0.74 (0.47 to 1.16), P=0.1850.33 (0.13 to 0.86), P=0.0241.32 (0.74 to 2.35), P=0.350Golimumab (53)0.86 (0.53 to 1.38), P=0.5300.46 (0.18 to 1.19), P=0.1111.07 (0.53 to 2.15), P=0.849JAKi (tofacitinib) (59)0.54 (0.30 to 0.99), P=0.0470.19 (0.04 to 0.82), P=0.0260.89 (0.41 to 1.96), P=0.779Rituximab (48)0.87 (0.55 to 1.37), P=0.5400.48 (0.20 to 1.18), P=0.1090.58 (0.26 to 1.34), P=0.205Abatacept (30)0.52 (0.25 to 1.07), P=0.0770.46 (0.14 to 1.56), P=0.2150.46 (0.14 to 1.52), P=0.203Tocilizumab (29)0.29 (0.14 to 0.63), P=0.0020.40 (0.12 to 1.30), P=0.1260.28 (0.09 to 0.90), P=0.033Methotrexate (792)0.95 (0.79 to 1.14), P=0.5610.86 (0.62 to 1.19), P=0.3620.98 (0.75 to 1.28), P=0.860Leflunomide (497)1.17 (0.99 to 1.39), P=0.0611.44 (1.06 to 1.96), P=0.0201.02 (0.80 to 1.30), P=0.856Sulfasalazine (48)1.18 (0.80 to 1.75), P=0.4011.94 (1.07 to 3.54), P=0.0300.85 (0.45 to 1.59), P=0.605Antimalarials (230)0.80 (0.65 to 0.98), P=0.0270.67 (0.45 to 0.99), P=0.0430.67 (0.50 to 0.92), P=0.011* All tests adjusted for other variables presented in the table and for age, baseline DAS28, disease duration, gender, smoking, seropositivity (RF/anti-CCP), previous malignancy, diabetes, hypertension, hypercholesterolemia, renal failure, ischemic cardiomyopathy, COPD, heart failure, use of corticosteroids, starting year, hypercholesterolemia, osteoporosis, hepatitis B and C.Conclusion:In our study, infliximab was related to an overall higher hazard of treatment course interruption than tolicizumab and tofacitinib, and higher hazard of interruption due to AEs than most other anti-TNF agents and tofacitinib. Maintaining antimalarials in patients receiving advanced therapies for RA may reduce interruption of treatment due to inefficacy and AEs.Disclosure of Interests:None declared
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Basualto S, Ziroldo Lopes JV, Rizzo Borges A, Abreu M, Albuquerque C, Araújo N, Bacchiega AB, Bica B, Brito D, Duarte A, Realle P, Ferreira G, Wagner Poti Gomes K, Melo AK, Stadler B, Maria Kakehasi A, Klumb E, Mariz H, Marques C, Mota L, Munhoz G, Paiva E, Pereira H, Salviato Pileggi G, Pinheiro M, Provenza JR, Gomides AP, Reis Neto E, Ribeiro S, Sato E, Laroca Skare T, De Souza V, Teodoro MLM, Valadares LDDA, Valim V, Calderaro D. AB0848 PARTICIPATION OF UNDERGRADUATE MEDICAL STUDENTS AS INVESTIGATORS IN A RHEUMATOLOGIC COHORT: IMPACT ON DEPRESSION, ANXIETY & STRESS SCALE. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1218] [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: 11/04/2022]
Abstract
Background:Mental health was widely affected during the new coronavirus pandemic. In addition, some measures adopted by most countries in order to contain the virus spread, such as isolation and social distancing, leading to the interruption of routine activities, including partial or complete interruption of face-to-face classes may be associated with increased stress, depression and anxiety among undergraduate medical students (1). From March to September, 2020, the Brazilian Society of Rheumatology carried out the Mario Pinotti II Project (MPII), a prospective, multicenter, observational cohort study designed to monitor the COVID-19 in patients with rheumatic disease on hydroxychloroquine, using periodic telephone calls performed by undergraduate medical students (2).Objectives:To compare the mental health status of medical students who were participating from the MPII with theirs colleagues not involved in this project.Methods:A web-based survey via google forms platform was developed by a panel composed of undergraduate medical students, rheumatologists, medical school professors, and a psychology professor. It included details on demographic and life habits data and domains regarding depression, anxiety and stress, using the DASS-21 (Depression, Anxiety & Stress Scale), Brazilian version. Data collection occurred from July 20th to August 31st, 2020. Statistical analysis was performed using the SPSS version 20.0. Univariate and multivariate linear regression analysis were performed to verify associations with the DASS-21, defined as dependent variable. A p-value < 0.05 was deemed as significant. This study was approved by the Institutional Research Ethics Committee.Results:A total of 684 undergraduate medical students were included in this study, of whom 228 as MPII volunteers (VG) and 456 as control group (CG). Median age was 23 years (IQ 21-24) and the CG was older than the VG (p<0.03). Most of them were white (68.8%) and women (63%). There were no significant differences regarding comorbidities, ethnicity, smoking status, alcohol intake and physical activity. Older age, male gender, participation of MPII study, absence of a worsening in sleep pattern during the pandemic and a lower number of prior comorbidities were associated with lower DASS21 scores, suggesting a better mental health (Table 1).Conclusion:Several aspects may be involved with mental health, including increased emotional maturity, gender and sleep pattern. Although with marginal independent association, medical students with participation in the MPII study had better mental health than their student colleagues not engaged with this research. Our data pointed out that voluntary participation in a research project which foresees interaction by telephone contact with rheumatic patients, professors, rheumatologists, and colleagues is associated with better mental health.References:[1]Meo SA, Abukhalaf AA, Alomar AA, Sattar K, Klonoff DC. Covid-19 pandemic: Impact of quarantine on medical students’ mental wellbeing and learning behaviors. Pakistan J Med Sci 2020;36(COVID19-S4):S43–8.[2]Gomides A, Ferreira G, Kakehas A, Lacerda M, Marques C, Paiva E et al. Impact of chronic use of antimalarials on SARS-COV-2 infection in patients with immune-mediated rheumatic diseases: protocol design for a multicentric observational cohort in Brazil. JMIR Research Protocols, 2020.PreprintTable 1.Univariate and multivariate analysis of predictors associated to the DASS-21 in undergraduate medical students during the COVID-19 pandemicUnivariate analysisMultivariate analysisVariableB95%CIp-ValueB95%CIp-ValueAge-0.32-0.61 to -0.030.03-0.47-0.81 to -0.130.008Female gender4.883.021 to 6.76<0.001---Stable love relationship-2.49-4.35 to -0.640.008-2.5-4.4 to -0.590.01Number of previous comorbidities reported4.693.71 to 5.68<0.0014.823.73 to 5.92<0.001MP-II volunteering-2.81-4.74 to -0.860.005---Worsening in sleep pattern6.414.62 to 8.20<0.0015.013.07 to 6.96<0.001Disclosure of Interests:None declared
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Salviato Pileggi G, Ferreira G, Gomides AP, Reis Neto E, Abreu M, Albuquerque C, Araújo N, Bacchiega AB, Bianchi D, Bica B, Bonfa E, Borba E, Brito D, Duarte A, Peixoto Gu e Silva de Souza M, Wagner Poti Gomes K, Maria Kakehasi A, Cavalheiro Do Espírito Santo R, Realle P, Klumb E, Lanna CC, Marques C, Monticielo O, Mota L, Munhoz G, Paiva E, Pereira H, Provenza JR, Ribeiro S, Rocha Jr L, Sampaio C, Sampaio V, Sato E, Laroca Skare T, De Souza V, Valim V, Lacerda M, Xavier R, Pinheiro M. POS1252 COVID-19 IN PATIENTS WITH RHEUMATIC DISEASES ON CHRONIC USE OF HYDROXYCHLOROQUINE IN A LARGE BRAZILIAN COHORT – A 24-WEEK PROSPECTIVE STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3727] [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:The role of chronic use of hydroxychloroquine (HCQ) in rheumatic disease (RD) patients during the SARS-CoV-2 pandemic is still subject of discussion.Objectives:To compare the occurrence of COVID-19 and its outcomes between RD patients on HCQ use with individuals from the same household not taking the drug during community viral transmission in an observational prospective multicenter study in Brazil.Methods:Participants were enrolled and monitored through 24-week (From March 29th to Sep 30th, 2020) regularly scheduled phone calls performed by trained medical professionals. Epidemiological and demographic data, as well as RD disease activity status and current treatment data, specific information about COVID-19, hospitalization, need for intensive care, and death was recorded in both groups and stored in the Research Electronic Data Capture (REDCap) database. COVID-19 was defined according to the Brazilian Ministry of Health (BMH) criteria. The statistical analysis was performed using IBM-SPSS v.20.0 software. Group comparisons were made using the Man-Whitney, Chi-Square and Fisher Exact Test, as well as multivariate regression models adjusted to confounders. Survival curves were performed using Kaplan-Meier analysis.Results:A total of 10,427 participants mean age (SD) of 44.04 (14.98) years were enrolled, including 6004 (57.6%) rheumatic disease patients, of whom 70.8% had systemic lupus erythematosus (SLE), 6.7% rheumatoid arthritis (RA), 4% primary Sjögren’s syndrome (pSS), 1.8% mixed connective tissue disease (DMTC), 1% systemic sclerosis (SSc) and others (15.9), including overlap syndromes. In total, 1,132 (10.8%) participants fulfilled criteria for COVID-19, being 6.7% RD patients and 4.1% controls (p=0.002). A recent influenza vaccination had a protective role (p<0.001). Moderate and severe COVID-19 included the need for hospitalization, intensive care, mechanical ventilation or death. Infection severity was not different between groups (p=0.391) (Table 1). After adjustments for multiple confounders, the main risk factors significantly associated with COVID-19 were higher education level (OR=1.29 95%CI 1.05-1.59), being healthcare professionals (OR=1.91; 95%CI 1.45-2.53), presence of two comorbidities (OR=1.31; 95%CI 1.01-1.66) and three or more comorbidities associated (OR=1.69; 95%CI 1.23-2.32). Interestingly, age >=65 years (OR=0.20; 95%CI 0.11-0.34) was negatively associated. Regarding RD, the risk factors associated with COVID-19 diagnosys were SLE (OR= 2.37; 95%CI 1.92-293), SSc (OR=2.25; 95%CI 1.05-4.83) and rituximab use (OR=1.92; 95%CI 1.13-3.26). In addition, age >=65 years (OR=5.47; 95%CI 1.7-19.4) and heart disease (OR=2.60; 95%CI 1.06-6.38) were associated with hospitalization. Seven female RD patients died, six with SLE and one with pSS, and the presence of two or more comorbidities were associated with higher mortality rate.Conclusion:Chronic HCQ use did not prevent COVID-19 in RD compared to their household cohabitants. Health care profession, presence of comorbidities LES, SSc and rituximab were identified as main risk factors for COVID-19 and aging and heart disease as higher risk for hospitalization. Our data suggest these outcomes could be considered to manage them in clinical practice.Table 1.Frequency and severity of COVID-19 in patients with rheumatic diseases on chronic use of hydroxychloroquine compared to their household controlsCOVID-19 outcomesTotal(%)GroupsPPatients(%)Controls (%)DiagnosisNo9256 (89.1)5300 (88.3)3956 (90.2)0.002Yes1132 (10.9)704 (11.7)428 (9.8)SeverityMild1059 (93.6)662 (94.0)397 (92.8)0.391Moderate52 (4.6)32 (4.5)20 (4.7)Severe21 (1.9)10 (1.4)11 (2.6)HCQ: hydroxychloroquine.Moderate and severe COVID-19 included the need for any of the following: hospitalization, intensive care, mechanical ventilation or death.Acknowledgements:To the Brazilian Society of Rheumatology for technical support and rapid nationwide mobilization.To all the 395 interviewers (medical students and physicians) who collaborated in the study and the participantsTo CNPq (Number 403442/2020-6)Disclosure of Interests:None declared
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Odriozola A, Ortega L, Martinez L, Odriozola S, Torrens A, Corroleu D, Martínez S, Ponce M, Meije Y, Presas M, Duarte A, Belén Odriozola M, Malik RA. Widespread sensory neuropathy in diabetic patients hospitalized with severe COVID-19 infection. Diabetes Res Clin Pract 2021; 172:108631. [PMID: 33346072 PMCID: PMC7746125 DOI: 10.1016/j.diabres.2020.108631] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/23/2020] [Accepted: 12/12/2020] [Indexed: 12/11/2022]
Abstract
AIMS To characterize the distribution and severity of sensory neuropathy using a portable quantitative sensory testing (QST) device in diabetic patients (DM) hospitalized with severe COVID-19 infection. METHODS Four patients with diabetes and severe SARS-CoV-2 requiring non-invasive ventilation for a protracted duration underwent clinical, laboratory and radiologic assessment and detailed evaluation of neuropathic symptoms, neurological assessment, QST on the dorsum of the foot and face using NerveCheck Master with assessment of taste and smell. RESULTS All four subjects developed neuropathic symptoms characterized by numbness in the feet with preserved reflexes. QST confirmed symmetrical abnormality of vibration and thermal thresholds in both lower limbs in all patients and an abnormal heat pain threshold on the face of two patients and altered taste and smell. CONCLUSIONS Severe COVID-19 infection with hypoxemia is associated with neuropathic symptoms and widespread sensory dysfunction in patients with DM.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Rayaz A Malik
- Department of Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar
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Ramos D, Mancuso R, Paiva L, Duarte A, Ferro K, Contieri B, Saad S, Lazarini M. A SUBFAMÍLIA RAC DE RHO GTPASES REPRESENTA UM POTENCIAL ALVO TERAPÊUTICO NA LEUCEMIA MIELOIDE AGUDA. Hematol Transfus Cell Ther 2020. [DOI: 10.1016/j.htct.2020.10.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Moretti K, Aluisio A, Chen J, Aguiar Martinez L, Vallejo J, Carranza H, Gallo Marin B, Duarte A, Clark M, Beaudoin F, Arbelaez C. 43 Knowledge and Confidence in the Treatment of Emergent Conditions among Graduating Medical Students Across Colombia. Ann Emerg Med 2020. [DOI: 10.1016/j.annemergmed.2020.09.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Montagna DR, Duarte A, Todero MF, Ruggiero RA, Isturiz M, Rearte B. Meta-tyrosine modulates the immune response induced by bacterial endotoxins. Immunobiology 2020; 225:151856. [DOI: 10.1016/j.imbio.2019.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 09/13/2019] [Accepted: 10/15/2019] [Indexed: 12/29/2022]
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Ruiz A, Bravo D, Duarte A, Adler RS, Raya JG. Accuracy of Ultrasound-Guided versus Landmark-Guided Intra-articular Injection for Rat Knee Joints. Ultrasound Med Biol 2019; 45:2787-2796. [PMID: 31327492 PMCID: PMC6718332 DOI: 10.1016/j.ultrasmedbio.2019.06.403] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 05/15/2019] [Accepted: 06/10/2019] [Indexed: 06/10/2023]
Abstract
Our aim was to test the effectiveness of ultrasound-guided intra-articular (IA) injection into the knee joint of rodents by an inexperienced operator compared with standard landmark-guided IA injections by a trained injector. Fifty landmark-guided and 46 ultrasound-guided IA injections in 49 rats were analyzed. Animal positioning and injection protocol were designed for use with the ultrasound system. Injection delivery was verified with a secondary imaging modality. We compared the success of IA injections by method (landmark and ultrasound-guided), adjusting for all other confounding factors (age, weight, experience, laterality and presence of surgery). Ultrasound-guided injections had higher success rates overall (89% vs. 58%) and helped to reduce the number of failed attempts per injection. None of the cofounding factors influenced the success of injection. In conclusion, we found higher accuracy for ultrasound-guided IA injection delivery than the traditional landmark-based injection method and also the technical feasibility for untrained personnel.
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Affiliation(s)
- Amparo Ruiz
- Center for Biomedical Imaging, Department of Radiology, New York University Langone Health, New York, NY, USA.
| | - Dalibel Bravo
- Department of Orthopedic Surgery, New York University School of Medicine, New York, NY, USA
| | - Alejandra Duarte
- Center for Biomedical Imaging, Department of Radiology, New York University Langone Health, New York, NY, USA
| | - Ronald S Adler
- Division of Musculoskeletal Radiology, Department of Radiology, New York University Langone Health, New York, NY, USA
| | - José G Raya
- Center for Biomedical Imaging, Department of Radiology, New York University Langone Health, New York, NY, USA
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Mendonça L, Trindade A, Carvalho C, Correia J, Badenes M, Gigante J, Duarte A. Metastasis is impaired by endothelial-specific Dll4 loss-of-function through inhibition of epithelial-to-mesenchymal transition and reduction of cancer stem cells and circulating tumour cells. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz269.005] [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: 11/14/2022] Open
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Fiedler IAK, Zeveleva S, Duarte A, Zhao X, Depalle B, Cardoso L, Jin S, Berteau JP. Microstructure, mineral and mechanical properties of teleost intermuscular bones. J Biomech 2019; 94:59-66. [PMID: 31427091 DOI: 10.1016/j.jbiomech.2019.07.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 06/12/2019] [Accepted: 07/09/2019] [Indexed: 12/12/2022]
Abstract
There is an increasing interest in understanding teleost bone biomechanics in several scientific communities, for instance as interesting biomaterials with specific structure-function relationships. Intermuscular bones of teleost fish have previously been described to play a role in the mechanical force transmission between muscle and bone, but their biomechanical properties are not yet fully described. Here, we have investigated intermuscular bones (IBs) of the North Atlantic Herring with regard to their structure and micro-architecture, mineral-related properties, and micro-mechanical tensile properties. A total of 115 IBs from 18 fish were investigated. One cohort of IBs, containing 20 bones from 2 smaller fish and 23 bones of 3 larger fish, was used for mechanical testing, wide-angle X-ray scattering, and scanning electron microscopy. Another cohort, containing 36 bones from 7 smaller fish and 36 bones from 6 larger fish, was used for microCT. Results show some astonishing properties of the IBs: (i) IBs present higher ductility, lower Young's modulus but similar strength and TMD (Tissue Mineral Density) compared to mammalian bone, and (ii) IBs from small fish were 49% higher in Young's modulus than fish bones from larger fish while their TMD was not statistically different and crystal length was 8% higher in large fish bones. Our results revealed that teleost IB presents a hybrid nature of soft and hard tissue that differs from other bone types, which might be associated with their evolution from mineralized tendons. This study provides new data regarding teleost fish bone biomechanical and micro-structural properties.
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Affiliation(s)
- I A K Fiedler
- Department of Physical Therapy, City University of New York - College of Staten Island, USA; Department of Osteology and Biomechanics, University Medical Center Hamburg Eppendorf, DE, Germany
| | - S Zeveleva
- Department of Physical Therapy, City University of New York - College of Staten Island, USA
| | - A Duarte
- Department of Physical Therapy, City University of New York - College of Staten Island, USA
| | - X Zhao
- Department of Chemistry, City University of New York - College of Staten Island, USA
| | - B Depalle
- Department of Materials, Imperial College London, UK
| | - L Cardoso
- Department of Biomedical Engineering, City University of New York - City College of New York, USA
| | - S Jin
- Department of Chemistry, City University of New York - College of Staten Island, USA
| | - J P Berteau
- Department of Physical Therapy, City University of New York - College of Staten Island, USA; New York Center for Biomedical Engineering, City University of New York - City College of New York, USA; Nanoscience Initiative, Advanced Science Research Center, City University of New York, USA.
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Abstract
Although oncogynaecological management of bulky vulvar tumors tends to minimally-invasive approaches preceded by neoadjuvant therapies, ultra-radical surgery with curative intent may still have an important role. These procedures remain associated with significant short and long-term complications, imposing the need for novel reconstructive techniques [Brown et al., 2017, Di Donato et al., 2017, Moreno-Palacios et al., 2015, Oonk et al., 2017]. We present a video highlighting the crucial surgical steps of a successful pelvic exenterative procedure followed by perineal reconstruction with a muscle-sparing flap technique. A 72-year woman with history of stage II vulvar epidermoid carcinoma, treated with radical surgery and adjuvant radiotherapy. At two-year follow-up local recurrence was diagnosed, handled with large excisional surgical treatment. Within four years a second local recurrence occurred, with infiltrative and bulky dimensions extending to perianal region and vaginal wall. A multidisciplinary surgical approach with curative intent was performed, involving gynecologists, colorectal and plastic surgeons: radical bilateral vulvectomy with distal colpectomy, abdominoperineal resection with colostomy, perineal reconstruction with deep inferior epigastric perforators (DIEP) flap. No major intraoperative or postoperative complications occurred, and the patient was discharged within two weeks with no readmissions for wound care. At two-year follow up she remains in complete remission of the disease. No flap complications occurred during this period. In highly selected patients with recurrent vulvar cancer previously submitted to multiple surgeries and radiotherapy, pelvic exenterative procedures followed by reconstructive techniques allow free surgical margins minimizing morbidity and pelvic disfiguring surgery. Association of reconstructive techniques to radical vulvo-vaginal surgery can shift the paradigm of oncological treatment approach, improving outcomes and quality-of-life. In selected cases of recurrent vulvar cancer, radical procedures still play a role. A multidisciplinary surgical approach is crucial for better outcomes. Novel reconstructive techniques improve patient satisfaction and quality-of-life. The DIEP flap is a complex but feasible option for large perineal defects.
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Affiliation(s)
- M Rei
- Department of Obstetrics and Gynecology, Centro Hospitalar de São João, Porto, Portugal.,Medical School, University of Porto, Portugal
| | - R Mota
- Department of Obstetrics and Gynecology, Centro Hospitalar de São João, Porto, Portugal
| | - V Paiva
- Department of Obstetrics and Gynecology, Centro Hospitalar de São João, Porto, Portugal
| | - A Duarte
- Department of General Surgery, Centro Hospitalar de São João, Porto, Portugal
| | - J Costa
- Department of Plastic Surgery, Centro Hospitalar de São João, Porto, Portugal
| | - A Costa
- Department of Obstetrics and Gynecology, Centro Hospitalar de São João, Porto, Portugal.,Medical School, University of Porto, Portugal
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Figueiredo MC, Dias H, Amendoeira J, Spínola A, André C, Godinho C, Duarte A, Pintor M, Ferreira M. O8 Impact evaluation of literacy on health in school from the third cycle of basic education: a scoping review. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz098.004] [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)
- M C Figueiredo
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), IPSantarém Research Unit, Polytechnic Institute of Santarém, Santarém, PORTUGAL
| | - H Dias
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), IPSantarém Research Unit, Polytechnic Institute of Santarém, Santarém, PORTUGAL
- Centre for Health Technology and Services Research (CINTESIS), University of Porto, Porto, PORTUGAL
| | - J Amendoeira
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), IPSantarém Research Unit, Polytechnic Institute of Santarém, Santarém, PORTUGAL
- Center for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, Lisbon, PORTUGAL
| | - A Spínola
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), IPSantarém Research Unit, Polytechnic Institute of Santarém, Santarém, PORTUGAL
- Centre for Health Technology and Services Research (CINTESIS), University of Porto, Porto, PORTUGAL
| | - C André
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), IPSantarém Research Unit, Polytechnic Institute of Santarém, Santarém, PORTUGAL
| | - C Godinho
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), IPSantarém Research Unit, Polytechnic Institute of Santarém, Santarém, PORTUGAL
| | - A Duarte
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), Polytechnic Institute of Santarém, Santarém, PORTUGAL
| | - M Pintor
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), Polytechnic Institute of Santarém, Santarém, PORTUGAL
| | - M Ferreira
- Health Higher School of Santarém, Monitoring Unity of Health Indicators (UMIS), Polytechnic Institute of Santarém, Santarém, PORTUGAL
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Meije Y, Pigrau C, Fernández-Hidalgo N, Clemente M, Ortega L, Sanz X, Loureiro-Amigo J, Sierra M, Ayestarán A, Morales-Cartagena A, Ribera A, Duarte A, Abelenda G, Rodríguez-Baño J, Martínez-Montauti J. Non-intravenous carbapenem-sparing antibiotics for definitive treatment of bacteraemia due to Enterobacteriaceae producing extended-spectrum β-lactamase (ESBL) or AmpC β-lactamase: A propensity score study. Int J Antimicrob Agents 2019; 54:189-196. [PMID: 31075401 DOI: 10.1016/j.ijantimicag.2019.05.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 01/27/2019] [Revised: 04/09/2019] [Accepted: 05/01/2019] [Indexed: 01/09/2023]
Abstract
Carbapenems are considered the treatment of choice for extended-spectrum β-lactamase (ESBL)- or AmpC β-lactamase-producing Enterobacteriaceae bacteraemia. Data on the effectiveness of non-intravenous carbapenem-sparing antibiotic options are limited. This study compared the 30-day mortality and clinical failure associated with the use of carbapenems versus alternative non-intravenous antibiotics for the definitive treatment of ESBL/AmpC-positive Enterobacteriaceae bacteraemia. This 12-year retrospective study (2004-2015) included all patients with bacteraemia due to ESBL/AmpC-producing Enterobacteriaceae at a Spanish hospital. Given the lack of randomisation of initial therapies, a propensity score for receiving carbapenems was calculated. There were 1115 patients with a first episode of bacteraemia due to Escherichia coli or Klebsiella pneumoniae, of which 123 (11.0%) were ESBL/AmpC-positive. There were 101 eligible patients: 59 in the carbapenem group and 42 in the alternative treatment group (trimethoprim/sulfamethoxazole 59.5%, quinolones 21.4%). The most frequent sources of infection were urinary (63%) and biliary (15%). Compared with the carbapenem group, patients treated with an alternative regimen had a shorter hospital stay [median (IQR) 7 (5-10) days vs. 12 (9-18) days; P < 0.001]. Use of an alternative non-intravenous therapy did not increase mortality (OR = 0.27, 95% CI 0.05-1.61; P = 0.15). After controlling for confounding factors with the propensity score, the adjusted OR of carbapenem treatment was 4.95 (95% CI 0.94-26.01; P = 0.059). Alternative non-intravenous carbapenem-sparing antibiotics could have a role in the definitive treatment of ESBL/AmpC-positive Enterobacteriaceae bacteraemia, allowing a reduction in carbapenem use. Use of trimethoprim/sulfamethoxazole in this series showed favourable results.
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Affiliation(s)
- Yolanda Meije
- Infectious Diseases Unit, Internal Medicine Department, Hospital de Barcelona, Societat Cooperativa d'Instal·lacions Assistencials Sanitàries (SCIAS), Diagonal 660, 08034 Barcelona, Spain.
| | - Carles Pigrau
- Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain; Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain
| | - Núria Fernández-Hidalgo
- Infectious Diseases Department, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain; Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain
| | - Mercedes Clemente
- Infectious Diseases Unit, Internal Medicine Department, Hospital de Barcelona, Societat Cooperativa d'Instal·lacions Assistencials Sanitàries (SCIAS), Diagonal 660, 08034 Barcelona, Spain
| | - Lucía Ortega
- Infectious Diseases Unit, Internal Medicine Department, Hospital de Barcelona, Societat Cooperativa d'Instal·lacions Assistencials Sanitàries (SCIAS), Diagonal 660, 08034 Barcelona, Spain
| | - Xavier Sanz
- Infectious Diseases Unit, Internal Medicine Department, Hospital de Barcelona, Societat Cooperativa d'Instal·lacions Assistencials Sanitàries (SCIAS), Diagonal 660, 08034 Barcelona, Spain
| | - Jose Loureiro-Amigo
- Infectious Diseases Unit, Internal Medicine Department, Hospital de Barcelona, Societat Cooperativa d'Instal·lacions Assistencials Sanitàries (SCIAS), Diagonal 660, 08034 Barcelona, Spain
| | - Montserrat Sierra
- Microbiology Department, Hospital de Barcelona, Societat Cooperativa d'Instal·lacions Assistencials Sanitàries (SCIAS), Barcelona, Spain
| | - Ana Ayestarán
- Pharmacy Department, Hospital de Barcelona, Societat Cooperativa d'Instal·lacions Assistencials Sanitàries (SCIAS), Barcelona, Spain
| | - Alejandra Morales-Cartagena
- Infectious Diseases Unit, Internal Medicine Department, Hospital de Barcelona, Societat Cooperativa d'Instal·lacions Assistencials Sanitàries (SCIAS), Diagonal 660, 08034 Barcelona, Spain
| | - Alba Ribera
- Infectious Diseases Unit, Internal Medicine Department, Hospital de Barcelona, Societat Cooperativa d'Instal·lacions Assistencials Sanitàries (SCIAS), Diagonal 660, 08034 Barcelona, Spain
| | - Alejandra Duarte
- Infectious Diseases Unit, Internal Medicine Department, Hospital de Barcelona, Societat Cooperativa d'Instal·lacions Assistencials Sanitàries (SCIAS), Diagonal 660, 08034 Barcelona, Spain
| | - Gabriela Abelenda
- Infectious Diseases Unit, Internal Medicine Department, Hospital de Barcelona, Societat Cooperativa d'Instal·lacions Assistencials Sanitàries (SCIAS), Diagonal 660, 08034 Barcelona, Spain
| | - Jesús Rodríguez-Baño
- Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain; Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, Hospital Universitario Virgen Macarena/Departamento de Medicina, Universidad de Sevilla/Instituto de Biomedicina de Sevilla, Seville, Spain
| | - Joaquim Martínez-Montauti
- Infectious Diseases Unit, Internal Medicine Department, Hospital de Barcelona, Societat Cooperativa d'Instal·lacions Assistencials Sanitàries (SCIAS), Diagonal 660, 08034 Barcelona, Spain
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Duarte A, Castro M, Fernandes O. What is the influence of the use of headphones on balance, assessed by the distance of postural oscillations, in young adults? Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz035.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Duarte
- RoboCorp, ESTeSC - Coimbra Health School, Instituto Politécnico de Coimbra, Portugal
| | - M Castro
- RoboCorp, ESTeSC - Coimbra Health School, Instituto Politécnico de Coimbra, Portugal
- CEMMPRE, Universidade de Coimbra, Portugal
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Sigmund EE, Baete SH, Luo T, Patel K, Wang D, Rossi I, Duarte A, Bruno M, Mossa D, Femia A, Ramachandran S, Stoffel D, Babb JS, Franks AG, Bencardino J. Correction to: MRI assessment of the thigh musculature in dermatomyositis and healthy subjects using diffusion tensor imaging, intravoxel incoherent motion and dynamic DTI. Eur Radiol 2019; 29:1061. [DOI: 10.1007/s00330-018-5606-9] [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: 10/28/2022]
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Rottenberg S, Duarte A, Duarte E, Francica P, Mutlu M, Blatter S, Sachs N, Clevers H, Jonkers J. BRCA-deficient mouse mammary tumour organoids as a rapid tool to study anti-cancer drug resistance. J Comp Pathol 2019. [DOI: 10.1016/j.jcpa.2018.10.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chevallier J, Duarte A, Löcherbach E, Ost G. Mean field limits for nonlinear spatially extended Hawkes processes with exponential memory kernels. Stoch Process Their Appl 2019. [DOI: 10.1016/j.spa.2018.02.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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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Duarte A, Botteldoorn N, Miller W, Coucke W, Martiny D, Hallin M, Seliwiorstow T, De Zutter L, Uyttendaele M, Vandenberg O, Dierick K. Relation between broiler and humanCampylobacter jejunistrains isolated in Belgium from 2011 to 2013. J Appl Microbiol 2018; 126:277-287. [DOI: 10.1111/jam.14132] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 12/31/2022]
Affiliation(s)
- A. Duarte
- Laboratory of Food Microbiology and Food Preservation; Department of Food Safety and Food Quality; Faculty of Bioscience Engineering; Ghent University; Gent Belgium
- National Reference Laboratory for Campylobacter; Sciensano; Scientific Service Foodborne Pathogens; Brussels Belgium
| | - N. Botteldoorn
- National Reference Laboratory for Campylobacter; Sciensano; Scientific Service Foodborne Pathogens; Brussels Belgium
| | - W.G. Miller
- USDA, ARS, WRRC, Produce Safety and Microbiology; Albany CA USA
| | - W. Coucke
- Section Quality of Laboratories; Sciensano; Brussels Belgium
| | - D. Martiny
- National Reference Center for Campylobacter; Saint Pierre University Hospital; Brussels Belgium
- Department of Microbiology; LHUB-ULB; Pôle Hospitalier Universitaire de Bruxelles; Brussels Belgium
| | - M. Hallin
- National Reference Center for Campylobacter; Saint Pierre University Hospital; Brussels Belgium
- Department of Molecular Diagnosis; LHUB-ULB; Pôle Hospitalier Universitaire de Bruxelles; Brussels Belgium
| | - T. Seliwiorstow
- Laboratory of Food Microbiology and Food Preservation; Department of Food Safety and Food Quality; Faculty of Bioscience Engineering; Ghent University; Gent Belgium
- Department of Veterinary Public Health and Food Safety; Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - L. De Zutter
- Department of Veterinary Public Health and Food Safety; Faculty of Veterinary Medicine; Ghent University; Merelbeke Belgium
| | - M. Uyttendaele
- Laboratory of Food Microbiology and Food Preservation; Department of Food Safety and Food Quality; Faculty of Bioscience Engineering; Ghent University; Gent Belgium
| | - O. Vandenberg
- National Reference Center for Campylobacter; Saint Pierre University Hospital; Brussels Belgium
- Department of Microbiology; LHUB-ULB; Pôle Hospitalier Universitaire de Bruxelles; Brussels Belgium
- Center for Environmental Health and Occupational Health; School of Public Health; Université Libre de Bruxelles; Brussels Belgium
| | - K. Dierick
- National Reference Laboratory for Campylobacter; Sciensano; Scientific Service Foodborne Pathogens; Brussels Belgium
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Bento MC, Canha R, Eira C, Vingada J, Nicolau L, Ferreira M, Domingo M, Tavares L, Duarte A. Herpesvirus infection in marine mammals: A retrospective molecular survey of stranded cetaceans in the Portuguese coastline. Infect Genet Evol 2018; 67:222-233. [PMID: 30445114 DOI: 10.1016/j.meegid.2018.11.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 11/12/2018] [Accepted: 11/12/2018] [Indexed: 10/27/2022]
Abstract
Herpesvirus (HVs) infection has already been reported in cetaceans, but available information on its epidemiology is scarce. In this study we surveyed a total of 179 cetaceans belonging to 6 different species. Samples were obtained from cetaceans stranded along the Portuguese coastline, belonging to populations that roam the north-east region of the Atlantic Ocean. Detection of HVs was performed by conventional nested PCR. Amplicons were sequenced by Sanger's method and sequences used to construct phylogenetic trees by Maximum Likelihood method. Our results show that prevalence of positive samples, among fresh carcasses, reached 14.3% (10/70) and both alpha and gammaherpesvirus were detected. Histopathology showed that herpesvirus infection varied from absence of signs compatible with disease, localized genital lesions and systemic disease. Phylogenetic analysis revealed three clusters within the alphaherpesvirus family; within the gammaherpesvirus no subdivision was detected. All clusters included animals from different species and geographic origins. In seven of the positive HVs samples, co-infections with other agents such as morbillivirus and toxoplasma gondii were detected. The viral nucleotide sequences were not assigned to a specific animal species, nor presented a given geographic distribution, which may imply a wider distribution of herpesvirus in these animal populations. Our results are also the first report of herpesvirus infection in common dolphins (Delphinus delphis), with both alpha and gammaherpesvirus detected.
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Affiliation(s)
- M C Bento
- CIISA Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal.
| | - R Canha
- CIISA Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal
| | - C Eira
- Department of Biology and CESAM, University of Aveiro, 3810-193 Aveiro, Portugal; Portuguese Wildlife Society, Department of Biology, Minho University, 4710-057 Braga, Portugal
| | - J Vingada
- Portuguese Wildlife Society, Department of Biology, Minho University, 4710-057 Braga, Portugal; Department of Biology and CESAM, Minho University, 4710-057 Braga, Portugal
| | - L Nicolau
- Department of Biology and CESAM, University of Aveiro, 3810-193 Aveiro, Portugal; Portuguese Wildlife Society, Department of Biology, Minho University, 4710-057 Braga, Portugal
| | - M Ferreira
- Portuguese Wildlife Society, Department of Biology, Minho University, 4710-057 Braga, Portugal; Department of Biology and CBMA, Minho University, 4710-057 Braga, Portugal
| | - M Domingo
- Departament de Sanitat i Anatomia Animals, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - L Tavares
- CIISA Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal
| | - A Duarte
- CIISA Centre for Interdisciplinary Research in Animal Health, Faculty of Veterinary Medicine, University of Lisbon, 1300-477 Lisbon, Portugal
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Duarte A, Ruiz A, Ferizi U, Bencardino J, Abramson SB, Samuels J, Krasnokutsky-Samuels S, Raya JG. Diffusion tensor imaging of articular cartilage using a navigated radial imaging spin-echo diffusion (RAISED) sequence. Eur Radiol 2018; 29:2598-2607. [PMID: 30382348 DOI: 10.1007/s00330-018-5780-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 05/16/2018] [Revised: 08/27/2018] [Accepted: 09/19/2018] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To validate a radial imaging spin-echo diffusion tensor (RAISED) sequence for high-resolution diffusion tensor imaging (DTI) of articular cartilage at 3 T. METHODS The RAISED sequence implementation is described, including the used non-linear motion correction algorithm. The robustness to eddy currents was tested on phantoms, and accuracy of measurement was assessed with measurements of temperature-dependent diffusion of free water. Motion correction was validated by comparing RAISED with single-shot diffusion-weighted echo-planar imaging (EPI) measures. DTI was acquired in asymptomatic subjects (n = 6) and subjects with doubtful (Kellgren-Lawrence [KL] grade 1, n = 9) and mild (KL = 2, n = 9) symptomatic knee osteoarthritis (OA). MD and FA values without correction, and after all corrections, were calculated. A test-retest evaluation of the DTI acquisition on three asymptomatic and three OA subjects was also performed. RESULTS The root mean squared coefficient of variation of the global test-restest reproducibility was 3.54% for MD and 5.34% for FA. MD was significantly increased in both femoral condyles (7-9%) of KL 1 and in the medial (11-17%) and lateral (10-12%) compartments of KL 2 subjects. Averaged FA presented a trend of lower values with increasing KL grade, which was significant for the medial femoral condyle (-11%) of KL 1 and all three compartments in KL 2 subjects (-18 to -11%). Group differences in MD and FA were only significant after motion correction. CONCLUSION The RAISED sequence with the proposed reconstruction framework provides reproducible assessment of DTI parameters in vivo at 3 T and potentially the early stages of the disease in large regions of interest. KEY POINTS • DTI of articular cartilage is feasible at 3T with a multi-shot RAISED sequence with non-linear motion correction. • RAISED sequence allows estimation of the diffusion indices MD and FA with test-retest errors below 4% (MD) and 6% (FA). • RAISED-based measurement of DTI of articular cartilage with non-linear motion correction holds potential to differentiate healthy from OA subjects.
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Affiliation(s)
- Alejandra Duarte
- Center for Biomedical Imaging, Department of Radiology, New York University Langone Health, 660 First avenue, 4th Floor, New York, NY, 10016, USA
| | - Amparo Ruiz
- Center for Biomedical Imaging, Department of Radiology, New York University Langone Health, 660 First avenue, 4th Floor, New York, NY, 10016, USA
| | - Uran Ferizi
- Center for Biomedical Imaging, Department of Radiology, New York University Langone Health, 660 First avenue, 4th Floor, New York, NY, 10016, USA
| | - Jenny Bencardino
- Center for Biomedical Imaging, Department of Radiology, New York University Langone Health, 660 First avenue, 4th Floor, New York, NY, 10016, USA
| | - Steven B Abramson
- Division of Rheumatology, Department of Medicine, New York University Langone Health, New York, NY, USA
| | - Jonathan Samuels
- Division of Rheumatology, Department of Medicine, New York University Langone Health, New York, NY, USA
| | | | - José G Raya
- Center for Biomedical Imaging, Department of Radiology, New York University Langone Health, 660 First avenue, 4th Floor, New York, NY, 10016, USA.
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Duarte A, Bojke C, Cayton W, Salawu A, Case B, Bojke L, Richardson G. Impact of specialist rehabilitation services on hospital length of stay and associated costs. Eur J Health Econ 2018; 19:1027-1034. [PMID: 29282588 PMCID: PMC6105206 DOI: 10.1007/s10198-017-0952-0] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 12/14/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Provision of specialist rehabilitation services in North Yorkshire and Humberside may be suboptimal. Local commissioning bodies need to prioritise investments in health care, but previous studies provide limited evidence to inform the decision to expand existing services on the basis of cost-effectiveness. We examine the impact of specialist rehabilitation services in the subregion on hospital length of stay (LoS) and associated costs compared to routine care. METHODS Comparison of hospital LoS and associated costs in centres with greater access (Hull) and limited access (i.e. routine care, York and Northern Lincolnshire), to specialist rehabilitation services for patients with complex disabilities following illness or injury, using Hospital Episodes Statistics data. RESULTS Average LoS and duration costs by Healthcare Resource Group (HRG) were lower for the majority of patients with greater access to specialist rehabilitation compared to routine care. Difference in LoS between groups widened with level of complexity within each HRG. For the more frequent HRG codes, the LoS difference was as high as 34 days longer for York compared to Hull and £7900 more costly. CONCLUSION Rehabilitation patients within York and Northern Lincolnshire areas appear to have longer LoS and higher associated costs compared to those admitted to the Hull Trust. This analysis suggests that specialist rehabilitation may be cost saving compared to routine care and supports the case for expansion of the existing services to improve coverage in the area.
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Affiliation(s)
- A Duarte
- Centre for Health Economics, University of York, Heslington, York, YO10 5DD, UK.
| | - C Bojke
- Faculty of Medicine and Health, Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9NL, UK
| | - W Cayton
- Hull and East Yorkshire Hospitals NHS Trust, Hull, HU3 2JZ, UK
| | - A Salawu
- Hull and East Yorkshire Hospitals NHS Trust, Hull, HU3 2JZ, UK
- Hull York Medical School, Hull, HU6 7RX, UK
- Department of Health, Sports and Exercise Science, University of Hull, Hull, HU6 7RX, UK
| | - B Case
- NHS Vale of York Clinical Commissioning Group, York, YO1 6GA, UK
| | - L Bojke
- Centre for Health Economics, University of York, Heslington, York, YO10 5DD, UK
| | - G Richardson
- Centre for Health Economics, University of York, Heslington, York, YO10 5DD, UK
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Oliveira J, Duarte A, Santos C, Pessoa L, Filho CM, Lima J, Carvalho D, Xavier T, Figueiredo E, Giovanetti M, Almeida B, Goes J, Lima F, Alcantara L, Siqueira I. Prevalence of Zika, dengue and Chikungunya virus infection in pregnant women and surveillance of congenital Zika infection in Salvador, Brazil. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3826] [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: 10/28/2022] Open
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Almeida B, Cabral J, Faiçal A, Oliveira J, Souza M, Salles C, Vianna M, D’Agostino E, Ferreira N, Reis L, Embiruçu E, Santos C, Duarte A, Acosta A, Siqueira I. Discordant congenital Zika virus infection in dizygotic twins: a case report. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Duarte A, Lopes de Almeida J, Martins Ú, Magro C, Lima C, Araújo S, Pereira N, Coutinho M, Marques H. Epiglottic kinematics alterations and risk of laryngeal penetration-aspiration. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Weckerly F, Bhaskar G, Duarte A, Luna R, Starns H. Heavier rumen–reticulum organs in white-tailed deer ( Odocoileus virginianus) is consistent with dietary bulk not quality. CAN J ZOOL 2018. [DOI: 10.1139/cjz-2017-0036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The organs that make up the gastrointestinal tract have high energy demands. Therefore, when these organs vary in mass, they should impact metabolic requirements. Mass of the rumen–reticulum organs, the organs that comprise the largest part of the gastrointestinal tract of ruminants, might vary from bulk or nutrient availability of the diet. We examined differences in mass of the rumen–reticulum organs in white-tailed deer (Odocoileus virginianus (Zimmermann, 1780)) from two sites in Texas, USA, with different diet types. Specifically, at one site deer were fed a pelleted ration and at the other site deer consumed a natural browse diet. Accounting for body mass, deer consuming the browse diet had rumen–reticulum organ masses that were about 1.7 times heavier than deer consuming the pelleted diet. Deer consuming the browse diet also had lower diet quality, as indexed by crude protein concentration, than deer consuming the pelleted diet. The digesta loads of deer, however, were similar for the two types of diet. Our study findings are consistent with increased mass of rumen–reticulum organs from greater bulk, not diet quality. Understanding variation in rumen–reticulum organ mass has implications for understanding energy conservation in white-tailed deer.
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Affiliation(s)
- F.W. Weckerly
- Department of Biology, Texas State University, San Marcos, TX 78666, USA
- Department of Biology, Texas State University, San Marcos, TX 78666, USA
| | - G. Bhaskar
- Department of Biology, Texas State University, San Marcos, TX 78666, USA
- Department of Biology, Texas State University, San Marcos, TX 78666, USA
| | - A. Duarte
- Department of Biology, Texas State University, San Marcos, TX 78666, USA
- Department of Biology, Texas State University, San Marcos, TX 78666, USA
| | - R.S. Luna
- Department of Biology, Texas State University, San Marcos, TX 78666, USA
- Department of Biology, Texas State University, San Marcos, TX 78666, USA
| | - H.D. Starns
- Department of Biology, Texas State University, San Marcos, TX 78666, USA
- Department of Biology, Texas State University, San Marcos, TX 78666, USA
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Sigmund EE, Baete SH, Luo T, Patel K, Wang D, Rossi I, Duarte A, Bruno M, Mossa D, Femia A, Ramachandran S, Stoffel D, Babb JS, Franks AG, Bencardino J. MRI assessment of the thigh musculature in dermatomyositis and healthy subjects using diffusion tensor imaging, intravoxel incoherent motion and dynamic DTI. Eur Radiol 2018; 28:5304-5315. [DOI: 10.1007/s00330-018-5458-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 03/23/2018] [Accepted: 04/03/2018] [Indexed: 12/20/2022]
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Duarte A, Graça S, Salvada A, Teixeira P, Pires Lourenço A, Costa E, Ribeiro J, Lima C, Abrantes A, Botelho M. PO-275 Effect of ionising radiation in FaDu cell line- preliminary results. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.306] [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: 11/03/2022] Open
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Caballero A, Palma E, Ruiz-Esteban P, Vazquez T, Sola E, Torio A, Cabello M, Lopez V, Jironda C, Duarte A, Alonso-Titos J, Hernández D. CXCR3 + Monocytes Increase Significantly in Graft Blood Compared to Peripheral Blood in Patients With Stable Kidney Graft Function. Transplant Proc 2018; 50:555-559. [PMID: 29579851 DOI: 10.1016/j.transproceed.2017.11.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 10/20/2017] [Accepted: 11/11/2017] [Indexed: 12/29/2022]
Abstract
INTRODUCTION We have recently reported that some lymphocyte populations do not maintain the same proportion in kidney graft blood as in peripheral blood, despite a stable function of the transplanted kidney. These results suggest that a comparative study between leukocyte cells from graft blood and those obtained from peripheral blood could provide information about the inflammatory state of the transplanted organ. In this work we selected the population of CD4+ lymphocytes and monocytes expressing CXCR3 to test this hypothesis. MATERIAL AND METHODS The study was performed by flow cytometry during month 3, 6, and 12 after transplantation in 58 patients who received an isolated kidney transplant and the same immunosuppressive regimen. The peripheral blood sample was obtained by venipuncture and the graft blood by fine needle aspiration. RESULTS We found a significant percentage decrease in CXCR3+ monocytes throughout the first year of transplantation in peripheral blood (15.9 ± 20.7 vs. 12.6 ± 12.4 vs. 6.3 ± 9.0, at 3, 6, and 12 months, respectively; P = .001), whereas the percentage of CXCR3+ monocytes in graft blood did not change over this period. This situation resulted in a significant percentage difference between the CXCR3+ monocytes from the graft blood and those from the peripheral blood at the sixth (15.8 ± 8.1 vs. 12.6 ± 12.4, respectively; P = .008) and 12th months (12.9 ± 8.1 vs. 6.3 ± 9.0, respectively; P < .001). CONCLUSIONS Therefore, we can conclude that the significant percentage increase of CXCR3+ monocytes in graft blood with respect to peripheral blood suggests the presence of inflammatory activity despite renal function being stable during the second half of the first year post-transplantation.
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Affiliation(s)
- A Caballero
- Immunology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - E Palma
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - P Ruiz-Esteban
- Immunology Department, Complejo Hospitalario General Universitario de Albacete, Albacete, Spain
| | - T Vazquez
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - E Sola
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - A Torio
- Immunology Department, Complejo Hospitalario General Universitario de Albacete, Albacete, Spain
| | - M Cabello
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - V Lopez
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - C Jironda
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - A Duarte
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - J Alonso-Titos
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain
| | - D Hernández
- Nephrology Department, Regional University Hospital of Malaga and University of Malaga, IBIMA, REDINREN (RD16/0009/0006), Malaga, Spain.
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